Idiopathic clubfoot or congenital talipes equinovarus is the commonest congenital foot deformities having 1 in every 1000 children born worldwide. Around 80% of the cases occur in developing nations. It remains the most difficult to treat. The most widely used treatment is the Ponseti method of manipulation and serial plaster followed by an Achilles tenotomy. This method is effective in 90% of all cases. The objective of this study was to evaluate the outcomes of the Ponseti manipulation and casting method in the management of idiopathic clubfoot. This is a prospective study of 80 feet in 52 children treated by the Ponseti method in the department of Orthopedics, Rajendra Institute of Medical Sciences (RIMS), Ranchi, and Jharkhand. Evaluation of the deformity was done by Pirani score before and after the treatment and the results were assessed. The average number of castings used to correct the deformity was 6.5 times (range: 4 to 12). Tenotomy was performed in 66 (82.5%) of the feet. In all patients, plantigrade foot was achieved. The patients with bilateral clubfeet, higher Pirani score and higher age had inferior final outcome compared to those with unilateral clubfoot, lower Pirani score and lower age. 11 (13.75%) feet had skin excoriation secondary to cast problems and four patients had pain and tenderness at the site of the tenotomy. Recurrence was seen in three cases. 90.38% of parents were completely satisfied with their child's gait and foot appearance.

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.

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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.