Background and objectives:The forearm represents a critical anatomic unit of the upper limb, permitting the effector organ of the upper limb, the hand, to perform multi axial daily activities of living. Historically, the closed management of forearm fractures has been met with poor functional outcome in adults, hence perfect fracture reduction and rigid fixation is mandatory and achieved by plating. Conservative treatment has resulted in malunion, nonunion, synostosis and ultimately poor functional outcome [1] . Hence the present study was undertaken to provide satisfactory functional outcome and to know the advantage and complications of the newer plate design, the LC-DCP. Materials and methods:The present study was conducted in Department of Orthopaedics at Sri Siddhartha medical college, hospital and Research Center Tumkur during the period from August 2014 and July 2016. A total of 32 patients attending the hospital during the study period with closed diaphyseal fracture of both bones forearm aged more than 18 years who were medically fit for surgery were included in the study. Results: In this study, Males were predominant with left forearm affection more than right. Most of the fractures were due to road traffic accidents and fall. The average age was 33.5 years with fracture being most common in second and third decade. Most of fractures both bones forearm were located in the middle third and the fracture pattern, transverse/short oblique was commonest. 32(100%) Radius and 32(100%) ulna united within 6 months. The results were based on Anderson et al, scoring system and in our study there were 26 (81%) patients with excellent results, 6 (19%) patients with satisfactory results. Conclusion: Our study shows that LC-DCP plating of both bones forearm produces excellent results when applied properly. To obtain excellent results: proper preoperative planning, minimal soft tissue dissection, adherence to AO principles, strict asepsis, proper postoperative rehabilitation and patient education are mandatory

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">Fractures of the distal radius continue to be one of the most common skeletal injuries. The methods which are commonly practiced are closed manipulation and plaster cast, pins and plaster, percutaneous pinning, external fixation and open reduction and internal fixation with or without bone graft. Surgeons are increasingly faced with the dilemma of when to consider operative management and when cast immobilization is the optimal treatment.</span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">47 cases of distal end radius fractures were operated in the orthopedic department of a tertiary care centre. The purpose of the present study was to compare the results of external and internal fixation methods for the treatment of fractures of distal end of radius. Patients operated by external fixation were classified as Group A and those operated by internal fixation were classified as group B. Patients were classified according to AO Classification. Patients were followed at regular intervals depending on the case and time of operation and evaluated by Gartland and Werley score</span>.<strong></strong></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">In our study, 29 patients were of extraarticular type, of which 86.20% had an excellent score and 18 patients were of intraarticular type, of which 83.33% had an excellent score. But when compared to groups A and B, the percentage of excellent score obtained in group B was more than that in group A in both extraarticular and intraarticular fractures. Yuan-kun et al did a study on intraarticular distal end radius fractures and evaluated the patients by Gartland and Werley point system, concluding that plating gives better results than external fixation supplemented by K wiring. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">We concluded that no method of fixation can be said superior to the other. Each method has fracture-specific indication. The results of open reduction and internal fixation can be better than external fixation in initial months, but in the long run, both the methods can have excellent score, provided the fixation is good and properly indicated.</span></p>

Objective: To evaluate the result of locking compressive plate in different types and severity of distal femoral fractures both clinically and radiologically. Methods: 40 male and 10 female patients aged 18 to 85 (mean 39.9) years treated with locking compressive plate for distal femoral fracture. The causes of injury were vehicular accidents (n=45), falls (n=5). According to AO classification, the fracture were classified as type 33A1 (n=20), 33A2 (n=7), 33A3 (n=4), 33C1 (n=17), 33C2 (n=12) and 33C3 (n=1). Most fracture were closed (n=41); Gustilo-Anderson type I (n=4), type II (n=4), type III (n=1). Clinical and functional outcomes were assessed using "KNEE SOCIETY SCORE". Results: The mean time to union was 17.99 weeks. 60% of patients had knee flexion of more than 90 degrees. One osteoporotic women with Gustilo type I 33A1 had moderate occasional pain. At 6-month follow-up 42 had excellent and 7 had good results? One 33C2 fracture had poor result. Out of 30 intraarticular fracture 24 had excellent and 5 had good results? No patient developed malunion, nonunion or implant failure. Conclusion:Locking compressive plate achieves favourable biological fixation for distal femoral fractures with few complications. Even with osteoporotic bone the distal end of plate never loosened. The outcome depends primarily on the etiology of the fracture, the severity of the injury, concomitant trauma, bone quality and early post-injury intervention, good surgical technique, anatomical reduction particularly in intraarticular fracture without varus and valgus collapse, stable biological fixation and early post-operative mobilization.

<p class="abstract"><strong>Background:</strong> Fixed valgus deformity presents a major challenge in total knee arthroplasty (TKA), especially in moderate or severe cases. In knee arthritis, fixed-varus deformity (50 to 55%) is three times more frequent than fixed-valgus deformity (10 to 15%). Valgus deformity occurs more commonly in rheumatoid arthritis and also in osteoarthritis with hypoplasia of the lateral femoral condyle. Valgus deformity is often associated with flexion or external rotation contracture of the knee. In this study we aim to study the surgical outcome of total knee replacement in valgus deformity via standard medial parapatellar approach using various techniques like Pie –Crusting release of lateral structures or combined technique of pie crusting and standard release of lateral structures. Aim: To evaluate surgical outcome of various surgical techniques via standard medial parapatellar approach in fixed valgus deformity in Total Knee Arthroplasty.</p><p class="abstract"><strong>Methods:</strong> The present study involved both male and female patients with osteoarthritis of knee with valgus deformity. In present series, 26 consecutive patients of osteoarthritis with valgus deformity operated with total knee replacement were included. Previously operated cases of high tibial osteotomy and patients having contraindication for TKA were excluded from the study.<strong></strong></p><p class="abstract"><strong>Results:</strong> Valgus angle in this study was between 13 to 27 degree with average 17.84 degree. These results were comparable to many such similar studies. In our study, post operatively, knee society score was average 87.69 and function knee score was 82.5. Mean range of motion was 105 degree. In our study, mean tibiofemoral alignment improved from 17.84 valgus to 4.7 valgus.</p><p class="Default"><strong>Conclusions:</strong> Knee society score is excellent with both techniques and there is no difference in both techniques Iliotibial band and posterolateral capsule are most common structures that require release. Initial ligament balancing should be done with pie crusting and then sequential lateral release if require. </p>

Aim and Objective: Lower lumbar burst fractures are rare entity with most of the literature restricted to small case series. There is no clear cut consensus on the guidelines for management. Here we present functional results of different modalities of treatment of this rare type of spine injury. Material and Methods: The study was conducted at two tertiary care centres over a period of 9 years. Patients with lower lumbar burst fractures were evaluated for associated injuries, modality of treatment, Pain score (VAS) and neurological status (Frankel Grade) at the time of injury and at final follow up were recorded. The final functional outcome was evaluated using Smiley-Webster functional score. Results: A total of 34 patients with an average age of 37.3 years (24 males; 10 females) and a mean final follow up of 27.9 months were enrolled. 21 patients had L3, 8 had L4 and 5 had L5 burst fractures. 10 patients were managed conservatively by brace and 24 underwent surgical intervention. The pain score (VAS) improved from a mean of 8.5 at the time of injury to a mean of 1.6 at final follow up. Patients with neurological injury had on average improvement of one Frankel grade. 88% patients had excellent to good final functional outcome. Conclusion: Lower lumbar burst fractures are high velocity injuries with other non-spinal injuries being associated. Most of the patients have good functional outcome with both conservative as well as surgical intervention. Patients with complete cauda equina have poor outcome with respect to neurological recovery.