male and female patients with Gartland type III supracondylar fracture of humerus presenting within 24 hour of injury, with age limit varying between 1-12 years were included in our study. The anteroposterior and lateral view X-rays were taken and evaluated for displacement and angulation, medial/ lateral displacement and angulation and rotation of distal fragment. After all aseptic measures, patient under general anesthesia, through posterior approach skin was incised, subcutaneous tissue dissected along the line of incision. Triceps apponeurosis was splitted and interposed soft tissue was released and fracture reduced and fixed with K-wire on both medial and lateral sides parallel to the long axis of humerus in lateral view and an angle of 30 o -40 o in A/P view. Wound closed in layers, aseptic dressing applied and well-padded back slab with elbow in appropriate angle of flexion was applied and pulses were checked. Postoperatively the hand was held elevated. Plaster of parries black slab was removed after four weeks; the wires were removed after six weeks. The follow-up ranged from 3 to 6 months. All the Data regarding patient were entered on well-designed proforma. The criteria for assessing the results were based on healing period, anatomical appearance, function and radiographic appearance. Results: Excellent results according to Mitchell-Adam's criteria were observed in 60 %. (120/200) cases, good results were observed in 27 % (54/200) cases. Overall excellent to good results were observed in 87% of cases. Conclusion: It is concluded that outcome of surgical treatment of supracondylar fractures of humerus (Gartland type III) fixed with medial and lateral placement of k-wires were excellent to good and it achieves stable fixation. As both wires were placed under vision so risk of ulnar nerve and radial nerve injuries were decreased as compared to closed reduction and percutaneous k-wiring. As this method is techinically easy, less demanding and effective for stabilization and can be applied for patients with these fractures. Key words:Kirschner wire, supracondylar fracture

Objectives: The purpose of present study is: 1. To know the results of surgicalintervention of Garland type III fracture Humerus in children.2. To know the early and latecomplication of surgical intervention. Study Design: Prospective interventional study. Setting:Department of Orthopedic Unit-II, Civil Hospital Karachi. Period: February 2010 to January2012. Methods: 200 male and female patients with Gartland type III supracondylar fracture ofhumerus presenting within 24 hour of injury, with age limit varying between 1- 12 years wereincluded in our study. The anteroposterior and lateral view X-rays were taken and evaluatedfor displacement and angulation, medial/ lateral displacement and angulation and rotation ofdistal fragment. After all aseptic measures, patient under general anesthesia, through posteriorapproach skin was incised, subcutaneous tissue dissected along the line of incision. Tricepsapponeurosis was splitted and interposed soft tissue was released and fracture reduced andfixed with K-wire on both medial and lateral sides parallel to the long axis of humerus in lateralview and an angle of 30o – 40o in A/P view. Wound closed in layers, aseptic dressing appliedand well-padded back slab with elbow in appropriate angle of flexion was applied and pulseswere checked. Postoperatively the hand was held elevated. Plaster of parries black slab wasremoved after four weeks; the wires were removed after six weeks. The follow-up ranged from 3to 6 months. All the Data regarding patient were entered on well-designed proforma. The criteriafor assessing the results were based on healing period, anatomical appearance, function andradiographic appearance. Results: Excellent results according to Mitchell–Adam’s criteria wereobserved in 60 %. (120/200) cases, good results were observed in 27 % (54/200) cases. Overallexcellent to good results were observed in 87% of cases. Conclusion: It is concluded thatoutcome of surgical treatment of supracondylar fractures of humerus (Gartland type III) fixedwith medial and lateral placement of k- wires were excellent to good and it achieves stablefixation. As both wires were placed under vision so risk of ulnar nerve and radial nerve injurieswere decreased as compared to closed reduction and percutaneous k-wiring. As this method istechinically easy, less demanding and effective for stabilization and can be applied for patientswith these fractures.

ORIGINAL PROF-3225 ABSTRACT… Objectives: 1. To assess the results of infected nonunion of tibia by Ilizarov techniques. 2. To ascertain the incidence of complications and advise methods to prevent them. 3. To determine various risk factors which contribute to these complications. Study Design: This descriptive case series.

Objectives: 1. To assess the results of infected nonunion of tibia by Ilizarovtechniques. 2. To ascertain the incidence of complications and advise methods to prevent them.3. To determine various risk factors which contribute to these complications. Study Design: Thisdescriptive case series. Setting: Department of Orthopaedic Surgery, Dow University of HealthSciences/ Civil Hospital Karachi. Period: 1st March 2010 to 28th Feb. 2013. Methods: A total of 30patients with infected nonunion of tibia with or without shortening and bone loss was includedin the study. Patients lying in supine position, after spinal anesthesia, radical debridement weredone and all previous infected implants and necrotic bone removed, pre-assembled ilizarovframe was applied with the help of four or five rings, each ring was fixed with k-wires andschanz pins. Olive wires were used where interfragmentary compression, correction of axialdeviation of fragment, in osteoporotic bones, transport of fibular fragment or more stability wasrequired. Results: Results were divided into bony and functional parts by ASAMI. We achieveexcellent to good bony result in 86.66% (26/30) of cases and excellent to good functional resultin 76.66% (23/30) of cases. Conclusion: It is concluded that bony and functional outcome ofinfected nonunion of tibia treated with ilizarov ring fixator is satisfactory. Although its applicationis lengthy but once applied patients get benefits, they can start walking with full weight bearing,limb length equality and soft tissue coverage achieved, so we recommend its applications insuch type of cases.

Introduction: Among the elbow fractures, the most common elbow fracture observed in children are the supracondylar humeral fracture. The advancement of modern surgical techniques has reduced the incidence rate of compartment syndrome and malunion. For the treatment of supracondylar humeral fractures, techniques such as closed reduction, traction, splint closed reduction, open reduction, k-wire fixation, and percutaneous pinning are used. There are different approaches that are applied for open reduction method which include double incision method (lateral and medial), medial, anterior, posterior and lateral approach. Till date among all these approaches, the posterior approach via muscles of triceps has produced very good results. Different studies have been conducted to compare the anterior and posterior approaches of surgical treatment. Aim:To compare the results of posterior and lateral surgical approaches while treating the type III supracondylar humeral fracture in children. Methodology:This study included 82 children, who had undergone the surgical treatment, 52 patients were treated by the posterior approach, and 30 patients were treated by the lateral approach. Both the groups had their follow up till 6 months postoperatively. Results:It was observed that the posterior approach had a very short surgery time as compared to the lateral approach. The results obtained according to the Flynn's criteria were 80.7% in the posterior group and 80% in the lateral group, and no statistical significance was observed between the two groups. Conclusion:The posterior approach had shorter operating time as compared to the lateral approach, however, no statistical significance was determined between the two groups in terms of functional results and complications.