MATERIALS AND METHODSThe common age group affected was 21-30 years with mean age being 35.5 years (13-60 years). Most of the injuries were caused by industrial accidents (57.6%). In 34.6% of cases, the dominant hand was involved. All patients were treated with wound debridement, external fixation and early mobilisation of the fingers. The follow-up period ranged between 2.3 -8.2 years (mean 4.4 years). Complications occurred in ten fractures. Loosening of the pin (6) was the most common complication. Except two, all the fractures healed. RESULTSThe functional recovery was analysed using the American Society for Surgery of the Hand (ASSH) criteria of TAM. Results were good or excellent in 86.7% of metacarpal fractures and in 85.7% of Phalangeal fractures with overall result of about 85.9%. Poor results occurred in about 14.1% fractures. Majority of these cases had multiple fractures or accompanied with severe soft tissue injuries. CONCLUSIONTo conclude external fixation is an adequate alternative treatment for unstable open Phalangeal and metacarpal fractures, which are accompanied by severe soft tissue injuries.

BACKGROUND AND OBJECTIVEManagement of femoral and Tibial diaphyseal fractures in the age group of 5-15 years is still controversial between conservative and surgical methods. Compared with young children, this group of children have high risk of malunion and shortening when managed conservatively. Surgical methods are widely used in this age group of children with intramedullary fixation being increasingly preferred. Aim of this prospective study was designed to examine the outcome and complications of Elastic Stable Intramedullary Nailing (ESIN) in the treatment of paediatric fractures of shaft of femur and tibia between 5 to 15 years of age group.

BACKGROUNDFemoral neck fractures are usually observed in the elderly population after a simple fall or minor trauma. In contrast, in young adults, femoral neck fractures are uncommon and are often due to high energy trauma caused by road traffic injuries, work injuries, or fall from a height. The surgical management of femoral neck fractures comprises various options: a) Closed or open reduction with internal fixation of the fracture with screw fixation, b) hemiarthroplasty and c) total hip arthroplasty. Selection of the mode of treatment depends on the patient's age, level of activity, medical comorbidities, degree of bone density, and degree of displacement of the femoral head. We hereby present results of a modified screw fixation technique (Four Quadrant Parallel Peripheral Screw Fixation) in femoral neck fractures of both young and old patients.

BACKGROUNDInfection in Orthopaedic surgery is a disaster for both patient and the surgeon with an infected implant in a fracture surgery resulting in bad outcomes ranging from Osteomyelitis to non-union and septicaemia. In a majority of such cases, the infection settles only after removal of the implant. In our study, we tried to retain the implant by using antibiotic coated bone cement to get rid of the infection.The aim was successful eradication of infection, with the patient remaining infection-free for 1 year.

AIM Now a day it becomes a challenge in treating proximal humerus fractures and as we know the commonest problem is shoulder stiffness. The aim was to analyse the rational and results of proximal humerus fracture fixation by various methods. MATERIAL AND METHODSWe operated on 36 patients from 2010-2016. The common age group affected was 51-60 years. Most of the injuries were caused by domestic accidents. Neer system was used for classification. Majority of the fractures were treated with closed reduction and percutaneous fixation. Failure to reduce the fracture by closed manipulation meant we ended up with open reduction and fixation with K-wire /screw/osseous sutures. RESULTSThe mean follow-up was 3.8 years. All fractures healed. Malunion occurred in six patients. Superficial pin tract infection, pin migration, pins loosening and avascular necrosis found only in few and that did not affect the final outcome. The functional results were analysed using Constant-Murley score. Four patients had moderate pain. Two patients had shoulder stiffness. The mean final constant score was 83 points or 89.65% of opposite normal shoulder. There is no statistically significant difference in Constant score found between different types of fractures. DISCUSSION AND CONCLUSIONSurgical fixation of the proximal humerus fractures gives good results with least stiffness and pain free joint. This was possible because of achieving anatomical realignment and early mobilisation after stable fixation by various methods depending on the type and personality of the fracture. KEYWORDSProximal Humerus, Neer, Minimal Fixation HOW TO CITE THIS ARTICLE: Kannan K, Palaniappan M, Anbu S, et al. Rationale and results of proximal humerus fracture fixation.