Background: Hip fractures are more common in elderly among them intertrochanteric fractures are most common, more than 50% fractures are unstable. The proximal femoral nailing (PFN) and dynamic hip screw (DHS) are frequently used modalities from last two decades in both stable and unstable fractures. The DHS has been shown to produce good results but complications are frequent, particularly in unstable inter-trochanteric fracture. The advantage of PFN fixation is that it provides a more biomechanically stable construct with good collapse control. The goal of this study was to compare the clinical and radiographical results of the DHS and PFN for the treatment of inter-trochanteric hip fractures as one is load bearing another is load shearing.Methods: In our study we included 70 inter-trochanteric fractures, out of which 40 were treated with DHS fixation and 30 were treated with PFN, and were followed up at regular intervals of 2 weeks, 8 weeks, 12 weeks, 6 months and annually thereafter.Results: The functional results were assessed with Harris hip score and observed 35% excellent results in DHS group and 63.3% excellent results in PFN group. We observed no statistically significant difference between two groups in view of late and early complications and time to union. We observed significantly better outcomes in PFN group for unstable inter-trochanteric fractures and in unstable fractures reduction loss was significantly lower in PFN group. We observed total duration of surgery was significantly lower in PFN group.Conclusions: We concluded that PFN may be the better fixation device for most unstable inter-trochanteric fractures.

Background: Monteggia fracture dislocations are a rare but a complex injury. The fracture of the ulna associated with proximal radioulnar joint dissociation and radio capitellar dislocation. This injury comprises less than 1% of all pediatric forearm fractures and typically affects patients between 4 and 10 years of age. There are many options for treatment of these fractures. The present study was planned to assess the clinical outcome of patients treated with open reduction and internal fixation of ulna with plating.Methods: The study was conducted in department of orthopedics, government medical college and hospital, Jammu from August 2018 to January 2021. 25 patients of Monteggia fractures were managed with open reduction and internal fixation of ulna with plating. Patients were evaluated at follow-up for pain, stability and disturbance of daily and sports activities. Functional outcome was assessed using elbow performance score.Results: Mean age of study participants was 8.2 years and male children predominated our study constituting 17 patients (68%). 14 patients were Bado type 1, four patients were Bado type 2 whereas seven patients were Bado type 3. The outcome was excellent in 18 patients (72%) and no cases of failure were encountered.Conclusions: Stable anatomical fixation by open reduction and internal fixation of ulna fractures with plating, that in turns leads to the stable reduction of radial head, in the management of acute Monteggia fracture dislocations in children has a very good outcome.