INTRODUCTION: Distal radius fracture is one of the common injury in orthopedic trauma. Traditionally,this fracture is being treated with closed reduction and immobilization in palmer flexion and ulnar deviation. This position of immobilization has been shown with poor functional result. So the aim of our study is to compare the radiological and functional outcome of distal radius fracture treated conservatively with respect to position of immobilization. MATERIAL AND METHODS: Hundred patients, all above 20 years of age with distal radius fracturewhere treated with closed reduction and below elbow cast application. Patients were randomly allocated to dorsal and palmer flexed plaster cast application, fifty in dorsiflexion group and fifty in palmer flexion group. All patients were followed up at 2nd week, 4th week, 6th week and 12th weeks. Radiological parameters measured in every follow-up and functional parameters measured after removal of cast in last two follow up. The results were scored and compared by Demerit Scoring System of Saito. For comparison, t test and Chi square test were used as necessary.RESULTS: All fractures united. All individual movements of wrist were significantly better in the dorsiflexed immobilized group as compared with  the  palmerflexed immobilized  group. Radiological parameters  were  also markedly better  in the dorsiflexed group.CONCLUSION: Both radiological and functional results of the extra articular distal radius fracture are better if the fracture immobilized in the dorsiflexed position after reduction rather than traditional palmer flexion position. Journal of Universal College of Medical SciencesVol. 6, No. 1, 2018, page: 46-51

Introduction: Several methods of reduction technique have been described for the anterior dislocation of shoulder but none technique is said to be ideal. The aim of this study was to show the efficacy of external rotation method which could be safe and painless method for the reduction of the acute anterior shoulder dislocation with or without fracture of the greater tuberosity and to search the cause of failure of reduction.Objective: Objective of this study was to assess the efficacy of the external rotation method for reduction of acute anterior shoulder dislocation and to find the cause of failure of reduction.Methodology: All cases of anterior dislocation encountered in emergency department reduced by external rotation method by consultant orthopedic surgeon using basic emergency setting for resuscitation were included in the study. Fifty cases of shoulder dislocation was treated by this method and prospective evaluation done with regard to type of dislocation, the effectiveness of the procedure in achieving reduction, the need for pre-medication, the ease of performing reduction and complication if any.Results: Out of 50 cases, successful reduction was achieved in 42 patients. Premedication was not required in 36 successful reduction. Average time of reduction was 2 minutes in 30 patients and 5 minutes in 8 patients. Four Patients complained severe pain during reduction process. This method was not successful in 8 patients 2 of whom had displaced greater tuberosity fracture.Conclusion: The external rotation method is reliable and safe method for the reduction of acute anterior shoulder dislocation which can be performed relatively with less pain for both subcoracoid and subglenoid dislocation provided there is no displaced fracture of the greater tuberosity.  BJHS 2018;3(2)6: 408-412.

Introduction: Management of late presented displaced fracture of lateral condyle of humerus in children is controversial, many recommend conservative management due to fear of complications like avascular necrosis but recently many are advocating for operative management with good results hence we studied the outcome of operative management in late presented displaced lateral condyle fracture of humerus in children. Methods: We studied 22 children aged between 4 to 11 years, presenting 3 to 16 weeks from injury. All underwent open reduction and internal fixation with Kirschner wires with or without additional screw and followed up for average 18.05 months. Elbow range of motion, angular or local deformity, premature fusion of physis, avascular necrosis and fracture union were noted and analyzed using modified Aggarwal et al criteria. Results: We had 9 (40.91%) excellent, 5 (22.73%) good, 5 (22.73%) fair, 3 (13.63%) poor result. Overall satisfactory results were seen in 19 (86.37%); 3 (13.63%) had poor result , one due to AVN, two due to premature fusion of physis and visible local deformity. All poor result were seen among delay of operation 6 weeks or later. There was significant improvement of elbow range of motion and all fracture united. Conclusions: Outcome of operation without bone grafting on lateral condyle fracture of humerus in children who presents late up to 5 weeks are excellent; whereas outcome of delayed operation up to 16 weeks also gives good functional recovery and union.

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Frontal bone osteomyelitis is a rare clinical disease which occurs as a result of frontal sinusitis, penetrating injury on head, post-operative complication after sinus surgery and hematogenous spread from distant site. Early diagnosis, appropriate surgical debridement and antibiotic are keys to prevent from life threatening intracranial complications. We report a 63 years old male patient with osteomyelitis of outer cortex of frontal bone. The wound was thoroughly debrided after computer tomography scan showed an osteolytic lesion on outer table of fontal bone and antibiotic was continued for 2 months until inflammatory markers become normal.Keywords: Frontal bone; Intracranial complications; osteomyelitis; pott’s puffy tumour.