Femoral nailing is the overall “gold standard” in
treating femoral shaft fractures. However, plate
osteosynthesis at the femoral shaft is still being done
in selected patients. We report a case of right femoral
implant failure after a broad limited contact dynamic
compression plate (LC-DCP) insertion and its
subsequent management using our minimally invasive
technique. Our technique is biologically compliant
as well as cosmetically friendly. We converted a loadbearing
implant into a load-sharing implant in view that
obesity is a significant predictive factor of non-union in a
femoral fracture treated with locking plate. The patient
subsequently recovered well with no complication.
Multiple carpometacarpal joint (CMCJ) dislocations are rare and are easily missed. The anatomical configuration renders stability to the joints. As a result, a high-velocity impact is required to dislocate the joint. We present two cases of multiple carpometacarpal joint dislocations with different mechanisms of injury and their subsequent management at our centre. In case 1, a 29-year-old gentleman presented with acute dislocations of the CMCJs involving the right middle, ring, and little fingers. An open reduction and fixation with Kirschner wires were done to stabilize the dislocated CMCJs and he subsequently recovered. In case 2, a 25-year-old gentleman had the CMCJ dislocations detected late due to other more profound injuries. Partial arthrodesis was performed to address the instability of the CMCJs of the right index, middle and ring fingers. He subsequently recovered and returned to work 6-months postoperatively. The diagnosis of carpometacarpal joint dislocation can be easily missed especially when there is a concurrent distracting injury. It is crucial to maintain a high index of suspicion as early diagnosis and prompt treatment is paramount to yield a better outcome
Marjolin’s ulcer is a malignant cutaneous ulcer
that undergoes transformation from a previously
traumatized or chronically inflammed skin.1 Causes
leading to ulcerations can be burn injury, trauma,
chronic osteomyelitis and varicose ulcers.2 It is named
after a French surgeon, Jean Nicolas Marjolin, who
first described the condition in patients who developed
malignant ulcers from burn scars.3 We report a case of
a chronic non-healing foot ulcer that has become a
Marjolin’s ulcer after 12 years. (Copied from article).
Cervical spine injury is commonly associated with
road-traffic accidents. The true incidence of cervical
spine injuries is unknown due to under-reporting of
such injuries. Cervical spine injury is associated with
high morbidity and mortality if it is missed. With the
advancement of imaging modalities, the number of
missed cervical injuries has reduced. Nevertheless, some
clinicians are dependent solely on imaging tools to rule
out cervical spine injury in a trauma victim. We report
two cases of “near miss” C6 fracture to highlight the
importance of a detailed clinical history and clinical
examination with imaging as an adjunct to rule out
cervical injury.