Background: Recent studies have reported that lateral hinge fracture (LHF) has a negative effect on bone healing at the osteotomy site after medial closing wedge distal femoral osteotomy (MCDFO). However, limited evidence exists in the literature regarding the predictive factors for LHF in MCDFO. Hypothesis: A large medial closing gap and a lateral hinge position in the supracondylar area would increase plain radiography–based and/or computed tomography (CT)–based LHF in MCDFO. Study Design: Case control study; Level of evidence, 3. Methods: We retrospectively evaluated 67 knees of 53 patients (mean age, 37.4 ± 16.9 years) who underwent MCDFO between May 2009 and June 2021. The surgical indications for MCDFO were genu valgum deformity combined with either lateral compartment osteoarthritis or recurrent patellar dislocation. The presence of LHF was evaluated based on immediate postoperative plain radiography and CT scans. The predictive factors for LHF in MCDFO were investigated using multivariate logistic regression analysis. Results: LHFs were identified in 21 knees (31.3%) through plain radiography and in 40 knees (59.7%) through CT. Multivariate logistic regression analysis showed that the medial closing gap and lateral hinge position were predictive factors for plain radiography– and CT-based LHF after MCDFO. Controlling for other variables, we found that an increase in the medial opening gap by 1 mm increased the likelihood of plain radiography–based LHF by a factor of 1.805 (95% CI, 1.291-2.525; P = .001) and CT-based LHF by 1.333 (95% CI, 1.003-1.772; P = .048). Moreover, a lateral hinge position in the supracondylar area increased the likelihood of plain radiography–based LHF by a factor of 9.870 (95% CI, 2.179-44.720; P = .003) and CT-based LHF by 5.686 (95% CI, 1.124-28.754; P = .036). Conclusion: A large medial closing gap and lateral hinge position in the supracondylar area are associated with LHF in MCDFO. Care should be taken to prevent LHF in MCDFO with a large medial closing gap. Moreover, a lateral hinge position in the supracondylar area should be avoided to decrease the incidence of LHF in MCDFO.

Supracondylar humerus fracture with forearm fractures are rare with reported incidence ranging from 3% to 13%. We have treated ten patients with ipsilateral supracondylar humerus fracture with distal radius fracture. One had a Gustillo-Anderson Grade 2 open supracondylar humerus fracture. All displaced fractures were treated with K-wire fixation by closed method except the open fracture which warranted wound debridement and subsequent open reduction. A follow up of at least 6 months is available for all our patients. All fractures showed signs of union by 6 weeks when K-wires were removed. At 6 months, 9 patients had excellent outcome while one patient with recovering radial nerve palsy had fair outcome. No cases of non-union or loss of reduction were seen in the post-operative period. Pin tract site infection was seen in one patient with open fracture which resolved after K-wire removal and antibiotic coverage. This study recommends a screening radiographs of forearm and wrist in patients with supracondylar humerus fractures to rule out any associated forearm/wrist injury. We also recommend closed reduction and K-wire fixation of the displaced supracondylar humerus as well as distal radius fractures.

Introduction: Knee joint derangement has a phenomenal growth in modern times owing to the immense expansion of industrial development, heavy vehicular traffic with increase in the number of accidents and enormous progress in sports-athletics. The anterior cruciate ligament (ACL) is one of the most commonly injured ligaments of the knee. Hamstring autografts have gained popularity for anterior cruciate ligament (ACL) reconstruction in recent years primarily due to significantly decreased postoperative pain and morbidity, allowing easier rehabilitation, compared with patellar tendon auto-grafts. The current study is aimed to compare different modalities of treatment of ACL injuries-arthroscopically, open procedure, mini open and pullout suturing Aim: To compare different modalities of treatment of ACL injuries-arthroscopically, open procedure, mini open and pullout suturing. Materials and Methods: This was a prospective study where all young and middle aged patients presenting with knee complaints and history of trauma to the knee in the Orthopaedics emergency and out patient department were evaluated by a thorough general and local clinical examination of the knee. The patients were included as per the specified inclusion criteria. The patients were treated using different modalities of treatment of ACL injuries-arthroscopically, open procedure, mini open and pullout suturing. The Post operative assessment was done by Lysholm Knee Score scale.Results and Discussion: In our study 52% of the patients who were treated with semitendinosus graft gave Excellent results on Lysholm Grading Scale and 55% of the patients who were operated with Quadriceps graft showed Excellent Grading on Lysholm Scale which means there is no statistical difference between outcome of ACL reconstruction and type of graft used. Also there is no significant statistical difference between type of Bundle And outcome according to Lysholm Grading as 55% of those treated with Single Bundle showed excellent results while 44% of those treated with double bundle showed excellent outcome according to Lysholm grading. Conclusion: Arthroscopic repair in ACL tear shows definitely better results with better outcome as compared to open repair of ACL tear.