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Background and objectives:The forearm represents a critical anatomic unit of the upper limb, permitting the effector organ of the upper limb, the hand, to perform multi axial daily activities of living. Historically, the closed management of forearm fractures has been met with poor functional outcome in adults, hence perfect fracture reduction and rigid fixation is mandatory and achieved by plating. Conservative treatment has resulted in malunion, nonunion, synostosis and ultimately poor functional outcome [1] . Hence the present study was undertaken to provide satisfactory functional outcome and to know the advantage and complications of the newer plate design, the LC-DCP. Materials and methods:The present study was conducted in Department of Orthopaedics at Sri Siddhartha medical college, hospital and Research Center Tumkur during the period from August 2014 and July 2016. A total of 32 patients attending the hospital during the study period with closed diaphyseal fracture of both bones forearm aged more than 18 years who were medically fit for surgery were included in the study. Results: In this study, Males were predominant with left forearm affection more than right. Most of the fractures were due to road traffic accidents and fall. The average age was 33.5 years with fracture being most common in second and third decade. Most of fractures both bones forearm were located in the middle third and the fracture pattern, transverse/short oblique was commonest. 32(100%) Radius and 32(100%) ulna united within 6 months. The results were based on Anderson et al, scoring system and in our study there were 26 (81%) patients with excellent results, 6 (19%) patients with satisfactory results. Conclusion: Our study shows that LC-DCP plating of both bones forearm produces excellent results when applied properly. To obtain excellent results: proper preoperative planning, minimal soft tissue dissection, adherence to AO principles, strict asepsis, proper postoperative rehabilitation and patient education are mandatory

In the authors' experience, the NPWT system developed from off-the-shelf components reduces the length of hospital stays and therefore cost, without any compromise on quality. It leads to a quicker wound closure and reduces the need for multiple surgeries or flaps. This modification presents a simple, cheap, and effective alternative to commercially available NPWT machines.

Background: Distal femur fractures are tough to handle, and the choice of implant for internal fixation remains controversial. One of the therapeutic principles that can be employed for the treatment of distal femoral fractures is retrograde intramedullary nailing, which follows the principle of biological osteosynthesis. Objective: To investigate in a retrospective manner the results of retrograde nailing in distal femoral fractures and selected cases of femoral shaft fractures. Emphasis was posed on long-term functional outcome, especially in daily activities. Materials and Methods: Retrograde femoral nailing was used from January 2010 to October 2015 in level 1 trauma center for the treatment of various types of femoral fractures (AO/ASIF-type 32/33) in 20 patients with 21 fractures. Patients were followed up till fracture healing and invited to a functional follow-up using Neer's knee scoring system. Result: Osseous healing occurred in shaft fractures in 18.33 weeks on an average when compared with 15.25 weeks in supracondylar fractures. Stiffness was seen as only late postoperative complication in five of 19 (26.31%) patients beyond 1 year of postoperation. Two patients with pathological fracture died on follow-up owing to metastasis. After a mean 20.4 month follow-up, the mean scores were 85 in shaft and 74 in distal femoral fractures (I/A and E/A). Motion was better in shaft fractures (arc of motion-mean: 116.67°) than in distal femoral fractures (arc of motion-mean: 102.18°). Conclusion: Retrograde nailing represents a reliable fixation method for extra-articular (33A) and intra-articular (33C) fractures of the supracondylar area. In femoral shaft fractures, retrograde inserted nails offer a valuable alternative, especially when the proximal femoral approach is obstructed. There is a need of methodologically sound clinical trials to generate high quality evidence for efficacy of retrograde nailing.

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