<p class="abstract"><strong>Background: </strong>Fracture shaft of femur is a common and major musculoskeletal injury and in most of the cases the patients are immediately brought to hospitals for specialist orthopaedic management. The purpose of this study was to evaluate the effectiveness of early protected weight bearing in fractures of shaft of femur.</p><p class="abstract"><strong>Methods: </strong>This was observational study conducted on 35 patient’s hospital with transverse fracture mid-shaft of femur, between March 2007 and July 2011. Patients with high velocity trauma, with transverse fracture of mid shaft of femur amenable to closed reduction and interlocking intramedullary nailing and otherwise healthy individuals were included in this study. The preoperative parameters were recorded included age, gender, side of the fracture and medical history. All patients were operated on second day of admission.</p><p class="abstract"><strong>Results: </strong>A total of 35 consecutive cases were included, 34 patients were males and 1 was female. In 74% cases closed intramedullary nailing given excellent healing of fracture, in 14% cases healing was good, in 6% cases it was average and 6% cases poor healing was observed.</p><p class="abstract"><strong>Conclusions: </strong>Our study demonstrate that this method provides anatomical reduction and maintenance of femur length and early ambulation which promotes fracture healing by a stable internal fixation allowing micro motion at fracture site enhancing callous formation.</p>

<p class="abstract"><strong>Background:</strong> Ankle injury is the most common weight bearing orthopaedic musculoskeletal trauma encountered in emergency medicine and practice. Ankle joint is highly congruous and any disturbance of normal articular relationship may result in some progressive arthrosis of biomechanical dysfunction. As with all intra-articular fractures it necessitates accurate reduction and stable internal fixation. The objectives were to study the functional outcome of surgical treatment of bimalleolar ankle fractures and to know the complications of open reduction internal fixation of bimalleolar fractures.</p><p class="abstract"><strong>Methods:</strong> 45 patients with malleolar fractures were included in this prospective longitudinal interventional study. Patients who underwent operative treatment were followed up regularly for 6 months with OPD visits and X-ray imaging at each stage. Patient parameters were recorded at immediate post op period, 6 weeks, 12 weeks and 24 weeks. Baird and Jackson scoring system for ankle were used for the functional outcome measurement.<strong></strong></p><p class="abstract"><strong>Results:</strong> Most common type of injury pattern was supination-external rotation with 21 cases (47% of cases). The results are excellent to good in 65% of patients, 27% of patients had fair and 8% had poor result. Syndesmotic screw fixation was done with 4.5 mm cortical screw in 7 cases. Most common complication was surgical site infection in 3 cases (6.67%). 2 patients underwent implant removal due to unresolved infection at 3 months.</p><p class="abstract"><strong>Conclusions:</strong> The results of operative fixation were satisfactory in 90% of patients. Most of the complications were minor and resolved within three weeks.</p><p class="abstract"> </p>

<p><strong>Background: </strong>Compartment syndrome is a potentially devastating situation. Raised intracompartmental pressure has been implicated as the primary pathogenic factor in compartment syndrome. The purpose of the study was early detection of compartment syndrome and corroborating the findings with other physical signs and symptoms, to prevent the onset of ischaemia and subsequent tissue changes that lead to crippling deformities.</p><p><strong>Methods:</strong> The present study was conducted in the Department of Orthopaedics, Pushpagiri medical college hospital, Thiruvalla over a period of 12 months.  Closed fractures of tibia admitted to the casualty unit within 36 hours of injury were selected for the study. A total of 24 patients were included with the majority in the age group of 31– 45 years. Whitesides technique was used to measure the compartment pressure. A differential pressure of less than 30 mm Hg was taken as the criterion for diagnosis of compartment syndrome. </p><p><strong>Results:</strong> The present study included 24 patients with affected 25 limbs.15 out of 25 limbs were with lower third fractures (60%) followed by upper third 6 (24%) and middle third 4 (16%). Out of 25 limbs 20 cases (80%) had associated fracture of fibula and 5 (20%) were not associated. In this study, out of 32% cases with increased compartment pressure, one case with upper third fracture (above 45 mm Hg) and one of the case with middle third fracture (20-30 mm Hg) with associated fibula had underwent immediate fasciotomy.</p><strong>Conclusion:</strong> Compartment pressure measurement is a very good index for predicting and preventing compartment syndrome. Fasciotomy to fully decompress all involved compartments is the definitive treatment for compartment syndrome in the great majority of cases. Delays in performing fasciotomy increase morbidity.

INTRODUCTIONClavicle is the bony link between thorax and shoulder girdle which contributes movement at shoulder girdle. Clavicle fracture is one of the common bony injury around the shoulder joint due to their subcutaneous position. It is more common in young active individual, who participate in activities or sports where high speed fall (e.g. Bicycling, motorcycle) or violent collision (e.g. Football, hockey) are frequent, road traffic accident, fall from height, fall directly over the shoulder or fall on outstretched hand (indirect trauma). Fracture clavicle accounts for approximately 5% to 10% of all fracture and up to 44% of injuries of shoulder girdle. Majority of clavicle fracture occur in mid-shaft of the bone around 80% to 85% where the typical compressive forces applied to the shoulder and the narrow cross section of the bone combine and result in bony failure. Distal third accounts for 20%14-18 and medial third fracture are rarest 5%. 1-3Fracture clavicle have been traditionally treated conservatively with closed manipulation and various method of immobilization; figure of eight splint most commonly used. Older studies suggested that clavicle fracture, even when significantly displaced, was an essentially benign injury with inherently good prognosis when treated non operatively. 4,5 Proponent of early fixation of fresh clavicle fracture is to prevent complication, like non-union, malunion, shoulder ABSTRACT Background: Clavicle fracture is one of common bony injury; which is more common in young active individual. It has been traditionally treated with non-operative method. This present study was undertaken to study the role of the surgical management in the fresh middle third clavicle fracture. Methods: 30 adult patients (21 male and 9 female) of average age of 32 years presented with fresh middle third clavicle fracture and treated surgically with open reduction and internal fixation with plate and screws and followed. Study conducted between November 2011 to November 2012. Results: In 27 patients fracture were united at end of 12 weeks, in 2 patients fracture were united at end of 24 weeks and 1 patient went for non-union. One patient had superficial infection. None had deep infection. One patient had plate loosening at 4week but fracture was united at the end of 24 weeks. 2 patients had persistent pain which is controlled with occasional analgesic but not effecting ordinary work. One patient had gross restriction of shoulder movement. Functional outcome assessed according to near shoulder scoring system. 24 patients had excellent result, 4 patients had satisfactory result, 1 patient had unsatisfactory result and 1patients had failure. Conclusions: The study showed rigid fixation with plate and screw for fresh middle third clavicle fracture especially displaced and comminuted give immediate pain relief and prevent the development of shoulder stiffness &non-union and give good functional outcome.