Management of Open Tibial Diaphyseal Fractures by Limb Reconstruction System As Primary and Definitive Treatment: A Prospective Cohort Study.

Background One of the most frequent long bone fractures that most orthopaedic surgeons see is a tibial diaphyseal fracture. The tibia has more open fractures than any other major long bone because it is covered by skin for the majority of its length. The best course of therapy is still up for debate due to the high occurrence of comorbidities linked to these fractures. Materials and methods In this prospective study, 30 patients who met the inclusion criteria were admitted to the Department of Orthopaedics of Shri B. M. Patil Medical College Hospital and Research Centre, Vijayapura, Karnataka, India. The period of study was from January 2021 to May 2022. The patients were followed up for a period of six months. Longer follow-up was required for some patients. Results In our study, there were 26 (86.7%) male and four (13.3%) female patients. The mode of injury was road traffic accidents in all cases. The functional outcomes obtained using the modified Anderson and Hutchinson's criteria were good results in 22 (73.3%), moderate results in five (16.7%), and poor results in three (10%) of the study population. Pin tract infections (six cases; 20%) and shortening (eight cases; 26.7%) were the most frequent complications Conclusion Because of the ease of use, good fracture stability, adjustable geometry, light weight, reasonable price, and patient friendliness, the limb reconstruction system (LRS) provides an excellent alternative treatment option for treating compound fractures of the tibia.

Functional Outcomes of Tibia Fractures Treated With Intramedullary Interlocking Nails by Suprapatellar Approach: A Prospective Study.

Background Tibia fractures are the most common lower extremity fractures. The subcutaneous anatomy of this long bone predisposes it to high fracture frequency in a high-energy trauma. The tibia is a major weight-bearing, long tubular bone that is axially and rotationally unstable when fractured, which ideally necessitates its surgical fixation in adults. Tibia fractures can be treated with a variety of choice of implants and surgical approaches. This study aims to assess the clinical and functional outcomes of a tibia fracture treated with intramedullary interlocking nails by a suprapatellar approach. Methodology A total of 32 patients were selected from patients admitted at Shri B. M. Patil Medical College and Research Centre with tibia fractures between January 2021 and May 2022. All the patients were treated with closed reduction and internal fixation with intramedullary interlocking nails by suprapatellar approach with a semi-extended knee position. All patients were followed up clinically and radiologically at regular intervals of six weeks, three months, six months, and one year. All functional outcomes were assessed based on modified Lysholm knee scores. Results A total of 31 patients showed union at the fracture site. One patient had nonunion and implant failure at the distal locking site, and two patients had persistent anterior knee pain at the end of one year. Functional outcome assessment based on modified Lysholm scores had excellent results, with a mean score of 95. Patients were followed up for a mean of 11.5 months. The mean time of union was observed as 12.5 months. Conclusions Suprapatellar tibia nailing is an effective alternative approach with ease of reduction and decreased intraoperative fluoroscopy time. The entry is in line with the medullary cavity preventing malreduction of proximal and distal tibia fractures. The additional proximal locking option also increases the stability of implant fixation.

Case Series - Osteochondromas at Rare Locations.

Introduction: Osteochondromas are very common. They are typically seen in long bones and rarely seen in smaller bones. Some of the rare presentations include flat bones, the body of pelvis, scapula, skull, and small bones of the hand and foot. Their presentation also varies according to the site of presentation. Case Report: We have included five cases of osteochondromas occurring at rare locations with variable presentations and their management. We have included one case of metacarpal, one case of skull exostosis, two cases of scapula exostosis, and one case of fibula exostosis. Conclusion: Osteochondromas can rarely occur at unusual locations. It is important to thoroughly evaluate all patients presenting with swelling and pain over bony regions to accurately diagnose osteochondromas and manage accordingly.

Groundwater fluoride contamination and its possible health implications in Indi taluk of Vijayapura District (Karnataka State), India.

Groundwater fluoride concentration and fluoride-related health problems were studied in twenty-two villages of Indi taluk of Vijayapura district, Karnataka, India. Present study (2015) was also used to compare groundwater fluoride concentration in same 22 villages with previous government report (2000). Groundwater fluoride concentrations of 62 bore wells of 22 villages were analyzed by using an ion-sensitive electrode. A total of 660 adults and 600 children were screened for fluorosis symptoms and signs. Sixty clinically suspected fluorosis patients' urine samples were further analyzed for fluoride. The mean value (1.22 ± 0.75 mg/L) of fluoride concentration of 62 bore wells and 54.83 % bore wells with ≥1.0 mg/L of fluoride concentrations in Indi taluk indicates higher than the permissible limit of drinking water fluoride concentration recommended for India. Clinical symptoms like arthritis, joint pains, gastrointestinal discomfort and lower limb deformities with high urinary fluoride concentrations in some subjects suggest fluorosis. Results also showed an increase in groundwater fluoride concentration of the same 22 villages between previous and present study. Preliminary arthritis symptom of the villagers could be due to drinking fluoride-contaminated water. Increase in fluoride concentration with time to the bore wells definitely indicates future danger.

Aneurysmal bone cyst of the pubis: a case report.

An aneurysmal bone cyst is considered as a locally aggressive benign tumour. Intra-lesional extended curettage and bone-grafting is the mainstay of the treatment for aneurysmal bone cysts. Grafting is used usually in cases where the lesion compromises the mechanical strength of the bone. However, the massive size of the highly vascular tumour and the relative inaccessibility of its deeper extensions into the femoral vessels and the intra-abdominal structures, especially the urinary bladder, make it a relatively challenging case to perform excision and curettage.Presenting a case of a 15 years old male patient with the complaint of a right inguinal swelling since the past eight months. The swelling had started growing since the past two months and it was associated with pain. X-ray showed a lytic blowout legion of the entire right pubic ramus. An intra-lesional curettage was done. Complete tumour excision which was done by intra-lesional curettage and biopsy yielded satisfactory results with low complications and low recurrence of aneurysmal bone cyst of the superior ramus of the pubis.

Giant cell tumor of lower end of tibia.

Introduction. Giant cell tumor of bones is an unusual neoplasm that accounts for 4% of all primary tumors of bone, and it represents about 10% of malignant primary bone tumors with its different grades from borderline to high grade malignancy. Case Report. A 35-year-old patient presented with complains of pain and swelling in left ankle since 1 year following a twisting injury to his left ankle. On examination, swelling was present over the distal and anterior part of leg and movements of ankle joint were normal. All routine blood investigations were normal. X-ray and CT ankle showed morphology of subarticular well-defined expansile lytic lesion in lower end of left tibia suggestive of giant cell tumor. Histopathology of the tissue shows multinucleated giant cells with uniform vesicular nucleus and mononuclear cells which are spindle shaped with uniform vesicular nucleus suggestive of GCT. The patient was treated by excision, curettage, and bone cement to fill the defect. Conclusion. The patient at 12-month followup is doing well and walking without any pain comfortably and with full range of motion at ankle joint with articular congruity maintained and no signs of recurrences.