Increased preoperative collection of autologous blood with recombinant human erythropoietin therapy in tertiary care hospitals of Jammu.

INTRODUCTION: To study whether the administration of recombinant human erythropoietin increases the amount of autologous blood that can be collected before orthopaedic surgery. MATERIALS AND METHODS: We conducted a randomized controlled trial of recombinant human erythropoietin in 68 adults scheduled for elective orthopedic procedures. The patients received either erythropoietin 600 units/kg of body weight or placebo intravenously every 5(th) day prior to each phlebotomy for 21 days during which time up to 5 units of blood was collected. Patients were excluded from donation when their hematocrit values were less than 33%. All patients received iron sulphate 325mg orally 3 times daily. The mean number of units collected per patient was 4.33 ± 0.4 for erythropoietin group and 3.05± 0.71 for the placebo group. RESULTS: The mean packed red cell volume donated by patients who received erythropoietin was 32% greater than that donated by patients who received placebo (196.3 vs. 169.4 ml, p<0.05). 68% in the placebo group and 9% of patients treated with erythropoietin were unable to donate ≥4 units. No adverse effects were attributed to erythropoietin. While participating in the study, complications developed in 2 patients one in each group necessitating their removal from the study. CONCLUSION: We conclude that recombinant human erythropoietin increases the ability of the patients about to undergo elective surgery to donate autologous blood units.

Trans-articular chondrosarcoma grade 2 of proximal phalanx resulting in its fracture along with destruction of middle phalanx of 2 toe right foot: a case report and review of the literature.

Foot is an unusual site for chondrosarcoma and involvement of phalanges is extremely rare. We report a case of grade 2 chondrosarcoma of proximal phalanx resulting in its fracture along with transarticular extension to the middle phalanx of the 2(nd) toe of right foot in a 62 year old female. The patient presented with 1 and (1/2) year history of pain and swelling in right 2(nd) toe. X-ray showed presence of expanding lytic lesion with amorphous calcification along with fracture proximal phalanx. Fine needle aspiration cytology showed some pleomorphs, osteoclasts and some giant cells. We went for amputation of toe without a biopsy. Histopathological examination of specimen showed multiple pleomorphic cells, nuclear atypia, hyperchromasia with some giant cells (grade 2 chondrosarcoma).

Distal tibial interosseous osteochondroma with impending fracture of fibula - a case report and review of literature.

Osteochondromas arising from the interosseous border of the distal tibia and involving distal fibula are uncommon. We present a 16 year old young boy with an impending fracture, erosion and weakness of the distal fibula, secondary to an osteochondroma arising from the distal tibia. Early excision of this deforming distal tibial osteochondroma avoided the future risk of pathological fracture of the distal fibula, ankle deformities and syndesmotic complications.

Giant cell tumor of talus: a case report.

Giant cell tumor of talus is a rare entity. In contrast to GCT of long bones, most cases occur in a younger age group and tend to be multicentric. The authors report a case of GCT in a 19 year old boy which had led to extensive destruction of the talus. In view of the extensive involvement, total talectomy along with tibio - calcaneal arthrodesis was performed. At 6 months of followup, the patient had a painless and well arthrodesed ankle. There was no evidence of recurrence at 18 months of followup.