In systemic inflammatory arthropathies, Ankylosing spondylitis (AS) is a major disease whose pathogenesis is not understood completely, but positive involvement of HLA-B27 markers is observed. It effects, hip in 30-50% patients with systemic inflammatory arthropathies. Primary THA (total hip arthroplasty) has shown long-term betterment of hip function in patients with AS (ankylosing spondylitis).

Fracture management have improve along with the advance of technology. Depending on bone and site of fracture, latest contour plates and nails are available. Even after the advance in implant material. On the other hand, controversy still persist among surgeons on cardinal indication required for implants removal. Implant removal mainly depend on the patient's symptoms. The aim of the study to detect the main causes for implant removal. Objective: To survey the primary cause for implant removal along with detecting which implants requires removal in orthopaedic surgeries. Materials and Methods: All adult patients who were admitted for implant removal in the orthopaedic ward. Results: A study group of 89 patients, 73 males and 16 females. The mean age of the study group was 38 years. The causes for implant removal were sorted into four categories: 1) Pain/discomfort, 2) Infection, 3) implant failure or resorption 4) Elective (patient's choice). Depending on our survey, implants frequently removed are distal Tibial/Ankle plates (14.45%), Femoral Intramedullary (IMIL) nails (13.25%), Olecranon both wires and plates (12.04%), Tibial IMIL nails and Patellar tension band wires (9.53%). Discussion and Conculusion: Clinical indications for implant removal has not been properly specified. According to our study pain / discomfort was the most dominant reason for implant removal (37.1%). The second common indication was infection (26.96%) removing the implant was mandatory. Third indication was Implant failure in symptomatic patients as a result of poor quality implants, inadequate or faulty implant and uncooperative patients. Fourth indication was on patients demand. Implant removal is a laborious surgery as factors like bone ingrowth and wear of the implants which makes it an onerous removal.

Background: Native bone setters are one of the largest group practicing traditional medicine in many developing countries. 1 Even in a country like ours with abundant of medical institutes and with the best advance medical care, about 60% of traumas are still treated by native bone setters. 1 The native bone setters are unqualified and inherited the method from their ancestor through generations. The aim of the study is to evaluate why patients prefers native bone setters treatment. Objective: This is an observational study to evaluate why patients prefers native bone setter's treatment and to identify common complications associated with it. Materials and Methods: Retrospective cohort study of 362 patients conducted on their medical datas who had presented in the orthopaedic department in tertiary medical care hospital. Results: A study group of 362 patients, 221 males and 141 females with a mean age of 38.6 years. 246 patients presented with upper limb fracture/dislocation and 116 patients presented with lower limb fracture/dislocation. Most of the patients were literate, most were guided by relatives and friends for treatment to the native bone setters. easy accessibility, fear of hospital admission and terrified of surgical method were the reasons preferential for native bone setters despite associated with high chances of malunion, nonunion, delayed union, pressure sore, chronic osteomyelitis, neglected dislocation, compartment syndrome, Volkmann's ischemic contracture and gangrene. Conclusion: In an era of advanced orthopaedic care, people prefer native bone setters due to their innocence, influential guidance and mostly reachable. Even educational status doesn't have much prevalence and still most of the population continue to prefer native bone setters despite of high chances of serious complications.