Introduction: The fracture neck of femur is one of the most common fractures in the elderly. The time-tested unipolar prosthesis is being slowly replaced by bipolar prostheses, which are claimed to have a lower incidence of complications. In the last two decades, bipolar replacements of the femoral head have gained popularity for treating femoral neck fractures. This study was conducted to analyse the results of the surgical management of the fracture neck of femur using cemented modular bipolar hemiarthroplasty.Objective: To assess and analyse the results of the management of fracture neck of femur with cemented modular bipolar hemiarthroplasty.Methodology: The present study was a prospective study of 22 cases of fracture neck of femur admitted to Navodaya Hospital, attached to Navodaya Medical College, Raichur, between the study period of Sept 2019 to May 2021. Cases were selected according to inclusion and exclusion criteria, i.e., patients with intra-capsular fracture neck of femur above the age of 50 yrs. Medically unfit patients and patients not willing for surgery were excluded from the study. Follow up was done after 6 weeks and for further at 3 months, 6 months, 9 months, and 1 year.Results: In our series of 22 cases there were 7 males and 15 females, with a maximum age of 85 yrs, minimum age of 55yrs. There was a slight predominance of left sided fractures when compared to the right. The mean duration of hospital stay was 22 days. At the final one year follow up assessment with Harris Hip Score 8 patients (36.36) achieved 'Excellent' result, 11 patients (50%) achieved 'Good' result, 2 patients (9.09%) achieved 'fair' result and 1 patients (4.54%) achieved 'poor' result. In our series, at the end of final follow-up, there was no evidence of loosening, radiolucent zones, distal migration or subsidence of prosthesis.Conclusion: We conclude that bipolar cemented modular hemiarthroplasty produces good functional outcomes with minimal complications for displaced intracapsular femoral neck fractures and has several advantages; these results are comparable to the other studies. However long term results using cemented modular bipolar hemiarthroplasty needs further study for a longer period in a larger sample.

Background: Femoral shaft fractures are a common paediatric injury that can be treated in a variety of ways. We conduct a randomised trial to compare two operational strategies.Material and methods: From 2019 to 2021, we treat 26 patients with fracture shaft femur.The patients ranged in age from 4 to 12 years old, with 15 boys and 11 girls. 12 patients had left-sided injuries, whereas 14 had right-sided injuries. The first group of 13 patients (8 males and 5 females) were treated with titanium elastic nails (TENS), while the second group of 13 patients (7 males and 6 females) were treated with open reduction and fixation utilising thin plates. The clinical and radiological findings were evaluated using the Flynn etal (2001) scoring system at regular intervals (2 weeks, 6 weeks, 3 months, 6 months, and 1 year). Results: Eight patients in the TENS group had outstanding results, while five others had good results with minor problems. With an average of 8.4 weeks, the union was completed (rang 6 - 12 weeks). Seven patients in the plating group had great results, four had acceptable results with mild problems, and two patients had poor results, including re-fracture after metal removal, severe infection that healed after later metal removal and debridement, and severe infection reaching the bone. Union took an average of 9.6 weeks, ranging from 6 to 14 weeks. Conclusion: Pediatric femoral fractures can be treated using TENS, which is a simple, dependable, successful, and less invasive approach.

Introduction: Proximal humeral fractures (PHFs) are the seventh most frequent fractures in adults [1]. Proximal Humerus Fractures constitute about 4% of all fractures and 26% of all humerus fractures [2]. Management of three-part and four-part fractures is still a challenge owing to associated complications including osteoporosis, angulation, unstable reduction, varus collapse, screw back out etc. Aim of our study was to assess the functional outcome proximal humerus fractures (Neers classification 2 part, 3 part and 4 part) treated with PHILOS (Proximal humeral locking system).Methods: Our study was a prospective study conducted at our institution from October 2018 to December 2019. The study group consisted of 30 patients including 6 female patients and 24 male patients. The Proximal humerus fractures were classified using Neer’s classification system. Open reduction and fixation with a PHILOS plate was carried out on all the patients under general anesthesia. All patients underwent a similar post-operative physiotherapy. Functional parameters were assessed using Constant-Murley scoring system. Results: In our study, 14 (46.7%) cases showed Excellent outcomes, 9 (30%) showed good outcomes, 4 (13.3%) showed fair outcomes and 3 (10%) showed poor outcomes. The mean constant score was 78 in our study. Our study group had 7 (23.3%) cases of complications. The most common complication was varus malunion which was seen in 3 (10%) cases.Conclusion: PHILOS plate provides a high degree of angular and axial stability eliminating screw loosening and backout. The divergent and convergent orientation of the screws engaging in the humeral head prevent pull out and failure of fixation.

Introduction and Purpose: COVID-19 pandemic has changed the field of traumatology world-wide. Exposure by inhalation of droplets from an infected person is the main route of spread. Numerous studies has shown aerosols are generated not only by coughing and sneezing but also by speaking, talking loudly and whisper. Lot of talking is involved during trauma surgery during handling instruments. Mask wearing especially N95 can force us to use louder speech. Here we introduce a new universal sign language for instruments and maneuvers inside the operating rooms in order to reduce the speech involved so that inter personnel spread can be minimized. Materials and Methods: We have charted a universal hand gestures for most commonly used instruments and maneuvers commonly involved in a fracture fixation surgery. These gestures are taught to all doctors and staffs involved in fracture surgery. The staffs are motivated to use gestures instead of speaking. Each instruments when needed is indicated by a specific gesture. For quick reference a simplified chart showing the gestures can be pasted inside operating room walls. Conclusion: Operating a COVID positive patient during his infectious period is inevitable since trauma surgeries cannot be delayed unlike elective surgeries. Avoiding excessive talking during the procedure and using sign languages inside operating rooms can minimize viral load from operating personnel and therefore can safeguard medical professionals.

Background: Tibial condylar fractures are often associated with depression of articular surface and commonly used classifications describe various fracture patterns. However, these classifications do not address the types of depression of articular fragments, so we tried to classify various types of depressions of articular surface associated with tibial condylar fractures and developed a treatment algorithm based on our study, with an aim to facilitate step-wise approach for classifying and modes of elevation of depressed fragments. Material and Methods: This was an intervention study of 950 tibial condylar fractures operated at our center by single surgeon between March 2002-2016. These patients were retrospectively evaluated for radiographic and functional outcomes. Results: The study revealed mean post op condylar tilt of 5.38° ±3.55, (0-12), condylar widening of 2.68 ±1.25 (0-6mm), articular step 2.98±1.86 (0-8mm), valgus tilt 6.64°±3, (0-13) and mean knee society score of 84.39±6.3, (60-98) at follow-up of 12 months post-op. All the cases were followed up for at least 24 months, mean follow-up time 87.39 ± 35. 97 months (7.25+2.91 years).The average radiographic bony union time was 17.07 ±1.4, (14-22wks) weeks, the average full weight bearing time was 15.04 ±2, (12-24) weeks. The average range of motion of the affected knees at 12 months was 127.6°±4.46, (120-135). Conclusion: Based on our study of the various types of depression of articular surface in tibial condylar fractures, we were able to classify depression, facilitate steps of surgery and improving outcomes.

Introduction: Intracapsular femoral neck fractures account for about 50% of all hip fractures. With increase in life expectancy, the incidence is increasing. Popular treatment is replacement of femoral head by bipolar prosthesis. Materials & Methods: This study was done to assess the functional outcome of cemented bipolar hemiarthroplasty. Patients aged 50-80 years with intracapsular femoral neck fractures reporting to the department of the institute were considered for the study. 30 such patients were selected. All were operated by cemented modular bipolar hemiarthroplasty. It was a retrospective as well as prospective study. Regular clinical and radiological follow up was done for a minimum period of 6 months. Results were assessed using Harris Hip score. Results: Out of 30 patients assessed, 17 were females and 13 were males with average age of 68 years. At 6 months of follow up, out of 30 patients, excellent results were observed in 70% cases, good in 20% cases, average in 10% cases and poor in 0% cases. Conclusion: Most patients reported good to excellent functional results post cemented modular bipolar hemiarthroplasty. Hence, Cemented Modular Bipolar Hemiarthroplasty is a safe and effective treatment modality in treating femoral neck fractures in middle aged to elderly individuals.

Background: Patellar fractures constitute about 1% of all skeletal injuries resulting from either direct or indirect trauma the subcutaneous nature of patella makes it vulnerable to direct trauma, whereas violent contraction of quadriceps result in indirect fractures of patella. Patella is the largest sesamoid bone in the body and forms integral part of extensor mechanism of the knee joint. Functional outcome of patella fractures depends on age, severity of injury, treatment modality, anatomical reduction and restoration of articular congruity, post-operative rehabilitation. Aim of the study is to assess the functional outcome of tension band wiring in transverse patella fracture.Materials and Method: This study was carried out at the Department of , Navodaya Medical College, Raichur over a period of 2 years. In this study 30 patients (23 male, 7 females) with transverse patella fracture were admitted and were treated by tension band wiring. Functional outcome was assessed as per knee pain score, good fellow grading for range of motion.Results: A total of thirty patients were evaluated in our study of which there were 23 males and 7 females. Out of which 24 patients had excellent results, 4 had good results and 2 had fair results. At the end of 6th month majority of patients show excellent results according to good fellow grading range of motion.Conclusion: The tension band wiring is safe and effective in the management of transverse patella fracture because of good stability of implant and easier postoperative rehabilitation.

Hemireplacement arthroplasty, cemented bipolar prosthesis, fracture neck femur

Humeral shaft fractures, flexible nails, closed reduction and fixation

Missed injuries, altered gcs, tertiary survey

Intertrochanteric femur fractures, trivial fall, rta

Medial tibial stress syndrome, hyperbaric oxygen therapy, shin splints, indian army soldiers, army recruits

Elbow fractures, distal humerus plating, approach for distal humerus

Closed reduction, percutaneous pinning, supracondylar fracture

Acromion, rotator cuff tear, type iii acromion, impingement syndrome, supraspinatus tear

Humeral shaft fractures; dynamic compression plate; radial nerve

Percutaneous mini, fasciotomy, compartment syndrome

Talus, posterior process fracture, open reduction

Caudal epidural steroid injection, lumbar radiculopathy, disc herniation