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 Background: When the patella is fractured it should be repaired and patellectomy should be avoided as much as possible even in comminuted fractures. In comminuted patellar fractures, a combination of cerclage wiring and tension band fixation is confirmed to provide good mechanical stability. The objective of the present work was to find out the effectiveness of comminuted patellar fracture fixation with combined cerclage and tension band wiring technique.  Method and patient: Forty-six patients underwent surgical stabilization for comminuted patellar fracture between year 1996 to 2016. All fractures were classified as 34-C3 according to the Orthopedic Trauma Association Classification. All the patients were underwent open reduction-internal fixation with combined Cerclage and tension band wiring technique. Result: Fracture healing was occurred within an average of 3-5 months, while in bilateral cases it was 4 -8 months. Full range of knee movements was seen in 42 (91.3 %) cases and knee flexion more than 120º was seen in 4 (8.7 %) cases. Quadriceps power was normal in 44 (95.6 %) cases, but 2 cases had quadriceps power of grade-IV. No extensor lag and no quadriceps atrophy were seen in any cases. Forty four (95.6 %) patients could squat fully and two (4.3 %) patients could squat up to half of the normal level. All patients were able to climb up and down stairs without any problem. Most patients have no subjective complaints like pain, difficulty in walking, difficulty in squatting and climbing. The clinical results after operation were evaluated by the clinical KJMS /

Background and objectives: Intertrochanteric fracture of the femur is one of the common and challenging fractures in the orthopedic field, which mostly affect old osteoporotic patients. Different method of fixation used to treat inter- trochanteric fracture of femur, including dynamic hip screws and proximal femoral nail .We compared the dynamic hip screw and proximal femoral nail methods of fixation in unstable intertrochanteric fracture of femur (AO Types A2 and A3) with respect to duration of surgery, blood loss, intraoperative complications, union rate and functional return. Methods:A prospective randomized and comparative study was conducted on forty two patients, 26 males (61.9%), 16 females (38.1%), from March 2015 to March 2017. Out of 42 cases, 20 patients (47.6%) treated with dynamic hip screw (group A) and 22 patients (52.4%) with proximal femoral nail (group B). In this study, maximum age was 80 years and minimum was 60 years old with a mean age of 70.9 years. Results: Our study found that proximal femoral nail fixation had relatively lesser operative time (74.5+2.6 minutes in dynamic hip screw group and 57+2.3 minutes in proximal femoral nail group), less blood loss observed (150±10.7 ml in dynamic hip screw group and 90±6.7 ml in proximal femoral nail group) and the patients were capable of early mobilization and lesser rates of implant failures (2 cases in dynamic hip screw group with no case in proximal femoral nail group), however, dynamic hip screw patients showed faster fracture healing (12-16 weeks in dynamic hip screw group and 16-24 weeks in proximal femoral nail group). Conclusions:Proximal femoral nail provides more stable fixation for unstable intertrochanteric fractures spe- cially AO type 31A3 and has more favorable short-term outcomes with a shorter procedure duration, less blood loss and no implant failures.

 Background: Developmental Dysplasia of the hip is common problem, both severe acetabular dysplasia and proximal femoral ante-version are the main pathology that should be managed as early as possible. Treatment of Developmental Dysplasia of the hip (DDH) should be commenced after delivery, during infancy and in very young children because maximum potential for development and remodeling of the acetabulum and proximal femur were encountered up to the age of 4 years. Surgical correction of idiopathic developmental dysplasia of the hip (DDH) is one of the most challenging problems in pediatric orthopedic surgery.