BACKGROUND Incidence of paediatric long bone fractures are increasing day-today due to high speed vehicle accidents. The aim of the study is to-1. Evaluate the surgical and functional outcome of surgical treatment of long bone shaft fractures in children by elastic nailing. 2. Study the union rates. 3. Compare the results with those in literature and study the complications associated with elastic nailing. MATERIALSANDMETHODS Forty patients in the age group of 5-16 years of age with diaphyseal fractures of femur and/or tibia admitted at SVRRGGH, Tirupati. During the study period of November 2014 to October 2016 at SVRRGGH, Tirupati, patient fulfilling the inclusion and the exclusion criteria (as given below) were the subjects for the study. Finally, after the diagnosis, the children were selected for the study depending on the inclusion and exclusion criteria. Postoperatively, all the cases were followed up to six weekly intervals till the fracture union. Results were analysed both clinically and radiologically. RESULTS This study comprises of 25 male and 15 female patients aged from 5 to 15 years. The follow-up ranged upto 24 weeks and union rate is assessed based on clinical and radiological aspect. CONCLUSION Based on our experience and results, we conclude that elastic stable intramedullary nailing technique is an ideal method for treatment of paediatric diaphyseal fracture between the ages of 5 to 16 years with good results.

Neglected rupture of the patellar tendon is a rare disabling injury that is technically difficult to manage. Many different surgical techniques have been described for reconstruction of the disrupted extensor mechanism of the knee. In this study we describe an improved technique for the reconstruction of patellar tendon using semitendinosus and gracilis tendon grafts preserving their tibial insertion distally and Ethibond suture augmentation instead of stainless steel wire having the added advantage of no further operative intervention needed for removal. MATERIALS AND METHODS: The study included 9 patients (7 male & 2 female) with mean age of 40.2 years (+/-2 SD) presented with pain, instability, difficulty in carrying out Activities of Daily Living (ADL) associated with neglected patellar tendon injury. The time since injury ranged from 3months to 2years. All the patients had loss of active extension, extensor lag between 30 0 to 50 0 with an average of 41.1 0 (+/-2 SD) and severe functional limitation of ADL. All the patients underwent patellar tendon reconstruction using semitendinosus and gracilis tendon grafts. The functional outcome was assessed using Lysholm Knee Score, Visual Analogue Score (VAS) and IKDC scoring system. RESULTS: Post-operatively with an average follow-up of 19 months (+/-2 SD) all the patients had decreased amount of pain, stable knee with active extension of knee without any extension lag with flexion up to 110 0 (90 0-125 0). Out of 9 patients 7 had good and two had fair functional outcome with improvement in ADL with the IKDC score of 83.5 (+/-SD), Lysholm Knee Score 90.8 (+/-SD) and no/little pain on Visual Analogue Scale. CONCLUSION: The results of our study shows that the use of ipsilateral semitendinosus and gracilis tendon grafts preserving their insertions on tibia distally for reconstruction of neglected patellar tendon ruptures along with Ethibond suture augmentation provides good knee stability and functional improvement in ADL without need for allograft or prosthetic material. The use of Ethibond suture instead of stainless steel wire has added advantage of no further operative intervention needed for its removal.

BACKGROUND AND OBJECTIVE: Incidence of ACL injuries are increasing due to motor sports and recreational activities involving high physical activity. Ligament injury accounts for nearly 40% of all knee injury problems and isolated anterior cruciate ligament injury constitutes nearly 50% of all knee ligament injuries. METHODS: 27 patients with ACL injuries were selected who were admitted in the S.V.R.R.G.G. Hospital, Tirupati between November 2013 and august 2015. Patients were treated with arthroscopic anterior cruciate ligament reconstruction using single bundle quadriple semitendinosus and gracilis tendon graft and followed up till functional recovery and assessed clinically. RESULTS: The study comprises of 25 male and 2 female patients aged from 15 to 50 years with mean age of 33 years. The follow up ranged from 6 to 14 months and results assessed using the Lysholm knee scoring system. INTERPRETATION AND CONCLUSION: arthroscopic anterior cruciate ligament reconstruction using single bundle quadriple semitendinosus and gracilis tendon graft has good results. AIM OF THE STUDY: To study the short term result of arthroscopic anterior cruciate ligament reconstruction by hamstring tendon graft by means of preoperative and postoperative subjective and objective evaluation scores.

Giant cell tumour of the bone (GCT) is a rare locally aggressive primary bone tumour with an incidence of 3% to 5% of all primary bone tumours. The most common location for this tumour is the long bone meta-epiphysis especially of the distal femur, proximal tibia, distal radius, and the proximal humerus. Involvement of distal ulna is rare accounting for 0.45% to 3.2%. Considering local aggressive nature and high recurrence, wide resection is the treatment recommended. Instability of ulnar stump and ulnar translation of the carpals are known complications following resection of distal ulna. To overcome these problems, we attempted a newer technique of distal ulna reconstruction using proximal fibula and TFCC reconstruction using Palmaris longus tendon following wide resection of giant cell tumour of distal ulna in a 44-yearold male. This technique of distal radio ulnar joint reconstruction has excellent functional results with no evidence of recurrence after one-year follow-up.

BACKGROUNDOnce described as "functionless remnants of leg muscle origin" by Bland Sutton, 1897, the menisci are now considered crucial structures of the knee. They are a pair of semilunar fibro cartilaginous structures well recognized to contribute to the maintenance of normal knee function, facilitating joint stability by deepening the tibial articulation for convex femoral surface, protection of articular cartilage by load distribution and shock absorption, improving mobility and joint lubrication with smooth low friction gliding surface and resilient to compression. MATERIALS AND METHODSProspective analysis of data in patients who underwent surgery for meniscal tear in single centre by a single surgeon. RESULTSThis prospective series consisted of 20 (18 male, 2 female) patients. No patient loss occurred during follow-up in this series. The average age at the time of meniscal repair was 36 years (range, 15-60 years). The average follow-up period was 6 months. Seven (35%) meniscal tears were rated acute (injury-to-surgery interval <2 months), and 13 (65%) tears were rated chronic (injury-to surgery interval >2 months). There were 10 (50%) isolated meniscal tears, and 10 (50%) tears were combined with arthroscopic ACL reconstruction. In total 20 patients (36 menisci repaired) most of the tears occurred in white-white zone.