Detachment of hamstring tendons from their tibial insertion is unnecessary and our results with accelerated rehabilitation without protective braces are satisfactory and comparable to other studies.

Objective: To compare effect of meniscus repair and meniscectomy in patients undergoing ACL reconstruction in terms of clinical instability and radiological tunnel widening 1 year after surgery. Introduction: Meniscectomy has been shown to have detrimental effects on knee in terms of increased contact pressure in femoral and tibial condyles, rotary instability and early changes of osteoarthritis. These changes are exaggerated in ACL deficient knees. Patients present to the surgeon at different times after injury ranging from 3 weeks to one year. Depending upon status of meniscal tears and its reparability at the time of surgery, surgeon has to choose between meniscectomy and meniscus repair during ACL reconstruction. We tried to compare meniscus repair and meniscectomy in terms of knee stability and radiological tunnel widening after ACL reconstruction in short term follow up. Methodology: 30 patients who underwent ACL reconstruction were selected after going through selection criteria, were divided between meniscus repair group and meniscus excision group. Meniscus tears, which were in the red red zone were repaired with inside out, all inside and outside in methods, depending upon their location from anterior to posterior zones. Those tears which presented late were irreducible, avascular and became loose body scuffing articular cartilage, were excised with shaver. All patients underwent standard ACL reconstruction with hamstring graft. Patients were evaluated clinically and radiologically at 3 months 6 months and 12 months. Results: Group 1 had 14 patients who underwent meniscus repair and group 2 had 16 patients who underwent meniscectomy during ACL reconstruction. Evaluation with Lachman's test showed that, 14% patients (2 out of 14) from Group 1 had grade 2 Lachman test. Thirty seven % of group 2 had grade 2 Lachman test though the difference was not significant (p = 0.151). Tibial tunnel diameter in meniscectomy group increased from 8 mm to 11.86mm (S.D= 1.11.) at 12 months. Tibial diameter in group 2 increased from 8 mm to 12.28 mm (S.D. = 1.52), (p= 0.394). Conclusion: Whenever ACL tear is associated with medial or lateral meniscal tears, meniscal repair is the preferred treatment over meniscectomy. The amount of tunnel widening is higher when meniscus is excised as compared to meniscal repair. The anterior tibial translation remains higher when meniscus is excised during ACL reconstruction, though short term functional results are same.

Background: Calcaneum fractures account for approximately 2% of all fractures, with displaced intra-articular fractures comprising 60-75% of these injuries of which 10% have associated spine fractures and 26% are associated with other extremity injuries. Several authors have reported that patients may be totally incapacitated for up to 3 years and partially impaired for up to 5 years post injury, Although modern surgical techniques have improved the outcome, controversy still exists regarding classification, treatment, operative technique, and post-operative management. Materials and Methods: 28 out of 31 cases were analyzed prospectively and retrospectively from July 2011 to August 2013 after local ethical and scientific clearance. Three patients had lost to follow-up. All patients with calcaneum fractures above age of 18 with either simple or open injuries were included in the study, excluding pediatric and complex injuries. All patients were clinically evaluated and Bohler’s, Gissane’s angles were calculated preoperatively. All patients were treated with one of the modalities, which include conservative, Steinmann pinning, and Calcaneum plate fixation. All patients were followed up in outpatient basis fortnightly for 3 months and on 6th month and 1 year respectively, to check signs of union of fracture, subtalar movements, and complications if any. After radiological evaluation, functional outcome assessment was done using American Orthopaedic Foot and Ankle Society Results: Mean age was 35.1 with range 20-52 years, male to female ratio of 9:1. 85% were due to high-velocity trauma. The most common type of injury was tongue type. Preoperative mean Bohler’s and Gissane’s angles which were about 14.87 and 121.5 degrees respectively, the improved angles postoperatively were 25.68 and 104.37 degrees. One patient had heel pain, one patient had residual edema, one patient developed subtalar and ankle stiffness, there was one case of tendocalcaneus weakness, one with broadening of heel, and one case of wound infection. Conclusion: Undisplaced or minimally displaced calcaneum fractures are best-treated conservatively with cast immobilization for 6 weeks. Essex-Lopresti technique of reduction was superior technique for displaced fractures and achievement of Bohler’s and Gissane’s angle to the after reduction was judgemental for optimal functional outcome. Keywords: Calcaneum, Essex-Lopresti, functional outcome.