Background: Intraarticular distal femur fractures are severe injuries posses many challenges in management and associated large number of complications like infection, knee stiffness, delayed union, nonunion, instability, and post-traumatic arthritis. The advent of distal femur locking plate has improved the operative outcome of these fractures. Aim and Objectives: This retrospective study aimed to determine the functional, clinical and radiological outcome of AO type C distal femur fractures treated with distal femur locking plate. Level and type of study: Level 4, A retrospective study. Methods: We retrospectively reviewed 52 patients with AO type C distal femur fracture in our hospital between January 2010 to December 2017. Patients were selected according to strict inclusions criteria and operated distal femur locking plate through medial parapatellar or modified swashbuckler approach. The functional and radiological outcome were studied using NEER knee score. Results: Total 52 patients in which 38 males and 14 females with a mean age of 41.77 years, a mean follow up of 14.56 months were included in our study. According to AO classification, 12 patients of type C1 fracture, 14 of C2 fracture and 26 of type C3 fracture were included. Average time of union was 18.4 weeks and average NEER score at final follow up was 77.68 with 18 patients had excellent, 22 patients had satisfactory results, 7 were had fair results and 5 had poor results. The average range of flexion was 95.86. Conclusion: Distal femur locking plate is better to provide angular stability, multiple options to secure fracture fragments both metaphyseal and articular to restore limb length, joint congruity, and varusvalgus alignment. Along with the anatomical reduction of joint surface and rigid fixation, early mobilization and proper physiotherapy are mandatory to get the optimum outcome.

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Background: Calcaneus fractures are the most common of tarsal bone fractures and displaced intra articular fractures accounts for 60% to &75% of all calcaneal fractures. Fractures of the calcaneus remain among the most challenging for the orthopedic surgeon to manage effectively as these injuries are more destructing and devastating. The management dilemma is still going on regarding conservative or operative treatment for such fractures as there is no clear evidence to delineate the gold standard treatment method which is superior in every aspect. Material and Method:We have done a prospective study of 58 patients (2 had bilateral fracture) with displaced intra-articular calcaneus fracture after applying strict inclusion and exclusion criteria. We have randomly allocated patients in operative (A, n-30) and non-operative group (B, n-30). We compared clinical, functional and radiological outcomes of both groups. Results: The mean age in operative group is 34.7 years and in non-operative group is 36.03 year. Average follow-up is 12.4 months and average time of union was 10.1 weeks in operative group while in non-operative group it is 11.03 month and 10.6 weeks respectively. The mean AOFAS score at final follow up of operative group is 84.2 and in the other group it is 79.4. Total 8(39%) patients undergoing operative management have excellent result, 15(50%) have good results,3(10%) have fair and 4(1%) have poor results as compared to other group 4 (13%), 9 (30%), 8(27%), 9(30%) respectively. Conclusion: Operative management has a better radiological, clinical and functional score in comparison with conservatively managed patients of displaced intra articular calcaneal fracture. However, operative management is also associated with increased number of surgery related complications like long hospital stay, cost effectiveness, local wound healing problems, superficial and deep infection, implant related problems as compared to other group.

Background: Spinal canal stenosis is a condition in which the spinal cord and the nerve roots are compressed by a number of pathologic factors, leading to symptoms such as pain, numbness, and weakness. This study was undertaken to evaluate clinical, functional and radiological outcomes of surgical decompression in spinal canal stenosis. Material and Method:We have included 26 adult patients with lumbar spinal canal stenosis in this prospective study who have not improved after conservative management for minimum 6 weeks. All the patients underwent standard open decompression using posterior midline approach. Patients were followed up at 6 weeks, 3 months, 6 months, and 1 year, they were assessed clinically and functionally using VAS score and ODI score. Results: In this study total 26 patients, out of which, 14(54%) were females and 12(46%) were males with an average age of 58.08 years. VAS of back pain improved from 2.85 on admission to 1.08 on final follow-up and leg pain form 8.00 on admission to 1.73 on final follow-up and ODI from 63.69 on admission to 14.54 on final follow-up. Conclusion: Decompression surgery is the gold standard treatment for central or lateral recess lumbar stenosis when conservative treatment fails as it provides significant clinical as well as functional improvement in term of VAS score and Oswestry Disability Index.