BACKGROUND:Inter-trochanteric fractures account for approximately half of the hip fractures in elderly; out of this, more than 50% fractures are unstable. The dynamic hip screw (DHS) has gained widespread acceptance in the last two decade and is currently considered as the standard device for comparison of outcomes. The DHS has been shown to produce good results but complications are frequent, particularly in unstable inter-trochanteric fracture. The advantage of Proximal Femur Nailing fixation is that it provides a more biomechanically stable construct by reducing the distance between hip joint and implant. METHOD: The goal of this study is to compare the clinical and radio graphical results of the DHS and PFN for the treatment of Intertrochanteric hip fractures (Load bearing vs Load shearing). In our study we included 68 intertrochanteric fractures, out of which 34 are treated with DHS fixation and 34 are treated with PFN. All surgeries done on traction table and are followed up at regular intervals of 4 weeks, 8 weeks, 12 weeks, 6months and annually thereafter. RESULTS: The functional results are assessed with Harris Hip Score and observed 50.00% excellent results in DHS group and 67.64% excellent results in PFN group. We observed no statistically significant difference between two groups in view and time to union. We observed significantly better outcomes in PFN group for unstable inter-trochanteric fractures and in unstable fractures reduction loss is significantly lower in PFN group. We observed total duration of surgery is significantly lower in PFN group. CONCLUSION: We concluded that PFN may be the better fixation device\for most unstable inter-trochanteric fractures.

<p>The objective is to study the effectiveness of Multiple stab incision technique in preventing acute compartment syndrome (ACS) in proximal and segmental fractures of both bones (Tibia and fibula) in leg. This study is prospective done<strong> </strong>at K. S. Hospital Koppal, Karnataka spanning for a period of one year (April 2020 to April 2021). A total of 20 patients of both genders aged 20-60 years were included in the study. Multiple stab incision technique was performed in patients after fixation of Tibia by either closed nailing or MIPPO plating. This procedure was done under spinal anesthesia. Multiple stab incision technique significantly decreased the chances of post-op ACS in proximal and segmental fractures of both bones (tibia and fibula) in leg. Multiple stab incision technique is help full in preventing developing compartment syndrome.</p><p><strong> </strong></p><h2> </h2>

BACKGROUND:This prospective study was done to evaluate the effectiveness of implants i.e., anatomical pre contoured dynamic compression plate in treatment of displaced mid shaft clavicular fractures. MATERIALS AND METHODS: fifty patients between 18 and 65 years of age were included in this study. They were treated by fixation with anatomically pre contoured dynamic plate and functional outcome was assessed. Clinical and radiological assessments were performed at regular intervals. Outcomes and complications of over 2 years of follow-up time were compared. RESULTS: Range of motion was well maintained in all the patients. Constant score was excellent in 44 patients (88%) good in 4 patients (8%) and fair in two patients (4%). No patients had a poor result on constant scoring. The mean time to union was 6.8 months. CONCLUSION: In this prospective cohort study, primary open reduction and internal plate fixation of acute displaced mid shaft clavicular fractures resulted in improved outcomes and a decreased rate of nonunion and symptomatic malunion. KEYWORDS: Displaced midshaft clavicle fractures/Anatomical precontoured plating. INTRODUCTION:Clavicle fractures are common injuries accounting for 5-10% of all fractures. Around 80% of clavicle fractures involve the midshaft and over half of these fractures are displaced. 1 The average age of patients sustaining a midshaft clavicular fracture is 33 years; 70% of the patients are male. 2 Traditionally, acute midclavicular fractures have been treated non operatively with either sling or figure-of-eight bandage, with a reported less than 1% rate of fracture nonunion. 3 However, more recent studies have reported nonunion rates of 4-29% and malunion rates of 14-36% with displaced clavicle fractures. 4 Several fixation methods have been reported including plate fixation, 5 intramedullary pin fixation 6 and placement of intramedullary threaded k-wires 7 and elastic intramedullary nails. 8 Earlier indications for surgery include the need for earlier functional mobilization in the patient with an isolated injury, in addition to open fractures, floating shoulders and patients with polytrauma. 9 In recent studies, the trend has moved towards surgical stabilization of selected clavicle fractures, with operative indications including significant shortening or distraction (>1.5 centimeters), displacement greater than 100%, and the presence of a zed fragment. 10 Plate fixation can provide immediate rigid fixation, helping to facilitate early mobilization. 11 A biomechanical study shows that plate fixation provides a more rigid stabilization compared to intramedullary fixation and may provide a stronger construction for early rehabilitation protocols. 12 In this study we evaluated the functional outcome of fixation of clavicle with anatomically contoured plates.

<p><strong>Background: </strong>Dislocation after total hip arthroplasty (THA) remains a major concern, because it is reported to range from 1% to 5%. The concept of dual mobility articulation was developed in 1970 by Bousquet to decrease dislocation risk. Several studies have looked at the outcome of dual mobility articulation in primary THA and in revision THA.<strong></strong></p><p><strong>Methods: </strong>This is a prospective study of 33 patients undergoing dual mobility THA during 24 months period from October 2017 to September 2019. Patients undergoing total hip replacement (THR) to have dual mobility cup (DMC) were those at high risk of dislocation. Patients were followed up for a mean period of 18 months.<strong></strong></p><p><strong>Results: </strong>33 patients (mean age 67 years) underwent DMC THA. 27 patients underwent primary hip replacement. The follow-up of our cases has ranged from 13 months to 3 years with a mean follow-up of 18 months. none of the patients had hip dislocation.</p><p><strong>Conclusions</strong>: The DMC is an effective solution for the management of high-risk cases undergoing total hip replacement to reduce the incidence of postoperative instability.</p>

<p><strong>Background:</strong> Mechanoreceptors plays a vital role in knee mechanics. Since there are controversies surrounding the overall recovery time of proprioception following surgery, it is necessary to define the factors affecting proprioceptive recovery after anterior cruciate ligament reconstruction and to investigate the relationship between proprioception and muscle strength following surgery.</p><p><strong>Methods: </strong>Current study is combined prospective and retrospective study done at K. S. hospital Koppal, spanning for a period of one year (December 2019 to December 2020). All patients presented with isolated anterior cruciate ligament (ACL) tear were included in the study. Patients were treated by arthroscopic ACL reconstruction with hamstring graft only and followed up for a period of year. Outcome measures include centre of mass proprioception in AP and medio-lateral direction and muscular strength through force gauze in Newton.</p><p><strong>Results:</strong> 26 patients (mean age 33) were included in the study, all ACL tears were treated by arthroscopic ACL reconstruction with hamstring graft and they underwent varying period of rehabilitation.</p><p><strong>Conclusions:</strong> This study shows that our understanding of biomechanics of ACL reconstructed knees is still evolving, and proprioception is found to be a key factor in determining post-op recovery. ACL remnant preservation intra-op along with proper mechanical positioning of the graft may help in better proprioception and functional outcome following the reconstruction.</p>