Cervical corpectomy in delayed presentation of irreducible cervical dislocation: experience with eight cases.

OBJECTIVE: To describe a single-staged procedure for the management of neglected subaxial cervical spine injuries. METHODS: Between January 2012 and December 2014, 12 patients presented to us with healed cervical sub axial dislocations. The deformities could not be reduced using skull traction. Eight were operated with anterior cervical corpectomy. American spinal injury Association (ASIA) grade, Neck Disability index (NDI), and Visual analog scale (VAS) score were recorded throughout the patient course and CT was done at 12 months for assessment of fusion. RESULTS: Four patients improved from ASIA C to ASIA D, two patients improved from ASIA B to ASIA E, one patient improved from ASIA D to ASIA E and one patient remained static at ASIA B. All patients except one showed evidence of fusion on CT scan at 12 months. NDI improved from preoperative range (18-32, mean 25) to postoperative range (8-16 mean, 11.25), VAS from preoperative range (3-6, mean 4.25) to postoperative range (1-3, mean 1.75). CONCLUSIONS: Single-stage in situ fixation does not disrupt ongoing natural healing and has good clinical and radiological outcomes.

Pathodynamics.

Osteoporosis and osteoporosis-related fractures in the aging population are becoming a health care problem and a burden on health service resources available. Osteoporosis is a systemic skeletal disorder that results from an imbalance in bone remodeling, leading to a reduction in bone strength with microarchitectural disruption and skeletal fragility, increasing fracture susceptibility. Osteoporosis is considered a well-known metabolic bone disorder. Although its prevalence is more commonly seen in women than men, it is eventually seen in both genders. In the elderly population, there is an increase in disability and mortality due to osteoporotic fractures.

Pathological Fracture of the Tibia in a Monostotic Anterior Cortical Fibrous Dysplasia: Hybrid Fixation with UnicorticalOsteoperiosteal Non-Vascularized Fibula Graft - A Case Report.

INTRODUCTION: Fibrous Dysplasia is a relatively rare Musculoskeletal disorders in which there is a defect in remodelling of immature bone to mature lamellar bone. Fibrous Dysplasia was first described by Von Recklinghausen in 1891, but it was Lichtenstein who labelled it polyostotic Fibrous Dysplasia in 1938. Union of Pathological Fractures in a bone affected by Fibrous Dysplasia poses a difficult set of Challenges for treating Physicians. CASE REPORT: We Report a 24 year-old female patient with a Pathological Fracture of the Tibia in a Monostotic Anterior Cortical Fibrous Dysplasia Hybrid Fixation with a UnicorticalOsteoperisoteal Non Vascularized Fibula Graft with a follow up until the union of fracture site on computed tomography scan and complete integration of unicorticalosteoperiosteal fibular graft . CONCLUSION: We provide additional and independent evidence that removal of the diseased cortex which were parts of the proximal and distal fragment and reconstruction of the defect in the cortex with a press- fitunicortical Non vascularized osteoperiosteal fibular strut graft with a hybrid fixation is a good treatment modality for monostotic fibrous dysplasia. Hybrid fixation includes retrograde intramedullary transarticular rodding extending across the subtalar and ankle joint into the tibia and augmentation of the primary fixation with a mono-planar rail Fixation in compression mode.