Recent trends have shown a decrease in nonoperative management for unstable distal radial fractures in elderly. The literatures available lack adequate information whether operative treatments are superior to nonoperative (cast) treatment. The purpose of this study was to compare the outcomes of two treatment methods that were used: (1) ORIF with volar locking plate and (2) closed reduction and plaster immobilization. 70 patients with a displaced and unstable distal radial fracture were randomized to ORIF with volar locking plate (n=35) or closed reduction and cast immobilization (n=35). Outcome was measured on the basis of the Patient-Rated Wrist Evaluation (PRWE) score; the Disabilities of the Arm, Shoulder and Hand (DASH) score; the pain level; the range of wrist motion; the rate of complications; and radiographic measurements including dorsal radial tilt, radial inclination, and ulnar variance. Patients in the operative treatment group had lower DASH and PRWE scores, indicating better wrist function in early postoperative period (p<0.05), but there were no significant differences between the groups at six and twelve months. Grip strength, dorsal radial tilt, radial inclination, and radial shortening were significantly better in the operative treatment group at the time of the latest follow-up (p<0.05).

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Introduction: Fractures of shaft of humerus is becoming common these days and there is debate about the choice of operative intervention in humerus shaft fractures requiring surgical intervention. The modes of treatment are also advancing, so this comparative study was conducted to assess the clinical outcome of this fracture managed by two most common methods antegrade interlocking nail fixation and dynamic compression plating. Aim of the study was to compare the results of open reduction and internal fixation with DCP or closed interlocking nailing in fractures shaft of humerus. Material and Methods: It was a prospective study, consisted of 32 patients with closed acute humeral shaft fractures were treated with either interlocking nailing or plating procedure divided in two groups randomly of 16 each. Study was conducted in department of orthopaedics KVG Medical College and Hospital, Sullia, D K, Karnataka. Results were evaluated and analyzed using Rodriguez-Merchan Criteria different parameter; age, male v/s female, mode of trauma, functional outcome and complications etc. Results: The average age of patient was 33 years, with male to female ratio 6:3, more common on right side 61.33%, road side accident in 63.33% cases as common mode of injury, middle third as common region 55.53%, most common AO type A3 52% cases, group A interlocking nailing shows 20% cases as excellent result and 45.67% cases showing satisfactory results. In group B, dynamic compression plating shows 85% cases excellent result with 20% cases shows satisfactory results. Preoperative radial nerve palsy was seen in 3 cases in our study. Conclusion:No single treatment is superior in all cases for a particular fracture and each case has to be individualized. In the present study it was concluded that compression plating is better than interlocking nail for management of fracture shaft humerus.

Unstable intertrochanteric fracture in elderly is a challenging surgical condition with a high risk of morbidity and mortality. The aim of this study is to evaluate the functional outcome following primary modular bipolar prosthetic replacement for unstable intertrochanteric fractures in elderly. Materials and Methods: A prospective Study of 46 patients were evaluated from tertiary hospital for a period of Dec 2014 to June 2017. 46patients (40 females and 6 males-all were 75 years old or above) who had bipolar arthroplasty for unstable intertrochanteric fractures were prospectively evaluated. Lateral approach was used in all patients. Harris Hip Score (HHS) used for functional evaluation, however radiological follow up was done using plain X-rays. Follow up period ranged from 6weeks to 30 months Results: The Harris Hip Score were. 6 cases (12.5%) had excellent, 11(25%) had good, 23(50%) had fair and 6(12.5%) had poor results. In this study 5 cases had complications; like shortening in 2 patients, anterior thigh pain in 1 patients, decubitus ulcer in 1 patient, External rotation deformity in 1patient. Conclusion: Primary modular bipolar prosthetic replacement is a viable option for treatment in a selected group of previously independently mobile elderly patients with unstable intertrochanteric fractures and osteoporosis. The patients rapid return to the pre fracture level of activity significantly reduced the incidence of complications related to immobilization early walking with full weight bearing is the major benefit and goal of the procedure.