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<p><strong><span lang="EN-IN">Background: </span></strong><span lang="EN-IN">Intra-articular calcaneus fracture is relatively rare and morbidity correlates with displacement and relative alignment of fragments. The treatment should address both components to maintain mechanics of foot. Among the available options open reduction and internal fixation is associated with major soft tissue complications and wound healing problems. As an alternative percutaneous fixation offer fewer complications yet good results for less severe calcaneus fractures. Our study aimed to contribute paucity of data available for these rare fractures and help to propose a preferred method of treatment.</span></p><p class="abstract"><strong>Methods:</strong> A hospital based study carried out on 20 patients over period of 2 year with closed displaced intra-articular tongue type of calcaneal fracture treated with percutaneous fixation and outcome was evaluated using clinical, radiological criteria and American Orthopaedic Foot &amp; Ankle Society (AOFAS) score. All patients were followed up for minimum 9 months with mean follow up of 13.5 month.<strong></strong></p><p class="abstract"><strong>Results:</strong> All patients had evidence of union within 2 month follow up. Mean correction in Bohler angle and Gissane angle was 23.2° and 25.4° respectively at final follow up. Mean change in heel height was 3.15 mm and width change was 2.75 mm compare to opposite side. Mean eversion inversion arch was 28° and near normal ankle range of motion. Functional outcome calculated on bases of AOFAS score revealed 18 patients (90%) had good results and 2 patients (10%) had fair results. Mean AOFAS score was 81.25. Complications were reported in three patients, one had signs of peroneal tendinitis and two had persistent pain and heel widening<span lang="EN-IN">. </span></p><p class="abstract"><strong>Conclusions: </strong>We believe percutaneous fixation should be considered as a preferred method for mild to moderately displaced tongue type of intraarticular calcaneus fractures. It potentially allows anatomical fracture reduction with lesser complications and good functional outcome<span lang="EN-IN">.</span></p>

Introduction: Fractures of phalanges are the most common fractures with Incidence of 2.9% every year. They are more common in the young to middle-aged males. The phalangeal fractures are usually considered as simple injuries. Such kind of injuries may results into deformity, if not addressed properly at beginning. Phalangeal fractures with unacceptable angulation and rotations in any plane require operative fixation. There are numbers of external fixators which are versatile in the designs but needs thorough expertise to use. We describe a simple, low cost, 'easy to construct and easy to use' external fixator which can be used for a variety of hand fractures, particularly in an emergency setting as well as definitive fixation. Method: There were 27 patients with different types of fracture of phalanges of hand in our study. Among them 19 male and 8 female patients [mean age -31.85 yrs]. There were 7 open fractures and 20 closed fractures. Out of 27 patients, 15 had fractures of proximal phalanx & 12 patients had fracture of middle phalanx. Our technique is to treat with k wire and plastic cap of spinal needle cap as a static external fixator device. One patient with tendon injury and one with skin loss which was treated by plastic surgical intervention. Result: At the end of 3 months of follow up, range of movements and TAM score out of 27 patients 19 had an excellent result (range 220-260), 5 patients had a good result (range 180-219)and 3 with fair result (range 130-179). Conclusion:This technique is simple, low cost, reproducible, easy applicabilty in the management of fractures involving the small bones of the fingers where complex fixators are not available or costly or needed expertise. Complex Unstable fractures can be converted into stable fractures by this robust and reproducible method. We recommend this simple, low cost, 'easy to construct and easy to use' fixator in the management of fractures involving the small bones of the fingers.

<p class="abstract"><strong>Background:</strong> Fractures of patella account for 1% of all skeletal injuries. There is no universal accepted treatment for patellar fractures. After a fracture of the patella, the best results are obtained by accurate reduction and stable internal fixation. Partial or total patellectomy is generally indicated when the patella is so severely comminuted that an accurate reduction and reconstruction of the retropatellar joint surface cannot be achieved.</p><p class="abstract"><strong>Methods:</strong> The prospective study of 50 cases of patellar fractures was carried out at the department of orthopaedics for the period from May 2015 to December 2017. The maximum period of follow up was 18 months with a minimum period of follow up of 5 months (average 11.68 months). Operative treatment was done in patella fractures for more than 2 mm of articular displacement or 3 mm of fragment separation. Surgical options includes internal fixation with tension band wiring with k wire and partial patellectomy with extensor mechanism repair.<strong></strong></p><p class="abstract"><strong>Results:</strong> We have studied 50 patients where 7 cases were treated conservatively. In the present series 22 patients were treated with internal fixation out of which 13 patients had excellent results. 6 patients had good results. 21 patients were treated with partial patellectomy where 6 patients had excellent results, 11 patients had good and 4 patients had fair results.</p><p class="abstract"><strong>Conclusions:</strong> Patella should be preserved and Osteosynthesis whenever possible has better chance for excellent results. A good surgical technique, optimal operation room environment and judicious use of antibiotics will reduce the possibility of infection.</p>

Introduction: Distal radius reconstruction every time needs aggressive operative intervention is still a debate among researchers and upper extremity surgeons. There is a role of nonoperative treatment in geriatric population and unfit patients. Novel techniques and revolution of implants advocated the best clinical outcome. Materials and Methods: We conducted a prospective study of 25 patients having AO OTA type A, B & C distal radius fractures treated with volar locking plate at our institute between 2015 to 2017. We include all close injuries in skeletally mature patients between ages 20-60 years. Outcome of the study was evaluated by using the Gartland and Werley score modified by Sarmiento & Patient Rated Wrist Evaluation (PRWE) score. Results: 6 patients had AO OTA type A, 11 patients had type B and 8 patients had type C fractures. Mean palmar flexion was 77 degrees. Dorsi flexion was 82 degrees observed. Average supination and pronation were 85 & 80 degrees respectively. Radial & ulnar deviations average 11 and 25 degrees were observed. 80% of the patients had loss of radial inclination less than 9 degrees. All the patients had less than 6 mm radial shortening. Loss of palmar tilt less than 6 degrees was observed. More than 90% of the patients had excellent to good outcome based on Gartland and Werley score. Conclusions: Volar plating is a proven method of choice in majority of distal end radius fractures regardless of comminution and fragments separation.