Background. Adhesive Capsulitis of shoulder (AdCS) is a treatment dilemma for surgeons. Intraarticular Corticosteroid Injection (IACI) has shown only short-term benefit in improving shoulder-related disability. Suprascapular nerve block (SSNB) has shown promise in trials in reducing chronic shoulder pain. Thus a RCT was conducted to compare the efficacy of SSNB versus IACI in the treatment of AdCS. Material and methods. 86 patients with AdCS were divided into SSNB and IACI groups by block randomization. SSNB group received single Suprascapular Nerve Block with 10ml of 0.5% Bupivacaine while IACI group received single injection of 40mg Triamcinolone and 1ml 2% Lignocaine in the shoulder; both followed by physiotherapy and followed-up and evaluated with SPADI and modified Constant scores at 1, 6 and 12 weeks. Results. Statistically significant improvements occurred in both groups. At 12 weeks, the SPADI and Con­stant score for SSNB improved to 9.62±10.07 and 36.95±3.43 respectively (p<0.001); and for IACI improved to 11.65±5.56 and 35.07±3.32 respectively (p <0.001). The difference in the scores between the 2 groups at 1st and 6th week was insignificant, but was statistically significant in favour of SSNB at 12 weeks (p=0.002). Conclusions. 1. Thus, from the present study it can be concluded that both Suprascapular Nerve Block and Intra-articular Corticosteroid injection are effective mo­dalities of treatment for Adhesive Capsulitis of the shoulder. 2. Suprascapular Nerve Block increased patients’ pain tolerability for effective mobilization, the effect be­ing persistent even at 12 weeks following injection. 3. It was safer than Intra-articular Corticosteroid in­jection with less incidence of adverse effects in our study and the literature. 4. It is an easy-to-perform outpatient procedure, with minimal chance of infection and other complications. 5. In light of the above, we may recommend Su­prascapular Nerve Block as the initial procedure of choice in patients with Adhesive Capsulitis of Shoulder.

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Bisphosphonates are widely used for treatment of osteoporosis and its use is increasing in geriatric population. Atypical femoral fractures are associated with bisphosphonate therapy. We report an unusual case of femoral shaft fracture following bisphosphonate therapy where the femoral canal of the proximal and distal fracture fragments was blocked and its management.

Supracondylar fractures of Humerus comprise about 17 percent of all childhood fractures. Treatment of supracondylar fractures has included closed reduction and casting in hyper-flexion, traction, open reduction with pinning and closed reduction with pinning. The goal of all forms of treatment is the same, to obtain and maintain an anatomic reduction of the distal humerus to minimize complications such as nerve injury, compartment syndrome. Volkmann ischaemic contracture, Cubitus varus deformity and limitation of elbow movements. The nonoperative management of supracondylar fracture of humerus including skin traction, skeletal traction and cast application has historically been associated with a greater incidence of failure to obtain and maintain the fracture reduction and subsequent complications as compared with surgical line of treatment. The high rate of complications associated with non-operative treatment led to the evolution of current techniques of percutaneous pinning for these difficult fractures over the past three decades. Standardization of surgical techniques for performing pin fixation with radiographic control has markedly reduced the incidence of poor outcomes. The advantages of percutaneous pinning methods include easier management of extensively swollen elbows, better maintenance of reduction and decreased risk of associated complications. 2 The present study is an attempt towards assessing and comparing the results of two methods of pinning-crossed pinning and lateral pinning -presently followed in the management of these difficult fractures.