Background: The incidence of femoral neck fractures, one of the most common traumatic injuries in the elderly increases continuously due to the ageing of population on the planet and urbanization. Aims and Objective of the Study: To study the incidence of intracapsular femoral neck fractures in the elderly population with respect to age, sex, occupation, fracture type and laterality of injury. Materials and Methods: The prospective study included 30 patients with intracapsular femoral neck fractures referred to the Department of Orthopaedics, Ashwini Hospital, Gulbarga were selected for this study. Patients with intracapsular femoral neck fractures and aged above 55 years were considered. Patients were briefed about the nature of the study, the interventions used and written, informed consent was obtained. Further, descriptive data of the participants like name, age, sex, detailed history, were obtained by interviewing the participants and clinical examination and necessary investigations were recorded on predesigned and pretested proforma. Results: Majority of the patients (seven patients, 23.33%) were in the age group between 71 to 75 years and five patients, (16.67%) each were in the age groups of 55 to 60 years, 76 to 80 years and above 80 years. In the present study, out of the 30 patients there 18 were female accounting to 60% and 12 male patients making up the remaining 40%. The average interval between admission to the hospital and surgery was 3.6 days with a range of 01 to 17days. The average duration of hospital stay was 13.3 days with a range of 7 to 26 days. The duration of hospital stay is less in our series as the patients were mobilized early. Out of 18 female patients 14 females were house wives. Three were retired from job, and one was self-employed. Among the males, seven were retired from their jobs, four males were businessman and one male patient was self-employed. Majority of the fractures occurred due to fall in bathroom (56.67%) and fall in living room (30%). Right side involvement was more commonly seen than the Left in this study group. Right side was involved in twenty patients making up for 66.67% of the fractures and the left was involved in ten patients accounting for 33.33% of the fractures. Out of the 30 fractures, majority were type IV fractures (23 patients) accounting for 76.7%. Remaining 23.3% (07 patients) were type III fractures. Conclusion: In conclusion, hip fractures are a serious injury in the elderly population. There is a very mortality rate and morbidity rate following hip fractures in the elderly. Once diagnosis has been made, appropriate stabilization of the patient from a medical standpoint and rapid operative fixation of the fracture or prosthetic replacement helps patients obtain a better functional result. Adequate rehabilitation in an inpatient setting, as well as at the patient's home with home health is an important adjunct to an overall successful outcome.

Background: Conservative treatment for Proximal humeral fractures were common in the past and often had compromised functional results. With the advancement of surgical techniques, proximal humerus fractures are now more often managed operatively for early rehabilitation and better functional outcome. The aim of this study was to assess the functional outcome of PHILOS plate fixation in proximal humerus fractures. Materials and Methods: A prospective, non-controlled, non-randomized study was conducted on patient admitted in our institution between July 2016 and August 2017 with displaced proximal humeral fractures with mean age of 50 years (range 24-75years). 15 patients were selected for the study. The outcome was assessed based on Constant-Murley score. Results: Results were analysed according to Constant-Murley score. Excellent results were achieved in 3 (20%), good results in 7 (46.66%), fair results in 3 (20%) and poor result in 2 (13.33%) of the cases. Avascular necrosis (AVN) and non-union was observed in one patient. Conclusion: PHILOS plate fixation for proximal humeral fracture is a good stable fixation with a good functional outcome especially in osteopenic elderly patients

Fracture neck of femur has always attracted the mankind due to its peculiar nature of going into non union and osteonecrosis of femoral head even with best fixation method and adequate reduction. A novel way to treat fracture neck of femur is with small diameter dynamic hip screw and an additional derotation screw. 30 patients aged 18-60 years presenting to Deen Dayal Upadhyay Hospital with fresh (<3 weeks old) fracture neck of femur were randomized into two groups and were treated with two different modalities of fixation: Small diameter sliding hip screw and plate with an additional derotation screw (Mini DHS group) and three cannulated cancellous screws in an inverted triangle configuration (CCS group). Intraoperative duration of surgery and blood loss was noted. All the patients were followed up for a minimum period of 12 months. The clinical outcomes were evaluated using UCLA score. Postoperative radiographs were used to look for evidence of union, loss of the alignment of the fracture, trabecular continuity at fracture line, late segmental collapse and the presence of avascular necrosis. Between group comparisons were performed using chi square test and Student's T test. Conclusion: Small diameter dynamic hip screw with an additional derotation screw is a good method to treat fracture neck of femur with increased incidence of union and less complications.

Closed Interlocking intramedullary nail is now the standard in the treatment of tibial shaft fractures however use of image intensifier precludes its common use in developing countries. This study was done to evaluate the outcome of open interlocking nailing under heading of fracture union, early mobilisation and early functional return of the limb and complication. We retrospectively reviewed 36 patients with Fracture shaft of tibia treated with open interlocking nailing. All fractures were simple transverse, short oblique. Serial follow up assessment was done for radiological and clinical union. Major complications encountered were infection. It was concluded that open interlocking nailing is a safe procedure for tibial shaft fractures, in the developing worlds with good functional and clinical results in the following situations: in hospitals with no image intensifier, in irreducible fractures and in female patients with pregnancy.

Treatment of distal third tibia and fibula fractures remains a challenge classically being treated with standard plating, but intramedullary nailing has gained popularity. As there is a mismatch between the diameters of the nail and the medullary canal, with no nail-cortex contact, the nail may translate laterally along coronally placed locking screws and increased stress in placed on the locking holes to maintain fracture alignment after surgery. Various techniques have been recommended to improve nailing in these fractures including fibular plating (distal third fractures), temporary unicortical plating, different nail design with different proximal bends (proximal third fractures) and blocking screws (poller screws). The aim of the study is to evaluate the clinical use of fibular plating as a supplement to stability in addition to intramedullary nailing in distal both bone fractures of leg. Methods: A prospective study of 20 cases of distal third tibia fibula fractures treated with statically locked intra medullary nailing with supplementary fibular plating between March 2017 and September 2018 at RIMS, Ranchi. All the fractures were followed through till union of fracture with clinical and radiological examination at intervals of 4 to 6 weeks. On follow up axial alignment was assessed and functional analysis was quantified using Karlstorm -Olerud score. Complications were divided into those which were related to fibular plate and those which were not. Results: All the fractures eventually united in a mean period of 12.8 weeks. Karlstrom-Olerud score was excellent in 12 fractures (60%), good in 5 patients (25%) and fair in 2 patients (10%) and poor in 1 patient (5%).The alignment was maintained in coronal plane till union with the mean remaining the same i.e 1.6 degrees. The mean sagital plane alignment at the time of union was 0.4 degrees, the loss of alignment was not statistically significant. The fibular plate related complications were encountered in two cases where we had skin necrosis and deep infection, which needed aggressive antibiotic therapy and those patients were also given cast support for twelve weeks. Conclusion: Fibular plating, when supplemented the intramedullary nailing of distal third tibia fibula fractures, were effective in achieving the fracture alignment especially in fresh fractures, Improves not only angular stability but also rotational stability, Maintained the fracture alignment till union and prevents loss of initial reduction.