Background: Pathological fracture of the paediatric femur after chronic osteomyelitis presents a challenging situation. It is complicated by the need for radical debridement, often leaving a wide bone gap and instability that is difcult to be managed by the traditional methods. The Ilizarov method due to its versatility is a potential treatment option for this condition. 19 children with pathological femur Materials and methods: fractures following chronic Osteomyelitis were treated with Ilizarov methods. 3 children were excluded, and the nal outcome was measured in 16 children. The mean age of the patients was 6.76±1.93 years, with 12 males (63.15%) and 7 females (36.84%). The Beit cure classication of childhood chronic osteomyelitis was used. The mean follow up after ring removal was 26.06±5.07 months. NEER's criteria was used to assess the radiological and functional outcomes. With a mean union time of 10.94±3.93 weeks, 100% union Results: was achieved in all of the 16 cases. The mean external xator period was 14.25±4.94 weeks. The infection was fully eradicated in all of the cases, except 1 (6.25%) child diagnosed with tubercular osteomyelitis is still having the active infection. According to NEER's functional and anatomical grading, excellent results were found in 6 (37.5%) cases, satisfactory in 8 (50%), and unsatisfactory in 2 (12.5%) cases. Pin tract infection was found in 10 (62.5%) children, axial deformity after ring removal in one (6.25%), and knee stiffness in 2(12.5%) children. In children w Conclusion: ith pathological femur fractures caused by chronic osteomyelitis, the Ilizarov method can be a viable treatment option. It helps to eradicate infection, promotes fracture healing, and produces satisfactory to excellent results.

Introduction: Acute compartment syndrome of the thigh is an orthopedic emergency. Compartment syndrome of the thigh without a fracture or any other associated pre-injury pathology is scantily reported in the literature. Lack of awareness and inexperience often results in a failure to diagnose it. Case report: In this article, we are presenting a rare case of acute compartment syndrome involving the anterior compartment of the thigh without any bony abnormality or a fracture in a 62-year-old male who sustained an injury to his lateral aspect of the right thigh by a fall from a height. We performed an emergency fasciotomy and decompression of the involved compartment. The patient needed a subsequent skin grafting for the wound closure. Finally, after 7 months of follow-up, an excellent clinical outcome of the affected limb has been achieved. Conclusion: Thigh compartment syndrome without a fracture or other pre-injury pathological abnormalities of the thigh is relatively rare, hence there is often a fair risk that a case will go unnoticed. Therefore, a high index of clinical suspicion and prompt treatment can protect a patient with thigh compartment syndrome from long-term disability.

BACKGROUND In fractures of the femoral neck, anatomic reduction is compulsory and maintaining the reduction is crucial. It is an enigma to orthopaedic surgeons and a curse for an individual with complications like avascular necrosis and non-union. 1 Fracture neck of femur in young adults are uncommon and only 2-3% of all intracapsular hip fractures occur in younger adults. 2 There is lack of consensus in treating the young adult patients. 3 Basicervical fractures of femur are relatively rare injuries which account for only 1.8-7.6% of hip fractures. 4 Traditionally, most intracapsular neck femur fractures in young adults had been treated with multiple Cancellous Cannulated Screws (CCS) whereas inter-trochanteric (extracapsular) fractures had been managed well in the past with the Dynamic Hip Screw (DHS). METHODS A prospective comparative study was done in the Department of Orthopaedics at Assam Medical College, Dibrugarh for a 2 year duration from June 2017 to December 2019 with a minimum of one year follow-up. Informed consent for inclusion in the study was taken from every patient. A detailed history and thorough physical examination was done followed by relevant investigations and radiological evaluation. RESULTS A total of 34 patients were initially included in this study. 17 patients were treated with CCS (Group 1), 17 with DHS with DRS (Group 2). One patient in group 1 and one in group 2 was lost to follow up due to change in address / contact number and were excluded from the study for final evaluation. CONCLUSIONS Basicervical fractures act as an unstable extra-capsular fracture rather than a stable intracapsular fracture neck of femur. The present study supports the hypothesis that this type of fracture neck of femur surely needs anatomical reduction and fixation for which Dynamic Hip Screw with derotation screw is a best implant in terms of both radiological and functional outcome. Although initial clinical outcome scores were better in DHS group, both implants have almost similar outcome in long term follow up. However, it is difficult to draw a common conclusion from such a small sample size. A larger sample size is probably needed to identify the definitive method for these fractures.

The purpose of this study was to assess the results of percutaneous autologous bone marrow injection in the treatment of delayed union of long bone fractures after definitive fixation. It has been a gruelling job for the orthopaedic surgeons to deal with the delayed union after definitive fixation due to the lack of patient compliance for reoperation like classical bone grafting technique for delayed union and non-union, unfavourable fracture site morphology for external compression, post-operative surgical wound issues etc., The percutaneous autologous bone marrow injection is a reasonable choice in this scenario for the treatment of Delayed union of long bone fractures after definitive fixation. The study was performed in the department of orthopaedics Assam Medical College and Hospital, Dibrugarh, Assam, India for a period of 2 years from July 2019 to June 2021. A total of 23 patients were taken with delayed union of long bone fractures after definitive fixation. These 23 patients were treated with percutaneous autologous bone marrow injection and followed up for 6 months. The results were evaluated on the basis of clinico-radiological criteria of union, and found to be excellent in 60.86% (14/23), good in 17.39% (4/23) and poor in 21.73% (5/23) cases. The percutaneous autologous bone marrow injection provides cellular stimulation and promotes fracture healing without the necessity for opening the fracture site. Hence it is an effective method to bring about successful outcome of delayed union of long bone fractures after definitive fixation without adding any significant complication to the patient and the fracture site.

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