Introduction: Patella fractures account for 0.5% to 1.5% incidence of all bone fractures. The gold standard procedure for the patella fractures so far is AO modified anterior tension band wiring with stainless steel and K-wires. The hardware related complication in this technique is high ranging from 0-60%. The purpose of the study is to evaluate the functional outcome for fixation done with high resistance suture material. Methods: A prospective study was conducted in a group of 24 patients who were hospitalised in Govt Kilpauk Medical College and Hospital, Chennai in the Department of Orthopaedics between August 2015 and September 2017. The patella fractures included in the study were performed open reduction and internal fixation (ORIF) with FiberTape using a novel transosseous tunnel technique. The functional outcomes were evaluated with Tegner-Lysholm score and Bostman scoring. The clinical and radiological outcomes were evaluated as well. Results: Among the 24 patients with patella fractures studied, all fractures united. The mean time of union is 3 months 8 days. 4 patients presented with minor complications like superficial infection, displacement < 4mm, anterior knee pain and extensor lag ~ 10°. Average scores: Lysholm -96, Bostman -27. All fractures united uneventfully. No hardware related complications or resurgery reported in the study. Conclusion:The complete non-metallic fixation rules out the most important complication of metallic fixation, which is the symptomatic hardware. It also brought down the reoperation rates and the infection rates post-surgery considerably. Using a non-absorbable suture material also precludes the possibility of a second surgery needed for the implant exit. Hence, these high resistance suture materials like Fiber Wire and FiberTape can be used for efficient non-metallic fixation of patella on par with that of traditional metallic fixation with reduced complications and re-surgery rates.

Background: To evaluate the correlation between bone tunnel diameter following Anterior cruciate ligament (ACL) reconstruction measured by computed tomography (CT) using multiplanar reconstruction (MPR) and functional outcome. Materials and methods:This study is a prospective study. Fifteen patients (14 men and 1 women, with mean age 30.27 years) who had undergone ACL reconstruction with hamstring tendon auto graft had subsequent CT scan during their follow up (mean follow up is 11.27 months) were included in this study. The diameter of both tunnels (femoral and tibial) were measured using MPR (multiplanar reconstruction) technique. Functional outcome was evaluated with International Knee Documentation Committee grade. Statistical analysis of the correlation between the diameter of the tunnels and IKDC grade were investigated. Results: The tibial and femoral bone tunnels were found to be significantly widened. There was no significant correlation between the diameter of bone tunnels and functional outcome (IKDC grade). Conclusion: Neither the diameter nor its widening during interval follow-up is correlated with functional outcome (IKDC Grade).

Background: Proximal humerus fractures accounts for 4-5% of all fractures. This is the third most common fracture in the elderly population. Surgical treatment is advised for displaced proximal humerus fractures. This study was done to evaluate the functional outcome of fractures operated with locking plates and to evaluate any significant difference of outcome present between age (< 60 years and > 60 years) and fracture pattern (AO Type A, B, C). Materials and methods: This is a Prospective study conducted at Government Kilpauk Medical College Hospital. 25 cases of proximal humerus fractures operated with proximal humerus locking plates. Post operatively functional outcome was evaluated with Constant Murley Shoulder score and radiological followup. Results: In our study, 14 cases were < 60 years and 11 cases were > 60 years. The mean constant score was 86.75 and 67.1 for < 60 and > 60 years respectively and it was statistically significant. The difference in the functional outcome of three fracture types was statistically significant with a p value of 0.048. Conclusion: Proximal Humerus Locking Plate is the implant of choice for treating displaced proximal humerus fractures. It provides stable internal fixation, allows early mobilisation and prevents secondary loss of fixation. The functional outcome was decreased in elderly individuals when compared to younger individuals. More complex initial fracture patterns have decreased functional outcome postoperatively, hence adequate stable fixation and appropriate physiotherapy and rehabilitation protocols should be followed to achieve optimal functional outcome. Keywords: Proximal humerus fractures, PHILOS Plating, Calcar screws IntroductionProximal humerus fractures account for 2 to 4% of all upper limb fractures. The treatment modality depends upon many factors like mechanism of injury, patient's health and activity level, bone quality and initial fracture pattern. Fracture that are undisplaced or minimally displaced are treated conservatively and fractures that are displaced require surgical treatment. Seventy five percent of proximal humerus fractures occurs in older patients aged more than 60 [1,10] . The mechanism of injury in this patients are a low energy trauma. The risk factors associated with fractures in older age group are osteoporotic bone quality, associated medical comorbid conditions, complex fracture pattern because of poor bone quality. Most of the fractures were treated conservatively or by semi rigid fixation. Recently with the increased use of proximal humerus locking plate the functional outcome of fixation of these fractures has improved a lot. This series has 25 cases of proximal humerus fractures, all were fixed with proximal humerus locking plate. The outcome was analyzed by the pain, range of movements, ADL and stability (bony union) using the Constant Murley scoring system.