Background: Most of lower leg external fixation are bulky and cumbersome and provides only temporary bony stabilization. Anatomically pre-contoured supracutaneous LCP has been utilized by many authors as an external fixator in patients with metaphyseal and diaphyseal fractures of tibia. Aim: The aim of this study is to analyse the end result of Supracutaneous LCP as a definitive external fixation and its effect on rate of union in metaphyseal and diaphyseal fractures. Materials and methods: A complete of 30 patients of compound fractures of tibia underwent "supracutaneous plating" of the tibia using an LCP. Average age was 44 years. Regular screw tract dressings were done. Average period of follow-up was 13 months. Results: The plate was kept ex situ for a period of 24-30 weeks. Proximal metaphysis, diaphysis and distal metaphysis united in 14 weeks, 20 weeks and 16 weeks respectively. Total of 30 patients were operated for Supracutaneous LCP of which one complicated with Infected Non-union resulting in implant removal and other complicated with Non-union which later underwent internal fixation. Conclusion: In compound fractures of tibia supracutaneous LCP are often used as a definitive external fixator because it gives good results especially for metaphyseal fractures and fewer complication rates, with Adequate stability. Advantageous effect of LCP in facilitating wound healing, cosmetic surgery procedure. Because it does not strike the contralateral leg therefore cosmetically acceptable and functional while ambulation. Because of nonoverlapping of implants fracture healing is easily assessed on x rays.

Introduction: Anterior and posterior portals used for ankle arthroscopy but anterior portals are safer, provide good access and visualisation of joint. Aims: The anatomical structures nearby portals are vulnerable to injury during surgery. To study the anatomy of ankle joint using dissection method. Methods and material: 20 cadaveric limbs were dissected and the distance of different portals to the nearby neurovascular structures was measured. Results: The mean distance from anteromedial portal to the great saphenous vein and saphenous nerve was 5.28 mm, 9.12mm and that between the medial midline portal to the dorsalis pedis artery and deep peroneal nerve was 10.08 mm and 16.20mm. The mean distance from anterocentral portal to the dorsalis pedis artery was 2.38mm, to superficial peroneal nerve was 7.09mm and deep peroneal nerve was 4.12mm. The mean distance from anterolateral portal to lateral branch of superficial peroneal nerve was 3.18mm. There was injury in one specimen. Conclusions: This present study concluded that medial midline portal is comparatively safe for ankle arthroscopy. Anterocentral portal has potential risk of injury to dorsalis pedis artery.

Background: Fractures of the distal end radius represent the most common upper extremity fracture. Distal end radius Fractures are recognized as very complex injuries with a variable prognosis. This type of fracture usually results from low Energy trauma in the elderly with low functional demand. Method: The present study patient with age 20 to 65 years included 90 cases of both extra articular and intraarticular distal end radius fracture treated with closed reduction and cast and closed reduction with K wire xation+ cast, it is a prospective study conducted at Gandhi medical college& associated Hamidia Hospital Bhopal between 2018 - 2020. Results: The most common mode of injury was fall on outstretched hand (65%), with male preponderance ( 60%) and right side more common in both the group. The average age in both the group was 45.90±10.16 year most common population in our study is 41.1% of age group 41-50 year. According to AO classication fracture type 2R3A2 is involved in 74.4% of the patients. Complications was higher in closed reduction with cast group. According to modied Gartland and werley scoring system results was in closed reduction with casting group3 patient had excellent ,9 patient had good , 28 patient had Fair and 5 patient had poor results. In closed reduction with percutaneous K Wire and casting group 7 patient had excellent , 19 patient had good , 15 patient had fair and 4 patient had poor results. Conclusions: Percutaneous Kirschner wire pinning is a minimally invasive technique that provides an effective means of Maintaining the anatomical fracture reduction. It does not required highly skilled personnel or sophisticated tools for Application. It is a suitable method for xation of displaced distal end radius fracture with minimal intra-articular Involvement. Hence we concluded that closed reduction with K-wire with cast was less complications and had better functionally as well as radiological outcome

Background-Most of distal humerus fractures are dealt with olecranon osteotomy approach which stand as cumbersome process resulting in excessive soft tissue damage and excess hardware interposition. Alternate paratricepital two window approach has been advocated by many authors as better approach to deal with AO type A, B, and C1 type distal humerus fractures. AIM -To evaluate functional outcome of distal humerus fracture xation through paratricepital two window approach Materials & Methods – A complete of 30 patients of closed fracture distal humerus fracture underwent open fracture xation through paratricepital approach. Average age of patient was 35yr .Regular follow up and physiotherapy sessions were carried out. Average period of follow up was 12 month. Results – Out of 30 patients 28 were nally followed up till 1 year, one patient died in between while another one undergoes implant removal due to infection. From 28, 20 patients has excellent functional outcome, 3 has good, 4 has fair outcome and one patient has poor results in terms of MEPS and DASH score. Conclusion – Based on present study and data analysis we conclude that distal humerus fracture treated through paratricepital two window approach results in excellent functional outcome which is evident from ability to early start various day to day to day activities like performing st nd personal hygiene, combing hairs ,putting shirt- shoes themselves and starts eating themselves by 1 or 2 week of surgery .Unlike traditional approach like Olecranon osteotomy , it maintains adequate Tricep extensor mechanism ,does minimal soft tissue damage ,minimal post op pain ,promote early wound healing and avoid excessive hardware transposition