Background: Diaphyseal fractures of humerus are common, representing 3% of all fractures and 20% of all humerus fractures. Though compression plate osteosynthesis is the gold standard, interlocking intramedullary nailing is also a reliable option. In this present study we evaluated the functional outcome of diaphyseal fractures of humerus treated with interlocking nails. A total of 36 patients with diaphyseal fractures of humerus, selected Materials and Methods: between OCTOBER 2020 to MAY 2021 were managed by closed interlocking nail of humerus. This was a prospective study and all patients were followed up to a minimum of 6 months. The primary outcome measures were functional outcome assessed using DASH Score (The Disabilities of the Arm, Shoulder & Hand Score) & Constant-Murley scoring system respectively. Secondary outcomes were intra-operative conditions such as operative time and blood loss and post-operative complications. The mean time of radiological union was 15.7 weeks ranging from14-26 Results: weeks. All 36 fractures were united including one delayed union which united at 26 weeks. In our series, 4 patients had post operative shoulder stiffness including one prominent nail, 1 patient developed radial nerve neuropraxia which recovered in 8 weeks. All patients were evaluated on the basis of Constant Murley score for shoulder function and DASH score. In our study of 36 patients 69.4% got excellent results, 19.4% got good results, 8.3% got moderate/fair results and 2.8% got poor results. Interlocking nailing is a relatively quick, minimally invasive, biomechanica Conclusion: lly sound, cosmetically better method of internal stabilization of shaft humerus fractures with less union time, less infection and lesser threat to radial nerve and other complications. Besides it allows early mobilization. With correct anatomical knowledge, preoperative planning, good surgical techniques and postoperative rehabilitation interlocking humeral nailing is a viable option in the management of fracture shaft humerus promising excellent outcome.

Acetabular fractures with quadrilateral plate involvement form a heterogeneous group of fractures which are not specifically defined by any current classification system. Surgical treatment of these fractures poses a challenge to Orthopaedic surgeons. The aim of this study was to evaluate the efficacy, safety and outcomes of the fixation technique by using IRBP for acetabular fractures with quadrilateral plate involvement via single modified Stoppa approach. A total of 30 patients with acetabular quadrilateral plate fracture, selected between January 2016 to June 2019, were managed by IRBP via modified Stoppa approach. This was a prospective study and all patients were followed up to a minimum of 2 years. The primary outcome measures were reduction quality and functional outcome which were evaluated according to Matta’s radiological criteria and modified Merle d’Aubigné and Postel score respectively. Secondary outcomes were intra-operative conditions such as operative time and blood loss and post-operative complications.Anatomic reduction was obtained in 22 (73.3%), Imperfect in 6 (20%), and Poor in 2 (6.7%) cases. The modified Merle d’Aubigné and Postel score outcomes were Excellent to Good in 25 (83.3%) patients, Fair in 3 (10%), and Poor in 2 (6.7%) with the mean score being 16.07 ± 2.68. 21 (70%) patients did not have any complications. None of the cases had quadrilateral screws entering the hip joint.The use of IRBP system is an effective and safe choice for acetabular fractures with quadrilateral plate involvement done via modified Stoppa approach as it has low rate of complications, addresses multiple fractures of acetabulum through a single approach and provides good functional and radiological outcomes over long term.

Congenital elevation of the scapula i.e. 'Sprengel's shoulder' is a congenital anomaly of the shoulder girdle that is associated with abnormal descent, and malrotation of the scapula. Conventional anteroposterior radiography of the chest including both shoulders along with CT or MRI is required for diagnosis and proper management. Most common therapeutic choice is surgical intervention for cosmetic and functional recovery of the shoulder. Surgical procedure: With the patient in prone position, in general anaesthesia, Skin incision was given paraspinal area, along superior-medial angle and medial border of the left scapula. After detaching supraspinatus muscle from the scapula along with its periosteum, omovertebral bar was excised, leaving remnant at the connection from the spinous process of c3 vertebra. Then muscles were reattached to the scapula in corrected position. Result: As follow-up after 6 weeks, the patient's active range of motions improved. Forward flexion was improved from 60° pre-operatively to 120° at six months follow-ups. Similarly abduction improved from 60° to 130°, internal rotation from 15° to 20° and external rotation 0° to 30°. Neurovascular evaluation was within normal limits. X-rays confirmed the position of scapula about 3 cm lower than the pre-operative position which is less than 1 cm higher as compare to right scapula.

Kaplan's injury is the dislocations of metacarpophalangeal (MCP) joint dorsally. It may be seen in all five fingers but usually index finger is more prone to such injury. In Kaplan dislocation the head of the metacarpal button-holed through the constraint soft tissue surroundings and the volar plate goes dorsal to the metacarpal head which makes it irreducible by closed method. Both dorsal & volar approaches have been described in many literature for open reduction for the dislocation. Though, the right approach to treat such lesions is still a debate, it is the volar approach which is widely used & described more in literature. Some prefer dorsal approach. Volar approach is very prone to iatrogenic neurovascular injure. Surgical Procedure: Dorsal approach was used. This volar plate was completely dorsally dislocated. Head of metacarpal found fractured. A longitudinal incision was made over the plate & the head of the metacarpal was gently elevated & allowed to relocate. K wire was inserted through fracture fragment into the metacarpal head. Result: As follow-up after 6 weeks, the patient's active range of motion consisted of metacarpophalyngeal joint hyperextension to 10° and 75° of flexion, proximal interphalangeal joint extension to 0° and flexion to 70°, and distal interphalangeal joint extension to 0° and flexion to 60°. Neurovascular evaluation was within normal limits. X-rays confirmed maintenance of reduction.

Background: Diaphyseal fractures of humerus are common, representing 3% of all fractures and 20% of all humerus fractures. Though compression plate osteosynthesis is the gold standard, interlocking intramedullary nailing is also a reliable option. In this present study we evaluated the functional outcome of diaphyseal fractures of humerus treated with interlocking nails. Materials and Methods: A total of 36 patients with diaphyseal fractures of humerus, selected between October 2020 to May 2021 were managed by closed interlocking nail of humerus. This was a prospective study and all patients were followed up to a minimum of 6 months. The primary outcome measures were functional outcome assessed using DASH Score (The Disabilities of the Arm, Shoulder & Hand Score) & Constant-Murley scoring system respectively. Secondary outcomes were intra-operative conditions such as operative time and blood loss and post-operative complications. Results:The mean time of radiological union was 15.7 weeks ranging from14-26 weeks. All 36 fractures were united including one delayed union which united at 26 weeks. In our series, 4 patients had postoperative shoulder stiffness including one prominent nail, 1 patient developed radial nerve neuropraxia which recovered in 8 weeks. All patients were evaluated on the basis of Constant Murley score for shoulder function and DASH score. In our study of 36 patients 69.4% got excellent results, 19.4% got good results, 8.3% got moderate/fair results and 2.8% got poor results. Conclusion:Interlocking nailing is a relatively quick, minimally invasive, and biomechanically sound, cosmetically better method of internal stabilization of shaft humerus fractures with less union time, less infection and lesser threat to radial nerve and other complications. Besides it allows early mobilization. With correct anatomical knowledge, preoperative planning, good surgical techniques and postoperative rehabilitation interlocking humeral nailing is a viable option in the management of fracture shaft humerus promising excellent outcome.