No abstract

No abstract

Introduction: Infected non-union is rare in pediatric patients. Various methods have been described in the literature to manage such cases. We present a familiar and simple technique to treat a non-union in pediatric population. Case Presentation: A 4-year-old boy came to us with a right-sided proximal forearm swelling and tenderness. Clinical and radiological features suggestive of osteomyelitis of ulna with a history of the right-sided forearm cellulitis when he was 4 months of age which was managed with incision and drainage at that time. The patient underwent surgery for surgical debridement with drilling of ulnar cortex for pus evacuation. Postoperatively, the patient developed a stress fracture at drilling site which eventually went into a non-union. In second surgery, bony union achieved with the help of non-vascularized fibular strut graft and iliac cancellous graft. Conclusion: There are numerous complications of osteomyelitis in pediatric patients and their management has been previously highlighted throughout literature. Here, we present a rare occurrence case report highlighting management of pediatric atrophic infected gap non-union of ulna by non-vascularized fibula strut stabilized by Titanium Elastic nail which offers a simple yet an elegant solution in a low-cost setting with complete bony union and restoration of function.

Introduction: Fractures with vascular injuries are often complicated with risk to limb survival and life. To quantify the severity of trauma and determine salvageability of the limb many numerical guidelines are available. Current study aims to assess salvageability of a limb with vascular injury at admission by using GHOISS and MESS score and determine correlation between them. A total of 50 patients Materials And Methods: with type IIIB with vascular injury were taken into study over a period of 18 months. Decision regarding limb salvage or amputation was taken by team of experienced orthopaedic and plastic surgeons and informed consent of patients were taken. Another study team independently calculated the GHOISS & MESS score of each patient and sensitivity, specicity ,PPV and NPV of each score were calculated. Both scores were compared using ROC(receiver operating characteristic) curve and Area under the curve. The sens Results: itivity and specicity of GHOISS were calculated as 61.90% and 100% respectively. . The sensitivity and specicity of MESS Score were calculated at 96.30% and 78.30% respectively. Conclusion: The GHOISS is more specic for amputation compared to MESS score. While MESS score has more sensitivity compared to GHOISS. GHOISS is better than MESS for predicting salvageability for open fractures. But score at which decision of salvage is determined needs further verication by multicentric study with larger population.

No abstract