<p class="abstract"><strong>Background:</strong> Hemi arthroplastyis a better option in treatment of fracture neck femur as it eliminates avascular necrosis of femoral head and non-union. It allows immediate weight bearing to return elderly patients to activity which helps in avoiding complications of recumbency and inactivity. The decision to perform hemi arthroplasty using a unipolar or bipolar prosthesis is a controversial issue. Both the prosthesis can be used even in remote areas both are cost effectives, good results can be achieved by general orthopaedic surgeons and post-operatively, it can be well adapted by Indian population. This study was done to compare the efficiency of Austin Moore’s prosthesis (AMP) and bipolar prosthesis for the management of intra capsular fracture neck femur in elderly patients.</p><p class="abstract"><strong>Methods:</strong> Patient’s above 60 years with fracture neck of femur were included. In all total 140 patients were randomly allocated for treatment by either AMP or bipolar prosthesis, in the department of Orthopaedics, IIMSR Medical College, Badnapur, Jalna between March 2014 to March 2017. The patients were followed up at 6 weeks, 12 weeks, 6 months and 1year. Functional outcome was assessed and compared with modified Harris hip score.<strong></strong></p><p class="abstract"><strong>Results:</strong> Modified Harris hip score was better with bipolar group as compared to AMP group. Functional activities like use of public transport were better with bipolar group. Complications like acetabular erosion were rare in bipolar group as comparison to AMP group.</p><p class="abstract"><strong>Conclusions:</strong> Fixed stem bipolar prosthesis is a superior option as compared to Austin Moore’s prosthesis.</p>

IntroductionInjury to the ulnar nerve following humerus shaft fracture is a very rare entity because the ulnar nerve is well protected from the bone by muscle and soft tissue, and thus remains unaffected in these fractures. We report what is, to the best of our knowledge, the first case of ulnar nerve injury due to a comminuted humeral shaft fracture. The injury manifested and was diagnosed the day after a high-velocity accident. The paucity of related literature and the necessity for early diagnosis and subsequent treatment of such injuries in high-velocity accidents urged us to document this case.Case presentationA 30-year-old Indian man presented to our Emergency Department after a road traffic accident. Our patient complained of right arm pain and the inability to move his extremity. The following morning he developed clawing. Nerve conduction studies on the peripheral nerves of his arm in addition to an X-ray confirmed the diagnosis of a possible injury to the ulnar nerve. Our patient was taken to our Operating Room for surgery, during which a fragment of bone was found abutting the ulnar nerve after penetrating his triceps. This fragment of bone was replaced and the fracture was reduced by open reduction and internal fixation using a dynamic compression plate and screws. Postoperatively, our patient received physical therapy and was discharged two weeks after surgery with no neurological deficit.ConclusionsThis case emphasizes the urgency and importance of careful neurological examination of all the peripheral nerves supplying the arm in patients with a fracture of the shaft of the humerus. In the setting of injury to the arm in high-velocity accidents, a differential diagnosis of ulnar nerve injury should always be considered.

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<p class="abstract"><strong>Background:</strong> With the increase in high velocity trauma, the incidence of intra-articular fractures of distal end of radius, particularly in adults- the working class of society is increasing. Normal functioning of wrist is of paramount importance for all activities of daily living and working. The present study was undertaken to evaluate the results of using volar locking plate for fixation of intra-articular fractures of distal end radius, with emphasis on return to pre-injury employment assessment.</p><p class="abstract"><strong>Methods:</strong> It is a combined prospective and retrospective study from January 2013 to June 2016. Twenty patients of intra-articular fractures of distal end of radius (AO type B2 and B3) were treated with volar locking plate through volar approach. The patients were regularly followed up for one year. The assessment of pain, range of motion, activity and grip strength were scored by Green and O’Brien’s system.<strong></strong></p><p class="abstract"><strong>Results:</strong> According to scoring system of Green and O’Brien the patients were assessed at 1 year follow up. 17 patients (85%) showed excellent results (scores 90-100). 2 patients (10%) showed good result (scores 80-89) while 1 patient (5%) had fair outcome (score 65-79). No patient had poor result (score less than 65). 19 patients (95%) returned to their pre-injury employment at 1 year.</p><p><strong>Conclusions:</strong> Open reduction and internal fixation with volar locking plate is reliable and excellent methods of management of intra-articular fracture of distal end of radius especially shear type of injury (AO type B2 and B3) in adults. </p>

<p class="abstract"><strong>Background:</strong> Tibia is the most commonly fractured long bone in the body. Interlocked nails, either reamed or unreamed, has become the established method of treatment of closed and Grade I, II and III A open fractures of diaphysis of tibia. The cephalo-medullary nail like V-nail, has advantages of less surgical time and cost effectiveness while disadvantage of rotational instability. The present study was undertaken to compare the short-term as well as long-term results of treatment of diaphyseal fractures of tibia with interlocked nail and V-nail.</p><p class="abstract"><strong>Methods:</strong> Forty patients with fracture of shaft tibia were treated with either interlocked nail or V-nail. Twenty patients were treated with interlocked nail while remaining twenty were treated with V-nail. The follow-up period ranged from 14 weeks to 10 months. The results were assessed according to Ekland grading.<strong></strong></p><p class="abstract"><strong>Results:</strong> In interlocking series, 85% patients had excellent and good result while 15% patients had fair and poor results. In V-nail series, 30% patients had excellent result, 70% patients had good and fair results while no patient had poor result.</p><p class="abstract"><strong>Conclusions:</strong> From our study we conclude that closed interlocked nailing is the most ideal method of management of fracture shaft tibia of all types, allowing early mobilization. Closed V-nail is a simple and short procedure with satisfactory results, when used in simple and unifocal fracture types.</p>