Introduction: Wiring is the earliest forms of internal fixation. A loop of SS (Stainless steel-316L) wire is passed around the fragments or through the drill holes and the ends are twisted together. It is used in Fractures of patella, olecranon and malleolus, greater trochanter of femur, greater tuberosity humerus, lateral end clavicle. In the present study, tension band wire technique was used which include use of 2 K wires and SS wire. The 2 K wires used, anchors to the TBW loop made by the SS wires and prevents tilting/rotation of fragments and holds the reduced fracture fragments in place till union. Aims and Objective: To study the technique of TBW and its principle as a modality of treatment. To clinically evaluate the results and efficacy of this principle and technique. We did prospective study of 30 patients of various fractures requiring K wire and TBW surgery for those fractures between October 2016 to October 2018. Results: We observed patella fracture is the most common constituting 33%, medial malleolus 30%, olecranon 17%, greater trochanter femur 7% and is followed by lateral one third clavicle, greater tubercle humerus, distal end ulna and non-union medial malleolus which is 3%. Superficial infection in 1(3.3%) case of medial malleolus fracture, joint stiffness in 3 (10%) cases (1 each of fracture patella, fracture olecranon, fracture bimalleolus), migration of K wire in 1(3.3%) case of fracture patella and osteoporosis in 1(3.3%) case of greater tuberosity humerus. Time for radiological union in weeks was 7.84, with 9 for fracture patella, 8 for medial malleolus, olecranon and distal end ulna, 6 for Greater Trochanter femur and 4 for lateral end clavicle and greater tuberosity humerus. Conclusion: TBW is a simple, inexpensive technique and effective means of fixing fracture based on biomechanical principle with minimum complication.

Introduction: Number of operative techniques have been described with the use of lag screws, steel wires, arthroscopic tight rope fixation, arthroscopic suture bridge technique. As there is continuous advancement in newer technique, we are comparing outcome of PCL tibial avulsion fixed by two different methods open reduction internal fixation by CC screw and arthroscopic suture bridge technique. Method: The PCL tibial avulsion was approached by posterior Burks and Schaffer approach, fixed by CC screw in half of the patient and in another half, we used arthroscopic suture bridge technique. One fiber wire is used in arthroscopic technique. Results: Anatomical reduction and fixation of PCL avulsion by arthroscopic fixation is equally effective when compared with ORIF by CC screw fixation. Conclusion:The use of CC screw could be a simple and reliable technique for PCL avulsion fractures of the tibia. Patients achieved good knee function after surgery, but arthroscopic suture bridge technique of PCL avulsion fixation gives better knee function and less intraoperative complications.

Introduction: Fibrous dysplasia is a benign disorder of unknown etiology. It represents a disturbance of normal bone development – a defect in osteoblastic differentiation and maturation that originates in the mesenchymal precursor of the bone. It is characterized by slow progressive replacement of bone by abnormal isomorphic fibrous tissue. Temporal bone involvement is extremely rare. We report an unusual case of fibrous dysplasia presented like a solitary osteochondroma. Case Report: A 14-year-old girl presented with the complaints of slow-growing swelling on the left temporal region in scalp near left eye for 2 years. The swelling was small to begin with, which increased gradually over a period of 2 years. There were no other presenting symptoms. Hearing was normal. Parents of the patient were concerned with cosmesis only. She had undergone 3D CT scan of skull where it showed bony outgrowth with features suggestive of exostosis. This bony outgrowth had cortex in continuity to cortex of temporal bone and medullary canal same as that of the temporal bone and ground-glass appearance. Repeat CT scan showed bony outgrowth with cortical continuity and had pedicle. It was suggestive of pedunculated osteochondroma. There was no evidence of malignant transformation as swelling showed calcified osteoid-like mass throughout. Hence, the clinical and radiological diagnosis of the left temporal bone solitary osteochondroma was made. However, histopathology showed irregularly shaped bony trabeculae in fibrous stroma of variable cellularity without accompanying osteoblast rimming. Thus, diagnosis was fibrous dysplasia of bone. Histopathological slide was reviewed by two independent pathologists with same conclusion. Conclusion: Our case was unique in that the lesion presented clinically and radiologically as solitary osteochondroma. However, in hindsight, lack of cartilage cap on CT scan should have prompted us to look for another diagnosis. To the best of our knowledge, this was unique varied presentation of fibrous dysplasia of temporal bone.

Introduction: Hip joint is commonly affected by osteoarthritis in Indian population and incidence of pain in hip and osteoarthritis is increasing in Indian population also. Retroversion of acetabulum is a type of hip dysplasia and a common cause of hip pain and Osteoarthritis of hip. Radiographic Diagnosis of the retroversion of Acetabulum is based on three signs: cross over sign (COS), posterior wall sign (PWS), prominent ischial spine sign (PRISS). All these signs are well described in literature and most of the Orthopedic surgeons don't know the significance of these signs. Method: We evaluated 372 normal adult radiographs of pelvis from our radiology department to find out the prevalence of these signs in our hospital population. We also correlated the crossover ratio (percentage of crossover) to the presence of other two signs. In 372 normal pelvis radiographs 744 hips were analyzed for presence or absence of these 3 signs and the measurement of crossover ratio was done in AGFA workstation. Results: The prevalence of COS is 17.7%, PWS is 7.3%, PRISS is 23.4%, and all 3signs are present in 4.4% hips. Radiographs with only COS were 46 hips and the mean crossover ratio is 18.61%; while mean crossover ratio in 33 hips with all 3 sign positive was 21.95% which is statistically high. Conclusion: Thus Higher crossover ratio is associated with PRISS and PWS positive hips. Higher values of crossover ratio is associated with PRISS sign.