<p>Despite the advances in trauma care, improved surgical techniques, latest implants and therefore the evolution of new adjuvants to healing, biologic agents, non-union still persists thanks to high energy trauma as initial event. Non-union of femur shaft represents a significant socioeconomic problem to the patient, related to prolonged patient morbidity, inability to return to figure, gait abnormality, re-operations and psycho-emotional impairment. Here we discuss the case of such non-union of fracture shaft femur presented to us with shortening of 3.5 cm managed with bone graft and intramedullary nailing. 22-year-old male patient had a history of trauma due to fall from bike due to dash from behind by tractor (high velocity road traffic accident) sustaining injury over right thigh leading to closed fracture mid-shaft femur of the same side treated immediately by femur nailing. After 6 months post-surgery, he noticed swelling over operated thigh which was increasing and causing difficulty in walking. X-rays revealed broken nail, re-operated at the same centre with dynamic compression plating (DCP) probably after freshening the fracture edges using 12-hole DCP, implant failure with whole plate and screw construct extrusion and re-fracture at the same site. This time patient presented to our institute. We planned of implant removal and intramedullary nailing with bone grafting. Management of aseptic femoral non-union with fracture gap of 2.5-4 cm range with intramedullary nailing combined with autologous fibular cortical and cancellous grafts showed good functional results at the end of 1 year post operative interval after prior repetitive failure of implants due to non-union. </p>

<p>Giant cell tumour (GCT) of bone is a benign but locally aggressive tumour with the potential of malignant transformation that mostly involves the meta-epiphyseal region of long bones. A 34-year-old female was presented to our institute with progressive pain and swelling in her right knee and was radiologically and histologically found to have a GCT of proximal tibia. She was treated with extended curettage with power burr, intra-lesion phenol application and internal fixation using the sandwich technique. No recurrence was found and the procedure led to a good functional outcome. A GCT of proximal tibia treated with joint preserving surgery with extended curettage and the sandwich technique fixation gives optimal results leading to a good functional outcome.</p>

<p class="abstract">Brodies abscess is an uncommon form of osteomyelitis. It is typically found in metaphyseal region of long bones particularly of lower limb. We herein report rare case of Brodies abscess of proximal shaft radius in 17-year-old male presented with pain over proximal aspect of left forearm for 2 months. A plain radiograph showed a translucent lesion of approximately 1.9×1.1 cm. Magnetic resonance imaging (MRI) showed Penumbra sign on T1 and T2 weighted images. Laboratory results showed no inflammatory response. Treatment was done by curettage. Culture report showed Staphylococcus aureus growth. Postoperatively administration of antibiotics was done. Follow up was uneventful. We diagnosed and surgically treated a rare case of Brodies abscess of proximal shaft radius in 17-year-old male. As the upper extremities are areas of unloaded bone, we successfully treated this patient by curettage and antibiotics without bone grafting.</p><p> </p>

Synovial lipomatosis is an extremely rare type of disease in which there is an excess of adipose tissue involving the synovium layer of joints or synovial sheath around the tendons causing pain, paraesthesia, and weakness. The most common site being reported till now is Knee joint or parapatellar space other joints such as elbows and shoulders are being reported after the knee joint, and the ankle joint is rarely reported 2 cases have been reported in the English literature. We report a case of a 28-year-old male presenting with swelling of the right foot for 12 years and developed symptoms of pain and tingling on the toes for 2-3 weeks. Multiple bony hard lesions were palpated on the base of the foot, ultrasonography (USG) showed a subcutaneous lesion around the extensor tendons of the foot and fine needle aspiration cytology (FNAC) had a picture of the synovial cyst. Surgical excision was done and histopathology was reported to be as a fibrofatty tissue with multiple adipocytes suggesting lipoma arborescent.