Specific objective: A study was undertaken to evaluate the superiority of Lowest occlusion pressure method of using the pneumatic tourniquet verus the other routine ways of usage of Pneumatic Tourniquets in Orthopaedics surgery which include the Fixed and Systolic Blood Pressure variants. Materials and methods:This study included 120 patients of both upper and lower limbs trauma. These patients were randomly included any of the three categories of study after fullfilling the inclusion and exclusion criteria. Three modalities of application of toruniquet were included in this study. They were Fixed, Systolic Blood pressure (SBP) and Lowest Occlusion Pressure methods (LOP). Each category included 40 patients and the results were analysed according to final outcome using Ishii et al. grading, VAS Score criteria. Results: In our study 120 cases managed by LOP had better results compared to fixed variant and Systolic BP variant in terms of less pressure needed to keep tourniquet, good operative field, pain score (VAS) at tourniquet application region and skin injury (reddening). But no complications like compartment syndrome, deep vein disorder, paresis, nerve injury has occurred before and after surgery Conclusion: LOP method of using the pneuamtic tourniquet is superior to the other methods of using Tourniquet in terms of less pressure needed for elevating tourniquet, Good operative (blood less) field, no skin abrasions.Keywords: Pneumatic tourniquet, lowest occlusion pressure, systolic blood pressure, orthopaedic surgery IntroductionThe use of pneumatic tourniquet in orthopaedic surgery has been widely debated over the years. A pneumatic tourniquet is a device that allows the surgeon to have a bloodless field for the duration of the surgery [1,2] . This allows the surgeon to reduce the surgical time since all the anatomic structures are clearly visualised. The reason for debate is due to the postoperative problems experienced by the patient. Tourniquet site pain, tourniquet palsy, chemical burns at the site of tourniquet are common patient related problems consequent to using a tourniquet [3][4][5] . Great efforts have been made to identify the minimum pressure to which the tourniquet should be inflated so as to avoid the above mentioned problems. [6] In this study, we aim to use the pneumatic tourniquet by inflating it to the lowest occlusion pressure (LOP) and study its effects in terms of quality of bloodless field and post-operative complications. The results were compared with the standard techniques of using a tourniquet described already in the literature.

Introduction: Fractures Neck of the femur is one of most common fractures seen by an orthopedician. The incidence of these fractures and the various problems arising from them are growing, the reason for this is mainly the increase in the occurrence of osteoporosis in elderly population. Aims and Objectives: To compare and analyze the functional outcome seen after hemiarthroplasty in displaced intracapsular fracture neck of the femur elderly patients using uncemented Austin Moore's prosthesis and uncemented non-modular bipolar prosthesis by using Harris Hip score system in rural population. Observations and Results:In the present study total number of cases registered is 52 and one patient from both groups could not complete the study due to myocardial infarction, male and female ratio was 24/28. Out of 52 patient, the youngest patient among these group is 60years and oldest among this group is 90 years. The average age of the patient in group A is 72.68 years in Group B is 70 years. All the patients were encouraged to ambulate after 3 days after the surgery. All the 50 patients were followed up for minimum period of one year. Loosening, erosions or deep infections did not occur in both the group until the last follow up in our study. Discussion: In the present study it was proved that femoral neck fractures in old patient causes severe problems both to patient as well as to society. In a present scenario, hemiarthroplasties are limitedly used for selective patients. Conclusion: Primary Hemiarthroplasty, it is an effective surgery for most of the neck fractures in old age patients. The success rate of this surgery mainly depends on proper planning and execution to get best outcome. One year later percentage of patients achieving good to excellent results and the functional outcome with non-modular uncemented bipolar prosthesis were more than those with unipolar Austin Moore's prosthesis though it was not statistically significant.

Introduction: Intracapsular fracture of neck femur usually present with severe swelling, difficulty in walking reduced length of affected limb. The most common Risk factors are old age, osteoporosis, taking excessive medications, alcohol, smoking and cancer. Diagnosis can be done by using X-rays, CT scan and MRI. Materials and Methods: It is a prospective study consists of all the patients admitted to JSS hospital with intracapsular fracture neck femur treated with unipolar or bipolar endoprosthesis. Results: The selected patients were randomized and divided into two groups, Group one (I) and Group two (II). Patients were suction tube is used are categorized into Group I and in those were suction tube is not used are categorized into Group II. These two groups were studied and observed for the following, fall in haemoglobin and PCV at 48 hours post-operatively. Complications are Persistent discharge, serous discharge from the wound for more than 10 days. Discussion: When the doctors are in doubt, then they need to insert a drain was countered by Halsted (1898). Now days in orthopedic cases, closed suction drains are being commonly used to decrease the complications. Blood accumulation in and around the tissue site will raise the tissue tension and thereby reduces tissue perfusion in and around the surgical wound site. Conclusion:We consider that there is ample evidence that closed suction drains is of no benefit in primary uncomplicated hemiarthroplasty. The advantage of the drains in orthopaedic surgeries should be debated as non use of drains drastically reduces anemia and requirement of blood transfusion after surgery. In a developing and under-developing countries, the cost increases because of the blood transfusion needs and costs of drain device which will outweigh any advantages of putting a drain.

The knee joint is one of the most commonly injured joint due to sports activities fall from a bike and fall at home so they come with pain especially in acute condition its very difficult to rely only on the clinical examination to accurately find the diagnosis so the patient is subjected to many investigation like radiographs, ultrasonography and MRI later invasive modality like diagnostic arthroscopy.so we conducted a study to compare all the three modalities to arrive at the diagnosis like clinical examination, MR imaging and diagnostic arthroscopy to know the accuracy of each modality of diagnosis to detect the posterior horn meniscal injuries of the knee joint. There were 30 patients with 26 male and 4 female patients age ranging from 18 to 55 years. History of fall from a bike with twisting injury was most common. The sensitivity and specificity of clinical examination and MR imaging with respect to arthroscopy was 83.3% and 77.78% and 91.67% and 55.56% respectively. So diagnosing meniscal injuries is of great significance to decrease the morbidity of the patient.