Background: Tibial plateau fractures are one of the commonest intra-articular fractures. They result from indirect coronal or direct axial compressive forces. This makes about 1% of all fractures and 8% of the fractures in elderly. Nevertheless, tibial plateau fractures challenging remain because of their number, variety and complexity. With advancements the treatment of each fracture type is still not defined hence we have taken up this study to analyze various fracture patterns and its outcome. : The study includes 40 patients having the fractures of the proximal tibialMethods metaphyseal; metaphyseodiaphyseal with or without intra-articular extension (including upper third fractures of tibia), closed fractures, fractures with Open grade-I wounds (Gustillo Anderson Classification).The study excludes compound fractures having grade II and III (Gustillo Anderson) and Paediatric patients. The treatment method was based on the type of fracture, the amount of displacement , the amount of depression and surrounding skin condition of the tibial plateau.We used the Schatzker classification because it is closest to describing the specific fracture type and it is easy to apply. In this study there were 40 patients with mean age of 39.18 (median 38.5 and min – max 25 to 55) with 25Results: male (62.5%) and 15 (37.5%) female with significant male preponderance. In this study road traffic accident was the commonest mode of injury (65%) and produced different types of fractures, followed by fall from height (22.5%), injury while playing sports (12.5%). The correct method of management of tibial condylar fractures depends onConclusions: good clinical judgment. If rational treatment is to be instituted the surgeon must have sound knowledge of the personality of the injury and a clear understanding of the knee examination, imaging studies and must be familiar with variety of techniques available at present for treating tibial condyle fractures.

BACKGROUND A Tip-Apex Distance (TAD) of greater than 25 mm has been shown to be an accurate predictor of lag screw cutout when Sliding Hip Screws (SHS) are used to treat Peritrochanteric (PT) fractures. The purpose of this study was to determine, which factors, including TAD correlated with successful clinical outcomes of PT hip fractures surgically treated with intramedullary devices. MATERIALS AND METHODS A total of 72 patients were included in this retrospective study. TAD values were radiographically analysed at a mean follow up of 13 months. This was correlated with limited functional status and rate of revision for implant failure or inability to achieve fracture union. Only 62 patients had adequate follow up to fracture union or definitive failure. RESULTS There were 36 intertrochanteric fractures and 26 subtrochanteric fractures. Overall, 5 patients (9.8%) went on to experience lag screw cut out. The average TAD of patients who did not cutout was 18 mm compared to 38 mm for those who did (p=0.012). All patients who cutout had IT fractures. CONCLUSION The percentage of cutouts correlated clinically to both the severity of IT fractures and the TAD. Using a cutoff of 25 mm, there was a statistically significant difference in the incidence of lag screw cutout (p<0.001). As in sliding hip screw, surgeons should strive for a TAD less than 25 mm when using IM devices in the treatment of PT hip fractures to help avoid lag screw cutout .

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Background : Recent clinical studies have identified a significant increase in the incidence and severity of ankle fractures in the elderly population. Kannus et al reported that between 1970 and 2000 there was a three-fold increase in the number of ankle fractures among Finnish patients over 70 years old [1]. In addition, the authors demonstrated an increase in the more severe Lauge-Hansen supination-eversion stage four fracture, compared to more stable ankle fracture patterns in this elderly patient population. In the data available from the United States, ankle fractures have been reported to occur in as many as 8.3 per 1000 Medicare recipients, a figure that appears to be rising steadily [2] . There continues to be controversy within the orthopaedic community regarding the optimal management of geriatric ankle fractures. Operative fixation has been proven to be a safe and effective method of managing unstable ankle fractures in younger patients [3 ] . However, certain authors have recommended conservative treatment in older patients, based on poor surgical outcomes secondary to osteoporosis, diabetes, peripheral vascular disease and skin issues commonly seen with advanced age [4, 5, 6, 7] . Recommendations on appropriate management also appear to differ based on geographical location, evidenced by a recent study by Koval et al [2] . The authors demonstrated that the percentage of ankle fractures in patients older than 65 treated with surgical stabilization varied considerably in various parts of our country. The current paper reviews the complex issues associated with ankle fractures affecting the geriatric patient population, focusing on risk factors for fracture and surgical versus nonsurgical management. 30 patientsMethods: with closed displaced bimalleolar ankle fractures presenting to Dr B R Ambedkar medical college casualty from September 2020 to February 2022 who underwent surgery were taken into the study . The maximum studyResults: population belonged to the geriatric age group .At the end of follow-up (64.8%) had excellent clinical result, (35.2%) had good clinical result, and no patient had a poor functional outcome. For the radiological assessment, there were 20 patients (66.6%) with excellent, 7 (23.3%) with good, 3(10.%) with fair, while none with poor resu :Conclusion Treatment bimalleolar ankle is challenging because of limited soft tissue cover, poor bone quality with osteoporosis and less vascularity. There are various treatment options for these fractures starting from closed reduction with casting to open reduction and internal fixation with a plate. The excellent functional results and lack of soft tissue complications suggest that a surgical management with CC screw and plating should be considered as an option in bimalleolar ankle fractures. A balance between anatomical reduction and soft tissue stripping is required to avoid any complications.

<p class="abstract"><strong>Background:</strong> Controversy still exists regarding using cemented or uncemented hemiarthroplasty for femoral neck fractures in elderly patients. The aim of this study is to compare the effectiveness and safety of the two surgical techniques in femoral neck fracture patients over 60 years old.</p><p class="abstract"><strong>Methods:</strong> We searched PUBMED from inception to December 2012 for relevant randomized controlled trials (RCTs). Outcomes of interest include postoperative hip function, residue pain, complication rates, mortality, reoperation rate, operation time and intraoperative blood loss. Odds ratios (OR) and weighted mean differences (WMD) from each trial were pooled using random-effects model or fixed-effects model given on the heterogeneity of the included studies.<strong></strong></p><p class="abstract"><strong>Results:</strong> Our control trial involved 132 patients (132 hips) who were eligible for the study. Our results demonstrate that cemented hemiarthroplasty is associated with better postoperative hip function (OR = 0.48, 95% CI, 0.31–0.76; p = 0.002), lower residual pain (OR = 0.43, 95%CI, 0.29–0.64; p&lt;0.0001), less implant-related complications (OR = 0.15, 95%CI, 0.09–0.26; p&lt;0.00001) and longer operation time (WMD = 7.43 min, 95% CI, 5.37–9.49 min; p&lt;0.00001). No significant difference was observed between the two groups in mortality, cardiovascular and cerebrovascular complications, local complications, general complications, reoperation rate and intraoperative blood loss.</p><p class="abstract"><strong>Conclusions:</strong> Compared with uncemented hemiarthroplasty, the existing evidence indicates that cemented hemiarthroplasty can achieve better hip function, lower residual pain and less implant-related complications with no increased risk of mortality, cardiovascular and cerebrovascular complications, general complications, local complications and reoperation rate in treating elderly patients with femoral neck fractures.</p>