Evaluation and management of Tuberculous Pyomyositis, a rare manifestation of Mycobacterium tuberculae. Materials and Methods: All the patients who had visited the orthopaedic OPD at Mahamaya Rajkiya Allopathic Medical College Ambedkar Nagar during the period from March 2012 to March 2019 and diagnosis supported by radiological evaluation by MRI/USG and established by acid fast staining/ histopathological evaluation of aspirate/biopsy of involved muscle. Results: Depends upon their clinical presentation initially 28 cases were suspected among which 16 cases (57.10%) found positive for tuberculous pyomyositis. Two patients were lost during follow up so finally there were 14 cases (50%) included in this study. Among 14 cases, 7 cases (50%) were female and 7 cases (50%) male. The age of patients varied from 9 year to 68 year and the duration of illness on presentation from 2 months to 12 months. The routes of infection were hematogenous in 11 cases (78.57%) and penetrating injury in 3 cases (21.42%). All cases were managed with anti tubercular drugs as per guideline, and surgery also needed in 8 cases (72.72%). Conclusion: Isolated presentation of tuberculosis as pyomyositis is rare and not widely reported in the literature. Tuberculous pyomyositis should be considered in long standing vague swelling of the upper and lower limb without constitutional symptoms and signs of inflammations. Thus it is our recommendation is to establish the diagnosis of tubercular pyomyositis followed by anti tubercular treatment; and in selected cases surgical drainage and debridement along with ATT.

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Bizarre parosteal osteochondromatous proliferation (BPOP) presents as painless bony swelling and also known as Nora's lesion. It is a benign surface osteocartilaginous lesion. This condition is seen most commonly in hands followed by feet. Long bone involvement is rare. Materials and Methods: This is a retrospective study of the patients who had visited the orthopedic OPD of our institute from January 2011 to December 2019. The diagnosis of BPOP was made by radiological evaluation and confirmed by histopathological evaluation. Results: There were 8 cases included in this study. Out of them, 4 cases (50%) were female, and 4 cases (50%) male. The age distribution of patients was 14 years to 36 years. The duration of the history of present illness was 6 months to 3 years. There were 6 cases (75%) of the upper limb and 2 cases (25%) of the lower limb. 4 cases (50%) had a history of trauma. All cases were operated on after pre-operative evaluation and the excisional biopsy specimen was sent for histopathological evaluation for confirmation. On follow up 2 cases (25%) had recurrence for which re-operation was done. Conclusion: BPOP involving long bones is exceedingly rare. The local recurrence rate after surgical resection of the lesion is high. En bloc resection of the lesion along with decortication of the underlying cortical bone was done to reduce the possibility of recurrence. Two patients in our series had a recurrence for which re-operation was done. This is an Open Access (OA) journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

INTRODUCTION:In recent years there has been an increasing interest in biologically active calcium phosphate ceramic materials for orthopaedic application. A number of materials from human, animal or non-biological sources have been used to fill defects with or without additional autogenus bone. It would be ideal to have bone substitute which is easily fabricated and preserved, is biocompatible with bone, and is biodegradable. The calcium phosphate system, and in particular hydroxyappatite (HA), has long been the subject of intensive investigation. MATERIAL AND METHODS: This observational two year study was undertaken at S.N. Medical College and Hospital, Agra (U.P.). The patients having the comminuted fracture of the long bone of lower limbs were treated with autogenus bone graft and calcium hydroxy Apatite bone block. Functional results were presented according to Klemm and Borner (1986) criteria. RESULTS: The total cases studied were 25 out of which 21 cases had fracture of both bones of leg and 4 were of fracture femur. The patients were aged between 15 to 70 years. Most of the patients were males and the common mode of injury was road traffic accident. An excellent result were seen in the majority 9(36%) of patients while 8(32%) patients showed a good result and 6(24%) showed a fair result. 17(68%) patients had compound fracture while 8(32%) patients were having closed fracture. CONCLUSION: Calcium Hydroxy Apatite is a suitable alternative to bone graft. There was no evidence of any foreign body reaction and infection at the Calcium Hydroxy Apatite implanted site. There was satisfactory healing of all the comminuted fractures. The movement of adjacent joints was nearly normal. No refracture was observed on follow up.