BackgroundFlexible intramedullary nailing has emerged as an accepted procedure for paediatric femoral fractures. Present indications include all patients with femoral shaft fractures and open physis. Despite its excellent reported results, orthopaedic surgeons remain divided in opinion regarding its usefulness and the best material used for nails. We thus undertook a retrospective study of paediatric femoral fractures treated with titanium or stainless steel flexible nails at our institute with a minimum of 5 years follow up.Material and methodsWe included 73 femoral shaft fractures in 69 patients treated with retrograde flexible intramedullary nailing with a minimum follow up of 5 years. Final limb length discrepancy and any angular or rotational deformities were determined.ResultsMean age at final follow up was 15.5 years (10-21 years). Mean follow up was 7.16 years (5.0-8.6 years). Titanium and stainless steel nails were used in 43 and 30 cases respectively. There were 51 midshaft, 17 proximal, and 5 distal fractures.All fractures united at an average of 11 weeks but asymptomatic malalignment and LLD were seen in 19% and 58% fractures respectively. LLD ranged from -3 cm to 1.5 cm. Other complications included superficial infection(2), proximal migration of nail(3), irritation at nail insertion site(5) and penetration of femoral neck with nail tip(1). There were 59 excellent, 10 satisfactory and 4 poor results.ConclusionFlexible intramedullary nailing is reliable and safe for treating paediatric femoral shaft fractures. It is relatively free of serious complications despite asymptomatic malalignment and LLD in significant percentage of fractures.

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Background: Fracture of the zygomatic bone is a frequent maxillofacial trauma, due to its distinction which influences it to bear the brunt of facial trauma but its pattern seems to vary geographically. This study was planned to find out etiologies of zygomatic bone fracture at a tertiary care hospital of South Punjab, Pakistan.Methods: This descriptive observational study was conducted at The Department of Oral and Dental Surgery, Shaikh zayed Medical College Hospital Rahim Yar Khan, Pakistan, from July December 2017. A total of 114 patients with isolated tripod zygomatic bone fracture were enrolled. Demographic characteristics of the patients along with etiologies of zygomatic bone fracture were recorded.Results: Out of a total of 114 patients having zygomatic bone fractures, there were 85 (74.6%) male. Majority of the patients, 58 (50.9%) were aged between 21 to 30 years, 78 (68.4%) belonged to rural areas, 42 (36.8%) laborers while socio-economic class of 66 (57.9%) patients was recorded to be middle income. Road traffic accidents were the commonest, seen among 48 (42.1%) patients followed by inter-personal violence and falls, noted among 26 (22.8%) and 17 (14.9%) patients respectively.Conclusions: Zygomatic bone fractures were most commonly seen among male gender and young age groups. Road traffic accidents and inter-personal violence were the most commonly noted etiologies in the present study.

Background: The pathologies associated with impacted maxillary canine tooth presented as radiolucent, radiopaque and mixed radiolucent radiopaque lesions on radiographs and adenomatoid odontogenic tumor was the most common pathology associated with it followed by dentigerous cyst, odontoma and calcifying odontogenic cyst after histopathological confirmation. This study was planned to determine the frequency of pathologies associated with impacted maxillary canine tooth in patients presenting at a tertiary care hospital.Methods: This cross-sectional survey was conducted at Dental / Oral Surgery Department, Shaikh Zayed Medical College / Hospital, Rahim Yar Khan, Pakistan from January to December 2017. A total of 60 patients with clinical and radiographic diagnosis of impacted maxillary canine tooth were enrolled. Orthopantomogram and/or para nasal sinus view were considered as the standard radiograph for assessment of pathologies associated with impacted maxillary canine tooth which were confirmed by histopathological examination. Demographics and radiographic findings and histopathological confirmation of pathologies were noted.Results: Out of a total of 60 patients, 38 (63.33%) pathologies associated with impacted maxillary canine presented as radiolucent lesion, 11 (18.33%) each presented as radiopaque and mixed radiolucent radiopaque lesion. Adenomatoid odontogenic tumor (30%) was the most common pathology associated with impacted maxillary canine tooth. The other pathologies associated were dentigerous cyst (26.67%), odontoma (18.33%), calcifying odontogenic cyst (11.66%), calcifying odontogenic cyst with an odonotoma (6.66%), Odontogenic keratocyst (3.33%) and Ameloblastoma (3.33%).Conclusions: The most common pathology occurring predominantly with impacted maxillary canine tooth was adenomatoid odontogenic tumor followed by dentigerous cyst, odontoma and calcifying odontogenic cyst.