OBJECTIVEDebate continues regarding the management of calcaneal fractures, between open reduction and internal fixation and closed treatment. Hence we aim at evaluating the radiological and functional outcomes of open reduction and internal fixation in displaced joint depression type of calcaneal fractures fixed with locking calcaneal plate.

METHODSIn this series, 28 patients (26 unilateral and 2 bilateral) with joint depression type of calcaneal fractures as per Essex-Lopresti classification system were operated on with locking calcaneal plate within 3 weeks of injury. Patients were evaluated in terms of associated injuries and X-rays of anteroposterior, lateral and axial views of the calcaneum. CT scan was done to assess the amount of comminution and articular depression. Patients were followed up clinically and radiologically at least for 1 year. Radiological assessment was done by Bohler's angle and Gissane's angle along with measurement of calcaneal height and width. Functional outcome was assessed using the American Orthopaedics Foot and Ankle Society (AOFAS) scale.

RESULTSAt average follow-up of 14.5 months, average AOFAS score was 86.3 (range 66 to 97), with 86% having excellent to good results and 2 (7.7%) and 1 (3.7%) having fair and poor results respectively. All patients had stable ankle joint with all having dorsiflexion and plantar flexion more than 30 degrees. Average subtalar range of motion was 17 degrees The mean Bohler's angle, mean Gissane's angle, calcaneal height and width were 25.47 degrees 121.3 degrees 4.32 cm and 3.81 cm respectively at final follow-up. Three patients had flap necrosis at incision site and one had superficial and deep infection. Subtalar arthritis was seen in 5 patients, whereas sural nerve hypoaesthesia in 1 patient. None of the patients had compartment syndrome, heel pad problems, peroneal tendinitis, reflex sympathetic dystropy or implant failure.

CONCLUSIONOpen reduction and internal fixation with locking calcaneal plate gives sound functional outcome, i.e. restoring anatomically reconstruction of height, width, Bohler's and Gissiane's angles of the calcaneum, and allowing early mobilization.

Ascorbic Acid ; administration & dosage ; Child ; Child Nutrition Disorders ; complications ; diet therapy ; Diagnosis, Differential ; Femoral Neoplasms ; diagnosis ; Femur ; diagnostic imaging ; Humans ; Male ; Protein-Energy Malnutrition ; complications ; diet therapy ; Radiography ; Scurvy ; diagnosis ; diet therapy ; etiology ; physiopathology ; Treatment Outcome

A 45 year old woman was diagnosed as having anteromedial radial head dislocation and distal radius fracture five months after her injury on right forearm. The radial head dislocation led to ulnar nerve compression. She had severe restriction of her elbow movements. She was treated with arthrolysis, decompression of the ulnar nerve and radial head resection. The reverse Essex Lopresti injury and radial head dislocation compressing the ulnar nerve has not been reported in English language literature to the best of our knowledge. A mechanism is proposed for the injury. In acute presentations, restoration of both the radioulnar joints should be done and neglected nature of such injury leads to suboptimal outcomes.
Female ; Humans ; Joint Dislocations ; complications ; Middle Aged ; Radius ; injuries ; Radius Fractures ; complications ; Ulna ; injuries ; Ulnar Nerve Compression Syndromes ; etiology

A 15 years old girl was found to have isolated trochlea fracture 10 weeks after an injury caused by a fall on her left elbow. Movement of the elbow was severely restricted. Radiographs showed a half moon-shaped and anterosuperiorly displaced osteochondral fragment. Medial approach capsulotomy of the elbow and excision of the intraarticular adhesions were done to expose the isolated trochlea fracture. Headless screws were used for fixation, combined with bone grafting. The follow-up showed union and excellent functional recovery of the elbow. Isolated trochlea fracture in adults is rare and usually associated with capitellar fractures and/or elbow dislocations. A neglected trochlea fracture is rarely reported in the English language literature to the best of our knowledge. Recognition of isolated trochlea fracture is vital to apprehend the pathomechanics of the injury and to devise a suitable treatment approach.
Adolescent ; Elbow Joint ; diagnostic imaging ; injuries ; Female ; Fracture Fixation, Internal ; Fracture Healing ; Humans ; Humeral Fractures ; diagnostic imaging ; surgery ; Radiography

Elbow dislocation with concomitant diaphyseal fractures of radius and ulna has been reported rarely. This injury could be included in Monteggia equivalent lesions based on the mechanism of injury, radiographic pattern and method of treatment as described by Bado. We report a rare case of Monteggia equivalent lesion in an adult with unclear mechanism of injury. The possible mechanism of injury, its management and the follow-up results were described. An attempt to solve the controversy regarding whether labeling it as type 1 or type 2 was made.
Adult ; Elbow ; Humans ; Joint Dislocations ; Monteggia's Fracture ; Radius ; injuries ; Radius Fractures ; therapy ; Ulna

Elbow dislocation with concomitant diaphyseal fractures of radius and ulna has been reported rarely.This injury could be included in Monteggia equivalent lesions based on the mechanism of injury,radiographic pattern and method of treatment as described by Bado.We report a rare case of Monteggia equivalent lesion in an adult with unclear mechanism of injury.The possible mechanism of injury,its management and the follow-up results were described.An attempt to solve the controversy regarding whether labeling it as type 1 or type 2 was made.

No abstract available.
Aged* ; Humans ; Leishmaniasis* ; Parasites*

The outward angulation of elbow with supinated forearm is cubitus varus deformity. This deformity is often seen as sequelae of malunited supracondylar fracture of humerus in paediatric age group of 5e8 years. The deformity is usually non-progressive, but in cases of physeal injury or congenital bony bar formation in the medial condyle of humerus, the deformity is progressive and can be grotesque in appearance. Various types of osteotomies are defined for standard non-progressive cubitus varus deformity, while multiple surgeries are required for progressive deformity until skeletal maturity. In this study we described a novel surgical approach and osteotomy of distal humerus in a 5 years old boy having grotesque progressive cubitus varus deformity, achieving good surgical outcome.
Child, Preschool ; Elbow Joint ; injuries ; Fractures, Malunited ; complications ; Humans ; Humeral Fractures ; complications ; Humerus ; surgery ; Joint Deformities, Acquired ; surgery ; Magnetic Resonance Imaging ; Male ; Osteotomy ; methods