Penile Fracture at the Crus of the Penis - A Rare Case Report.

Penile fracture is an uncommon acute surgical emergency, typically occurring after sexual intercourse, self-manipulation and at times, may be accidental. We report here a 39-year male who attended the department of emergency with swelling and bruising of the scrotum and penis. Physical examination exhibited a diffuse abdominal and perineal ecchymosis. Imaging confirmed a crural penile fracture. Operative fixation was performed appropriately and satisfactory erectile function was reported at the follow-up. We report a very rarely documented case involving the penile crus fracture and its management. Key Words: Crus, Penile fracture, Surgical repair.

Comparison of shoulder function, radial nerve palsy and infection after nailing versus plating in humeral shaft fractures.

OBJECTIVE: To compare shoulder function, radial nerve palsy and infection after interlocking nailing with plating of fractures of shaft of humerus during 30 weeks of follow-up. STUDY DESIGN: Experimental study. PLACE AND DURATION OF STUDY: Orthopaedic Wards of Combined Military Hospital, Rawalpindi, from November 2006 to November 2008. METHODOLOGY: Two groups of 30 patients each were inducted. Group A (n=30) was treated with intramedullary interlocking nailing while Group B (n=30) underwent plating with dynamic compression plate (DCP). Shoulder function using ASES score, radial nerve palsy and infection were observed for 30 weeks. RESULTS: In group A, 11 patients had severe or moderate shoulder dysfunction (ASES score below 39), out of whom 8 (72%) were above 50 years. This age related disability was significant (p=0.003). Transient palsy was observed in 3 patients (10%) and mild wound infection in 2 (6%), which was not associated with age or open fracture. In group B, only 1 patient had severe shoulder dysfunction, the difference was statistically significant between the two groups (p=0.001), especially in patients above 50 years of age. There was no statistical difference in infection and palsy rates between the two groups. CONCLUSION: Although nailing and plating are effective treatments for fractures of shaft of humerus, ante-grade nailing may not be suitable in elderly patients, as it can cause significant shoulder dysfunction.