Fibular on-lay graft in the management of radial giant cell tumour--a case report

The management of bone loss following tumour resection poses a problem particularly in the upper limb where limb preservation is paramount. For bone loss less than 6cm, nonvascularized fibular graft has been advocated whereas in bone defects larger than this, vascularized fibular graft is the preferred option. In this case study, we have used a nonvascularized fibular on-lay graft (supplemented with cancellous bone graft) in the management of a distal radial bone loss of ten centimeters following resection of a giant cell tumour with remarkable success.

Spontaneous pubic symphysial diastasis following vaginal delivery

Public symphysis diastasis is an uncommon condition which is caused mostly by severe trauma like road traffic accidents and fall from heights. We present cases of pubic symphysis diastasis following spontaneous vaginal delivery. This is to reiterate the fact that this type of public symphysis diastasis is different from other types of traumatic pubic symphysis diastasis and can be managed successfully with absolute bed rest.

Acute calcific tendinitis simulating tendon sheath infection

Tendon sheath infection has catastrophic consequences if not diagnosed. We present acute calcific tendinitis, a simulator of tendon sheath infection with a good prognosis in a 14 year old athletic tennis player.

Report on the 2nd symposium of the International Cartilage Repair Society

The articular cartilage is a unique tissue and a functional articular cartilage is critical to proper joint function. The inability of the articular cartilage to heal traumatic defects with a similar quality tissue has been appreciated since the time of hippocrates. Although a variety of surgical procedures have been developed over the past 50 years in attempt to overcome this treatment challenge, none has been successful in achieving regeneration of normal articular cartilage. It is these treatment challenges that form the reasoning behind the formation of the International Cartilage Repair Society (ICRS) and her 2nd annual symposium is presented.

Ceftriaxone-PMMA beads--a slow release preparation?

The use of various drug delivery systems to achieve high levels of the desired antibiotic(s) at the site of infection has become commonplace in orthopaedic and trauma units the world over. One of these techniques uses the implantation of antibiotic-impregnated beads at operation sites. Commercial antibiotic beads such as the gentamicin bead are available but expensive, especially for patients in developing countries. We have shown that ceftriaxone-polymethylmethacrylate beads can be produced locally and at low cost in a resource-poor environment. We have also shown that such beads elute the antibiotic (ceftriaxone) effectively in vitro, achieving similar or better activity when measured by zones of inhibition against various bacteria species compared with standard antibiotic discs. This technique offers a cost-effective method of treating chronic bone infections in resource-poor settings.

An investigation of the frequency of co-existence of osteophytes and circumscribed full thickness articular surface defects in the knee joint

Osteophytes are osteochondral repair tissues formed usually at the margins of synovial joints in response to a more central full thickness articular cartilage defect. These defects can be managed using the autologous chondrocytes implantation technique or with composite osteochondral grafting. Materials for osteochondral grafting of circumscribed full thickness articular surface defects may be obtained from osteophytes. In this study, the frequency of co-existence of these two intra-articular lesions was studied prospectively in patients undergoing therapeutic arthroscopy for painful knee conditions. Thirty-three of 88 knees (37.5%) had full thickness articular surface defects and 23 of these (69.7%) had associated osteophytes formation.

Primary hyperparathyroidism as a cause of multiple long bone fractures in a young Nigerian adult

Primary hyperparathyroidism is a recognized though relatively rare cause of multiple limbs fractures. We report a case in a young Nigerian adult. It is emphasize that primary hyperparathyroidism may be asymptomatic and therefore under-recognized in this environment because it is very uncommon.

A review of 100 cases of supracondylar fractures in children seen in Ibadan

Supracondylar fracture of the humerus in children is one of the commonest fractures in children of school age all over the world. The experience of the mode of presentation, mechanism of injury and the different modalities of treatment in the University College Hospital, Ibadan is presented. The results suggest that severely displaced supracondylar fractures in this environment are better managed with open reduction and internal fixation.

Intra-operative antibiotic bead maker--point of technique

Chronic osteomyelitis is a disease of soft tissue and bone and it is common in the developing countries. The management of this debilitating disease requires the delivery of the appropriate chemotherapeutic agent at the site of the infection after adequate debridement. The search for a suitable carrier for these chemotherapeutic agents is the advent of the 'septopal' or gentamycin-polymethylmethacrylate (gentamycin-PMMA) beads. Septopal beads are expensive and are not affordable by patients in the developing countries. Moreover, most of the micro-organisms (mixed flora) responsible for chronic osteomyelitis in our hospitals are sensitive to ceftriaxone and only in a few cases were gentamycin-sensitive micro-organisms isolated. Therefore, it was imperative that patient-specific and antibiotic-specific PMMA beads would be the way forward and this is the reasoning behind the production of the intra-operative antibiotic bead maker (IABM) and the point of technique is hereby presented.