STUDY DESIGN: Non-randomized, prospective analysis of 68 patients of lumbar disc herniation treated with ozone nucleolysis.

BACKGROUND: Distal femur fractures are commonest fractures in high velocity trauma, the records of a consecutive series, from 1969 to 1976, of 135 adult patients with 137 fractures of which Eight-three fractures were caused by moderate and 52 by severe trauma. 1 Isolated fractures can lead to complications such as ARDS and pulmonary embolism. This leading to the need for early stabilization of fractures, with internal fixation being the choice of treatment for distal femur fracture by LCP. Plating has given the best results in terms of recovery, fracture union, return to work and in turn the functional outcome. OBJECTIVES: To study the functional outcome of the distal femur fracture fixation using LCP with MIPPO technique. METHODS: The surgical outcome of 30 patients (24 males and 6 females) who were treated by closed reduction with locking compression plate using MIPPO technique, were followed for an average of 12 months, then by radiological and clinical evaluation assessment was done using the NEER'S score. RESULTS: In the study of 30 patients with acute trauma, median age being 45 years ranging from 22-68 years. 22 fractures were caused due to RTA, 6 of them with self-fall and 2 presenting with assault. 23 amongst them were fractures of the right femur and the rest being the left. Using the NEER'S scoring system 50% excellent results were obtained, with 30% good, 20% fair results. Range of motion of hip and knee was well preserved with excellent to good results. Gait and weight bearing after complete union was satisfactory. CONCLUSION: Closed reduction and internal fixation of the distal femur fractures by LCP using MIPPO technique is one of the best modalities of treatment, with the extension of fractures into the articular congruencies, maintaining of the same is very vital. Fixation with locking condylar plates proved to be very effective especially in severe osteoporosis, decrease in the duration of hospital stay was also seen along with faster recovery, earlier union rates and good functional outcome compared to alternative procedures known. KEYWORDS: Supracondylar femur fracture, locking condylar plate, MIPPO technique, intra-articular fractures, NEER's scoring system, closed reduction and internal fixation. INTRODUCTION:With the increase of RTA and industrialization many young lives have crippled and need for decreasing their morbidity is gaining demand.Fractures of the distal end of the femur are often difficult to treat due to their complexity and intra articular involvement at times and their associated complications.In the early 1960's, there was a great reluctance towards the operative intervention of these fractures as they were associated with higher rates of malunion, non-union, sepsis, inadequate fixation, lack of proper tools and so on. Then the traditional management of supra condylar femur displaced fracture swept, mainly consisting of skeletal traction, manipulation of fracture and external immobilization in the form of casts and cast bracings. These were associated with problem...

BACKGROUND:This prospective consecutive case series was done to evaluate indications, technical pearls and pitfalls and functional outcomes of elastic stable intramedullary nailing of displaced mid clavicular fractures and the effectiveness of the titanium elastic stable intramedullary nails in the surgical treatment of the mid clavicular fractures in adults. MATERIALS & METHODS: A total of 80 patients (60 men, 20 female) were included in this study. Constant score and radiographs were evaluated after 1 and 6 weeks, 3 months and 6 months in 80 patients. Mean age was 28 years. RESULTS: Length of incision, operation time, blood loss and duration of hospital stay were significantly less. The average follow-up was 17 months. Mean operation time was 62 minutes. Open reduction through an additional small incision was necessary for some fractures. Mean hospital stay was 1.2 days. The Constant score averaged 81 after 1 week, 96 after 6 weeks and 98 after 6 months. Compared to the contralateral side, average shortening of the clavicle was 1.7 mm. CONCLUSION: Elastic Intramedullary Nailing provided a good restoration of the length of the clavicle allowing immediate active mobilization and early return to normal activity with excellent functional results. KEYWORDS: Clavicle fractures; Intra medullary nailing; elastic stable intramedullary nails. INTRODUCTION:Fracture of the clavicle is a frequently seen injury which represents about 10-15% of all fractures in adults. (1) In most cases a fall with a direct trauma causes the clavicle to fracture. About 80% of all clavicular fractures involve the middle third of the bone. (2) Standard treatment for this fracture pattern is non-operative, using an arm sling or figure-ofeight bandage for external fixation. For open fractures, imminent skin perforation, neurovascular involvement, floating shoulder or in combination with multiple ipsilateral rib fractures, open reduction and plating is generally accepted. (3) While fracture healing and functional outcome is generally good for non-operatively treated mid clavicular fractures, a poor cosmetic result due to shortening and angulation is not uncommon. (2) Non-unions occur in an average of 5%. (3) Furthermore decreased shoulder function due to clavicular shortening of more than 1-2 cm after non-operative fracture management has been reported. (5,12) Whereas a mild decrease in shoulder function is easily tolerated by most patients, restoration of the clavicle length and early return to full activity with unimpaired function is of great importance for every individual irrespective of the profession or socio-economic group they belong to.As non-operative treatment is successful in most cases for this fracture, relevant clinical benefit may be limited to a selected group of patients with a high demand on shoulder function.

Background: Tremendous advance in mechanization and fastness of travel have been accompanied by steep increase in number and severity of fractures and those of tibial plateau are no exception. Knee being one of the major weight bearing joints of the body, fractures around it will be of paramount importance. Objective: 1. This study is to analyze the functional outcome of ORIF with plating with or without bone grafting in tibial plateau fractures in adults. 2. To study complication of operative management Methods: Conrmed cases of Tibial plateau fractures admitted in Department of Orthopaedics in Basaweshwara Teaching and General Hospital attached to Mahadevappa Rampure Medical College, Kalaburagi. The purpose of the study is to include with tibial plateau fractures diagnosed with history taking, Examination and investigations: knee X ray-AP and Lateral view. The need of operative intervention is assessed based on the Shatzker`s classication and intervention done by techniques like anterolateral plating bicondylar plating, posteromedial plating. Patients will be reviewed at 6 weeks, 3 months and 6 months interval and their assessment done by Rasmussens functional and radiological scoring. In our Results: series, majority of the patients were males, middle aged, with road trafc accident being the commonest mode of injury, Most of the cases were Type I fractures i.e., split fracture of lateral condyle according to Schatzker`s classication, Surgery was performed with in 6.48 average days, Union was noted clinically and radiologically and functional evaluation was done by Rasmussen functional and radiological score. Excellent results were present in 23 patients (76%), 4(20%) good and 1(4%) poor results. Achieving and maint Interpretation /Conclusion: aining anatomical reduction with plates with less soft tissue dissection helps in early mobilization and hence obtaining good functional and radiological outcomes of tibial plateau fractures early physiotherapy for rehabilitation

Total knee arthroplasty is the gold standard in treatment of end-stage osteoarthritis, with excellent functional outcome, and long term pain relief. But its acceptance in the rural setting comes with its own set of challenges. This study highlights our experience in managing patients undergoing TKR in rural Karnataka. We evaluated the outcome by comparing the pre-op and post-op Knee society scores, and incidence of early infection. We selected 34 patients, belonging to rural Karnataka who underwent TKR, and gave informed consent to be a part of this study. The follow-up was of minimum 6 months. In our study, majority of patients belonged to 66-70 age group. Mean BMI was 25.68. The knee society score improved from an average pre-op score of 43.82 to an average of 84.47. The incidence of complications in our study was 9%. We found a significant increase in the KSS scores after undergoing TKR. Based on this series, we conclude that there is no significant difference in the outcomes of Total Knee Replacement, when compared with other series.