Background: The number of anterior cruciate ligament (ACL) injuries reported in skeletally immature athletes has increased over the past 2 decades. The reasons for this increased rate include the growing number of children and adolescents participating in competitive sports vigorous sports training at an earlier age and greater rate of diagnosis because of increased awareness and greater use of advanced medical imaging. There is a growing need for a consensus and evidence based approach for management of these injuries to frame a dedicated age specific treatment strategy.Methods: This article does a systematic evidence based literature review of management of Pediatric ACL injuries seen in several forms: tibial eminence avulsion fractures partial ACL tears and full thickness ligament tears and its outcome analysis.Results: The mechanism of Safe and effective surgical techniques for children and adolescents with ACL injuries continues to evolve. The numerous age matched techniques are extensively discussed. Neuromuscular training can reduce the risk of ACL injury in adolescent girls.Conclusion: This review outlines the current state of knowledge on diagnosis treatment and prevention of ACL injuries in children and adolescents and helps in guiding the treatment through a dedicated algorithm.

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The total hip replacement (THR) has probably become the surgical procedure of choice for vide variety of hip joint disabling diseases. The prosthesis used for THR is often grouped into cemented, cement-less and hybrid ones. There has been increasing trends in use of cement-less components citing more number of complications namely loosening, increased infection rate etc. however with additional cost factors as well. We conducted this study to ascertain whether in a developing country like ours should we really switch over to un-cemented hip replacements dreading such complications or can we still use cemented prosthesis with equally good if not better results. METHODS A study of functional results of cemented total hip replacement was done in patients with varied age groups ranging from 40 years to 75 years with the average age being 54.8 years. 20 patients with 21 diseased hips were treated with cemented total hip replacement by Moore's posterior approach at NSCB Subharti medical college, Meerut, UP from December 2010 to December 2013 and reviewed thereafter with an average follow-up period of 4.2 years. Average surgical time required was one and half hour. Patients were asked to come for follow up on 1st month, 3rd month and 6th month and then every 6 months and were assessed as per modified Harris Hip Score. RESULTS All the patients were evaluated according to the Modified Harris Hip Scoring system. The results showed 14(67%) hips with excellent results, 4(19%) with good results, and 3(14%) hips with fair results. No poor outcome was noted in this study. 2 cases of dislocation (10%) were noted one on the 5th post-operative day and the other occurred after the patient was discharged from the institution.

Introduction: Sacrum fractures are rare pathologies seen after spinal traumas. The incidence of a sacral fracture after trauma is 0.6% in childhood. Case presentation: A 13-year-old girl was admitted to our emergency room after having suffered a fall. Radiological tests revealed S1 S2 fracture dislocation. Appropriate load distribution through a spinopelvic fixation as well as neural decompression were performed together with an S1-S2 partial laminectomy. Post operatively iliac screws started impinging so all the screws were removed 3 months post operatively. At one year follow -up patient is walking pain free without any neurological deficit. Conclusion: It is very difficult to make a generalization for treatment of sacral fracture dislocation due to small number of patients. Each patient should be individualized and lumbosacroiliac instability should be treated.

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