Intramedullary spinal epidermoid cysts are rare, with only few cases having been reported in the literature. We are reporting a case of a 10-year-old female child who presented with symptoms of meningitis with progressive paraparesis. Magnetic resonance imaging of the spine revealed an intramedullary epidermoid cyst from C6 to D5. Near-total excision of the tumor was performed. Histopathological report confirmed the diagnosis of epidermoid cyst. The patient showed progressive recovery.

Comparing with other modalities this method is cost-effective, less time consuming, minimally invasive, low rate of recurrence, and can be carried out under local anesthesia, and does not require any special instrument and an easy-to-learn technique.

Background:The purpose of the present study was to evaluate the clinical utility of Mangled extremity severity score (MESS) in severely injured lower limbs.Materials and Methods:Retrospectively 25 and prospectively 36 lower limbs in 58 patients with high-energy injuries were evaluated with the use of MESS, to assist in the decision-making process for the care of patients with such injuries. Difference between the mean MESS scores for amputated and salvaged limbs was analyzed.Results:In the retrospective study 4.65 (4.65 ± 1.32) was the mean score for the salvaged limbs and 8.80 (8.8 ± 1.4) for the amputated limbs. In the prospective study 4.53 (4.53 ± 2.44) was the mean score for the salvaged limbs and 8.83 (8.83 ± 2.34) for the amputated limbs. There was a significant difference in the mean scores for salvaged and amputated limbs. Retrospective 21 (84%) and prospective 29 (80.5%) limbs remained in the salvage pathway six months after the injury.Conclusion:MESS could predict amputation of severely injured lower limbs, having score of equal or more than 7 with 91% sensitivity and 98% specificity. There was a significant difference in the mean MESS scores in the prospective study (n=36), 4.53 (4.53 ± 2.44) in thirty salvaged limbs (83.33%) and 8.83 (8.83 ± 2.34) in six amputated limbs (16.66%) with a P-value 0.002 (P-value < 0.01). Similarly there was a significant difference in the mean MESS score in the retrospective study (n=25), 4.65 (4.65 ± 1.32) in twenty salvaged limbs (80%) and 8.80 (8.8 ± 1.4) in five amputated limbs (20%) with a P-value 0.00005 (P-value < 0.01). MESS is a simple and relatively easy and readily available scoring system which can help the surgeon to decide the fate of the lower extremity with a high-energy injury.

Background: Fractures of distal end of radius are one of the most common skeletal injuries encountered in orthopaedics. There are various modalities for treatment like close reduction and cast application, external fixators, ORIF with plate etc. CR and cast application or K-wire fixation, external fixation is associated with immobilisation, wrist stiffness, loss of reduction postoperatively. So we performed volar plating for distal end radius fractures and calculated its results.Methods: We performed ORIF with plating (Volar approach) in 35 patients (22 male and 13 female) of distal end radius fractures depending on inclusion and exclusion criteria. Fractures were classified according to AO classification. All patients were operated under tourniquet. Results were analysed using Mayo score.Results: Out of 35 patients, 14 had type A, 16 had type B and 5 had type C fractures (AO classification). Average operative time was 45 minutes and blood loss of 50 ml. Average time to clinico-radiological union was 7 weeks. Average follow up time was 8 months. Average time to wrist mobilisation was 8 days. According to Mayo score, 16 patients had excellent results, 15 had well and 4 had satisfactory results.Conclusions: Volar plating for fracture distal end radius reduces chances of wrist joint stiffness and loss of reduction and good results can be obtained. So in our opinion, volar plating for treatment of fracture distal end radius is good method with excellent outcomes.

Femoral shaft fracture is the commonest major pediatric orthopedic injury requiring hospitalization. Controversy persists regarding management of femoral fractures in the patients aged between 5-15 years. 11 patients were followed up for the mean period of 12 months and evaluated using Flynn's criteria. All the fractures united between 8-12 weeks. 3 patients had knee stiffness, 1 patient had shortening > 2 cm and 1 had superficial infection. We conclude that TENs is simple, rapid & effective treatment for displaced pediatric femoral shaft fractures between 5-15 years of age with very less complication rate.