Nora lesion is a rare benign parosteal osteochondromatous proliferation involving feet and hand. Aggressive features on imaging and confusing results on histopathological studies make its diagnosis difficult. Since the time of its discovery, only few cases have been reported in the literature. Authors report a case of Nora's lesion on the planto-medial aspect of metatarsal head of great toe of left foot. The diagnosis was suspected by imaging characteristic features and was confirmed by histopathology. Treatment was surgical, with complete excision. There are no clinical or radiological signs of recurrence on further review 1 year post-operatively.

Abstract:Aneurysmal bone cysts are enigmatic, locally destructive, blood filled lesions of bone with unknown cause and unusual presentations. We report a case of 16 year old female with aggressive aneurysmal bone cyst of proximal left femur complicated by transcervical fracture neck of femur. As the age of the patient was not suitable for replacement, a successful attempt was made to salvage the hip with intralesional curettage and fixation with 2 fibular struts and a cancellous hip screw. Femoral head is viable till date.

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Introduction: ACL avulsion mainly occurs from its tibial attachment. Open are arthroscopic fixation is required in comminuted avulsions. Screw fixation is stronger construct than any other modality. In this study we have included patients operated by arthroscopic fixation with suture disc and endobutton. This is cheaper modality with simple instrumentations. Purpose of study was to assess the clinicoradiological outcome of such patients. Material Methods: 15 patients were included in the study. Who were assessed by lachman test and radiographs pre operatively, post operatively and follow up. Suture disc and endobutton were used for the arthroscopic fixation. Knee bending exercises and quadriceps strengthening exercises advised post operatively. Result: Union was present in 100% patients on radiographic evaluation. 93.3% patients were returned to their pre injury status within one year. 6.6% patient developed extension lag and stiffness. Infection was not seen in any patient. Conclusion: This is newer and cheap modality of fixation with satisfactory outcome. Large sample size studies are required.

Introduction: Diaphyseal fractures of humerus treated with bridge plating are showing superior results in view of post-operative pain and union time. In our study we have evaluated the clinical, radiological, and functional outcome of such fractures in 15 patients, all of them were managed with dynamic compression plate over an average follow up period of 12 months. Though open reduction and plating technique of humerus shaft fracture is gold standard, this technique also gives good outcome. Materials and Methods: Fifteen patients with humerus shaft fractures were managed by anterior bridge plating using Minimum invasive osteosynthesis technique between Jan 2017 and Jan 2018 were included in this study. All cases were managed with closed reduction and 4.5mm dynamic compression plate fixation over anterior aspect in bridging mode using the MIPO technique. The dominant side, gender ratio, surgery time, and fracture union time, and complications were noted. The UCLA shoulder and Mayo elbow scores were used for assessing the shoulder and elbow function. Results: Out of the fifteen patients in the study, eleven were males and four were females. The mean age was 40.2 years (range 25 to 60 years). Ten out of fifteen patients (66.67%) had the dominant side fractured. Mean surgical time in minutes was 90min (range: 60-120 minutes). The mean fracture union time was 10.6 weeks (range: 10-18 weeks). However Shoulder function was excellent to good in 13 cases (86.6%), fair in 1 case (6.67%) & poor 1 case (6.67%) on the UCLA score. Conclusion:In our study, small incision percutaneous anterior bridge technique for fracture shaft humerus results in good functional outcomes. It is based on relative stability which provides healing, and subsequent formation of the bone callus, and reduces the possibility of infection and non-union.it requires experience and a good assistance.