Combined ipsilateral femoral neck and shaft fractures are uncommon and challenging injuies to manage. Treatment of these type of fractures are different and associated with high rate of complication. Choosing a right implant is necessary to get optimal results with minimal complication. To evaluate the functional, radiological and anatomical outcomes of these cases treated by single implant or individual implant for each fracture by osteosynthesis. A total of 20 patients with ipsilateral femoral neck and shaft fractures were included in our study. Patients were divided into single implant group (Group I; 10 patients) and multiple implants group (Group II; 10 patients). All the patients were followed up prospectively for two years. Fracture union was confirmed radiologically, and functional evaluation was done as per Harris Hip Score.70% of both groups achieved successful fracture union with the remaining 30% with either nonunion, malunion or necrosis of the femoral head but with no statistical significant difference between both the groups. Upon comparing single versus multiple implants methods nearly similar results; were clinically and radiologically obtained. However, it is difficult to draw a definite conclusion as the number of cases were relatively smaller. A study with a larger population scale probably can give a definite conclusion.

Tibial Pilon fractures are challenging injuries for the orthopaedic surgeon to manage successfully. The main challenges in the management of these fractures are compromised skin and soft tissue envelope, comminuted fracture, displacement of fragments, metaphyseal region of fracture. In our prospective study, we have done different modalities of treatment of closed pilon fracture with no or minimal soft tissue injury in adults and observed the final functional score and complication rates. 20 patients were followed up to 12-24 month.12 cases (60%) unite in between 16-20 weeks,4 cases (20%) are unite in 12-16 weeks and rest 20% cases unite after 20 weeks. Complication like superficial thrombophlebitis in 2 cases which treated conservatively. Superficial skin infection in one case of primary ORIF and 2 cases of MIPPO. Deep infection occure in 1 case of ring fixator. Final functional outcome in our study according to AOFAS Score, 11 patients (55%) had excellent result and 6 cases (30%) good& 3 had fair (15%) result.

BACKGROUND Giant Cell Tumour (GCT) is a locally aggressive benign bone neoplasm characterized by proliferation of mononuclear stromal cells and many osteoclastlike multinucleated large giant cells affecting the epiphyseal segments of long bones mostly in females of 20 - 40 years age group. Distal radius is the third most common site of occurrence of GCT next to distal femur and proximal tibia. Resection or extended curettage remain the main modalities of treatment in Campanacci Grade I and II while en-bloc excision with reconstructive procedures, arthrodesis or amputation are the treatments of choice in Grade III with the latter two procedures leading to loss of joint function. Fibula being a non-weight transmitting bone of the lower limb, can be harvested in its proximal 1 / 3 rd and used for the reconstruction of the distal radius. In this study, we evaluate the functional and clinical results of resection and reconstruction using a nonvascularized fibula graft in the distal radius GCT. METHODS This is a prospective study of 20 patients diagnosed with GCT of distal radius either treated primarily at our institution or reviewed here after having been treated elsewhere. After confirmation of diagnosis, the patients underwent resection of the tumour and reconstruction of the distal radius using ipsilateral non vascularized fibula graft, fixed with dynamic compression plate. Follow-ups were done at regular intervals and radiological signs of graft healing, recurrence of tumour, wrist range of motion, and revised Musculoskeletal Tumour Rating Scale (MSTS) was used for assessing the functional outcome. RESULTS In our study, it was found that mostly females 13 (66.6 %) of the age group 30 - 35 yrs. were affected. The average grip strength achieved was 71 % (42 - 86 %) & average combined movements of 64 % (29 - 78 %) of contralateral normal side. Mean duration of union was 24 weeks (14 - 42 weeks). One case of non-union was seen which eventually achieved union with bone grafting. There was one case of soft tissue recurrence but the patient refused any further procedure. Complications were seen in 8 cases (41.6 %). We achieved excellent results in 15 (75 %), good in 2 (10 %), satisfactory in 2 (10 %) and poor in 1 (5 %) case. CONCLUSIONS We found that in GCT resection of the distal radius and reconstruction arthroplasty using autologous non-vascularized proximal fibular graft is useful in preserving the functional status as well as achieving satisfactory range of movement and grip strength with lesser chances of tumour recurrence. KEYWORDS Distal Radius, Giant Cell Tumour, Resection Reconstruction, Fibula

Resumo Objetivo O tratamento da fratura de Colles pode deformar o pulso. Alguns estudos afirmam que essa deformidade raramente dificulta as atividades diárias, enquanto outros relatam o contrário; assim, a redução anatômica é desejável. Nosso objetivo foi analisar os resultados anatômicos e funcionais da fratura de Colles para descobrir os valores de parâmetros individuais correspondentes ao melhor desfecho funcional. Métodos Este estudo prospectivo incluiu 70 pacientes idosos com fratura de Colles. Todos os pacientes foram tratados de forma conservativa. Os parâmetros anatômicos foram a angulação dorsal, a inclinação radial e a altura radial, avaliados de acordo com Stewart et al. O resultado funcional foi avaliado segundo a tabela de pontuação de pulso Mayo. Os resultados foram analisados por meio do teste de associação do qui-quadrado, considerando o valor de p < 0,001 estatisticamente significativo. A força das associações foi analisada por razões de possibilidades com intervalos de confiança de 95%. Resultados Excelentes e bons resultados anatômicos e funcionais foram obtidos em 68,5% e 78,5% dos casos, respectivamente, com diferença estatística significativa (p = 0,0009). Dos três parâmetros anatômicos, a angulação dorsal inferior a 10° e a perda da inclinação radial inferior a 9° apresentaram associação estatisticamente significativa com os resultados funcionais (p = 0,0006), mas não a perda de altura radial inferior a 6 mm (p = 0,0568); no entanto, a perda da altura radial inferior a 4 mm foi associada de forma significativa aos desfechos funcionais (p = 0,00062). Conclusão As fraturas com redução anatômica apresentam melhores desfechos funcionais. Os parâmetros anatômicos limítrofes aceitáveis para a obtenção de resultados funcionais excelentes ou bons são angulação dorsal inferior a 10°, perda da inclinação radial inferior a 9° e perda da altura radial inferior a 4 mm.