Background: Older adults who sustain hip fractures usually have multiple comorbidities that may impact their treatment and outcome. This study was conducted with the aim to analyze the risk factors that contribute to falls in elderly individuals and analyze the effect of comorbidities on the outcome and the treatment in elderly patients with hip fractures. Methods: This cohort study was conducted on patients with hip fractures. We prospectively analyzed 140 individuals with geriatric hip fractures who had undergone surgery. The Charlson Comorbidity Index (CCI) and American Society of Anesthesiology (ASA) score of each geriatric hip fracture patient were calculated based on data obtained from medical records. Clinical assessment was assessed using a modified Harris Hip Score (HHS) during each visit. Results: The mean age of patients was 72.21 ± 12.2 years. Their mean CCI and ASA was 1.02 ± 0.3 and 2.0 ± 0.53, respectively, and both were significantly associated with time-to-surgery (P < 0.001) and surgical treatment (P < 0.001). The length of hospital stay, duration of postoperative intensive care, and hospital expenses were associated with both CCI (P = 0.037) and ASA (P = 0.002). The greater the CCI and ASA scores were, the higher the chances of developing postoperative complications were (X2 = 15.724; P = 0.001). Delirium was the most common postoperative complication (15.7%), and pulmonary infection (11.4%) was the most fatal complication. Conclusion: Patients with high CCI and ASA grading, and revision surgery were at high risk of postoperative complications, morbidity, and mortality. Orthogeriatric care offers the best chance for a successful outcome through efficient medical comanagement of these patients.

Background: The purpose of this study is to formulate a simple and effective method of calculating native joint line and Posterior Condylar Offset (PCO) in proper lateral modern lateral radiographs of knee joint with minimal magnification coefficient. Methods: Knee joint line is measured from a. Posterior condylar flare and b. Tibial tuberosity. Line (A) was drawn from posterior cortex of femur that crossed the flare of posterior condyles. Joint line was measured by a perpendicular line (B) from the proximal most point of tibial tuberosity to the line joining the posterior cortex femoral line on lateral view. Posterior condylar offset: PCO was measured (B) relative to the tangent of the posterior cortex of the femur. The ratio was calculated from these measurements in relation to KSS also. Patients attending to Nizam's Institute of Medical Sciences, Hyderabad, in orthopaedic OPD with ideal body mass index who were evaluated for knee radiographs are included in the study after taking proper consent (n=210). Insta RIS PACS software is used to measure the parameters. Results: The mean joint line measured was 16 mm (range 14 to 18) with 3.0 as standard deviation and the mean PCO was 25mm (Range 19 to 31) with a standard deviation of 3.0. The KSS score had a mean of 85 (Range 80 to 90) indicating excellent score with standard deviation of 2.0. Joint line ratio was 95% Confidence interval (CI) and the ratio for PCO was also 95% CI. There was a significant difference in the measured joint line between genders. Conclusion:Using the current measuring method related to standard fixed bony land marks (Posterior femoral line, posterior femoral condyle and tibial tuberosity) which are unaffected even post-surgery the restoration of native joint line and PCO is reliable and reproducible.

Background: Mesenchymal stromal cells are origin for benign tumor osteoclastoma of bone. Different location of presentations with varied manifestations is a unique feature of osteoclastoma. Extended curettage of the lesion and supplementary allogenic bone grafting in selected cases is widely used treatment regimen. Selection of cases is important for successful outcome using this as a treatment protocol. Our study with 30 cases aims in selection of cases for successful outcome with this treatment protocol. Materials and Methods: Biopsy proven (core and open biopsy) 30 cases of osteoclastoma are selected. The cases are evaluated clinically, radiographically, CT &MRI scan and by histology. Campanancci grading and Enneking staging was used in the study. Chi square tests, Mann Whitney test and ANOVA were used for statistical analysis. Tumors with cortical breach which is confined to one surface and cortical breach less than one third of circumference were managed by extended curettage and bone grafting. Results: The average age of presentation was 25 years. Distal femur is the commonest site (16 cases) followed by upper end of tibia (12 cases) and 2 cases are from distal radius. Pathological fractures were seen in 2 cases. 4 tumors had less than 5 mm of subchondral bone free of tumor. The average follow up period was 18.6 months (range 2-84). 4 cases of recurrence were seen in a grade III recurrent distal femur lesion (3) and proximal tibia group (1) in the intralesional curettage group. Conclusion: Extended curettage with allogenic bone grafting is a reliable method with good functional outcome with less complications than other methods (enbloc excision) whenever we stick on to principles of tumor surgery with proven guidelines of case selection. Recurrence can always be treated with recurettage.

Introduction: Computed Tomography (CT) Biopsy is a corrigible coruscate procedure that corrected the discrepancy of the results between final biopsy and unguided Biopsy. CT guidance permits biopsy of nearly all lesions regardless of size and position. Recognition of the accuracy of biopsy and simple methods of treating pneumothorax has brought this method within the reach of most radiologist and pathologist. Infections and other neoplastic process may be proven by this method. In cases of malignancy of the lungs, cytopathological examination of material obtained by CT guided biopsy offers a quick and specific diagnosis which help clinicians implement appropriate anticancer measures like chemotherapy and radiotherapy. The present study is undertaken to determine the accuracy and efficacy of percutaneous biopsy in diagnosis of various lung lesions, and correlate the concordance with available results and available other methods. An interest to analyse the age, gender, topographic distribution and cytopathological diagnosis of thoracic mass lesions using CT guided biopsy is specially stepped in the current study. Aim: To assess the role of Computed tomography (CT) guided biopsy in the diagnosis of thoracic mass lesion and to analyse and compare the results with other studies. To evaluate the diagnostic accuracy and complication of Computed tomography (CT) guided biopsy in thoracic masses. To know the pathological spectrum of thoracic mass lesions and to correlate CT findings with cytopathological report. Methods: This Prospective study was done at Nizam's Institute of medical sciences, Hyderabad, surrounded by thickly populated districts which provide surplus material for doing research work and is also fully equipped with all the required modes and means for researches and health care. This study was conducted totally at indoor site including both OPD and IPD males and females from both urban and rural exclusively adults. Fifty one cases having Lung masses both malignant and benign were selected and subjected to CT guided biopsy. Statistical analysis was carried out by Using SPSS soft ware version 12. Results: Majority of the patients with lung masses in present study were males who constituted 66.6% and the females were 33.4%. Minimum age was of 22yrs and maximum age was of 92 yrs from the patients of this study. The mean age is 57 yrs. The chief etiological factor for the initiation of the pathogenesis of lung masses was found to be smoking. Out of the total cases included for the study 49% were malignant and 37% were benign lung masses. The complications observed were very few only in 8 cases (15.8%) in total of 51 cases selected for the study. The pneumothorax was noticed in 13.7% and haemoptysis in 1.9%. Conclusion:This CT guided biopsy stands as fruitful topic for study will be to elucidate the diagnostic and prognostic procedures in chest. This procedure of diagnosis with prosaic complications like Pneumothorax or Haemothorax or Haemoptysis and with its mosaic results outstands and extends its scope of study.