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Introduction: Anterior bridge plating with minimally invasive technique for type A shaft humeral fractures is reported as an acceptable less traumatic and reproducible procedure by several authors. We have evaluated the clinical, radiological, and functional outcome of such fractures in twenty patients, all of which were managed with dynamic compression plate over an average follow-up period of 12 months. Though open reduction and plating technique of humerus shaft fracture is prevailing, this technique also gives favorable outcome. Materials and Methods: Twenty patients with type a humerus shaft fractures were managed by anterior bridge plating using MIPO technique between March 2017 to November 2019 were included in this series. All cases were treated with closed reduction and 10-12 whole 4.5mm dynamic compression plate fixation over anterior aspect in bridging mode using the MIPO technique. The dominant side, gender ratio, surgery time, and fracture union time, and complications were noted. The UCLA shoulder and Mayo elbow performance scores were used for assessing the shoulder and elbow function. Results: Of the Twenty patients in the study, ten were males and ten were females. The mean age was 34.3 years (range 18 to 85 years) twelve out of twenty patients (60%) had the dominant side fractured. Mean surgical time in minutes was 88.98 (range: 50 to 150 minutes). The mean fracture union (radiological) time was 14.3 weeks (range: 10-16 weeks) and clinical union time was 10.4 week. However Shoulder function was excellent in 20 cases (100%) on the UCLA score. Conclusion:This study confirmed a high overall rate of union and excellent functional outcomes. Mini incision anterior bridge technique for type A fracture shaft humerus gives good functional results and should be considered as an effective, cosmetically advanced surgical option in the treatment of type A humeral shaft fractures. It is a safe and less time consuming method for type a humeral shaft fractures when the surgeon is experienced in the technique.

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Background: Femoral neck fractures are one of the problems in clinical treatment. The prognosis is uncertain. Currently, no internal fixation method is superior to other internal fixation methods in the treatment of femoral neck fractures. Therefore, the internal fixation system needs to be further explored. The aim of this study was to compare clinical outcomes of femoral neck dynamic Hip screw system and multiple cannulated compression screws in the treatment of femoral neck fractures. Methods: This randomized control trial was conducted in the

Introduction: Chronic Low back pain with lumbosacral radiculopathy is one of the most common complain amongst patient in any orthopaedic out patient department . Therapeutic management of this problem is still a big task. Lumbar intervertebral disc herniation stands out to be most common cause , others include spinal stenosis , disc degeneration, post lumbar surgery syndrome. Epidural injections are used in patients with chronic low back pain with radiculopathy not relieved by conservative management. The aim of the study was to check the efcacy of uoroscopy guided epidural Injection of local anaesthetic and steroid in chronic low back pain with bilateral lower limb radiculopathy and compare the results with existing data of blind epidural injection without uoroscopic control. Materials And Method: The study was conducted among 52 patients visiting our out patient department at SMIMER hospital with complain of chronic low back pain bilateral lower limb radiculopathy not responding to conservative treatment. Outcomes were evaluated on the basis of pain relief (VAS score was used pre and post procedure), improvement in Oswestry low back disability score ,short term relief -6 months and long term relief > 6 months. Secondary outcome measure was functional status , psychological status and return to work. Results: In our study of 52 patients with chronic low back pain with bilateral lower limb radiculopathy not responding to medications, epidural injection was given under uoroscopic guidance after which 90.3%(47 patients) reported signicant improvement with mean VAS score improvement to 1.89 post procedure from mean score of 8.89 post procedure. Oswestry low back disability score decreased post procedure to 9% from pre-procedure score of 56.8%. No complications were reported in our study group. Conclusion: Epidural steroid injection is an effective treatment for the patients with chronic low back pain with bilateral lower limb radiculopathy not responding to therapeutic treatment. It is cost effective, safe and minimizes use of analgesics, allows early return to work and prevents or postpones surgical intervention needed for the same. Fluoroscopy adds on the benet of precision and accuracy of the epidural space for injection leading to increased efcacy and no requirement of sequential dosage as in epidural injection without uoroscopy due to lack of accuracy in that.