Talus with its unique anatomy and function predisposes it to un4common but serious injuries, usually due to high energy trauma. obtaining satisfactory clinical results, while avoiding complications, presents a unique challenge in the treatment of talar fractures, especially of talar neck as it also remains controversial the requirement of emergency treatment in these fractures. Despite of all excellent management, nonunion rate in type 3 and type 4 Hawkins fracture was found to be 5% and AVN of body of talus was found to be 25% types 2,3,4 were associated with talar body dislocation which caused excessive pressure on soft tissues causing significant soft tissue complications. We retrospectively reviewed 25 patients with talar ractures treated operatively with an average follow up period of 1 year. Displaced talar fractures was a therapeutic challenge which had early and late complication

Introduction: Proximal humerus fractures are commonly encountered fractures in general orthopaedic practices around 6% of fractures of humerus fractures. Material and Method: The present study had 40 cases of proximal humerus fracture treated by PHILLOS plate. This prospective study was conducted in the department of orthopedics at a tertiary care centre, Krishna hospital and research centre karad from May 2017 to November 2019 Observation: The most common complications included varus malunion the occurrence of which was 12.5%, AVN 5%, screw perforation of the humeral head into the joint 10% and infection 2.5% Results: The study shows 20% excellent, 60% good, 15% satisfactory and 5% poor results on Constant Murley Score. Conclusion: PHILOS plate holds the key to stabilization of proximal humerus fracture.

Fractures around the hip joint in the elderly is a major health concern with respect to perioperative and post operative morbidity, especially in the 1-year postoperative period. The prospective and retrospective study was carried out at Krishna Institute of Medical Sciences, Karad, over a period of 1 year. Various comorbidities play a detrimental role in the postoperative outcome of these fractures. 100 patients of the gediatric age group with fracture around the hip joint were studied and followed for about a year to assess 1-year morbidity. An attempt is made to categorize all the comorbidities and create a Comorbidity Index. The Predictors included in the Comorbidity Index are age, pre-fracture mobility, anaemia, gender, diabetes mellitus, hypertension, ischemic heart disease, renal disease, dementia, alcohol dependence, tobacco chewing, serum protein levels, previous surgeries, stroke, antiplatelet drug intake, duration between operation and death and cause of death. The outcome of the Comorbidity Index determines the deceased patients had an average of 13.73 Comorbidity Index Score, whereas the non-deceased patients had an average of 4.95 Comorbidity Index Score. This score can also be helpful in providing counselling to the patient and the patient's relative  about the patient's outcome for surgery. This score will also prove useful in reducing medico-legal complications and will be documented and explained to the patient's relatives.

The posture on the two wheeler at the speed we travel, makes knee the vulnerable joint of all in any of the mishaps. We as orthopedic surgeons see the fractures around the knee joint as one of the most studied concept in the subject. This is a prospective study conducted, over 2 years, in Krishna Institute of Medical Sciences, Deemed to be University, Karad. In this study, 20 cases of fracture distal femur and 20 cases of ipsilateral fracture femur and tibia were studied to evaluate outcome of knee joint and post surgical stabilization of fractures. The fractured limb was stabilized with splinting the limb in Thomas splint or plaster slab. The type of fracture, type of fracture fixation, duration of hospital stay, time of union and time to start weight bearing are evaluated. According to Neer’s score, Good outcome was found in both Fracture Distal femur and Ipsilateral Fracture Femur and tibia. The functional outcome was found to be better in diaphyseal fractures femur and tibia treated with intramedullary interlock nailing which allowed early mobilization and weight bearing than in intra-articular fractures treated with plating. Bony union occurred early in closed, diaphyseal and simple transverse or oblique fractures and delayed in open, intraarticular and comminuted fractures.

Introduction: Role of epidural analgesia is well established in the literature and practice. Epidural anaesthesia is a very common procedure of anaesthesia for induction of lower limb orthopaedic cases. Considering the intra-articular fractures of the knee, they are one of the most common fractures associated with knee stiffness. Even after an adequate and rigid fracture fixation early rehabilitation is necessary to drastically improve the outcome and reduce stiffness. Hence, epidural analgesia through a lumbar epidural catheter is the most commonly used protocol in top up after surgery for post-operative analgesia. The aim of this study is to evaluate whether this method of post-operative analgesia can be helpful in improving rehabilitation after peri-articular knee injuries. Methodology: This is a prospective study. A total of 40 patients with peri-articular of distal femur and proximal tibia were included in the study. Patients were randomised into 2 groups. Group A was given spinal anaesthesia for surgery and Group B was given combined spinal plus epidural anaesthesia with a lumbar epidural catheter. Site chosen was L1-L2 /L2-L3 for epidural analgesia and site for spinal analgesia was L3-L4 was used (in case of combined spinal epidural).Post operatively knee ROM was initiated on day 1 in both the groups. Total knee ROM was recorded on Day 2, Day 10, Day 42 (6 weeks) and Day 90 (3 months). Assessment of knee ROM was done by a single observer who was blinded for the groups. Results: A total of 40 patients were included in this study, out of which 9 were female and 31 were males. Mean knee range of motion for group A was 20 degrees on day 2, 45 degrees at Day 10, 90 degrees at 6 weeks and 120 degrees at 3 months whereas the mean knee range of motion for group B was 40 degrees on day 2, 70 degrees at Day 10, 110 degrees at 6 weeks and 130 degrees at 3 months. Conclusion: Peri-articular knee fractures are a common cause of limitation in knee function despite proper surgery which can be due to inadequate rehabilitation. To address this problem, it is important to give a pain-free post-operative period to the patient to develop and initiate proper post-operative rehabilitation. This can be achieved by performing peri-articular fracture fixations using Epidural anaesthesia through which post-operative analgesia can be continued in a more effective manner which also increases overall outcome of the patient.