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1.  Comment on Xu et al.: A retrospective study of posterior malleolus fractures 
International Orthopaedics  2013;37(5):993-994.
PMCID: PMC3631486  PMID: 23340675
2.  Sprengel’s shoulder treated by the Woodward procedure: analysis of factors affecting functional and cosmetic outcome 
To report the functional and cosmetic results of cases with Sprengel’s shoulder who underwent the Woodward procedure.
Materials and methods
Twelve children were operated at a mean age of 5.58 years and reviewed at an average follow up of 31.83 months.
The mean preoperative Cavendish grade for cosmetic evaluation was 3.17, which decreased to 1.25 postoperatively (statistically significant, p < 0.0005, Wilcoxon signed-rank test). Similarly, the range of abduction at the shoulder increased from a mean of 115.83° preoperatively to 153.33° at final review (p < 0.0005). Age had a negative correlation with both functional improvement (r = −0.55, Spearman correlation coefficient) and cosmetic improvement (r = −0.11), although the latter suggested a very weak association, if any. Cavendish grade improvement and increase in abduction had a strong positive association (r = 0.713). However, there was no correlation between the increase in abduction and lowering of the scapula achieved (r = 0.131). The presence of an omovertebral bar did not affect the final functional outcome, nor did the presence of associated congenital anomalies.
The Woodward procedure is a reliable method for obtaining uniformly predictable results in Sprengel’s shoulder. The surgery should be performed at a younger age in order to optimise the functional outcome.
PMCID: PMC3425699  PMID: 23904895
Sprengel’s shoulder; Woodward procedure; Scapula; Congenital
3.  Pucker sign in proximal humeral fractures: implications on management 
Fracture of the surgical neck of humerus in young patients is a relatively rare injury. We reviewed the available material on the topic and identified puckering at the shoulder in high-energy fracture of the surgical neck as a finding which has been reported infrequently but signifies a need for open reduction. We present a review of the literature on the subject and our similar experience in two young males who had puckering and ecchymosis at the shoulder.
PMCID: PMC3732668  PMID: 23737123
Surgical neck humerus fracture; Puckering; Dimpling; Buttonholing; Open reduction
4.  Osteochondritis dessicans of the talus in a 26-year-old woman 
BMJ Case Reports  2009;2009:bcr06.2008.0091.
PMCID: PMC3028610  PMID: 21686937
5.  Iatrogenic ulnar nerve injury resulting from a venous cut down procedure 
BMJ Case Reports  2008;2008:bcr0620080264.
We present a case of an iatrogenic left ulnar nerve injury caused during the basilic vein cut down in a 25-year-old woman presenting with a ruptured ectopic pregnancy and requiring an emergency laparotomy. Two months after her discharge from the hospital, the patient presented to the hand surgery clinic with a weak grip strength and paraesthesias in the left hand, diagnosed to be resulting from a deficient ulnar nerve function. Surgical exploration of the nerve showed a complete section of the nerve. End to end repair and anterior transposition of the nerve was done. At 10 months follow up, the patient showed recovery in the flexor digitorum profundus and flexor carpi ulnaris, thus partially improving the grip strength. The patient was still under follow-up at the time this report was prepared.
PMCID: PMC3124750  PMID: 21716827
6.  Results of operative treatment of acetabular fractures from the Third World—how local factors affect the outcome 
International Orthopaedics  2007;33(2):347-352.
The objective of this study was to assess the outcome of operations on acetabular fractures from a developing country in the presence of locally available facilities. Sixty-three acetabular fractures were assessed at an average follow up of 52.94 months after operation. Twenty-six patients operated upon in the first three years and 37 operated thereafter were separately studied to discover the effect of the learning curve. Regarding the fractures, 47 of 63 (74.6%) had excellent/good results (Harris Hip Score>80). The complications included broken drill bit in eight patients (12.69%), deep infection and heterotopic ossification in five patients (7.93%), avascular necrosis and sciatic nerve palsy in two patients (3.17%) and implant failure in one patient (1.58%). The results collected during the learning curve were inferior in the complex fractures (p value<0.001). Complications were common in patients opting for local implants and in those operated after over 2 weeks delay.
PMCID: PMC2899060  PMID: 17940767

Results 1-6 (6)