Lipoma Arborescens is a rare, chronic, gradually progressive intra-articular lesion of benign nature. It is seen in most commonly in the knee but can also be seen in shoulder, elbow and wrist joints. It is characterized by villous proliferation of Synovium and replacement of Sub synovial tissue by mature adipocytes. We report a 20 years old male patient. We elaborate clinical features, role of investigations, differential diagnosis and treatment options available. Case report: We present you a 20 years old male patient diagnosed with lipoma arborescens of knee joint. The MRI report of right knee showed synovium which appeared markedly thickened and showed post-contrast enhancement with fat containing non-enhancing frond-like synovial masses outlined by concurrent joint effusion. These frond like masses were found predominantly in suprapatellar pouch. This patient underwent open synovectomy which showed multiple grey yellow papillary like excrescences seen arising from underlying flat piece of synovium. Approximately 80 cc of lobulated globules were removed and was sent to histopathological examination which confirmed synovial lipomatosis (Hoffa’s disease) associated with chronic lymphoplasmocytic synovitis. On 3 months follow up the patient had complete symptomatic relief.

Pigmented Villonodular Synovitis

Synovectomy

Joint effusion

Infrapatellar fat pad

10.22271/ortho.2019.v5.i3j.1593

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A STUDY ON MANAGEMENT OF FRACTURES OF PATELLA, OLECRANON AND MEDIAL MALLEOLUS BY TENSION BAND WIRING TECHNIQUE

Journal of Critical Reviews (2019)

Sandip R. Patil Ram Jethmalani

Introduction: PAUWEL Used Principle Of Tension Band Wiring In Internal Fixation Of Bone.The Tensile Forces Will Have To Be Absorbed By Tension Band Wire And Bone Itself Has To Withstand Axial Compression.The Principle Of Tension Band Wiring Is That THE IMPLANT ABSORBS THE TENSION AND THE BONE COMPRESSION. Material And Method: At Krishna Institute Of Medical Sciences, Karad From July 2017 To January 2019, Eccentric Fractures Were Taken Into Consideration For TBW Of 15 Cases Each Of Fracture Patella, Olecranon And Medial Malleolus Observation: Majority Of Our Cases Was Physically Active Males In The Age Group Of 31 To 40 Years. Road Traffic Accidents Were The Commonest Mode Of Injury. Most Of The Cases Were Operated In 30 To 40 Minutes. Results: Excellent In 60% Of The Patients, Whereas Good Radiological Results Were Present In 24.44% While 8.88% Scored Poor And Equal Number Of Fair Radiological Results. Conclusion: Advantages of Tension band wiring early mobilization of joints, weight bearing, minimization of hospital stay, prevention of wasting of muscles; working hours-time-money spent on physiotherapy saved.

Tension band wiring

Medial malleolus

Tension (geology)

Malleolus

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