Objectives: To know the functional outcome of Intramedullary Kirschner Wire fixation of unstable Radius-Ulna fractures in children. Study Design: Descriptive study. Period: 27/03/2009 to 26/03/2010. Setting: Department of Orthopedic and Trauma, Khyber Teaching Hospital, Peshawar. Patients and Methods: All patients were admitted from OPD . Children less than 16 years with Unstable Radius- Ulna fractures were included in the study. Patients with open fractures and adults with polytrauma were excluded from the study. Unstable Radius-Ulna fractures were treated by Intramedullary Kirschner Wire fixation under general anesthesia and tourniquet control. Follow up till radiological and clinical union was done. K-wires were removed after healing of fractures. Patients were assessed functionally and radiologically and results were graded according to Price et al Criteria. Results: A total of 64 children with unstable radius and ulna fractures were included in the study. The age range was 6 to 15 years with average age of 10.41 years. 47 were male and 17 were female. The average time of radiological union was 7 weeks and K-wires were removed at 8 weeks time. At final assessment there were 47 Excellent, 10 Good and 7 Fair results. Conclusions: Excellent results can be achieved by Intramedullary K-Wires fixation. In children with unstable Radius-Ulna fractures. It should be the method of choice for treating these fractures.

Background: Intertrochanteric (IT) fracture is common in elderly population. The dynamic hip screw is widely accepted in the treatment of IT fractures of the proximal femur. Objectives: To determine the outcome of dynamic hip screw in intertrochanteric fracture of femur in elderly patients. Design: A descriptive observational study Setting: Department of Orthopaedic Khyber Teaching Hospital, Peshawar.Period: From 7th Jan 2008 to 7th Jan 2009. Material and Methods: 113 consecutive patients with intertrochanteric fracture of the femur treated with dynamic hip screw. All patients were investigated and optimized for surgery. An accurate close reduction was done under fluoroscopic control. A dynamic hip screw (DHS) was inserted by a standard technique. Patients were reviewed clinically and radiographically on 2nd, 6th, 12th and 24th weeks. Results: We studied 113 Patients of intertrochanteric (IT) fracture, 13 patients were lost to follow up and the study was completed on 100 patients. Forty seven (47.0%) patients were male and 53 (53.0%) were female. Postoperatively seven patients (7%) suffered from infections, 3 (3.0 %) patients suffered from restricted hip joint movements. There was shortening of lower limb in 3 (3.0%) patients, 2 (2.0%) patients developed non union of the fracture site, 1 (1.0%) patient develop varus deformity. Seven (7.0%) patients had implant failure, 3 of which have lag screw cut-out through superior cortex, 3 patients have broken leg screw at barrel shaft junction and 1 patient has broken leg screw at 3 sites. 77 (77.0%) healed without complications. Conclusion It is concluded that the Dynamic Hip Screw is safe, suitable and reliable method of fixation for Boyd and Griffin type I and type II intertrochanteric fracture of femur.