Background: Fracture of lateral condyle humerus in pediatric population is second most common elbow injury. There is controversy regarding treatment of minimally displaced (less than 2mm) fracture. If this group can be taken care with non operative treatment it will be an easier and lot cheaper option especially for rural parts of west Nepal. Aim: To see the viability of treatment of minimally displaced lateral condyle humerus fracture with non operative treatment and look for short and immediate results. Methodology: This was a prospective observational, hospital based study carried out in Nepalgunj Medical College teaching Hospital from Jan. 2013 -Jan. 2014. In children between 2.5 -13 years, with minimally displaced fracture of lateral condyle humerus were radiologically followed up for 12 weeks. All patients underwent long arm cast and serial radiographs in follow ups. At 12 weeks; range of motion, tenderness and carrying angle were looked for. Results: There were 12 patients in the study with average age of 6.95 years, range (SD 2.92). There were no displacements in follow ups. At 6 weeks all had full range of motion and at 12 weeks all had full range of motion without tenderness. Three kids had approximately 5 degrees of carrying angle change on other side to varus. Conclusion: Non operative treatment with 4 weeks of long arm cast in supination is a good alternative option for minimally displaced lateral condyle fracture humerus. A good follow up of the treated patients is an integral part of management along with radiological evidence. Parents need to be warned about bump in the lateral side during healing.

Background:The Lisfranc injury is an injury of the foot in which one or more metatarsal bones are displaced from the tarsal bones. Due to their low incidence and complexity, these injuries are often missed on initial evaluation. Prompt recognition and then anatomic reduction and stabilization gives best outcomes post treatment. Aim: The study aimed to compare short-term treatment results for tarso-metatarsal joint injuries with treatment outcomes and compare it with type of injury per classification. Methods: This was a prospective observational, analytical hospital based study. The subjects included in the study were classified according to radiological findings and treated with open reduction and K-wire fixation. Study subjects were immobilized for six weeks. Weight bearing was progressed slowly. Short term result was calculated by American orthopaedic foot and ankle society score (AOFAS) at six months. Results: Of the nine cases included in the study, low energy fall, five (55.55%) was commoner cause for injury followed by high energy road traffic accident (RTA) in four (44.44%) patients. Six fractures (66.67%) were of type A while, three (33.3%) were type B. Average day from injury to surgery was 3.11 (range 2-5). AOFAS Score calculated in six months average was 82.44(SD±12.79). In patients with type A injury mean AOFAS score was 89(SD+-2.6), while in patients with type B injury had mean of 69.33(SD±15.82). The AOFAS score difference for the group A and B was statistically significant (P<0.05). Conclusions: Lisfranc injuries are life changing injuries as scores of AOFAS get lower even after 6 months of injury. Patients with type B injuries have poorer outcome than type A injuries.