A Rare Case of Garre's Osteomyelitis of Tibia in an Adult.

To explore a rare case of Garre's osteomyelitis in an adult, typically observed in children, and detail its diagnostic and treatment approach, we conducted a case study of a 40-year-old male presenting with persistent right tibial pain. Through diagnostic procedures, including radiography and MRI, a broad differential diagnosis was established. Histopathological examination post-surgical intervention confirmed Garre's osteomyelitis. The treatment, which included corticotomy debridement, saucerization, ceramic granules insertion, and targeted antibiotic therapy, resulted in significant improvement over one year. This case underscores the importance of considering Garre's osteomyelitis in the differential diagnoses of chronic tibial lesions in adults and highlights the necessity of a comprehensive diagnostic and treatment approach in managing such rare cases, thus contributing valuable insights to orthopedic practice and literature.

Reconstruction of Delayed Proximal Interphalangeal Joint Fracture-Dislocation Using Hemi-Hamate Arthroplasty: A Case Report.

This case report aims to delineate the clinical outcomes and technical considerations of hemi-hamate arthroplasty in the reconstruction of a delayed proximal interphalangeal (PIP) joint fracture-dislocation. It underscores the procedure's viability as a reconstructive option for complex finger injuries with delayed presentation. A 23-year-old male presented six weeks post-injury with a PIP joint fracture-dislocation of the left index finger. Traditional management options were limited due to the delayed presentation and the nature of the injury. A surgical intervention was performed using an autologous osteochondral hemi-hamate graft to reconstruct the articular surface. Herein, we describe the detailed surgical steps, postoperative care, and rehabilitation protocols. Over a five-month follow-up period, the patient demonstrated significant functional improvement. The range of motion in the PIP joint increased substantially, with a notable reduction in pain levels. Radiographic assessments showed successful graft incorporation and joint alignment. The patient reported satisfaction with the aesthetic and functional outcome, highlighting an enhanced quality of life post-surgery. Hemi-hamate arthroplasty emerges as a favorable surgical option for delayed PIP joint fracture-dislocations, offering improved articular congruity, joint stability, and functional outcomes. This case contributes to the growing body of evidence supporting the procedure's effectiveness and underscores the importance of considering innovative approaches in complex hand injuries.

How Not To Fix a Tibial Fracture: A Case Report on Treatment By a Quack.

Quackery in the orthopaedic profession has existed for quite a long time. Due to the shortage of orthopaedic healthcare staff in public hospitals and the high costs in private facilities, members of disadvantaged communities turn to unlicensed and unskilled practitioners (quacks). The main factors responsible for the increased number of quacks performing orthopaedic treatment are illiteracy, high treatment cost, mismatch in the orthopaedic surgeon-to-population ratio, especially in rural areas, and the absence of any form of health insurance. Moreover, their easy availability and offer of low-cost treatment draw innocent and illiterate patients to them, even though these quacks perform orthopaedic treatment in the most unhygienic, unsterilized, and unconventional manner. The government should intervene and take measures to make orthopaedic treatment more affordable and accessible, especially to the rural population.

Isolated Tillaux Fracture in a Skeletally-Mature Patient: A Rare Presentation.

Isolated Tillaux fractures are uncommon injuries that occur due to external rotational forces acting on the ankle joint. They are more commonly seen in adolescents due to the presence of open epiphyses. In adults, isolated Tillaux fractures present as plafond fractures well described with the AO (Arbeitsgemeinschaft für Osteosynthesefragen) Classification as well as Types 1, 2, and 3 according to the degree of articular comminution present. They occur rarely and can be easily missed or misdiagnosed as other ankle injuries. A thorough clinical examination, combined with imaging studies such as X-rays and CT scans, can aid in accurate diagnosis and treatment planning. Management typically involves open reduction and internal fixation, followed by a short period of immobilization and early mobilization with non-weight bearing. We present a case report of a 27-year-old female who presented with an isolated Tillaux fracture of the ankle following a road traffic accident. This type of fracture is typically seen in teenagers and young adults due to the incomplete closure of the growth plate, which makes it more susceptible to injury. The patient underwent open reduction and internal fixation with a contoured three-hole 3.5 mm titanium T-plate, followed by immobilization in a plaster splint for one week. Early mobilization was encouraged with strict non-weight bearing for 8-10 weeks. Follow-up at 12 weeks revealed complete union at the fracture site, with the patient being asymptomatic except for minimal pain and mild restriction in dorsiflexion.

Report of a Rare Case of Pubic Symphysis Tuberculosis in an Eight-Year-Old Child: An Unusual Presentation of the Disease.

Tuberculosis is a well-known and ancient disease with a wide range of clinical presentations. Although tuberculosis is a well-known infectious disease, involvement of the symphysis pubis is rare, with only a few documented cases in the medical literature. Distinguishing it from other more common conditions, such as osteomyelitis of the pubic symphysis and osteitis pubis, is essential to avoid delay in diagnosis and to minimize morbidity, mortality, and complications. We present a rare case of tuberculosis of the symphysis pubis in an eight-year-old female from India who was initially misdiagnosed with osteomyelitis. Following the correct diagnosis and commencement of anti-tuberculosis chemotherapy, the patient demonstrated improvement in symptoms and hematological parameters at the three-month follow-up. This case emphasizes the importance of considering tuberculosis as a differential diagnosis in cases of symphysis pubis involvement, especially in areas with a high incidence of tuberculosis. Early diagnosis and appropriate treatment can prevent further complications and improve clinical outcomes.

Squamous Cell Carcinoma Arising in Chronic Osteomyelitis: A Rare Presentation.

BACKGROUND: Malignant transformation of chronic osteomyelitis is extremely rare. Squamous cell carcinoma (SCC) is the most frequently reported malignancy, with a latency period of 20-50 years after the onset of osteomyelitis. CASE PRESENTATION: A 61-year-old man presented with recurrent discharge from the left distal thigh 30 years after open femur fracture. Histopathology showed SCC arising from chronic osteomyelitis with bone invasion. The patient initially declined amputation but eventually consented to transfemoral amputation after symptom recurrence. TREATMENT AND OUTCOME: Intraoperative frozen section was utilized to determine the level of amputation. CONCLUSIONS: This case highlights the importance of definitive surgical treatment with amputation for SCC arising in chronic osteomyelitis, even after initial patient refusal. Recurrence should prompt the reconsideration of amputation.