Introduction: Open fracture of tibia is one of the most common injuries seen in ortho pedic practice. The appropriate treatment of open tibial fractures is one of the priority problems in modern era of traumatology. New tibial titanium nail with a biodegradable gentamicin-loaded coating (UTNPR Otect, Synthes) was CE-certified in August 2005. The main goal of locally delivered antibiotics is to prevent bacterial colonization of the implant surface, there by reducing the risk of implant-related infections. Aims and Objectives: To assess functional and clinical outcome after intramedullary locking nail fixation of open fracture shaft of tibia. Method and Materials: 25 patients were selected of age group 18-65 yrs presenting with open fracture shaft tibia on the basis of OPD and emergency admissions in M.B. Govt Hospital Udaipur. Fractures were classified as per gustilo anderson classification. All patients were treated operatively with antibiotic coated intramedullary interlocking nail. and its outcomes were assested on the basis of Alho and Ekeland Criteria and complications were observed with follow up to 6 months clinically and radiological imaging.Result: In this study of 25 patients of age group 18yrs to 65yrs were treated with antibiotic coated Intramedullary inter locking nail, 80% cases were male and 20% cases were female. Mean time of union 16.5weeks.no implant related infection occurred only superficial infection found in two patients. Conclusion: the use of the antibiotic coated nail was good clinical and radiological outcome after 6 months. These prelimnary results support the use of antibiotic coated implants as a new potiential treatment option for prevention of infection in trauma patients.

Introduction: Avascular necrosis (AVN), most commonly affects femoral head. Etiology may be traumatic or non-traumatic. The goal of treatment is preservation of head of femur in early stages I and II by different hip preserving methods & to delay hip arthroplasty. Aims and Objectives: To evaluate and discuss the results of iliac crest cancellous bone graft enhanced with platelet rich plasma and core decompression in of AVN head of femur grade I and II. Method and Materials: This study was done in Deptt of Ortho., RNT MC & Hospital, Udaipur from 1 Oct. 2016 to 30 Sep. 2018. 25 Patients (38 hips) of both sex and aged between 25 to 50 years with AVN head of femur grade I and II were treated by core decompression with platelet rich plasma enhanced cancellous bone graft. Final results were graded according to Harris hip score. Results: Final Results were 10 hips (26.3%) had excellent, 17 hips (44.7%) good, 7 hips (18.4%) had fair and 4 hips (10.5%) had poor result. There was improvement in mean Harris Hip Scores by 10.1 points (73.1 to 83.2). Conclusion: Pain relief was achieved and probably due to decompression, and curettage of necrotic area. Improvement in Harris hip score and delay the need for THR.

<ul><li><p class="abstract"><strong>Background:</strong> The present study was undertaken to to compare the efficacy of treatment of intracapsular neck of femur fracture operated by anterior and posterior approaches.</p><p class="abstract"><strong>Methods:</strong> A total 100 patients of either sex, aged &gt;65 years with intracapsular neck femur fracture were operated with hemiarthroplasty. The patients were divided into two equal groups and patients were operated alternatively one with anterior approach and the second with posterior approach. Functional outcomes were compared using Harris hip score and range of movements assessed clinically. Hip function and final outcome measures were noted and compared between two groups.<strong></strong></p><p class="abstract"><strong>Results:</strong> The mean age of patients was 63.1±5.3 years in group A and 65.8±5.4 years in group B with female to male ratio was 1.7:1 for group A and 1.8:1 for group B. Operating time for group A and for group B was 65 and 78 minutes respectively. Mean intraoperative blood loss was 120 ml in group A and 150 ml in group B. The most common complication in both the groups were infection and rate in group A was 9.70% and in group B was 13.50%. Posterior approach carried an increased risk of prosthetic dislocation as compared to anterior approach. There was no intraoperative mortality seen in follow up period.</p><p class="abstract"><strong>Conclusions:</strong> Anterior approach for hip hemiarthroplasty in elderly population with intracapsular femoral neck fractures provided significant benefit in early postoperative period when compared to the posterior approach in terms of duration of surgery, intraoperative blood loss, time of recovery, hip dislocation rate.</p></li></ul>

Introduction: Globally, Clubfoot is the most serious cause of physical disability among congenital musculo skeletal defects. Etiology and risk factor are unknown but there is female predominance and increased prevalence in monozygotic twins. The goal of study to provide a brief knowledge regarding management of clubfoot via Ponseti mesthod i.e. simple manual correction of Deformity and plaster cast application and to reduce the need of extensive surgery for the clubfoot. Aims and Objectives:To analyze the efficacy of Ponseti's method in management of CTEV and To evaluate the outcome of Ponseti's method for treatment of clubfoot and to compare the result between two age group i.e. less than 3 months of age and between 3 months to 1 year of age. Material and Methods: For study purpose two groups were made with 50 babies in each group with congenital idiopathic clubfoot. Group A 50 babies from birth to upto 3 months of age and Group B of 50 babies from 3 months-1 year of age were selected from outdoor patient department at Depts of Orthopaedics, RNTMC & Hospital, Udaipur from 1st July 2017 to 31st May 2019. Results: Group-A Required less number of casts (1.2) as compared to group B(1.6) for Cavus correction, Required less number of cast (2.6) as compared to group B(3.2) for correction of Varus & Adduction, Required no surgical correction or procedure except than Percutaneous Tenotomy. Conclusion: At the end of study all babies were free from deformity and having flexible, plantigrade, cosmetically acceptable foot which implies that Ponseti method can be used easily up to 1 year of age. The Ponseti method is very useful in our country which having less resources and huge patient load.

Orthognathic surgery can be extremely useful in management of patients with complex malocclusions. It can benefit the patients by treating the esthetic and functional deformities. The collaboration between orthodontists and oral surgeons is crucial in obtaining optimal results for such complicated cases. The timing of the treatment and the age of the patient at the time of treatment play an important role in determining the type of treatment. This review discusses the different types of malocclusions in which the patient can be treated with conventional mechanics if presented during growing period and surgical management if presented after the growth is completed. Furthermore, the review describes the recent introduction of mini-screws and the non-surgical methods that can be used to treat complex malocclusions for adult patients.