The hip allows mobility of the entire extremity in 3 planes. Therefore any little derangement in the anatomy of the hip can affect it's functioning and can cripple & severely affect daily living of the person. The most common causes of disability are trauma and degenerative disease, and till date the most successful2 treatment for joints severely damaged has been replacement by artificial parts. Today replacement arthroplasties are very commonly performed by orthopedic surgeons the world over. In India too this procedure has gained wide acceptance among both surgeons and patients. The primary goal of this procedure is to restore normal anatomy of the hip joint so as to provide painless free mobility with a stable hip, and immediate functional outcomes of this procedure are very satisfactory. Technically there is little debate that the results of revision procedure are less satisfactory and the primary THR offers the best chances of success. Therefore it would be rational to assess and eliminate the human/iatrogenic factors that would-be influencing and jeopardizing the longevity of the implant since such surgeries in Indian patients are mostly once in a lifetime job. Also since the indications of arthroplasty have expanded and more surgeries are being done, so there is a statistic increase in the percentage of loose implants, which ever the reason. Although definite evidence and impact of loosing manifests late but the parameters reflecting the causative factors can be detected early in the form of altered anatomy and function. And repetitive cyclical loading of the implant in an unfavorable mechanical environment will over time, ultimately build up to a negative result.

Background: In Colles' fracture closed reduction and POP cast application has been the mainstay of treatment, difficulty lies in predicting and maintaining the proper reduction due to dorsal communition of fracture. Percutaneous K-wire stabilization is also a widely accepted treatment option for continued maintenance of reduction till fracture union. But there is no consensus on its outcome in comparison to closed reduction and cast application. Objectives: To evaluate the results of closed reduction and cast application vs closed reduction with percutaneous K-Wire fixation in the treatment of the distal radius extra-articular fractures. Materials and methods:The study was conducted on 60 patients from September 2017 to April 2019 with extra-articular fractures of distal radius. The cases were randomly divided into two equal groups of 30 patients, group A and B, the first group treated by closed reduction and below elbow cast,while the second group were treated by closed reduction percutaneous K-wire application. The results of both groups were evaluated radiologically and functionally as per our protocol. Results: At 6 months postoperatively, according to Gartland and Werley, Group A we had 13(43%) excellent results, 9(30%) good results, 7(23%) fair results and 1(3%) poor results. In group B, 11(36%) excellent results, 13(43%) good results, 5 (16%) fair results and 1(3%) poor results. Our study demonstrates that there is no significant difference in the functional outcome obtained with closed reduction and cast versus closed reduction, K-wire fixation and cast. However, K-wire fixation plays a role in maintaining post-operative reduction and to achieve near normal anatomical union. Conclusion:Colles' fracture treated by percutaneous K-wire fixation along with below elbow cast provided additional stability and good radiological outcome in comparison to patients treated with closed reduction and below elbow cast alone. However, closed reduction and cast application alone gives same functional outcome as K-wire fixation.

Fractures of the tibial shaft are important for the reason that they are common and controversial. The exposed anatomical location of the tibia makes it vulnerable to the direct blow and high energy trauma as a result of motor vehicle accidents, thus resulting in comminuted fractures, which are frequently open with significant loss of skin and soft tissues. Because of the high prevalence of complications associated with these fractures, management often is difficult and the optimum method of treatment remains a subject of controversy. MATERIALS AND METHODSWe aim to study all the cases with diaphyseal fractures of tibia in adults. We also wanted to study clinically and radiologically the incidence, causes, types and various types of management of diaphyseal fractures of tibia with special emphasis on Ender nailing. Finally, we compared our results of cases managed by different treatment methods. CONCLUSIONOut of the various treatment modalities, in our experience surgical management of diaphyseal tibia fractures has better functional outcomes compared to conservative management. The incidence of complications like knee and ankle stiffness and malunion are much lesser in surgical management compared to the patients managed conservatively. Out of the two surgical methods, patients operated with IMIL nails had better function and lesser complications.