Introduction-The present study report results of a series of type 3A and 3B open fractures treated with debridement and fracture fixation and immediate bone grafting. Methods-Twenty one patients were treated from January 2017 to January 2018. All fractures were treated with a modular external fixator. Nine fractures were type 3A and 12 were type 3B. All fractures received debridement, external fixation, bone grafting and flap or skin graft coverage. All fractures were analyzed for time to fracture union, incidence of pin tract infection, incidence of wound infection, flap complications, and delayed or non union. Results-After a mean follow up period of 14 months (range 12 to 16 months), it was concluded that the time to fracture union was 22 weeks, and all fixators were removed only after radiological evidence of fracture union. 1 (5%) patients developed deep wound infection, one experienced delayed union. Conclusion-Along with early wound coverage and external fixation, primary bone grafting can be employed in grade 3 open fractures of tibia with good results and without any increased risk of wound complications

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Introduction-Treatment of extra-articular distal humerus fractures is often difficult using conventional plates. Plates having enough screws (three to four) in the distal fragment either impinge on the olecranon fossa, or gain purchase by placing screws in the lateral or medial column of the distal humerus avoiding the olecranon fossa. Objectives-This study was to ascertain the effectiveness of modified distal tibial locking plate for use in distal third shaft humerus fracture. Methods-By using a modified distal tibial locking plate, a six to eight locking head screws can be easily placed in the in the limited length of distal fragment proximal to the olecranon fossa. Fourteen cases treated in such manner were followed up for a minimum of 24 months. Results-Union was achieved in all cases with no loss of reduction or implant failure. No patient complained of hardware complication, functional limitation or infection. Conclusion-Modified distal locking plate can be safely used in the limited space above olecrenon fossa in distal thirds humerus shaft fractures