Background: Intracapsular fractures of the neck of femur are a major cause of morbidity and mortality in elderly population in India. The primary goal of treatment in these patients is to get the patients to the preinjury level of functionality as early as possible and with minimal complications. Multiple modes of operative treatment in the form of fixation devices (screws, plates, nails) and replacement (hemi or total replacement) are available for this fracture. However, a high rate of complications and revision surgeries has been found after internal fixation in this population group owing to the unique challenges to fixation in the form of co morbidities and osteoporosis among others. Instead of internal fixation, replacement is thus a viable option. Materials and Methods: 100 patients (age >65 years) with a femoral neck fracture were treated over a two-year period (May 2018 to April 2020) with some form of hip replacement after appropriate anesthetic fitness. Results: We had good results in majority of the patients in terms of return to pre-fracture level of functionality, independent ambulation and satisfaction with the results. A majority of patients treated with hemiarthroplasty recovered without incidence while all patients of total hip replacement progressed without incidence. There were 10 cases of suture line infection which recovered satisfactorily with a change of antibiotics, 4 cases of deep infection for which debridement and implant removal was required, 3 cases of deep vein thrombosis and 7 cases of dislocation. Conclusion: Hip replacement is a viable option for treatment of femoral neck fractures in patients more than 65 years of age. Return to preinjury level of functionality is pretty satisfying and early if the patient is actively mobilized as early as possible postoperatively. There are no risks of nonunion, malunion and implant related complications as compared to internal fixation devices.

<p><strong>Background:</strong> Degenerative lumbar canal stenosis remains an important public health problem in today’s date. With the overall average age of the world’s population rising steadily it is important to have an optimal treatment plan affordable to the masses. Non-instrumented fusion after decompression remains an important treatment option which is affordable to the masses and effectively treats the instability occurring due to degeneration process. This study aims to understand the results of such treatment in a tertiary care center catering to the masses.</p><p><strong>Methods: </strong>The study was conducted in 34 patients with diagnosed degenerative lumbar canal stenosis with neurogenic claudication who underwent decompressive laminectomy with a posterolateral strut graft posterolateral fusion from July 2018 to August 2020. Each patient was followed up for 12 months.</p><p><strong>Results: </strong>In the present study, a total of 34 patients with degenerative lumbar canal stenosis with neurogenic claudication were included. There were 18 male and 16 female patients. The pre-operative Swiss spinal stenosis Score was 61-80 (52.9%) and these scores improved to a majority of patients in the category of 21-40 (82.4%) at 1 year postoperatively. The average VAS score was 4.7±1.8 preoperatively while the average post op VAS score was 0.8±0.77.</p><p><strong>Conclusions: </strong>Non-instrumented fusion of the vertebrae with decompression has significantly improved results at 1 year follow up postoperatively and it is an excellent easy and cost-effective technique if used in a properly selected patient. Further studies are required to assess its long-term results.</p>

<p class="abstract"><strong>Background:</strong> Different treatment methods were tried with variable success rates but Ponseti method of serial casting and manipulation stood apart due to better understanding of foot biomechanics and became accepted choice of treatment worldwide.</p><p class="abstract"><strong>Methods:</strong> 50 patients were enrolled in the study out of which 40 were available for final follow-up. We studied 40 cases during October 2018 to December 2020 at Government Medical College, Aurangabad. Out of 40 cases 31 were male and 9 were female. 25 were unilateral and 15 were bilateral. All cases were idiopathic. 4 inches Plaster of Paris (POP) bandages were cut into half and such 2 inches POP bandages were used for casting. Tenotomies were performed under controlled environment of Operation Theater with general anaesthesia. Number 12 surgical blade was used. Dennis-Browne splint was used for maintenance of correction.<strong></strong></p><p class="abstract"><strong>Results:</strong> Out of total 55 feet studied, 10 feet (18.18%) required tendo Achilles tenotomy and 45 feet (81.82%) were treated with casting alone. There were 8 cases of relapses (20%). All relapsed cases were treated with repeat casting as per Ponseti protocol and none of them required repeat tenotomy. Complications related to plaster were minimal and there were no incidence of rocker bottom deformity.</p><p class="abstract"><strong>Conclusions:</strong> We conclude that in a low income developing country like India where case load is very high; Ponseti method is effective, inexpensive form of treatment with minimal complications. Need for extensive soft tissue procedures vastly reduced with this method.</p>