A rare case of plasma cell osteomyelitis with atypical presentation

Plasma cell osteomyelitis is an uncommon type of localized chronic osteomyelitis which is characterized by the absence of typical clinical features of infection. It usually affects the metaphysis of long bones and presents as dense thickening of bone without sequestrum formation. We present an atypical case of plasma cell osteomyelitis with a lesion in the diaphysis of long bone and sequestrum formation. A 23 year old male patient came to our OPD with complaint of pain in mid-thigh radiating to the left knee since 2 months. X-ray showed radiolucencies in the medulla of middle third of shaft of femur along with a linear sequestrum suggestive of chronic osteomyelitis. An open biopsy was performed and surgical curettage was done. Histopathological examination was consistent with plasma cell osteomyelitis. Chronic plasma cell osteomyelitis is a rare condition with nonspecific findings and an unclear cause. Histopathology is the definitive tool for obtaining a diagnosis. Knowledge of this condition and proper management can give a better outcome, at the same time avoiding unnecessary investigations and procedures

Operative stabilisation versus non-operative management of mid-shaft clavicle fractures

Introduction: Fractures of the mid-shaft clavicle are commonly encountered in clinical practice. These can be managed either by conservative method or operative by internal fixation. This study aims to compare the outcomes of conservative and operative management. Methods: Forty patients with displaced and comminuted mid-shaft clavicle fractures were included in the study, among which twenty-five patients were treated conservatively and 15 patients underwent surgery and were followed up for a period of 1 year. Time taken for union, functional outcome, complications, and patient satisfaction were compared. Results: In the non-operative group, 28% of the fractures took less than twelve weeks to unite, whereas in the operative group 60% of them took less than 12 weeks to unite. At the end of 1 year, there was no statistical difference in mean UCLA (University of California and Los Angeles) score and the mean DASH score of the non-operative group and operative group. There were more complications in the operative group. Re-operative rate in the operative group was 40%. Patient satisfaction was 80% in the non-operative group, whereas 48% of patients were satisfied in the operative group. Conclusion: Displaced and comminuted mid-shaft clavicle fractures treated conservatively have more advantages when compared to surgically treated fractures