Introduction:The tibia is the most commonly fractured long bone in the body and understanding of the mode of injury, fracture pattern is necessary to decide an operative management. Tibia shaft fractures are commonly managed by interlocking nail. This study is to assess the surgical management and assess the functional outcome of tibia shaft fractures. Materials and Method:The study consist of 50 patients with tibia shaft fracture treated with tibia interlocking nail. Clinical outcome and function results were evaluated by Alho & Ekland's criteria. Result: In this study, we have operated a total 50 cases with tibia interlocking nail in tibial shaft fractures. The average union time was 17.68 weeks. The study yielded about 82 % of excellent result. Conclusion:The present study shows that closed fractures of the tibia shaft treated with interlocking intramedullary tibia nailing involves minimal surgical trauma and negligible blood loss. It provides the advantages of early ambulation, lower rates of infection and non-union. A significant advantage of interlocking nail in addition to early joint mobilisation, is early weight bearing which allows earlier return to work. Hence the study concluded that closed interlocking intramedullary nail is the treatment of choice in closed tibia shaft fracture.

Background: Proximal femur fractures [PFF] are most common among all fractures around hip. Operative treatment and early mobilization is ideal to decrease morbidity and mortality. Aim of this study is to evaluate and assess functional and radiological outcomes of Long Proximal Femoral Nail [PFN] and Dynamic Hip Screw [DHS]used for fixation of PFF. Material and Method: This prospective analytic study was conducted in the department of orthopaedic, SBKSMIRC, during the year 2014 to 2016. Total 40 cases were selected by inclusion and exclusion criteria. Twenty cases were treated with Long PFN and other 20 with DHS. According to Evan's classification, 57.5% Fracture were stable type, 32.5% fracture was unstable type and 10% fracture was subtrochanteric or reverse oblique type. All patients were followed-up to48 th week postoperatively. Observation and Result: In our series, overall clinical & radiological outcome among each treatment group was 85% satisfactory. Infection rate in DHS group was 15% while in PFN group was 5%. By 6 th postoperative week, 90% patients could bear partial weight in PFN group while in DHS group only 70% patients were able to do same. Full weight bearing in PFN group was between 12 th -18 th postoperative weeks while in DHS group it was between 12 th -24 th postoperative weeks. Conclusion: In this study, it was concluded that there is no major difference in functional and radiological outcome on long term follow up in both the treatment group.

Introduction: Ulnar hemimelia is a congenital ulnar deficiency of the forearm characterized by complete or partial absence of the ulna bone. History and Examination: 18 years female presented to us with deformed left upper limb. Cosmetically, the forearm looked curved with concavity towards the ulnar side. Materials and Method:The correction was carried out in 2 stages. In first stage, the wedge shaped bone was osteotomised and correction was then fixed with dynamic compression plate. The ulna was fixed with ilizarov frame. In second stage, the corticotomy of proximal ulna was done and rush nail was passed intra medullary before distraction to prevent translation. The ulna was lengthened until it reached the distal radio ulnar joint. Result and Conclusion: In our case report, the girl with ulnar hemimelia was not able to do routine activities of daily living before the operation. Hence treatment was necessitated to improve cosmetic and functional outcomes. Management of such cases is highly individualised and mainly involves improvement of function.

Malignant fibrous histiocytoma (MFH) is a tumor of late adulthood that occurs in men more commonly than women. Proximal humerus involvement in PMFH is comparatively rare. A 45 year old female presented with complain of pain and mild swelling over the left shoulder with restricted range of movement since 15 days. Radiography of the affected part was suggestive of an osteolytic eccentric lesion with a pathological fracture. A trucut needle biopsy showed minimal tumour tissue with abundant necrosis and showed giant cells with pleomorphic mononuclear cells. So intralesional curettage followed by osteosynthesis with PHILLOS plating and bone cementing was done. Intra operative specimen sent for histopathological examination showed presence of fibroblast cells arranged in storiform pattern s/o MFH along with occasional multinucleated giant cells. Postoperatively patient was started with adjuvant chemotherapy. Patient had good results functionally and clinically with no signs of recurrence till follow up of 1.5 years.

Introduction: Generally Anterolateral and posterior surgical approaches are most commonly used approaches for fractures of middle thirds and distal third of the humerus. In posterior approach, usually splitting of triceps is done for exploring humerus. We studied an alternative, triceps reflecting para tricipital approach which spares the extensor mechanism. We are using it for the lower third extra articular humerus fracture to achieve good exposure of humerus so as to avoid muscle splitting and gaining the early ROM range of motion [1,2] . Materials and Methods: We studied 15 skeletally mature distal humerus fractures at our center treated by Triceps sparing approach with minimum follow up for a period of 6 months. They were functionally assessed with MAYO score [3] , measurements of ROM and radiological union. Mean duration of follow up was 10 months with range from 6-14 months. Results:The average Mayo score was 95 indicating an excellent performance with a mean functional ROM 132 degree with range from 120-140 degree. Only 1 patient had complication of infection which was not related to approach. Conclusion:The triceps reflecting approach (TRA) is a valuable option for ORIF in distal shaft humerus fractures. The extensor mechanism-sparing Paratricipital approach is an invaluable approach for fixation of lower third fractures of the humerus without negative effects on triceps strength. The clinical outcome parameters of our series revealed excellent maintenance of strength compared to the contralateral side. This approach gives us liberty to mobilize elbow joint actively as well passively and also avoids complications related to triceps adhesions.