Indigenous Proximal Femoral Nails and Their Novel Complications.

Pertrochanteric fractures are one of the commonest fractures in the geriatric age group. Management of these fractures has been revolutionized by the use of proximal femoral nails (PFN), with a screw or a helical blade for fixation in the femoral head. Multiple complications like Z-effect, screw cut out, head penetration, varus collapse, and so on are known with poor technique in proximal femoral nails antirotation (PFNA). We present a case where an indigenous implant presented to us a novel problem of helical blade breakage inside the bone in situ. Removal of this blade needed an open approach, extending the surgical time as well as blood loss. This led to poorer outcomes and the intraoperative struggle for the surgeon. We feel that all surgeons, especially when using indigenous implants, should be aware of such complications and thoroughly check the helical blade and its collapsing mechanism before inserting this in the bone.

Recurrent Ganglion Cyst In Peroneus Longus.

Ganglion cysts are benign cystic lesions that are lined by a synovium and are filled with a gelatinous mucoid material. Ganglion cysts are most commonly located in the hand and the wrist. We present a rare case report of a 45-year-old male with a recurrent intramuscular ganglion cyst in the peroneus longus for two years. The patient underwent drainage one year back, but the swelling recurred one month after surgery. Magnetic resonance imaging showed a delineated, round, lobulated fluid collection consistent with the appearance of a ganglion cyst that was present within the proximal part of peroneus longus. Surgical exploration revealed an encapsulated mass present within the peroneus longus muscle belly. The complete excision of the ganglion cyst was performed, and the diagnosis was confirmed by histology. Postoperatively, at a two-month and six-month follow-up, he was completely asymptomatic with no recurrence and a normal neurological function. Ganglion, which arises from the peroneus longus muscle or tendon, presents with swelling over the lateral aspect of leg due to compression of the common peroneal nerve. Careful preservation of the nerve with complete ganglion excision gives excellent results.