Background: Fracture-dislocation of the humerus refers to the fracture of the proximal part of humerus associated with dislocation of the head from the humero-glenoid joint. It is occurs most commonly in elderly due direct low velocity trauma, while in younger age group, high-velocity trauma is needed. 1 Management of fracture dislocation of proximal humerus needs early reduction and fixation. In or prospective study we have observed the functional outcome and complications of management of displaced proximal humerus fragments with various methods.; Methods: A two-year prospective study was conducted after getting ethical approval at tertiary care centre on cases admitted with proximal humerus fracture dislocation as per the inclusion criteria based on Neer's classification evaluation was done after investigations like xray CT scan and surgery was performed. Postoperative follow-up was done at 1st, 6 th month and 1 year and outcome were evaluated for each case based on Neer's shoulder score of constant score. Results: 30 cases were studied which were operated according to neers classification by various methods. Mean age was 42.6 years. Constant Shoulder score was good in maximum patients (46.67%) followed by excellent in 33.67%, three patients (10%) had fair score while it was poor in 2 patients (6.66%). Conclusions: Proximal humerus fracture dislocation can be managed with various methods of treatment. Each method has its own advantage and disadvantages.

: Back pain being the most common complaint faced by medical practitioner poses a great burden over health system. Clinical examination, MRI helps in making diagnosis in this spectrum of diseases. Of many modalities available selective nerve root block offer a micro invasive alternative for treatment and even evaluation of patients. Peri-ganglionic selective nerve root block given in patient after complete clinical and radiological evaluation of patient. Patient was postoperatively followed up for 6 months with augmentation with physiotherapy and traction. Functional evaluation of patient done using VAS score, Modified Oswestry lower back pain disability questionnaire 6 months post-operatively.: 25 patients included in this study showed a female prevalence with majority patients from 45-60 years of age group. L4 was the most common nerve root involved. In the study significant reduction in VAS score, Modified Oswestry lower back pain disability questionnaire score 6 month post-operatively found. VAS score was reduced from 8.24 to 3.28 and Modified Oswestry lower back pain disability questionnaire score from 31 to 12.76.: Selective nerve root block is an effective method for evaluation and treatment of degenerative spine diseases patients. Which provide significant pain and symptomatic relief. Accompanied with vigorous back strengthening exercises this can offer a good functional outcome. This can act as a good screening tool for patients with degenerative spine diseases without red-flag signs for operative intervention. Future studies are warranted on this with larger sample size.

Background: Thoracic and lumbar spine fractures account for 90% of all spine fractures recorded. In low- and middle-income countries, spinal injuries are associated with significant disability and decreased life expectancy. Non-operatively, these injuries can be managed with a thoracolumbar orthosis or hyperextension cast. The operative management with a posterior, anterior or combined approach will offer immediate mobilization and earlier rehabilitation, providing a better environment for restoration of neurological function. Aim of the study was to find out epidemiology of patients with thoracolumbar spine fracture patients. Methods: A cross sectional observational study was conducted in department of orthopaedics at tertiary care, teaching hospital among patients with traumatic thoracolumbar spine fractures. Epidemiological data variables were collected. In statistical analysis data from 60 patient reported was recorded and analysed. Results: Fall from height is the leading mechanism of injury among middle aged people (30-60years) with male predominance, accounting for 58.33 percent of all spinal cord injury cases. The majority (45%) of fractures were of the burst kind, followed by compression (28.3%), and then translation/rotation (21.6%). And the most-rare of all was the distracted type (just 5%). An only 15% of patients had had a complete spinal injury, whereas the remaining 85% had sustained incomplete/ no spinal cord injury. Conclusions: Knowledge about the burden brought on by spinal cord injury makes it clear that preventing such injuries is the backbone of care. preventive measures for high-risk individuals and early definitive response by paramedics can help reducing the load caused by these injuries.

Introduction: Proximal humerus fracture represents the second most common fracture in upper extremity in elderly. Percutaneous fixation has reported to have good functional outcome and has lesser complications rate. In our study we have tried to observe the functional outcome and complication rates of percutaneous fixation for proximal humerus fracture in elderly with Neer type I, II & III. Aim: This study aimed to observe the functional outcome and complication rates of percutaneous fixation for proximal humerus fracture in elderly with Neer type I, II & III. Materials and Methods:This study included 28 patients aged between 55 to 80 years having proximal humerus fracture Neer Type I, II and III presenting to our institute between June 2021 and September 2022. Patients were evaluated clinically and radiological evaluation was done in the form of Xray and CT scan. All patients fulfilling the inclusion criteria were managed with percutaneous K-wire fixation. Postoperative check Xray was done and physiotherapy was advised. Patient were followed up for minimum 10 months and evaluated for radiological union and function outcome using the DASH score. Results: All patients had radiological union in mean 8.2 months. DASH core was used to evaluate shoulder function. DASH score was excellent in 20 patients and was good in 6 patients while it was fair in 2 patients. Out of 28 patients 22 patients did not have any major complications 7 had k wire backout, 2 patients had entry point infection and 1 patient had K-wire migration. Conclusion: K wire fixation of proximal humerus fracture in elderly with Neer type I, II and III, gives a good radiological and functional outcome comparable with other modalities of treatment with low complication rate.

First metacarpophalangeal (MCP) joint dislocations are very uncommon injuries. These dislocations are classified as volar or dorsal, and then as simple or complicated, based on the direction of the dislocation and its reducibility. Dorsal being the most common approach as it is safer. It is found that reduction was stable and started with immobilisation for 15 days followed by physiotherapy. Postoperatively patient was having range of motion (25-50 deg) and post operative 2 months patient was able to do daily activities with his affected hand with VAS score of 1. Complex metacarpophangeal joint dislocations needs operative management combined with postoperative physiotherapy to achieve good clinical outcomes so as to reduce the risk of arthritis and decreased grip force.