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1.  Ulnar buttress arthroplasty after enbloc resection of a giant cell tumor of the distal ulna 
Indian Journal of Orthopaedics  2013;47(2):211-214.
Enbloc resection with or without ulnar stump stabilization is the recommended treatment for giant cell tumors (GCT) of the distal ulna. A few sporadic reports are available where authors have described various procedures to prevent ulnar stump instability and ulnar translation of carpal bones. We report a GCT of the distal ulna in a 43-year-old male which was resected enbloc. The distal radioulnar joint was reconstructed by fixing an iliac crest graft to the distal end of the radius (ulnar buttress arthroplasty) and the ulnar stump was stabilized with extensor carpi ulnaris tenodesis. After a followup at three years, there was no evidence of tumor recurrence or graft resorption; the patient had a normal range of movement of the wrist joint and the functional outcome was excellent as per the score of Ferracini et al.
PMCID: PMC3654475  PMID: 23682187
Distal ulna; enbloc resection; giant cell tumor; ulnar buttress arthroplasty
2.  Authors’ reply 
Indian Journal of Orthopaedics  2011;45(6):584-585.
PMCID: PMC3227371  PMID: 22144760
3.  Use of intramedullary fibular strut graft: a novel adjunct to plating in the treatment of osteoporotic humeral shaft nonunion 
International Orthopaedics  2008;33(4):1009-1014.
Humeral shaft fractures respond well to conservative treatment and unite without much problem. Since it is uncommon, there is not much discussion regarding the management of nonunion in the literature, and hence this is a challenge to the treating orthopaedic surgeon. Osteoporosis of the fractured bone and stiffness of the surrounding joints compounds the situation further. The Ilizarov fixator, locking compression plate, and vascularised fibular graft are viable options in this scenario but are technically demanding. We used a fibular strut graft for bridging the fracture site in order to enhance the pull-out strength of the screws of the dynamic compression plate. Six patients in the study had successful uneventful union of the fracture at the last follow-up. The fibula is easy to harvest and produces less graft site morbidity. None of the study patients needed additional iliac crest bone grafting. This is the largest reported series of patients with osteoporotic atrophic nonunion of humerus successfully treated solely using the combination of an intramedullary fibular strut graft and dynamic compression plate.
PMCID: PMC2898981  PMID: 18563410
4.  A novel approach to juxta-articular aggressive and recurrent giant cell tumours: resection arthrodesis using bone transport over an intramedullary nail 
International Orthopaedics  2006;31(2):179-184.
Aggressive juxta-articular giant cell tumours of the lower limbs occurring in young patients are a challenge to the average orthopaedic surgeon. Although it is the treatment of choice for these tumours, wide resection creates a problem for the reconstruction of large bone gaps. We describe our results after resection arthrodesis of such tumours using the technique of bone transport over a long intramedullary nail in 27 patients. This is the first and largest study of its kind in the management of giant cell tumours in the literature. All our patients fared well with this mode of treatment, and none had recurrence or major complications.
PMCID: PMC2267554  PMID: 16724184
5.  Ilizarov treatment of complex tibial pilon fractures 
International Orthopaedics  2006;30(2):113-117.
We treated 21 consecutive patients between 1998 and 2002 with complex tibial pilon fractures, eight type B and 13 type C, using percutaneous reduction and fixation with the small diameter Ilizarov apparatus. The average patient age was 34±5.6 years (range 28–52 years). Nine of the patients had open fractures (two type I, four type II, and three type IIIA). The patients were followed up regularly at 6-month intervals for 2 years. All fractures united. The fixator was removed at an average of 26.6±4.2 weeks (range 20–34 weeks). The average American Orthopaedic Foot and Ankle Society ankle-hind foot score was excellent in 11 patients, good in five, fair in four, and poor in one. Thirteen patients were able to squat and climb stairs.
PMCID: PMC2532070  PMID: 16435148

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