Management of childhood femoral neck fractures

Forty-three children with displaced transcervical femoral fractures were reviewed at a mean follow-up of 7.2 years and results were assessed using Ratliff's criteria. Of 22 patients treated by internal fixation alone, 10 had good, 6 had fair and 6 had poor results. The results in 21 children treated by internal fixation along with primary transverse intertrochanteric undisplaced osteotomy were: 14 good, 5 fair and 2 poor, but none improved to a statistically significant level (P = 0.139). However, the osteotomy improved the fracture union significantly and no delayed union or non-union was noted in this group (P = 0.05). There were no complications related to the osteotomy itself.

Ulnar translocation after excision of giant cell tumour of distal radius

Translocation of the ipsilateral ulna has been carried out in six cases after radical resection of a giant cell tumour of the distal radius. The carpo-ulnar junction united readily in all cases. Union of the radio-ulnar junction is often delayed, but this can be overcome by the addition of cancellous grafts at the time of ulnar translocation. All the patients had very good forearm rotation and an acceptable appearance. There were no significant complications.

Percutaneous tension band wiring for minimally displaced fractures of the patella

Percutaneous tension band wiring was carried out on 26 minimally displaced transverse fractures of the patella. Plaster immobilisation was not necessary and knee movements were encouraged after the 5th day. Excellent function was regained in every case.

Resurfacing of skin in hand injuries

The Authors discuss their experience with the use of various flaps (radial artery, groin and abdomen) in the primary or delayed cover of skin defect in the hand, in a total number of 20 cases. All the three types of flaps took up well in 3-4 weeks with minimal complications. The Authors preferred the radial artery flap to the groin and abdominal flaps, in that order.

Morphological variations of the ulnar styloid process

P.A. radiographs of both wrists were taken in 400 normal individuals to study the configuration of the styloid process of the ulna. Five different morphological variations were noticed, the commonest being an elongated process (102 wrists). Medially deviated (41 wrists), parrot beaked (27 wrists) and hypertrophic (16 wrists) patterns were less common. One person had bilateral unfused separate ossification centres for the ulnar styloid. There was no correlation between the length of the styloid process and ulnar variance.

Morphological Variations of the Ulnar Styloid Process

P.A. radiographs of both wrists were taken in 400 normal individuals to study the configuration of the styloid process of the ulna. Five different morphological variations were noticed, the commonest being an elongated process (102 wrists). Medially deviated (41 wrists), parrot beaked (27 wrists) and hypertrophic (16 wrists) patterns were less common. One person had bilateral unfused separate ossification centres for the ulnar styloid. There was no correlation between the length of the styloid process and ulnar variance.

Dual extensor tendon entrapment in Galeazzi fracture-dislocation: a case report

A rare case of blocked reduction of the distal radio-ulnar joint in a Galeazzi fracture-dislocation is presented. In this case both the extensor carpi ulnaris and extensor digiti minimi tendons were displaced on either side of the ulnar head. After relocation of these tendons the distal radio-ulnar joint could be easily reduced.

Ipsilateral supracondylar fracture of humerus and forearm bones in children

A total of 34 children with ipsilateral supracondylar fractures of the humerus and forearm were studied over an 8-year period. Of these, 19 patients had fractures of the distal quarter of the forearm bones while eight patients had a distal radial epiphyseal injury. Five of the patients had undisplaced supracondylar fractures. One patient had an anterior supracondylar fracture. All forearm fractures were treated by closed reduction. Nine displaced supracondylar fractures which could not be reduced by closed manipulation were treated by olecranon pin traction in two cases and by percutaneous pinning in seven cases. Excellent or good results were found in 29 children after an average follow-up of 3.8 years.

Continuous suction and intermittent irrigation for septic coxitis

This prospective study was undertaken on 42 children with septic arthritis of the hip diagnosed within 5 days of onset of symptoms. The mode of treatment used was continuous catheter suction and intermittent saline irrigation of the hip joint together with parenteral antibiotics. All but 4 children responded to this treatment; 2 of these were less than 3 years old. We conclude that continuous suction-irrigation is effective in children older than 3 years very early in the course of the disease; the majority need not undergo arthrotomy.

Plantar panmetatarsophalangeal dislocation--a hyperflexion injury

A rare panmetatarsophalangeal dislocation of the foot in a young male is described. Hyperflexion was instrumental in causing this injury. The dislocation was in the plantar direction.