Sequential tendon ruptures in ochronosis: case report

Alkaptonuria is a rare autosomal recessive disorder characterised by the absence of homogentisic acid oxidase, due to deficiency of an enzyme that degrades HGA in the tyrosine degradation pathway. Homogentisic acid (HGA) and its metabolites accumulate in the connective tissues leading to dark pigmentation of connective tissue in patients with alkaptonuria. HGA deposits in connective tissue causes weakness of the tendon and subsequent rupture, especially the large tendons in the body. Only few cases are reported in the literature with multiple tendon rupture but many case reports are available with isolated rupture of tendons. We report on a patient with sequential tendon ruptures in a patient. The case is reported for its rarity

Extensor indicis proprius to extensor pollicis longus transfer in spontaneous rupture of extensor pollicis longus following non displaced fracture distal end radius

Exact incidence of extensor pollicis longus (EPL) ruptures following distal radius fracture is not known. Peculiarly it’s common in nondisplaced fracture of the distal radius with an incidence of EPL rupture of 0.2-5%. Cortical irregularities from distal radius fractures or osteophytes easily abrade the tendon, causing gradual attrition and ultimately rupture. Compromised blood supply is also related to EPL rupture which is supported by microcirculatory anatomic studies. We present a case of 49 year old female who presented with spontaneous rupture of the EPL following a nondisplaced fracture of the distal radius managed by extensor indicis proprius (EIP) transfer. EIP transfer gives promising outcome. Optimum tension of the tendon is crucial for good functional outcome. We recommend suturing the tendon with thumb in extension and wrist in neutral position for optimum tension of tendon to avoid extensor lag and to prevent loss of IP flexion

Challenges and outcome of total hip arthroplasty in patients with developmental dysplasia of the hip: a clinical series with a spectrum of disease manifestation and technical notes

Patients with developmental dysplasia of hip eventually lead on to secondary osteoarthritis in adulthood and may end up with total hip arthroplasty at a younger age. Because of the altered anatomy of dysplastic hips, total hip arthroplasty in these patients is a technically demanding procedure. Altered anatomy of the acetabulum and proximal femur together with leg length discrepancy pose challenges during total hip arthroplasty. Since the majority of the patients are in the younger age group, soft tissue balance is of great importance to maximise postoperative functional result and longevity of prosthesis. In this paper, we present a series of our patients with a spectrum of disease manifestation from mild to severe form and also discuss the associated challenges and the technical solutions and their outcome

Simple and effective method to protect from toxic fumes of methyl methacrylate (bone cement) in operation theatre

Methyl methacrylate is a monomer of acrylic resin widely used in a variety of medical, dental, and industrial applications. Its extensive use in surgery, particularly for arthroplasties, has often raised concerns regarding potential human toxicity for orthopaedic surgeons, surgical nurses, and other operating-room staff who are occupationally exposed to the compound

Challenges and outcome of total hip arthroplasty in patients with developmental dysplasia of the hip: a clinical series with a spectrum of disease manifestation and technical notes

Patients with developmental dysplasia of hip eventually lead on to secondary osteoarthritis in adulthood and may end up with total hip arthroplasty at a younger age. Because of the altered anatomy of dysplastic hips, total hip arthroplasty in these patients is a technically demanding procedure. Altered anatomy of the acetabulum and proximal femur together with leg length discrepancy pose challenges during total hip arthroplasty. Since the majority of the patients are in the younger age group, soft tissue balance is of great importance to maximise postoperative functional result and longevity of prosthesis. In this paper, we present a series of our patients with a spectrum of disease manifestation from mild to severe form and also discuss the associated challenges and the technical solutions and their outcome