Background:Giant cell tumor (GCT) of the distal radius poses problems for reconstruction after resection. Several reconstructive procedures like vascularized and non-vascularized fibular graft, osteo-articular allograft, ceramic prosthesis and megaprosthesis are in use for substitution of the defect in the distal radius following resection. Most authors advocate wrist arthrodesis following resection of distal radius and non vascularized fibular graft. Here we have analyzed the results of aggressive benign GCTs of the distal radius treated by resection and reconstruction arthroplasty using autogenous non-vascularized fibular graft.Materials and Methods:Twenty-four cases of giant cell tumor of the distal radius (mean age 32 years, mean follow-up 6.6 years) treated by en-bloc resection and reconstruction arthroplasty using autogenous non-vascularized ipsilateral fibular graft with a minimum followup of two years have been included in this retrospective study. Nineteen cases were of Campanacci grade III and five were of Grade II recurrence. The mean resected length of the radius was 9.5 (8-12) cm. Routine radiographs and clinical assessments regarding pain, instability, recurrence, hand grip strength and functional status were done at regular intervals and functional results were assessed using (musculoskeletal tumor society) MSTS-87 scoring.Results:Early radiological union at host-graft junction was achieved at mean 12.5 weeks, (range 12-14 weeks) and solid incorporation with callus formation was observed in mean 29 weeks (range 28-32 weeks) in all the cases. Satisfactory range of motion (mean 63%, range 52-78%) of the wrist was achieved in 18 cases. Grip strength compared to the contralateral hand was found to be 67% (range 58-74%). Functional results were excellent in six cases (25%), good in 14 cases (58.3%) and four (16.7%) cases had fair results. Soft tissue recurrence was seen in one patient. The most commonly encountered complication was fibulo-carpal subluxation (10 cases, 41.7%).Conclusion:Resection of the distal radius and reconstruction arthroplasty with non-vascularized proximal fibular graft is useful in preserving the functional movement and stability of the wrist as well as achieving satisfactory range of movement and grip strength.

Giant cell tumor (GCT) of bone arising from a phalanx of a finger is extremely rare. We report two cases of GCT arising from a phalanx of a finger. One case presented with recurrence following the amputation of the left ring finger (performed elsewhere). He was treated successfully with ray amputation. The other case was treated primarily by intralesional curettage and autogenous bone graft. At their most recent follow-ups (80 and 24 months, respectively), both were recurrence free and had returned to their previous occupational and recreational activities.

No abstract

No abstract

To identify potential risk factors for hearing loss from the infant with high risk criteria as guided by the Joint Committee on Infant Hearing (JCIH, 2000). 490 infants with age range of 2 days to 6 months who had undergone detailed audiological evaluation during for the period of 3 years at Gauhati Medical College Hospital were taken for the study. The hearing screening was performed on each infant using Distortion Product Otoacoustic Emission (DPOAE) testing. The infants who failed DPOAEs screening were followed up and Auditory Brainstem Response testing. Out of 490 high risk infants who had undergone detailed audiological evaluation 145 infants were found to be having hearing loss. Out of 145 infants 73 infants were male and 72 infants were female. The risk factor for hearing loss with the highest incidence was hyperbilirubenemia, Apgar scores of 0-4 at 1 min or 0-6 at 5 min was the second most prevalent risk factor, followed by TORCH infections. This study suggests the need for review of high risk register that is used along with the physiological and electrophysiological hearing test to screen the infants. The high risk register remains helpful in determining follow up plans so that children who may develop late onset of hearing loss will not be missed. Being aware of which risk factors are more likely to cause hearing loss in infants would be helpful to plan for follow up these children.