Background: The aim of the study was to evaluate results of hybrid fixation technique (radius nailing and ulna plating) in closed proximal radius and ulna fractures in adults. The hypothesis behind hybrid fixation is to provide rigid fixation and restoration of forearm length, by ulna plating and large diameter square nail in radius gives rotational stability without any posterior interosseous nerve palsy in proximal radius and ulna fractures. Closed nailing of proximal radius avoid posterior interosseous nerve palsy which has high probability in open surgical approach. Materials and method:We prospectively evaluated 25 patients with closed proximal radius and ulna fractures. 20 males and 5 females with mean age of 30.7 years underwent closed reduction and intramedullary nail fixation in radius and open reduction internal fixation in ulna with plating. The fractures were classified according to the AO/OTA system. The average follow up was 1 year (range 6 months -18 months). Results:The average time to union was 12.77 weeks (10-14 weeks). Union was achieved in all 25 patients in both radius and ulna. Using the Grace and Eversmann rating system7 patients were excellent, 16 good, 1 acceptable and 1 unacceptable results. Using Andersons scale 23 patients had an excellent, 2 unsatisfactory, 0 failure. None of the patients had intraoperative as well as postoperative complications and no posterior interosseous nerve palsy occurred in any of case. Conclusion: Closed reduction internal fixation with use of Hybrid fixation modality in closed proximal radius and ulna fractures has good results. Rigid fixation by ulna plating and rotational stability in radius by large diameter square nail provides almost the same construct as with dual plating with minimal invasive approach. Complication rates are lower as compared to plate osteosynthesis especially with similar union rates in terms of posterior interosseous nerve palsy.

<p class="abstract"><strong>Background:</strong> Shoulder pathologies can cause significant pain, discomfort, and affect the activity of daily living. The aim of this study was to compare the efficacy of clinical examination, ultrasound, magnetic resonance imaging (MRI) with shoulder arthroscopy in diagnosing various shoulder pathologies, considering shoulder arthroscopy as the gold standard tool.</p><p class="abstract"><strong>Methods:</strong> This was a prospective, comparative study conducted over 35 patients, between 18-75 years of age presenting with chronic shoulder pain or instability of more than 2 months duration. All patients were examined clinically, followed by high resolution ultrasound, MRI, arthroscopy of the affected shoulder.<strong></strong></p><p class="abstract"><strong>Results:</strong> The sensitivity and specificity of ultrasonography (USG) for diagnosing full thickness tear was 100% each and for MRI was 88% and 100% respectively. For subacromial impingement USG had sensitivity of 66.67%, specificity of 94.12%, positive predictive value of 50% and negative predictive value of 88.89%. For rotator cuff tear USG had sensitivity of 92.86%, specificity of 50%, positive predictive value of 81.25% and negative predictive value of 75% considering shoulder arthroscopy as gold standard.</p><p class="abstract"><strong>Conclusions:</strong> USG and MRI both are sensitive techniques for diagnosing of rotator cuff pathologies. USG has high accuracy in diagnosing partial thickness tears as compare to MRI. MRI proved to be superior in estimation of site and extent of tear. Considering shoulder arthroscopy as gold standard, it can be reserved for patients with suspicious of USG/MRI findings or those who may need surgical intervention simultaneously.</p>

The aim of the study was to evaluate results of benign cystic lesions of proximal femur treated by non vascularized autologous fibular strut graft and supplementary fixation using cannulated cancellous screw. Non vascularized autologous fibular strut graft which act as mechanical as well as biological graft. The hypothesis behind this study to add fixation to fibular strut graft which helps in immediate structural support, early consolidation of defect and remodeling. Methods and Materials: We prospectively and retrospectively evaluated clinical outcomes of surgically treated 8 patients with benign lytic lesions of proximal femur. Out of these 6 were males and 2 females with mean age of presentation was 17 years. Average follow up time was 36 months. Histological diagnosis included simple bone cyst, aneurysmal bone cyst, fibrous dysplasia. Results: 8 patients with benign cystic lesions of proximal femur were treated with curettage and autologous fibular strut grafting. The average operation time was 148 minutes. All patients were allowed unprotected full weight bearing by a mean of 13.2 weeks after surgery. All patients had regained normal unrestricted activity without pain by 12 months of follow up. None of the patients sustained pathological fracture of femur following the surgery. All patients achieved partial or complete consolidation of the lesion within 8 months. None of the patients had local recurrence of tumor in their long follow up. None of the patients were suffered from postoperative wound infection, deep vein thrombosis, chronic hip pain. Conclusion: We conclude that non vascularized autologous fibular strut graft with internal fixation using cannulated cancellous screws is a safe and effective method of treatment for benign cystic lesions of proximal femur.