associated medical problems where operative intervention is not an option. Localized depressions of up to 10 millimeters in the articular surface of lateral plateau may result in stable knees and have good outcomes when treated non-operatively. 13 This interventional and prospective study was conducted in minimally displaced and depressed tibial plateau fracture with displacement of less than 4 mm, depression of less than 8 mm and less than 10 degrees of instability to evaluate the functional outcome and complications of conservative treatment. MATERIALS AND METHODSThis interventional and prospective study included forty-two randomly selected cases of tibial plateau fracture in adults more than 20 years of age who presented in the and treated with conservative method. Inclusion criteria ABSTRACT Background & Objectives: Tibial plateau fr actur es have been studied and reported extensively and exhaustively but still controversy exists over its management, whether surgical or conservative. Although several methods of treatment have been devised, each method of treatment offers their own advantages and disadvantages. In this study we utilized conservative method which like any other mode of treatment restores articular congruity, axial alignment, joint stability, functional motion and avoids complications. This study was conducted with an objective to evaluate the functional and radiological outcome of conservative treatment. Materials & Methods: For ty two r andomly selected cases of tibial plateau fracture in adults more than 20 years of age were treated with above knee plaster of Paris cast for 4 to 6 weeks. At the end of six months outcome of this study was analyzed by Modified Rasmussen clinical criteria and radiological evaluation. Results: The Clinical assessment showed that 48% had excellent, 28% had good, 10% had fair and 14% had poor outcome while radiological outcome of this study showed 40.5% excellent, 33.3% fair, 9.5% fair and 16.7% poor result. Conclusion: In appropriately selected cases conservative treatment is a reliable alternative and is certainly without the complications associated with surgery.

Background & Objectives: Supracondylar fracture is one of the commonest fractures in children. Although the technique of pinning is controversial, percutaneous medio-lateral entry pinning is theoretically considered more stable biomechanical construct. The drawback of this method is injury to ulnar nerve which is not encountered in only lateral entry pinning.Materials & Methods: This was a prospective, comparative and observational study done in 60 patients which was alternately divided into two groups. The first group (A) underwent medio-lateral entry pinning and the second group (B) underwent lateral entry pinning. They were followed for 24 weeks and the outcome was assessed using Flynn’s criteria.Results: At twenty-four weeks, the mean loss of range of motion of elbow in medio-lateral pinning group was 3.70 degrees (SD±1.93) and that in lateral pinning group was 4.23 degrees (SD ±1.38). The mean loss in carrying angle at twenty-four weeks in medio-lateral group was 2.93 degrees (SD±2.19) and that in lateral group was 4.17 (SD±2.24). There were 2 (6.67%) cases of iatrogenic ulnar nerve injury in medio-lateral pinning group. Out of thirty patients, in medio-lateral pinning group, 25 had excellent results, 5 had good results and none had fair or poor results. While out of 30 patients in lateral pinning group, 23 had excellent results, 7 had good results and none had fair or poor results.Conclusion: There is no significant difference in outcome in terms of loss of carrying angle and range of motion between the medio-lateral pinning group and the lateral pinning group at the end of 6 months.Journal of College of Medical Sciences-Nepal, Vol.11(4) 2015: 28-31

Introduction: Human-wildlife conflict in the Himalayan kingdom of Nepal is the major concern in and around the protected area due to dramatic change in the ecosystem which includes a rise in human population and their basic requirements that leads to loss of natural habitat for agriculture farming and residential purpose. On the other hand, successful conservation programme in some protective areas leads to a rise in a number of wildlife. This conflict ultimately leads to damage of the crops, property, livestock and the most important human casualties which is the main focus of this study.Methods: This is a hospital-based retrospective study in which 32 patients visiting the emergency and outpatient department with a history of wild animals attack were included. Advanced trauma life support protocol for polytrauma patients was followed. Anti tetanus and anti-rabies prophylaxis given followed by antibiotics coverage. Operative and multidisciplinary interventions were made as per the requirement.Results: Out of the total 32 patients, soft tissue injury Oestern-Tscherne grade 3 was the commonest type of injury seen in 19(59.4%) of the cases, the commonest species involved was rhinoceros 8(25%). The anatomical site most commonly involved was lower limb 10(31.3%). Fracture fixation was required in 8(25%) cases. The commonest complication was wound infection in 5(16%) cases.Conclusion: This research elaborates the current scenario of human-wildlife conflict, facilitates to identify and face the common type of injuries, their complications, the role of a multidisciplinary approach and hence implement certain treatment protocols as a part of effective management to avoid major consequences to public health.