Idiopathic clubfoot or congenital talipes equinovarus is the commonest congenital foot deformities having 1 in every 1000 children born worldwide. Around 80% of the cases occur in developing nations. It remains the most difficult to treat. The most widely used treatment is the Ponseti method of manipulation and serial plaster followed by an Achilles tenotomy. This method is effective in 90% of all cases. The objective of this study was to evaluate the outcomes of the Ponseti manipulation and casting method in the management of idiopathic clubfoot. This is a prospective study of 80 feet in 52 children treated by the Ponseti method in the department of Orthopedics, Rajendra Institute of Medical Sciences (RIMS), Ranchi, and Jharkhand. Evaluation of the deformity was done by Pirani score before and after the treatment and the results were assessed. The average number of castings used to correct the deformity was 6.5 times (range: 4 to 12). Tenotomy was performed in 66 (82.5%) of the feet. In all patients, plantigrade foot was achieved. The patients with bilateral clubfeet, higher Pirani score and higher age had inferior final outcome compared to those with unilateral clubfoot, lower Pirani score and lower age. 11 (13.75%) feet had skin excoriation secondary to cast problems and four patients had pain and tenderness at the site of the tenotomy. Recurrence was seen in three cases. 90.38% of parents were completely satisfied with their child's gait and foot appearance.

Background: The incidence of femoral neck fractures, one of the most common traumatic injuries in the elderly increases continuously due to the ageing of population on the planet and urbanization. Aims and Objective of the Study: To study the incidence of intracapsular femoral neck fractures in the elderly population with respect to age, sex, occupation, fracture type and laterality of injury. Materials and Methods: The prospective study included 30 patients with intracapsular femoral neck fractures referred to the Department of Orthopaedics, Ashwini Hospital, Gulbarga were selected for this study. Patients with intracapsular femoral neck fractures and aged above 55 years were considered. Patients were briefed about the nature of the study, the interventions used and written, informed consent was obtained. Further, descriptive data of the participants like name, age, sex, detailed history, were obtained by interviewing the participants and clinical examination and necessary investigations were recorded on predesigned and pretested proforma. Results: Majority of the patients (seven patients, 23.33%) were in the age group between 71 to 75 years and five patients, (16.67%) each were in the age groups of 55 to 60 years, 76 to 80 years and above 80 years. In the present study, out of the 30 patients there 18 were female accounting to 60% and 12 male patients making up the remaining 40%. The average interval between admission to the hospital and surgery was 3.6 days with a range of 01 to 17days. The average duration of hospital stay was 13.3 days with a range of 7 to 26 days. The duration of hospital stay is less in our series as the patients were mobilized early. Out of 18 female patients 14 females were house wives. Three were retired from job, and one was self-employed. Among the males, seven were retired from their jobs, four males were businessman and one male patient was self-employed. Majority of the fractures occurred due to fall in bathroom (56.67%) and fall in living room (30%). Right side involvement was more commonly seen than the Left in this study group. Right side was involved in twenty patients making up for 66.67% of the fractures and the left was involved in ten patients accounting for 33.33% of the fractures. Out of the 30 fractures, majority were type IV fractures (23 patients) accounting for 76.7%. Remaining 23.3% (07 patients) were type III fractures. Conclusion: In conclusion, hip fractures are a serious injury in the elderly population. There is a very mortality rate and morbidity rate following hip fractures in the elderly. Once diagnosis has been made, appropriate stabilization of the patient from a medical standpoint and rapid operative fixation of the fracture or prosthetic replacement helps patients obtain a better functional result. Adequate rehabilitation in an inpatient setting, as well as at the patient's home with home health is an important adjunct to an overall successful outcome.

Background: Conservative treatment for Proximal humeral fractures were common in the past and often had compromised functional results. With the advancement of surgical techniques, proximal humerus fractures are now more often managed operatively for early rehabilitation and better functional outcome. The aim of this study was to assess the functional outcome of PHILOS plate fixation in proximal humerus fractures. Materials and Methods: A prospective, non-controlled, non-randomized study was conducted on patient admitted in our institution between July 2016 and August 2017 with displaced proximal humeral fractures with mean age of 50 years (range 24-75years). 15 patients were selected for the study. The outcome was assessed based on Constant-Murley score. Results: Results were analysed according to Constant-Murley score. Excellent results were achieved in 3 (20%), good results in 7 (46.66%), fair results in 3 (20%) and poor result in 2 (13.33%) of the cases. Avascular necrosis (AVN) and non-union was observed in one patient. Conclusion: PHILOS plate fixation for proximal humeral fracture is a good stable fixation with a good functional outcome especially in osteopenic elderly patients

Introduction: Supracondylar fractures of humerus are the most common fracture pattern of elbow in children. Severely displaced supracondylar fractures of the distal humerus in children are a challenging problem. Many treatment methods have been described for treatment of displaced supracondylar fractures of humerus, however there is no clear consensus as regards choice of treatment. The purpose of this study is to asses and compare the results of closed reduction and cast application versus open reduction and internal fixation[ORIF] by K-wires for completely displaced supracondylar fractures [Gartland Type-III fractures ]. Materials and Methods: This prospective non-randomized comparative study was carried out over a period of 12 months in a sample size of 40 children at Rajendra Institute of Medical Sciences [RIMS], Ranchi. 20 children were treated by closed reduction and external immobilization and 20 by open reduction and internal fixation by K-wire. Patients were followed up for 6 months and functional outcome of the 2 groups were evaluated and compared using Flynn's criteria. Result: Most cases were in the age group of 5 to 8 years [67.5%]. In conservative group 8 patients [40%] had satisfactory results whereas in operative group 18 patients [90%] had satisfactory results. Conclusion: The present study shows that open reduction and K-wire fixation has better results compared to closed reduction and external immobilization for Type-III Supracondylar Fractures of humerus.

Fracture neck of femur has always attracted the mankind due to its peculiar nature of going into non union and osteonecrosis of femoral head even with best fixation method and adequate reduction. A novel way to treat fracture neck of femur is with small diameter dynamic hip screw and an additional derotation screw. 30 patients aged 18-60 years presenting to Deen Dayal Upadhyay Hospital with fresh (<3 weeks old) fracture neck of femur were randomized into two groups and were treated with two different modalities of fixation: Small diameter sliding hip screw and plate with an additional derotation screw (Mini DHS group) and three cannulated cancellous screws in an inverted triangle configuration (CCS group). Intraoperative duration of surgery and blood loss was noted. All the patients were followed up for a minimum period of 12 months. The clinical outcomes were evaluated using UCLA score. Postoperative radiographs were used to look for evidence of union, loss of the alignment of the fracture, trabecular continuity at fracture line, late segmental collapse and the presence of avascular necrosis. Between group comparisons were performed using chi square test and Student's T test. Conclusion: Small diameter dynamic hip screw with an additional derotation screw is a good method to treat fracture neck of femur with increased incidence of union and less complications.