Introduction: Infected non-union is rare in pediatric patients. Various methods have been described in the literature to manage such cases. We present a familiar and simple technique to treat a non-union in pediatric population. Case Presentation: A 4-year-old boy came to us with a right-sided proximal forearm swelling and tenderness. Clinical and radiological features suggestive of osteomyelitis of ulna with a history of the right-sided forearm cellulitis when he was 4 months of age which was managed with incision and drainage at that time. The patient underwent surgery for surgical debridement with drilling of ulnar cortex for pus evacuation. Postoperatively, the patient developed a stress fracture at drilling site which eventually went into a non-union. In second surgery, bony union achieved with the help of non-vascularized fibular strut graft and iliac cancellous graft. Conclusion: There are numerous complications of osteomyelitis in pediatric patients and their management has been previously highlighted throughout literature. Here, we present a rare occurrence case report highlighting management of pediatric atrophic infected gap non-union of ulna by non-vascularized fibula strut stabilized by Titanium Elastic nail which offers a simple yet an elegant solution in a low-cost setting with complete bony union and restoration of function.

Introduction: Fractures with vascular injuries are often complicated with risk to limb survival and life. To quantify the severity of trauma and determine salvageability of the limb many numerical guidelines are available. Current study aims to assess salvageability of a limb with vascular injury at admission by using GHOISS and MESS score and determine correlation between them. A total of 50 patients Materials And Methods: with type IIIB with vascular injury were taken into study over a period of 18 months. Decision regarding limb salvage or amputation was taken by team of experienced orthopaedic and plastic surgeons and informed consent of patients were taken. Another study team independently calculated the GHOISS & MESS score of each patient and sensitivity, specicity ,PPV and NPV of each score were calculated. Both scores were compared using ROC(receiver operating characteristic) curve and Area under the curve. The sens Results: itivity and specicity of GHOISS were calculated as 61.90% and 100% respectively. . The sensitivity and specicity of MESS Score were calculated at 96.30% and 78.30% respectively. Conclusion: The GHOISS is more specic for amputation compared to MESS score. While MESS score has more sensitivity compared to GHOISS. GHOISS is better than MESS for predicting salvageability for open fractures. But score at which decision of salvage is determined needs further verication by multicentric study with larger population.

Background: Femoral neck fractures are commonly seen in elderly people. Hemiarthroplasty remains the most common modality of treatment with bipolar prosthesis, which claimed to have a lower incidence of complications. Hence the present study was undertaken to evaluate the functional outcome of intracapsular fracture of femoral neck with cemented or uncemented bipolar prosthesis in elderly Indian population. Method: Total 43 elderly patients were enrolled and operated after being put into lateral decubitus position by the lateral approach or posterior approach of Moore. Modied harris hip score (HHS) was used for analysis of functional outcome, X ray for radiological and patients' pain was assessed by VAS scoring and nally all three parameters compiled and analyzed. Results: The mean age of patients was 68.58 years. Majority of patients had Garden grade III (62.79%) and right sided hip fractures (72.09%). Most of the patients were managed using cemented prosthesis (74.41%) with 45mm prostheses (44.18%). On immediate post-operative assessment, 39 of the 43 patients had fair outcome. At 6 and 12 weeks, 36 and 39 patients respectively had good outcome by HHS. At 6-month follow-up, 30 patients had good outcome while 11 patients had excellent outcome and one patient was died. There was signicant decrease in the VAS score till 6-month follow-up. 40 of the 43 patients had a stable stem xation while 3 patients showed signs of unstable xation. Conclusion: Patient with fractures of the femoral neck get more pain free interval and more rapid return to unassisted activity after bipolar hemiarthroplasty with an acceptable complication rate.

Intro- For TKA, there are two types of bearing designs: xed-bearing and mobile-bearing. Round femoral components articulate with a relatively at tibial articular surface in a xed-bearing knee design. Because the insert does not hinder the natural movements of the femoral component, the mobile-bearing (MB) TKA design is thought to allow more exibility of motion than the xed-bearing (FB) variety. Aim and objective: To compare xed bearing and mobile bearing total knee arthroplasty. Material and methods:This study is a prospective type of study done at Seth GS medical college Mumbai, Department of Orthopaedics during August 2019 to June 2021 on patients undergoing total knee arthroplasty. Patients who were to undergo total knee arthroplasty were invited to take part in the study. This study, done on them was explained in detail to them. An informed consent was obtained. Patients fullling the inclusion criteria were listed. Result: Range of motion achieved after mobile arthroplasty was 123.62±2.94 and in xed arthroplasty it was 121.96±2.74. Pain after last follow up in mobile arthroplasty was 48.83±0.62 and for xed arthroplasty was 47.39±0.86. Flexion gap after last follow up in mobile arthroplasty was 24.13±0.45 and in xed was 24.02±0.45. Stability was almost similar in both mobile and xed arthroplasty. Conclusions: there is no signicant difference between xed arthroplasty and mobile arthroplasty as far as Range of motion, Pain ,Flexion gap. Stability was almost similar in both mobile and xed arthroplasty.

Background: Trauma is one of the leading cause of acetabular fractures, which are becoming more common in developing nations. The treatment of displaced acetabular fractures is a difcult challenge for the orthopedic surgeon. The current study objective was to look at the functional and radiological outcomes of operated acetabular fractures. From 2018 to 2019, we retrospect Methods: ively reviewed the medical records of patients who had operatively treated acetabular fractures at a Tertiary Care Centre and had at least a one-year follow-up. The research was completed by 47 patients in total. The key objectives were functional and radiographic outcomes, as well as complications. The mean age of patients was Results: 40.06±11.84 years with male predominance (82.97%) and road trafc accident was the main reason of fracture (72.34%). The most prevalent acetabulum fracture pattern was left posterior wall (17.02%) and right both column (17.02%). The mean duration before surgery was 8.02±4.84 days. Most common post-operative complication was arthritis seen in 5(10.63%) cases followed by infection 3(6.38%). Radiological outcome was poorly xed in 7(14.90%) patients and well-xed in 40(85.10%) patients at the end of one year. In 53.19% cases Harris Hip Score was excellent followed by good in 29.79% cases. 3(6.38%) patients required secondary surgery. There was signicant association of functional outcome and duration of surgery as per Chi-Square test (p<0.05). Results suggest that operative outcome Conclusion: of acetabular fractures is reliable if judicious operative decision taken at the earliest. Anatomical to fair reduction can give excellent clinical result in these fractures. On follow up, radiological outcomes correlated well with clinical condition of the patient.