Purpose. To review the outcome after open reduction and internal fixation using a periarticular raft construct through a locking plate without bone grafting for split-depression tibial plateau fractures. Methods. Records of 38 knees in 31 men and 7 women aged 25 to 75 (mean, 42.7) years who underwent open reduction and internal fixation using a periarticular raft construct through a locking plate without use of a bone graft or bone substitute for split-depression (>5 mm) proximal tibial plateau fractures (Schatzker type II or AO/OTA type 4.1 B3) were reviewed. The integrity of the articular surface was assessed using radiographs. The Rasmussen radiological score and clinical score, the Lysholm knee score, and the Tegner activity score were also assessed. Results. The mean follow-up period was 22.8 (range, 6-36) months. All patients achieved bone union after a mean of 13.2 (range, 8-26) weeks. The mean range of motion was 118º (range, 100º-130º). The Rasmussen radiological score was excellent in 27 patients, goodUse of a raft construct through a locking plate without bone grafting for split-depression tibial plateau fractures in 9, and fair in 2. The Rasmussen clinical score was excellent in 15 patients, good in 21, and fair in 2. The Lysholm knee score was excellent in 26 patients, good in 8, and fair in 4. 32 of the 38 patients recovered to their preoperative Tegner activity scores. Only one patient with severe comminution had loss of reduction after full weightbearing. Conclusion. Fixation using a periarticular raft construct through a locking plate without use of a bone graft or bone substitute for split-depression proximal tibial plateau fractures is a viable option.

<p class="abstract"><strong>Background:</strong> Surgical treatment of supracondylar or intercondylar distal femoral fractures (AO/OTA types 33-A to 33-C) remains a significant surgical challenge with significant complication rates. Supracondylar and intercondylar fractures of femur are very often difficult to treat and they are notorious for many complications. We have studied use of LCP (locking compression plate) in the treatment of metaphyseal fractures. These implants improve fracture healing, especially in osteoporotic bone due to better holding capacity. Objective wass to assess the efficacy of LCP in maintenance of post-operative distal femoral alignment and in preventing post-operative varus collapse in supracondylar fracture of femur.</p><p class="abstract"><strong>Methods:</strong> Prospective Longitudinal observational study Conducted at Post Graduate Institute of Swasthiyog Pratishthan, Miraj, Maharashtra involving 50 patients with supracondylar fracture. The fractures were classified as supracondylar femur fracture (AO/OTA type 33) (A- C). Fractures that were supracondylar with significant proximal fracture extension were classified as an AO/OTA type 33 fracture unless there was a separate diaphyseal fracture. Data was analysed by using SPSS 16.0 version and expressed as percentages.<strong></strong></p><p class="Body"><strong>Results:</strong> Majority of patients were from 30-39 years age group i.e. 32%. Majority of patients were males i.e. 46 (92%). 7 (14%) patients had healing time &lt;4 months. 24 (48%) patients had healing time between 4-6 months. 19 (38%) patients had healing time more than 6 months. To assess the overall results, we used Knee society score. In 38% of patients, we found excellent results. Good and fair results were seen in 32% and 26% of patients.</p><p class="abstract"><strong>Conclusion: </strong>Locking compression plate is an ideal implant for fixation of supracondylar fracture of femur 33 (A-C) especially in C3 type where articular comminution is present.</p>

INTRODUCTIONAge related bone loss and bone loss due to osteoporosis pose major problems for orthopedic surgeons, not only because of diminished bone stock in which fixation devices must find anchorage, but also because future bone formation at the site may fail to solidify the construct or because future bone resorption may cause loosening of construct and failure. Osteoporosis is multi factorial disease, which is caused by complex interaction between genetic and environmental factors that influence bone turnover, bone mass, skeletal geometry and risk factors. 1,2 By age of 60, approximately 15% of all women have osteoporosis and this figure increases to 38% by age of ABSTRACT Background: Osteoporosis is multi factorial disease, which is caused by complex interaction between genetic and environmental factors that influence bone turnover, bone mass, skeletal geometry and risk factors. Distal femur fracture needs aggressive management in terms of open reduction and internal fixation with locking compression plate and early mobilization. Objectives were to study the role of locking compression plate in the management of osteoporotic metaphyseal fractures. Methods: Present study is a prospective study comprising of 50 patients who sustained various fractures in different bones of body due to osteoporosis and were treated using locking compression plate (LCP). All patients were evaluated for effectiveness of LCP. Results: In present series majority of patients (44%) fall in age group of 61-70 years having senile osteoporosis, followed by 12 (24%) from 51-60 years age group. Majority of the cases involved were distal femur fractures (50%). 15 i.e. 30% cases were fracture of proximal tibia and 20% were fracture of proximal humerus. 96% had osteoporosis. C1 type of fracture was commonly seen in 6 (12%) patients. The mean constant score at one month was 58 and at the end of one year it was 80. The mean oxford score at one month was 28 and at the end of one year it was 38. Conclusions: Locking compression plate is an ideal implant for fixation in metaphyseal osteoporotic bones when used methodically.

Background: The spinal injuries are common problems encountered by an ortho Paedician in day to day practice. The data on clinical outcome after instrumented spinal fusion is scant. Hence this study was undertaken to study the clinical outcome of the instrumented spinal fusion. Material and Methods: A prospective interventional study was undertaken among adult patients with acute thoracolumbar injuries admitted to the tertiary care hospital were included. Fifty adult patients with acute thoracolumbar injuries underwent the fusion with pedicle screws and rod instrumentation (Tango RS, Fa. Ulrich, Germany) with posterolateral fusion. The patients were followed up at 6 th , 12 th and 24 th post-operative weeks. Results: The mean age was 40.1 years and more than three fourth were males. Fall from height was the major cause for the injury. The decrease in regional angle was statistically significant at 6 th , 12 th and 24 th follow up visits when compared to baseline. The anterior wedge angle decreased to 5.24 0 , 5.8 0 and 5.72 0 at 6 th , 12 th and 24 th post-operative weeks respectively which was statistically significant when compared with the baseline. About 44%, 48% and 54% of the patients had normal sensory and motor functions at 6 th , 12 th and 24 th weeks of follow up after surgery which was statistically significant when compared to the base line. Conclusion:This study was able to show that the postero lateral fusion had good clinical outcome.

Background: Intertrochanteric fracture (ITF) is a major part of fracture in femur. 95% of ITF are found in elderly patients. Osteosynthese is the preferred method of choice. However, elderly patients had osteoporotic, combined with many of chronic disease conditions that increase the rate of osteosynthese failure. Hemiarthroplasty bipolar long-stem is a surgical method that helps patients relieve pain, facilitate early rehabilitation, limit long-term complications, and improve quality of life for patients. Aim: The aim of our study is to evaluate the clinical of the result of primary cementless bipolar long stem hemiarthroplasty in treatment for unstable ITF in the elderly patients. Methods: We retrospectively analyzed 35 cases of primary hemiarthroplasty performed for osteoporotic unstable intertrochanteric fractures (AO/OTA type 31-A2.2 and 31-A2.3 and Evans type III or IV fractures). There were 26 females and 9 males with a mean age of 77.1 years (range, 62-89 years). Results: Mean age of studied subjects was 84.29 ± 6.17, the lowest was 71, the highest was 96; ratio of male/female was 1:288. Follow-up of 33 patients for at least 6 months showed 88.6% caused by a lowenergy injury; Average rehabilitation time was 4.63 ± 1.7 days. The average Harris point at the end was 90.4 ± 4.72. Conclusion: Primary cementless bipolar long stem hemiarthroplasty is one of good choices in treatment of unstable ITF in elderly patients with severe osteoporosis, helped patients improve the quality of life.

Background:The degenerative spondylolisthesis is a common problem treated by an orthopaedician in day to day practice. The available data on the outcomes of posterior lumbar interbody fusion with posterolateral fusion in terms of functional and radiological parameters is scant. Hence we had evaluated the functional and radiological outcomes in degenerative spondylolisthesis patients treated with posterior lumbar interbody fusion with posterolateral fusion. Material and Methods: A prospective interventional study was undertaken among adult patients with degenerative spondylolisthesis admitted to the tertiary care hospital were included. Seventy-five adult patients who had degenerative spondylolisthesis treated with a posterior lumbar interbody fusion with posterolateral fusion. The patients were followed up at 3 rd , 6 th and 12 th postoperative months. Results: The mean age was 62.9 years and more female patients are present in our study. The improvement in pain determined by visual analog scale (VAS) was statistically significant at 3 rd , 6 th and 12 th months follow up visits when compared to baseline. In our study with respect to the patient to return to work, 63 (84%) patients show an excellent result, taking the result as satisfactory. Our study show posterolumbar interbody fusion level 5: seen in 75 levels, level 4: seen in 07 levels and posterolateral fusion grade A score is seen in 67 levels in with minimal complication rate. Conclusion: This study was able to show that posterior lumbar interbody fusion with posterolateral fusion had a good clinical outcome.

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Background: In aged patients, a femoral neck fracture is the most common hip fracture injury and most commonly treated with bipolar hemiarthroplasty. The available data on the outcomes of cemented bipolar hemiarthroplasty or uncemented bipolar hemiarthroplasty in terms of functional parameters is scant. Hence we had evaluated the functional outcomes in a femoral neck fracture patients treated with either cemented bipolar hemiarthroplasty or uncemented bipolar hemiarthroplasty. Material and Methods: About 120 aged patients who had a femoral neck fracture, constituted the total sample size. Out of which 60 aged patients were treated with cemented bipolar hemiarthroplasty and rest 60 patients were treated with uncemented bipolar hemiarthroplasty. The patients were followed up at 3 rd , 6 th and 12 th postoperative months. Results: The mean age was 69.83 years in cemented bipolar hemiarthroplasty group and 69.6 years in uncemented bipolar hemiarthroplasty. The Harris Hip Score was 90.2 in cemented bipolar hemiarthroplasty group and 87.9 in uncemented bipolar hemiarthroplasty group. Our study show more blood loss in the cemented bipolar hemiarthroplasty group while more implant-related complications in an uncemented bipolar hemiarthroplasty group. The follow up rate was 100% in our study. Conclusion:This study was able to show that cemented bipolar hemiarthroplasty had a good functional outcome.