We conducted this study to evaluate the use of rail fixation system in infected gap non-union of femur and tibia as an alternative to the established Ilizarov circular fixator technique. Prospective study. The study was done in the Department of Orthopaedic surgery in a medical school and level I trauma center to which the authors are/were affiliated. Between June 2010 and June 2015, 40 patients with infected gap non-union of femur and tibia were treated with the rail fixation system. Patients who were willing to undergo surgery and participate in the post-operative rehabilitation were included in the study. After radical debridement, the system was applied and corticotomy done. For closure of bone gap, acute docking and distraction was done in 18 cases and segmental bone transport in 22 cases. Early mobilization of patient was done along with aggressive physiotherapy. Bone and functional results were calculated according to ASAMI scoring system, and complications were classified according to Paley classification. The mean follow-up period was 22.56 months (range 8–44). Bone union with eradication of infection was achieved in all but 1 case (97.5%). Bone results were excellent in 57.5%, good 40%, fair 0% and poor in 2.5% cases, while functional result was excellent in 32.5%, good 65%, fair 0% and poor in 2.5% cases. The rail fixation system is an excellent alternative method to treat infected gap non-union of femur and tibia. It is simple, easy to use and patient-friendly.

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Introduction: Leptospirosis is a zoonosis caused by infection with pathogenic Leptospira species. Leptospirosis has protean manifestations and rare, unusual presentations should be kept in mind in relevant epidemiological scenario. Reactive arthritis refers to acute non-purulent arthritis complicating an infection elsewhere in the body. It is attributed to an immune activation following certain infections; it is, therefore considered as aseptic arthritis. Very few case reports are available attributing leptospirosis as an established cause of reactive arthritis. We present a case of reactive arthritis of the hip joint due to leptospirosis. Case Report: Here, we present a case of a 12-years- old female child who was admitted to our hospital with complaints of fever, headache, and pain in the right hip joint since past 5 days from admission. Subsequent elaboration revealed a past history of fever, headache, and myalgia for around 5-7 days around a week before the present complaints. There was rat infestation near her house and her father was working as sewage cleaner. Routine investigations, Ultrasonography (USG), Magnetic Resonance Imaging (MRI) of both hips and subsequently, diagnostic hip aspiration was performed. USG revealed synovitis, MRI revealed hip joint arthritis of infective or inflammatory origin. Diagnostic hip aspiration was negative for any microorganism. On 10th day of admission, patient started developing icterus with yellowish discolouration of urine. Patient was evaluated for the cause of jaundice. Screening for Leptospira was positive. Synovial biopsy of hip was performed, which showed inflammation with no specific pathology and no growth of any microorganism. In addition, Leptospira IgM MAC ELISA was done which was positive. Patient was thus confirmed to be having leptospirosis and reactive arthritis as a consequence of it. Conclusion: The presentation of reactive arthritis secondary to leptospirosis is rare. Leptospirosis can be an etiological fa

Introduction: Congenital Talipes Equinovarus is one of the most common congenital deformities of foot and ankle. Ponseti method of serial manipulation and once weekly casting has claimed a success rate of 95 %. However, modification of the Ponseti method in terms of duration with twice weekly casting can shorten the time immobilized in plaster with increased parents compliance. Materials and Methods: A randomized comparative study was carried out for total 64 patients (100 clubfoot) attending the Outpatient department of Orthopaedics, Silchar Medical College and Hospital from 1 st June, 2017 to 31 st May, 2018. 32 patients each in Standard Ponseti group and Accelerated Ponseti group were allotted according to computer generated randomisation plan. The method of manipulation was similar in both the groups with once weekly casting in Standard Ponseti group and twice weekly casting in Accelerated Ponseti group. The initial and final Pirani scores, number of casts required for correction, treatment time in plaster, rate of tenotomy and relapse of deformity in the Standard and Accelerated Ponseti groups were recorded and compared using paired and unpaired t-test methods as required.Results: The two groups did not differ with respect to their initial and final Pirani scores. The mean number of casts required was 5.92 + 1.09 in Standard Ponseti group, and 6.09 + 1.11 in Accelerated Ponseti group (p-value = 0.4203). However, there was significant difference in the treatment time in plaster with mean treatment time of 41.42+7.62 days(range -28 to56 days) in Standard Ponseti group and 21.13 +3.94days(range-14 to 31 days) in Accelerated Ponseti group with p-value < 0.05. 41 out of 48 feet in Standard Ponseti group and 46 out of 52 feet in Accelerated Ponseti group required percutaneous tenotomy. Relapse of equinus and adduction deformity was seen in 3 feet each in Standard and Accelerated Ponseti groups on follow up. Conclusion: Accelerated Ponseti method of twice weekly casting has similar results as Standard Ponseti method with the advantage of earlier correction of the deformity and better parents compliance.

Background: Knee osteoarthritis (OA) is a cause of considerable pain and disability in the affected individuals. Proximal Fibular Osteotomy is a straightforward and comparatively new surgery that results in pain relief and maintenance of joint space in osteoarthritis. It is a day care procedure that helps in realigning the knee joint and may result in delay of knee replacement by a decade or in some cases even longer. Materials and Methods: 20 adult patients (25 knees) with medial compartment knee osteoarthritis admitted in Silchar Medical College and Hospital (SMCH) and treated with Proximal Fibular Osteotomy between June 2018 to May 2019 were included. Preoperative and postoperative weight bearing radiographs are taken to evaluate the medial joint space. Visual Analogue Score and American Knee Society Score were used to assess knee pain and knee ambulation activities, respectively. Results: It was observed that all patients experienced pain relief following proximal fibular osteotomy. Weight bearing lower extremity radiographs showed an average increase in the postoperative medial joint space. Additionally, correction of lower limb alignment was observed in eight patients. Conclusion:Proximal Fibular Osteotomy is a simple, cost effective procedure which significantly reduces knee pain and improves joint function in medial compartment knee osteoarthritis.