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A ten year old boy presented with a zip trapping the penis of two days duration. The zip was removed successfully under local anaesthesia. Various methods of removal of a zipper are described Case Report A 10 year old boy reported to Government District Headquarters Hospital, Kumbakonam, India with a history of trapping of the prepuce by a zip of two days duration. (Figure 1

Background: The management of young individuals seeking medical attention due to progressive hip pain as a result of secondary osteoarthritis and who want active and pain-free hip was challenging in past. The actual incidenece of secondary osteoarthritis is difficult to ascertain. Young individuals with secondary osteoarthritis hip due to developmental dysplasia of hip, coxa plana (Legg-Calvé-Perthes disease), post-traumatic, slipped capital femoral epiphysis, Paget disease, Haemophilia, Avascular necrosis of femoral head, and so on can be effectively managed with primary uncemented total hip replacement (THR) with good functional outcome in short-term follow-up. This will increase the revision THR rate later. Long-term follow-up is required to watch for prosthesis-related complications Materials and Methods: Material includes 64 patients who attended our OPD from Oct 2013 to Dec2017 and all of them were diagnosed to have secondary osteoarthritis hip with poor hip function as assessed by Harris hip score. All of them underwent uncemented total hip replacement (THR) through posterior/anterolateral approach to hip. Conventional HA-coated stem and acetabular components were used. They were post-operatively assessed at regular intervals with Harris hip score and were found to have excellent functional outcome with high level of patient satisfaction. Result: All patients have excellent Harris hip scorepost-operatively. Patients became independent and were able to carry out day-to-day activities with ease. No complications were noticed. The dramatic change in their hip function was appreciable even on the day of surgery itself. Conclusion:We conclude that uncemented THR using conventional HA-coated components is an excellent surgical modality for the management of secondary osteoarthritis in young individuals with poor hip function. The functional outcome is promising and makes patient independent and pain free. The said procedure is cost-effective and reliable based on excellent hip function achieved in immediate post-operation. Long-term follow-up is recommended.

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