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Background: Osteochondroma is the most common benign skeletal neoplasm and is found most often in long bones, especially in the distal femur and proximal tibia. They usually present as painless swelling near the joint and can be complicated by mechanical irritation, compression or injury of adjacent structures, fracture, malignant transformation, and post-operative recurrence. Locking of the knee refers to flexion of the knee without complete extension and passive extension is limited resulting in significant pain. Excision is a successful form of the treatment for symptomatic osteochondromas. Case Report: A case of osteochondroma of the proximal tibia illustrates extra-articular cause of locked knee secondary to the incarceration of pes anserinus tendons by the lesion. Conclusion: Surgical excision of the bilobed pedunculated posteromedial proximal tibia osteochondroma and restoration of the gracilis and semitendinosis to its normal anatomic position resulted in the complete resolution of symptoms.

<p class="abstract"><strong>Background:</strong> Gap non-union is one of the most perplexing problems facing the orthopedic surgeon today. Fibula is the preferred site of non-vascularized bone graft due to its easy accessibility to surgical resection and minimal donor site complications.</p><p class="abstract"><strong>Methods:</strong> The study comprised 11 patients of gap non-union between 13 to 80 years (mean=34.9 years). The fibular graft was harvested from the mid shaft and cortico-cancellous bone graft taken from the iliac crest was applied at both ends of the fibular graft to aid in union.<strong></strong></p><p class="abstract"><strong>Results:</strong> The average bone gap was 7 cm (4-13 cm). 64% of the patients achieved bone union after the first procedure, of the remaining 4 patients, 1 patient showed union after secondary cortico-cancellous bone grafting, while two are planned for the same. The remaining one patient has only completed 16 weeks follow-up at present and is not showing signs of union at present. Functional range of motion was achieved in both the proximal and distal joints in all cases.</p><p class="abstract"><strong>Conclusions:</strong> Non-vascularized fibular bone grafting is a simple and effective treatment option which does not require any special skill, has a very low complication rate and has very high patient compliance.</p>

<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>

Giant cell tumour of bones is an unusual neoplasm that accounts for 4% of all primary tumours of bone, and it represents about 10% of malignant primary bone tumours with its different grades from borderline to high grade malignancy. GCT generally occurs in skeletally mature individuals with its peak incidence in third decade of life. Distal femur and proximal tibia are the commonest sites followed by distal radius. Less than 4% of these tumours are known to affect the ankle joints. But, its biological behaviour at this rare location is quite unpredictable. Case Summary: 24 years old male presented with history of nontraumatic pain of left knee since 2 years. Patient was initially evaluated from peripheral hospital with x rays and MRI. It showed a welldefined osteolytic lesion in the epiphysis involving the metaphysical bone of right fibular head without intra-articular extension. Conclusion:In cases of GCT, the management depends upon the various factors such as site, age, involvement of the bone, extent of bone involvement and whether there is articular involvement or not. Extra-articular GCT can be managed with extended intralesional curettage. However, in the proximal fibula, total en bloc excision of the tumor is the treatment of choice.