This study shows that FCL screws in locking plates allow uniform callus formation and fracture union with minimal complication rates.

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<p class="abstract"><strong>Background:</strong> In era of increased air travel, airport security screening measures has been increased. A lot of anxiety to the patient, that may trigger an alarm at airport securities post-surgery. The purpose of this study is to find out experiences of patients after total hip arthroplasty (THA) passing through airport security.  </p><p class="abstract"><strong>Methods:</strong> A retrospective case series of 269 THA patients in a single high-volume center from January 2016 to June 2018, who had passed through airport security and met inclusion criteria. Patient were contacted during their regular follow ups or via phone. The patients were asked for alarm trigger, perceived inconvenience, whether security officials asked to show documentation regarding prosthesis, and any extra screening procedures check measures.<strong></strong></p><p class="abstract"><strong>Results:</strong> Out of 269 patients, 52 patients met inclusion criteria travelling by airplane. 27 patients reported alarm trigger. 7 patients had to undergo additional security check measures. 43% of the patients believed that having their THA increased the inconvenience while traveling.  </p><p class="abstract"><strong>Conclusions:</strong> This study provides information to surgeons regarding airport travel post THA. Patients can be counselled regarding the inconvenience and to be prepared for delays in airport and to be prepared to present documentation of their prosthesis.</p>

Introduction:Total knee replacement is a common surgical procedure in the elderly. The number of surgeries has increased owing to the increasing life expectancy of the population and better functional outcomes postsurgery. Postoperative cognitive dysfunction (POCD) is an identified entity postsurgery in elderly but most of the studies have been on patients undergoing cardiac and other nonorthopaedic surgeries. The studies have shown variable incidence due to selection bias. We studied the incidence and probable predictive factors of POCD in elderly Indian population undergoing total knee replacement under spinal anesthesia.Materials and Methods:We designed a prospective, observational study at a single center including patients above 60 years of age undergoing total knee replacement under spinal anesthesia. Preoperative mini-mental scale examination, electrolytes, urea and creatinine levels were recorded. Postoperatively, mini mental scale evaluation (MMSE) was done 2 days postsurgery, at 3 months, 6 months, and 1 year follow-up. Laboratory values postoperatively were recorded.Results:The average preoperative MMSE was 27 and declined to 25.4 on second postoperative day the value increased to 25.9, 26.6, and 27 at 3 months, 6 months, and 1-year follow-up, respectively. Sixty-three out of 600 patients developed POCD at second postoperative day. Forty-three patients showed recovery in subsequent visits and 20 patients had persistent dysfunction at the end of 1 year. Electrolyte imbalance, oxygen saturation, and age over 80 years were factors that showed statistically significant difference in multiple comparison analysis.Conclusion:In our study, we have found POCD to be a definitive entity which can cause short- and long-term cognitive defect in elderly Indian population undergoing total knee replacement and electrolyte imbalance, age, and oxygen saturation were the significant factors in the patients who developed POCD.

Case: A 45-year-old man presented with a Gustillo Anderson type III A open segmental right femur shaft fracture with intercondylar extension and with an 18-cm extruded segment of bone. After sterilization, the segment of bone was reimplanted. The fracture healed, and the patient is ambulant without support with no signs of any infection after 2 years of follow-up. Conclusions: In cases of open fracture with an extruded bone segment available, depending on the timing of presentation, soft tissue status, and level of contamination of the bone segment, reimplantation of the extruded bone can yield a satisfactory result.