Background:Surgical management of posttraumatic elbow stiffness has been reported with poor outcome following treatment. Sequential release in earlier stages of stiffness yielded much better results. The goal of our study was to assess the outcome in improvement of the range of motion of the elbow after surgical release and to analyze a tailor-made approach according to individual needs to yield good result.Materials and Methods:A prospective study was conducted in 47 cases of elbow stiffness due to various types of injuries. All the cases were treated with sequential release if there was no progress after adequate supervised conservative management except in unreduced dislocations. All the cases were followed up for a minimum period of 24 months. Overall outcome was rated with the functional scoring system by Mayo Clinic Performance Index.Results:Twenty-five (44.68%) out of 47 patients had excellent results with a mean preoperative range of motion of 33.9° and postoperative range of motion of 105° with net gain in range of motion of 71.1° (‘t’ test value is 19.27, P < 0.01). None of the patients had elbow instability. Patients not having heterotopic ossification, who underwent surgery from three to six months post injury had a mean gain of 73.5°. In patients who waited for more than six months had mean gain of 66.8°. However, the results in cases having heterotopic ossification followed a slightly different pattern. In cases where release was performed from three months to six months had mean gain of 77.5°. Cases in which release was performed after six months had gain of 57.1°.Conclusions:In cases of posttraumatic elbow stiffness after a failed initial conservative treatment, early arthrolysis with sequential surgical soft tissue release yields good result than delayed surgery.

Background: Subtrochantric region is cortical in nature and vascularity is slow so healing is not as fast as highly vascular area of bone. This area of femur is subjected to stress due to its muscular insertions. So there is greater chance of fixation failure, non-union, and failure of procedure. Keeping all these in view present study has been designed to study the anatomical and functional outcome of subtrochantric fracture treated with proximal femoral nail, to access the stability of fixation and mobility of the patients and compare the result with standard treatment. Method: Patients with sub trochanteric facture admitted in the department of orthopaedics and trauma are enrolled for this study based on inclusion and inclusion criteria. Standard operative procedure was followed management of subtrochantric fracture by proximal femoral nail. Demographic, intra-operative, post-operative variavles are recorded. Result: The duration of surgery was 95.636 + 16799 minutes in present study. The mean volume of blood lost during surgery was 114.387 + 17.90 ml and regarding complication of in intra operative period 12% patient required open reduction. Regarding post operative complication no patient were presented with implant failure, malunion and delayed union was present in 10% patients. Joint stiffness and shortening of limb was present in 8% patients. Discussion and Conclusion:We can conclude that subtrochantric fracture is common in elderly and trivial fall is common cause. Intra-operative variables during proximal femoral nailing were good with less blood loss and minimum deformities. Post-operative variables like non union and joint stiffness was less. Most of the patients have good functional out come.

Background: Treatment of fracture of humerus was always a challenge to medical practitioner as recorded by in ancient medical literature but iatrogenic damage during management was always concentration. Present study has been designed with an aim to evaluate surgical management of fracture shaft of humerus using nailing and plating technique. Method: Patients with fracture shaft of humerus who require surgical stabilisation were selected for fixation with dynamic compression plate or fixation by intramedullary nailing randomly by using sealed envelope method. In dynamic compression plating we used 4.5 mm compression plate in all patients. Regular evaluation of the patient was done by local examination and radio graphic examination functional evaluation, was done by Myo elbow performance scale, Shoulder function (Constant and Murley score) and American shoulder and elbow surgeon score (ASES scare). Result: Regarding functional status of joints based on score, the Myo elbow performance score was excellent in 12 patients in DCP group, good in 7 seven patients and fair in one patient. In interlocking nail group the score was excellent in 14 patients, good in 4 patients and fair in 2 patients. The p value was more than 0.05 which is not significant statistically. In DCP group the shoulder score (constant and Murley score) was excellent in 13 patients, good in 6 patients and fair in one patient. Discussion and Conclusion:Based on our observation we can conclude that there is no significant difference in functional outcome between platting and nailing group groups. Regarding complication between two group adhesive capsulitis was common in nailing group and delayed union was more in plating group.