There is little internationally comparable statistical data on incidence, trends and distribution of disability. Musculoskeletal diseases are one of major causes of disability. Aim of this study is to retrospectively analyze data of physically disabled population of musculoskeletal affection. Materials and Methods: Permanent disability of more than 40% of musculoskeletal affection in all ages and both sexes of single district of our state who voluntarily attended Disability Assessment and Certification Camp at Department of Orthopaedics at our teaching institute on first and third Friday of every month from 2012 to 2017 were included. Temporary disability, disability of hearing, visual, mental retardation etc., disability of less than 40% and disabled evaluated and certified at camps outside our Institution were excluded. Disability percentage was calculated as per standard method prescribed by Guidelines and Gazette by Government of India. Diagnosis was clinical in majority but whenever needed, appropriate investigations were done. Educational and occupational status was evaluated on using Kuppuswamy's method. Authors realized that monthly income in each category of Kuppuswamy's method was quite low considering today's context and therefore was modified and used to evaluate income status. Results: 367 persons fulfilled our criteria and included. Mean age was 29.67 years (1-69 years). Majority (20.99%) in 30-40 years age and least (6.82%) in 60-70 age. Males (73.30%) and rural population (75.75%) were thrice more common than their counterparts. Highest percentage of disability was 95%, average being 60.85% and majority (42.78%) had 40-50% disability. Acquired conditions (63.76%) were almost double to congenital condition (36.24%). Cerebral palsy (45.12%) was most common congenital cause and amputation (17.95%) was most common acquired cause. Illiterate, primary school certificate and middle school certificate constituted majority (71.38%). Clerical job, Shop owner and Farm owner was most common (39.84%) followed by un-skilled worker (20.71%) and unemployed (13.90%). 23.83 % had monthly income of Rs 1000 or less and 22.26 % had between Rs 1001 to Rs 2999. Conclusion:This study provides an epidemiological data of musculoskeletal disabled population which can be utilized for policy making and implementation for prevention, treatment and rehabilitation programs.

BACKGROUNDDistal tibia fractures are a common consequence of road traffic accidents or sport injuries and are considered to be difficult to treat surgically as tibia lies subcutaneously, has precarious blood supply, has high risk of infection, risk of skin necrosis after internal fixation and may also go for malunion and non-union. The prime advantage with Ilizarov technique is that with this technique one can treat the patients with an immediate single stage procedure irrespective of soft tissue status. METHODS19 patients (M=15, F=4) in 18-65 years age group with isolated distal tibia extraarticular fractures open type I & II who were undergoing treatment with circular external fixator (Ilizarov technique) were included in the study conducted from 1 st July 2017 to 31 st May 2018. Depending on the type of fractures, 3 or 4 rings with or without foot frame were used. Full weight bearing was allowed in all cases. Operative time (In minutes), intraoperative blood loss by mopping method, clinico-radiological union, intra-operative complications, post-operative complications, and ankle range of motion were assessed. American Orthopaedic Foot and Ankle Society (AOFAS) score was taken to assess functional outcome. Average follow up period was 11 months (Range 6-16 months). RESULTSAccording to AO classification, A1 fractures were five, A2 fractures were ten and four had A3 fractures. 11 had Gustilo type I and 8 had type II injuries. Mean hospital stay was 9 days (range 5-14 days). Mean ankle dorsiflexion was 18 0 and plantarflexion was 30 o . Pin tract infection was seen in 5 (26.31%) of our cases which were not deep, and they were treated successfully after giving oral antibiotics and local pin tract care. All patients had satisfactory AOFAS score. Only one patient had non-union which was treated with corticotomy and distraction osteogenesis. CONCLUSIONSWe recommend using Ilizarov circular ring fixator application in such type of fractures as it has got minimum complication rate and most importantly it can be done as single stage procedure irrespective of soft tissue status. Immediate postoperative ambulation and weight bearing can be given via this device.