Femoral shaft fractures are common fractures in paediatric age group. In children, fractures of the femoral shaft have been traditionally treated mostly by conservatively immobilization in a Spica cast, either immediately or after a period of traction. But this safe form of treatment has major drawbacks. The management of paediatric femoral shaft fractures gradually has evolved towards a more operative approach in the past decade. Elastic stable intramedullary nailing (ESIN) or Titanium elastic nailing system (TENS) is a recent technique which allows stable reduction, maintenance of reduction and early mobilization. . Aim of study is to assess the functional outcome of fracture shaft of femur in pediatric age group treated with titanium elastic nailing system. It is a prospective study which was conducted in the all children between 5-14 years of age with diaphyseal fractures of femur. Outcome of  fracture  shaft  of  femur  in  pediatric  age  group  treated  with titanium elastic nailing system was studied studied by observing following, Type of reduction among children with diaphyseal fractures of femur, .Duration for union after surgery , Range of motion after surger, weeks of  Weight Bearing started , Limb length discrepancy, Malalignment . From present study we conclude that femur diaphyseal fracture in children between 5-14 years of age can be effectively managed with titanium elastic nails. TENS offers a biological, minimally invasive method of treatment for fracture shaft of femur in children with advantages of sufficient axial stability, early mobilization and more rapid return to function. this technique yields higher rate of excellent functional outcome. Keywords: Femur, Diaphyseal Fracture,  Children, TENS

Background: Clavicle fractures are common, with an overall incidence of 36.5 -64 per 100,000 people every year. Traditionally, midshaft clavicle fractures have been treated nonoperatively. Recently, there has been increasing interest in the operative treatment and plate fixation or intramedullary nailing is often the treatment modality of choice. Numerous clinical studies have been published to compare surgical and conservative treatments. The best treatment for displaced midshaft clavicle fractures remains a topic of debate. So We sought to compare patient-oriented outcome and complication rates following nonoperative treatment and those after operative treatment of displaced midshaft clavicular fractures. Objectives: To compare functional outcome and complication rates following nonoperative treatment and those after operative treatment of displaced midshaft clavicular fractures. Materials and Methods: 60 patients with a displaced midshaft fracture of the clavicle who were presented to RL Jalappa Hospital from June 2015 to October 2016 and either treated by conservative or operative methods of treatment and who were in regular follow up are selected. Functional assessment was done at 6 weeks, 3 months and 6 months with use of the Disabilities of the Arm, Shoulder and Hand (DASH) and Constant scores Complications, if any will be recorded. Results: DASH Scores and Constant scores were significantly better in the operative group compared to the conservative group at all time points. Conclusion: Operative treatment resulted in early return to function compared to conservative treatment but at the cost if complications like infection and other hardware related problems.

Background: Fractures around the trochanteric region of the femur are one of the commonest fractures encountered in orthopedics in elderly and young patients. In younger patients, the fractures usually result from high-energy trauma like RTA or fall from height and older patients suffering from a minor fall can sustain fracture in this area because of weakened bone due to osteoporosis. Methods: Forty-nine patients, aged above 40 years with closed intertrochanteric fractures who were operated using proximal femoral nail anti-rotation (PFN-A) were evaluated for functional outcome and analyzed for the technical problems and complications associated with surgery. Results: Nineteen patients were less than 60 years of age group and all patients of this group had excellent and good outcome. 25 patients who belonged to more than 60 years of age group of which 7 patients had fair and poor outcome and it was statistically significant (p=0.0139). Conclusion:Closed reduction and internal fixation using PFN-A is an excellent method of treatment for an intertrochanteric fracture, to provide rapid recovery and good functional outcome. Age is a significant predictor of final outcome following surgical treatment. Younger is the age better the outcome.