Introduction: Infected non-union of the tibia is difficult to manage due to problems like osteomyelitis, soft tissue distortion, draining sinuses, demineralization of bone, joint stiffness, and multidrug-resistant polybacterial infection. Material and Methods: We report the outcome of 18 patients (16 males and 2 females) of infected nonunion tibia treated with the Limb reconstruction system. The causes were open fracture in 15 cases and infection following internal fixation in 3 cases. We assessed the limb reconstruction system in the management of infected non-union of the tibia in terms of, union rate, control of infection, and associated complications. The assessment parameters were based on the Association for the Study and Application of Methods of Ilizarov (ASAMI) criteria. Result: 88% were male and 11% were female, mean age was 32 ±9. The mean bone gap was 3.1±1.0. Draining sinus was present in 10 (55.6%) of the patients. Corticotomy and fibula osteotomy was performed in 14 (77.8%) of the patients. Bony union was seen in 17 (94.4%) of the patients. The mean time of union was found to be 9.7±1.7 months. The mean limb length discrepancy was 1.1±0.6 cm. Deformity angle of less than 7 degrees was present in 16 (88.9%).15 (83.3%) patients had excellent ASAMI bone scores and the remaining 02 (11.1%) had a good score. One patient in which the union was not observed had a poor score. For the functional component, 12 (66.7%) had an excellent score, 05 (27.8%) had a good score and 01 (5.6%) with non-union of the tibia bone was found to have a poor score. Conclusion: Limb reconstruction system is easy to perform, has predictable healing for infected nonunion, has a short learning curve, ensures compliance in patients, and provides reliable results with lesser complications.

Introduction: Synovial chondromatosis is a rare, benign disorder of the synovium, which leads to loose body formation due to metaplastic transformation. It presents as multiple cartilaginous bodies in the synovial joints, bursae and in tendon sheaths. The diagnosis often delayed in hip involvement due to insidious onset of symptoms. Surgical management is essential to manage synovial chondromatosis, which includes hip dislocation and debridement, arthroscopic removal or using arthrotomy. Case Report: A 20-year-old male patient presented with complaints of pain in the left hip since 1 year and difficulty in walking for 6 months. On examination, the patient had mild tenderness over the left hip with the restriction of joint movements. He had flexion deformity of 30°, adduction and external rotation deformity of 10 and 15°, respectively. X-ray of the pelvis with both hips anteroposterior and left hip lateral view revealed calcified nodular mass over superior, inferior part of the femoral head, and anterior part of the neck with decreased joint space. As the patient was disabled with pain, stiffness especially restricted flexion and abduction and difficulty in daily routine activities, we planned for surgical excision of the loose bodies. Using lateral approach to the hip, intra-articular loose bodies were removed through arthrotomy without hip dislocation. At present 2-year follow-up, the patient is having full hip range of motion with no difficulty in squatting, sitting cross-legged, and radiological examination showed no evidence of recurrence. The patient is fully satisfied with the chosen treatment and participating in running and other sports. Conclusion: Although hip synovial chondromatosis are rare, early surgical intervention with complete removal of loose bodies, joint distraction for 6 weeks to allow healing, and early initiation of hip physiotherapy helps in getting better outcome even in patients with early stages of hip arthritis. The early surgical interv

Aim and objectives:To identify baseline factors relevant risk factors for intertrochanteric fractures and to assess the functional outcome in follow up. Method: A retrospective study was conducted among 95 patients admitted in our institution (a tertiary medical care) over a period of 1 year between 2019-2020. Various aspects have been compared. The predictors used were the calcaneal bone mineral density, age, gender and assessing functional outcome based on surgery type i.e. Dynamic hip screw, nailing, or replacement surgeries. In multivariate hazards models, several risk factors increased the risk of intertrochanteric fracture. Other factors also played a major role in occurrence of intertrochanteric fracture in various populations' Steroid use and impaired functional status and Poor health status being some of them. Data were analyzed with t-test, Pearson's correlations, and multivariate regression. Result: A total of 97 patients were selected of which 95 patients completed the study with an average follow up time of 6 months. 2 patients died in the course of follow up and the rest 68 were eligible for analysis with Harris his score (HHS) and Euro 5 dimension were taken at final follow up and came into the following conclusions. Conclusion:We could identify several baseline factors associated with intertrochanteric fractures in the given population which helped us in treatment and functional outcome, and also if extrapolated to the general population could help in avoiding the occurrence of intertrochanteric fractures in various strata of general population.

Giant cell tumour of bones is an unusual neoplasm that accounts for 4% of all primary tumours of bone, and it represents about 10% of malignant primary bone tumours with its different grades from borderline to high grade malignancy. GCT generally occurs in skeletally mature individuals with its peak incidence in third decade of life. Distal femur and proximal tibia are the commonest sites followed by distal radius. Less than 4% of these tumours are known to affect the ankle joints. But, its biological behaviour at this rare location is quite unpredictable. Case Summary: 24 years old male presented with history of nontraumatic pain of left knee since 2 years. Patient was initially evaluated from peripheral hospital with x rays and MRI. It showed a welldefined osteolytic lesion in the epiphysis involving the metaphysical bone of right fibular head without intra-articular extension. Conclusion:In cases of GCT, the management depends upon the various factors such as site, age, involvement of the bone, extent of bone involvement and whether there is articular involvement or not. Extra-articular GCT can be managed with extended intralesional curettage. However, in the proximal fibula, total en bloc excision of the tumor is the treatment of choice.