Introduction: A variety of fracture patterns are seen in supracondylar humerus fractures in children and these are well described by Bahk et al. Currently followed treatment protocol doesn't recognize these common fracture patterns and pin placement is done at the discretion of the treating surgeon. The aim of the study is to evaluate the usefulness of Bahk classification system in deciding the pin configuration for the specific fracture patterns and thereby assess the functional outcome in the management of supracondylar fractures in children. Method: The study was done on 100 children of 2e12 years of age from February 2019 to January 2020. After closed reduction under general anesthesia, fractures were classified and pin configuration was decided according to Bahk classification. In the follow-up, patients were assessed for clinicoradiological outcomes based on Modified Flynn's criteria, Baumann angle, and anterior humeral line. Results: In our study Typical transverse and low sagittal fracture were the most common fracture patterns. In the final follow up as per Flynn's criteria, 93% of the patients showed excellent results. Mean Baumann's angle was not significantly different from the uninjured side and anterior humeral line passed through anterior or middle third of the capitulum in 95% patients. Conclusion: Using pin configuration suitable to fracture pattern as per Bahk classification improves functional outcome in supracondylar humerus fractures in children and minimizes complications.

Distal phalangeal osteomyelitis of the thumb occurs rarely. Bilateral affection of the distal phalanges has not been described in the literature so far. Here, we present a case study of a patient who was successfully treated for distal phalangeal osteomyelitis of bilateral thumbs. A 65-year-old woman presented with bilateral thumb pain and swelling. She had dyschromic changes in the right nail and onychodystrophic changes in the left nail. On inquiry, she gave a history of applying nail enamel only to both thumbs for several years. Radiography of both the thumbs showed changes suggestive of osteomyelitis of the distal phalanges. She was treated successfully with debridement and sequestrectomy. Culture from necrotic tissue yielded polymicrobial flora. Onychodystrophy is relatively common and occurs secondary to infective as well as non-infective disorders of nails. Compulsive nail biting (onychophagia), nail picking, and allergic and irritant contact dermatitis secondary to cosmetic agents and household detergents are common predisposing factors. A high degree of suspicion of infective nail bed can aid in the early treatment of such cases with favorable outcome.

INTRODUCTION: Knowledge of normal value of carrying angle is important while managing injuries around elbow. However there is paucity of literature documenting carrying angle in Indian children. Inuence of various factors like age, sex, height, weight on carrying angle is still debated. With this study we tried to bridge this gap in knowledge. MATERIALS AND METHODS: We conducted cross sectional study of 1893 children in the age group of 3 to 15 years. Student having history of previous fractures, orthopaedic deformities, neurological conditions were excluded. To assess the effect of the age, the patients were separated into ve cohorts: 3 to 5, 5 to 7, 7 to 9, 9 to 11, 11 to 13 and 13 to 15. The carrying angle of elbow was measured using universal standard extendable goniometer. To avoid interobserver variability, all measurements were recorded by a single orthopaedic surgeon with 5 years postgraduate experience. RESULT: Carrying angle was more in females 9.67 (SD 3.16) compared to males 8.33 (SD 2.63). . We observed increasing value of carrying angle with age. Pearson correlation coefcient showed carrying angle had positive correlation with age (r= 0.5, P< 0.001), height(r= 0.5, P< 0.001). However BMI Z score, which is weight adjusted for age and sex did not show any correlation with carrying angle and no signicant difference was noted between carrying angle on right and left side. DISCUSSION: Finding of our study differed with available literature in respect to lower value of carrying angle in both males and females. We did not found changes in carrying angle on left or right side in contrast to previous studies showing larger carrying angle in dominant side. Further studies with larger sample size are required in this aspect.