<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">Treatment of low back ache due to prolapsed intervertebral disc is still controversial. Several conservative modalities are available with varied results. Surgical discectomy may lead to failed back syndrome due to change in vertebral column anatomy and its mechanics. To prevent it, conservative means are better and Ozone discolysis is one of the nonsurgical methods. The indications and effectiveness of this condition is not well defined. The present study was done to correlate the clinical outcome of this technique.</span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">This was a prospective study conducted on 67 patients presenting with symptoms of back pain with arid without radicular symptoms. X ray and MRI were done in all cases. Then intradiscal ozone gas was given at one level from a specialized machine under C arm guidance. For evaluation Oswestry disability index and Macnab scoring system was used. Post injection patients were evaluated at 2, 6 weeks and 6 months</span>.<strong></strong></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">Sixty seven patients with mean age of 47.7 years were followed up for 7.8 months. Low back pain was the commonest symptom and SLR was positive in 5.36%. The modified Macnab scoring with good and fair score improved from 16% to 89% and Oswestry disability index with minimal and moderate disability improved from 41% to 91% at end of 6 months. Seven patients had relapse of pain due to repeat disc prolapse. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">Ozone discloses is better modality of treatment for low back pain with disc bulge and early disc prolapsed.</span></p><p class="abstract"> </p>

BACKGROUND Facet joint injuries are increasing day by day due to increase in road traffic accidents produced by rotation of head in flexion or extension. It commonly affects lower cervical spine due to anatomical considerations being a very mobile part between head and a fixed torso. The architecture of vertebra in lower cervical spine also predisposes to injury are combination of lower height, smaller anteroposterior diameter of the superior facet and a more horizontally oriented superior facet at C6 and C7 levels. 1 MATERIALS AND METHODS In our series of 19 cases, both unilateral and bilateral facet dislocation were taken into consideration either with or without fracture. Unilateral fracture dislocations were associated with less neurological deficit, but were difficult to reduce while bilateral fracture dislocations had more and many times permanent neurological deficit. Majority of our patients were treated by open reduction and internal fixation with Bohler's triple wiring and bone grafting to achieve fusion. RESULTS The goal of treatment is to preserve functional and anatomical continuity of spinal cord and nerve roots, restore spinal alignment, establish spinal stability and provide freedom from post injury pain or delayed neurological problem. In our series of 19 cases, 16 were treated operatively and they experienced better stability and pain relief. None of our cases showed post-treatment deterioration in neurological status. Improvement in neurological status was seen more in partial or incomplete loss cases, i.e. Franklin B or C. CONCLUSION Cervical facet fracture dislocations should be reduced, stabilised and fused as early as possible for better rehabilitation and chances of neurological recovery. Bohler's triple wiring seems to be cheap and reasonably good method of fixation.

<p class="abstract"><strong>Background:</strong> This study compared functional outcome and results between cemented and uncemented bipolar hemiarthroplasty in patients older than 60 years with displaced femoral neck fracture.</p><p class="abstract"><strong>Methods:</strong> Total fifty four patients with displaced femoral neck fracture were enrolled in this study. Out of total twenty eight patients underwent uncemented bipolar hemiarthroplasty and remaining twenty six patients underwent cemented bipolar hemiarthroplasty. Physical examination and radiographs were performed at the first and sixth months after operation and results were recorded. The patient’s pain and functions were evaluated with visual analogue scale and Harris Hip Score<strong> </strong>and then compared to each other.<strong></strong></p><p class="abstract"><strong>Results:</strong> All patients were followed up for at least 6 months. Mean operation and bleeding times were longer in cemented group compared to the uncemented group (p&gt;0.05). The mean pain score was significantly less in the cemented group compared to the uncemented group (p=0.001). Hip functional outcome based on HHS was more in the cemented (p=0.001). The intraoperative and postoperative complication rate was higher in the uncemented group (p&lt;0.05).</p><p><strong>Conclusions:</strong> Although higher rates of intraoperative bleeding and surgery time were seen with cemented bipolar hemiarthroplasty in older patients with femoral neck fracture compared to uncemented bipolar hemiarthroplasty, cemented bipolar hemiarthroplasty can cause less complication and improve patient’s function in less time. </p>

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">Lower cervical spinal injuries are potentially devastating injuries of the axial skeleton. Many effective procedures are available for degenerative cervical spinal injuries that are unresponsive to conservative management. Our present aimed to observe the outcome for the treatment of different types of spinal injuries based onASIA impairment scale (modified Frankels scoring system) by using different treatment concepts.</span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">This study was conducted at Indira Gandhi institute of medical sciences and Nalanda medical college during the period 2012 – 2015. 14 patients with lower cervical spine injury attended to emergency department were included in the study. All the 14 cases were operated by different surgical procedures based on type of injury. The outcome was measured by using ASIA impairment scale (modified Frankels scoring system)</span>.<strong></strong></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">Out of 14 cases, 3 were burst fractures, 4 were unilateral facet dislocations, 5 were bilateral facet dislocations and 2 with distractive extension injury. Cases with burst fractures operated with corpectomy with cage and plate, for unilateral and bilateral dislocations open reduction and Bohlmantriple-wiring and posterior fusion was done and for distraction injury, open reduction and anterior plating was done. Improvement in Frankel scoring system was good in about 3 cases with unilateral dislocations. Overall, neurological recovery was observed in 35% cases. Recovery was much better in Quadriparesis patients. None of the patients had iatrogenic paresis. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">Satisfactory results and outcome was observed in unilateral facet dislocations after treatment by open reduction and Bohlman triple-wiring and posterior fusion. The outcome in bilateral facet dislocations was poor as they are easily reduced with closed traction methods.</span></p>

BACKGROUND Fractures and dislocations of the talus are a challenging injury. Fractures of the talus are generally thought to be relatively uncommon. However, the talus is the second most commonly fractured tarsal bone. The purpose of this study is to evaluate clinical and radiological outcomes of operatively treated displaced talus fracture. MATERIALS AND METHODS The study is a prospective study of twelve cases of displaced fracture neck of talus evaluated and treated at the department of orthopaedics, Nalanda Medical College and Hospital, Patna from 20 August 2015 to 18 August 2017. RESULTS Reduction was anatomical in six cases (50%), nearly anatomical in 3 cases (25%) and poor in 3 cases (25%). Two patients (16.66%) developed an early superficial infection and required surgical irrigation and debridement and appropriate antibiotic treatment. Using the AOFAS ankle-hindfoot scale, the average functional score was 75.17 points. There was excellent result in four patients, good result in three cases, fair in three and poor result was found in two cases. CONCLUSION Fracture neck of talus (Hawkins type 2 and 3) treated with anatomical reduction and near anatomical reduction had a satisfactory clinical and functional outcome, whereas (Hawkins type 4) had fair to poor outcome with complications like AVN, arthritis and malunion due to poor initial reduction. KEYWORDS Talar neck fractures, Avascular necrosis, AOFAS ankle-hindfoot scale, Hawkins type of fracture.