Background: In adults, distal humerus fractures are uncommon and intra-articular, oftenly involve both the medial and lateral columns. Open reduction and surgical fixation with plating gives good results. The aim of this study is to evaluate clinical outcome in intra articular distal humerus fractures treated with dual plating.Methods: This is a prospective type of study of 20 cases of supra condylar fracture humerus with inter condylar extension treated surgically with dual plating one on the medial boarder and another on posterior surface of lateral column using standard dorsal approach, olecranon osteotomy.Results: The range of age was between 18-52 years, with mean age of 32.55 years. The maximum incidence was between 18 to 40 years i.e. 16 cases (80%). With road traffic accident (RTA) as major cause of injury. Most   of the patients were males 14 (70%) with right upper limb was involved in 12 (60%) cases. According   to MEP score clinical outcome was excellent in 4(20%) good in 10(50%) fair in 5(25%) and poor in one (10%).Conclusions: Distal humerus fractures are known for their complex nature and technical difficult in surgical management. Proper anatomical articular reconstruction and stable fixation helps in restoring painless and functional elbow.

Introduction: Intertrochanteric and femoral neck fractures account for nearly 90% of proximal femur fractures. It is customary to use 65 years of age to define the elderly. One year mortality in these elderly patients ranges from 12%-36%. The main objective of this prospective study is to study the effect of age, sex, co morbidities, delay in surgery and complications on outcome in elderly with proximal femur fractures and to identify optimal measures that can be taken to improve outcome in these patients. It was presumed that early surgery within 48 hours after stabilization of co morbid conditions improves outcome in these elderly patients with proximal femur fractures. Materials and Methods: In this prospective study elderly patients with proximal femur fractures were selected, after careful selection with inclusion and exclusion criteria. They underwent surgery after preoperative assessment and followed for up to one year at a tertiary referral centre. Results: Increasing age and male sex are not significant factors affecting outcome. Increasing number of co morbidities (2, 3 or more) is associated with significant increase in mean length of hospital stay (p values .006, and .001), increased incidence in number of complications (p value .008) and mortality (p value .028). Presence of complications is significantly associated with increase in mean length of hospital stay (p values .000, .001), decline in recovery of pre injury mobility status (p value 0.018), increased incidence in number of deaths (p value .01). Delay in surgery more than 48 hours is associated with significant increase in mean length of hospital stay (p value .001) and increased incidence in number of complications (p value .028). Conclusion:Early surgery within 48 hours after stabilization of co morbid conditions is associated with improvement of outcome in elderly patients with proximal femur fractures is proved correct in terms of decreasing mean length of hospital stay and decreasing incidence of number of complications.

Introduction: Intertrochanteric and sub trochanteric fractures account for 50% of all fractures of the proximal femur. Surgical treatment is the preferred method in these fractures to reduce the complications of prolonged immobilization. Recently proximal femoral locking compression plate (PF-LCP) has been applied in the treatment of proximal femur fractures. Materials and methods: This is a prospective type of study of 12 cases of comminuted inter trochanteric and sub trochanteric fractures of femur treated surgically with proximal femoral locking compression plate (PF-LCP). All the cases were operated electivley on regular operation theatre days. Results: In age distribution, 6 (50%) patients were between 50-75years. The range of age was between 20-75 years, with mean age of 43.8years. In sex distribution, there were 8 (66%) males and 4(34%) females. Left lower limb was involved in 9 (75%) cases and right lower limb in 3 (25%) cases. In mode of injury, 8 cases (66%) were due to slip and fall and 4 cases (34%) were due to road traffic accident. Kickstand screw was used in 9(75%) cases and not used due to narrow femoral neck in 3(25%) cases. Proximal screw was back out two patients (16%). Varus collapse occurred in one patient (8%). Delayed union in two patients (16%). Conclusion:The PF-LCP is appropriate for complex and unstable proximal femoral fractures with poor bone quality.

Introduction:The Anterior Cruciate ligament (ACL) is the primary stabilizer of the knee and prevents the knee against anterior translation. Arthroscopic reconstruction of torn ACL has become the gold standard in treating ACL tears. The surgical reconstruction of the anterior cruciate ligament with auto graft represents an attempt to reestablish knee kinematics.

Introduction: Double disruptions of the superior suspensory shoulder complex (SSSC) resulting in ipsilateral mid shaft clavicular and scapular body/neck fractures, are commonly referred to as a 'floating shoulder' injury. If not treated properly, this could lead to malunion, drooping shoulder deformity, shoulder pain and weakness, subacromial impingement syndrome, traumatic arthritis, and even delayed nerve and vascular damage and other complications. Materials and Methods: This is a retrospective type of study of 15 cases of floating shoulder injury treated by different surgical methods. All the cases were operated electively on regular operation theatre days. Results: The age range in total 15 patients was from 22 years to 62 years with mean age at the time of injury was 40.4 years. Out of 15 cases 12 (80%) were males and 3(20%) were females. High energy trauma in 12(80%) cases, fall from height in 2(13.3%) cases and fall of heavy metal object in one (6.6%) case. Associated injuries in the form of rib fractures with haemothorax in 5(33.3%) cases, head injury in 3 (20%) cases, tibial shaft fracture in one(6.6%) case and tibial spine avulsion in one (6.6%) case. Total of 7(46.6%) cases treated with only clavicle fixation, 5(33.3%) cases with both scapula and clavicle fixation and 3(20%) cases treated conservatively. Mean Herscovici score was 12.4 with excellent results in 4, good in 6, fair in 3 and poor in 2 cases. Conclusion: Significant displacement at one or both fracture sites of floating shoulder injury can result in a poor functional outcome which can be improved with surgical intervention. Conservative management with acceptable results reserved for patients with minimally-displaced fractures.