The stability of the thoracic and lumbar spine depends significantly on the posterior ligamentum complex (PLC). Therefore, it is essential to diagnose PLC injuries accurately before deciding on a treatment plan for thoracolumbar injury patients. However, the efficacy of magnetic resonance imaging (MRI) in diagnosing PLC remains undetermined. Overview of Literature: MRI has become the ultimate tool in diagnosing spine injury cases, as previous literature suggests that it has very high sensitivity and specificity. But this is still controversial and as many surgeons rely on just MRI for selecting the patient for surgery, it becomes important to know the diagnostic accuracy of it. Methods: Patients who sustained injuries from T1 to L3 and required posterior surgery were prospectively studied. The treating surgeon and musculoskeletal radiologist participating in the study reviewed preoperative MRI images to characterize the level(s) of injury and the integrity of the six components of the PLC. These were classified as intact, incompletely disrupted, or disrupted. During the surgical procedure, the surgeon also classified each component of the PLC, and the radiologist's and surgeon's findings were compared. Results: Out of 66 patients, 46 were males (69.7%) and 20 were females (30.3%), and the average age was 34.12 years. According to the kappa score, there was a moderate level of agreement between the radiologist's interpretation and the intraoperative findings for all PLC components except for the thoracolumbar fascia and ligamentum flavum for which there was a slight agreement. The sensitivity for the intact PLC components ranged from 100% (supraspinous ligament) to 66.67% (ligamentum flavum). The specificity ranged from 100% (interspinous ligament) to 52% (thoracolumbar fascia). The Spearman's rank correlation ranged from 0.061 for the thoracolumbar fascia to 0.918 for the interspinous ligament, and the percentage agreement ranged from 81.82% (interspinous ligament to 36.36% (thoracolumbar fascia). Conclusions: The sensitivity and specificity of MRI for diagnosing injury of the PLC in this study were lower than those previously reported in the literature. The integrity of the PLC as determined by MRI should not be used in isolation to determine treatment.

Introduction: Anterior cruciate ligament (ACL) is a common injury which has been conventionally managed by various graft reconstruction using bone patellar tendon bone, or quadruple hamstring autograft, to name a few. However, all these grafts are associated with many complications. Lately, peroneus longus tendon (PLT) autograft has shown promising results in this field, although there is still a dearth of data on its use. We, therefore, aimed at carrying out a study to evaluate the functional outcome and knee stability results of ACL reconstruction using PLT graft. Patients and Methods: Patients with a completely torn ACL were included in the study. The PLT was harvested, and graft length, thickness, and harvesting time were noted intraoperatively. Knee stability and functional scores were evaluated clinically and using Lachman test (primarily) and KT-2000 arthrometer and subjectively with International Knee Documentation Committee (IKDC) score at 6, 12, and 24 months (secondary outcome) postoperatively. Ankle scores were also recorded by making use of American Orthopedic Foot and Ankle Score (AOFAS)–Hindfoot Scale. Results: Forty-eight patients met the inclusion criteria. The graft harvest time was 7.4 min (5–9 min). The mean thickness of the graft on doubling was 7.9 mm (7–9 mm). Ninety-six percent of the patients were satisfied with their results of the knee surgery, and 95% of the patients had no complaints of ankle joint. The mean IKDC score postoperatively was 78.16 ± 6.23, and the mean AOFAS score was 98.4 ± 4.1. None of the patients had any neurovascular deficit. Conclusion: ACL reconstruction using PLT graft yields a good functional score (IKDC, KT-2000 arthrometer) even at 2-year follow-up. It is a safe and effective autograft option for ACL reconstruction.

Distal femoral fractures are difficult to treat and ideal treatment of such fractures will include anatomical reduction, rigid fixation of articular surfaces and early mobilization of knee joint. The purpose of the study is to evaluate the end results of surgical management of fracture of distal end of femur using various surgical modalities and analyze the complications and the causes of fractures. Materials and methods: A Retrospective Study of 75 patients were evaluated from tertiary hospital for a period of july 2007 to July 2009. There were 75 fractures in 75 patients involving the distal femur, which were treated  surgically by internal fixation using various surgical modalities. Results: At the end of study, the cases were followed up for an average period of 15.6 months and functional results were evaluated using modified Schatzker and Lambert (1982) criteria. 36 cases were fixed with Supra Condylar nail ( SC nail), 20 cases were fixed with dynamic Condylar screw(DCS), 6 cases were fixed with Dynamic Compression Plate(DCP), 6 cases were fixed with Cancellous Screw, 4 cases were fixed with Enders Nail, 3 cases were fixed with Ext. Fixator Conclusion; Fractures of distal femur can be very effectively treated by surgical methods. The satisfactory osteosynthesis of fractures and stable osteosynthesis is achieved by the right approach and correct surgical technique. Keywords: distal femur fracture, internal fixation, dynamic condylar screws, supracondylar femur nail

<p class="abstract"><strong>Background:</strong> Total hip arthroplasty (THA) is one of the most successful and cost-benefit surgical treatments. However, there are concerns about the safety of the procedure and higher complications. We aimed to evaluate the complications and outcomes of one-stage bilateral total hip arthroplasty (BTHA) with anterolateral approach.</p><p class="abstract"><strong>Methods:</strong> A total of 24 patients from February 2014 to October 2019 underwent BTHA in Government Medical College and Attached Group of Hospitals, Kota. A prospective analysis of the functional outcomes and complications was performed. All surgeries were performed via anterolateral approach. All patients were followed up till 1.5 years post-operative.<strong></strong></p><p class="abstract"><strong>Results:</strong> During period of study 16 men and 8 women with a mean age of 40.12±2.52 years at the time of presentation were entered. The mean surgical time was 112±6 mins. The mean hospital stay was 7 days. Hemoglobin level decreased significantly after operation (p=0.046) mean of 10.83±0.3 mg/dl. There was no reported patient with perioperative death, deep venous thrombosis, pulmonary embolism, infection, dislocation, periprosthetic fracture or heterotrophic ossification. The mean preoperative MHHS score was 45.93±5.33 in patients. MHHS score improved to 92.06±2.47 in the last follow-up (p=0.0001).</p><p class="abstract"><strong>Conclusions:</strong> Our results recommend the use of one-stage BTHA through anterolateral approach in cases indicating bilateral THA without increase in rate of complications. Functional and clinical outcomes are comparable and hospital stay is significantly shorter.</p>

Background: Giant cell tumours of bone are aggressive, potentially malignant lesions. Juxta articular giant cell tumours of lower end ulna are rare and present a special problem of reconstruction after tumour excision. Out of the various treatment procedures described, use of iliac crest bone graft for wrist reconstruction after wide resection of the tumour is done with satisfactory functional results. Methods: Six patients with a mean age of 21 years, with proven giant cell tumours of distal end ulna were treated with wide excision and reconstruction with tricortical iliac crest graft. Wrist reconstruction and xation of graft was done with 4.o mm cancellous screws and K wire. The distal stump of resected ulna was stabilised by Extensor carpi ulnaris tendon slip. Results: The follow up ranges from 3 years (mean 30 months). At last, follow up, the mean MSTS was 71 and mean grip strength improved from 28 kg. to 37 kg. with an attainment of mean grip strength of 80% as compared with the contra lateral hand and a fair range of movements. There was no incidence of recurrence, any malignant transformation, loss of function, neurovascular decit. There were no cases with any infection or wound dehiscence. Conclusions: Distal ulna can be replaced with xation iliac crest bone graft provided it is attached to the triangular bro cartilage and ulnar collateral ligament which results in restoration of the anatomy and stability of distal radioulnar joint respectively. The distal resected stump of the ulna should be stabilised with ECU by tenodesis to prevent impingement which gave a good result in our cases.