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Objective Unstable intertrochanteric fractures continue to be a challenge for orthopedic surgeons due to the functional limitations it results in the postoperative period. Anatomical reconstruction of the posteromedial fragment becomes difficult through conventional lateral approach, leading to excessive fracture collapse and limping. Materials and Methods: prospective, nonrandomized study was done with 40 patients. They were operated in prone position through posterior approach. Cancellous screws or SS-wires were used to fix the greater or lesser trochanteric fragments and dynamic hip screw (DHS) or dynamic condylar screw (DCS) for the main two fragments. Bone grafts were used to pack cavities at the posterior trochanteric regions. Results: Fracture healing occurred earlier compared to conventional lateral approach without excessive fracture collapse in majority of cases (average time to achieve union was 13.8 weeks; range: 10–18 weeks). Good functional recovery was noted with 75% 'Good' or 'Excellent' Harris Hip Scores at 24 weeks. Conclusion: Anatomical reconstruction of unstable trochanteric fractures becomes easier through posterior approach with earlier and better functional recovery.

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Idiopathic chondrolysis is a rare condition characterized by the ultimate loss of femoroacetabular articular cartilage seen in a child with no history of trauma, slipped capital femoral epiphysis, infection, prolonged immobilization, or any other previously described disorder. The diagnosis is often delayed secondary to the insidious onset of symptoms, progressive radiographic findings, and the absence of diagnostic laboratory test. Typical radiographic features include localized osteoporosis, subchondral erosions, femoral head changes, and reduction of the joint space. Later changes include complete loss of the joint space, subchondral cysts, trochanteric and epiphyseal physeal closure, osteophytes, and in severe cases, protrusio acetabuli, ankylosis, and osteoarthritis. Magnetic resonance imaging of the hip demonstrates cartilage loss, joint effusion, marrow edema, femoral and acetabular remodeling, significant regional muscle atrophy, and synovial enhancement. We report a case of Idiopathic chondrolysis of the hip in an 11-year-old Indian girl.

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Neurogenic fibrolipomatous hamartoma (FLH) is a benign lesion that can affect any of the peripheral nerves, causing significant enlargement. Though the pathology is a rare one, median nerve is the most common nerve in the body to be affected. The most common segment of the nerve to be affected is that around the wrist. We present a case of carpal tunnel syndrome caused by FLH of the median nerve associated with macrodactyly.

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Background Hip replacement has transformed the lives of hundreds of thousands of people regardless of the underlying aetiology. Debate about the role of arthroplasty for an acute displaced femoral neck fracture has been ongoing for decades. In this article we are going to evaluate whether dislocation rate is higher in total hip replacement done for acute displaced fracture neck of femur. Materials and Methods: Retrospective study of sixty two patients who underwent total hip replacement in Sri Ramachandra medical center. The minimum follow-up was taken as 5 years. Patients were divided into two group; traumatic and non traumatic group. We had 38 patient who underwent hip replacement for non traumatic indications. Traumatic group had 24 patients. The inclusion criteria for the traumatic group were acute displaced fracture neck of femur above 50 years and fracture neck with fracture head with dislocation above 50 years. We used the Harris hip score (Modified) for clinical and functional evaluation. Results: We had 89% excellent/good results in non traumatic group 75% excellent/good result in traumatic group. We had one dislocation in non-traumatic group and four dislocations in traumatic group. Conclusions: There is an increase rate of dislocation in patient who underwent total hip replacement for a traumatic condition when compared to their non traumatic counterpart.

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A rare case of primary intraosseous meningioma of the calvarial bones presenting as solitary osteolytic lesion on the skull radiograph and correctly diagnosed pre-operatively on computed tomography (CT) and magnetic resonance imaging (MRI) by correlating the clinical and imaging findings is reported in this communication. The clinical, radiographic, CT and MR imaging features of the case and the difficulties in making a correct clinico –radiological diagnosis are highlighted in this communication.

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Osteochondromas are common benign tumors. They probably are developmental malformation rather than true neoplasm and are thought to originate within the periosteum and small cartilage nodule. They rarely develop in the joint. Trevor disease or dysplasia epiphysealis hemimelica (DEH) refers to intraarticular epiphyseal osteochondroma. DEH has an incidence of 1 in 1 million and is characterized by asymmetric overgrowth of cartilage. Though many cases of DEH are asymptomatic, but they may be troublesome when they cause mechanical and pressure symptoms depending on the size and location. We report a case of Trevor's disease of the knee in a 21-year-old male with mechanical obstruction.

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Radial head fracture is the most common type of elbow fracture in adults. It results from a fall on an outstretched hand. However, simultaneous bilateral radial head fractures are extremely rare. We report a case of simultaneous bilateral mason type IIb radial head fractures in a young female, which was treated nonoperatively with excellent results.

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