Traditionally the Ilizarov’s ring fixator was used in the management of non-union of long bones, especially in the cases with infection. But limb reconstruction system (LRS) is a viable lightweight, technically easier alternative for the same. The aim of this study was to assess the functional outcome, the radiological outcome and the complications associated with the management of fracture non-union femur treated with LRS. A prospective case series was undertaken comprising of 10 patients. Both infected and non-infected shaft of femur fractures were enrolled. Patients underwent debridement, implant removal and definitive fixation with LRS. Post-operative radiological outcome and functional outcome using the ASAMI (Association for the Study and Application of the Method of Ilizarov group) score. In 70% cases the mechanism of injury was road traffic accident. Mean period of non-union before admission was 11.9 months, mean time for union was 10.10 months, with 90.0% cases successfully uniting. 70% cases underwent lengthening following Ilizarov’s principles. ASAMI radiological outcome was excellent in 70%, good in 10%, fair in 10% and poor in 10% cases. ASAMI functional outcome was excellent in 60%, good in 10%, fair in 10% and poor in 20% cases. Pin tract infection was the most common problem at 70.0% while knee stiffness at 40% was the most common true complication. Thus by this study it can be expressed that LRS is a feasible alternative to ring fixators for the management of fracture non-union shaft of femur.

Introduction: Management of fracture non-unions of the tibia are demanding due to the hampered vascular supply, poor bone quality and the deficient soft tissue cover. Instead of the traditional Ilizarov's ring fixator which is bulky, technically demanding and has a poor patient compliance, the Limb Reconstruction System (LRS) is a viable alternative. The aim of this study is to assess the functional and radiological outcome and the complications associated with the management of fracture non-union tibia treated with LRS. Method: A prospective case series was undertaken comprising of 20 patients. Both infected and noninfected shaft of tibia fractures were enrolled. Patients underwent debridement, implant removal and definitive fixation with LRS. Radiological and functional outcome were assessed using the ASAMI (Association for the Study and Application of the Method of Ilizarov Group) score. Results: In 90% cases the mechanism of injury was road traffic accident. Mean period of non-union before admission was 12.85 months, mean time for union was 9.30 months, with 95.0% cases successfully uniting. 55% cases underwent lengthening following Ilizarov's principles. ASAMI Radiological outcome was Excellent in 80%, Good in 15% and Poor in 5% cases. ASAMI Functional outcome was Excellent in 40%, Good in 50% and Poor in 10% cases. Pin tract infection was the most common problem at 70.0% while ankle stiffness at 35% was the most common true complication. Conclusion:Thus by this study it can be expressed that LRS is a feasible alternative to ring fixators for the management of fracture non-union shaft of tibia.

Background: A number of opinions exist regarding the management of proximal humerus fractures starting from conservative to tension band-wiring to internal fixation with plates. The aim of this study is to assess the functional outcome, the radiological outcome and the complications associated with the management of proximal humerus fractures treated with proximal humerus interlocking osteosynthesis system (PHILOS). Methods: A prospective descriptive study was undertaken comprising of 40 patients. Closed proximal humerus fractures meeting Neer’s criteria for operative displacement were enrolled. Patients underwent open reduction internal fixation with PHILOS plate. Post-operative radiological outcome was estimated with follow-up x-rays, functional outcome using the Constant and Murley score. Results: 60% patients were female, with the most common mode of injury being fall at a ground level. Late complications were noted in 25% of patients, which were malunion 5%, joint stiffness 10%, joint instability 5% and heterotopic ossification 5%. The mean Constant and Murley score was 79.5 and it was found to be statistically significant to the type of fracture according to the Neer’s classification (Kruskal Wallis test, p=0.005). Joint stiffness was also found to be statistically significantly correlated to the type of fracture pattern (Chi square test, p=0.016). The average time to union was 10 weeks. Conclusions: Thus, by this study it can be expressed due to appropriate articular reduction by open reduction and by the use of a fixed angle implant like the PHILOS plate, operative management of proximal humerus fractures by the said implant is a viable option to enable quick and early rehabilitation of patients.