Background: Clavicle fractures are representing 2.6% of total body fractures. The common fracture is the midshaft fracture of the clavicle. The outcomes of non-operative treatment are not preferred nowadays, so the trend to surgical treatment of these fractures has grown. The aim of the work:The current study aimed to compare the outcomes of conservative and operative treatment of displaced midshaft clavicular fractures with plate fixation to clarify the merits and possible disadvantages of each method.Patients and Methods: Twenty patients as a convenient sample were included. These patients were subdivided into two groups, group I for conservative treatment and group II for operative treatment with plate fixation. All patients will be subjected to complete history taking, clinical, general &local examination, a standard anteroposterior view of the clavicle was done and follow up average 6 months.Results: At the end of follow up period, according to Constant Shoulder Score (CSS), 11 patients had excellent results (CSS: < 11), 4 patients had good results (CSS: 11-20), 3 patients had fair results (CSS: 21-30), 2 patients had poor results (CSS: >30). Pain VAS was significantly higher in group I compared with group II. There is a significant difference found between the groups as regard (outcome, pain VAS, the strength of abduction and the extent of internal rotation) P value < 0.05. There is no significant difference found between the groups as regard (socio-demographic data, comorbidities, fracture characteristics, fractures classification, degree of forward flexion, degree of lateral elevation and extent of lateral rotation) P value >0.05. Conclusion:Operative treatment with plate fixation is better than conservative treatment in management of pain, high union rate, good functional outcomes and greater patients satisfactory after displaced mid shaft clavicular fractures.

Background: Total knee Replacement proved to be an effective surgery that leads to restoration of joint function, limb alignment, beside elimination of pain in patients with osteoarthritis. Aim of the work:To assess the results of treatment of osteoarthritis of the knee with severe malalignment by total knee arthroplasty.Patients and Methods: 30 patients [12 males & 18 females] aged from 48 -68 years who had advanced knee arthritis were operated by total knee replacement at Al-Azhar University Hospital [Damietta] and Damietta Specialized Hospital and followed up for average 12 months from December 2016 to March 2019. All patients were assessed by history taking, examination, radiological and laboratory investigations, and all were subjected to a three-phase postoperative rehabilitation protocol.Results: 19 patients [63.3 %] had excellent final result, 8 patients [26.7%] had good result, 2 patients [6.7 %] had fair result and one patient [3.3 %] had poor final result. In addition, there was significant improvement in pain relief and joint function. Conclusion:Total Knee Replacement in severe malalignment is a challenging surgery. However, it leads to significant changes in the quality of life in most patients; regarding pain relief, improvement in joint function and early return to daily activities.