Tuberculosis (TB) of the scapula is a very rare presentation among tuberculosis of bones and joints. The following case report describes a rare case of tuberculosis involving the inferior angle of the scapula in a young, immune-competent adult presenting with pain, swelling and an osteolytic lesion over the inferior angle of the scapula with a cold abscess. The diagnosis was confirmed on histopathology and culture, with Magnetic Resonance Imaging (MRI) acting as an adjunct to an early diagnosis. The patient was managed successfully with surgical debridement and a four-drug anti-tuberculous regimen.

The main purpose of this article is to evaluate the clinical outcomes and survivorship of cruciate-retaining (CR) knee arthroplasties for valgus deformity. This article is retrospective consecutive series of 110 valgus knees using CR implants with a minimum 2-year follow-up. Deformity correction was achieved using stepwise sequential soft tissue releases (iliotibial band, popliteus tendon, lateral collateral release through sliver femoral condylar osteotomy). Demographic data, range of movement, and degrees of deformity were collected. The Oxford Knee Score (OKS) was used as patients' reported outcome measure at final follow-up. One-hundred and four patients (110 knees) were included (87 females/17 males) with mean age of 68.7 years. Primary diagnosis was osteoarthritis in 85 patients and rheumatoid arthritis in 19 patients. Mean follow-up was 5.5 years (median: 5 years; range: 2–14 years). Preoperative valgus deformity was measured radiographically using the mechanical tibiofemoral angle with a mean 18.6° (standard deviation [SD]: 7.5; range: 11–38°). At final follow-up, mechanical tibiofemoral angle was 3.8° (SD: 1.97; range: 2–8°). A p-value was <0.0001 and mean OKS was 42 (SD: 5.4; range: 36–48) suggesting satisfactory patients' reported outcomes with no implant revision for any cause. CR implants for valgus knees using staged soft tissue releases including sliver condylar osteotomy had excellent medium-term survivorship and satisfactory patient reported outcome measures. The Level of Evidence for this study is IV.

To determine a more precise and reliable method between Greulich-Pyle (GP) and MacKay's (MK) method for the determination of skeletal age in an Indian pediatric population. We carried out a cross sectional study for the assessment of skeletal age on the basis of examination of hand and wrist radiographs of 106 patients (1-15 years of age) who presented with soft tissue injury to hand by the GP and the MK method. These radiographs were evaluated by a radiologist and an orthopedic surgeon independently. In girls, the mean age difference between chronological and skeletal age was 8 months by the GP method, whereas it was 17 months by MK method. For boys, the mean age difference was 10 months by the GP method and by MKs method, it was 20 months. By the GP method, 44% of the boys showed a more reliable estimate of age whereas it was 10% by the MK method. However, the same for girls was 25% by the GP method and 16% by the MK method. The inter-rater reliability for the raters was found to be κ=0.68 and this was statistically significant (P<0.001), 95% confidence interval (0.504-0.848). We concluded that the GP method appeared to be more reliable in the determination of skeletal age in the Indian pediatric population.

Giant Cell Tumour is a common benign tumour of bone accounting for 3 to 5% of all primary bone tumour. It commonly affects in second decade of life between 18 years to 40 years. Distal ulna is less commonly affected site with reported incidence varying from 0.45% to 3.2%. The current available literature is nonconclusive regarding treatment protocol of distal ulna giant cell tumour and whether stabilization procedure of ulna is required or not after excision of distal ulna to avoid the symptoms of ulnar impingement syndrome. We are reporting a case of right distal ulna Giant cell tumour in 51 year old right hand dominant female patient who presented to us with persistent pain and restricted wrist movements. We performed a wide excision of tumour with dynamic stabilization of distal ulnar stump using extensor carpi ulnaris split tendon graft. We have 2 year follow up of the patient with no recurrence and a good functional outcome having a Mayo wrist score of 80.