Introduction:An isolated coronal fracture of either or both femoral condyles is a rare entity and is usually associated with high-energy injury trauma. Such fractures should be meticulously fixed for a good functional outcome as they involve the articular surface of a weight bearing joint. A modified swashbuckler approach provides adequate exposure for appropriate reduction and fixation of such fractures.Case Presentation:A 32-year-old male sustained a bicondylar Hoffa fracture of the right femur which was treated by open reduction and internal fixation using a modified swashbuckler approach. At two years of follow-up, the patient had excellent radiological and functional outcome.Conclusions:In our study, we treated this rare fracture successfully using a modified swashbuckler approach and found it to be a good approach for such fractures as compared to the conventional approach.

<p class="abstract"><strong>Background:</strong> The femoral neck-shaft angle is the measurement of the angle formed between the oblique oriented neck with the vertical shaft and is an important anatomic measurement for the evaluation of biomechanics of hip.<span> The neck shaft angle is important in surgeries that involve the neck of femur, Intertrochanteric fractures, slipped capital femoral epiphysis, and developmental dysplasia of hip. Different variation of neck shaft angle has been seen in different literature and all the orthopedic implants are designed according to the values of the western literature which is different from the Indian subcontinent</span><span lang="EN-IN">.</span></p><p class="abstract"><strong>Methods:</strong> <span>Pelvic radiographs of patients who presented to Accident and emergency care or the outpatient department were used in the study</span> 110 patients radiographs were assessed in the study. There were 55 males and 55 females in our study. The mean age for males was 46.5 years and that for females was 43.2 years. The pelvis radiographs were studied for neck shaft angle .The measurements were performed bilaterally on the digital screen using the PACS (picture archiving and communication system) with handheld 360 degree goniometer.<strong></strong></p><p class="abstract"><strong>Results:</strong> The mean neck shaft angle in our study was129.26 degree for males and 126.62 degree for females .The overall mean neck shaft angle in 110 radiographs was 128.60 degree<span lang="EN-IN">. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">We conclude that consideration of neck shaft angles in orthopedics surgery and designing of implant can give more angle options for the surgeons which can improve the overall prognosis of the patient.</span></p>

INTRODUCTIONTibial eminence fracture is a bony avulsion of the anterior cruciate ligament from its insertion on the anteromedial tibial eminence. 1 These injuries are commonly seen in children aged between 8-14 years and are usually sports related, however in adults these injuries are mainly related to high energy trauma usually road traffic accidents and concomitant injury to the menisci, articular cartilage, and collateral ligaments can also be seen. [2][3][4][5][6][7][8] Meyers and McKeever in 1959 described the severity of the displacement of fracture into 3 types, type I fractures have minimal or no displacement of the fragment, type II fractures have anterior one half avulsion of the eminence, but seated posterior part, and type III fractures have displaced fragment.9 Zaricznyj further modified and divided type III fractures into classes A and B, where type IIIA describes the pathology when the fragment with complete separation is displaced minimally, and type IIIB the pathology when the fragment is twisted or fragmented resulting in rotational malalignment. 10 ABSTRACTBackground: Several techniques of arthroscopic treatment of tibial spine avulsion fractures have been described in the literature. We conducted a study to analyze the results of arthroscopic assisted wire loop technique for treatment of tibial spine avulsion in adults and pediatric patients. Methods: From June 2011 to December 2016, 52 patients with tibial spine fractures were surgically treated with arthroscopic reduction and wire loop fixation. Forty-four patients were adults and eight were in their pediatric age group. The age group ranged from 9 years to 52 years with the mean age of 26.2 years. 28 patients were type 2 and 24 were of type 3 fracture as classified by Myeres and Mckeever's classification. The final analysis was done using clinical tests, radiological evaluation and International Knee Documentation Committee (IKDC) and Lysholm score. Results: At final follow-up, the mean IKDC and Lysholm knee scores were, 92 and 93 respectively. All patients had a complete functional recovery and were able to return to work and to resume their activities. Conclusions: Arthroscopic wire loop fixation is an excellent method for tibial eminence fracture in adults and children which gives excellent results in form of control tension on ACL on each side of avulsed fragment and also gives adequate mechanical strength for early rehabilitation.

Introduction-Treatment of extra-articular distal humerus fractures is often difficult using conventional plates. Plates having enough screws (three to four) in the distal fragment either impinge on the olecranon fossa, or gain purchase by placing screws in the lateral or medial column of the distal humerus avoiding the olecranon fossa. Objectives-This study was to ascertain the effectiveness of modified distal tibial locking plate for use in distal third shaft humerus fracture. Methods-By using a modified distal tibial locking plate, a six to eight locking head screws can be easily placed in the in the limited length of distal fragment proximal to the olecranon fossa. Fourteen cases treated in such manner were followed up for a minimum of 24 months. Results-Union was achieved in all cases with no loss of reduction or implant failure. No patient complained of hardware complication, functional limitation or infection. Conclusion-Modified distal locking plate can be safely used in the limited space above olecrenon fossa in distal thirds humerus shaft fractures

Introduction-The present study report results of a series of type 3A and 3B open fractures treated with debridement and fracture fixation and immediate bone grafting. Methods-Twenty one patients were treated from January 2017 to January 2018. All fractures were treated with a modular external fixator. Nine fractures were type 3A and 12 were type 3B. All fractures received debridement, external fixation, bone grafting and flap or skin graft coverage. All fractures were analyzed for time to fracture union, incidence of pin tract infection, incidence of wound infection, flap complications, and delayed or non union. Results-After a mean follow up period of 14 months (range 12 to 16 months), it was concluded that the time to fracture union was 22 weeks, and all fixators were removed only after radiological evidence of fracture union. 1 (5%) patients developed deep wound infection, one experienced delayed union. Conclusion-Along with early wound coverage and external fixation, primary bone grafting can be employed in grade 3 open fractures of tibia with good results and without any increased risk of wound complications