AIM:Technique for the fixation of two, three, and four part proximal humerus fractures has rapidly shifted towards the use of locking plates. The objective of this prospective study was to evaluate functional outcome and complications of proximal humeral fractures managed with proximal humerus internal locking system (PHILOS). METHODS: 16 men and 9 women aged 19 to 82 (mean, 49.24) with an acute proximal humerus fracture were treated with PHILOS plate by using deltopectoral approach. Outcome measurements included Constant score, complications, and radiographic assessment. RESULTS: 11 patients had 2-part fractures, 11 patients had 3-part fractures, and 3 patients had 4-part fractures. After 6 month follow up, a mean Constant score 57.4 was achieved. Outcomes were excellent in 16%, good in 44%, fair in 16% while poor in 24%. The Constant score was poorer for Neer type IV fractures as compared to other types. The most frequently occurring complications in our patients were malreduction 20%, screw perforation 16%, infection 12%, avascular necrosis 8%, frozen shoulder 8%, impingement 4% and plate pull out 4%. CONCLUSION: Fixation of proximal humerus fractures with proximal humerus locking plates is associated with satisfactory functional outcomes in 2-part and 3-part fracture. The incidence of complications and subsequent re-operation is relatively high. Advanced surgical skills and surgeon's experience are considered to be more critical for successful operative treatment.

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: Docosahexaenoic Acid (DHA) is an essential polyunsaturated omega-3 fatty acid, and a fundamental structural component of the phospholipid membranes, especially of neural and retinal cells. DHA is found to be critical for the normal development and functioning of neurons and synaptogenesis in the brain, and is required during pre- and post-natal stages of life. Also, DHA has been observed to exhibit neuroprotective, cardioprotective, anti-inflammatory properties. However, geographical dietary variations and poor economic conditions lead to insufficient DHA levels resulting in various health deficits like improper brain development, cognitive disorders, and other clinical complications. Thus, to prevent its deficiency-induced derangements, several authoritiesrecommended DHA as a supplement during pregnancy, infancy, and throughout adulthood. In past decades, the soft gelatin capsule was only feasible resolute of DHA, but due to their limitations and invent of new technologies; it led to the development of new dosage forms with improved physicochemical characteristics of DHA. This article will discuss in detail about the role of DHA in brain development, microalgae oil as an emerging source of DHA, clinical- and pharmacologicalactivities of DHA, issues related to DHA oil, current formulation of DHA along with their application, limitations, and strategies used to improve and future prospective.

Aim Modern trend in the management of fractures is fast changing in favor of rigid fixation and early mobilization with minimal period of plaster immobilization. We present a prospective cohort study of fixation of medial malleolus fractures with Minifragment T-plate and its evaluation in terms of maintenance of accurate anatomical reduction, stable fixation, and early restoration of functions. Materials and methods A total of 25 patients of median age 45 years (22–70), with medial malleolus fractures were treated by open reduction and internal fixation using Minifragment T-plate. Outcome was evaluated using the American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Score. Results A total of 80% cases had anatomical reduction, 12% had good reduction (<2 mm displacement), 4% had fair reduction (2–5 mm displacement), and 4% had poor reduction (>5 mm displacement). After 6 months follow-up, outcome was excellent in 20 cases (80%), 3 cases (12%) had good result, and 2 cases (8%) had fair result according to AOFAS score. Out of 25 cases, in 2 cases (8%) infection occurred, 6 cases (24%) had limitation of movements, 1 case (4%) had instability at ankle, and 2 cases (8%) had delayed union of fracture. Conclusion Weighing the advantages and disadvantages of fixation with Minifragment T-plate, it can be safely concluded that Minifragment T-plate can be an effective alternative option in the management of medial malleolus fractures. At the same time, it is warned that this technique should not be used indiscriminately without technical skill. Clinical significance Minifragment T-plate fixation provides rigid fixation along with early return of movements with limited period of immobilization. Studying this alternative method expands the present knowledge for management of medial malleolus fractures. How to cite this article Sohal HS, Garg RS, Jindal S, Wadhwani J, Bansal V, Ahmed M. Minifragment T-plate Fixation: An Alternative Method for Medial Malleolus Fracture Fixation. J Foot Ankle Surg (Asia-Pacific) 2016;3(1):10-14.

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