IntroductionEwing’s sarcoma is second most common primary malignant bone neoplasm in children and adolescents. We report a case of Ewing’s sarcoma of ilium in an 18-year-old female mimicking clinically and radiologically inflammatory arthritis of hip joint, a rare entity not mentioned in literature.Case presentationAn 18-year-old girl presented with pain hip, limp and fever off and on. Patient had restricted range of motion, raised erythrocyte sedimentation rate, leucocytosis and radiograph showed reduced joint space. Magnetic resonance imaging pelvis revealed an altered marrow signal of acetabulum with a large soft tissue component. Histopathology revealed a malignant round cell tumor consistent with Ewing’s sarcoma.ConclusionClassical clinical and radiological presentation of Ewing’s sarcoma of ilium may not be the rule. One should be highly suspicious of the disease even if there is no direct pointer to the disease as was encountered in our case.

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We studied the outcome of minimally invasive percutaneous plate osteosynthesis (MIPPO) using locking plate for closed fractures of distal tibia in a consecutive study consisting of 25 patients. Preoperative variables were age of patient, mode of trauma, type of fracture, and soft tissue status. Postoperative variables included wound status, time to union, return to activity, and AO foot and ankle score. After 1 year, all the fractures had united. The average time to union was 16.8 weeks. There were two cases of superficial infection. We also had two cases of deep infection, which required removal of hardware after the fracture was united. The average AO foot and ankle score was 83.6 in our study. We concluded that using MIPPO is a safe and effective method for the treatment for distal tibial fractures in properly selected patients.

Ewing's sarcoma is a highly malignant tumor of bone and is more common in children in the age group of 10 to 20 years. Sometimes the classic clinical and radiological presentation of Ewing's sarcoma may not be the norm and patient may have an atypical presentation leading to diagnostic confusion. This situation is especially true for Ewing's sarcoma involving iliac bone. We report a case of Ewing's sarcoma involving the right ilium in a patient presenting with right lower quadrant pain and nonspecific radiological changes. To the best of our knowledge, this scenario has not been reported in literature. We recommend early magnetic resonance imaging and computed tomography to diagnose the disease early when there is slightest suspicion of the disease.

Forty-five displaced femur fractures in children were treated with unilateral external fixation as a standard treatment from March 2007 to March 2009 and the last follow-up was completed in May 2012. The average age of the children at presentation was 9.93 years. Patients were followed up till union, at 1 year, and at an average of 3.5 years after fixation. The fixator was removed at an average of 12.23 weeks. Twenty-one (47%) patients had a minor complication of pin-site infection. One patient had a major complication of refracture. Treatment of uncomplicated femur fractures using an external fixator in children yields satisfactory results. Our series had a longer duration of follow-up and fewer refractures compared with other series.