Background. Anterior bridge plating with minimally invasive technique in humeral shaft 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 eleven patients, all of which were managed with dynamic compression plates over an average follow-up period of 22 months. Material and methods. Forty patients with humerus shaft fractures managed by anterior bridge plating using the MIPO technique between 2014 and 2016 were included in this series. All cases were treated with closed reduction and 10-12 hole 4.5mm dynamic compression plate fixation over anterolateral aspect in bridging mode using the MIPO technique. The UCLA shoulder and Mayo elbow performance scores were used for assessing shoulder and elbow function. Results. Of the forty patients followed up for a minimum of 18 months in the study, 26 were males and 14 were females. The mean age was 34.3 years (range 20 to 53 years). 24 out of the forty patients (60%) had the dominant side fractured. The mean surgical time was 72.5 minutes (range: 45–100 minutes) and mean radiation exposure was 160 seconds (range: 100–220 seconds). The mean radiological fracture union time was 13 weeks (range: 8–18 weeks). Shoulder function based on the UCLA score was excellent to good in 33 cases (82.5%), fair in 6 cases (15%) and one patient (2.5%) developed infection for which the plate was removed prematurely at the 4th month and the wound was meticulously debrided and then managed conservatively. Road traffic accident (RTA) was the most common mode of injury, found in 27 cases; 12 patients sustained blunt trauma due to a fall; one patient sustained an injury following a direct blow by stick. Conclusions. 1. The mini-incision anterior bridge technique for humeral shaft fractures gives good functional results and should be considered an effective, cosmetically advanced surgical option in the treatment of humeral shaft fractures. 2. The mini-incision anterior bridge technique is a safe and less method for simple types of humeral shaft fractures when the surgeon is experienced in the technique.

Background: Transverse fractures of body of the patella are by far the most common fractures of this bone. Surgical fixation is the recommended treatment in displaced fractures with extensor lag. Although, tension band wiring (TBW) technique is the gold standard for these fractures, few surgeons recommend augmentation with circumferential cerclage wiring to improve the strength of the fixation. We compared the results of the internal fixation of displaced transverse fractures of the patella using TBW and circumferential cerclage wiring with those treated with TBW alone. Methods: We treated 54 displaced transverse fractures of the patella at our institution. We segregated the patients into two groups: Group 1 (n=23) included fractures treated with tension band wiring (TBW) along with augmented circumferential cerclage wiring while as Group 2 (n=31) included fractures treated by TBW alone. Outcome was studied, graded and compared on the basis of knee pain, knee stiffness, quadriceps wasting, loss of flexion and loss of extension. Results: 73.90% patients among group 1 and 70.96% among group 2 showed excellent to good results (P value < 0.1). Fixation failure and need for revision surgery among group 1 and group 2 was found to be 8.69% and 9.67%, respectively (P value < 0.6). Infections and non union occurred among 4.34% patients in group 1 whereas in group 2 it was 6.45% of the patients who encountered the same (P value < 0.6). Conclusions: The use of circumferential cerclage wiring along with tension band wiring for displaced transverse fractures of patella seems to have no added advantage over fixation with tension band wiring alone.Keywords: Patella fracture, Tension band wiring, cerclage wiring

Background: Calcaneum fractures constitute the majority of the tarsal bone fractures worldwide. There is no gold standard consensus as of now for the management of the displaced intra articular calcaneal fractures. Open reduction and internal fixation with plating is one of the management options available. Methods: Authors studied the results of open reduction and internal fixation with plating in 22 calcaneal fractures in a study with a minimum follow up of 6 months. Outcome was studied using Maryland foot score. Results: Authors observed excellent results in 5 patients (22.72%), good results in 12 patients (54.54%), fair results in 4 patients (18.18%) and poor result in 1 patient (04.54%). Authors encountered wound infection in 1 patient (4.54%), heel varus in 1 patient (4.54%), heel broadening in 1 patient (4.54%), reduced range of motion at ankle in 2 patients (9.9%) and persistent heel pain in 1 patient (4.54%). Conclusions: Open Reduction and Internal Fixation (ORIF) with calcaneum plating, through an extensive lateral approach, for displaced intra articular fractures of the calcaneum is an effective treatment modality with very good results in experienced hands.

<p class="abstract"><strong>Background:</strong> Osteochondroma is the commonest benign bone tumor in humans. This tumor may either be solitary or present as multiple lesions. Solitary osteochondromas are much more common. Femur is the single most common long bone involved followed by tibia and humerus. Osteochondromas may be either asymptomatic or may present as pain, pressure symptoms or functional impairment. Most of the symptomatic lesions need surgical excision.</p><p class="abstract"><strong>Methods:</strong> This was a prospective study which included 32 patients with solitary osteochondromas of femur, who were managed with surgical excision. Only the symptomatic cases were operated. Minimum follow-up period was 18 months after surgery.<strong></strong></p><p class="abstract"><strong>Results:</strong> This study involved 23 males (71.87%) and nine females (28.12%). 30 osteochondromas (93.75%) were located in the distal femoral metaphysis while as only two cases (6.25%) of proximal metaphyseal involvement were seen. The commonest indication for surgery was pain. Other indications included cosmetic causes, restricted joint movement, fracture of osteochondroma and paresthesia or numbness. The complications included post-operative hematoma formation which was seen in 2 patients (6.25%), infection which was seen in one patient (3.12%), post-operative hypoaesthesia in 2 patients (6.25%) and recurrence of the tumor occurred in one patient (3.12%).</p><p><strong>Conclusions:</strong> Surgical excision of the solitary symptomatic femoral osteochondromas is a rewarding and safe procedure with minimal complications. </p>

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