No abstract

Background: Charcot neuroarthropathy is a severe disease involving several joints but most commonly affecting the foot and ankle.Charcot arthropathy is a serious late complication of many pathologies like diabetes mellitus, syphilis, and meningiomyelocele. It may result in fractures, permanent deformity, and even limb loss. Ankle fusion with internal fixation has high morbidity and complications. External fixation can provide stability to the joint and correction of the deformity with less risk for surgical complications.Objectives: To assess the clinical and functional outcomes of ankle joint arthrodesis using external fixator in patients with severe Charcot ankle arthropathy. Materials and Method:This study is descriptive cross-sectional hospital-based study that involved an 18 patients with advanced Charcot arthropathy of the ankle joint. Ankle fusion with Ilizarov external fixation was done for all patients. The patients were followed, and the frame was removed after clinical and radiological evidence of union were obtained. The American Orthopedic Foot and ankle Society scale (AOFAS) was assessed before surgery and one year after surgery. The post-operative complications and patient satisfaction also evaluated. The Data was analyzed using IMP SPSS version26.Results: Number of patients was 18, 14 males and 4 females. The most frequent age group was more than 50 years (11 patients, 61.1%). Preoperative AOFAS score was poor for all of the patient (100%). The postoperative AOFAS score was improved, 6 patients (33.3%) obtained excellent result, 5 patients (27.8) good, 4 patients (22.2) fair, while 3 patients (16.7) remained poor. 13 patients (72.2%) were satisfied with the outcome while 5 of them (27.8%) were unsatisfied. The most frequent complication rate was for pin track infection which occurred in 6 patients (33.3%). Conclusion:Fusion of the ankle joint with ring external fixator is useful treatment option for Charcot-arthropathy instability and deformity, particularly in cases where internal fixation methods are ineffective. With an acceptable rate of complications, it can lead to a satisfactory outcome and an improved functional score.

Background: Disorders of the Achilles tendon can occur in adolescents and adults and include both traumatic and non-traumatic problems such as insertional tendinitis, intra-substance tendinopathy, complete rupture. Insertional tendinitis radiographically present as Huglund's deformity, posterior calcaneal spur and retro-calcaneal calcification. Diagnosed based on history clinical examination to radiography.Objectives: to correlated between clinical and radiographically finding in patents with insertional Achilles tendonitis.Methodology: This study is a descriptive cross-sectional hospital-based study conducted in Khartoum state, Sudan. The study was total coverage, data collected questionnaire and patents' X-rays were studied.Results: A total of 25 patients and 30 feet was studied most of them were within age group (41-60) representing 53.3% and 14 were female representing 46.7%. concerning the severity 12 case were severe (40%), 13 were moderate (43.3%) and 5 cases were mild in their presentation with 16.7% of total cases.8 cases(mild) had posterior calcaneal spur (26.7%), 10 cases (4 mild, 4 moderate and 2 sever) had patchy calcification (33.3%), 8cases (severe disease) had both spur and Huglund's deformity and calcification. The relation between the severity of the Insertional Achilles Tendinitis and the radiographic finding was found to be statistically significant (p-value less than 0.05). Conclusion and Recommendations:Our study concluded that there is significant correlation between radiographic and clinical presentation but this correlation is weak. Based on this finding X-rays alone is not valid method for diagnosis and severity determination of Achilles tendonitis. Our study was done on a short period so a recommendation to be done over long duration, in order to involve more cases. Also we recommend that the size and the length of posterior calcaneal prominence taking in consideration over is presence or absence. And the study group must be matched to the control group for more accurate and reliable results.

Background: A malignant bone tumour is a neoplastic growth of tissue in bone which can be benign or malignant. Amputation is the removal part or all of a limb. When used to treat cancer, amputation removes the limb part with the tumour, some healthy tissue above it, and everything below it. The prognosis depends on the type of tumour. The outcome is expected to be good for people with benign tumours, although some types of benign tumours may eventually become malignant.Methods: Observational descriptive cross-sectional hospital-based study was conducted in Ibrahim Malik Teaching Hospital in Khartoum State in the period from January 2018 to September 2018. Data was collected using a datasheet. Data entered and analyzed using SPSS version 25.0. Results:This study covered 50 study participants, most of them (96%) were less than 40 years of age. Our study found that only (16%) of the study participants were fully aware of their disease while (40%) were not aware at all. Furthermore, there was a delay between the presentation and starting the treatment among most of them (90%) while (82%) had tried other traditional or non-formal methods of treatment. Concerning the type of tumour, most of the study participants (84%) were diagnosed with osteosarcoma, while a small proportion of them was diagnosed with Chondrosarcoma (6%), Ewing sarcoma (6%), and Admantinoma among only (4%). The study found that the total number of patients with primary bone sarcoma were 65 patient from January to June 2018(hospital records) so the incidence of amputation at that time was 76%. Regarding the management applied, all study participants were amputated, of which (56%) had chemotherapy and (12%) had radiotherapy. The analysis found that there is a significant association between the level of education and the delayed presentation (pvalue < 0/001). Conclusion:A high awareness of malignant bone tumours are essential to avoid diagnostic delays. Some might even be dangerous.

Background: Disorders of the Achilles tendon can occur in adolescents and adults and include both traumatic and non-traumatic problems such as insertional tendinitis, intra-substance tendinopathy, complete rupture. Insertional tendinitis radiographically present as Huglund's deformity, posterior calcaneal spur and retro-calcaneal calcification. Diagnosed based on history clinical examination to radiography.Objectives: to correlated between clinical and radiographically finding in patents with insertional Achilles tendonitis.Methodology: This study is a descriptive cross-sectional hospital-based study conducted in Khartoum state, Sudan. The study was total coverage, data collected questionnaire and patents' X-rays were studied.Results: A total of 25 patients and 30 feet was studied most of them were within age group (41-60) representing 53.3% and 14 were female representing 46.7%. concerning the severity 12 case were severe (40%), 13 were moderate (43.3%) and 5 cases were mild in their presentation with 16.7% of total cases.8 cases(mild) had posterior calcaneal spur (26.7%), 10 cases (4 mild, 4 moderate and 2 sever) had patchy calcification (33.3%), 8cases (severe disease) had both spur and Huglund's deformity and calcification. The relation between the severity of the Insertional Achilles Tendinitis and the radiographic finding was found to be statistically significant (p-value less than 0.05). Conclusion and Recommendations:Our study concluded that there is significant correlation between radiographic and clinical presentation but this correlation is weak. Based on this finding X-rays alone is not valid method for diagnosis and severity determination of Achilles tendonitis. Our study was done on a short period so a recommendation to be done over long duration, in order to involve more cases. Also we recommend that the size and the length of posterior calcaneal prominence taking in consideration over is presence or absence. And the study group must be matched to the control group for more accurate and reliable results.