Tip of the greater tuberosity to pectoralis major distance Pectoralis major tendon tear Pectoralis major tendon repair a b s t r a c t Background: Pectoralis major tendon tears are encountered in young active patients. Methods: In 10 fresh cadaveric shoulders we measured-1. Proximal to distal insertion width of the pectoralis major tendon. 2. The distance of the superior border of the tendon from the supero-medial tip of the greater tuberosity (GT). Results: The average insertion width was 46 mm. The average distance between the superior border of the tendon and the tip of the GT was 48.5 mm. Conclusion:The superior border of the tendon should be repaired with two anchors at a distance of 48.5 mm from the tip of the GT so as to cover a width of 46 mm.

Purpose This study aimed to analyze the distance between the superior edge of the pectoralis major and the top of the humeral head and evaluate whether this distance is a consistent measurement. Methods Twenty-two shoulders in eleven cadavers were dissected and the attachment of the pectoralis major tendon was preserved. Two distances were recorded with the help of digital vernier caliper: the distance between the upper edge of pectoralis major and tangent to the top of humeral head (PM–T) and the distance between the superomedial tip of greater tuberosity (GT) and the upper edge of the pectoralis major tendon (PM–G; ± standard error of the means). Results The mean PM–T distance was 53.8 mm (±0.8 mm) and the mean PM–G distance was 46.8 mm (±0.9 mm). The distance between the top of humeral head and tip of the GT was 7 mm. The PM–T distance was a significant outlier in three shoulders as it inserted high on the humerus. Conclusion We can conclude that the PM–T and PM–G distances were a consistent measurement. Clinical Relevance The distance between the pectoralis major tendon and top of the humeral head was measured in this study as a reliable method that can be used intraoperatively to decide the height of the humerus prosthesis in comminuted fractures of the proximal humerus.

<p class="abstract"><strong>Background:</strong> Outpatient orthopaedics department of a tertiary care hospital sees large number of patients. However, the funds and resources are limited and have to be judiciously distributed. This study aims to study the etiological pattern of different patients that present to the outpatient department (OPD).</p><p class="abstract"><strong>Methods:</strong> Nine consecutive OPD’s data was studied for the etiology of the different diagnosis of new patients presenting to the OPD. Etiology of various diagnoses was studied as a percentage of the total patients.<strong></strong></p><p class="abstract"><strong>Results:</strong> Trauma of upper limb and lower limb formed a higher percentage of the total patients. Degenerative spine was more common than traumatic spine.</p><p class="abstract"><strong>Conclusions:</strong> Traumatic conditions of the lower and upper limb make up majority of the cases. Degenerative spine is more common than the traumatic etiology.</p>

Background: Supracondylar fractures of Humerus are one of the most common fractures in the children. Closed reduction and percutaneous k wire fixation are one of the most commonly used and widely accepted treatment modality in Gartland type 3 fracture, but controversy continues regarding the ideal pin fixation techniques. This study was conducted to compare lateral divergent k wires versus cross k wire (medial and lateral) in terms of the stability, functional outcome and iatrogenic ulnar nerve injury. Material and Method: This was a retrospective record based study. Total 30 patients of displaced supracondylar fracture of the humerus of age 3-12 years were divided into 2 groups which were evaluated from post-surgery. In group one crossed pinning was done for type 3 supracondylar fractures and other group was treated with lateral pinning and outcome of these patients record was assessed on basis of pain, motion, stability and function according to Flynn's criteria and follow-up record of 2 year was studied. Data was analysed with the help of SPSS 20.0 version. Results: According to Flynn criteria, the final result was excellent in 90 %and good in 10 % of cases with 0% fair and 0% poor results. There was no statistically significant difference between medial-lateral entry group and lateral entry group. Conclusions: Lateral pinning is an equally good as compared to crossed pinning treatment of choice in terms of terms of the stability and functional outcome. The risk of ulnar nerve injury was zero in lateral divergent k wires. Both these methods give comparable functional and cosmetic results.

Study design: Retrospective study. Purpose: The aim of this study was to analyze various diagnostic tools, including Gene Xpert, for the management of tuberculosis of the spine. Aim of study: The aim of this study was to analyze various diagnostic tools for the management of tuberculosis of the spine, particularly the use of Gene Xpert, and to compare it with other diagnostic tools. Inclusion criteria: All cases which had at least one positive test out of Gene Xpert, smear, culture sensitivity and histopathology Exclusion criteria: All cases which tested negative for Gene Xpert, smear, culture sensitivity and histopathology Materials and methods: A Retrospective study done at Dr. R. N. Cooper Municipal General Hospital and HBT Medical College. Data collected from January 2018 to January 2020 on 2-year follow-up was available for 31 cases. Results: Among the cases in which Gene Xpert was used, the sensitivity for the detection of Mycobacterium tuberculosis was 77% (24/31). Moreover, the sensitivity of Gene Xpert to detect rifampicin resistance was 100% (31/31) in our study. In 11 of the 31 patients (35%), diagnosis was confirmed on the basis of a culture. All 31 (100%) patients exhibited a typical magnetic resonance imaging (MRI) picture. Among the 31 patients, 14 patients underwent biopsy, in 21 patients, diagnosis was confirmed on the basis of histopathology (67%). Smear microscopy was positive in 38% (12/31) of the patients. ESR was raised in 80% of the patients and CRP was reactive in 58% of the patients. TestSensitivity Gene Expert 77% Histopathology 67% Smear Microscopy 38% Culture 35%Conclusions: Gene Xpert is a rapid and highly sensitive tool to diagnose tuberculosis and rifampicin resistance in patients with tuberculosis of the spine. Furthermore, we achieved a 77% sensitivity for the detection of Mycobacterium tuberculosis and 100% sensitivity for the detection of rifampicin resistance in our study.