Background: Supracondylar fracture of distal humerus is the most common paediatric fracture. Type III supracondylar fractures should be treated with anatomical reduction and stable Kirschner wire (K- wire, pin) fixation to prevent the cosmetic deformity. The configuration of wires is debatable. Although two crossed K-wires are bio-mechanically stable, there is a risk of iatrogenic ulnar nerve injury. Lateral 3 K-wires is a good alternative. This study was done to compare the outcome of cross K- wire and lateral 3 K-wires in terms of stability. Materials and Methods: This is a prospective study done in Manipal Teaching Hospital. All the Gartland type 3 supracondylar fractures of the distal humerus were treated with closed reduction and stabilized with K wires. In Group I, fractures were stabilized with cross K wire fixation and in group II they were stabilized with 3 lateral K-wires. The patients were followed up at 4-5 weeks for wire removal and at 3 months and 6 months after surgery. Baumann's angle, a functional outcome as per Flynn's criteria, and range of motion were recorded in each visit. Outcomes were compared in term of displacement of fracture. Result: Seventeen children in each group were taken up for the study. There were no significant differences in term of patients and fracture character. No patients had significant loss of reduction at final follow up. There is no statistically significant difference seen in mean changes of Bauman's angle. According to Flynn's criteria good result was seen in more than 95% of cases in both groups. Conclusion: Both cross K-wires and Lateral 3 K-wires provide good stability. Fixation of supracondylar fracture from lateral side had an advantage of no risk of iatrogenic Ulnar nerve injury. Addition of third K-wire from lateral side provides good stability as that of cross K- wire fixation.

Background: Fracture clavicle is a common fracture around the shoulder joint accounting about 2.6% of all fracture and 44% in shoulder region. Mid shaft clavicle fracture accounts about 81% of total clavicle fracture. Open reduction and plate fixation is a good treatment method for displaced mid shaft clavicle fracture with benefit of early pain free movement of shoulder joint and early return to work. The anatomical contoured clavicular plate maintains mechanical strength and has less soft tissue complications. Aims and Objective: The aim of the study was to evaluate the clinical and radiological outcome, time for fracture union and complications in midshaft clavicle fracture managed with anatomical contoured clavicularlocking plate. Material and Methods: This study was done in Manipal Teaching Hospital, Pokhara, Nepal.There were a total of 30 patients (19 male and 11 female) who had displaced mid shaft fracture. All patients underwent plate osteosynthesis with anatomical contoured locking plate. The patients were followed up at 3 weeks, 6 weeks, 3 month and 6 months’ time. Results: There were 30 patients among whom; one patient had bilateral clavicle fracture. The mean age of the patient was 37.19 (11.96) years. The mean time for clinical and radiological union was 8.77 (1.17) weeks and 17.03 (3.06) weeks. All patients in our study had union of fracture with only one patient having superficial surgical site infection. Conclusion: Open reduction and plate fixation is a good option for displaced mid shaft clavicle fracture which help the patient for early pain-free movement of shoulder. Use of anatomical contoured clavicle plate provides fixation of clavicle to its normal contour and provides better fixation and stability.

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Introduction: Distal radius fractures are common fractures which are treated by orthopaedic surgeons. However, they are complex injuries with a variable prognosis and if they are not treated optimally, they can be associated with various complications. Methods and Materials:We studied 80 cases of closed distal radius fractures. These patients were treated and their X-rays were evaluated to determine whether the reduction was radiologically acceptable or not. These patients were then followed up at 1.5 and 3 months to evaluate them both radiologically as well as functionally by using the Modified Mayo Scoring System and the Gartland and Werley's Functional Scoring System.Results: In our study, 68 patients had an acceptable reduction and 12 patients had an unacceptable reduction. All the fractures healed by the end of the study. The radiological parameters improved from the pre-operative to the immediate postoperative X-ray and all the parameters remained the same till 3 months of follow up. The grip strength improved during the 1.5 to the 3 months follow up. We observed that the trend of the final X-ray score correlated with the pre-treatment X-ray score: however, the functional outcome did not correlate with the X-ray scores. Conclusion:We could not find any correlation between an acceptable reduction to a better functional outcome according to the G and W and the MM scores. We believe that a longer follow up will give us the true functional outcome of these patients and thus a true picture of the correlation between them.