To study the fractures of distal end of femur and the mechanism of injury in distal end femur fractures, the advantages and disadvantages of open reduction and internal fixation of distal end femur fractures by distal femoral locking compression plate osteosynthesis and to analyse the outcome in terms of range of Knee motion, time to union, and limb shortening. RESULTS The mean age of patient is 44 years, 85% are males, road traffic accidents account for majority (80%), right side involved in 70%, Muller's type C fracture is common, good range of movements is seen 90% of cases and union occurred in 95% in 5 months. The results were assessed using Neer's score, seven (35%) patients had excellent results, eight (40%) patients had good results, four (20%) patients had fair results and one (5%) patient had poor result. CONCLUSION From our study, we conclude that DF-LCP is a safe and reliable implant and has shown excellent to satisfactory results in majority of intra-articular fractures (AO type C). Fixation with locking compression plate showed more effectiveness in severely osteoporotic bones, shorter operative stay, faster recovery, faster union rates and excellent functional outcome.

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BACKGROUNDThe distal end of radius fractures continue to pose a therapeutic challenge. Post-traumatic osteoarthrosis decreased grip strength, and endurance, as well as limited motion and carpal instability, are the complications because of intraarticular and extra-articular malalignment 1 Barton's fracture was named after the American surgeon John Rhea Barton. Barton's fracture is a fracture of the distal end of the radius that involves the articular surface of distal radius and is usually accompanied by subluxation or luxation of the radiocarpal joint. These fractures may result from high-or low-energy injuries, and they account for approximately 1.2 % to 4.2 % of distal radial fractures. Barton's fractures are classified into volar or dorsal Barton's fractures based on the site and shifting the direction of fragments. According to AO classification, volar Barton's fractures are classified as type B3 fractures of the distal radius. Conservative treatment is usually unsuccessful and fraught with complications, such as early osteoarthrosis, deformity, subluxation, and instability. ORIF with a volar Ellis plate system is currently practised for the treatment of volar Barton's fracture as it results in good reduction and provides immediate stability. Moreover, the patients can be mobilised early and quickly potentially reducing wrist stiffness. RESULTSAll cases were followed up periodically during the period 2016 to 2018 at 1, 3, 6, 12 months postoperative period, and results evaluated at the end, and scored by Gartland and Werley scoring system. 11 (55%) had an excellent result, 7 (35%) had good result, 1 (5%) had fair and 1 (5%) had a poor result. CONCLUSIONEllis plates gave successful results for the volar Barton's distal radius fractures. This method, which is effective in anatomic realignment, allows early joint motion, owing to its fixation strength.Close placement to joint interface and screwing capability in different orders are its biomechanical superiorities.The volar approach provides both access with minimal surgical trauma on distal radius and fixation with a better adoption to surrounding tissues. In the subjects of our study, a successful anatomic alignment was acquired with the volar approach, regardless of the direction of fracture angulation. The patients who were young adults in the majority went back to their daily activities with 90% recovery. These Ellis plates not only provide restoration of radial length but also help in stabilizing palmar angulation. They maintain intraarticular congruity thus reducing radiocarpal arthritis and decrease in grip strength. At last, not the least they also provide quicker recovery and better functional range of movement and provide better fixation in an osteoporotic bone.

AIMS AND OBJECTIVES:To study the fractures, mechanism of injury, union rates and functional results of humeral shaft fractures treated with open reduction and internal fixation with dynamic compression plate. RESULTS: In present study, 25 patients of diaphyseal fractures of humerus, surgically managed by dynamic compression plate & screws, between October 2012 to September 2014 in government general hospital attached to kurnool medical college were included. The average age of the patient is 38.9 years, road traffic accidents being the most common mode of accident with 72%, middle third fractures were commonest with 80%, transverse fractures were the commonest with 52%, anterolateral approach was used in 88%, union achieved in 88% with mean time for union 15.56 weeks, iatrogenic radial nerve palsy in 4%, postoperative infection in 4%, full range of movements in 80%, with 8% nonunion. CONCLUSION: By the analysis of the data collected in the present study, dynamic compression plate & screws remains the implant of choice in the management of diaphyseal fractures of humerus.

To evaluate the results of closed interlocking intramedullary nailing without reaming in the treatment of open fractures of the tibial shaft and study the difficulties (complications) encountered during the operative study. To compare the efficacy of interlocking intramedullary nailing without reaming in treating open fractures of tibia, Time required for the union of fracture, Range of motion of ankle and knee joint, Rate of malunion and mal rotation and Pain at the knee joint. RESULTS: The average age of patient is 32 years,83.33% are males, road traffic accidents account for majority(79.16%),right side involved in 58.33%,gustillo type II and type I compound fractures are common, full range of movements is seen in 66.67% by 12 weeks and union occurred in 95.83% by 9 months. Thirteen (54.17%) patients had excellent results, six (25%) patients had good results, four (16.67%) patients had fair results and one (4.16) patient had poor result. CONCLUSION: Unreamed interlocking intramedullary nailing with the help of image intensifier seems feasible in open diaphyseal fractures of tibia with the advantages of minimal blood loss, low risk of infection, early mobilisation, earlier soft tissue coverage, Promotes early union,minimal hospital stay and early returns to activities.