BACKGROUND 1. To evaluate the incidence and coexistence of multiple knee joint pathologies causing painful knee and their correlation to age and sex. 2. To evaluate the Magnetic Resonance Imaging (MRI) features in various knee pathologies and to identify the common lesions. MATERIALS AND METHODS A retrospective study was performed using the clinical data of patients presenting with painful knee joint which were evaluated with MRI. Data from 200 patients examined between September 2015 and August 2016 were included into this study. The data was analysed statistically to evaluate the correlation between the MR pathological findings to age and sex of the patients. RESULTS The patient's age ranged between 8 and 75 years (mean: 36 years). Anterior cruciate ligament (ACL) tear was the commonest finding (60%) followed by bursitis (55%), meniscal degeneration (54.6%) and meniscal tear (52%). Primary signs of ACL tear were hyperintensity, discontinuity and nonvisualisation. Secondary signs like Posterior cruciate ligament (PCL) buckling, PCL index of greater than 0.5, uncovered Lateral meniscus (LM) and bone contusion assisted in diagnosis in indeterminate cases. Mid substance was the commonest site of ACL tear (64%). PCL tear accounted for only a small percentage (7%). Medial Meniscus (MM) tear (35%) was commoner than LM tear (17%). The posterior horn of meniscus was the commonest site of injury (86.5%). Age was significantly correlated with meniscal degeneration and tear, Medial collateral ligament (MCL) degeneration, parameniscal cyst, and chondromalacia patellae. A significant correlation between male gender and ACL injury was noted. Meniscal injury was significantly correlated with bursitis, as well with MCL injury. Bone bruise was significantly correlated with ACL injury, MCL injury and Lateral collateral ligament (LCL) injury. CONCLUSIONS MRI findings of certain pathologies in a painful knee can coexist and significantly correlate with each other, age and sex of the patient.

BACKGROUND There is no consensus about the best option of internal fixation for unstable intertrochanteric fractures of femur. This study aimed to evaluate the treatment effects of contra-lateral reverse distal femoral locking compression plates in unstable femoral intertrochanteric fractures as a viable alternative to intramedullary devices. MATERIALS AND METHODS A total of 30 cases with unstable femoral intertrochanteric fractures were treated with contra-lateral reverse distal femoral locking compression plates. The period from injury to operation was 3-10 days. RESULTS The intra-operative blood loss was 160.5 ± 80 ml and the operation time was 55 ± 20 mins. The fractures united within 12-24 weeks (average 16.4 weeks). According to the Modified Harris Hip Score, the results were excellent in 15, good in 12, fair in 2 and poor in 1 case. Excellent and good rate of clinical results were 90%. 2 cases developed trochanteric bursitis due to irritation by hardware. 1 case had plate collapse who was offered surgical option but sought no treatment for malunion. None of the cases had any implant failure, non-union and any surgical site infection. CONCLUSION Contra-lateral reverse distal femoral locking compression plate is an effective way for treating unstable femoral intertrochanteric fractures. However, early weight bearing should be avoided and judicious use of bone grafting wherever it is needed is recommended to achieve early union.

BACKGROUND External Fixation (EF) and Open Reduction and Internal Fixation (ORIF) have been the traditional surgical modalities for unstable distal radius fractures. The Locking Compression Plates (LCP) acting as "internal external fixators" are particularly valuable in difficult situations of fractures. We undertook a study to evaluate the outcome of unstable distal radius fractures treated with ORIF with LCP versus those treated by ligamentotaxis with external fixators. MATERIALS AND METHODS A comparative study was carried out in a tertiary care centre with 30 cases of unstable distal radius fractures (15 cases in each group). In one group, open reduction and internal fixation with distal radius volar locking compression plate was carried out and in the other group ligamentotaxis with external fixator was done. The patients were treated and followed up over a period of one and a half year between June 2011 to November 2012. The fractures were classified according to AO classification (Arbeitsgemeinschaft für Osteosynthesefragen: German for "Association for the Study of Internal Fixation" or AO). The functional results were evaluated at the end of 6 months according to Demerit point system of Gartland and Werley modified by Sarmiento (1975) and the anatomical results as per Lindstrom criteria (1959) modified by Sarmiento (1980). RESULTS Overall 86.66% (13) cases had good-to-excellent anatomical results in external fixator group as compared to 93.33% (14) cases in LCP group. The functional outcome was excellent in 80% (12) and good in 13.33% (2) cases in external fixator group as compared to 66.66% (10) excellent and 26.66% (4) good in LCP group. CONCLUSION Both open reduction and internal fixation with locking compression plate and ligamentotaxis with external fixators are good treatment modalities for unstable distal radius fractures. However, the choice should be guided by the fracture configuration, surgeons' experience and patient's profile.