Healing of a Large Bone Defect Secondary to Tuberculosis in an Infant: A Case Report.

CASE: A 9-month-old male child presented with swelling over the distal radius that was debrided, and histopathology revealed tuberculosis. Curettage left a large bony defect in the distal radius metaphysis. The defect was not surgically addressed because near-complete spontaneous filling of the defect was seen at 3 months' follow-up. The patient was given antituberculous therapy for 12 months and had excellent outcomes at 24 months' follow-up. CONCLUSION: A large bony defect secondary to tuberculosis, in the distal radius metaphysis in an infant, regenerated spontaneously without the need for bone substitutes, bone grafting, or complex microvascular procedures.

Retro-Odontoid Pseudotumor Without Radiographic Instability with Congenital C1 Assimilation and C2-C3 Fusion: A Case Report.

CASE: The authors present a case of retro-odontoid pseudotumor (ROP) with congenital C1 assimilation and C2-C3 block vertebra without radiological instability who presented with cervical myelopathy with spastic quadriparesis. The patient was managed with occipitocervical fusion and C1 laminectomy. She had rapid neurological recovery in 3 months postoperatively and at 2 years had complete resolution of the retro-odontoid mass. CONCLUSION: C1 assimilation without apparent radiographic instability as a cause of ROP is underappreciated. This case report and review of literature highlight that C1 assimilation and C2-C3 fusion can lead to ROP even in the absence of apparent radiographic instability with posterior atlantoaxial fusion alone providing good results.

Syringobulbia in a Setting of Charcot Arthropathy of the Elbow Secondary to Syringomyelia: A Case Report.

CASE: The authors present a case of syringobulbia in a setting of elbow arthropathy due to syringomyelia. The patient had painless elbow instability with subtle neurological findings such as ulnar neuropathy, palatal palsy, and dysphonia. As she denied surgery, she was managed with physiotherapy and orthosis. At 24 months of follow-up, she had good clinical outcome without neurological or functional worsening. CONCLUSION: Many patients with neuropathic joints due to syringomyelia present to an orthopaedician before a neurologist. A high index of suspicion and thorough neurological examination is essential. Conservative management of such a joint provided good results in this patient.

Retrieval of broken bone biopsy needle from the sacroiliac joint - A case report and review of literature.

Bone biopsies whether Computed Tomography guided or open, are one of the commonest procedures undertaken. Our literature review proves that bone biopsy needle fracture in a bone is a rare complication with no literature available on a needle fracture in a joint. We report a 7-year-old male who underwent an open needle biopsy. During the procedure, the bone biopsy needle fractured with the distal 2.7 cm fragment being completely embedded in the right sacroiliac joint. Considering the location of the fragment, the standard techniques described in literature for extraction could not be applied due to intra-articular nature of the fragment and the risk of complications. We describe a method using a 2.5 mm drill bit to safely extract the foreign body. We have found that reasonable erosion of adjacent cortex, exposes the needle tip, prevents the needle from shattering and avoids further articular damage. There was an uneventful 15 months follow up. This case highlights the fact that bone biopsy procedure mandates correct technique and supervision and as far as possible a disposable pre-sterilized bone biopsy needle should be used.