BACKGROUND: Intra-articular distal humeral fractures are common, but complex elbow injuries. To obtain good results, anatomical reduction with rigid fixation and early range of mobilization is required. Treatment of these fractures with conventional plates is associated with many complications such as non-anatomic reduction of articular surfaces, malunion, nonunion, loosening of implant, residual stiffness of the elbow and post-traumatic osteoarthrosis. In this situation the application of locking plates having a fixed angle plate screw construct can minimise most of the above complications. OBJECTIVE: To evaluate radiological and functional outcome of locking plate application for the management of intra-articular distal humeral fractures. MATERIAL AND METHODS: This prospective study was conducted from January 2013 to December 2014. We operated 20 patients of AO type-C intra-articular distal humeral fractures. Fracture was exposed using modified Campbell's posterior approach in less comminuted fractures and a V-shaped Olecranon osteotomy was done to get better exposure of the articular surface in cases with severe articular comminution. The fracture was stabilized using an intercondylar screw, pre-contoured locking compression plates and/or locking reconstruction plates as per preoperative planning. Patients were reviewed at monthly interval for clinicalradiological evaluation. Final outcome measures included radiological assessment, range of motion and Mayo elbow performance score (MEPS). RESULTS: All the fractures were united at an average 12 weeks. Two patients developed numbness in the distribution of ulnar nerve and one patient developed superficial infection in immediate postoperative period. None of the patients had malunion and loosening of implant. The average arc of flexion-extension was 105`, although no patient had loss of supination/pronation. Mayo Elbow Performance Score was excellent in 15 (75%), good in 3 (15%), fair in 1 (5%) and poor in 1 (5%). CONCLUSION:The locking plate is a useful implant for the treatment of complete articular (type-c) distal humeral fractures.

Introduction: Femoral neck fractures are one among the leading causes of death in elderly patients. Magnitude of fracture displacement, patient's age, comorbid disorders, and prefracture activity level are some of the critical factors in determining the clinical practice for treating femoral neck fracture. In this study, we have studied the functional outcome and survivorship in fracture neck of femur in the elderly population operated with both internal fixation (IF) and cemented hemiarthroplasty (HA). Material and Method: All 100 patients were reviewed clinically and radiologically at 15 days, 1 month, and then subsequent 1 year. Out of 100 patients, 54 have been operated with HA and 46 have been operated with screw fixation. Results: Overall reoperation rate in HA group was 5.05%, with total mortality rate being 7.4% compared to 6.5% of IF group. Out of 46 patients of screw fixation, the overall reoperation rate was 20% with 4 patients being developed avascular necrosis and 13 being developed nonunion, and rest of the patients have average Harris hip score of 60–65 with 34%, while patients having poor Harris hip score compared to those of HA with Harris hip score of 80–90 with 88.2% having excellent to fair. Conclusion: Hip arthroplasty as compared to Internal fixation for the treatment of femoral neck fractures significantly reduces the risk of reoperation at the cost of higher superficial infection and blood loss. Furthermore, postoperative function as evaluated by the Harris hip score was significantly higher in the arthroplasty compared to the IF group up to the 6-month evaluation.

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Eight patients with displaced fractures of the humeral capitellum were treated by open reduction and internal fixation of the capitellar fragments with Herbert/ 4mm cc screws. As per Bryan and Morrey classification, there were five type I fracture and three type II fracture evaluated using the Mayo elbow performance score. Follow up period till 1 year. All patients had a stable pain free elbow with acceptable range of motion at last follow up. There was no evidence of avascular necrosis or degenerative change.

BACKGROUNDThe term osteomyelitis literally implies inflammation of bone and its bone marrow. The infection involves the marrow space, the Haversian system, and the subperiosteal space. The bone is involved secondarily. (1) Chronic osteomyelitis generally cannot be eradicated without surgery, that is sequestrectomy and resection of scarred and infected bone and soft tissue. The hall mark of osteomyelitis is infected dead bone with in a compromised soft tissue envelope. This avascular envelope of scar tissue leaves systemic antibiotic essentially ineffective. Antibiotic impregnated bone cement beads, specifically designed to combat infection localised to bone and soft tissue, have beads, developed to counter these challenges.