Introduction: Palmaris longus and flexor digitorum superficialis of the little finger are highly variable anatomically. The tendons vary in different parts of the globe and different regions of the same country. Many studies have negated an association between the tendons. However, most of the studies have a sample size of less than 500 subjects. Aims and objectives: The aim was to study the tendons in the Indian population and study the association, if any between the tendons and to test functional significance of the tendons using the Michigan Hand Outcomes Questionnaire. Methods and material: It was a single centre cross-sectional study with a sample size of 1500 in the age group of 20–60 years. The subjects were tested for the presence of the tendons and their functionality was assessed by Michigan Hand Outcomes Questionnaire. The data was tabulated and was assessed using SPSS 13.0 software. Results: Palmaris longus was bilaterally absent in 10.9% and flexor digitorum superficialis of the little finger was bilaterally absent in 42% of the cases. There was a statistically significant association between the tendons when considered bilaterally. The tendons did not have any bearing on the functionality as assessed by the Michigan Hand Outcomes Questionnaire. Conclusions: There is significant variability in the palmaris longus and flexor digitorum superficialis tendon to the little finger not only in the different countries but in different regions of the same country. However despite the various clinical and medicolegal aspects concerning both the tendons, they do not have much bearing on the functionality of the hand.

A bstract Aim and objective To study the radiological and functional outcomes as well as complications in the management of fractures involving both columns of the acetabulum using a single surgical approach. Design Type IV, prospective clinical study. Setting Level I trauma centre. Materials and methods Inclusion criteria were as follows: (a) patients over 20 year of age and (b) patients suffering from acetabular fractures involving both columns as per Letournel and Judet classification, namely transverse, transverse + posterior wall, T type, anterior column posterior hemi-transverse (ACPHT) and associated both columns. Exclusion criteria were as follows: (a) patient suffering from isolated anterior column, posterior column, anterior wall, posterior wall and posterior wall + column fractures; (b) patient who have undergone surgical procedures of the hip prior to trauma; and (c) compound acetabular fractures. A total of 23 patients having both column acetabulum fractures were included prospectively from June 2016 to December 2018 and followed up till 1 year postoperatively. Open reduction and internal fixation were performed through one of three described approaches, i.e., iliofemoral, Kocher-Langenbeck, and anterior intrapelvic or ilioinguinal. Results Our study population consisted of 30.4% transverse, 39.1% associated both columns, 21.7% T type and 8.7% anterior column + posterior hemi-transverse. Of these, 65.2% were operated using the Kocher-Langenbeck approach, while 30.4% of patients required the anterior intrapelvic approach. The remaining 4.3% of patients were operated by the iliofemoral approach. Anatomic reduction was achieved in 100% of our study population with remaining displacement less than or equal to 1°mm. At 1-year follow-up, all fractures showed a satisfactory union with an excellent Matta index in 100% study subjects. Complications at 1 year included one case of foot drop, which was present preoperatively but failed to improve and one case of post-traumatic arthritis. Average Harris Hip score (HHS) and mean Merle D'Aubigne (MDA) scores suggested good clinical outcomes in the study population. Conclusions A single approach can be used to achieve good functional and radiological outcomes in carefully selected bicolumnar fractures of the acetabulum, with less approach-related morbidity. Clinical significance Traditionally, multiple approaches are used for acetabulum fractures involving both columns, but with proper patient selection, single approach can be used with good functional and surgical outcomes. How to cite this article Patil A, Attarde DS, Haphiz A, et al. A Single Approach for Management of Fractures Involving Both Columns of the Acetabulum: A Case Series of 23 Patients. Strategies Trauma Limb Reconstr 2021;16(3):152–160...

We treated 54 patients with complex acetabular fractures by single ilioinguinal approach, open reduction and internal fixation using plate osteosynthesis for anterior column and lag screw for posterior column through anterior approach and prospectively followed them up for a mean period of 10.50 years (minimum 3 and maximum 27 years). We assessed patients during their serial follow-up using Harris hip score , Merle De Aubigne and Postel scrore. We correlated our results with Matta's radiological fracture reduction criteria. All patients achieved union. Reduction achieved was poor in 13%, imperfect in 33.7% and anatomical in 53.3% patients. Our mean Harris hip score and Merle de Aubigne score at mean follow up improved from19.22 & 2.57 to 85.78 & 15.6 at end of mean follow up of 10.5 years. There were 2 cases of infection and 2 cases required revision and conversion to the conventional anterior + posterior approach. There were two cases of secondary osteoarthritis of hip in patients with poor reduction. With our study we conclude that ilioinguinal approach with anterior column plating and lag screws for posterior column anteriorly offers good functional, clinical and radiological outcome for complex acetabular fractures .It must be used in experienced hands and patients selection is key to success. Comminuted posterior column fracture or fractures with more comminuted posterior column as compared to anterior column must be dealt with posteriorly. Aim must be to achieve anatomical reduction radiologically for better functional results.

Introduction:Osteopoikilosis or osteopathia condensans disseminata is a rare hereditary autosomal dominant sclerosing bone dysplasia. Patients are usually asymptomatic and the diagnosis is usually made incidentally on radiographs which show presence of symmetric, multiple, well defined, small ovoid areas of increased radiodensity clustered in peri-articular osseous regions with propensity for epiphyseal and metaphyseal involvement. There are no increased risks of pathological fracture in a case of osteopoikilosis and traumatic fracture healing in a case of osteopoikilosis is similar to fracture occurring in other normal patients.Case Report:A 34 years male, electrician came with history of accidental fall from height while working in office leading to development of pain and swelling over left lower leg and ankle diagnosed with Ruedi-Allgower classification type I pilon fracture(without fibula fracture) no distal neuro-vascular deficit. Patient was offered surgical treatment in form of open reduction and internal fixation of tibial fracture by plate osteosynthesis using antero-medial approach, showed complete union and was followed up for eight months.Conclusion:Osteopoikilosis has a benign course and it should always be kept as a possible differential diagnosis for osteoblastic metastasis to avoid diagnositic dilemma. Diagnosis can be settled by routine x-rays (for type, extent and site of lesions, bones affected), clinical features of patient, histopathology and other systemic or pre-existing conditions.

Introduction: Posterior lumbar interbody fusion (PLIF) is been used increasingly for degenerative lumbar spine disease to achieve a 360 degree fusion. With the advent of newer techniques and instrumentations the results are good. Aim: To study the outcome of PLIF with cages and that with bone graft for degenerative Lumbar spinal canal stenosis. Material and Methods:We did a double blinded randomized controlled trial at single center. All patients who met with our inclusion criteria and operated from 2007 to 2010 were included in our study. The patients were followed up serially for 5 years for the final outcome. Modified Oswestry low back score and final CT scan based interpretations were applied. Results: Totally 101 patients were included in the study of which 53 underwent PLIF with titanium cage and rest 48 underwent PLIF with bone grafting. We found the results of union rates in both the groups were gratifying, but early and better results with fewer complications were in group with titanium cages. Conclusion: We fairly conclude that better and faster fusion rates with good ambulation can be achieved with titanium cages rather than bone grafting in degenerative lumbar spine disease.