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Chondromyxoid fibroma is a rare benign tumor of cartilaginous origin with myxoid and fibrous components. It accounts for approximately 1% of bone tumors. Metaphysis of long bones is the most common location of this tumor. However, there a few case reports of this tumor arising from epiphysis of short tubular bones of the hand and feet. An 11-year-old girl presented to our OPD with complaints of pain and a gradually progressive swelling of the right great toe. On examination, the swelling was diffuse with no signs of inflammation. X-ray examination revealed a well-defined, longitudinally oval lytic lesion in the right distal phalanx of great toe, involving the growth plate and, eroding the medial cortex. Computed tomography (CT) scan did not show any evidence of calcification, septations or involvement of soft tissue. Open biopsy and curettage was done and the specimen was sent for histopathological examination. Histopathological examination (HPE) showed a lobular pattern consisting of myxomatous stroma and immature cartilaginous cells in lacunae. The lobules were separated by fibrous septae. It was reported to be Chondromyxoid fibroma. The patient presented six months later with persisting pain and X-ray showed recurrence of the tumor. Hence, complete excision of the tumor was done and the defect was filled using synthetic bone graft. At six months follow up, the patient did not complain of pain and X-rays showed signs of bone formation with incorporation of the graft. Chondromyxoid fibroma is a low grade tumor, which may demonstrate nuclear atypia histologically and mimic chondrosarcoma. Differentiating these two is of paramount importance to avoid over-diagnosis and aggressive treatment. Recurrence is common with marginal excision and especially in younger patients like in our case. Complete resection is the mainstay of management. Long-term follow up of patients is necessary to watch for malignant transformation, a rare complication. Chondromyxoid fibroma is an extremely rare neoplasm of bone. There are no specific radiologic features, and histopathology provides a definitive diagnosis. It should be considered in differential diagnosis of lytic lesion, and differentiated from other tumors, especially from chondrosarcoma to treat the patient appropriately.

ABSTRACT:Fractures of distal end of radius continue to pose a therapeutic challenge. Intra articular and extra articular malalignment can lead to various complications like post-traumatic osteoarthrosis, decreased grip strength and endurance, as well as limited motion and carpal instability. Open reduction and internal fixation is indicated to address the unstable distal radius fractures and those with articular incongruity that cannot be anatomically reduced and maintained through external manipulation and ligamentotaxis, provided sufficient bone stock is present to permit early range of motion. METHODS: Sixty adult patients with distal radial fractures treated at Dept. of Orthopaedics, Government General Hospital and Royal Hospital, Vijayawada between May 2010 and April 2015 were included in this study. RESULTS: In this series 9(15%) patients were between 21-30 years, 15(25%) between 31-40 years, 24(40%) between 41-50 years, 9(15%) between 51-60 years and 3(5%) patients between 61-70 years. The age of the patients ranged from 26-62 years with an average of 43.3 years. Out of 60 patients, 48(80%) were males and 12(20%) were females, showing a male preponderance with the ratio being M: F 4: 1. Right side (Dominant wrist) was involved in 42(70%) patients and the left side was involved in 18(30%) patients. In our study there were 36 (60%) patients with road traffic accidents and 24(40%) patients fell on their outstretched hand. Of the 60 cases, 12(20%) of the fractures were of Type I Frykman's classification, 6(10%) of Type II, 21(35%) of Type III, 9(15%) of Type IV, 3(5%) of Type V and 9(15%) of Type VIII. There were no cases of Type VI and VII fractures. SUMMARY: Males were predominant with right wrist affection more than left. All fractures were either due to road traffic accidents or fall on the outstretched hand, with road traffic accidents being more common of the two. Most of the fractures were of Frykman Type I, III and IV. All (100%) the patients had their range of motion within the normal functional range. None of the patients had wrist stiffness. Complications were minimal. There was 3(5%) case of extensor pollicis longus tendon irritation which was because of long volar to dorsal screw and the pain subsided once the screw was removed. There was 3(5%) case with an intra-articular fracture developed grade I radiocarpal arthritis doing well with physiotherapy.

Basal Cell Adenoma (BCA) known as monomorphic adenoma is a rare type of benign epithelial salivary neoplasm that mostly occurs in the parotid gland. Clinically BCA appears as a firm, mobile, slow-growing mass and is usually diagnosed during the histopathological examination of the resected surgical specimen. Histological differential diagnosis ranges from benign to malignant neoplasms such as pleomorphic adenoma, basal cell adenocarcinoma, adenoid cystic carcinoma and basaloid squamous cell carcinoma. The treatment of BCA is surgical excision, due to its varied prognosis with the different histological subtypes; a regular long term follow up of the patient postoperatively is mandatory. We report a rare and interesting case of basal cell adenoma of the parotid gland in a 52 year old female. We review the literature; discuss the diagnosis and management of this rare histological entity.

Tibial fractures are one of the commonest orthopedic injuries. Tibial fractures are one of the commonest orthopedic injuries. In the past several years there has been a trend towards by use of small diameter nails without remaining in the management of unstable tibial shaft fractures. However it is important to remember that many closed fractures with less severe soft tissue injury, Treatment with an intramedullary nail with reaming allows placement of larger implant, thereby minimizing the incidence of mechanical failure. While maintain high rates of union. METHODS: In our study, 100 cases of tibial diaphyseal fractures were treated with Interlocking nailing in between May-2012 to April 2015 at Siddhartha Medical College/Government General Hospital, Vijayawada. RESULTS: In our study, among 100 cases 86 were closed fractures, and 8 were open fractures and 6 non-unions. Of the 100 cases 56 (56%) on right side, 38 (38%) on left side, 6 cases (6%) were bilateral. The commonest type of fracture is spiral or long oblique in 40 cases (40%). Transverse or short oblique in 28 cases (28%), comminuted in 24 cases (24%) and segmental in 8 cases (8%). The average time for union is 14 weeks with a range of 12-40 weeks. . 2 patients developed delayed union due to distraction at the fracture site. KEYWORDS: Interlocking nailing tibia, fracture tibia shaft. INTRODUCTION:Tibial fractures are one of the commonest orthopedic injuries. By its very location it is frequently exposed to injuries. These fractures continue to pose vexing problems for orthopedic surgeons, because of their common occurrence and morbidity. One of the problems among them is selecting the optimal method of treatment. They can't be managed by simple set of rules. According to Nicoll 1 tibial shaft fractures are important for two reasons. Firstly they are common, secondly their management is controversial. The incidence of tibial fracture is 9 times more than femoral fractures. Modern treat ment of tibial fractures include both operative and non-operative management, which allow near normal functional restoration of the extremity.It is incumbent on the orthopedic surgeon to be skilled in a variety of treatment methods including, closed functional cast bracing, external skeletal fixation, open reduction and internal fixation using indirect reduction techniques, intramedullary nailing. Because the spectrum of injuries to the tibia is so great that usually no single method is applicable to all fractures. With recent advances in metallurgy (Cold curing, variety of metals) and design of the nails such as prebent nails, prefabricated holes in nails, which lock fragments with screws have made trauma surgeon more confident in a dealing with these fractures. At present interlock nailing seems to be ideal method of treatment of tibial diaphyseal fractures. Sarmiento and co-workers, 2 documented their experiences with functional bracing in the successful management of closed tibial fracture. However, not all tibial fractures are amenable to brace treatment. It ...