Paraplegics with spinal cord injury, independent in activities of daily living (ADL) are known to have upper limb neuropathy due to constant use for mobility and transfers. Additionally architectural barriers, disabled unfriendly public transport, diffi cult terrains and sociocultural barriers in a developing country like India, further adds strain on the upper limbs. Hence, it is important to know the effects of these increased demands in terms of prevalence of peripheral neuropathies in rehabilitated spinal cord injured population from developing countries. In this study we tried to find prevalence of upper limb neuropathy in SCI population in South India.

Patients with spinal cord injury with a neurological level T2 and below, not having any other associated complication of upper limb due to any other disease apart from SCI were recruited in the study. Total 51 patients (45 male and 6 female) out of 183 patients screened, met key inclusion criteria. All the subjects who were recruited in the study underwent electrodiagnostic studies for the median, ulnar and radial nerves (both sensory and motor). The baseline demographic parameters such as time since injury, age, sex, American Spinal Injury Association scale (AIS), vocation, comorbidities and current mode of indoor and outdoor mobility were recorded. The final diagnosis based on electrodiagnostic study of median/ulnar/radial nerve was graded in scale of 0-2 with 0 being normal, 1 being neuropathy of one hand and 2 being involvement of both the hands.

The scores from demographic data and electrodiagnostic data were accessed and categorical comparison was made between different types of mobility aids and neuropathy (CTS/ulnar/radial). The study showed an overall prevalence of 80% for median neuropathy, 24% for ulnar neuropathy and 16% for radial neuropathy. However, no statistical correlation was found between the use of any particular mobility aid, time since injury, vocation and neuropathy.

We found high prevalence of upper limb compressive neuropathy in the spinal injured population studied, however, due to the small sample size, no statistical signifi cance could be found. We also found carpal tunnel syndrome to be the commonest neuropathy amongst the population especially in the groups that use wheelchair and elbow crutches for mobility.

To identify predictors affecting total hospital length of stay(TLOS) and receiving lower limb prosthesis of amputees after surgery in a Singapore tertiary hospital.

A retrospective study of 96 patients was undertaken with various levels of lower limb amputation admitted to Singapore General Hospital (SGH) from January 2009 to December 2014. Patients were divided into two groups: 40-59 and 60 to 80 years old. We correlate clinical variables with TLOS and receiving prosthesis at 6 months from surgery.

For the cohort of age 40-59, presence of IHD (B=22.4), wound infection (B=17.8) and those needing inpatient rehabilitation(B=36.8) correlate to increased TLOS. Premorbid independence (B=28.6) and presence of care-giver (B=23.3) led to a reduction of TLOS. For successful receiving of prosthesis at 6months from surgery, diabetes (B=0.69) and CRF (B=0.31)were negative predictors. In the older cohort, presence of care-giver (B=18.6) predicted shorter TLOS whereas those needing inpatient rehabilitation contributed to longer TLOS(B=25.61). Those who needed for inpatient rehabilitation had statistically signifi cant higher chance of receiving prosthesis later(B=0.53).

IHD, wound infection and need for inpatient rehabilitation, premorbid independence and care-giver availability are important predictors of TLOS. For receiving of prosthesis at 6months, predictors include needing inpatient rehabilitation, diabetes and CRF.

Congenital muscular torticollis is a common congenital problem. It is considered to be amenable to treatment which may be conservative or surgical. There are as yet no fixed guidelines as to the methodology or the timing of treatment. It is certainly advised to be prudent in selecting the appropriate treatment which should neither be too conservative nor over-invasive. We are reporting a series of 15 cases in which we did a unipolar release of the sternocleidomastoid muscle at the lower attachment. Retrospective analysis of 15 consecutive patients is done. During the postoperative period the parents were advised to regularly continue with the stretching exercises, focus on activities on the opposite side of the face and use a semi-rigid cervical collar, specially designed for active correction of these cases. We got very satisfactory postoperative results in most of our patients except one who had resistant deformity due to advanced age. In conclusion we would like to bring the focus back to unipolar release which is shifting unduly in favour of a bipolar release. This would also reduce the chances of the complication of accessory nerve injury. We have used the scoring system developed by Cheng et al and modifi ed by Shim in which the present cases showed improvement of 7 points with p-value of less than 0.0001

Oculo-auriculovertebral spectrum (OAVS) or the Goldenhar syndrome is a rare developmental disorder with plethora of congenital anomalies which mostly affects structures arising from the first and the second branchial arches. The affected structures include cheekbone, jaws, mouth eyes, ear and vertebrae. The case which we are presenting here had classical features such as microsomia, unilateral microtia, microphthalmia and facial nerve palsy along with vertebral anomalies with additional signs as unilateral hearing loss and radial limb anomalies. OAVS with radial defect and limb abnormalities is a rare presentation and thus reported‥

Scoliosis is defined as a lateral curvature of spine greater than 10 degrees as measured by the Cobb method. Idiopathic scoliosis is the most common form of scoliosis and adolescent idiopathic scoliosis is the commonest presentation which is detected after 10 years but prior to skeletal maturity. The treatment depends on the measurement of Cobb's angle and subsequent exercises, bracing and surgery.

A 13 years girl presented with idiopatic scoliosis, pes cavus and hand knee gait which incapacitated her ambulation. Her spine radiograph revealed thoracic scoliosis with apex T8. She was given Boston brace with corrective exercises for scoliosis both in and out brace and a pair of floor reaction AFO's with modifi cations in footplate for pes cavus. There was signifi cant improvement in the gait and posture of the girl and she started going to school after a few months.

Conservative management in the form of bracing can prevent curve progression and floor reaction AFO's can indirectly affect the remote body segments and improve gait and posture.