Our modern civilization is currently standing at a crossroads due to excessive emission of anthropogenic CO2 leading to adverse climate change effects. Hence, a proper CO2 management strategy, including appropriate...

<p class="abstract"><strong>Background: </strong>Recurrent anterior shoulder dislocations are quite common in young patients with Bankart lesions. The open Bankart repair was the gold standard for years, however arthroscopic Bankart repair has gained popularity. The aim of the study was to evaluate the functional results of arthroscopic Bankart repair in patients with post-traumatic recurrent anterior glenohumeral instability.</p><p class="abstract"><strong>Methods: </strong>Patients who underwent arthroscopic Bankart repair for post-traumatic recurrent anterior shoulder dislocation were included in the study. This was a prospective study conducted at a tertiary care Hospital in Kolkata, India between August 2017 to May 2019. All patients were followed up at an interval of 2 weeks, 6 weeks, 12 weeks, 6 months, 9 months and 1 year. Rowe score was used to assess the functional outcomes of the patients.</p><p class="abstract"><strong>Results:</strong> 34 (91.9%) patients reported good to excellent results, whereas only 2 (5.4%) patients had fair outcome and 1 (2.7%) patient demonstrated poor surgical result. The total rowe score improved from 46.62 pre-operatively to 94.20 post-operatively after 1 year (p&lt;0.01). By the end of 1-year follow-up, 35 (94.6%) patients had full range of motion in all the planes. Majority of (89.2%) patients did not have any complications. Only 1 patient out of 37 had a recurrence (2.7%).</p><p class="abstract"><strong>Conclusion: </strong>Arthroscopic Bankart repair is an effective, cosmetic and safe surgical procedure with good clinical outcomes and excellent post-operative shoulder range of motion. This surgical intervention also has low recurrence rate and minimum surgical complications.</p>

<p><strong>Background: </strong>The treatment option for inferior pole of patella fracture is still being debated. Although tension‑band wiring is the most widely used technique to treat patellar fractures, metal implant‑related complications such as implant failure, palpable hardware are very common and additional procedures are often necessary to treat the complications. The aim of the study was to evaluate the functional results in patients with inferior pole of patella fracture treated by trans-osseous non-absorbable suture fixation.</p><p><strong>Methods:</strong> Patients who underwent trans-osseous suture fixation by no. 5 Ethibond for post-traumatic distal pole patella fracture were included in the study. This was a prospective study conducted at a tertiary care Government Hospital in Kolkata, between December 2018 to May 2020. All patients were followed up at an interval of 2 weeks, 6 weeks, 12 weeks, 6 months and 9 months. Bostman score was used to assess the functional outcomes of the patients.</p><p><strong>Results: </strong>Outcome at final follow-up was assessed with Bostman scoring system. In a total of 11 patients, 8 (72.8%) patients showed excellent and 3 (27.2%) patients had good results during the final follow-up. None of the patients demonstrated unsatisfactory result. At the end of 9 months, the average Bostman score for 11 patients was 27.9.</p><p><strong>Conclusions: </strong>The trans-osseous suturing with non-absorbable sutures is a safe and effective fixation technique for the treatment of distal pole patella fractures. It allows for rapid recovery with minimal implant‑related complications. It also reduces the re-surgery rates significantly.</p>

<p>Patellofemoral instability is a painful and often recurring disorder with many negative long-term consequences. Surgical treatment for patellar dislocation has evolved from the initial medial reefing to the present-day anatomical reconstruction of medial patellofemoral ligament (MPFL) which is thought to be the most appropriate treatment. MPFL reconstruction successfully addresses patellofemoral instability by restoring the deficient most important static primary soft tissue restraint. This prospective case series was conducted at a Tertiary care Govt. Hospital in Kolkata between January 2019 to August 2020 on 15 patients who underwent MPFL reconstruction for recurrent patellar dislocation. All patients were followed up at an interval of 2 weeks, 6 weeks, 3 months and 6 months. Kujala score was used to assess the functional outcomes of the patients. Out of 15 patients, 13 (86.7%) showed good to excellent results whereas 2 (13.3%) had Fair outcome and none of the patients demonstrated Poor surgical result. The mean Kujala score improved from 49.6 pre-operatively to 92.7 post-operatively. By the end of 6 months follow-up, 13 (86.7%) patients achieved almost full range of motion. Majority (80%) of patients did not have any complications. Only 2 patients had a post-operative recurrence (13.3%). Reconstruction of MPFL using autologous hamstring graft showed excellent results over the short term with a low re-dislocation rate and acceptable complication rates. It greatly helps in preventing further episodes of patellar subluxations or dislocations and in improving quality of life.</p>

Acetabular fractures with quadrilateral plate involvement form a heterogeneous group of fractures which are not specifically defined by any current classification system. Surgical treatment of these fractures poses a challenge to Orthopaedic surgeons. The aim of this study was to evaluate the efficacy, safety and outcomes of the fixation technique by using IRBP for acetabular fractures with quadrilateral plate involvement via single modified Stoppa approach. A total of 30 patients with acetabular quadrilateral plate fracture, selected between January 2016 to June 2019, were managed by IRBP via modified Stoppa approach. This was a prospective study and all patients were followed up to a minimum of 2 years. The primary outcome measures were reduction quality and functional outcome which were evaluated according to Matta’s radiological criteria and modified Merle d’Aubigné and Postel score respectively. Secondary outcomes were intra-operative conditions such as operative time and blood loss and post-operative complications.Anatomic reduction was obtained in 22 (73.3%), Imperfect in 6 (20%), and Poor in 2 (6.7%) cases. The modified Merle d’Aubigné and Postel score outcomes were Excellent to Good in 25 (83.3%) patients, Fair in 3 (10%), and Poor in 2 (6.7%) with the mean score being 16.07 ± 2.68. 21 (70%) patients did not have any complications. None of the cases had quadrilateral screws entering the hip joint.The use of IRBP system is an effective and safe choice for acetabular fractures with quadrilateral plate involvement done via modified Stoppa approach as it has low rate of complications, addresses multiple fractures of acetabulum through a single approach and provides good functional and radiological outcomes over long term.