We present our experience organizing an orthopaedic camp in rural part of India in a mobile surgical unit (Life Line Express) on a train. The camp was held for 15 days from 25th may to 10th June 2009. We performed deformity correction surgeries; corrective plaster castings and follow up the cases for the next six month. We assess the pros and cons of this orthopaedic camp on a train where minor and major procedures were carried out.

Introduction: Primary osteoarthritis(OA) of the elbow is a rare condition, characterized by painful stiffness, mechanical symptoms, and the presence of hypertrophic osteophytes. Elbow osteoarthritis typically affects middle-aged men who engage in strenuous manual activity. We hereby present a case of bilateral primary elbow osteoarthritis and discuss its various treatment options. Case report:A 45 years old male patient presented to outpatient department with complaints of pain in both elbows since one year. There was no history of previous trauma or other complaints pertaining to elbow. He was a manual laborer working in farms. He had tenderness on deep palpation of elbow. All movements at elbow (extension, flexion, supination and pronation) were terminally restricted. X-rays of both elbows revealed osteoarthritis of elbow. After thorough discussion of treatment options with patient, he opted for non-operative management. Key massage: It requires a high index of suspicion to diagnose primary OA of elbow. Best treatment optioninvolves capsular release and removal of impinging osteophytes but non-operative treatment remains the first step in the early management of elbow osteoarthritis.

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The focal calcification or ossification of ligamentum flavum is a rare cause of thoracic myelopathy and most often occurs among individuals of Japanese descent. It is rare in other ethnic groups and in individuals below the age of 50 year. It is most often described at the lower thoracic level, being uncommon in the lumbar region and rare in the cervical region. Here, we present the case of a 40-year-old Indian female patient who sought medical attention with a six month history of paraesthesia of the lower limbs and progressive difficulty in walking. The clinical profile, together with computed tomography and magnetic resonance imaging of the spine, led to a diagnosis of compressive lumbar myelopathy due to ossification of the ligamentum flavum of lumbar spine. The patient underwent laminectomy and dissection of some of the affected ligamentum flavum. After three months of clinical follow-up, the patient had progressed favorably, having no sensory complaints and again becoming ambulatory. CASE REPORT: A previously healthy 40-year-old female patient sought medical attention at our hospital. The patient presented with a 2-month history of ascending paraesthesia of the left leg, with progressive worsening and right leg involvement, accompanied by reduced (right and left) leg muscle strength. She reported lower back discomfort. She also found difficulty in sitting and walking showing signs of neurological claudication. Neurological examination revealed paraparesis. A computed tomography (CT) scan of the lumbar spine revealed the following: calcification of ligament flavum at L2-L3 to L4-L5 levels worst at L3-L4 and lateral recess stenosis at L3-L4 and L4-L5.