<p class="abstract"><strong>Background:</strong> Forearm fractures are one of the commonest injuries accounting for 40% of paediatric fractures with a refracture rate of nearly 5%. Forearm refractures are increasing probably due to poor bone mineralization as a result of decreased physical activity, Vitamin D deficiency. These are treated by conservative measures with closed reduction and casting or by surgical fixation with flexible nails or plates. There are no definitive guidelines for management of forearm refracture and implant removal.</p><p class="abstract"><strong>Methods:</strong> The study is aimed at the epidemiology, methods and difficulties of management and functional outcome of forearm refracture treatment. A prospective study of all the cases of forearm refracture who presented to our institution from 2010 to 2016 with refractures treated either by conservative methods or by IMN. All cases were followed up for 2 years and functional outcome was assessed serially according to price et-al criteria.<strong></strong></p><p class="abstract"><strong>Results:</strong> Our study contained 17 males and 8 females between 6 years and 14 years. 76% refractures occurred before 16 weeks and majority had only tricortical union at this time. 42% patients underwent surgical fixation following refracture. Price et al criteria showed excellent results in 72% of patients.</p><p class="abstract"><strong>Conclusions:</strong> Forearm refractures in children can be treated both conservatively and surgically like a primary fracture depending on the indications but needs 2 to 3 more weeks of immobilization. A good functional outcome was obtained in majority of the cases. We suggest using splints till quadricortical union is achieved to prevent chances of refracture.</p>

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Background: Total joint replacement is a frequently done procedure in modern day practice of any orthopedics unit. Limiting blood loss both postoperatively and intraoperatively presents a challenge to the surgeon. Use of tranexamic acid (TA) reduces perioperative blood loss and need for allogenic blood transfusion in patients undergoing total knee replacement. Methods: This is a randomized controlled study that involved 105 patients who underwent primary total knee arthroplasty at our institute. A total of 105 consecutive patients underwent total knee replacement (TKR) between 2009 and 2014 at our institute. No patients who had primary TKR were excluded from the study. The information was collected prospectively but reviewed retrospectively. Patients were allocated to either the TA group (TA, n = 55) or the control group (n = 50). Results: The results were analyzed and no significant differences between the groups were found in the demographic data. Our results demonstrate significant reduction in blood loss with the use of TA. Conclusions: We can conclude that TA use might be a good solution to the problem of massive allogenic transfusion requirements especially in developing countries. A meta-analysis which looked at double-blinded randomized controlled trial also found that TA was useful in reducing blood loss in major orthopedic procedures.

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