INTRODUCTION; Clavicle fracture is a common traumatic injury around shoulder girdle due to their subcutaneous position. It is caused by either low-energy or high-energy impact. Fracture of the clavicle accounts for approximately 5 to 10% of all fractures and upto 44% of injuries to the shoulder girdle. About 80% of these fractures are in the middle third of the bone and less often in the lateral third (15%) and medial third (8%).AIMS AND OBJECTIVES;To study the role of open reduction and internal fixation in clavicular fractures, study various surgical procedures over fracture clavicle, clinically evaluate the results of various surgical procedures over fracture clavicle,discuss merits and demerits of the various surgical procedures, finally draw conclusions of overall study.METHODOLOGY; The present study was carried out from June2010 to December 2013 at Orthopaedics Department Bangalore medical college and research institute,in this period 40 patients of clavicular fractures were treated surgically. Adult male and female patients above 18 years who require surgical intervention for displaced andcomminution fracture. RESULTS AND OBSERVATIONS;we had 32 cases of middle third clavicle fracture and 8 Lateral third fracture with no medeal third fracture.. The functional outcome is assessed by constant and murleyscore.In this study on 32 patients (80%) with middle third clavicle fracture treated with plate and screws 24 patients (60%) had excellent functional outcome, good functional outcome in 6 patients (15%) and fair functional outcome in 2 patient.For 8 patients of lateral third clavicle fracture fixed with Kirschner wire and tension band wire 4 patients (10%) had excellent functional outcome results and 2patients (5%) had good functional outcome 1 patient had fair functional outcome and with 1 patient fixed with hook plate had fair functional outcome.CONCLUSION;Clavicle fractures are usually treated conservatively but there are specific indications for which operative treatment is needed like comminuted, displaced middle third clavicle fractures and displaced lateral third clavicle fracture.In this study primary open reduction and internal fixation with plate and screws of fresh middle third clavicle fractures provides a more rigid fixation and does not require immobilization for longer periods.In this study locking compression plates were used as it is provides strong fixation due to locking between the screw and plate, Dynamic compression plate is strong but it gives excessive prominence through the skin and it is difficult to contour. For displaced, comminuted middle third clavicle fracture plate and screws fixation and early mobilization gave excellent results.

Introduction: Distal Tibia fractures continue to be one of the most controversial fractures that we treat. Most of the controversy resides in the treatment techniques, as the indication for surgery is fairly clear. Plate osteosynthesis with Minimally invasive plate osteosynthesis(MIPPO) principle for fractures of the distal tibia is often associated with good healing but infection, and hardware problems.Locked intramedullary nailing is the treatment of choice for closed fractures of the tibial shaft .For proper alignment, the nail should be centrally placed in both the proximal and distal fragments ,but does not fit properly into the distal fragment of the lower third of the tibia. This places additional stress on the distal locking bolts and may lead to breakage and malalignment.AIMS AND OBJECTIVES; The main aim of the study is to compare the functional recovery of the patients who had distal extraarticular fracture ,AO type 43A treated with Intramedulary interlocking nail and plate osteosynthesis (Mippo). Also The aim of treating a fracture is to produce a stable construct which allows early mobilisation and weight-bearing, but with minimal complications.MATERIALS AND METHODS; This study was done in the department of orthopedics from June 2010 to January 2013 in young age above 18yr and below 60 yr. which includes 30 patients with distal tibia fractures. Patients having fracture of distal tibia at metadiaphysial area.1.Extraarticular fracture, minimum of 3cm of distal fragment 2.Age above 18yrs and less than 60yr old3.Open fracturegustilo Anderson type 1 and type2SUMMARY; In this study 30 cases of distal tibia fracture were treated surgically with internal fixation with IMIL nail for 15 case and ORIF plating for 15 cases. In our study of30 cases AO Type 43 , 12 case were type A1,9 (76%)patients operated with IMIL nail and 3(23%) patient with plating. Type A2 we had 12 cases out of which 5 patients(41.6%) treated with nail and 7 patient(58.3%) treated with plate.TypeA3 we had 6 cases.one case 16.6% treated with nail and 5 cases 83.3% with plate. We faced more malalignment(11.11%),delayed union(16.6%),non union(5.5%),secondary procedure( 22.2%)done for the complication was more with nail .where as with plate group we never had significant malalignment.Had one delayed union(32weeks) for which no secondary surgery done,One superficial skin necrosis of surgical site .CONCLUSION;In study of distal tibia fractureOTA\AO 43 Type A ,we compared with both nail and plate surgery. We conclude that segmental alignment is difficult with nail due ankle joint is near ,more distal the fragment difficult to treat with nail. Because of more complication associated with nail than plate.We conclude plating in distal tibia fracture AO 43 TypeA is safe and provide better alignment than nail.

INTRODUCTION Most of these fractures except intra-articular fractures are treated with interlocking nail. 1,2 These nails are a boon for these fractures. But as the fracture nears to the joint stability the fracture fixation will be compromised due to malreduction and alignment, it leads to increased chances of delayed and nonunion. 3 Locking anatomical plates are evaluated for anatomical and relative stability fixation. Since then most intra and near intra-articular fractures are fixed with these plates with minimally invasive percutaneous plate osteosynthesis method, these plates have given excellent result 4. But again these plates have some disadvantages 5. This study is done to see the outcome of locking plates in distal tibia fracture. METHODS This study is done in the Department of Orthopaedics, Bangalore Medical College, Bangalore. This study is done from 2013 to 2015. 30 patients who came to outpatient department were treated with locking plates. All patients above 16 years having distal third tibia fracture are included. All open fractures except type 1 and elderly above 60 years and pathological fractures are excluded in our study. All patients were followed up for initial 5 months, thereafter, once in 3 months, for clinical and radiological evaluation of union status, knee range of motion, ankle range of motion and other complications. Assessment of the patient with functional recovery was done with American Orthopaedic Foot and Ankle Surgery(AOFAS) 6 minimum 5 months after injury. RESULTS Majority of the patients are from age group 18-29 years (50%). Average age group was 30 years. Majority of the patients were males 80.6% (25). All fractures were closed fractures except 2 cases which are type 1. There were 12 cases of AO type A, 8 patients were AO type B and 10 patients were type C. Majority of the patients had fracture due to road traffic accidents, 74%. All fractures were united by the end of 20 weeks. There was delayed union in (22%) 4 patients for which secondary surgery with bone grafting procedure was done after 4 months. According to AOFAS, 7 we scored the functional outcome of the patients after 5 months of injury. We had 23% of excellent result, 30.4% good and 46% fair with plate. CONCLUSION Locking anatomical plates are a boon and have started a new era in orthopaedic surgery in fixation with articular fractures. But due to lack of locking plate principle it is again cumbersome. Locking plates give relative stability for fracture and need as much as possible anatomical reduction of articular margins unlike in nail where we can do dynamisation if fracture going for delayed union in locking plates is not possible, hence doing as much as possible fracture alignment and then stabilising the fracture with screws is recommended.

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Background: Joint pain or inflammation is a common complaint among the elderly and is conventionally treated with steroidal or non-steroidal anti-inflammatory drugs (NSAIDs). Because of the adverse effects of these drugs, the present herbal formulation is being developed for the long-term control of pain and inflammation. Objective: The objective of this study was to assess the efficacy and safety of Dr. Ortho Oil in patients with knee pain, low back pain, joint stiffness, sports injuries, and joint inflammations. Methods: This was a single-centre, open-label, non-randomised study. 120 participants were selected based on the inclusion and exclusion criteria. All individuals were instructed to use Dr. Ortho Oil for 60 days. The primary outcome was a change in the frequency of subjects with a significant reduction in joint pain, stiffness, and inflammation. Secondary outcomes were improvements in investigator assessment scale (IAS) and subject self-assessment questionnaire (SAQ) scores at successive administrations compared with the baseline. Results: The study indicated that topical use of Dr. Ortho Oil for 30 days reduced all dimensions of pain. SAQ and IAS scores also decreased significantly.