Tahir Ansari

Giant cell tumour of tendon sheath with simultaneous two tendon involvement of the foot treated with excision of the tumour and reconstruction of the flexor retinaculum using tibialis posterior tendon in a paediatric patient: A rare case report

Giant cell tumour of tendon sheath is a benign soft tissue tumour arising from the tendon sheath. The involvement of foot and ankle by such tumours is relatively rare. Children are not commonly afflicted by this condition. All such tumours are reported to arise either from a single tendon sheath or one joint. We report a case of giant cell tumour of tendon sheath in a 12-year-old child, arising simultaneously from the tendon sheaths of tibialis posterior and flexor digitorum longus tendons, as well as extending into the ankle joint. It was treated by complete excision of the mass along with the tendon sheaths with reconstruction of the flexor retinaculum. The location of the tumour, age of the patient, diffuse nature of the tumour and novel technique of reconstruction of the flexor retinaculum make this case extremely rare and the first to be reported in literature.

Instrument fails, but surgeon should not. Surgical techniques for retrieval of broken intramedullary reamer from tibia

Intramedullary interlocking nail has become standard mode of treatment for fracture of long bones of leg. Where instrumentations, like flexible reamers, are restraint, it can be sufficed with serial reaming with straight reamer. However, straight reamer makes the surgery difficult at times, because it has a tendency to break. We encountered a similar situation and would like to share how we retrieved the broken piece of straight reamer from the medullary canal.

Use of ring fixator in the management of degloving injuries of lower limb

High-velocity trauma causes degloving injuries of extremities. Management depends upon the viability of the degloved flap. The degloved area must be covered either with flaps or with split skin grafts. Various methods have been described to provide skin coverage. However, graft uptake depends upon the surgical expertise, graft quality, graft bed circulation and of course immobilization of the grafted area, especially across joints. We describe here a simple technique, which eventually helps graft bed preparation, eases application of graft tissue, facilitates graft care and allows passive mobilization of joints as well.

Sudden peroneal nerve palsy in an osteoarthritic knee: a case report

Peroneal nerve injuries have been reported in association with various causes around the knee such as traumatic varus injury, traumatic dislocation, upper tibial osteotomy, knee arthroscopy and total knee arthroplasty. Two instances of varus arthritic knee associated with a peroneal nerve palsy have been reported so far. One presented with gradual onset peroneal nerve palsy that recovered with time and the other with sudden onset peroneal nerve palsy that did not recover. We describe the case of a 63-year-old man who presented with a symptomatic varus arthritic knee and sudden onset peroneal nerve palsy with synovial cysts over the lateral aspect of the knee. We performed a total knee arthroplasty with decompression of the synovial cyst in the same patient. Three months following the surgery the patient was walking pain free with a completely recovered nerve palsy.

The extremes in orthopaedics! Whom to blame?

Traditional medicines especially the herbal paste is routinely prescribed by the herb sellers. The unsupervised combinations and preparations are easily available in our part of world. The demand and supply of such irrational combination is only based on the principle that anything natural is safe. Drugs and preparations made by the people who lack the scientific knowledge of traditional herbal medicines adversely affect the consumer. We put forward few complications that resulted after herbal paste application in those who already had visited the specialist but opted the easily available unsupervised herbal preparations.

Why we still punish school kids

Musculoskeletal injuries in children who were punished in school are unusual injuries. Literature is tacit about such injuries. Manners of punishment differ across the globe but none results in physical harm, culminating in musculoskeletal injuries. We report one such injury where school child was punished keeping an ink pen in between index and middle finger and pressing them thereafter, which resulted in a type II epiphyseal injury of proximal phalynx of index finger.