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<p class="abstract"><strong>Background:</strong> Distal end radius (DER) fractures represents one of the common fractures in the paediatric age group. Most of this injury are managed by closed reduction and casting. We investigated the degree to which the clinical and radiographic follow-ups reveal complications that lead to a change in management of the un-manipulated distal radius fractures in children less than 14 years of age. We determined the frequency and type of complications registered during treatment, and assessed the stability of the different fracture types.</p><p class="abstract"><strong>Methods:</strong> Study includes examination of 30 patients with closed DER fractures who were admitted in tertiary care centre between August 2016 to April 2018.<strong></strong></p><p class="abstract"><strong>Results:</strong> Closed reduction and casting was modality of treatment in 40%, casting was done in 33.3% and closed reduction and k wire were done in 26.7%. In patients with closed reduction and k wire slab was given. Gartland and Werley’s scoring system was used and found that 60% patients have 0 score, 30% have 1 score, 6.7% have 2 score and 3.3% have 3 score. 29 patients had excellent result and 1 patient had fair result.</p><p class="abstract"><strong>Conclusions:</strong> In this study of management of DER fracture in children with different modality of treatment, we noted that if it is an undisplaced fracture, can be managed with casting. If it is displaced fracture and reduction is achieved then closed reduction and casting can be done. If displacement is more than 50% of bone diameter then closed reduction and k wire can be done.</p>

<p class="abstract"><strong>Background:</strong> The treatment of long bone fractures in children from 6 to 14 years is a challenging scenario. Titanium elastic nail (TEN) fixation was originally meant as a gold standard treatment method for femoral fractures, but was gradually applied to other long bone fractures in children, because it represents a middle path between conservative and surgical modality.</p><p class="abstract"><strong>Methods:</strong> In the present study paediatric patients in the age group of 6 to 14 year with long bone fractures to be treated with TEN in the Department of Orthopaedics were admitted to MGM Hospital (Kamothe) were selected. A total of 30 patients consenting to undergo this study were subjected for treatment after screening using the inclusion and exclusion criteria.<strong></strong></p><p class="abstract"><strong>Results:</strong> The mean age of the patients was 9.67±2.68 years. There was male preponderance (63.3%). In our study, RTA was observed to be the main cause of fracture (80%) whereas 20% fractures were due to fall. In our study, 50% patients had fracture of radius ulna followed by fracture of tibia 23.3%, femur (23.3%), and humerus (3.3%). The mean time to union was 5.30±1.06 weeks.</p><p class="abstract"><strong>Conclusions:</strong> TEN seems to be simple, biocompatible, more physiological, reliable and effective method of treatment of all long bone shaft fractures in 6 to 14 years old children. It is a rapid, safe and simple procedure with advantages of short operative time, minimal blood loss, shorter hospital stays early union, allowing early mobilization and early return to function with minimal complications.</p>

Background: Mid-shaft clavicle fracture management has been inclined more toward osteosynthesis in recent times for better functional outcomes. The aim of the study was to find out does operative management in displaced mid-shaft clavicle fractures provide better outcomes than conservative? Materials and Methods: The randomized trial was conducted between December 2017 and July 2019 at a tertiary trauma center on 50 consecutive patients with displaced mid-shaft clavicle fracture. The inclusion criteria included age between 16 and 60 with acute isolated closed displaced mid-shaft clavicle fracture. Patients with neurovascular deficit, compound fractures, pathological fractures, and nonunion/malunited fractures were excluded. Group A had 25 patients who were treated with operative line of management and Group B had 25 patients who were treated with a conservative line of management; division was done on basis of odd (Group A)–even (Group B) technique. Results: Out of 50 patients, the mean age group of patients was 35.5 ± 1 years of life with others ranging from 16 to 60 years. Out of 50 patients, 45 (90%) patients were male and 5 (10%) were female. Out of 50 patients, 42 had a history of road traffic accidents, while 8 had a history of falls. The right side clavicle was affected in 18 patients and left was affected in 32 patients. Out of 50 patients, the mean time of union in operative group was 11.36 ± 2.56 and 11.36 ± 2.75 weeks in nonoperative group. Constant shoulder score was 85.16 ± 15.30 and 84.64 ± 13.52 in the operative group and nonoperative group, respectively. Conclusion: In this prospective cohort study, we have concluded that long-term functional outcomes of conservative versus operative management of displaced mid-shaft clavicle fracture are similar, but primary open reduction with internal fixation of displaced mid-shaft clavicle fracture in young adult patients ensures anatomical reduction, early mobilization, and faster recovery for functional activity while avoiding complications such as malunion.