Aneurysmal bone cyst, affecting two or more adjacent bones in a limb is uncommon. Singhal, Slevapandian and Daniel (1975) reported a case in which the middle and medical cuneiform bones of foot were involved in a primary lesion of aneurismal bone cyst. But, the authors did not mention whether or not the lesion were confluent or separate. An aneurysmal bone cyst of the fifth lumbar vertebra expanding into the ala of the sacrum was, however, recorded (Barnes 1956). A case of aneurysmal bone cyst affecting the navicular and medial cuneiform bones of the same foot as separate lesions is described.

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The role of airborne bacteria in post-operative wound infection is a debatable subject. Several recent studies have demonstrated a reduction in wound infection rate after introduction of “ clean air� in operation theatre. In Charnley’s (1972) ten-year study of 5,800 total hip replacement operations, the incidence of deep wound infection fell from 7 per cent to 0.5 per cent purely as a result of measures taken against exogenous infections. Similar reduction after introduction of a “ clean air� system in the operation theatre was observed by several other workers (Could, Bone and Scott 1973, Nelson et al. 1973). Any theatre performing major operation, where bacterial count is more than 10 per cubic foot (cft) runs a high risk of wound sepsis (Blowers 1962, Bourdillon et al. 1948). Bacteriological culture of air can be done by settle plate technique or by a slit-sampler. Apart from being an expensive item to provide within a small hospital, slit-sampler needs a person to monitor it and the noise made by the exhaust pump is rather annoying to the surgeon. The present study was done to assess the actual advantage of slit-sampler over the age-old settle plate technique of air culture.

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Congenital pseudrthrosis of the clavicle is a rare entity. Since it was first described by Fitzwilliams (1910) in his series of craniocleido dysostosis, several authors have reported it (Saint Pierre 1930, Carpenter and Garret 1960, Stevenson 1962). Alderd (1963) described a series of 9 cases of congenital pseudo-arthrosis of clavicle, stressing on the development and treatment. Robert Owen (1970) while presenting 33 cases, favoured excision and bone grafting as the method of treatment. A case is being reported hear in view of the rarity of the lesion.

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Osteomyelitis continues to be a major problem in our country inspite of the advent of antibiotics and chemotherapeutic agents. Although in this era of antibiotics, its incidence has decreased to some extent, yet there are numerous instances where there is failure of antibiotic therapy due to development of drug resistance. Changing antibiotic susceptibility of bacteria has been reported due to wide spread use of antibiotics and other factors (Rogers 1959). The present study was undertaken to assess the causative organisms of osteomyelitis and to study in virto sensitivity of these organisms to antibiotic and chemotherapeutic agents.

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Wound infection in orthopaedic practice is a common clinical problem. The bacterial flora in infected lesions usually are staphylococcus, streptococcus, escherichia coli, protens, klebsiella and pseudomonas. The incidence of infections caused by relatively less common gram-negative micro-organisms began to increase appreciably following the introduction of antibiotics and immunosuppressive agents. These, now, account for a sizeable percentage of infections in patients requiring long term hospitalisation (Lewis and Fekety 1969). Among gram-negative bacilli, pseudomonas aeruginosa is the most serious menace and beginning to rival staph, pyogenes as the hospital scourge. Not only it is being found with increasing frequency in infections in hospitals, but the infections tend to be severe and since there is no really effective chemotherapy, have a high mortality; reaching almost 100 per cent in cases of established septicaemia. The present study was undertaken to find out the incidence of pseudomonas aeruginosa infection in orthopaedic practice, its rate of endogenous autoinfection and sensitivity to various drugs. Once this is known, it would be easier to combat the problem, if possible, at source or at the site of attack.

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Primary liposarcoma of bone is an exceedingly rare tumour. Ewing (1928) found no published record of liposarcoma of bone. Stewart (1931) was one of the first to report three such cases. Reszel, Soule and Coventry (1966) in a review of 222 cases of liposarcoma involving the limb gridles and extremities did not encounter a single case destroying bone. Not a single case was reported by Dahlin (1957) who reviewed 2276 cases of primary bone tumour from Mayo Clinic. However, to our knowledge, only 16 cases have been reported under this title and several of these are difficult to accept as they were not true intra- osseous in origin. The majority of the reported cases occurred in lower extremity, upper end of tibia was the most common site (Catto and Stevens 1963, Cohen 1958, Dawson 1955, Duffy and Stewart 1938, Mueller and Robbins 1960, Retz 1961, Ross and Hadfield 1968, Schwartz, Shuster and Becker 1970, Stewart 1931). The present report is that of a liposarcoma completely confined to the medullary cavity of the tibia.

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Poliomyelitis, though practically wiped out from some parts of the world, still continues to be a common affection in developing countries like India. Though the paralysis at first appears quite haphazard, some pattern has exists in the apparently irregular distribution of paralysis. This pattern has been studied in detail by Sharrard (1955, 1975, 1971). However, non such study has been reported from India. We are presenting our observations on the patterns of residual poliomyelitic paralysis of lower limbs as seen in Ahmedabad.

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Various skin and spinal anomalies are frequently associated with intraspinal dermoid. These include spina bifida (Sharpe and Sharpe 1928, Hipsley 1933), congenital dermal sinus, (Walker and Moor 1939), combined spina bifida and congenital dermal sinus (Stammers 1938, Tytus and Pennybaker 1956), dilation of spinal canal (Bradford 1938), pigmentation and hypertrichosis of overlying skin (Bradford 1938, Boldrey and Elvidge 1939) and capillary angioma (Schwartz 1952). Present case report describes an unusual association of multiple anomalies of upper dorsal vertebrac and a large intramedullary dermoid cyst producing paraplegia.

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Pain is the main disabling feature in cases of early osteoarthritis of the knee. It has been a standard practice to palliate the symptoms and preserve the function by physiotherapy. The joint was thus made to last as long a possible and the surgical procedures in the from of arthrodesis and arthroplasty are reserved for severe incapacitated patients. Role of minor operative procedures in the treatment of early osteoarthritis of knee joint was considered worth reporting.

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Several descriptions about internal fixation devices (Egger 1948, Venable 1951, Kuntscher 1958) have mainly been clinical. While most of the laboratory work has dealt with metallurgical aspects of the problem with particular reference to corrosion, there is scope for further study on measurement of strength of internal fixation devices. Here, we have endcavoured to evaluate the effectiveness of implants, commonly used for fixation of tibial shaft fractures, in bending and torsion and we suggest a modified device. Some experiments were done with modified device specially for torsional type of long spiral fractures, which is mechanically more effective than commonly used onlay plates, screws and intramedullary nails.

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With the development of arthroplasty of the knee, and the decline in the incidence of tuberculosis and poliomyelitis, arthrodesis of the knee is currently not in common use in affluent countries. There are, however, certain conditions such as advanced suppurative, tuberculous, degenerative, and post-traumatic arthritides, deformed rheumatoid knee, neuropathic knee, poliomyelitis and congenital dysgenesis of the femur where arthrodesis is an effective method of providing a stable and pain free extremity. Many methods of arthrodesis of the knee joint from simple technique of Hibbs’ angles to each other (Lucas et al. 1961) have been described. However, after charnley (1948) reviewed and refined the compression arthrodesis popular. This paper compression the observations on performing knee arthrodesis by using a nearly semilunar curved ‘V’ tibial nail passed from anterior femoral cortex through the denuded lower end of femur and the upper end of tibia onto the anterior tibial cortex.

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Aneurysmal bone cyst was first described by Jaffe and Lichtenstein in 1942 while discussing unicameral bone cysts. They recognized this to be a distinct benign lesion of skeleton with characteristic pathological and clinical features. The same authors in 1950 independently described the condition in more detail and it is now accepted as a distinct clinical and pathological lesion though its incidence is relatively rare. A number of cases have been reported in the literature (Lichtenstein 1953, 1957, Dahlin et al. 1955, Cruz and Colocy 1956, Barnes 1956, Taylor 1956, Clough and Price 1968, Slowick et al. 1968). Thirty six cases have been reported from India in 25 years indicating that possibly this lesion is not widely recognised (Bhende and Kothare 1950, Hardly et al. 1956, Sirsat 1958, Chitkara et al. 1960, Das and Basu Mallick 1960, Subramaniam and Mathias 1962, Sandhu et al. 1962, Sambasivam et al. 1971, Anjaria et al. 1973, Saxena and Sharma 1974, Shaw et al. 1975). Most of the cases reported so far are those collected from the records of several clinicians. Cases seen and treated by any individual surgeon rarely exceeded three or four. In this communication, we are presenting a study of 11 cases of ancurysmal bone cyst investigated, treated and followed up at the N.R.S Medical College, Calcutta from June 1958 to May, 1976 of which or cases were treated by the senior author. Two of the cases (Cases 1 and 2) have been reported previously (Das and Basu Mallick 1960).

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To an orthopaedic surgeon, information on the normal growth of foot as a whole is needed in timing of certain orthopaedic procedures such as arthrodesis of foot. While such norms have been made available in the Western Countries (Clapham 1950, Dick 1952, Anderson, Blasis and Green 1956), there is complete lack of information on the growth of foot in Indians in general. Due to considerations of ethnic variations, the data can not be directly applicable to individuals belonging to other ethnic groups. The present study is aimed at reporting some base line data on norms of foot growth particularly in North Indians.

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A case of giant cell tumour of fifth metacarpal bone, which was treated by total excision of the involved metacarpal and bone grafting is being reported.

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The medullary cavity of the long bone has a high fat content but it is surprising that lipomas and liposrcomas are among the rarest in bone (Jaff 1958, Lichtenstein 1965). Since Stewart (1931) reported the first case of liposarcoma of bone, various authors have described single case reports (Table). The rarity of the lesion has prompted this case report.

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Repair of gaps by accurate apposition of the ends of tendo-achillis is not usually possible in old standing cases because of reaction and contracture of the proximal end. In pathological rupture unhealthy degenerated and avascular tendon tissue becomes extensively shredded and friable and requires excision before repair. Snug apposition of healthy tendon with proper tension at the sture site with a minimum of foreign material is essential for accurate repair. This article is to describe the causes of large gaps in tendo achillis and the methods and results of its repair.

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Fractures involving the joints (osteochondral fractures) are quite common in clinical practice. According to Hardacer et al. (1971), these fractures do not unite readily, lead to joint stiffness and ultimately lead to degenerative changes in the involved joints. In its management importance of (i) anatomical reduction and (ii) early mobilization has been emphasized by all. Anatomical reduction is usually difficult to obtain and maintain by closed methods. Prolonged immobilization in most cases leads to joint stiffness. So an early return of function is also important for a favourable outcome. Based upon the above facts, the present study was undertaken to evaluate the fate of surgically created osteochondral fractures in experimental animals and to assess the role of internal fixation in its treatment

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