Sameer Chaitanya Sahini

Abstract

Tardy ulnar nerve palsy is a condition presented as late onset ulnar neuropathy. Most commonly occurred as a delayed complication of non-union of lateral epicondyle humerus with valgus deformity. Whereas tardy ulnar nerve palsy occurred as a complication of fracture non-union of medial epicondyle was rare and a very few cases were reported in literature. We report a case in a 15 year old boy with tardy ulnar nerve palsy after neglected fracture non-union of medial epicondyle of humerus on left side, patient presented with tingling and numbness of medial side two fingers with left hand weakness. We treated him operatively by tension band wiring and olecranon bone grafting for fracture non-union medial epicondyle of left humerus and ulnar nerve exploration and anterior transposition was also done. Keywords: Tardy ulnar nerve palsy medial epicondyle fracture non-union ulnar nerve anterior transposition tension band wiring.

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Abstract

Purpose: The purpose of this study is to assess the role of distension hydrodilatation and viscosupplementation of the glenohumeral joint in the management of frozen shoulder. Materials and Methods: A total of 50 Patients suffering with frozen shoulder presented to Yashoda hospital, malakpet, Hyderabad. All patients were treated by distension hydrodilatation and viscosupplementation under fluoroscopy (C-ARM) guidance as a day care procedure. The study period was from August 2018 to February 2019. All the patients were followed-up for a minimum period of 6months to maximum 1 year. The mean age of the study group was 45.86 years. Results: All cases were assessed by oxford shoulder score (OSS) and visual analogue score (VAS) pre-procedure and post-procedure. All the patients regained near normal to normal shoulder movements in all directions by the end of 3rd week. Complete pain relief was seen by 2 weeks following the procedure. There was decrease in Oxford Shoulder Score (OSS) by mean of 18.22 (pre-procedure was 31.34 and post-procedure was 13.12), Visual Analogue Scale (VAS) mean was also decreased from 8.42 to 1.14. 43 of 50 patients obtained full free range of movements. Remaining 7 patients had restriction of terminal rotational movements, 3 of 7 patients had restriction of 100 of external rotation, 4 of 7 had restriction of 100 of internal rotation. Conclusion: Distension hydrodilatation and viscosupplementation is a definitive treatment modality in patients with frozen shoulder. It results in significant and sustained relief of pain and also results in regaining of full range of shoulder movements. Keywords: Frozen shoulder, Distension hydrodilatation, Viscosupplementation.

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Abstract

Aneurysmal bone cyst (ABC) is a benign skeletal tumor which is eccentric, expansile and osteolytic lesion. It contains blood-filled spaces separated by fibrous septa. Aneurysmal bone cyst occurs most commonly in long bones and rarely in the sacrum. Because of its proximity to sacral nerve roots standard surgical resection or curettage and bone grafting is not optimal. Recent therapeutic strategy is to treat it with denosumab injections subcutaneously. We report a case of aneurysmal bone cyst involved in entire right half of sacrum in a 13 year old girl and we treated with denosumab injections (60mg/ml) subcutaneously in every month at regular interval for a period of 12 months and followed for a period of 1year, there was symptomatic and radiological improvement present. Keywords: Aneurysmal bone cyst (ABC), Bone tumor, Sacrum, Denosumab.

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