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Aim:To study the functional outcome in unstable Hangman s fracture managed with anterior decompression and stabilization with cervical locking plate and tricortical bone graft.Materials and Methods:Between 2010 and 2016, 44 patients (range: 19-75 years) with unstable Hangman's fracture underwent anterior decompression and stabilization with cervical locking plate and tricortical bone graft in our institution.Result:According to the Levine and Edwards classification, all patients were unstable with Type IA 6 (13.6), Type IIA 35 (79.5%), Type II (0), and Type III (6.8). The mean period of follow-up was 17 months (range: 6-48 months). Neurological recovery was observed in all nine patients. All patients were relieved from axial pain. None of the patients received blood transfusion. All patients showed solid fusion with no complication related to bone graft and plate.Conclusion:The anterior C2/C3 discectomy, fusion, and stabilization with cervical locking plate and tricortical bone graft are feasible and safe method in treating HangmanÊs fracture, with the benefit of high primary stability, anatomical reduction, and direct decompression of the spinal cord.

ObjectiveTo evaluate the results of operative management of subaxial spine injuries managed with 2-level anterior cervical corpectomy and fusion with a cervical locking plate and autologous bone–filled titanium mesh cage. MethodsThis study included 23 patients with a subaxial spine injury who matched the inclusion criteria, underwent 2-level anterior cervical corpectomy and fusion at our institution between 2013 and 2016, and were followed up for neurological recovery, axial pain, fusion, pseudarthrosis, and implant failure. ResultsAccording to Allen and Ferguson classification, there were 9 cases of distractive extension; 4 of compressive extension; 3 each of compressive flexion, vertical compression, and distractive flexion; and 1 of lateral flexion. Sixteen patients had a score of 6 on the Subaxial Injury Classification system, and the rest had a score of more than 6. The mean follow-up period was 19 months (range, 12–48 months). Neurological recovery was observed in most of the patients (78.21%). All patients experienced relief of axial pain. None of the patients received a blood transfusion. Twenty-one patients (91.3%) showed solid fusion and 2 (8.69%) showed possible pseudarthrosis, with no complications related to the cage or plate. ConclusionTwo-level anterior cervical corpectomy and fusion, along with stabilization with a cervical locking plate and autologous bone graft-filled titanium mesh cage, can be considered a feasible and safe method for treating specific subaxial spine injuries, with the benefits of high primary stability, anatomical reduction, and direct decompression of the spinal cord.

Introduction: We would like to analyze the role of cemented hemiarthroplasty in elderly osteoporotic unstable intertrochanteric fractures through trochanteric fracture window.Materials and Methods: The study was conducted from July 2011 to July 2014. From a total of 265 consecutive patients with intertrochanteric fractures of 42 patients were selected according to inclusion criteria and results were analyzed prospectively. All patients were operated at tertiary care institute. Patients which matched the inclusion criteria were selected. 42 patients entered the study and all completed the study. Primary cemented hemiarthroplasty was done in all patients. Modified Harris Hip Score was used to assess all the patients.Results: 42 patients were included in the study with an average age of 80.7 years. Only AO/OTA type 31-A2.2 and 31-A2.3 were included, average HHS at final follow up of three years was 86.2. No revision or reoperation was done.Conclusion: In a selected cohort of patients primary prosthetic replacement in elderly osteoporotic unstable intertrochanteric fractures is good option and the surgical technique allowed us to perform it more easily.

Indian dairy sector is a blend of formal (cooperatives and private) and informal sector (small processing units, milk vendors etc.). Informal sector still dominates in terms of procurement of the sizeable milk surplus of the country. The present paper has examined the cost and return structure of 27 informal dairy processing units in Karnal district of Haryana for the year 2018-19. The net returns of these processing units are mainly attributed to varying level of milk handling capacity and diversification towards value added products. Dahi turned out to be most profitable product with 53 per cent of profit over cost followed by ghee (12.75 %). The costs of dairy products were found to be decreasing with rising milk processing capacity. Solvency status of dairy processing units was found to be satisfactory yet there is a need for further strengthening.

In this paper, we analysed how the adoption level of food safety practices varies with milk procurement system in the informal milk processing sector and also developed a composite food safety index (FSI) deliberating the interplay of factors and actors. Primary data were collected from value chain actors, viz., small and micro dairy processing units (main actors), milk supplier, i.e., dairy farmer and milk vendors (upstream actors) and traders (downstream actors) in Karnal district of Haryana state of India. FSI of two identified milk procurement systems, viz., (i) own collection centres, and (ii) private vendors were compared. Processing units with own collection centres in production catchments have been able to establish better linkages with dairy upstream actors and resulted in better overall FSI (0.66) than those processing units procuring milk from private vendors (with FSI as 0.51). Further, the profitability of the processing unit is positively associated with the FSI, as consumers are willing to pay higher prices for safe milk. There was a need to design efficient milk procurement systems; design and development of efficient milk transport systems and processing technology along with training in post-milking handling for small vendors and processors for better food safety compliance in the milk value chain of the informal sector.

Background: Femoral shaft fractures are usually treated with intramedullary nailing. In this study, we report a modified closed surgical technique with reduction with bone levers through a small percutaneous stab incision without opening fracture site for this type of fracture.Methods: From June 2015-January 2017, this technique was used on 43 patients with femoral shaft fractures. Patients were followed up postoperatively for clinical evaluation. The surgical technique involves a mini-percutaneous incision slightly distal to the fracture site, and fracture reduction is performed with bone levers without opening the fracture site.Results: 39 patients were included in final assessment. 29 fractures (74.4%) healed in the first 6 month. 35 (89.7%) fractures were united by one year. 4 (10.3%) patients needed bone grafting. The functional results were considered excellent and good in 36 (92.3%) patients, 3 (7.7%) patients had poor results.Conclusions: The advantages of this procedure include that no fracture site is opened, there is a shorter operation time, less radiation exposure and it is especially suitable for multiple trauma and obese patients.

Antegrade nailing is associated with good union rates and low infection rates and is a good option in open fractures and in polytrauma patients.