Fractures of the eccentrically loaded bones like patella, olecranon and medial malleolus are one of the most common fractures encountered by an orthopaedic surgeon, with better operative techniques, internal fixation of these fractures with tension band wiring has become an accepted mode of treatment with its matching outcome results enabling the patient to smoothly resume his work without hampering his day-today life. Internal fixation of fractures hastens healing and rehabilitation. It also allows for early mobilization of the joint thereby preventing stiffness of joints and other complications related to immobilization. The aim of the study is to prove tension band wiring is a simple, inexpensive technique and effective means of fixing fracture based on biomechanical principle with minimum complications. Fifty cases of fractures were treated with tension band wiring, which comprised of fracture patella 20 cases, fracture olecranon 15 cases and medial malleolus 15 cases. Operated during period of 2013 to 2015. About 96% of fractures had united after 12 weeks. One case of wire migration was noted and superficial infection in one case who was a diabetic patient. In present study, there were 50% excellent, 32% good, 14% fair and 4% poor results.

The purpose of this study was to evaluate the clinical and functional outcome of Uni-condylar Locking Compression Plating for Extra-articular Distal Humeral Shaft Fractures in adults and comparison with other techniques for management of extra-articular distal humerus fractures. Methods: This Prospective Study was carried out in the

Patients commonly present to their general practitioner with swellings of the hand. These include a variety of diagnoses with certain lesions (for example, ganglion) being more common than others. Some may even be familiar as they are often site-specific. This article aims to provide general practitioners with clear and concise information regarding swellings to be ruled out before suspecting giant cell tumor of tendon sheath. Swellings of the hand are commonly encountered in a general practice with different diagnosis. They may arise from any tissue in the hand including skin, subcutaneous fat, muscle, nerves, vessels, tendon, bone and cartilage. Fortunately, most are benign, asymptomatic and may not require surgical intervention. Ganglions, epidermoid inclusion cysts, giant cell tumours of the tendon sheath, and swellings associated with arthropathy comprise the majority of lesion. This study includes 16 cases which are presented with similar history and presentation of finger swellings as that of giant cell tumor tendon sheath but the final diagnosis has varied.

Flexible intramedullary devices such as Ender’s nails are minimally invasive and biologically friendly method of osteosynthesis for transverse, oblique, and short spiral diaphyseal fractures of femur in the immature skeleton. The aim of this study is to compare the clinical outcomes between 2 different fixation, that is,“C-C” and “C-S” constructs in diaphyseal fractures of femur by Enders nailing system. There were 34 patients who were treated with Enders nail for femoral diaphyseal fractures during the year 2010 to 2014 included in this study. Total number of patients were 34 of which 24 of them were fixed in the C-C construct pattern and 10 of them were fixed with the C-S construct pattern that included. All 34 fractures healed with an average time of 8.8±3.8 weeks. Callus was first noted on follow-up radiographs at an average of 3 weeks (range, 2 to 6 wk). Implant removal was done at an average of 9±3 months. The mean operation time was 40.2±15.2 minutes (range, 32 to 100 min). The proportion of patients who experienced any complication did not differ significantly between the C-C (20%) and C-S (26%) construct groups (P>0.05). C-C construct is more stable under torsional loading, whereas C-S construct has greater resistance to axial loading than C-C construct. C-C construct is more stable in treating middle 1/3 and upper 1/3 femur, whereas C-S construct in distal 1/3 femoral diaphyseal fractures.

<p class="abstract"><strong>Background:</strong> Total knee replacement (TKR) is associated with substantial blood loss and thus the need for blood transfusions. Risks and costs of allogenic blood transfusions requires strategies to reduce blood loss in surgery. The objective of this study was to assess the efficacy of tranexamic acid treatment in reducing blood loss and blood transfusion requirements during TKR.</p><p class="abstract"><strong>Methods:</strong> A randomized controlled trial was conducted on 60 patients who were operated for unilateral TKR from January 2016 to January 2019 in Shadan Institute of Medical Sciences. 30 patients were in each control and study groups. In study group 12 mg/kg bolus of tranexamic acid was given as a slow IV dose, 40 minutes before deflation of tourniquet followed by 1.2 mg/kg/hr infusion for 12 hours with standard treatment of hospital and compared to the control group. Later blood loss was compared both intra and post operatively. Fall in haemoglobin after surgery was also compared.<strong></strong></p><p class="abstract"><strong>Results:</strong> Total blood loss in tranexamic acid group was 543.3±184.85<strong> </strong>ml (control group 685.83±176.74 ml) which is statistically significant (p&lt;0.05). Blood loss was markedly decreased in tranexamic acid group (379.16±174 ml in tranexamic acid vs. 513.33±143.89 ml in control group) statistically significant (p&lt;0.05).</p><p class="abstract"><strong>Conclusions:</strong> Tranexamic acid is an effective strategy to reduce blood loss in patients undergoing total knee replacement and thus minimizing the need for blood transfusions.</p>