From January 1990 to December 1998, 48 patients with 50 recurrent anterior dislocations of the shoulder were treated using a modified Boytchev procedure. The age of the patients varied from 18 to 35 years (average 24.7 years). The follow-up period was in average 88 (26-132) months. Six patients were lost in follow-up. Forty-two shoulders showed excellent results. There was one traction injury of the musculocutaneous nerve and one patient with immediate recurrence of the dislocation. Superficial wound infection occurred in five cases, all of which were controlled by antibiotics.Résumé De janvier 1990 à décembre 1998 48 patients avec 50 luxations antérieurs récidivantes d'épaule ont été traités en utilisant la procédure de Boytchev modifiée. L'âge de patients a varié de 18 à 35 ans (moyenne 24.7 ans). Le suivi était en moyenne de 88 (26 à 132) mois. Six patients ont été perdus de vue. Quarante-deux épau-les ont montré des résultants excellents. Il y avait une blessure par traction du nerf musculocutaneous et une luxation récidivante précoce.Une infection superficielle s'est produite 5 fois, toujours contrôlée par les antibiotiques.

Hydatid disease is a parasitic tapeworm infection caused by the Echinococcus species. Involvement of the long tubular bones is rare in hydatid bone disease. Patients are initially asymptomatic and usually present at a later stage of the disease when the bony lesions are extensive. Diagnosing bone hydatid disease is challenging, even in endemic regions, and a high index of suspicion is required because the radiologic findings often mimic other bone pathologies. Recurrence following treatment can occur after a long period of quiescence.This article describes a case of hydatid disease in a 62-year-old woman with extensive diaphyseal tibial involvement. She was treated with initial chemotherapy followed by extended curettage, polymethylmethacrylate cementation, and intramedullary fixation. Functional outcome was excellent, with no recurrence at 60-month follow-up. She was fully weight bearing with no pain or discomfort and had full hip, knee, and ankle range of motion.This case was important due to its rarity, the diagnostic challenge it presented, and the composite nature of the treatment used to avoid recurrence. Diaphyseal bone hydatidosis can be initially treated like a low-grade malignant tumor with curettage and high-speed burring, followed by filling the defect with polymethylmethacrylate cement. The composite treatment of chemotherapy with the surgical protocol described offers a reasonable chance of long-term disease suppression. Recurrent disease can be treated with repeat curettage and cementation. Wide excision with reconstruction of the resulting defect should only be considered for recalcitrant diaphyseal hydatid disease.

Background:The conventional technique of free non-vascularized fibular grafting is attended with some amount of morbidity and a long scar. We report a technique with little interference to the surrounding soft tissues to harvest more than one-third of whole length fibula.Patients and Methods:Thirty four patients of average age 23.5 years (range 8 to 51 years) having various pathologies like simple bone cysts (n=9), fibrous dysplasias (n=6), giant cell tumors (n=7), fracture non-union (n=10) and aneurysmal bone cysts (n=2) were taken up for the study. The fibula were harvested by two separate incisions, 1 cm each at proximal and distal extent of proposed donor site for taking out of graft after elevating the periosteum circumferentially using a periosteum stripper. Compression bandage and above knee plaster immobilization was applied to reduce the dead space collection.Results:The mean followup is 34 months. The patients were evaluated clinicoradiology. Thirty three patients showed good results. One patient had fair result due to delayed wound healing from hematoma which was treated surgically.Conclusion:The approach of harvesting fibula suggested by author reduces donor site morbidity and is safer than conventional approach.

lantar fibromatosis is a disorder of fibrous tissue proliferation, characterized by a slowgrowing nodular thickening, most often within the central band of the plantar aponeurosis. The fibromatotic process grows slowly and invades the skin and deeper structures.1 The similarities of this condition to those observed in palmar fascia (Dupuytren's disease) seem to support the theory that the two diseases are expressions of the same disorder.2 Although much has been discussed about Dupuytren's contracture in the international literature; little or no information is available regarding plantar fibromatosis from the Indian subcontinent. We present a case of a young woman with isolated disease of her right sole and describe the clinical and pathomorphological features of this rare clinical entity. Case reportA 30 year-old housewife presented to our out-patient department with a history of painful swelling of her right sole. (Fig.1) The swelling appeared six years ago and was gradually progressive. It is associated with a dull aching type of pain which on later stages prevented her from walking even small distances. On examination, she had multiple nodular, non compressable swellings in her right sole. The biggest nodule measured 2 cm in diameter. The swellings were tender to touch with no local rise in temperature. The skin over the swelling was normal. No flexion contracture of toes 2 or neurovascular deficits was noted. Motion of the foot and ankle were within the normal range. The examination of skin and subcutaneous tissues elsewhere in her body and the palms did not reveal any similar swelling. The patient denied any history of diabetes mellitus 3 , epilepsy, chronic liver disease or keloidal tendencies.