Posterior column fractures of the tibial plateau are relatively rare, as described by Duparc in his revised classification as less as 5% of the tibial plateau fractures although Barie et al has shown upto 30% incidence among tibial plateau fractures [1] . This posteromedial fragment can exist as a solitary fragment or a part of bicondylar tibia plateau fracture is usually not straightforward to diagnose, usually necessitating a CT scan to establish it's presence and morphology. Study was conducted in department of orthopaedics, at Institute of Medical Science & Research Centre, from march 2017 to January 2019.All cases presenting to the outpatient and emergency department fulfilling the below mentioned criteria were taken up for study. Of 15 patients, Functional outcome was assessed using Oxford knee score 12 patients i.e. 85.7% had excellent outcome, 2 patient's i.e. 10.7% had good and 1 patient i.e. 3.6% had fair results. The mean OKS score was 40 (range 36 to 44) at the end of one year ange of motion > 130 degrees was achieve in 12 patients with rest of the three between 110 to 130 degrees. The commonest cause of tibial plateau fracture was Road Traffic Accident, which accounted to 12 patients i.e. 79% and domestic fall accounted for 3 patients i.e. 21%.Amongst the Road Traffic Accident group, 10 had excellent outcome and 2 had good outcome. Amongst the domestic fall group, 2 had excellent outcome and 1 had fair outcome.

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">Recognition of fracture patterns and fixation of fracture to secure and maintain reduction is the key for successful management of more complex intra articular fractures of distal radius. Devices like buttress plates have been shown to provide excellent stability for an unstable fracture with either dorsal or volar metaphyseal comminution. The objective of the study was to evaluate the functional outcome of intra articular fracture of distal end of radius treated by open reduction and internal fixation by buttress plate using Criteria of Gartland and Werley Point System.</span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">Twenty patients with intra articular fracture of distal end radius were treated by open reduction and internal fixation by buttress plate in Al-Ameen medical college, Bijapur. </span><span lang="EN-IN">Statistical analysis: The data obtained was represented as percentage</span>.<strong></strong></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">The study included 20 patients, 11 males and 9 females aged from 21 to 69 years with mean of 40.2 years. The average duration of follow-up was 7 months ranged from 6-10 months. Using the Demerit scoring system of Gartland and Werley, we had 20% excellent results, 45% good results, 20% fair results and 15% poor result whereas, excellent to good results were found in 65% of patients. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">Open reduction and internal fixation by buttress plate provides better functional outcome in treating the intra articualar fracture of distal end radius. Excellent to good results are produced by using buttress plate for fixation of intra articular fractures of distal end radius. So, this procedure can be used as alternative to other procedures in treating intra articular fractures of distal end radius.</span></p>

<p class="abstract"><strong>Background:</strong> Modern hip replacement has resulted in huge benefit for patients with arthritic hip disease, providing them with reduction of pain, return of function and consequently an improved quality of life. Evaluation of long term outcomes of an operative procedure is important to determine the durability of the procedures like uncemented total revision hip arthroplasty. In the present study, clinical and functional outcome and complications of uncemented total hip arthroplasty in failed primary hemiarthroplasty was assessed.</p><p class="abstract"><strong>Methods:</strong> Patients with failed primary hemiarthroplasty with Unipolar or Bipolar prosthesis (cemented and uncemented) due to aseptic loosening, protrusio causing groin pain, dislocation, breakage of implant leading to loss of function, periprosthetic fracture and acetabular osteolysis were included. During each visit, medical history was taken and physical examination was done. Range of movements (ROM) was recorded. The clinical and functional outcomes were evaluated by Harris Hip Score evaluation. Statistical analysis: Student’s paired t-test was used to find out the significance of difference between pre-operative and post-operative Harris Hip scores.<strong></strong></p><p class="abstract"><strong>Results:</strong> In 7 cases modular series was used for uncemented total hip arthroplasty, of which calcar replacement was done in 4 cases, and in one case constrained liner was placed. The maximum stem size used was 15mm and the minimum stem size 11mm. Stem size 11 was most frequently used. About 30% of the cases presented with pain postoperatively till the last follow-up, of which two cases reported mild pain with no effect on average activities and one case reported with moderate pain with some limitation of ordinary activity or work. The difference between the average pre-operative Harris Hip Score post-operative score was found to be highly significant (p=0.0001).</p><p><strong>Conclusions:</strong> This study has shown excellent results following the uncemented modular total hip arthroplasty in failed primary hemiarthroplasty in terms of pain relief, increased walking distance, and functional capabilities of the patients.</p>

Intertrochanteric fractures are one of the most common injuries sustained predominantly in patients over 60 years of age. They are 3 or 4 times more common in elderly women who are osteoporotic, in whom trivial trauma is the most common mode of injury. A total of 98 patients of intertrochanteric fractures of the femur were operated during this period in our institute. Among these patients, 26 patients died after surgery and did not follow up and were not included in this study. The rest of the patients were not traceable via telephone, some even by home visitations by us due to difficulty in tracing certain home addresses. Patients who were followed up for upto 6 months to 1 year were included in this study. All patients were in Sahlstrand's Grade 1 walking ability before trauma. Post-op walking ability in this study shows 60%PFN patients walking without support with 33.3% DHS patients walking without support and 66.7% patients of DHS walking with cane and 13.3% patients of PFN needing 2 canes or walker postoperatively measured at 6 months post-op. It was found that proximal femoral nailing had better functional outcome in patients with especially unstable fractures and DHS had better functional outcome among the stable fractures.

Background: Covering soft tissue defect of the foot is important with respect to function and aesthetic means. It is a challenging task and requires a clear cut planning so as to use the right flap for the right size and site in the foot. Materials & methods: A total of fifty three patients with soft tissue defects in the foot admitted between August 2014 to April 2015 under Hand & Microsurgery, Department of Orthopaedics, were included in this study. Post-operatively they were monitored for any flap related complications. Results: The most common defects were trauma related followed by trophic ulcers and infective causes. Various coverage options which include fasciocutaneous flaps, muscle flaps, free flaps and split thickness skin grafts (STSG) were used. All the flaps were satisfactorily taken up at the end of follow-up period (three months). Conclusion: Planning of the defect based on site and size is very important so as to obtain satisfactory result.