Background: In adults, distal humerus fractures are uncommon and intra-articular, oftenly involve both the medial and lateral columns. Open reduction and surgical fixation with plating gives good results. The aim of this study is to evaluate clinical outcome in intra articular distal humerus fractures treated with dual plating.Methods: This is a prospective type of study of 20 cases of supra condylar fracture humerus with inter condylar extension treated surgically with dual plating one on the medial boarder and another on posterior surface of lateral column using standard dorsal approach, olecranon osteotomy.Results: The range of age was between 18-52 years, with mean age of 32.55 years. The maximum incidence was between 18 to 40 years i.e. 16 cases (80%). With road traffic accident (RTA) as major cause of injury. Most   of the patients were males 14 (70%) with right upper limb was involved in 12 (60%) cases. According   to MEP score clinical outcome was excellent in 4(20%) good in 10(50%) fair in 5(25%) and poor in one (10%).Conclusions: Distal humerus fractures are known for their complex nature and technical difficult in surgical management. Proper anatomical articular reconstruction and stable fixation helps in restoring painless and functional elbow.

Background and purpose: Little is known about the epidemiological features of amyotrophic lateral sclerosis (ALS) in sub-Saharan Africa, and data from the region are limited to clinical series or case reports. The aim of the study was to investigate the incidence rate and presentation of ALS in an ethnically diverse region of South Africa. Methods: We performed a 4-year prospective incidence study in the Western Cape Province of South Africa between 1 July 2014 and 30 June 2018, and used a two-source capture-recapture method for case ascertainment. Age-and sex-adjusted incidence rates (ASAIRs) were calculated using the 2010 US population as the reference. Results: A total of 203 incident cases were identified over the study period, resulting in a crude incidence rate (IR) of 1.09 [95% confidence interval (CI) 0.94-1.24] per 100 000 person-years in the at-risk population (aged >15 years). Capture-recapture analysis resulted in an estimated IR of 1.11 (95% CI 1.01-1.22) per 100 000 person-years. The ASAIR was 1.67 (95% CI 1.09-2.26) overall; 1.99 (95% CI 1.60-2.39) for men and 1.37 (95% CI 1.06-1.68) for women. When analysed separately, there was a substantial difference in ASAIRs between the different population groups, with the highest in the European ancestry group (2.62; 95% CI 2.49-2.75), the lowest in the African ancestry group (0.56, 95% CI 0.0-1.23), and an ASAIR in between these two in the mixed ancestry group (1.09, 95% CI 0.80-1.37). Conclusion: The overall incidence of ALS in the Western Cape Province of South Africa appears to be lower than in North African and Western countries, but higher than in Asian countries. As suggested by previous epidemiological studies, ALS may be less frequent in people of African ancestry.

Introduction: Intertrochanteric and femoral neck fractures account for nearly 90% of proximal femur fractures. It is customary to use 65 years of age to define the elderly. One year mortality in these elderly patients ranges from 12%-36%. The main objective of this prospective study is to study the effect of age, sex, co morbidities, delay in surgery and complications on outcome in elderly with proximal femur fractures and to identify optimal measures that can be taken to improve outcome in these patients. It was presumed that early surgery within 48 hours after stabilization of co morbid conditions improves outcome in these elderly patients with proximal femur fractures. Materials and Methods: In this prospective study elderly patients with proximal femur fractures were selected, after careful selection with inclusion and exclusion criteria. They underwent surgery after preoperative assessment and followed for up to one year at a tertiary referral centre. Results: Increasing age and male sex are not significant factors affecting outcome. Increasing number of co morbidities (2, 3 or more) is associated with significant increase in mean length of hospital stay (p values .006, and .001), increased incidence in number of complications (p value .008) and mortality (p value .028). Presence of complications is significantly associated with increase in mean length of hospital stay (p values .000, .001), decline in recovery of pre injury mobility status (p value 0.018), increased incidence in number of deaths (p value .01). Delay in surgery more than 48 hours is associated with significant increase in mean length of hospital stay (p value .001) and increased incidence in number of complications (p value .028). Conclusion:Early surgery within 48 hours after stabilization of co morbid conditions is associated with improvement of outcome in elderly patients with proximal femur fractures is proved correct in terms of decreasing mean length of hospital stay and decreasing incidence of number of complications.

Aim & Objectives: The aim of the present investigation is to evaluate the results of bipolar hemiarthroplasty with respect to pain, range of motion, clinical functional outcome and complications in cases of Intra capsular fracture neck of the femur treated with bipolar hemiarthroplasty. Methodology: It is prospective observational study consists of 22 adult patients of Intracapsular fracture neck of the femur, who are treated with Bipolar hemiarthroplasty in NRI Medical College & general hospital, Guntur from 01-07-2017 to 31-06-2018.Results: This series consisted of 22 cases of intracapsular fracture neck femur treated surgically by Bipolar hemiarthroplasty. In the present study, out of the 22 patients 14 were females accounting to 63.64% and 8 were males making up the remaining 36.36%. Females are more affected than males. Age of all the patients in this study, ranged above 60 years. Majority of the patients were in the age group between 60 to 70 years. In this study group, left side (54.55%) was more commonly involved than the right (45.45%). The average interval between admission to the hospital and surgery was 4.5 days with a range of 2 to 15 days. The average duration of hospital stay was 15 days with a range of 7 to 30 days. The commonest mode of injury occurred due to fall on a slippery floor (86.36%) and Road Traffic Accident (13.64%). Harris hip score was used to evaluate the functional results. Using this rating scale, the functional outcome was measured. There were Seven patients (31.82%) with excellent results, Twelve patients (54.55%) with good results, Two patients (9.09%) with fair results and One patient (4.55%) with poor outcome. Conclusion:We conclude that bipolar hemiarthroplasty produces good functional outcomes with minimal complications for displaced intracapsular femoral neck fractures and has several advantages.