BACKGROUND AND OBJECTIVEFemoral neck fractures have been considered 'Unsolvable fracture' in the olden era of orthopaedics due to high rate of associated complications, which include nonunion and avascular necrosis of the femoral head. Prosthetic replacement as a primary procedure eliminates osteonecrosis and non-union as complications of femoral fractures and also allows immediate weightbearing to return elderly patients to activity and help avoid complications of recumbency and inactivity. The decision to perform hemiarthroplasty using a unipolar or bipolar prosthesis remains controversial with proponents on either side. So in view of varied opinions, we desire to compare the efficiency of these two prosthesis, unipolar and bipolar prosthesis for the management of intracapsular fracture neck femur in elderly.

ABSTRACT:Fractures of distal end of radius continue to pose a therapeutic challenge. Intra articular and extra articular malalignment can lead to various complications like post-traumatic osteoarthrosis, decreased grip strength and endurance, as well as limited motion and carpal instability. Open reduction and internal fixation is indicated to address the unstable distal radius fractures and those with articular incongruity that cannot be anatomically reduced and maintained through external manipulation and ligamentotaxis, provided sufficient bone stock is present to permit early range of motion. METHODS: Sixty adult patients with distal radial fractures treated at Dept. of Orthopaedics, Government General Hospital and Royal Hospital, Vijayawada between May 2010 and April 2015 were included in this study. RESULTS: In this series 9(15%) patients were between 21-30 years, 15(25%) between 31-40 years, 24(40%) between 41-50 years, 9(15%) between 51-60 years and 3(5%) patients between 61-70 years. The age of the patients ranged from 26-62 years with an average of 43.3 years. Out of 60 patients, 48(80%) were males and 12(20%) were females, showing a male preponderance with the ratio being M: F 4: 1. Right side (Dominant wrist) was involved in 42(70%) patients and the left side was involved in 18(30%) patients. In our study there were 36 (60%) patients with road traffic accidents and 24(40%) patients fell on their outstretched hand. Of the 60 cases, 12(20%) of the fractures were of Type I Frykman's classification, 6(10%) of Type II, 21(35%) of Type III, 9(15%) of Type IV, 3(5%) of Type V and 9(15%) of Type VIII. There were no cases of Type VI and VII fractures. SUMMARY: Males were predominant with right wrist affection more than left. All fractures were either due to road traffic accidents or fall on the outstretched hand, with road traffic accidents being more common of the two. Most of the fractures were of Frykman Type I, III and IV. All (100%) the patients had their range of motion within the normal functional range. None of the patients had wrist stiffness. Complications were minimal. There was 3(5%) case of extensor pollicis longus tendon irritation which was because of long volar to dorsal screw and the pain subsided once the screw was removed. There was 3(5%) case with an intra-articular fracture developed grade I radiocarpal arthritis doing well with physiotherapy.

OBJECTIVES:To evaluate the results of bipolar hemiarthroplasty with respect to pain, range of motion, clinical functional outcome and complications in cases of Intra capsular fracture neck of femur treated with bipolar hemiarthroplasty. METHODS: The present study consists of 22 adult patients of Intra capsular fracture neck of the femur, who are treated with Bipolar hemiarthroplasty in Government General Hospital, Vijayawada from 01-07-2012 to 31-06-2014. The patients were followed up at an interval of 6 weeks, 3 months and 6 months and their functional outcome assessed using Harris Hip score. RESULTS: The mean age of our patients was 65.3 years with range from 60 to 75 years. There were 8 males and 14 females. 12 fractures were left. Sided and 10 were right sided. Type of fracture is Type-3 8 and Type-4 are 14 according to Garden's classification. Hospital stay range from 7-30 days with average of 15 days. We observed that 16 patients in our series had no pain. Out of 6 patients who had slight pain, one patient had superficial infection and rest of the patients had no post-operative complication. Seven of our patients have varying degree of limping. 7 patients had excellent results with Harris Hip Score, 12 patients had good results and 2 had fair results.

Tibial fractures are one of the commonest orthopedic injuries. Tibial fractures are one of the commonest orthopedic injuries. In the past several years there has been a trend towards by use of small diameter nails without remaining in the management of unstable tibial shaft fractures. However it is important to remember that many closed fractures with less severe soft tissue injury, Treatment with an intramedullary nail with reaming allows placement of larger implant, thereby minimizing the incidence of mechanical failure. While maintain high rates of union. METHODS: In our study, 100 cases of tibial diaphyseal fractures were treated with Interlocking nailing in between May-2012 to April 2015 at Siddhartha Medical College/Government General Hospital, Vijayawada. RESULTS: In our study, among 100 cases 86 were closed fractures, and 8 were open fractures and 6 non-unions. Of the 100 cases 56 (56%) on right side, 38 (38%) on left side, 6 cases (6%) were bilateral. The commonest type of fracture is spiral or long oblique in 40 cases (40%). Transverse or short oblique in 28 cases (28%), comminuted in 24 cases (24%) and segmental in 8 cases (8%). The average time for union is 14 weeks with a range of 12-40 weeks. . 2 patients developed delayed union due to distraction at the fracture site. KEYWORDS: Interlocking nailing tibia, fracture tibia shaft. INTRODUCTION:Tibial fractures are one of the commonest orthopedic injuries. By its very location it is frequently exposed to injuries. These fractures continue to pose vexing problems for orthopedic surgeons, because of their common occurrence and morbidity. One of the problems among them is selecting the optimal method of treatment. They can't be managed by simple set of rules. According to Nicoll 1 tibial shaft fractures are important for two reasons. Firstly they are common, secondly their management is controversial. The incidence of tibial fracture is 9 times more than femoral fractures. Modern treat ment of tibial fractures include both operative and non-operative management, which allow near normal functional restoration of the extremity.It is incumbent on the orthopedic surgeon to be skilled in a variety of treatment methods including, closed functional cast bracing, external skeletal fixation, open reduction and internal fixation using indirect reduction techniques, intramedullary nailing. Because the spectrum of injuries to the tibia is so great that usually no single method is applicable to all fractures. With recent advances in metallurgy (Cold curing, variety of metals) and design of the nails such as prebent nails, prefabricated holes in nails, which lock fragments with screws have made trauma surgeon more confident in a dealing with these fractures. At present interlock nailing seems to be ideal method of treatment of tibial diaphyseal fractures. Sarmiento and co-workers, 2 documented their experiences with functional bracing in the successful management of closed tibial fracture. However, not all tibial fractures are amenable to brace treatment. It ...

OBJECTIVES:The aim of this study was to compare the outcome of intertrochanteric fractures treated with Dynamic Hip Screw and Proximal Femoral nail. METHODS: This study was conducted on 80 cases of Intertrochanteric fractures of femur treated by a dynamic hip screw and proximal femoral nail. Patients were operated on standard fracture table under image intensifier control. RESULTS: The average age of the patient was 63.2 years. Most common mechanism of fracture was domestic fall. The unstable pattern was more common in old aged patients with higher grade of osteoporosis. The average blood loss was 240 and 320ml in PFN and DHS group respectively. In PFN there were more no. of radiation exposure intraoperatively. The average operating time for the patients treated with PFN was 100min as compared to 80 min in patients treated with DHS. No complications of non-union and infection. In the PFN group the amount of sliding on X-rays was less as compared to DHS. The patients treated with PFN started early ambulation as they had better Harris Hip Score in the early period (at 1 and 3 month). In the long term both the implant had almost similar functional outcomes. CONCLUSION: From the study, we concluded PFN is better alternative to DHS in management of intertrochanteric fractures but is technically difficult procedure and requires more expertise compared to DHS.