BACKGROUND Fracture clavicle is one of the most common conservatively treated fractures. Conservative management showed lesser rates of non-union and satisfactory results for fracture clavicle initially. Recent studies showed that the functional outcome following conservative management was not as optimal as it was thought to be. With changing injury patterns, increased incidence of high velocity trauma and increased functional demands of the modern patients which led to thorough evaluation of the functional outcomes following conservative management of fracture clavicle, the outcome was not optimal. Recent studies showed increased rate of non-union among conservatively managed cases compared to those which were fixed internally. Some found residual deficits among patients treated conservatively. We wanted to study the functional outcome and complications following internal fixation of clavicle fractures by using plating techniques. METHODS This prospective study was done in Department of Orthopaedics, Andhra Medical College, Visakhapatnam. We studied functional outcome of 30 fractures of clavicle which were fixed using plating technique during the period October 2016 - October 2018. Thirty patients (n = 30) were treated with plating technique using precontoured locking plates and recon plates. The fractures in this study were middle third clavicle fractures which were divided into two types based on the classification of Robinson. Type 2 Robinson clavicle fracture implies that it is a middle third clavicular fracture, which is further divided based on fracture morphology. 2b1: Displaced simple or wedge comminuted fractures 2b2: Segmental comminuted fractures. In this study, superior plating was done. The implants used were precontoured LCP and recon plates. Functional outcome was assessed using Constant Murley scoring and Quick Dash score at 10 weeks. The follow up period was for 1 year - October 2016 to October 2018. RESULTS The average time of union for the fractures treated with plating technique in our study was around 10.2 weeks. The mean Constant Murley score of our study was 91. Eighteen out of 30 patients had excellent outcomes. One patient had fair outcome due to stiffness of the shoulder. 10 patients had good result. The average DASH score of the patients was about 9.8. CONCLUSIONS Treatment of fracture middle third of clavicle using plating technique provides good functional outcome and faster recovery with minimal complications. KEYWORDS Clavicle A02.835.232.087.227, Wounds and Injuries C26, Postoperative Complications C23.550.767

Background: Osteoarthritis (OA) is a degenerative disorder of synovial joints in which there is gradual softening and disintegration of articular cartilage accompanied by the new growth of cartilage and bone at the joint margins(Osteophytes), cyst formation and sclerosis in the subchondral bone, mild synovitis, and capsular brosis. It differs from simple wear and tears in that it is asymmetrically distributed, often localized to only one part of a joint i.e., weight bearing, and often associated with abnormal loading rather than frictional wear. It is a dynamic phenomenon and shows features of both destruction and repair. Cartilage softening and disintegration are accompanied from the very outset by hyperactive new bone formation, osteophyte formation and remodeling. Osteoarthritis is an age-related phenomenon, and it affects more than 80% of people greater than 55 years of age. Body mass index (BMI) plays a vital role in osteoarthritis in weight-bearing joints. People with obese or overweight were approximately 4.6 times more likely to have knee OA than normalweight individuals. In addition people with metabolic and endocrine disorders are also more prone for osteoarthritis at an early age. Methods: Sixty patients suffering from grade1and 2 osteoarthritis knee joint who attended the outpatient department of orthopaedics, King George hospital, Visakhapatnam between November 2018 to October 2020 were included in the study. Informed and written consent was taken from the patients. General physical examination was done. Neurovascular status of both lower limbs was also examined. X-ray of both knee joints in antero-posterior and lateral views were taken in standing position. Routine pre-injection WOMAC and VAS score were recorded. Under aseptic conditions, two platelet-rich plasma (PRP) injections were injected into the knee joint at four weeks interval. Functional status of the knee was evaluated using WOMAC and VAS score at one, three and six week's interval. This study is a anlyticl comparative study. Results: There is a signicant difference in the VAS score and WOMAC score before giving an injection and after giving an injection, in patients with grade 1 and grade 2 osteoarthritis. The visual analogue score showed a mean of 7.16 at pre-injection period, which decreased to 5.95 at 1st week and 4.81 at 3rd week and 4.06 at six weeks follow up. Conclusion: In the present study the effectiveness of two aliquots of PRP injection was evaluated. Although studies including more than 2 PRP injections and more advanced stages of osteoarthritis were compared, the time frame was xed to 6 weeks. The functional outcome of the patient was better after 2nd dose of PRP. The present study concluded that two doses of PRP injection decreases the joint pain, alleviates the symptoms and enhances the activity of daily living and quality of life in short term duration.