Background: Calcaneum is the most common tarsal bone fractured. The treatment is difficult and rehabilitation can be time-consuming, and still the outcome is highly unpredictable. This makes calcaneal fractures a huge socio-economic burden to society. This made us search for a variable, like Bohler's angle, which we could relate with functional outcome in patients with intra articular calcaneal fractures. Material and method: 42 patients who had intra-articular fracture of a calcaneum were selected. All the patients were investigated preoperatively with x-rays and CT scanning. The Bohler's angle was calculated on the lateral radiograph manually with the help of goniometer and a record was prepared for future references. Randomization was done and all patients were managed with open reduction and internal fixation with plate with or without bone graft. Bohler's angle was measured post operatively and at follow up on 4 weeks, 6 weeks, 8 weeks and after 3 and 6 months and 1 year. Assessment of the patient with Functional recovery was done with American orthopaedic foot and ankle score (AOFAS) minimum 6 months after injury. Result: Our study of 42 calcaneal fractures confirms that there is statistically significant difference between the functional outcome of patients regarding correction of the Bohler's angle obtained during surgery. When Bohler's angle is restored within normal limits, in an operated calcaneus fractures, fewer complications and statistically significant better results were observed. We also confirmed that autologous bone graft is beneficial in achieving and maintaining restoration of calcaneal height and anatomic reduction. Conclusion: In view of the excellent results obtained with restoration of Bohler's angle, we advocate the use of Bohler's angle as a key to achieve excellent result in displaced calcaneal fracture and also use of autologous bone graft in achieving and maintaining normal Bohler's angle.

Introduction: Medial Compartment Osteoarthritis of the knee is becoming a widespread problem. The surgical options include high tibial osteotomy, unicompartmental knee replacement, and total knee replacement. Replacement surgeries are not advised in the younger age group, so in these patients, high tibial osteotomy is the only option. In this study, we have assessed the functional and radiological outcomes of high tibial osteotomy done by hemicallostasis method. Method: We report the outcome of 30 patients (30 knees) who underwent hemicallostasis with a dynamic external fixator for medial compartment osteoarthritis of the knee. The radiological assessment was done with the help of Hip Knee Ankle angle. The functional scoring was done via Oxford knee score, IKDC, KOOS, and WOMAC score. Results: At a mean follow up of 35 months, the preoperatively mean HKA angle was 172 ± 30. The mean HKA angle postoperatively was 184 ± 10. Appropriate correction of the HKA angle was achieved in 24 of 30 patients (80%). Whereas, there was under correction in 3 patients (10%) and overcorrection in 3 (10%) patients. All the functional scores showed significant improvement in the postoperative scores. There was a positive correlation between the HKA angle and oxford, IKDC, KOOS, and WOMAC Score. Complications like superficial pin tract infection were seen in 3 (10%) patients, deep infection in 1 (3%), and early union of osteotomy in 1 (3%) patient leading to revision of the osteotomy. . Conclusion: HTO is effective in improving pain, function, activity of daily living, and quality of life in patients suffering from medial compartment Osteoarthritis of the knee. Hip Knee Ankle Angle is an important parameter to restore for better functional outcomes. The Advantage of using a dynamic axial fixator is the precision in achieving calculated correction without any implant in the bone once the correction is achieved along with good healing rates.

Enchondromas are benign lesions of hyaline cartilage usually in small bones of hand and foot. Curettage with bone grafting is the treatment of choice. We present a case of enchondroma of 5th metacarpal head treated with curettage and bone graft substitute. Clinical, radiological and histopathological findings in this case are presented with a brief discussion of literature.

<p class="abstract"><strong>Background:</strong> The purpose of our study was to compare the efficacy of a wrist splint with a forearm counterforce strap brace in the management of tennis elbow.</p><p class="abstract"><strong>Methods:</strong> This prospective study was conducted between January and December 2018 comprising of 75 patients suffering from lateral epicondylitis managed conservatively with splints. Patients were randomized into three treatment groups, group 1 received tennis elbow forearm brace, group 2 received wrist extension splint, group 3 received both tennis elbow forearm brace and wrist extension splint. The patient-rated tennis elbow evaluation (PRTEE) score and visual analogue scale (VAS) scores were calculated at 0, 3 and 6 weeks of the treatment.<strong></strong></p><p class="abstract"><strong>Results:</strong> Mean difference of pre-treatment and post-treatment PRTEE score was significant in all three groups and was maximum for group 3 patients (32.42) followed by group 2 patients (27.04) followed by group 1 patients (20.06). Pre-treatment and post-treatment VAS score difference was maximum for group 3 patients.</p><p class="abstract"><strong>Conclusions:</strong> Significant symptomatic relief can be achieved in patients with tennis elbow by using either tennis elbow forearm brace or wrist extension splint or both. Provided proper patient selection and compliance, wrist extension splint achieves better symptomatic relief and functional outcome as compared to tennis elbow brace.</p>

Introduction: Primary total hip replacement (THR) surgery for the neck of femur (NOF) fracture in a case of below-knee amputation with distal femur shaft non-union is rare. Case Report: This case describes the traumatic right NOF fracture in a 49-year-old male patient with distal femur shaft non-union. The patient has a history of ipsilateral below the knee amputation along with right distal femur shaft fracture managed with retrograde femur nailing 10 months back following a road traffic accident. The NOF fracture was managed by primary THR as the definitive procedure after distal femur nail removal and distal femur plating with allograft for non-union. Conclusion: Primary THR with distal femur plating and allogenic bone grafting in such cases provides satisfactory outcomes. It allows for early ambulation and rehabilitation of the patient. Key words: Primary total hip replacement, Below-knee amputation, Distal femur non-union.