The main aim of this study is to evaluate functional and radiological outcomes after treatment of intra-articular distal radius fractures by close reduction external fixation. Materials and Methods: Twenty five patients of intra-articular fracture distal radius fulfilling the inclusion criteria were treated between Jan. 2016 to Nov. 2017 with close reduction external fixation using principle of ligamentotaxis. The fixator was removed after 6-8 weeks and patients were followed up for 6 months postoperatively. At final follow up functional assessment was done using Gartland and Werley score and radiological assessment done measuring radial inclination, volar tilt and ulnar variance. Results: Seventeen (68%) male and eight (32%) females with mean age 45.4 years with intra-articular distal radius fractures were treated with external fixator. At 6 months follow up functional assessment was done using Gartland and Werley score, reported excellent to good outcome in 88% cases and satisfactory outcome in 12% cases and radiological parameters were within acceptable range. There was no correlation of age, sex or fracture type (as per AO classification) with functional outcome. Conclusions: External fixator is a simple, cost-effective and reliable means of treating intra-articular distal radius fractures with good functional outcomes.

Ganglion cysts around knee joint are uncommon and that from Hoffa's fat pad are even rarer. We present a case of 30 year old male patient with complaint of pain and swelling in left knee joint. Radiograph did not show any bony abnormality. MRI showed large tubulocystic lesion within Hoffa's fat pad which showed low signal intensity on T1-weighted images and high signal intensity on T2-STIR images. Open excision of the lesion was done. Histopathology of the specimen confirmed the diagnosis of the ganglion cyst. In follow-up, patient had asymptomatic left knee with full range of motion and did not show any sign of recurrence. Ganglion cysts from fat pad though very rare but should be considered in differential diagnosis to have an early diagnosis and management. Symptomatic ganglion cyst should be excised by open procedure or arthroscopically depending upon the size and extent of the lesion.

To study the clinical course including radiological union, fracture union time and functional outcome of plate osteosynthesis for proximal one third ulna fracture in skeletally mature individuals. Method: 30 patients of proximal ulna fractures who were treated by plate osteosynthesis were included in this study. Result: 30 patients were followed up for minimum duration of 6 months and the clinical outcomes were assessed according to the Mayo Elbow Performance Score (MEPS). Out of 30, our study included 21 olecranon fractures and 9 monteggia fractures. At final follow up of 6 month, our case series of olecranon fractures resulted mean MEPS of 89.3with 57.1% excellent results and 42.9 % good results, and all patients returning to pre-injury daily activities. For monteggia fractures, resulted mean MEPS score is 93.8 with 88.9% excellent result & 11.1 % good results. All fractures in our study had united by 6 months, both clinically and radiologically. Our study group had reported the complication of delayed union in 6 cases of olecranon fractures. No complications reported in treatment of monteggia fractures. Conclusion:Our study has yielded excellent results in respect of functional outcome, radiological and clinical union without any implant related complications in internal fixation of proximal one third ulna fracture including olecranon fractures and monteggia fractures with plate osteosynthesis. Monteggia fractures treated with plate osteosynthesis yielded slightly better outcome in respect of functional outcome, radiological and clinical union than olecranon fractures. Plate osteosynthesis can be done in comminuted along with non-comminuted proximal one third ulna fractures. We recommend plate osteosynthesis for proximal one third ulna fracture, because of its consistent results with respect to fracture union, stability across the fracture site and early mobilization for better functional results.

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The main aim of this study is to radiologically assess the components alignment in various planes in total knee replacement and to assess its relationship to the functional outcome using the knee society score. Materials and Methods: This hospital based prospective observational study of 30 patients was conducted in the department of Orthopaedics at Maharaja Agrasen Hospital, New Delhi on patients who underwent elective primary Total Knee Arthroplasty and the period of study being 24 months from June 2016 to May 2018. All patients were assessed clinically and functionally using the Knee Society Score pre and post operatively for a follow up period of 6 months. Results: The mean coronal alignment and rotational alignment of femoral component in our study was 5.87 degrees and 2.99 degrees of external rotation respectively. The mean tibial component coronal and rotational alignment in our study was 90 degrees and 17.77 degrees respectively. The mean preoperative flexion of 81.33 degrees increased to 113.5 degrees postoperatively with a significant p value of <0.001. There was significant improvement of Knee Clinical Score and Knee Functional Score following Total Knee Arthroplasty with a p value <0.001. Conclusion:In our study the use of conventional extra medullary guide for tibia and intramedullary guide for femur to align a total knee replacement provided acceptable alignment and gives a good functional outcome as measured by knee society score.