Tuberculosis (TB) remain as one of the leading opportunistic infection in patients with Human immunodefficiency virus (HIV) infection in developing countries. Here we report a case of huge primary psoas abscess of tubercular origin in an HIV patient who presented with hip pain and limping. Psoas sign was evident on examination and CT scan of abdomen revealed a large iliopsoas abscess extending from abdomen to upper part of thigh. Patient underwent percutaneous drainage of abscess and improved with anti-tuberculous drugs while continuing anti-retroviral therapy.
The symptomatic nonunion of the scaphoid is disabling condition and the majority of patients are of young working-class and hence surgical intervention to get union in these cases are very important. Our study analyses the early functional outcome of scaphoid nonunion treated with bone grafting and Herbert screw fixation. The study was conducted in The Department of Orthopedics, Government Medical College, Thrissur from December 2017 to May 2018 and study included 12 patients whose wrist function evaluated with modified mayo's wrist score. Our series resulted in 58.3% excellent, 33.3% good and 8.3% fair functional outcomes. The average time from injury to surgical fixation was 13 months and mean age of the patients was 27.9 years. Our study concluded that the management of scaphoid non unions with the herbert screw and bone grafting can provide enough stability to allow fracture healing without much external splintage. The wrist function improvement is more satisfactory and the fixation reduces the progression of wrist osteoarthritis.
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