ABSTRACT
Methicillin-resistant Staphylococcus aureus (MRSA) osteomyelitis is difficult to treat due to multidrug resistance, biofilm formation, and the need for prolonged intravenous therapy. This observational study involved 14 patients (6 chronic osteomyelitis, 8 septic non-union; age 14–78 years), all with MRSA sensitive only to vancomycin. Treatment included surgical debridement, high-dose local vancomycin via polymethylmethacrylate (PMMA) beads or coated nails, and a short intravenous vancomycin course with oral linezolid in selected cases. All patients achieved infection cure; fracture union occurred in all septic non-union cases, with no systemic toxicity. High local antibiotic delivery improved outcomes and reduced hospitalization, though PMMA required secondary removal. Dual mode vancomycin therapy appears effective for MRSA osteomyelitis and septic non-union, but larger controlled trials are needed for validation.

ABSTRACT
Giant cell tumour (GCT) of bone is a benign but locally aggressive neoplasm, frequently involving the epiphyseal region of long bones, particularly around the knee [1-3]. We report a case of GCT of the right proximal tibia in a skeletally mature patient who presented with pain and swelling. Radiological evaluation showed a well-defined expansile lytic lesion without evidence of metastasis [1-4]. The patient was managed with extended intralesional curettage using a high-speed burr, adjuvant chemical cauterisation, and defect reconstruction with polymethylmethacrylate (PMMA) bone cement [3, 4]. Post-operative recovery was uneventful, with excellent knee function and no recurrence at follow-up. Bone cement provided immediate stability, enabled early mobilisation, and facilitated detection of recurrence on imaging [4, 5]. This case highlights that extended curettage with adjuvant therapy and cement reconstruction is an effective joint-preserving technique for proximal tibial GCT, offering good functional outcomes and low recurrence rates [3–5].

ABSTRACT
Background: Transverse acetabular fractures often involve the weight-bearing dome of the acetabulum and require precise anatomical reduction for optimal functional recovery. Open reduction and internal fixation (ORIF) using the Kocher-Langenbeck approach remains a preferred method for managing such injuries. This study aimed to evaluate the functional outcomes following ORIF of transverse acetabular fractures using this posterior approach. Methods: This prospective observational study was conducted in the Department of Orthopaedic Surgery at Dhaka Medical College Hospital over 24 months from July 2017 to June 2019. A total of 25 patients aged 21–80 years with radiologically confirmed transverse or associated acetabular fractures were included. All underwent ORIF through the Kocher-Langenbeck approach within three weeks of injury. Functional outcomes were assessed using the Merle d’Aubigné and Postel scoring system at six months postoperatively. Results: The mean age of patients was 36.2 ± 14.12 years, with most (76.0%) between 20–40 years. Anatomical reduction was achieved in 80.0% of cases. At six months, 40.0% of patients had excellent, 20.0% good, 4.0% fair, and 36.0% poor outcomes. Overall, 76.0% had satisfactory outcomes. Pain-free status was observed in 76.0%, normal walking in 76.0%, and 95%–100% hip range of motion in 60.0% of patients. Functional outcome showed a significant distribution difference (p = 0.021), though not significantly associated with reduction quality (p > 0.05). Conclusion: ORIF through the Kocher-Langenbeck approach provides favorable functional outcomes in the majority of patients with transverse acetabular fractures.

ABSTRACT
This study examines the effects of diet and physical activity on the well-being of older people in Abidjan, by comparing institutional norms and real-life experiences. The aim is to analyse how these practices influence the physical, psychological and social health of older people, in a context of changing diets and unequal access to sports facilities. The triangulated qualitative approach involves semi-structured interviews with senior citizens from a variety of backgrounds, ethnographic observations in sociable spaces (markets, sports clubs, health centres) and an analysis of institutional discourse on active ageing. The results show that while certain dietary and sporting practices enhance autonomy and socialisation, economic constraints, cultural perceptions and infrastructure deficits limit their adoption. The discussion highlights the tension between globalised prescriptions and local roots. In conclusion, it appears essential to adapt public policies to the realities of the Ivory Coast in order to promote inclusive active ageing.

ABSTRACT
Background: Few studies have investigated which of the classification systems between Dimeglio and Pirani best correlates with the number of casts required to achieve clubfoot correction. This study aims to analyse the two scoring systems to determine the best in predicting number of casting sessions required for idiopathic clubfoot correction. Objectives: To determine the correlation between the Pirani and Dimeglio scoring systems with the number of casts required for correction of idiopathic clubfoot using Ponseti method of treatment. Material and Methods: This work was a 12 months prospective interventional study. 55 Patients with 94 idiopathic clubfeet who met the selection criteria and consent given by their Parent/guardian were recruited for the study. Each clubfoot was scored at presentation using the Pirani and Dimeglio scoring systems. All clubfeet were treated using the Ponseti method until correction was achieved (with or without percutaneous tenotomy). The correlation between the two scoring systems and the number of casts required to achieve correction was analysed. Results: The mean number of casts required to achieve initial correction was 4.38 (range: 2-7). There was a positive correlation between the Pirani scores at presentation (r=0.854, p=<0.001) and the Dimeglio scores at presentation (r=0.809, p=<0.001) with the number of casts required to achieve correction. Multiple linear regression analysis showed that the Pirani score at presentation significantly predicts the total number of casts better than Dimeglio scores. Conclusion: The Pirani score showed better accuracy in predicting the total number of casting sessions required for correction of idiopathic clubfoot.

ABSTRACT
Patellar fractures, which compromise the knee's extensor mechanism, are commonly encountered orthopedic injuries. Tension band wiring (TBW) is the standard approach for managing simple transverse fractures but is not without complications such as wire migration and breakage. This case report introduces a modified TBW method intended to enhance mechanical stability and mitigate common hardware-related issues. A 51-year-old woman presented with right knee pain and swelling after a fall. Radiographs showed a transverse patellar fracture. She underwent surgical fixation using a triple-bundle wire technique designed to boost construct integrity and prevent wire migration. Postoperative management involved early mobilization with continuous passive motion and gradual progression to full weight-bearing. At a three-month follow-up, the patient exhibited complete fracture healing and excellent knee function, with no implant-related issues. This modified TBW approach proved to be biomechanically stable, safe, and conducive to early recovery, warranting consideration for wider clinical application.

ABSTRACT
Background: Supracondylar fractures are the most common elbow fractures in children, with Gartland type II fractures posing treatment controversies regarding conservative casting versus operative fixation. Optimal management remains debated to achieve the best functional and radiological outcomes while minimising complications. Aim of the Study: The aim of this study was to compare conservative casting and operative treatment by K-wire in Gartland type II supracondylar fracture in children. Methods: This observational comparative study was conducted in the Department of Orthopaedics, President Abdul Hamid Medical College Hospital, Kishoreganj, Dhaka, Bangladesh from January 2024 to May 2025. This study includes 50 paediatric patients presenting with Gartland type II supracondylar fractures of the humerus. The participants were divided into two groups each containing 25 patients: Group a included patients treated with conservative casting and Group B include patients treated with K-wire fixation. Result: Excellent outcomes were observed in 64% of Group A and 80% of Group B. The operative group showed significantly better extension recovery (mean extension lag: 2.2° vs. 3.4°, p=0.01). Baumann’s angle, flexion range, and fracture union times were similar between groups. Hospital stay was significantly shorter in the conservative group. Complications differed, with loss of reduction and malunion in Group A, and pin site infections and nerve injuries in Group B. Conclusion: Both conservative casting and operative K-wire fixation are effective for Gartland type II fractures. Operative treatment showed trends towards better extension outcomes and fewer reductions lost, while conservative management effectively avoided surgical risks with reduced hospital stay.