Background: In adults, distal humerus fractures are uncommon and intra-articular, oftenly involve both the medial and lateral columns. Open reduction and surgical fixation with plating gives good results. The aim of this study is to evaluate clinical outcome in intra articular distal humerus fractures treated with dual plating and evaluate the intermediate term results (minimum follow up of two years) of communited intra-articular distal humerus fractures treated with bicolumnar plating with or without olecranon osteotomy in elderly Indian population. Methods: This is a prospective type of study of 20 cases of supracondylar fracture humerus with inter condylar extension treated surgically with dual plating which were admitted to Jaya Aarogya Hospital & Trauma Center, Gwalior, Madhya Pradesh, between 2015 to 2016. All the patients of supra condylar fracture distal humerus with age between 18 to 60 years with medical fitness for surgery were included in the study. Results:The mean age of the patient was 40±2 years, 12(60%) cases were males, and 8(40%) cases were females. Right sided involvement was more frequent in the present study 13(65%) cases. 14(70%) cases sustained fracture due to road traffic accident, 06(30%) cases had a domestic fall. The average duration of surgery was 94±10 mins. The average duration of the radiological union was 14±06 weeks in 12(60%) cases, 15±04 weeks in 5 (25%) cases, 19±05 weeks in 3 (15%) cases. The outcome was calculated using the ASES and DASH scores. The American shoulder and elbow surgeons score showed excellent in 5 (25%) good in 11 (55%) fair in 4(20%) and no poor outcome. Conclusions: For good functional results, precise preoperative planning, adequate surgical approach, anatomical inter fragmentary stabilization, medial-post erolateral plating, and early post-operative physiotherapy help in restoring painless and functional elbow for distal humeral intra-articular fractures. This step-by-step approach results in satisfactory functional results.

Introduction: Extra-articular proximal tibial fractures account for 5-10 % of all tibial shaft fractures and it result from high-velocity trauma. Closed reduction with minimally invasive plating and locked intramedullary nailing have been widely used for treatment of proximal tibia extraarticular fractures. Our pupose is to compare the pros and cons of these two methods. Materials and Methods: 22 patients were included in this study for a period of 2 years. Patients treated with IMN were kept in group A patients treated with percutaneus plating were kept in group B. Standard approach of nailing and plating were used and proper follow up were taken for next upcoming 1 year. Results: Combined average age was 38years. Male were more commonly affected than female (13:8). Majority of fracture were of type A33. Operative time was < 2 hours in both groups. Less blood loss occurred during intramedullary nailing as compared to locking plate fixation. Surgical site infections (SSIs) were seen in two patients in the PTP group. Delayed union occurred in two patients in the IMN group. The average range of motion was 119.7(range 90-150, SD= 19.18) in group A and 115.2(range 80-150, SD = 17.28) in group B. Conclusion:In treatment of proximal tibia extra articular fracture use of IMN and PTLCP gives comparable results. To validate this issue further a large sample size multicentric study is recommended.

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