Outcomes of traditional treatment methods of lateral epicondylitis are variable because of poor tendon healing properties secondary to poor vascularization. Platelet rich plasma provides locally high concentration of growth factors and have shown its efficacy in many tendinopathies and wound healing. We tried to measure the efficacy of locally injected autologous PRP, subjectively by functional oxford elbow score and pain score as well as objectively by ultrasonographic evaluation of the morphologic changes (focal hypoechoic, odema, tendon thickness, fraying, tear, cortical erosion, calcification) in common extensor origin in 30 patients with mean age of 39.3 years of recalcitrant lateral epicondylitis. The mean pain VAS Score improved from 7.7 before injection to 1.8 at final follow up i.e. after 6 months post injection. The Oxford elbow score improved from a mean of 19.2 prior to treatment to 41.3 after the injection at final follow. Ultrasonography of the involved elbow showed decrease in focal hypoechoic, decreased edema, improvement in thickness of the tendon and healing of the tear at the origin site. This study confirms that local PRP by supplying growth factors helps to enhance the stromal and mesenchymal stem cell proliferation and increases tendon vascularity and prevents angiofibroblastic degeneration and thus improves tendon repair and healing property by releasing growth factors and increasing vascularity, which can be documented by improved tendon morphology.

Introduction: The hip abduction brace is an orthotic device made after taking individual measurements and works on the principle by assisting or resisting the movements of joint and bypass the load on Implant and hip joint. Materials and Methods: In this study 19 patients are evaluated during 3years period from July 2012 to July 2015 with mean follow up of 9 months, conducted in M.Y. Hospital Indore. Abduction brace applied immediately in postoperative period till three months in all those fracture which were fixed in varus. We radiologically analyzed inter-trochanteric fracture patient operated with PFN fixation in immediate postoperative period, at 6 weeks, 3 months and 9 months period. Results: Inter-trochanteric fracture patients operated with PFN and identified as cases of impending failure were protected with hip abduction brace in immediate postoperative period giving good to excellent results in terms of reduced complication rate. Conclusion: Hip abduction brace or an Orthotic assisted weight bearing mobilization of these patients prevent further varus collapse and screw cut outs. Abbreviations: PFN-Proximal Femoral Nail.

Distal humerus fractures constitute 2 to 7% of all the elbow fractures. Young males are most commonly affected due to high energy trauma and secondly seen in elderly women due to osteoporosis. Due to complex anatomy and neurovascular network nearby, the treatment is very difficult. Anatomical reconstruction is the key for successful functional outcome. We compared the TRAP and olecranon osteotomy approach for the management of intraarticular fractures of the humerus in terms of functional, clinical and radiological outcome. The study was conducted in the Department of Orthopaedics & Traumatology, MGM Medical College and MY Hospital, Indore from August 2019 to August 2021 on 30 patients with intra-articular fractures of humerus. 15 patients were treated with olecranon osteotomy and 15 patients were treated with TRAP approach, on patients fulfilling all the inclusion, but none of the exclusion criteria. The functional outcome was measured using Mayo Elbow Performance Score (MEPS) and radiographs were used for evaluating the bone union time.There was a male predominance. Assault, fall and road traffic accidents were the modes of injury. 13-B2, 13-C1 and 13-C3 were commonly seen fracture types. Mean MEPS was significantly better in TRAP (P<0.05) and full triceps strength was achieved in 86.7% patients by 3 months in TRAP and by 6 months in olecranon osteotomy group. The mean blood loss and duration of surgery was significantly longer in olecranon group (P<0.05). The bone union time and hospital stay were comparable between the groups (P>0.05). 73.3% patients of TRAP and 64.3% patients of olecranon osteotomy group achieved excellent outcome by 6 months.TRAP approach is comparatively better than osteotomy approach. Both the methods provide a stable fracture fixation, but complications are more in osteotomy in comparison to TRAP and we found TRAP to be functionally better.: TRAP-triceps reflecting anconeus pedicle approach, MEPS-Mayo Elbow Performance Score, DASH-disabilities of the arm, shoulder and hand, POP-plaster of Paris