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Optimal method of humeral shaft fracture fixation remains in debate till date. Two techniques under study include intramedullary nailing and dynamic compression plate fixation. Plating provides satisfactory results but requires extensive dissection and meticulous radial nerve protection. Theoretical advantage of intramedullary nailing included less invasive surgery, undisturbed fracture hematoma and use of load sharing device support. Purpose of this study is to compare outcomes of each method of fixation for fracture shaft of humerus. MATERIALS AND METHODS: Patients with diaphyseal fractures of the humerus were divided in two groups of 20 treated with dynamic compression plate or with intramedullary interlocking nail. Postoperatively both groups received same type of physiotherapy. They were followed up regularly. Time taken for radiological union in two groups was compared. After satisfactory radiological union, functional outcome was assessed by "Disabilities of Hand, Shoulder and Elbow (DASH) Questionnaire". RESULTS: Functional outcome was better in DCP group compared to interlocking nailing group which was statistically significant (P= 0.062). Rate of healing was marginally better in DCP group as compared to I.M nail. CONCLUSION: We are of opinion that when surgery is opted as a choice of treatment, both modalities of treatment i.e. dynamic compression plating and interlocking nailing are good as far as union of fracture is concerned, but considering number of complications and functional outcome, we opine that dynamic compression plating offers better result than antegrade interlocking nailing with respect to pain and function of shoulder joint.

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Background: Degenerative changes in the knee occur with increasing frequency after the third decade of life. In early osteoarthritis with no mal-alignment of the knee, arthroscopic surgery is an attractive alternative for many elderly patients as it reduces the degree of surgical insult and postoperative rehabilitation with hope of restoration of painless mobility. To study the role of arthroscopic debridement in alleviation of pain in cases of osteoarthritis knee and to evaluate the effectiveness of arthroscopy in diagnosis of osteoarthritis knee and its co-relation with radiological diagnosis. Methods: The present study is cross-sectional study of consecutive cohort of 53 patients. Body mass index was calculated based on height and weight of the patients and from their assessment of X-Rays patients were graded from 0 to 4 based on Kellegren-Lawrence radiological grading method. Selected patient were then assessed by pain domain of the knee society scoring system, which is joint specific score ranging from 0 to 50. These patients were then subjected to arthroscopic examination and debridement. Results: Overall 17 (32.08%) out of total 53 cases studied showed improvement after one year. Majority of patients improved were grade 2 (57.89%) but none of the grade 4 patients showed improvement at 1 year. Conclusions: Arthroscopic debridement does not influence the ongoing pathological process; it is only useful for symptomatic relief in cases of low grade osteoarthritis where it provides pain relief. Conversely, in patient with sever osteoarthritis there is very limited role of arthroscopy.

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High-grade spondylolisthesis is better dealt with surgical methods. There are various methods to achieve solid fusion and decompression in the presence of symptomatic spinal stenosis. In our case report, we have compared delta fixation with interbody fusion methods, especially in high-risk patients (American Society of Anesthesiologists grade III) with its various merits and demerits, and we have attempted to discuss it with respect to the literature available.

Cauda equina syndrome is widely considered as a surgical emergency. The cause of cauda equina syndrome usually is a large central lumbar disc herniation, prolapse or sequestration. Decompression at the earliest has been suggested by many authors but the planning of surgical management becomes challenging when the patient is a breastfeeding mother. Fear of harmful effects of the drugs (administered in the mother) on the infant, always confuses clinicians regarding the treatment approach. So the multidisciplinary approach is necessary with involvement of anaesthetist, paediatrician and also a gynaecologist if necessary. Thorough knowledge of the safety of drugs to be used in operative and post operative period becomes a necessity keeping the baby into consideration. We present a case of one month postpartum female with cauda equina syndrome and present a stepwise multidisciplinary approach, which involves active contributions from surgeon, for safety of the mother and the infant.

Introduction Os-odontoideum is a rare condition, described radiographically and clinically as a congenital anomaly of the second cervical vertebra (axis), it a smooth, independent ossicle of variable size and shape separated from the base of a shortened odontoid process by an obvious gap, with no osseous connection to the body of C2. Material and methods This study reviewed the literature on OO to evaluate its etiology, the clinical presentations, differential diagnosis, imaging modalities and outcomes in the management of asymptomatic and symptomatic cases of os odontoideum. PubMed, EMBASE, Google Scholar and Cochrane key articles were searched. Discussion Considering etiology traumatic hypothesis is favoured over congenital hypothesis as per recent literature on OO. Clinical presentation varies from asymptomatic to mild neck pain to severe myelopathy and neurodeficit. Various C1-C2 instrumentation and fusion techniques like wiring, trans articular screw and laminar screws have been described with good success rates. Conclusion Os odontoideum is a rare condition with limited existing literature. Considering significant risks involved if conservative management is opted like severe neurodeficit to sudden death on trivial trauma and the recent improvement of imaging tools helping to understand the pathology of the disease, surgery can be indicated even in an incidentally detected os odontoideum. Although for asymptomatic stable patients’ individual case-by-case approach can be considered depending on factors such as age, activity level, comorbidities, syndromic association and radiographic findings. Keywords: ‘Os-odontoideum’, ‘surgical management’, ‘etiology’, ‘Atlanto-axial instability’ ‘complications’