No abstract

Introduction: Fracture of shaft of humerus is a common fracture of the upper limb which consists of 1-3% of all fractures. The most common method of fixation is open reduction internal fixation with plate and screw, and closed reduction with intramedullary nail fixation. The purpose of this study was to evaluate the clinical outcome of plate fixation versus intramedullary nail fixation. The study of fractures of shaft of humerus is important due to chances of these fractures to go in mal-union and non-union and the functional disability to the patient after these fractures being a hindrance in earning their daily living. Material and Method: We randomly followed 50 cases of humeral shaft fracture of which 24 treated by closed reduction and intramedullary nailing and 26 treated with open reduction and platting. Union, functional outcome and complication were compared between both the groups. Evaluation of follow-up as per ASES (American shoulder and elbow surgeons) score was done on last follow-up. Result: The average age of patient was 37.8 years; most common site was middle 1/3 rd shaft of humerus. The average duration to achieve union with closed reduction and intramedullary nailing is 10.91 weeks and average duration of union with open reduction and platting was 12 weeks. Functional outcome was assessed by using ASES score value. The average ASES score for platting was 80.36 and that of nailing was 76.23. Complications like Non-union (12.5%), iatrogenic nerve injury (11.5) and infection (7.7%) were encountered in plate group where in IM nail group Non-union (12.5%), shoulder stiffness (16.6%) and impingement. Conclusion: Functional outcome of Platting group is better than IM nail. Early mobilisation with IM nailing is advantage compare to platting. IM nail when used, one has to take precautions, like proper countersinking of the nail at entry point to prevent shoulder movement restriction, irrigation of entry point site to remove all reamed bone debris. Careful dissection of rotator cuff to prevent its damage.

Aim: This is a prospective study of 30 patients with distal tibia fracture (Closed extra-articular distalthird tibia fractures - 4 to 11cm from tibial plafond) who underwent surgical fixation were included inthis study after excluding compound, pathological and pediatric fractures. Materials and Methods:15 underwent closed intramedullary interlocking nail and 15 were treated with plate osteosynthesis(MIPO). Results: The age distribution ranged from 23 to 68 years with the mean age of 39.4 years.The mode of injury in all patients was due to vehicle accidents. All 30 patients were classifiedaccording to AO classification of which 15 belonged to A1, 14 belonged to A2, and 1 belonged to A3.The time of fixation from injury varied from 6 hours to 18 days. Conclusion: Plate osteosynthesisby minimally invasive technique and Intramedullary interlocking nailing is an equally effectivemethod of stabilization for distal tibia fracture when considering the union rates and final functionaloutcome. However, malunion, nonunion and secondary procedures were more frequent afterintramedullary interlocking nail. In MIPO platting Infection followed by an exposed plate occurs in 2patients. Randomized prospective evaluation of distal tibia fractures may clarify the efficacy of plateversus nail treatment and optimize patient care.

Introduction: Subtalar or peritalar dislocation is defined as simultaneous dislocation of talocalcaneal and talonavicular joint. Most injuries are caused by moderate to high energy trauma including motor vehicle accidents and falls from height. This case is operated for lateral subtalar dislocation treated with open reduction. Case: A 35 year old male patient came to