Background: Fractures of the distal femur comprise 4% to 6% of all femoral fractures. Elderly patients are predisposed to lowenergy fractures due to osteoporosis. Treatment of these fractures in the elderly group remains a challenge. Our hypothesis is that locking plates inserted with minimally invasive plate osteosynthesis (MIPO) techniques will produce better results compared to those inserted by open technique. The objective of this study is to evaluate the clinical outcomes of MIPO technique using locking plates in the elderly patients. Materials and Methods: A total of 24 elderly patients (mean age 73 years) with distal femur fractures treated using the MIPO technique (2007)(2008)(2009)(2010) were reviewed retrospectively. Parameters analyzed included classification of fracture, time to fracture union, knee range of motion, functional knee score (Knee Society Score-Functional) at 6 months, and other significant complications. One patient was lost to follow-up. Results: In all, 88% of the fractures were extraarticular. The mean time to union was 13.48 (range: 8-28) weeks. Mean range of motion achieved at 6 months and beyond was 100 ranging from 0 to 30 (extension) to 90 to 140 (flexion). Functional knee scores at 6 months from fixation were satisfactory (mean score 88.8). There were no cases of implant failure, nonunion, and infection. In all, 6 (25%) patients developed deep vein thrombosis (DVT) in the early postoperative period, all of which were below the level of the knee joint. Conclusion: Locking plates inserted using MIPO techniques in elderly patients with distal femur fractures appear to be promising based on clinical outcome measurements. However, there was a high incidence of DVT noted.

Core needle biopsy is an accurate and reliable diagnostic tool for musculoskeletal tumours if performed by skilled persons and adequate tissue is obtained.

We present a 52-year-old man with congenital absence of the posterior arch of the atlas and concomitant fusion of the posterior tubercle of the atlas to the spinal process of the axis. He had normal reflexes and no motor deficit. He underwent C3-C7 laminoplasty and achieved good outcome.

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