Background Isolated fractures of the mandibular body separate the dentate border and compress lower border when subjected to masticatory forces. This study aims at evaluating the efficacy of two Orbita plates in Champy's osteosynthesis lines along with achieving 3D configuration and preventing trauma to mental foramen. Aims (1) To achieve a near 3D configuration by fixing the terminal parts of both plates in contact with each other; (2) to preserve the mental nerve within the ellipse created by two Orbita plates; and (3) to prevent damage to the root apices from the upper plate. Materials and Methods This study was performed on 20 patients with mandible body fracture through the mental foramina. With the intraoral vestibular approach, two Orbita miniplates were fixed in Champy's osteosynthesis lines. A geometrically closed quadrangular relationship was achieved in the shape of an ellipse, with the mental nerve emerging from it. Results Fracture healing was optimum in all the cases along with satisfactory occlusion. Postoperative intermaxillary fixation was not required. Mental nerve function impairment was insignificant. Conclusion This served to achieve satisfactory functional outcomes in patients with mandible body fracture without injury to roots and along with achieving a geometrically close quadrangular relationship even where 3D miniplates cannot be placed.

Introduction: Lateral malleoli fractures are one of the most commonly encountered injuries. Conventionally lateral fibula plating was done for fibula fracture but several studies have come up showing advantages of posterior antiglide plating for fibula. In this study, we aim at comparing the functional and radiological outcome in patients treated with conventional lateral fibula plating and posterior antiglide plating. Materials and methods: 30 patients with external rotation lateral malleoli fractures were studied prospectively. Lauge-hansen's classification was used to classify these injuries. Patients were randomly divided into 2 groups. Group 1 was operated by lateral fibula plating and Group 2 by posterior antiglide plating. Comparison of the outcome between the 2 groups was done using Weber's criteria. Result: The most common age group was 40-59 years with male dominance. Majority were supinationexternal rotation injuries. Both groups showed 33% excellent, 60% good and 7% poor outcomes. Lateral plating group exhibited few technical disadvantages like more hardware use, implant prominence and patient discomfort. But both groups were comparable in terms of surgical time, complications and final functional and radiological outcome. Conclusion:The outcome of the surgical management of a displaced lateral malleolus fracture is comparable with both techniques. Although few studies have reported some advantages using the antiglide technique, our data do not support one technique over the other.

AIM:To study average clinical and radiological union time and range of motion at knee joint in case of proximal tibia fracture treated with Minimally Invasive Percutaneous Plate Osteosynthesis. MATERIALS & METHODS: 30 patients with proximal tibial fractures were treated surgically using the Minimally Invasive Percutaneous Plate Osteosynthesis technique between June 2011 and December 2013 with a 1 year follow-up. The fractures were classified using the AO and Schatzkar classifications (Figure 1). Closed and Compound fractures, both were included in the study. Patients were followed up on 14 th post-operative day, 4 weeks, 6 weeks, and then monthly for 3 months and yearly later on. The functional outcome was evaluated using the Knee Society Score. RESULTS: Primary union was achieved by 29 of the 30 study subjects. The mean union time was 13.87 weeks. The rate and type of complication such as implant failure, wound gapping has not been observed. Acceptable range of movement with going back to activities of daily living was observed in our study. The mean Knee Society score was 88.7 at final follow-up visits, 26 patients achieved an excellent result, 2 a good result and 2 a fair result. There were 3 cases with infection, of which 2 healed uneventfully and one required implant removal after healing. Functional results were similar for primary and staged MIPO (p = 0.109). CONCLUSION: It could be hence inferred that MIPPO (Minimally Invasive Percutaneous Plate Osteosynthesis) or Biological plating preserves vascularity and hence has less complications, less union problems with early recovery in form of joint movement. KEYWORDS: Proximal Tibia, Fracture, Minimally Invasive Plate Osteosynthesis, Knee Society Score. INTRODUCTION:Among all the fractures in the body, tibia is the single largest bone that is commonly involved in injuries. Owing to the increase in vehicular accidents and industrial mishaps, high velocity trauma produces tibial fractures in increasing numbers. Fractures of the proximal tibia can be quite challenging to manage as they are difficult to reduce, align and stabilize and prone to develop wound complications and infections. 1 Preservation of soft tissue, fracture hematoma and periosteal compression are the key to good results in proximal tibial fracture management. Intramedullary nails and Open reduction with compression plating have failed to give satisfactory results. 2 Minimal Invasive Percutaneous Plate Osteosynthesis (MIPO) using a locking plate has become alternative technique for proximal tibial fractures. The preservation of periosteal blood supply allowed by MIPO offers a clear biological advantage over traditional plating, because it reduces iatrogenic damage to surrounding soft tissues. 3,4,5 The purpose of this study was to assess the results and the efficacy of MIPO for closed and open fractures of the proximal tibia.

Background: Temporomandibular joint disorders (TMD) can be defined as pain and dysfunction of the temporomandibular joint (TMJ). There is increasing evidence with comparative studies showing that 30-60% of patients with dentofacial deformity will have clinical TMD. More than 53% of class II in comparison to less than 10% of class I and class III, will have computed tomography and magnetic resonance imaging evidence of TMD. Objectives: Correction of mandibular retrognathia to help alleviating excessive forces on the joint, hence reducing TMJ pain and improving jaw function. Methods: 22 female patients (age 20-35 years) with mandibular retrognathia and associated severe TMJ dysfunction, who are not improving with minimally invasive TMJ arthrocentesis, were recruited for the study. All patients were assessed subjectively and objectively (visual analogue scale, Helkimo index, and Research Diagnostic Criteria for TMD). 11 patients underwent bilateral sagittal split osteotomy using standard Obwegeser procedure; while the other 11 patients did not undergo any surgical intervention. All patients were followed up for at least one year. Findings: In the operated group, 10 out of 11 patients had successful outcome with significant improvement of pain and jaw dysfunction, while in the non-operated group only two out of 11 patients improved within the same follow up period. Conclusion: Larger scale study is encouraged to confirm positive outcome of surgical correction of mandibular retrognathia in patients with coexisting TMD found in this pilot study.

Introduction: Placement of endosseous plateau implants represents a valid treatment in the setting of limited alveolar bone height. This study's objectives were to evaluate the effect of submerging and platform switching on crestal bone loss and redistribution of occlusal forces, the advantage of plateau design in providing more surface area for osseointegration, and the outcome of autogenous bone grafting from the implant osteotomy site as an alternate to exogenous bone graft.

Introduction: Bicondylar tibial plateau fractures with posteromedial fragment have always posed a challenge to the surgeons. Time to time, with better imaging modalities, the understanding of these fractures have improved and fixation modalities have changed. The morphology and position of the posteromedial fragment is such that lateral locking plate alone may not be sufficient to hold this fragment, leading to late varus collapse. To counter this problem, a separate posteromedial buttress plate is now been used by surgeons and our study aims at analysing the functional outcomes in patients treated with these posteromedial buttress plate. Materials and method: This was a prospective study carried out between June 2016 to June 2019 at Civil hospital Ahmedabad. 30 patients with Schatzker type IV, type V and type VI injuries with posteromedial fragment were included. They were operated with posteromedial buttress plate and lateral locking plate or screws. These patients were followed up at 15 days, 1.5 months, 3 months and 6 months and outcome was assessed according to Rasmussen's radiological and functional scoring. Results: The most common age group in these patients was 20-39 years with male predominance. Road traffic accident was the commonest mode of trauma. Excellent outcome was found in 67%, good in 26%, fair in 7% and no case of poor outcome. There were no cases of loss of reduction, malalignment or late varus collapse. The rate of complication was low. Conclusion: Posteromedial fragment in tibial plateau fractures is best managed with a separate posteromedial buttress plate rather than relying on lateral based fixation device. Properly planned fixation with accurate anatomical articular reduction and rigid fixation results in overall excellent outcome with low rate of complication.