Browsing by Author "Sharma, Niraj Kumar"
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Publication Conservative Management of Late-Onset Legg-Calvé-Perthes Disease in a 10-Year-Old Child: A Case Report(Nepal Medical Association, 2025) Banjade, Rishi Ram; Dhakal, Sandesh; Nepal, Prithu; Sharma, Niraj KumarAbstract Legg-Calvé-Perthes disease is a childhood condition characterized by avascular necrosis of the femoral head, with a poorer prognosis in children over 8 years. This case report describes a 10-year-old boy presenting with persistent left thigh pain, limp, and limited hip motion following a fall 3 months earlier. Imaging revealed osteonecrosis of the left femoral head with degenerative changes. Despite surgical intervention being the standard for late-onset LCPD, the patient was managed conservatively using bilateral skin traction and a Petrie’s cast due to financial constraints. Follow-up monthly for 6 months showed significant improvement, highlighting conservative treatment's potential in resource-limited settings.Publication Missed T8-T9 translational fracture with intact neurology: A Case report(Nepal Medical Association, 2025) Sharma, Niraj Kumar; Banjade, Rishi Ram; Pokharel, Sabin; Ghimire, SharmilaAbstract Translational fracture of the thoracic spine, though rare due to its stability, is often associated with spinal cord injury and neurological deficits. Few cases present with intact neurology. We report a case of a 28-year-old woman who, after a road traffic accident, had persistent back pain with intact neurology. The initial chest radiograph showed a subtle deformity that was missed, likely because a lateral view was not done, and the patient was discharged. Persistent back pain led to CT imaging, revealing a T8–T9 translational fracture, left 4th and 5th posterior rib fractures near the costovertebral junction, and a T7 transverse process fracture. MRI confirmed these findings. She underwent posterior instrumentation and decompression, with symptom relief, and remained asymptomatic on follow-up. Translational thoracic spine fractures, typically associated with neurological deficits, can be missed when neurology is intact. Timely imaging and intervention are crucial for optimal outcomes.