A Rare Case of Simultaneous Acute Bilateral Quadriceps Tendon Rupture and Unilateral Achilles Tendon Rupture.

INTRODUCTION: There have been multiple reported cases of bilateral quadriceps tendon ruptures (QTR) in the literature. These injuries frequently associated with delayed diagnosis, which results in delayed surgical treatment. In very unusual cases, bilateral QTRs can be associated with other simultaneous tendon ruptures. CASE REPORT: We present a rare case of bilateral QTR with a simultaneous Achilles Tendon Rupture involving a 31 years old Caucasian man who is a semi-professional body builder taking anabolic steroids. To date bilateral QTR with additional TA rupture has only been reported once in the literature and to our knowledge this is the first reported case of bilateral QTR and simultaneous TA rupture in a young, fit and healthy individual. CONCLUSION: The diagnosis of bilateral QTR alone can sometimes be challenging and the possibility of even further tendon injuries should be carefully assessed. A delay in diagnosis could result in delay in treatment and potentially worse outcome for the patient.

Anterior Segmental Distraction Osteogenesis in the Hypoplastic Cleft Maxilla: Report of five cases.

Orthognathic surgery and distraction osteogenesis play a prime role in the correction of maxillary hypoplasia in patients with cleft lip and palate (CLP). Advancement of the anterior maxilla alone without interfering with the velopharyngeal sphincter may be advantageous in cleft patients, who more commonly have speech deficits and dental crowding. We present a case series of anterior maxillary segmental distraction for maxillary hypoplasia in 5 CLP patients with a one-year follow-up. A custom-made tooth-borne distraction device with a hyrax screw positioned anteroposteriorly was used. The evaluation comprised of hard and soft tissue analysis and speech assessment. A stable occlusion with positive overjet and correction of dental-crowding without extraction was achieved at one year post-distraction. Facial profile and lip support improved. There was no deterioration in speech.

Prosthesis survivorship and clinical outcome of the Austin Moore hemiarthroplasty: An 8-year mean follow-up of a consecutive series of 500 patients.

The results of a consecutive series of 500 patients treated with Austin Moore hemiarthroplasty prosthesis are reported. The range of follow-up was from 5-12 years and the mean was 8 years. Only 10 patients were lost to follow-up and 398 (81%) patients died within the follow-up period. The mean age of the patient population was 82 years, and 85% were women. The cumulative survivorship of the prosthesis was calculated at 94% (95% CI 90-96%) at 5 years and 83% (95% CI 65-94%) at 12 years. A total of 66 secondary operations of any type were required in 46 (9%) patients. Revision of the Austin Moore prosthesis was performed in 23 cases (5%). Of the long-term survivors contacted for follow-up, 66 (81%) had no pain or minimal pain, whilst 5 (6%) reported constant pain in the hip. The revision rates in our series were higher for younger patients, those from their own home and with good pre-fracture mobility and mental function. For the frail elderly with a displaced intracapsular fracture this prosthesis can still be recommended. This paper presents the largest consecutive series, with the longest follow-up, currently available.

CT-Cephalometry-A study in Indian population.

Determination of obstructive site in obstructive sleep apnoea (OSA) is of paramount importance is planning the management. Cephalometric evaluation of lateral X-rays when combined with clinical assessment and fibreoptic examination of the airway helps in locating the site of obstruction. The usual technique of cephalometry has been modified so as to give a better delineation of the soft tissues. Holding a 2mm card board in the mouth and using barium paste helped in more accurate calculations. Using our technique, various parameters have been quantified and a number of controls were studied and normal range derived. Further improvement in cephalometry has been done by using C.T. cephlometry topogram technique. A topogram is a scan done on a running table top cranio-caudally. Using the topogram technique 38 OSA patients were evaluated for all the parameters. The technique, its advantages over traditional cephalometry and the values obtained in the study are discussed in this paper.