Notes

Portrayal of the book HLA-A*23:118 allele by two next-generation sequencing techniques.
This gives excellent clinical and radiological results.
Osteoarticular tuberculosis (TB) constitutes 1-3 % of cases and about 10% of osteoarticular TB affects the foot and ankle. In foot, TB calcaneus is the most commonly affected bone.

A 21-year-old male presented with pain, swelling in the right heel for 5 months and difficulty in walking for 2 months. Plain X-ray (axial) view of calcaneus showed a lytic lesion in calcaneus. Biopsy was done under local anaesthesia and histologic examination revealed a characteristic granuloma, caseous necrosis, and Langhans giant cells which confirmed our diagnosis. The patient was treated with anti-TB chemotherapy for 12 months. Radiographs at 18 months follow-up showed a healed lesion. At present, the patient is comfortable with no complaints.

TB calcaneus is rare condition and a high index of clinical suspicion along with imaging studies helps in diagnosis. Conservative management with anti-TB chemotherapy for adequate duration helps in complete resolution of the infection with good functional results.
TB calcaneus is rare condition and a high index of clinical suspicion along with imaging studies helps in diagnosis. Conservative management with anti-TB chemotherapy for adequate duration helps in complete resolution of the infection with good functional results.
While odontoid fractures frequently lead to non-union in elderly population, they are relatively rare in the younger age group. We present our management of a rare case of neglected odontoid fracture in an ankylosed spine of a young female.

A 28-year-old female presented to our emergency department with neck deformity after a history of fall 1 year back. She presented with clinical symptoms and signs of cervical myelopathy. Diagnostic imaging confirmed ankylosis of the cervical spine with a non-union of the odontoid fracture with atlantoaxial instability and kyphosis. She was treated with anterior release of the odontoid through a standard Smith-Robinson approach, anatomical reduction, and posterior occipitocervical stabilization and fusion.

Non-union with a malpsitioned odontoid fracture in an ankylosed spine can be addressed by an anterior release and reduction with posterior fusion with good functional outcome.
Non-union with a malpsitioned odontoid fracture in an ankylosed spine can be addressed by an anterior release and reduction with posterior fusion with good functional outcome.
Acromioclavicular joint (ACJ) separation is a common sports injury. Suture- button repair is favoured technique with a complication rate of 20%. We are the first to report the migration of a suture button into the glenohumeral joint.

A 28-year-old right-handed rugby player presented with symptoms of laxity and catching within the right shoulder 4 years after reconstruction using an ACJ Dog Bone TM Technique (Arthrex Inc.). learn more Magnetic resonance imaging showed that the coracoid suture button had migrated into the glenohumeral joint.

The patient was successfully treated with an arthroscopic examination of the glenohumeral joint and removal of the button. We outline the risk factors and treatment options involved in this unique presentation.
The patient was successfully treated with an arthroscopic examination of the glenohumeral joint and removal of the button. We outline the risk factors and treatment options involved in this unique presentation.
Gossypiboma is an iatrogenic lesion, caused by a retained surgical sponge in the operating field. It is an extremely rare event following musculoskeletal procedures and has devastating medicolegal consequences. It is hardly ever reported, and hence, the incidence is difficult to determine.

We present a case report of a 70-year-old gentleman who presented with a painless swelling in the right thigh for 7 months. He had undergone open femoral nailing 10 years ago. Imaging studies suggested a soft-tissue sarcoma, but the biopsy was not conclusive. Intraoperatively, the mass was excised and found to have a thick fibrous wall with a gauze piece inside. Polarizing microscopy confirmed the diagnosis of gossypiboma.

Gossypiboma is an infrequent but devastating consequence of a human error. It is often difficult to diagnose and is confused with a soft-tissue sarcoma. Prevention of such untoward incidents by strict adherence to protocols is far better than cure.
Gossypiboma is an infrequent but devastating consequence of a human error. It is often difficult to diagnose and is confused with a soft-tissue sarcoma. Prevention of such untoward incidents by strict adherence to protocols is far better than cure.
Bilateral intracapsular neck of femur fractures is rare and has been reported in patients with metabolic bone diseases, after electroconvulsive therapy and due to stress fractures. Total hip arthroplasty (THA) is considered as a treatment of choice for old aged patients. Surgery done in a single sitting for such patients helps in early mobilization.

A 60-year-old male, known case of epilepsy and chronic renal disease, presented to us with bilateral intracapsular fracture of neck of femur following episode of convulsion. The patient was operated for a distal loading stem THA on both sides in a single sitting. Proximally deficient hip was managed with screw and cerclage looping fixation of greater trochanter on both sides. The post-operative course was uneventful. At 2 weeks, the patient was allowed protected weight-bearing with a walker. At 8 weeks, the patient was doing full weight-bearing, while at 4 months, the patient was carrying out all activities of daily living. Mean Harris hip score was 86 at the end of 6 months.

Bilateral long stem distal loading THA can give good clinical and functional outcomes in a case of the bilateral neck of femur fracture with a deficit of proximal femur. The patient can safely be operated for arthroplasty on both sides in a single sitting. Single sitting surgery will help in early mobilization and better functional outcomes.
Bilateral long stem distal loading THA can give good clinical and functional outcomes in a case of the bilateral neck of femur fracture with a deficit of proximal femur. The patient can safely be operated for arthroplasty on both sides in a single sitting. Single sitting surgery will help in early mobilization and better functional outcomes.
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