BACKGROUNDThis prospective consecutive case series was done to evaluate indications, technical pearls and pitfalls and functional outcomes of Titanium elastic nailing system of displaced mid-clavicular fractures and the effectiveness of the Titanium elastic intramedullary nails in the surgical treatment of the mid-clavicular fractures in adults. MATERIALS & METHODSA total of 60 patients (45 male, 15 female) were included in this study. Constant score and radiographs were evaluated after 1 and 6 weeks, 3 months and 6 months in 60 patients. Mean age was 28 years. RESULTSLength of incision, operation time, blood loss and duration of hospital stay were significantly less. The average follow-up was 17 months. Mean operation time was 62 minutes. Open reduction through an additional small incision was necessary for some fractures. Mean hospital stay was 1.2 days. The Constant score averaged 80 after 1 week, 96 after 6 weeks and 98 after 6 months. Compared to the contralateral side, average shortening of the clavicle was 1.7 mm. CONCLUSIONTitanium Elastic Nailing System provided a good restoration of the length of the clavicle allowing immediate active mobilisation and early return to normal activity with excellent functional results.

BACKGROUND & OBJECTIVES Ankle fractures are among the most common injuries treated by orthopaedic surgeons. However, very few investigators have examined the functional recovery following operative treatment of ankle fractures. Anatomic restoration with open reduction and internal fixation is the goal of management in ankle fractures. The purpose of this study is to analyse the functional outcome following operative treatment of ankle fractures using subjective as well as objective criteria. METHODS 90 patients with ankle fractures who fulfilled the inclusion criteria were included in the study. All patients underwent surgical fixation of the fractures. The follow-up assessment which consisted of subjective (Pain, Walking, Activity, Radiographs, Ankle and Subtalar Joint Function) and objective (Olerud and Molander Ankle Score) evaluations, were performed at 6 weeks, 3 months and 6 months postoperatively. RESULTS Out of 90 patients, the commonest injury pattern seen was supination-external rotation, followed by supination-adduction. The most common modality of fixation for the lateral malleolus was 1/3 rd tubular plate and for the medial malleolus was 4 mm cannulated cancellous screws with washer. Syndesmotic screws were not applied in any of the cases. At 6 weeks follow-up 40% (n=36) had complications of persistent swelling, residual pain. We found a statistically significant improvement in the subjective assessment of pain, walking, activity levels, ankle and subtalar joint function from 3 rd month to 6 th month postoperatively. However, subjective radiographic assessment failed to show any statistically significant improvement. The mean Olerud and Molander Ankle Score was statistically significant 47.5±19.7 at 3 rd month post-op and, 81.7±16.2 at 6 th month post-op. Age was a significant predictor of final outcome, with younger patients having a better functional outcome. CONCLUSIONS Operative treatment for ankle fractures results in good functional outcome postoperatively. Anatomical reduction of the fracture is associated with better functional outcome. Early treatment without delay, anatomic reduction and fracture fixation, stringent postoperative mobilisation and rehabilitation should help improve outcome in an operated ankle fracture.