INTRODUCTION; Clavicle fracture is a common traumatic injury around shoulder girdle due to their subcutaneous position. It is caused by either low-energy or high-energy impact. Fracture of the clavicle accounts for approximately 5 to 10% of all fractures and upto 44% of injuries to the shoulder girdle. About 80% of these fractures are in the middle third of the bone and less often in the lateral third (15%) and medial third (8%).AIMS AND OBJECTIVES;To study the role of open reduction and internal fixation in clavicular fractures, study various surgical procedures over fracture clavicle, clinically evaluate the results of various surgical procedures over fracture clavicle,discuss merits and demerits of the various surgical procedures, finally draw conclusions of overall study.METHODOLOGY; The present study was carried out from June2010 to December 2013 at Orthopaedics Department Bangalore medical college and research institute,in this period 40 patients of clavicular fractures were treated surgically. Adult male and female patients above 18 years who require surgical intervention for displaced andcomminution fracture. RESULTS AND OBSERVATIONS;we had 32 cases of middle third clavicle fracture and 8 Lateral third fracture with no medeal third fracture.. The functional outcome is assessed by constant and murleyscore.In this study on 32 patients (80%) with middle third clavicle fracture treated with plate and screws 24 patients (60%) had excellent functional outcome, good functional outcome in 6 patients (15%) and fair functional outcome in 2 patient.For 8 patients of lateral third clavicle fracture fixed with Kirschner wire and tension band wire 4 patients (10%) had excellent functional outcome results and 2patients (5%) had good functional outcome 1 patient had fair functional outcome and with 1 patient fixed with hook plate had fair functional outcome.CONCLUSION;Clavicle fractures are usually treated conservatively but there are specific indications for which operative treatment is needed like comminuted, displaced middle third clavicle fractures and displaced lateral third clavicle fracture.In this study primary open reduction and internal fixation with plate and screws of fresh middle third clavicle fractures provides a more rigid fixation and does not require immobilization for longer periods.In this study locking compression plates were used as it is provides strong fixation due to locking between the screw and plate, Dynamic compression plate is strong but it gives excessive prominence through the skin and it is difficult to contour. For displaced, comminuted middle third clavicle fracture plate and screws fixation and early mobilization gave excellent results.

BACKGROUNDThe caesarean section under spinal anaesthesia is a common procedure performed in operation theatres. Perioperative shivering and hypothermia will be present in the majority of these cases. Shivering is bothersome to mother and the anaesthesiologist and will impair early maternal bonding to the baby. The maintenance of normothermia is an important function of the autonomic nervous system. Autonomic blockade at spinal level leads to internal redistribution of heat from the core to peripheral compartment and a rapid decline in core temperature. It is often challenging to treat core-peripheral redistribution of heat. However, redistribution can be prevented by preanaesthetic cutaneous warming. The purpose of this study is to compare the efficiency of forced air pre-warming and pre-warmed intravenous fluids 15 minutes prior to spinal anaesthesia in patients undergoing a caesarean section.

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Total hip arthroplasty (THA) is considered one of the most successful surgical procedure in Orthopaedics. The dual articulation cup was developed by Professor Gilles Bousquet and André Rambert in 1974 and combined the "low friction" principle of THA popularised by Charnley with the McKee-Farrar concept of using alarger diameter femoral head to enhance implant stability. Multiple studies have shown decreased instability and lower dislocation rates in primary hip arthroplasty with dual mobility implants, resulting in the use of dual mobility implants for primary THA in younger, lower-risk patients or as treatment method for recurrent instability, studies report dislocation rates of dualmobility implants ranging from 0% to 3.6% in THA. The purpose of this study is to demonstrate the performance and reliability of "DUAL MOBILITY CUP" used during Total hip arthroplasty. Materials and Methods: It is a hospital based prospective study of 20 patients diagnosed clinically and radiologically with conditions require THR between Nov 2017 -Jan 2020. All the patient who received a dual mobility cup between Oct 2017 and Oct 2019 in hospitals attached to Bangalore Medical College & Research Institute, Bangalore were studied for a duration of 12 months. The functional outcome was assessed with HARRIS HIP SCORE and PMA SCORE. The data was analysed using descriptive statistics. Results: In our study the HHS improved from mean value of 63.89 in first month to mean value 90.3 as in 12 months and 11 patients shows excellent outcome at the 12 th month follow up with p value < 0.001 and the PME score improved from mean 12.26 in first month to mean value of 15.72 as excellent in month, 18 patients shows excellent outcome at final follow up.Out of the 20 patient one sustained peri prosthetic fracture (5%) (Vancouver AL), One patient developed SSI(5%), One patient died postoperatively due to medical issues (5%) (Acute renal failure), all other patients had no complications related to total hip arthroplasty with implant survivorship of 94% at the end of 1 year. Conclusion: Dual mobility cup total hip replacement is an acceptable method for patients who are planned for Total Hip Arthroplasty as it provides pain relief and good function without compromising the stability. Use of dual mobility cup in total hip arthroplasty is shown good results in the short term follow up (Good to Excellent) compared to conventional total hip replacement. High-quality, prospective, comparative studies are needed to evaluate further the use of dual mobility components in THA.