Giant-cell tumour of proximal radius in a 50-year-old female with wrist drop: a rare case report

Abstract Giant-cell tumour is a locally aggressive tumour of long bones of epiphyseal region commonly occurring in adults aged 20–40 years. Most common location is distal femur, proximal tibia, and distal radius. Different treatment options being used are curettage with bone graft or bone cement, resection with arthrodesis, reconstruction, radiation, and chemotherapy. We are reporting a case of giant-cell tumour of right proximal radius in a 50-year-old female with posterior interosseous nerve palsy. It is very rare, and only four cases have been reported in the literature. It was treated by wide margin resection with fibular grafting, titanium elastic nail system along with cancellous bone graft reconstruction

Broken needle in gluteal region following an intramuscular injection: a case report

Incidence of broken hypodermic needle in patients has been decreased because of superior manufacturing techniques. Breaking of hypodermic needle after intramuscular injection has been rarely reported. We report a case of broken needle in the gluteal region in a 36 years old woman following an intramuscular injection. Patient arrived in the emergency after 2 days of the episode. Patient was taken for surgery for removal of the needle. Initially attempts for removal of needle were made without use of image intensifier under local anaesthesia, but it failed as it was very difficult to locate the needle. Patient was taken up for surgery under spinal anaesthesia with the use of image intensifier. Broken needle was located and removed. The following case describes the management of broken hypodermic needle and suggests valuable guidelines for minimising the chances of undue complications arising due to needle migration

Role of PFN in ipsilateral fracture neck and shaft femur: a single solution to double fracture

Background: Ipsilateral, concomitant femoral neck and shaft fracture is a rare fracture pattern that presents a diagnostic and treatment challenge. A variety of management modalities have been tried to treat this complex fracture pattern ranging from conservative approach to recently introduced proximal femoral nails (PFN).Methods: We analysed the retrospective data of 25 consecutive patients who had sustained a high energy trauma who had concomitant ipsilateral fractures of the femoral shaft associated with proximal femur fractures treated with PFN between January 2010 and January 2017.Results: Average follow up period was 1.2 years. All ipsilateral neck and shaft fractures were united with proximal femur nail (PFN). Neck fracture union averaged 4.3 months (range, 3–6 months). Shaft fracture union averaged 5.4 months (range, 4–7 months). Eighteen patients (70%) had a good functional result, five patients (21%) had fair result and in two patients the result (9%) was poor.Conclusions: We observed although technically demanding, the reconstruction nail is an acceptable, cost effective and minimal invasive alternative for the management of concomitant ipsilateral fractures of the femoral neck and shaft, with a good functional outcome and fewer complications

Correlation of acromial morphology in association with rotator cuff tear : a retrospective study

Purpose: There have been many studies that have attempted to correlate radiographic acromial characteristics with rotator cuff tears, but the results have not been conclusive. Rotator cuff tears (RCT) are the common aetiology of shoulder pain. We assessed the association of rotator cuff tears with commonly used radiographic parameters of acromial morphology and their different radiographic characteristics. Material and methods: From a retrospective study of 98 patients, we characterised acromial type and measured acromial thickness (AT), critical shoulder angle (CSA), lateral acromial angle (LAA), acromiohumeral distance (AHD), and acromion index (AI) on a 1.5T MRI, from 68 patients with partial or full-thickness supraspinatus tendon tears and 30 controls without tears. Results: Out the 68 patients with rotator cuff tear, supraspinatus was the most commonly affected tendon, with 86% (59) cases showing abnormalities. The average age of the patients was 45.11 ± 21.45 years with male dominance (80%). Partial tears of rotator cuff were more common than complete tears. Forty-eight cases showed partial tears in supraspinatus as compared to 11 cases of complete tears. The acromial type did not show any correlation with any particular cuff lesion. The AT and AI of controls were significantly smaller than cuff-tear patients. The LAA of cuff-tear patients was significantly different from that of control patients. The impingement patients demonstrated a significantly greater acromial thickness, larger CSA, decreased AHD, and decreased LAA than their control counterparts. Conclusions: A higher prevalence of rotator cuff tears and impingement associated with low lateral acromial angle, larger CSA and decreased AHD was observed. AT and AI have a direct correlation with rotator cuff tear

A comparative study of efficacy of oral pregabalin and clonidine for attenuation of pressor response to intubation

Background: Endotracheal intubation is associated with hemodynamic stress responses. Various drugs have been used in the past to attenuate the pressor response; however, none has been proved to be ideal. Present study was planned to evaluate the oral pregabalin 150 mg and clonidine 200 µg for attenuation of pressor response to intubation.Methods: The study was conducted on 100 adult patients of either gender scheduled to undergo elective surgeries under general anaesthesia (GA). The patients were randomly allocated into 2 groups. In group A patients received pregabalin 150mg and in group B patients received clonidine 200µg orally. The hemodynamic parameters were recorded until 10 minutes after intubation. The sedation, anxiety and side effects were also assessed.Results: In clonidine group, the mean HR remained below the baseline value at all the time intervals. In pregabalin group, the mean HR remained below the baseline value at most of the time intervals but increased above baseline just after intubation (T0i) and 1 minute after intubation (T1i) where increase was only 1.488±1.20% and 0.45±1.16% respectively from baseline. In both pregabalin and clonidine groups, the mean SBP and MAP remained below the baseline value (Tb) at all the time intervals from T0.5 to T10i. Both clonidine and pregabalin provided adequate anxiolysis and sedation with pregabalin providing more pronounced sedation and anxiolysis than clonidine.Conclusions: Both clonidine and pregabalin are effective oral premedication drugs for attenuation of the pressor response to laryngoscopy and endotracheal intubation.

A Rare Case of Aneurysmal Bone Cyst – Navicular Bone Treated by Intralesional Sclerotherapy Agent Polidocanol

Introduction: Aneurysmal bone cyst (ABC) is an intraosseous arteriovenous malformation, usually treated by surgical excision but with higher recurrence rates. The occurrence of this lesion in navicular bone is a rare entity. Repetitive sclerotherapy using 3% polidocanol is a minimally invasive, safer method of treatment for ABCs. Methods: A patient of ABC of the navicular bone precisely diagnosed through X-ray, MRI, and biopsy was given periodic injections of 4 ml of 3% polidocanol under aseptic precautions from April 2018 to July 2018. A total of four injections given at an interval of 1 month. Results: Regular follow-up done for 1 year. At the end of all the four injections, the lesion healed completely with a relief in presenting symptoms. No complications were reported. At 3 months post-therapy, the patient was able to walk without pain. After 1 year of follow-up, the patient was symptom-free with no signs of recurrence. Conclusion: Surgical resection/curettage has higher chances of recurrence; therefore, usage of intralesional sclerotherapy agent polidocanol should be considered the treatment of choice in the lesions smaller than 5 cm. Keywords: Aneurysmal bone cyst, sclerotherapy, polidocanol.</jats:p

Intracranial schwannomas arising from cranial nerves: Case series and review of literature

Tumors arising from the cranial nerve sheath are common intracranial neoplasms, with only few articles describing their imaging characteristics. In this present study of four cases of schwannomas originating from the cranial nerves in the head region, we are discussing the radiological features on imaging with the clinical presentation and contrasting them with other differentials in their respective locations. Magnetic resonance imaging and computed tomography were done in these cases and correlated with clinical and biopsy findings

Giant cell tumour of clavicle: Occurrence of a common tumour in a rare location

AbstractIntroductionThe clavicle is rare site of bone tumours. Majority of the tumours of clavicle are malignant and are often misdiagnosed due to low index of suspicion. The oncological patterns of clavicle resemble that of flat bones.Case presentationA 60year old man presented to our centre with pain and swelling over lateral end of left clavicle. After thorough investigation a provisional diagnosis of giant cell tumor was made which was treated with partial claviculectomy. At one year follow up, there was no shoulder disability or any incidence of recurrence.ConclusionSince majority of clavicular tumors are malignant so any selling occurring in this area should be seen with high index of suspicion and should be investigated thoroughly