Background: Aneurysmal bone cysts (ABCs) are rare, representing about 1% of primary bone tumors, and 15% of all primary spine/sacral tumors. Notably, when they are located in poorly accessible regions such as the spine and pelvis, their management may be challenging. Treatment options include selective arterial embolization (SAE), curettage, en bloc excision with reconstruction, and radiotherapy. Case Description: A 16-year-old male presented with 2 months of mid back pain, left-sided thoracic radiculopathy, and left lower limb weakness (MRC – 3/5). MR imaging revealed an expansile, lytic lesion involving the T9 vertebral body, and the left-sided posterior elements resulting in cord compression. He underwent SAE followed by intralesional excision, bone grafting, and a cage – instrumented fusion. ABC was diagnosed from the biopsy sample. Postoperatively, the pain was reduced, and he was neurologically intact. Five months later, he presented with a new lesion that was treated with repeated SAE and three doses of zoledronic acid. At the end of 2 years, the subsequent, MRI and CT studies documented new bone formation in the lytic areas, with healing of lesion; additionally, he clinically demonstrated sustained pain relief. Conclusion: Here, we emphasized the importance of surgery for patients with ABC who develop focal neurological deficits. Treatment options should include SAE with bisphosphonate therapy for lesions that recur without neurological involvement.

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BACKGROUND: High-energy tibial plateau fractures, i. e., the bicondylar Schatzker type V fractures and the comminuted Schatzker type VI fractures are complex injuries that require adequate preoperative planning, detailed evaluation and surgical expertise. MATERIALS AND METHODS: From September 2009 to September 2014, 20 patients with high-energy (Schatzker type IV to type VI) tibial plateau fractures were treated with Open reduction and internal fixation with dual plating at the Department of Orthopaedic Surgery, Chettinad Hospital and Research Institute. RESULTS: A follow up ranging from 12 to 18 months showed that all fractures went in for union, both clinically and radiologically. The average time between the surgery and union was 16 weeks (range, 12-20 weeks). Functional outcome was evaluated using Rasmussens criteria, which showed 90%of acceptable anatomical and functional results. CONCLUSION: Open reduction and internal fixation is recommended for high-energy tibial plateau fractures with significant displacement. By careful selection of patients with "acceptable" soft tissues, a reasonable outcome can be expected, even in more severe injuries.

Introduction: Trochanteric fractures are extra capsular fractures resulting commonly among elderly patients due to trivial fall. The complications of the surgeries result in severe life threatening conditions, consequently leading to increased disability, mortality and decreased quality of life. This study was done to assess the surgical outcomes of trochanteric fractures using a composite scoring system. Methodology: This cross sectional study was carried out among 40 patients with trochanteric fractures who were treated surgically using Dynamic Hip Screw (DHS) or Dynamic Condylar Screw (DCS). A comprehensive scoring system was developed considering clinical, radiological and functional outcomes assessment. Results: In 40 cases of trochanteric fractures type I and type II were 33 cases constituting an incidence of 82.5% and type III and type IV constituting an incidence of 17.5%. About 36 cases (90%) were operated by dynamic hip screw and plate (DHS) and in 4 cases (10%) dynamic condylar screws and plating (DCS) were deployed. About four participants developed post operative complications. Excellent to good outcomes were obtained in 29 cases (72.5%), fair results in 8 cases (20%) and poor results in 3 cases (7.5%). Conclusion: Management of trochanteric fractures by DHS technique produces better functional outcomes and also improves the quality of life to pre fracture states, especially among older patients.