Twenty-one years ago, a 47-year-old male suffered from back pain for 7 months then developed disc herniation at L4-L5, L5-S1 level. Patient underwent open discectomy and recovered gradually. Five years after operation, patient developed mild back pain with numbness over L5-S1 sensory area of right foot and found to be developed retrolisthesis via MRI analysis. Retrolisthesis is a rare condition, and this case was chosen as case report due to its unusual presentation where it can develop as complication of lumbar disc surgery.
Spindle cells named on the basis of their appearance under microscopy are found in both healthy tissues and tumors. Spindle cells look long and slender shaped cells on microscopy. Extra abdominal Fibromatosis is common in patients between puberty and 40 years of age group with female predominance. A 15 years old male admitted with complain of pain and swelling in his right arm for 1.5 years without any history of antecedent trauma. Swelling was insidious in onset and gradually progressed to become the size of about 8 *6 cm.
MRI of right arm showed lobulated altered signal intensity lesion of size 63*41*84mm (AP*TR*CC) in lateral aspect of mid arm involving deltoid and triceps muscle with few enlarged lymph nodes. PET CT was suggestive of FDG avid soft tissue density in the lateral aspect of right mid arm involving mid arm muscles sparing the underlying bone and overlying skin with ipsilateral axillary lymph nodes involvement.
Using posterior lateral approach to arm wide excision of the tumor done protecting the radial nerve. Postoperative follow-ups showed no neurological deficit in upper limb.
The free fibular bone graft constitutes one of the surgical options in the filling of the loss of bone substances after tumor resection on long bones in young patients followed for cancer with single or multiple metastasis. The lack of vascular supply of fibular grafts could be one of the non-union factors that characterize the failures observed after their placement in bone reconstructions of more than 6 cm. We report in our observation the limits of the non-vascularized fibular bone graft after excision and bone reconstruction of a loss of substance in the treatment of a pathological fracture of the humerus in a 47-year-old patient followed for mammary carcinoma; and also insisting on the urgent need to perform a biopsy for any lesions suspected of metastasis in a patient followed for cancer so as not to overlook a benign or malignant tumor which may turn out to be more aggressive than the known tumor.
Aim: To study the comparative effects of conventional vs. conventional and scapula rehabilitation protocol on pain, position of scapula and function in shoulder dysfunction patients over 3 weeks.
Study design: Randomized control trial, double blinded.
Place and duration of Study: Musculoskeletal OPD at K.J. Somaiya College of Physiotherapy, Mumbai, and the community setting, 18 months.
Methodology: The study was conducted on 31 participants (15male,16females) in the age group of 40-65 years (mean age- 50.48 +6.62). The patients were divided into two groups Group A (conventional) and Group B (conventional+ scapula rehabilitation) using random table number. Visual analogue scale, Lennie test and SPADI were used as outcome measures. Outcome measures assessed pre intervention and post 3weeks (9 sessions).
Results: Total 31 samples were recruited and allocated into 2 groups by random number table. The average age of the patients was 50.48 (+6.62) with 56% females and 44% males. P value of less than 0.05 was considered statistically significant VAS (P= 0.6827), Lennie (1H P= 0.9510, 2H P= 0.2431, 3H P= 0.6127, V P= 0.6490) and SPADI (P= 0.7825) were found to be not significant between the two groups. Within the group, for Group A, VAS (P= 0.0003) and SPADI (P= 0.002) were all significant. For Group B, VAS (P< 0.0001), Lennie (1H P= 0.0454 and 3H P> 0.0313) and SPADI (P= 0.0001) were significant.
Conclusion: Conventional and scapula rehabilitation protocols, both have an effect on pain and function in older adults.
Clavicle fractures make 2 to 5 % of skeletal injuries; in adult age group. While treating fractures of clavicle, primary aim is to restore the shoulder activity to status before the injury; and guide towards healing with minimal residual deformity; with minimal pain and near normal shoulder range of movements. The study was conducted at Krishna Institute of Medical Sciences, Karad, over a period of 40 months; in 100 patients.