Isolated proximal tibiofibular joint dislocation in an elite rugby union player.

The case is presented of a professional international rugby union player who sustained an isolated proximal tibiofibular dislocation in a training ground injury. Diagnosis was made based on clinical details, plain radiography and magnetic resonance imaging. An initial attempt at closed reduction failed. Open reduction and internal fixation were subsequently carried out. Following early rehabilitation, the patient made a successful try-scoring return to international rugby union.

Quinolone-associated tendonitis: a potential problem in COPD?

BACKGROUND: Quinolones have traditionally had limited application in the area of community-acquired respiratory tract infections due to poor cover against Streptococcus pneumoniae. This trend is changing with the broader spectrum of newer fluoroquinolones. A rare serious side effect of fluoroquinolones is tendinopathy. AIMS: This study describes two cases of levofloxacin-associated tendinopathy in patients with severe chronic obstructive pulmonary disease (COPD) and the implications and mechanisms involved are discussed. CONCLUSIONS: The finding of two cases of levofloxacin-induced tendinopathy in our patients suggests that the problem may be more frequent than previously considered. Patients with COPD treated with fluoroquinolones may have other risk factors for tendinopathy such as advanced age, corticosteroid use and renal impairment and merit vigilance for signs of tendonitis.

Pseudoaneurysm of the profunda femoris artery due to intertrochanteric fracture of the hip.

Arterial injury caused by hip fracture is a rare event. We report a case of pseudoaneurysm of the profunda femoris artery that presented 4 weeks after correction of an intertrochanteric hip fracture with a dynamic hip screw. The diagnosis was confirmed by Duplex ultrasound scanning, and it was treated by ligation of the profunda femoris artery at the level of the pseudoaneurysm.

Fluid spaces in normal and osteomyelitic canine bone.

When cortical bone is afflicted by an infectious process, significant alterations in the physiology and anatomy occur at the cellular level. Included in these alterations are modulations of the various fluid spaces of cortical bone. Volume of distribution studies with 14C-labeled sucrose and 99Tc-labeled red blood cells in an animal model of acute, subacute, and chronic osteomyelitis of the tibia were performed to quantitate the various fluid spaces in cortical bone. Additionally, the studies were performed in cortical bone from the radius and tibiae (following sham operations) to allow comparison with normal and control values. The total exchangeable water, vascular, and interstitial fluid spaces were increased in all three types of osteomyelitic bone. With one-way analysis of variance and Duncan's multiple range test, the alterations observed in each type of osteomyelitic bone (acute, subacute, or chronic) were statistically different from those observed in normal bone (p = 0.001) and controls (p less than or equal to 0.01). The differences of the mean values observed among the three types of osteomyelitic bone were not statistically significant (p greater than 0.05). These pathophysiologic alterations in osteomyelitic bone must be considered when one studies the ability of various antimicrobials to reach bactericidal concentrations in the interstitial fluid space, the primary site of drug-microorganism interaction.

Congenital pseudarthrosis of the clavicle.

Congenital pseudarthrosis of the clavicle is a rare entity. Its aetiology and pathogenesis still remain obscure. The condition is predominantly right-sided. Differential diagnosis lies between birth fracture and cleido-cranial dysostosis. Surgery when indicted gives good results.

Fracture of the neck of the femur in childhood.

Fractures of the femoral neck in children are rare. They are commonly associated with severe complications, especially avascular necrosis of the femoral head, non-union, coxa vara and premature closure of the upper femoral epiphysis. A review of current literature and a detailed analysis of cases seen in this hospital are given. Our experience indicates that early operation using internal fixation offers the best results.