We report a case of isolated displaced fracture of the capitulum in both elbows. Treatment was by closed manipulation and immobilisation for 3 weeks which achieved a satisfactory result, both elbows regaining 100 degrees of flexion.

BACKGROUND: Distal femur fractures with intra-articular extension are complex injuries which have been treated by different methods. The authors studied the functional outcome of management of distal femur fractures with the published literature. MATERIALS AND METHODS: Distal femur fractures with intra-articular extension treated with open reduction and internal fixation during the period Jan 2011-dec 2012 at Govt. Medical College, Surat formed the study population. They were evaluated to assess their clinical and functional results using Neer's Scoring system and compared with the available literature. The results were analyzed using different parameters; male vs. female, age distribution, functional outcomes and complications etc. RESULTS: The results were excellent in 56%, good in 24%, fair in 12%and poor in 08%. Results were assessed and found to be excellent in majority of cases with mean knee flexion being 94.1degrees, mean fracture union time of 16.7 weeks, with mean full weight bearing duration of 13.92 weeks complications being knee stiffness (5), delayed union (6), infection (7), shortening (5) knee pain (15) CONCLUSION: Surgery in the form of ORIF is recommended for distal femur fractures with intra articular extension for good outcome and early mobilization with minimum preventable complications.

Introduction: Different modalities of treatment are available for fracture shaft of humerus. It includes various conservative methods like immobilization in a sling, Thomas arm splint, U slab, hanging cast, shoulder spica cast and surgical treatment such as intramedullary nailing, plate osteosynthesis, and external fixator. These different methods have their own advantages and disadvantages. Method of plate osteosynthesis is sometimes associated with infection and iatrogenic damage to radial nerve. The selection of a method for treating fracture shaft of the humerus depends on various factors which are related to patient and type of fracture. We decided to undertake the study of fracture shaft humerus treated with plate osteosynthesis. Aim: To study patients with diphyseal fracture of shaft of the humerus treated with plate osteosynthesis. Materials and Methods: This was a prospective study of 40 patients with diaphyseal fractures of humerus treated by plate osteosynthesis. All the patients were treated as indoor patients at the Department of Orthopaedics, New Civil Hospital, Surat from January, 2004 to March, 2006. The maximum period of follow-up was 2 years and the minimum period of follow-up was 5 months with average follow-up of 6 months. Patients were operated as soon as they were fit for surgical procedure under anaesthesia. An informed written consent was taken. Most of the patients were operated by posterior approach except two operated through anterolateral approach. AO type narrow 4.5mm dynamic compression plates with 4.5mm cortical screws were used. Patients were called for follow-up regularly at interval of 2-4 weeks as per need. At each visit, patients were examined for pain, tenderness, skin condition, elbow and shoulder movements. All the findings were recorded. Final results were evaluated as per criteria laid down by Hunter. Results and discussion: In the present series, 88% had excellent to good results which were almost consistent with the series reported by Dominik Heim et al. One patient had superficial infection which responded to daily dressing and proper antibiotic use. In Robert and Vander series, postoperative infection rate was 5.6%. In our study, 2 patients had radial nerve palsy at the time of trauma and 1 patient had postoperative radial nerve palsy. Usually, these injuries are neuropraxia. All 3 patients had full recovery within 3-4 months. Conclusion:Though the series is relatively small and the period of follow-up is small, however it appears that: Plate fixation appears to be a good surgical option for treatment of the diaphyseal fractures of humerus. Radial nerve palsy is usually of neuropraxia and it recovers within 4-6 months.