Background: The present study was done to evaluate the functional outcome and complications after open reduction and internal fixation of acetabulum fractures. Material and methods: The present study was done in 44 patients of fracture acetabulum managed by open reduction internal fixation in the Department of Orthopaedic surgery, Indira Gandhi Medical College, Shimla. Results: There were 16 prospective (36.4%) and 28 retrospective (63.6%) cases. The mean age was 45.07 years with maximum number of 39 (88%) patients in the age group of 21- 60 years. Majority (77.3%) of the patients was males and 22.8 % were females. Modified Merle d’Aubigne and postel (MDA) score was excellent in 77%patients, good in 13%, fair in 10%. Matta’s radiological score at final follow up was excellent in 54.55%, good in 36.36%, fair in 4.55% and poor in 4.54% patients. The average Modified Harris Hip score was 94 at final follow up in 44 patients. Patients with anterior column fracture had HHS of 96 at final follow up; posterior wall fracture patients had average HHS of 92 at final follow up. Two patients had complications. One patient had femoral head fracture along with fracture of posterior wall developed AVN and also had subsequently Secondary OA with post-operative subluxation of femoral head. Thus three complications were seen in this patient. Another patient with fracture dislocation with fracture of posterior wall developed AVN and subsequently secondary OA 5 year after surgery. No patient developed sciatic nerve injury post operatively. None of patients developed postoperative sciatic nerve palsy. No patient died during treatment or follow up. Conclusion: Open reduction and internal fixation as a gold standard for acetabulum fractures which is indicated with excellent to good results in majority of the patients as assessed by Modified Merle d’Aubigne score, Modified Harris hip score and Matta Radiological score with minimal complications at final follow up.

Background: Present study was done to evaluate the Postoperative Clinical and Radiological assessment among patients of proximal tibial fractures treated with open reduction internal fixation with locking compression plate. Material and Methods: The study was conducted during 1st August 2019 to 31st October 2020 in the Department of Orthopaedic Surgery, Indira Gandhi Medical College Shimla that included 21 prospective and 4 retrospective cases who fulfilled the inclusion criteria with closed tibial plateau fracture. Results: All the patients were above 18 years of age; 60% of patients were between 31 to 60 years with mean age of 42.5±14.4 years. There were 21 males and 4 females. The ratio between male to female patients was 5.3:1. Post-operatively eighty percent patients had no articular step and 20% had residual step less than 5 mm. Condylar width was normal in 84% patients while 16% patients had residual widening of less than 5mm. Osteoarthritis occurred or progressed by one or two grades in 16% patients. Eighty four percent of the patients had no or mild pain and 16% of the patients had moderate pain on activity involving the knee joint. Average knee flexion achieved at final follow up was 128.40±9.20 and average extension was 8.60±1.20. All patients exhibited excellent to good stability. Rasmussen’s criteria showed excellent functional result in 56% patient, good in 36% patient and 8% patient had fair result. Mean Rasmussen functional score was 27.32.Excellent radiological results were observed in 76% patients, 20% patients had good and 4% had fair results. Mean Rasmussen radiological score was 8.24. Conclusion: Post-operatively, there was decrease in articular depression, restoration of condylar widening to normal, osteoarthritis was not present or not progressed, restoration of full Range of motion both in flexion as well in extension and had excellent Clinical and Radiological results according to Rasmussen score in majority of treated patients.

Background: The present study was done to evaluate the sociodemographic and clinical parameters after open reduction and internal fixation of acetabulum fractures. Material and methods: The present study was done in 44 patients of fracture acetabulum managed by open reduction internal fixation in the Department of Orthopaedic surgery, Indira Gandhi Medical College, Shimla. Results: There were 16 prospective (36.4%) and 28 retrospective (63.6%) cases. The mean age was 45.07 years with maximum number of 39 (88%) patients in the age group of 21- 60 years. Majority (77.3%) of the patients was males and 22.8 % were females. Forty three (97.7%) patients belonged to rural area and remaining 1(2.3%) patient belonged to urban area. Road traffic accident was the mode of injury in 63.6% patients followed by fall from height in 36.4%. Eighteen (41%) patients had posterior wall fracture followed by posterior wall with posterior column fracture was seen in 12 (27%). Average time interval between injury and surgery was 15 days (range 3-55 days). Thirty six percent of the patients were operated between 8-14 days and 34 % of patients between 0-7days. Thirty (68%) patients were operated by Kocher-Langenbeck approach in lateral position followed by 7 (15%) patients with ilioinguinal approach in supine position. Autogenous Bone graft was used in 31.7% of patients. Mean duration of hospital stay was 24 days (range 7-35 days). Conclusion: Study concluded that most of the patients were in the age group of 21- 60 years, males, belonged to rural area, injured due to Road traffic accidents, had posterior wall, operated within 15 days and were operated by Kocher-Langenbeck approach in lateral position.