We conducted this study to evaluate the use of rail fixation system in infected gap non-union of femur and tibia as an alternative to the established Ilizarov circular fixator technique. Prospective study. The study was done in the Department of Orthopaedic surgery in a medical school and level I trauma center to which the authors are/were affiliated. Between June 2010 and June 2015, 40 patients with infected gap non-union of femur and tibia were treated with the rail fixation system. Patients who were willing to undergo surgery and participate in the post-operative rehabilitation were included in the study. After radical debridement, the system was applied and corticotomy done. For closure of bone gap, acute docking and distraction was done in 18 cases and segmental bone transport in 22 cases. Early mobilization of patient was done along with aggressive physiotherapy. Bone and functional results were calculated according to ASAMI scoring system, and complications were classified according to Paley classification. The mean follow-up period was 22.56 months (range 8–44). Bone union with eradication of infection was achieved in all but 1 case (97.5%). Bone results were excellent in 57.5%, good 40%, fair 0% and poor in 2.5% cases, while functional result was excellent in 32.5%, good 65%, fair 0% and poor in 2.5% cases. The rail fixation system is an excellent alternative method to treat infected gap non-union of femur and tibia. It is simple, easy to use and patient-friendly.

Worldwide osteoarthritis is the most common joint disorder. It results from mechanical and biological events that destabilize the normal processes of degradation and synthesis of articular cartilage chondrocytes, extracellular matrix and subchondral bone. These changes include increased water content, decreased proteoglycan content and altered collagen matrix, leading to the degeneration of articular cartilage. There is trend on rise to use platelet rich plasma to promote healing of the degenerated cartilage. The aim of the study was to evaluate whether the newer method i.e platelet rich plasma has any significant advantage. The study included a total of 50 cases with individuals ageing greater than 40 years. Patients without evidence of degenerative arthritis and with KL grade 3 and grade 4 were excluded from the study. At 1 month only 14% cases showed excellent, 68% cases showed and. 18% cases showed fair results. At 3 months follow up 16% cases showed excellent, 82% cases showed good and fair results were seen in 2% cases. No case had poor results. At 6 months follow up 16% cases showed excellent, 86% cases showed good and 6% cases showed fair results and no case had poor results. Platlet rich plasma is an excellent method of treatment in early osteoarthritis of knee.

<p>Proximal humerus fractures are usually associated with other injuries in and around the shoulder joint like clavicle fracture, acromion process fracture, coracoid process fracture, and dislocation of the shoulder joint or acromion-clavicular joint. Similarly, distal humerus fractures are normally associated with fractures of olecranon, radial head or dislocation of the elbow joint itself. However, simultaneous fracture of both the ends of humerus is rarely encountered. Literature search does reveal only a few cases of such type. This variety is also termed as floating arm. We are presenting here two cases of fracture of both the proximal and distal end of same humerus following fall from height, one of which the proximal humeral fracture was Gustillo-Anderson type II open fracture. The patient was managed by wound debridement and open reduction and fixation of the proximal fracture followed by closed manipulation and K wire fixation of the distal fracture. The second case was also managed by closed reduction and K wire fixation of both the fractures. </p>

Background: Intertrochanteric fractures is the fracture of the proximal femur, in which the fracture line extends from the greater trochanter to lesser trochanter 1

Background: Calcaneum fracture contributes to significant morbidity to the patients. Therefore debate continues regarding choice of its management, between open reduction internal fixation and closed treatment. The aim of this study was to compare the outcomes of open reduction and rigid internal fixation of displaced calcaneal fractures using locking plate with that of non-operative treatment. Materials and Methods: Thirty patients with thirty-two displaced intra-articular calcaneal fractures were selected during July 2016 to June 2017 with taking inclusive and exclusive criteria into account and randomly allocated to surgical and non surgical groups. First group of patients was treated with open reduction and internal fixation using reconstruction plate and screws through lateral extensile approach. Patients in second group were treated with closed reduction and cast immobilization using Omoto technique. The observations in both the groups were analyzed and compared. Results: The significant difference between the outcomes of surgical treatment and nonsurgical method were noted. The fracture got united between 12 -16 weeks and no case of non-union has reported. Few patients had reported with wound related complications and were managed with antibiotics and regular antiseptic dressings. The functional assessment of patients during follow ups has suggested that 87.5% patients of operated group has good to excellent outcome while 87.5% patients of conservatively managed patients has good to fair outcome. Conclusion:Open reduction and internal fixation of close displaced calcaneal fractures in absence of severe osteoporosis, comminution, and co-existing morbidity may be the preferred method of treatment.