Suture Anchor Fixation for Fifth Metatarsal Tuberosity Avulsion Fractures: A Case Series and Review of Literature.

Fifth metatarsal tuberosity avulsion fractures are common. Despite good outcomes with nonoperative treatment, acute fractures with displacement, intra-articular involvement, comminution, or painful nonunion have been reported to benefit from early open reduction and internal fixation, especially in athletes. No consensus has been reached regarding the best surgical fixation technique. We present a case series of 4 patients with displaced fifth metatarsal tuberosity avulsion fractures and an innovative technique of fixation for the tuberosity avulsion fractures using a suture anchor.

Repair of Achilles tendon ruptures with peroneus brevis tendon augmentation.

PURPOSE: To report 22 patients who underwent repair of compound Achilles tendon ruptures with peroneus brevis tendon augmentation. METHODS: Records of 6 women and 19 men aged 21 to 42 (mean, 28) years who underwent repair of compound Achilles tendon ruptures with peroneus brevis tendon augmentation were reviewed. All the wounds were transverse/oblique, minimally contaminated, and could be closed primarily. Patients were evaluated at months 3, 9, and 12, using the Foot and Ankle Outcome Score (FAOS) questionnaire. RESULTS: Of the 22 patients, 3 developed superficial skin complications that healed gradually, and 2 developed a superficial discharging sinus and underwent minor debridement. No patient had a re-rupture of the Achilles tendon. At the one-year follow-up, all patients achieved good functional outcome in terms of the FAOS. CONCLUSION: Repair of Achilles tendon ruptures with peroneus brevis tendon augmentation achieved good functional outcome.

Cervical epidural haematoma causing Brown-Sequard syndrome: a case report.

Brown-Sequard syndrome secondary to compression of the spinal cord by an epidural haematoma following minor trauma is rare. A 65-year-old woman presented with neck pain and sudden onset hemiplegia with contralateral anaesthesia. Magnetic resonance imaging showed a haematoma in the epidural space in the C3 to C5 levels. She underwent open-door laminoplasty for evacuation of the haematoma. At the 2-year follow-up, she had regained normal sensations and a neurological grade of 5/5.

Myopericytoma of the thoracic spine: a case report and review of literature.

BACKGROUND CONTEXT: Myopericytoma is a recently proposed term to describe a group of tumors originating from perivascular myoid cells. The tumor is most commonly located in the subcutaneous tissues and dermis of the extremities. Myopericytoma involving the skeletal system is a very rare entity, with only two such cases previously reported in literature. PURPOSE: To present only the third reported case of myopericytoma of the spine along with a review of literature. STUDY DESIGN: Case report with and review of literature. METHODS: We report the case of a 50-year-old woman who presented with pain in the back with gradual onset of paraparesis. Magnetic resonance imaging showed ill-defined signal changes in the body and posterior elements of the vertebrae with epidural soft tissue mass encasing the spinal cord. RESULTS: The patient underwent excision of the lesion with spinal fusion followed by a short course of radiotherapy. The patient recovered functional power after surgery, and at 32-month follow-up, there is no radiological evidence of recurrence of the lesion. CONCLUSIONS: Myopericytoma should be considered in the differential diagnosis of lytic lesions of the spine. Surgery is curative; however, a short course of chemotherapy or radiotherapy may be required to prevent recurrent disease in case of incomplete tumor excision.

Simultaneous bilateral tibial tuberosity avulsion fractures in adolescence: case report and review of 60 years of literature.

Simultaneous bilateral avulsion fracture of the tibial tuberosity is a rare injury. Since the first reported case in the 1950s only 21 such cases have been reported in literature. When they do occur, it is usually in an adolescent athletic male, generally in the absence of any underlying pathology although rarely it may be associated with an underlying connective tissue disorder. The age range of the injury corresponds to the time of growth plate closure and maturation of the fibro-cartillagenous attachment of the tuberosity. Most of the fractures require open reduction and internal fixation and usually heal well without any significant complications.

Doctor patient communication-a vital yet neglected entity in Indian medical education system.

Doctor patient communication is the most important and an integral part of any treatment regimen. Properly carried out it has been shown to have a therapeutic effect equivalent to drugs. Despite being so important part of treatment it is more than often taken and carried out casually. Apart from apathy towards this practice, its omission in the medical study curriculum is an important factor. This study was carried in amongst the surgical residents of surgical departments of various medical colleges to assess the attitude of surgical residents towards patient doctor communication. A questionnaire was forwarded by mail and email and the response was assessed: The responses of the surgical residents from various residents from different medical colleges were similar. Most of the residents prefer inclusion of communication skill in medical education curriculum.