Background: Fractures of the humeral mid shaft are common. The advantages of operative management are early mobilization and patient comfort but, operative management carries the risk of technical errors and post-operative complications like infections and nerve injuries. Aims and Objectives:To study the fracture pattern and surgical management of fracture midshaft humerus by intramedullary nailing and plating. Materials and Methods: Forty eight patients were studied in the Department of Orthopaedic, MLB Medical College Jhansi from August 2018 to August 2019, after randomizing them into plating or interlocking nailing. A thorough history and clinical examination was done. Once the patients were randomized, pre-operative planning and investigations were done and the patients were posted for open reduction and internal fixation with plating or interlocking nailing. The patients were followed up every second week till radiological union was seen. The functional outcome was measured by the "Disabilities of Arm, Shoulder and Hand" (DASH) Questionnaire at nine months or at full recovery which ever was earlier.Result: Out of 60 fractures shaft of humerus, 48 were operated and the rest 12 treated conservatively. Mean time taken for radiological healing in the interlocking group was14.05 and in plating was 16.06. The mean DASH score in the plating group was 24.1 and in the interlocking group it was 43.1 (0.024). Postoperatively in the plating group there were 13 complications and in the interlocking group there were 6 cases with complications (p=0.009). Conclusion:Cases where both plating and interlocking nailing can be done, plating should be preferred as plating offers better result with respect to pain and function of the shoulder joint.

Prolotherapy is one of the injection-based alternative therapeutic options for the treatment of chronic musculoskeletal pain. However, for chronic musculoskeletal conditions, corticosteroid and local anesthetic preparation like Lignocaine is widespread and initial injection therapy of choice. There are several other techniques also such as autologous whole blood, platelet-rich plasma, bone marrow, dry needling, and extracorporeal wave therapy. In prolotherapy, a very small amount of irritant or sclerosing solution is injected into joint space, ligament, or tendon insertion sites as a complementary medical treatment over several treatment seasons. Hyperosmolar dextrose, phenol–glycerine–glucose, and morrhuate sodium are the three most commonly used prolotherapy solutions. There are several studies and evidence available regarding the efficacy of prolotherapy over various musculoskeletal conditions such as chronic low back pain, osteoarthritis of joints, subluxation and joint instability, ligament laxity, hypermobility of joints, and tendinopathy. The efficacy of prolotherapy for different musculoskeletal conditions with different injections is different, and the precise mechanism of prolotherapy effect is still not clear, so further studies and clinical trials are recommended.

Background: Type C tibial plateau fractures are complex injuries, and an ideal method for their treatment is still controversial. In the present study, we discuss the outcomes of Arbeitsgemeinschaft für Osteosynthesefragen (AO) type C tibial plateau fractures treated with dual locking plating and single lateral locking plate supplemented with two medial cannulated cancellous (CC) screws. Materials and Methods: This prospective study included 34 patients of AO type C tibial plateau fractures divided into two groups. Dual locking plating and single lateral locking plate supplemented with two medial CC screws were the treatment methods in group 1 and groups II, respectively. The patients were evaluated using the Rasmussen clinical grading system at 1 and 2 years postoperatively. Results: The range of motion (ROM) was observed as 121.0° ± 1.9° and 126.3° ± 2.6° in group II, whereas in group I, ROM was 112.5° ± 3.1° and 120° ± 1.5° at 1 and 2 years, respectively. Pain, walking capacity, and final outcome were significantly better in group II at 1 and 2 years postoperatively. No significant difference was observed in two groups in terms of radiological results. Conclusion: Lateral locking plate supplemented with two medial CC screws proves to be a better method to treat AO type C tibial plateau fractures in adults, with minimal complications.

Background: Fracture neck femur has been termed as an 'unsolved fracture' as it has always presented a great challenge to the orthopaedic surgeons regarding the ideal management and the prognosis. Aims and objectives: To study the incidence, causes and management of neglected fracture neck femur. Materials and methods: Fifty patients having fractures of neck femur presenting after 3 weeks were studied in the Department of Orthopaedics, M.L.B. Medical College, Jhansi, between January 2018 to Aug 2019; after dividing them into two groups. Group A (n=20): patients <60 years of age with fracture neck of femur of >3week since injury treated with valgus inter-trochanteric osteotomy and DHS with 120° double angle barrel plate and Group B (n=30): patients >60 years of age with fracture neck of femur of >3week since injury treated with bipolar hemi hip replacement arthroplasty. A detailed history of patient regarding, age, sex, Mode of injury, duration, associated injuries, past history, clinical examination and radiological examination were done along with the X-Ray pelvis. All cases were followed up at monthly interval after surgery for 6 months and then at three monthly intervals for next 6 months, then 6 monthly interval and results evaluated by using Haris Hip Scoring System (HHS). Results: Mean age of patients in Group A was 38.9 years and that in Group B was 74.6 years. Mean Pauwel`s angle, neck shaft angle and limb length shortening and Harris Hip Score was improved post operatively in Group A. The mean HHS in group B preoperatively was 65.6 and after surgery it was increased to 91.4. Quality of internal fixation was satisfactory in 90% cases. Consolidation at osteotomy site was achieved in 95% cases. In 80% cases fracture united within 6 months. In Group B, 4 patients lost to follow up, out of 26 remaining patients, 14 patients had no pain and 10 patients had slight pain at the end of 6 months. Out of these7 patients had no limp and 19 patients had slight limp. At the end of one year, 21 (80.7%) patients could walk more than 1000 meter with single cane. Conclusion: Valgus osteotomy in young and bipolar hemi hip replacement arthroplasty in elders has high success rate in neglected fracture neck of femur.

Background: Now a days there is increased utilization of volar locking plates fixation over external fixation. However, the comparative complications and outcomes of both surgical methods are still unclear. Purpose: The purpose is to compare if volar locking plate is superior to external fixation for distal radius fractures with comparison of complications associated with both surgical methods. Materials and Methods: An observational study was done from 2020 to 2022 among patients presented with displaced distal end radius of 30 patients in which 15 were treated with external fixator with cross k – wire and 15 were treated with volar locking plate with an average of 12 month or longer follow up. Results: Acceptable functional outcomes were observed with DASH scoring in 70% of study population. The functional outcome score was higher in younger population with an overall complication rate of 17% including pin track infection, hardware related issues, tendon injury, nerve dysfunction. Conclusions: In the volar plating patients outcomes (DASH SCORE), In the first 3 and 6 months is better than External fixation, However after 1 year the outcomes of both techniques found equal with little difference in terms of range of motion, grip strength, osteoarthritis.