Zygomycosis is the third leading cause of invasive fungal infection after candidiasis and aspergillosis. Although zygomycosis mostly affects immunocompromised individuals trauma may potentiate infection in immunocompetent individuals. The mortality rate of Zygomycosis is around 50% due to angioinvasion. Here we report a series of 5 cases of angio invasive fungal infection in immunocompetent individuals who sustained trauma in urban areas, out of which only one patient survived following high above knee amputation.

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">The management of displaced intra-articular calcaneal fractures (DIACFs) remains challenging and controversial. A prospective study to assess the functional outcome of patients with displaced intra-articular calcaneal fractures treated with percutaneous reduction, cannulated screw fixation.</span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">Ultimately, 14 patients with a DIACFs, underwent. percutaneous reduction, cannulated screw fixation. Functional outcomes were evaluated using the American Orthopaedic Foot and Ankle Society (AOFAS) hind foot scores. Radiological results were assessed using plain radiographs and computed tomography (CT) scans, and postoperative wound-related complications were also recorded</span>.<strong></strong></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">A total of 46 adult patients were assessed in our study. Twenty patients did not meet the inclusion criteria and were excluded. Twelve patients were excluded due to severe medical ailments (2 patients) and non-adherence to the treatment plan (10 patients). Therefore, 14 patients with an average age of 42.5 years old (range, 20 to 72 years) including 10 men and 4 women participated in the study. All patients were followed-up for 12 months averagely (range, 11 to 18 months). Complete articular reduction is achieved in 8 patients, 6 patients had articular depression of posterior facet, 3 patients had heel widening and lateral impingement. There was no wound complications in any of the patients, 2 patients developed sub talar arthritis at 2 years of follow up. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">Surgical treatment of intra articular calcaneal fractures remains challenging task. Minimally invasive reductions remain good option to minimize wound complications. Cannulated cancellous screw fixation is good option for intra articular calcaneal fracture.</span></p>

<p class="abstract"><span lang="EN-US">Pain following TKA is often severe in most patients. The purpose of this case series was to assess the efficiency of intra-operative peri-articular cocktail injection in management of pain following total knee arthroplasty. This case series involves 16 patients with inflammatory arthritis of knee undergoing total knee arthroplasty (TKA). All patients had received peri-articular cocktail of drugs before the implantation of prosthesis with cement. In our study, there was significant improvement of Knee Clinical Score and Knee Functional Score following TKA. The mean KSS score was 37.5 (range: 31-44) improved to 92.5 (range, 86-99) and the functional score improved from 25.5 (range, 18-33) to 76 (range, 72- 80) at 6 months and 93 (range: 90-96) at 12 months. Intraoperative peri-articular injection with 20 ml of 0.5% ropivacaine, 1 ml of ketorolac, 1ml of clonidine and 0.5ml noradrenaline diluted in 20 ml of saline is effective in reducing immediate post-operative pain and thereby improving the overall functional outcome.</span></p>

<p class="abstract">Acetabular fractures are complex fractures that pose a challenge for orthopaedic trauma surgeons due to their extension into the hip joint. The simultaneous occurrence of contralateral neck of femur fracture in an obese patient makes postoperative wound healing and rehabilitation even challenging. Here, we report a case of management of acetabulum fracture with contralateral neck of femur fracture in an obese patient. We are reporting a case of a 50-year-old obese female from Chennai who presented to the Department of Orthopaedics, SRIHER, Chennai, with complaints of bilateral hip pain and inability to weight bear on bilateral lower limb, following a high-velocity road traffic accident. She was diagnosed to have left acetabulum fracture with right hip displaced neck of femur fracture. We managed her with right hip bipolar hemiarthroplasty and left acetabulum open reduction and internal fixation. 6 month follow up showed excellent radiological and functional outcome. This case report highlights how obesity alters the surgical and medical management in obese patients with contralateral acetabulum and neck of femur fracture and the importance of a multidisciplinary approach in such polytrauma patients.</p>