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<p class="abstract"><strong>Background:</strong> Closed reduction is difficult not only to achieve but also to maintain because of the thinness of bone of the distal humerus between the coronoid and olecranon where most supracondylar fractures occurs. For this reason percutaneous pinning techniques have become the treatment of choice for most supracondylar fractures. By this procedure even the displaced and rotated fracture can be treated successfully with minimal incidence of complications. The purpose of this study is to determine the efficacy of management of displaced supracondylar fractures using closed reduction with percutaneous K-wire pinning and to analyze the results, loss of carrying angle, and loss of motion with incidence of complications.</p><p class="abstract"><strong>Methods:</strong> 20 cases of displaced supracondylar fractures in children aged between 5 and 12 years were treated by closed reduction and percutaneous pinning and were studied prospectively for functional outcome. 8 cases were treated with crossed pinning. 11 cases were treated with 3K wire fixation and 1 with lateral pinning.<strong></strong></p><p class="abstract"><strong>Results:</strong> 85% of the patients observed excellent results. 15% of the patients observed fair results. Of the cases treated by 3K wire fixation 55% had excellent results and cases with crossed pinning 40% had good results and 5% had poor results. All the patients treated with lateral pinning had excellent results.</p><p class="abstract"><strong>Conclusions:</strong> The results obtained in this study shows that anatomical reduction by closed method and stabilization with K-wire fixation is the first treatment of choice for displaced supracondylar fractures.</p>

INTRODUCTIONFractures of the proximal humerus represent approximately 4% of all fractures and 26% of humerus fractures.1 These are the second most common upperextremity fracture and the third most common fracture, after hip and distal radial fractures. The fractures can occur at any age, but the incidence rapidly increases with age. The risk factors for proximal humeral fractures are primarily associated with low bone mineral density and an increased risk of falls. The most common mechanism of injury in proximal humeral fractures in elderly patients is a fall from standing height onto an outstretched upper extremity. In patients aged less than 50 years, the mechanism is often related to high-energy trauma, such as significant falls from height, motor vehicle accidents, or athletic injuries.The injury is of great importance when it affects the young and middle age groups of the population. It leads to temporary disability and loss of working hours. ABSTRACT Background:Fractures of the proximal humerus are the second most common upper extremity fracture and the third most common fracture, after hip and distal radial fractures. The fractures can occur at any age, but the incidence rapidly increases with age. Methods: The study was conducted in patients treated for displaced proximal humerus fracture at Adichunchanagiri Institute Of Medical Sciences, BG Nagar from the month of June 2014 to August 2016. Twenty proximal humerus fracture patients were taken into the study; all were fixed with PHILOS plate. Patients' age ranged from 18 to 75 years with a mean of 42.9. Results: The sample consisted of twenty patients of proximal humeral fractures. 08 were males and 12 females. The patients' ages ranged from 18-75 years with a mean age of 42.9 years. The causes of fractures were road traffic accident in 13 patients, fall in 06 patients and electric shock in 1 patient. 11 fractures involved the right side and 09 involved the left. Patients were followed up from 03 weeks to 06 months. Functional outcome was rated as per Constant-Murley Shoulder Score, we got excellent results in 04 cases, satisfactory in 10, unsatisfactory in 05 xi and failure in 01 patient. Mean Constant-Murley score of this study at the end of the final follow-up period was 81.6. Conclusions: The PHILOS plate is a good implant to use for fractures of the proximal humerus. However, proper placement of the plate and fixation are required to produce satisfactory results. We recommend use of this implant in Neer 2-part, 3-part, 4-part fractures with or without dislocation and osteoporotic fractures.

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Background and Objectives: Ankle fractures represents 10% of all fractures making it a second most common fractures of lower limb after hip. Peak incidence of ankle fractures in younger men & older women have a bimodal distribution. Typically low energy injuries with majority occurring due to simple falls or Sports. Ankle joint is very congruous and any disturbance of the normal articular relationship may result in some progressive arthrosis of biomechanical dysfunction. Determining ankle stability for planning fracture management is very critical. Stable fractures can be managed conservatively but outcomes of unstable fractures are always better with surgical management. ORIF has shown clearly the superiority in literatures. Lateral malleoli without any deltoid ligament involvement can be treated conservatively with good results whereas lateral malleoli with deltoid ligament involvement leads to talar subluxation and arthritis hence needs to be fixed stably. The objectives is to study the functional outcomes and results of surgical management of malleolar fractures, and to know the complications of open reduction internal fixation of malleolar fractures. Methods: 30 patients with fresh malleolar fractures were taken into study. As soon as the patients were brought to emergency room a complete survey was done to rule out any significant injuries. Then radiographs were taken, both antero-posterior and lateral views of ankle joints. On admission history was elicited in relation to age, sex, occupation, address, mode of injury, past illnesses, associated medical aliments and was subjected to thorough clinical examination. Analgesics and below knee slabs were applied to alleviate the pain. Eventually fractures were classified according to Lauge Hansen's classification system. Patients were operated as early as possible once they were fit for Surgery. Results: Out of 30 patients treated 23(76.6%) had good to excellent results, 4(13.3%) had fair & 3(10.0%) had poor results, our study showed that mean age of presentation was 37.87 years with male preponderance & involvement of dominant limb(right side), most common mode of injury was road traffic accident, analysis according to lauge Hansen classification were found to have supination external rotation injury in common, there were no intraoperative complications, But had poor outcomes due to the superficial skin infection which was treated appropriately. Interpretation and Conclusion: Mechanism of injury is necessary for accurate reduction & further management. Fibular length has to be maintained, Anatomical reduction is essential in all intra articular fractures like ankle joint, were weight bearing is essential. Open reduction and internal fixation Guarantees high standard of reduction besides eliminating the chances of loss of reduction. Chances of non-union of medial malleolus was reduced by preventing interposition of periosteum or any other soft tissue. Even after cast immobilization for 3-4 weeks the results are satisfactory due to the vigorous physiotherapy whic...