Supracondylar fractures of the humerus in children are common and can be distressing injuries to the child, the parents and to the surgical team. Type 1 fractures are managed nonoperatively, however displaced fractures (Types 2, 3 and 4) are usually managed surgically. Accurate and repetitive neuromuscular assessment is critical not just for medicolegal reasons but also to expedite management with different specialists if needed. The Rock, paper, scissor, OK technique is simple which is easily understood by most children. We discuss the current evidence with regards to pin diameter, number, pin configuration along with a simple algorithm on how to manage a child with a displaced supracondylar fracture with no pulse focussing mainly on the extension-type fracture.

Background:Failed intertrochanteric fractures in elderly patients are surgical challenge with limited options. Hip arthroplasty is a good salvage procedure even though it involves technical issues such as implant removal, bone loss, poor bone quality, trochanteric nonunion and difficulty of surgical exposure.Materials and Methods:30 patients of failed intertrochanteric fractures where hip arthroplasty was done between May 2008 and December 2011 were included in study. 13 were males and 17 were females with average age of 67.3 years. There were 2 cemented bipolar arthroplasties, 19 uncemented bipolar, 4 cemented total hip arthroplasty and 5 uncemented total hip arthroplasties. 16 patients had a trochanteric nonunion, which was treated by tension band principles. Total hip was considered where there was acetabular damage due to the penetration of implant.Results:The average followup was 20 months (range 6-48 months). Patients were followed up from 6 to 48 months with average followup of 20 months. None of the patients were lost to followup. There was no dislocation. All patients were ambulatory at the final followup.Conclusion:A predictable functional outcome can be achieved by hip arthroplasty in elderly patients with failed intertrochanteric fractures. Though technically demanding, properly performed hip arthroplasty can be a good salvage option for this patient group.

Fifty patients (5 men and 45 women) in the age group 0(25 to 65 years with abdominal incisiona) hernia were studied. The most common antecedent cause (in 86 per cent patients) was found to be a gynaecological opera› tive procedure done earlier through a lower midline incision. All patients underwent anatomical repair and were followed-up after repair for an average of 18 months (range 6-32 months). The results were reviewed and it was seen that there was evidence of recurrence in 3 patients only.MJAFII996; 52: 236-238 KEY WORDS: Abdominal incisional hernia; Hernia ventral; Surgical wound dehiscence.