PurposeLiterature suggests that the lower modulus of elasticity of titanium makes it ideal for use in children compared with stainless steel. Better fracture stability was observed in association with titanium nails on torsional and axial compression testing. However, stainless steel nails are stiffer than titanium counterparts, which may provide a rigid construct when fixing paediatric femoral shaft fractures. Complications have been observed more frequently by various researchers when titanium nails are used for fracture fixation in patients with increasing age or weight. The concept of this study was to compare the functional outcome after internal fixation with titanium elastic nail system and stainless steel elastic nail system in paediatric femoral shaft fractures.MethodsThe study was conducted on 34 patients admitted in the department of orthopaedics, LLRM Medical College & SVBP Hospital, Meerut, India from January 2013 to August 2014. We included patients aged 5–12 years with fracture of the femoral shaft, excluding compound fractures, pathological fractures and other lower limb fractures. Patients were treated by titanium (n = 17) or stainless steel (n = 17) elastic nail system and followed up for one year. The clinical parameters like range of motion at hip and knee joints, time to full weight bearing on the operated limb and radiological parameters like time to union were compared between two groups. A special note was made of intra- and post-operative complications. Functional outcomes were analysed according to Flynn criteria.ResultsBased on the Flynn criteria, 59% of patients had excellent results, 41% had satisfactory results, and no one showed poor results. There was no clinically significant difference between the two groups with respect to time to union and full weight bearing. But the incidence of puncture of the opposite cortex while inserting the nail and trying to advance it through the diaphysis during operation is greatly different. Only one such case was observed in titanium group but five in stainless steel group.ConclusionMajority of paediatric femoral shaft fractures are now treated operatively by elastic stable intramedullary nails. Operative intervention results in a shorter hospital stay and has economic and social benefits over conservative treatment. The cost of stainless steel nail is one third the cost of titanium nail. However, the clinico-radiological results are not significantly different between titanium and stainless steel nails at one year follow-up as observed by our study.

Introduction Platelet-rich plasma (PRP) is promoted now­adays as an ideal autologous biological blood-derived product. It enhances wound healing, bone healing, tendon healing and is currently being widely used. Aims and objectives A prospective cohort study was done to assess the efficacy of autologous PRP injection and to compare it with corticosteroid injection in treatment of plantar fasciitis (PF). Materials and methods Eighty patients were included in the study and divided into two groups. Group I (30 patients) received PRP injection and group II (50 patients) were given steroid injection. Patients were clinically assessed at different intervals. Functional outcome was evaluated on the basis of visual analog scale (VAS) and foot and ankle ability measure (FAAM) scores. Planter fascia thickness was assessed pre- and postinjection by ultrasound. Results Platelet-rich plasma and corticosteroid injection groups at the initial visit had VAS score of 8.44 and 8.38 respectively which was reduced to 1.46 and 3.02 at the end of 6 months. The PRP and corticosteroid injection groups at the initial visit had FAAM score of 29.9 and 31.6 respectively which increased to 83.4 and 69.1 at the end of 6 months. After injection, the PRP group had significant reduction (35.90%) in the thickness of plantar fascia as compared to corticosteroid group (28.67%). Conclusion Treatment of PF with PRP extract reduces pain and significantly increases function, exceeding the effect of steroid on long-term follow-up. How to cite this article Tank G, Gupta R, Gupta A, Rohila R. Comparative Study of Platelet-rich Plasma and Corticosteroid Injection in the Treatment of Plantar Fasciitis. J Foot Ankle Surg (Asia-Pacific) 2017;4(2):84-89.

As an elective procedure, total knee arthoplasty is under scrutiny to evaluate clinical and functional outcome. In this regard, we examined 32 knee arthoplasty to assess factors associated with better functional outcome. METHOD: It is a prospective study of 32 knee cases in between 2006-2012. In this 28 knee had osteoarthritis knee and 6 knee had rheumatoid arthritis. Infective, traumatic and metabolic bone disease knees were excluded from study. All patients were evaluated by American knee society score (KSS and functional score).RESULT: Total knee arthoplasty was found to be associated with substantial functional improvement. The greatest amount of improvement is seen within few months after surgery with more gradual improvement occurring up to years of surgery. CONCLUSION: Total knee arthoplasty is a very effective procedure for overall functional improvement and pain relief of the patient with arthritic knee.

BACKGROUND: Fractures of distal end radius are the most common fractures of the upper extremity, encountered in orthopaedic practice. The goal of treatment has always been to restore the anatomy of the radius i.e. length, tilt, inclination and joint surface. Fixation of these fractures by volar plating provides restoration of distal radial anatomy and most consistent correction of displacement. The purpose of this study was to evaluate the functional outcome of patients with distal end radius fractures managed operatively by volar plating. METHODS: Between August 2007 and March 2012, eighty patients with distal end radius fractures were treated with volar fixed-angle locking plate. Fractures were classified according to the AO/ASIF classification system as type A(n = 16), B(n = 12) and C(n = 52). Anatomical evaluation was done by Sarmiento's modification of Lind Storm criteria while clinical and functional outcome was done by demerit point system of Gartland and Werley with Sarmiento et al's modification. RESULTS: The average follow up of patients was 62.5 weeks. On anatomical evaluation at final follow up we found that 68 patients (85%) had excellent restoration of anatomy, 8 (10%) had good and 4 (5%) had fair restoration of anatomy. Functionally 60 patients (75%) had excellent, 12 (15%) had good and 8 (10%) had fair results. Poor function correlated with residual displacement and poor patient compliance. 9 patients had joint stiffness and 3 had paresthesia in median nerve distribution and 2 had reflex sympathetic dystrophy. CONCLUSION: The treatment of intra and extra-articular fractures of the distal radius with a volar plating system have an excellent to good anatomical restoration of anatomy and excellent functional outcomes. This treatment is associated with a very small and statistically insignificant loss of volar tilt, radial inclination and radial length upon comparison of immediate postoperative alignment with that seen after more than 1 year follow-up. These results suggest that stabilizing the fracture with volar plating is a very effective method.

Isolated involvement of patella as extra pulmonary Tuberculosis is very rare. We report a rare case of Tuberculosis patella in an eight year old baby girl. She was complaining of pain, swelling and joint stiffness around her right knee. Diagnosis was based on biopsy. She was treated by surgical debridement and curettage, Anti-tubercular treatment (ATT) with early mobilization of joint.