Femoral shaft fracture is the commonest major pediatric orthopedic injury requiring hospitalization. Controversy persists regarding management of femoral fractures in the patients aged between 5-15 years. 11 patients were followed up for the mean period of 12 months and evaluated using Flynn's criteria. All the fractures united between 8-12 weeks. 3 patients had knee stiffness, 1 patient had shortening > 2 cm and 1 had superficial infection. We conclude that TENs is simple, rapid & effective treatment for displaced pediatric femoral shaft fractures between 5-15 years of age with very less complication rate.

Revision of a failed acetabular component in the presence of an intact femoral prosthesis comprises approximately 20% of revision total hip replacements performed by the senior author. During this procedure, the femoral trunnion is at risk of damage because of scratching from retractors, reamers, or other instruments. Scratching can result in mechanically assisted crevice corrosion or adverse local-tissue reaction or trunnionosis leading to implant failure. We have used a variety of techniques for protection of the femoral taper over the last 30 years. We describe our current method of taper protection, using a cut segment of #5 silicon laryngeal airway, which is a simple and effective method.

Introduction: Tibia fractures are the most common long bone fractures encountered by the orthopedic surgeons and distal tibia fractures have the second highest incidence of all tibia fractures after the middle third of tibia the distal tibial fractures are unique and are considered as most challenging fractures to treat due to its proximity to the ankle joint and its superficial nature. The objective of this study is to compare two osteosynthesis systems developed for surgical treatment of distal tibia fractures: the intramedullary nailing and the MIPPO technique. Methods: The study was conducted between Jan 2011 to Dec 2012. 63 patients with extra-articular distal tibia fracture treated with intramedullary nailing and MIPPO technique were reviewed retrospectively and clinical outcome was evaluated according to American Orthopaedic Foot and Ankle Score. Results: 31 patients were treated with intramedullary nail & 32 with MIPPO technique. Fibular fixation was done in cases where fibular fracture was at or below the level of tibial fractures. We found no difference in terms of time for fracture union, mal-union, non-union, duration of surgery and amount of blood loss. But there was significant difference in terms of infection and duration of hospital stay. Also weight bearing was possible much earlier in intramedullary group as compared to the MIPPO group. Conclusion: Thus we conclude that intramedullary nailing is better choice of implant in patients with extra-articular distal tibia fractures & helps in early weight bearing and ambulation of patient with fewer complications.

Purpose Reconstruction of extensive acetabular bone defects is one of the most challenging problems encountered by arthroplasty surgeons. Triflange patient matched implants (PMI) offer the potential advantages of immediate, rigid fixation with a superior individualized fit. The purpose of this study was to evaluate the clinical and radiographic midterm results of PMI in extensive acetabular defect reconstruction. Materials and Methods The current prospectively designed retrospective review examined 13 consecutive patients (5 males and 8 females) with a mean age of 69 years undergoing revision hip arthroplasty with Paprosky type 3B acetabular defects reconstructed using PMI between October 2011 and December 2016. A successful result was defined as a postoperative increase in Harris hip score (HHS) of >20 points with a radiographically stable implant (assessed with hip X-rays) and no need for additional acetabular reconstruction. Results Twelve out of the 13 patients in the study were available for follow-up with mean duration of 50 months. One patient died during the study period due to an unrelated cause. The mean HHS increased from 41 to 82 points. Eleven out of 12 acetabular components were well fixed and pelvic discontinuity healed in all patients. Conclusion Custom triflange PMI is an excellent option for management of complex and extensive acetabular defects with or without pelvic discontinuity.