Background: The angle between femur neck and the long axis of shaft is known as neck shaft angle which plays vital role in stability, control of lateral balance, walking and hip movements. The main goal was to compare the NSA in intertrochanteric fracture of femur immediately after the surgical fixation using either Dynamic Hip Screw or Proximal Femoral Nail. In the elderly among all of the hip fractures approximately half are intertrochanteric fractures and out of which approximately 50% of fractures are unstable.Method: X-ray of pelvis with both hips was taken prior to fixation and after fixation, done either with PFN or DHS and morphometric measurements were taken.Result: The mean neck shaft angle restored after fixation with PFN (131.10±7.24 degree) was almost similar to that of normal side (129.58±5.79degree) whereas it was more with DHS (141.65±9.78 degree).Conclusion: Restoration of Anatomical NSA is more achievable with PFN as compared to NSA.

Introduction: With the increasing incidence of trauma worldwide there has been an increase in the incidence of fractures involving the long bones globally as compared to the past (1, 2). There are a variety of associated injuries that occur along with the complex fractures in cases of trauma. Materials and Methods: The study was conducted after institutional research board clearance and after approval from the human ethics committee. All patients fulfilling the inclusion and exclusion criteria admitted at A.J.I.M.S. will be considered for the study after obtaining informed written consent. Once the patient was fit for surgery patient were operated by senior staff. Preoperatively the urine was sent for detection of fat globulin and Postoperatively the urine was sent for detection of fat globulin evaluation within 3 hours of surgery. The collected data was analysed by SPSS 17.0 version software.Observations and Results: Males were 88% p =0.008, left side 52% p =0.078. 33% were admitted within 4-5 Among all bones tibia was the commonest of the bone fracture involved 67 cases, combination of tibia and fibula was the commonest seen in 44.00%.The examination of urine for fat globulin post operatively was negative in all 100 of the cases. The examination of urine for fat globulin pre operatively was positive in 2% of the cases. Conclusion: 1 The present study we found that urine fat globulins in fractures involving the long bone are present in two percent of cases. In both cases the patients had sustained multiple bone fractures. There was a delay in presentation to the hospital of more than 4 hours in both cases. Both patients had an elevated BMI fat in urine in fractures involving the long bone have no correlation to complications.

Introduction: Proximal humerus fractures are common and debilitating injuries, especially in elderly as osteoporosis and deforming forces of muscle attached. Wide range of treatment modalities ranging from conservative management to shoulder arthroplasty. In our study we have evaluated proximal humerus interlocking osteosynthesis (PHILOS) plate in internal fixation of proximal humerus fracture. Background and Objective: The objective of study 1) To evaluate and analyse the functional outcomes of PHILOS plate for displaced fractures of proximal humerus 2) To improve stability in osteoporotic humeral bone 3) To preserve the biological integrity of the humeral head and to secure an anatomical reduction with multiple locking screws with angular stability 4) To study the complication rates of PHILOS plating in proximal humerus fractures Material and Method: A prospective study of treatment of proximal humerus fractures treated with PHILOS plate was carried out at our institute, at the Department of Orthopaedics, S.S.G. Hospital Vadodara from June 2021 to august 2022, where after applying exclusion and inclusion criterion, 20 patients of proximal humerus fractures were included in our study. Fractures were classified as per AO classification. Assessment of union, movements at shoulder, constant score and complications were done during regular follow-up of 4 month. The functional outcome was measured using Constant and Murley Shoulder Scoring System.Results: We had 20% excellent, 55% good results, 15% fair & 10% poor results.Discussion and Conclusion: The divergent and convergent orientation of the locking screws of PHILOS plate provides stable biological fixation with high union rate to use for treatment of fractures of the proximal humerus in Neer’s 2-part, 3-part, and 4-part with better functional and radiological outcome especially in osteoporotic bone due to low complication and early postoperative mobilization. Potential minimal complication can be prevented by advanced surgical skill and expertise and rotator cuff tying.

Introduction: Tip Apex Distance (TAD) is well established method of prediction of outcome in intertrochanteric fractures managed by Dynamic Hip Screw. This retrospective study was done to assess the significance of Tip Apex Distance in the management of the intertrochanteric fractures by proximal femoral nail.Methodology: Selection of Cases-An informed written consent will be taken from all the patient/relatives/guardian after the approval of Institutional Ethics Committee.Source of Data: Patients admitted to Sri Aurobindo Medical College and PG Institute, Indore for fracture proximal humerus in adult patients.Conclusion: This study indicates that the Tip Apex Distance can be used as a useful predictor of the outcome of the proximal femoral nail in intertrochanteric fractures.

Background: Vertebral compression fracture occurs when vertebral body collapses and it leads to severe pain, loss of vertebral height and deformity. Most commonly occurs in thoraco-lumbar region. Most common fracture in patients with osteoporosis.Materials and Methods: A total of 20 patients with osteoporotic vertebral compression fracture was treated in this study from November 2021 to October 2022.Results: After 1 Year of Follow up, result Was Excellent in 15 Patients, Good in 3 Patients, Fair in 1 Patient and cement leakage in 1 patient.Conclusion: We conclude that vertebroplasty is safe and minimally invasive procedure for osteoporotic vertebral compression fractures. Proper selection of patient, evaluation, and technique are important to obtain good outcomes and minimize the complications.

Background: Clubfoot is the commonest musculoskeletal congenital deformity affecting the foot. The idiopathic variety is the most common type and worldwide the agreed treatment method is the Ponseti method. In bilateral cases, the feet may have different anthropometric characteristics. These differences were evaluated in this study.Objective: To assess the effect of the differences in the anthropometric parameters of the legs and feet (Calf circumference, foot length, degrees of cavus, adduction and equinus and Pirani score) in a child with bilateral clubfoot on the treatment outcome and recurrence of the deformity.Method: This was a prospective study that analyzed idiopathic bilateral clubfoot patients aged 0-5 years and treated using the Ponseti Technique at Federal Medical Center, Umuahia from October 2019 to September 2020. The Pirani scores, the lengths of the feet, the calf circumferences and degrees of cavus, adduction and equinus were measured at initial presentation, commencement of bracing and 3 months after commencement of treatment. These measurements were then compared.Results: A total of 47 patients participated in the study with a male preponderance. The right calf circumference and length of the right foot were consistently bigger than the left at each measurement; and these differences were statistically significant. The degrees of cavus, adduction and equinus were significantly worse on the right foot at presentation. Thirty-six patients (76.6%) had the same Pirani score on both feet at presentation. The differences in anthropometry parameters did not predict the number of casts needed to correct the deformity, the need for tenotomy nor the recurrence of the deformity.Conclusion: Although there were differences in the lower limb anthropometry of children with bilateral clubfoot, they did not predict deformity correction nor recurrence.

Plantar Fasciitis is responsible for 15% of all foot problems. Over ten percent of the population will be affected at some point in their lives. It is caused by inflammation of a broad band of tissue that links your heel bone to your toes and runs across the bottom of your foot (plantar fascia). Plantar fasciitis is a type of plantar fasciitis that causes stabbing pain when you take your first steps in the morning. The discomfort usually goes away as you get up and move around, but it may come back after long periods of standing or when you stand up after sitting. Runners are more likely to get plantar fasciitis. The plantar fascia is made up of of white-coloured fibers that run longitudinally from the calcaneum to the toes. The attachments include the following: Proximal- Affixed to the calcaneum's medial tubercle. The fascia fanning out into five slips against the metatarsophalangeal joints and attaches to the base of the appropriate toes' proximal phalanges. Chronic heel pain is a difficult condition to treat and takes a long time to resolve. This study outlines both PRP and steroid are effective and safe modalities in the treatment of plantar fasciitis. But statistical data suggest that steroid injection is effective for immediate pain relief. And PRP injection is better for long term pain relief in plantar fasciitis with no side effects.

Objective: To evaluate the functional outcomes of the patient having Unstable Inter-trochanteric fracture with or not with sub-trochanteric extension treated by long PFN with or without augmentation. Materials and Methods: In our institute, a prospective study of 24 patients who underwent surgical intervention for inter-trochanteric fractures with or without sub-trochanteric extension using long PFN alone or along with augmentation and studied their mechanism of injury, sex prevalence, classification, outcomes and complications for a period of one year from January 2021 to January 2022. Results: The patients were follow-up for duration of 9 months. At the 6th month, the mean Harris hip score was determined to be 86. Out of the total participants, 10 patients achieved an excellent score, 10 patients had a good score, 2 patients had a fair score, and 2 patients had a poor score. Conclusion: Based on this study, both Long PFN with and without augmentation yield comparable outcomes in terms of functional results, implant-related complications, and fracture healing rates for unstable inter-trochanteric fractures with or without sub-trochanteric extension. The decision to augment the fixation with wire cerclage should be made on a case-by-case basis, considering fracture characteristics, bone quality, and surgeon expertise. Prospective randomized controlled trials.

Background: Complex primary total hip replacement presents a challenging condition for both new arthroplasty surgeons and experienced ones. Similar to a revision scenario, there may be difficulties such as shortening, soft tissue contractures, and fragile bones. Furthermore, these patients are at a higher risk of postoperative hip dislocation.Method: We present a case of a 57-year-old patient with a Pipkin fracture of the left femoral head and avascular necrosis (AVN) of the femoral head. This patient had a history of chronic alcoholism and smoking and had experienced a fall four years prior, resulting in gross shortening and complete loss of hip movements, except for flexion from 200 fixed flexion deformity (FFD) to 70. To achieve good outcomes, we used the latest evidence and opted for a Capitol C Monoblock dual mobility cemented cup (Evolutis...) and Exeter V40 cemented stem (Stryker...) for left hip reconstruction, successfully achieving perfect limb equalization.Conclusion: Total hip replacement in patients with alcoholism and ASA grade > 3+ is always a challenging surgical problem. Orthopaedic surgeons may not be aware that ASA grade > 3+ patients are at a higher risk of dislocation following hip replacement. By following the latest evidence-based principles and choosing a dual mobility cup for this patient, who had more than two risk factors for postoperative dislocation, we achieved a very good patient outcome.

This paper, describes a novel technique of graft harvest from the drill site during plate osteosynthesis of fractures of upper limb. The grafts harvested are corticocancellous chips which we prefer to name as 'Drill dust'. This drill dust usually goes wasted as surgeons tend to ignore to collect the drilled out bone which is usually washed out during or after the procedure. We decided to collect these drilled out bone in a meticulous and systematic manner and found that they form a significant amount of bone to be used as a graft at the fracture site which can potentially enhance fracture union. We did a study utilising our technique assessing clinical and radiological union in a subset of patients undergoing upper limb fracture plate osteosynthesis between July 2018 to Jun 2019. We found that there was an enhanced radiological and clinical union in all 28 of our cases where this technique was used. There were no complications noted with the procedure.