Madelung’s deformity is one of the rare congenital deformities of the forearm and wrist, typically seen as positive ulnar variance and increased volar tilt due to the “Vickers” ligament. Different corrective surgical methods for this have been done in the literature. In this case of a 9-year-old Madelung’s like deformity, we have performed a modified dual osteotomy with periosteal preservation allowing natural articulation and bone to be modified, especially in a younger child. This article gives the surgical option to orthopedics for the future, especially in a younger child with severe deformity. This is a level V evidence-based therapeutic study.

Hydatid cysts caused by Echinococcus species mainly involve visceral organs. Rarely skeletal involvement occurs. The spine and pelvis account for half of the cases of osseous hydatidosis, making humeral hydatid cysts one of the rarest conditions. We report a case of humeral hydatidosis in a 42-year male who presented to us with pain and swelling over the left upper arm, radiological investigations suggestive of osseous cystic lesions were inconclusive and diagnosis of hydatidosis was confirmed with a biopsy subsequently. Surgical excision and curettage of bone and surrounding soft tissue were done, and the void was filled using PMMA cement followed by antihelminthic chemotherapy. No complication or recurrence has been found postoperatively at the end of 6 months of follow-up, with preservation of limb function. To keep orthopedic surgeons aware of this morbid condition, due to its low prevalence, and advanced presentation which is likely misdiagnosed, and even after the early intervention, there is a high recurrence rate which makes this one of the rare cases of humeral hydatidosis notifiable.

Allergic rhinitis (AR) refers to an IgE-mediated inflammation following exposure to allergen. Often deemed as a minor inconvenience rather than a disease, AR impairs the QOL. Medical treatment has a beneficial effect. To evaluate the QOL in patients of AR. Patients of AR with ≥ 18 years age, receiving treatment in our department are included. Pre and Post treatment VAS (Visual Analogue Scale) and RSDI (Rhinosinusitis Disability Index) are compared to know the effect of disease and treatment on QOL. The patients of PAR (Persistent Allergic Rhinitis) had a greater impact on QOL. In PAR, a combination of INCS (Intranasal Corticosteroids) + oral antihistaminics result in significant reduction in VAS & RSDI scores. In IAR (Intermittent Allergic Rhinitis), Oral antihistaminics monotherapy was most effective in reducing itching while Oral antihistaminics + 1 week of intranasal decongestant was most effective in reducing sneezing, running nose and nasal blockage. Oral antihistaminics + LTRA (Leukotriene Receptor Antagonist) was most effective in reducing physical RSDI score. Oral antihistaminics + 1 week of intranasal decongestantwas most effective in reducing functional and emotional RSDI score. Functional RSDI scores had improved much higher than emotional and physical scores. All these observations were statistically significant. AR does affect the QOL while pharmacotherapy helps in improving the overall QOL. Oral antihistaminic alone or in combination with local decongestant/LTRA in IAR cases while INCS + oral antihistaminic in PAR cases are significantly effective in controlling symptom scores and QOL.

IntroductionGiant cell tumor (GCT) or bony tumor mainly involving long bones of arms and legs is very rarely associated with the small bones of hands and feet. Due to its nonspecific signs and symptoms, it is not easy to diagnose based on clinical findings; therefore, histopathological evidence is required to confirm it. MethodA total of 16 patients with positive histopathological bone lesions enriched with giant cells were included in our study. After a complete evaluation of their case records, the required radiological assessment was carried out. Campanacci's method of staging was used to evaluate the advancement of lesions. The Musculoskeletal Tumour Society (MSTS) score was recorded postoperatively. All the patients were followed up for a mean duration of 2.8 years until they were lost to follow-up. ResultThe result of the current study shows that 62.5% of our patients presented in their twenties and 81.25% of patients came at a reasonably advanced stage. Hand and foot were involved in 1:1 cases. Patients were treated by one of the following options: extended curettage with bone graft or cement, wide excision, or en bloc resection. Phenol, a neoadjuvant, was used in all patients. Two of our patients (6.25%) who underwent curettage with bone graft showed up with recurrence during follow-up -one was then treated with wide excision and the other with amputation. ConclusionGiant cell tumors should undoubtedly be aggressively approached with the goal of preserving limb function while reducing recurrence risk to as minimal as possible. GCT of hand is more aggressive comparatively and should be treated accordingly.