<p class="abstract"><strong>Background:</strong> The treatment of proximal humeral fractures is controversial. The advantages of percutaneous Kirschner’s wire (K-wire) fixation include preservation of periosteal blood supply, minimal blood loss, less soft tissue damage and shorter hospital stay. The aim of this study was to evaluate the 2 part and 3 part proximal humeral fractures in terms of functional outcome at final follow up.</p><p class="abstract"><strong>Methods:</strong> This was a prospective study of 21 patients aged 20 to 60 years with mean age of 44.2 years including two part and three part proximal humeral fractures based on Neer’s classification, treated by percutaneous K-wire fixation. Functional outcome was assessed by Constant-Murley score at 1 year follow up.<strong></strong></p><p class="abstract"><strong>Results:</strong> On the basis of Neer’s classification, 13 patients had 2 part fracture, 8 patients had 3 part fracture. Radiological union was achieved within 7 to 15.2 weeks, with an average of 11.6 weeks. The mean constant score at 1 year follow up was 78.2, range (42 to 96). In the present study, complications were seen in 8 (38.1%) patients. The results were in proximity with the existing literature.</p><p class="abstract"><strong>Conclusions:</strong> Percutaneous fixation is minimally invasive technique with preservation of periosteal blood supply, minimal blood loss, less soft tissue damage, surgery can be done under brachial plexus block, less chances of avascular necrosis, shorter hospital stay, no hardware in situ, thus no hardware symptoms, leaves no surgical scar and lowers the rate of complications.</p><p class="abstract"> </p>

<p class="abstract"><strong>Background: </strong>Tension band wiring is the most common operative technique for the internal fixation of olecranon fractures. Stable internal fixation with figure of eight tension band wiring used for simple transverse fractures allows early range of motion, minimize stiffness and gives good results. The aim of this study is to evaluate the functional outcome of simple transverse fractures managed by tension band wiring.</p><p class="abstract"><strong>Methods:</strong> This was an observational prospective study of 24 patients with Mayo type IIA fractures aged between 18 to 65 years, with mean age of 42.5 years treated by tension band wiring. Functional outcome was assessed with Mayo Elbow Performance Score (MEPS) and Visual Analogue Scale (VAS) subjective pain score.</p><p class="abstract"><strong>Results: </strong>Our study was conducted on 24 patients with Mayo type IIA, out of which 16 were males and 8 were females. Most common mode of injury was fall from standing height (75%), followed by road traffic accident (16.7%) and assault (8.3%). The age range was between 18 to 65 years, with mean age of 42.5 years.</p><p class="abstract"><strong>Conclusions:</strong> Tension band wiring is an effective method for the treatment of transverse, non-comminuted and unstable fractures of the olecranon which provides stable fixation, early rehabilitation and gives excellent results when done in expert hands.</p>

Background: Treatment of proximal humeral fractures is challenging. In the past, the fractures were treated conservatively which compromised the functional results. PHILOS plate provides a good functional outcome with context to the early joint mobilization and rigid fixation of the fracture.Methods: This was the prospective study of 30 patients aged 20 to 60 years (mean age 48.4 years) with proximal humeral fractures including two part, three part and four part fractures based on Neer’s classification, treated by open reduction internal fixation with PHILOS plating. Functional outcome was assessed using Constant-Murley Score.Results: The final outcome was observed at 6 months follow up. The results were comparable with the existing literature. The Mean Constant Score at 6 month follow up was 79.4, range (38 to 92). Out of 30, (n = 12, 40%) had excellent outcome, (n = 9, 30%) had good functional outcome, 6 (20%) had moderate outcome, 3 (10 %) had poor outcome. Out of 30 patients, one patient with four part fracture had a lowest CS of 38. Complications were observed in 5, (16.7%) patients. Varus malunion in one patient, avascular necrosis in one patient, stiffness in one patient.Conclusions: PHILOS plate gives stable fixation, enables early range of motion and minimizes complications with good functional outcome if done with expert hands.

Background: Patella is the largest sesamoid bone in the quadriceps tendon in the body. The main function of patella is to improve the efficiency of quadriceps muscle by improving the mechanical leverage of the quadriceps muscle. There are various methods used for fixation of these fractures. Tension band wiring (TBW) works by converting tensile forces into compressive forces when movements occur at the knee joint. The aim of our study was to evaluate the clinico-radiological and functional outcome of surgical management of displaced transverse fracture of patella in adults managed by TBW.Methods: This was the prospective study of 22 patients aged 20 to 60 years (mean age 41.4 years) with displaced transverse fractures of patella managed by TBW.Results: The final outcome was observed at 6 months follow up. The results were comparable with the existing literature. Radiological union was achieved within 10 to 16.2 weeks, with an average of 12.4 weeks. Out of 22, (n=16, 72.7%) had excellent outcome, (n=5, 22.7%) had good functional outcome, (n=1, 4.5%) had fair outcome. Complications were observed in 6 (27.3%) patients.Conclusions: It is concluded that the surgical treatment with TBW is the best treatment in the management of displaced transverse fractures of patella.

<p><strong>Background:</strong> Treatment of proximal humeral fractures is challenging. Despite a rising incidence in proximal humeral fractures, there is still no evidence for the best treatment option, especially for the elderly patients. The aim of this prospective study was to evaluate the radiological in terms of union and functional outcome in terms of pain, range of motion of conservatively managed proximal humeral fractures in elderly patients.</p><p><strong>Methods:</strong> This was an observational prospective study of 35 patients aged above 65 years with proximal humeral fractures including 2 part, 3 part and 4 part based on Neer’s classification, treated by conservative method. Functional outcome was assessed by using Constant score at follow up of 1 year.</p><p><strong>Results: </strong>Out of 35 patients, 21(60%) were female and 14 (40%) were male with mean age of 76.8 (range 65 to 91years). On the basis of Neer’s classification, majority of patients (15, 42.8%) had 3 part fracture. Radiological union was achieved within 13 to 24 weeks, with an average of 18.4 weeks. Out of 35, 5 (14.3%) had<strong> </strong>excellent outcome, 8 (22.8%) had good functional outcome, 16 (45.7%) had moderate outcome, 6 (17.14%) had poor outcome. The results were comparable with the existing literature.</p><p><strong>Conclusion: </strong>In the present study, our data shows that the proximal humeral fractures can be effectively managed conservatively in the elderly patients. Two part fractures have best functional outcome and four part fractures have highest rate of complications.</p>