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Background: Subtrochanteric fractures account for 10-30% of all hip fractures, affecting persons of all ages. Mostly, these fractures are seen in older osteopenic patients after a low-energy fall and younger patients involved in high-energy trauma. Extramedullary as well as intramedullary fixation techniques have been used to fix such fractures.Objective: To study the clinical outcomes in patients with subtrochanteric femur fractures treated with extramedullary or intramedullary devices for fixation. Materials and Methods:Prospective study of traumatic subtrochanteric fractures of femur was carried out among 36 patients at department of Orthopaedics, New Civil Hospital, Surat during January 2013 to December 2014. During surgery, reduction was aimed by closed techniques but when required direct or indirect methods were applied as deemed necessary. Reduction of medial wall and calcar buttress were given prime importance. Pre designed and pre tested semi structured questionnaire was used and analysed with MS Excel and SPSS.Result: Extramedullary fixation among 17 cases and intramedullary fixation among 19 cases were carried out. Mean follow up was 23.9 months (16.5-27.6 months). Mean age was 42.4 years (19-60 years). A mean incision size was 10.3 cm in intramedullary fixation and 21.8 cm in extramedullary group. Average stay in hospital was 15 days (8-46 days) for intramedullary group and 20.41 (7-55 days) for extramedullary group.Conclusion: Intramedullary method of fixation requires smaller exposure (incision size) hence lesser blood loss, shorter operating time and shorter hospital stay than extramedullary method of fixation.

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<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">Suppurative arthritis of hip is pyogenic inflammation of synovial membrane of the hip, usually due to bacterial infection. The main aim of early diagnosis and treatment of septic arthritis of hip is to prevent damage to articular cartilage and growth plate, give stable and painless hip and to resume normal development and prevent sequelae.</span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">Pro</span><span lang="EN-IN">spective interventional study consisted of 34 patients with 36 Hips septic arthritis of hip less than one year of age carried out at Department of Orthopedics of a tertiary care centre during August 2011 to December 2013. Risk factors and related laboratory investigations were carried out. Data entry and analysis was done by MS Excel 3.0</span>.<strong></strong></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">In our study more than 70% patients presented after one week. Left sided hip involvement (59%) was more common followed by right hip (35%). Sex ratio of the study population was   M: F-4:6.  NICU admission was present in 94% cases.  In many of our patients there were more than one risk factors like septicemia, low birth weight, jaundice and ventilator support. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">All NICU neonates should be handled with strict aseptic precaution.</span></p>

Many surgical approaches to hip have evolved over the period of time surgical approaches differs chiefly in position of patient in supine or lateral and whether the hip is dislocated anteriorly or posteriorly. The choice of surgical approaches is largely depending on personal preference and training. Gibsons posterior and hardinges direct lateral approach are the two most commonly used surgical approaches. Arthroplasty surgeons remained discordant in their choice between two approaches. In this study we try to evaluate the clinical, radiological and functional outcome of hemi-replacement and total hip replacement operated by posterior or lateral approach. No significant difference was found in limb length discrepancy in both approach. Incidence of dislocation was found high in patients operated by posterior approach. Peri prosthetic fractures were seen in 2 cases operated by lateral approach. Dislocation rate was 10 percent with posterior approach. Postoperative lurch was found significantly higher in THR with lateral approach. No significant difference was seen in intra-op blood loss, duration of surgery. Superiority of one approach over another approach could not be established.