Background: Lateral condyle fracture of humerus in children is the second most common fracture around elbow occurs less commonly than supracondylar fracture in the range of 15% to 20% that must be treated by operation. To find out the demographic variations, causes, functional movements and complications of late cases of lateral condyle fracture of humerus in children treated by open reduction and internal fixation and also comparison with early cases. Materials and methods: This prospective interventional study was carried out in the Department of Orthopaedic Surgery, Bangabandhu Sheikh Mujib Medical University and Chittagong Medical College Hospital for the duration of 03 years and 06 months. Total 24 patients of fracture lateral condyle of humerus in children age ranges from 02 to 14 years were selected but due to loss of follow up, 20 children were taken in account for the study. Total patients were divided into two groups- group I: early (Up to 4 weeks) and group II: late (5 to 12 weeks) according to time interval from injury to operative treatment. Results: In this study, Out of 20 patients, male (85%) were more than female (15%) left side involvement was 60% and right side was 40%. Among causes of injury, 55% was due to sports injury, 30% was fall from height and 15% from RTA. 35% initially treated by plaster cast, 60% by traditionally bone setter. 55% were misdiagnosed, complications were 10% in group I and 30% in group II. Outcome was satisfactory with 100% in group I and 70% in group II.+ Conclusion: Outcome was better in early cases by operative treatment but late cases up to 12 weeks should be treated by operation. JCMCTA 2019 ; 30 (2) : 10-15

Background: Traditionally Gustilo III B fractures are treated with external fixators initially, which leads to various complications. Purpose of this study was to evaluate the role of definitive management of Gustilo type III B tibia fractures with intramedullary nailing and flap coverage within two weeks on overall outcome. Materials and methods: This was a single group clinical trial and was conducted in the Department of Orthopedic Surgery and of Burn and Plastic Surgery of CMCH for a period of two years. Twenty two patients were enrolled through inclusion and exclusion criteria. Patients were followed up for 15 months and overall outcomes were measured by Tucker criteria. Results: In this study, Out of 22 patients, male (90.9%) were more than female (9.1%). According to post-operative complications, superficial infection was in 09 (40.9%) patients, deep infection was in 05 (22.7%) patients, 07 (35%) patients had delayed-union, 05 (25%) patients had non union and only 01 (05%) patient had knee stiffness. Mean ± SD time for fracture union was 11.27 ± 2.738 months (Range: 8-15 months). Functional outcome at the final follow-up, 10 (50%) had excellent outcome. Good outcome was in 02 (10%), fair outcome was in 03 (15%) and poor outcome was in 05 (25%) patients respectively according to Tucker et al. criteria, Post-operative infection and non union showed statistical significance according to p value. Conclusion: After 15 months of surgery, intramedullary nailing and flap coverage within two weeks is a feasible treatment option for Gustilo type III B tibia fractures providing excellent to good outcome, minimum fracture union time and low rate of complications. IAHS Medical Journal Vol 4(2), December 2021; 24-27

Background: Extra-articular proximal and distal metaphyseal fractures of tibia pose a significant challenge to the surgeons. Debate continues regarding choice of fixation devices. Evaluate these fractures fixation with intramedullary expert tibial nail and extramedullary locking plate and screws. Materials and methods: This is a prospective interventional study which had been conducted in the Department of Orthopaedics & Traumatology, Chittagong Medical College Hospital, Chattogram from July, 2018 to June, 2019. Total 60 cases (30 cases in each group) with proximal and distal metaphyseal tibial fractures (AO/OTA 41A2 to A3 and 43A1 to A3) were taken. Functional assessment was done atleast 6th month of surgery using Tegner Lysholm knee scoring scale and Kaikkonen ankle scale. Results: According to assessment scale, excellent outcome was observed in 20 (66.7%) patients, good in 05 (16.7%), fair in 03 (9.9%) and poor in 2 (6.7%) patients in ETN group while in LPS group, 18 (60%) patients were excellent, 05 (16.7%) good, 04 (14.3%) fair and 03 (9.9%) patients were poor. Difference in functional outcome in both the groups was statistically non-significant. Conclusions: There was no significant difference statistically in functional outcome of patients treated with intramedullary and extramedullary fixation method. JCMCTA 2021 ; 32 (1) : 59-64

Background: The aim of this study is to evaluate the management of intertrochanteric fracture of the femur using Proximal Femoral Nail Antirotation (PFNA). Materials and methods: Sixty patients of unstable pertrochanteric fractures were treated by closed reduction and internal fixation by proximal femoral nail antirotation from July 2015 to June 2017. Four patients were lost to follow-ups. The remaining 56 patients were followed for a mean period of 2 years. The results were evaluated by assessing the patients regarding their clinical and functional outcome at follow up as per kyle’s criteria Results: Peroperative failure to proximal head neck blade fixation (n-1) jamming of nail (n=2) and post operative lateral migration of head neck blade (n=1) and fracture related infection (n=1) were complications observed. End results were excellent in 46.34%, good in 36.58%, fair is 14.64% and poor in 2.43%. Conclusion: Proximal Femoral Nail Antirotation (PFNA) is the biomechanically and biologically suitable implant for the management of intertrochanteric fracture of the femur. JCMCTA 2020 ; 31 (1) : 64-70