<p class="abstract"><strong>Background:</strong> The LRS is an excellent option treating the failed osteosynthesis in long bone fractures, because of failure in healing due to loosening of implant, infection, nonunion, poor bone quality and bone loss associated with deformities, limb length discrepancy, soft tissue problems, functional and financial issues.</p><p class="abstract"><strong>Methods:</strong> we prospectively treated 30 cases of failed osteosynthesis of long bones (7 plating, 22 nailing &amp; 1 k-wire with plaster) between April 2009 to October 2015 with LRS. Initially we managed by implant removal, freshening of fracture site or radical debridement followed by LRS application.<strong></strong></p><p class="abstract"><strong>Results:</strong> Union occurred in 93% cases. The eradication of infection was seen in 96.5% cases. Average lengthening done was 4.2 cms. We had 93% excellent and 7 % poor bony result. Functional result was excellent in 45%, good in 48% and failure in 7% cases using ASAMI scoring system.</p><p class="abstract"><strong>Conclusions:</strong> LRS is an excellent option in the management of failed osteosynthesis especially associated with infection, nonunion, deformities, limb length discrepancy, soft  tissue problems, functional and financial issues and also where re-osteosynthesis is challenging with poor bone quality and bone stock. It is simpler technically, patient friendly and short learning curve.</p>

Introduction: Diaphyseal fracture of ulna and radius present specific problems in Addition to those common to all fractures of shaft of long bones due to their anatomical Characteristics and conservative treatment of these fractures lead to poor functional outcome. Stoffel et al showed that plate osteosynthesis with rigid fixation has shown a high complication Rate including delayed or nonunion, infection, hardware failure and most importantly refracture after plate removal, primarily due to necrosis of bone under the plate. To evaluate results of locking compression plate in closed diaphyseal Forearm fractures in adults. Methods: In prospective study, 22 adults with (38 forearm bones= Radius-20 & Ulna-18) acute closed diaphyseal fractures were treated by open reduction and internal fixation with Locking Compression Plate. Follow up was obtained on all 22 patients. The average duration of follow up was 12 months. Results: The functional outcome was assessed with the grading system of Anderson et al. We had excellent results in all patients. Conclusion:Locking compression plate with a combihole provides fixation of fractures in a single implant with vast application according to the situation and useful in wedge or complex or osteoporotic or comminuted fractures because it preserves periosteal blood supply and provides a stable fixation ensuring early mobilisation. Studies having a larger number of fractures treated with different modes are needed to evaluate the outcome of locking compression plate osteosynthesis in forearm bones fractures, but the early results are promising.

Background & Objectives: Preservation of the articular congruity is the principle prerequisite for successful recovery following distal radius fractures. The best method of obtaining and maintaining an accurate restoration of articular anatomy however, remains a topic of considerable controversy. External fixation as a method of treatment for distal end of radius fracture has more than 60 yrs of documented clinical experience. The main aim of this study is to evaluate the results obtained by treatment of distal end radius fractures by external fixation. Methods: In a prospective controlled study, 30 cases of intra-articular fractures of distal end radius in adult patients were treated with uniplanar bridging type of external fixation using the principle of ligamentotaxis and augmentation by K wires. Mean age of the patients was 37.3years, External fixator was applied for a mean duration of 6 weeks and cases were followed up for an average of 37.0 weeks post operatively. Results: Assessed as per De merit point system of Gartland and Werley (modified by Sarmiento 1975) for functional results at the end of 6 months of follow up. Excellent to good functional result was noted in 83.3%. Conclusion: External fixation and ligamentotaxis provides better functional and anatomical results in intra-articular fractures of distal end radius. The success not only depends on the anatomical restoration of the articular surface. It also depends on the associated soft tissue injuries and articular damage.

The aesthetic appearance of the thumb hasn't been analysed to a similar extent as thumb function which would aid during reconstructive surgeries of the thumb and first web space and analyse its outcome. The purpose of this study is to determine the relative length, girth, nail width of thumb with respect to the index finger and intermetacarpal distance. Measurement of the 1 st web space arc radius has been done to tackle the problem of webbing which is not addressed by IMD and palmar abduction angles. A total of 482 hands in 241 subjects were studied to measure the relative length of the thumb with respect to the index finger, the relative nail width of thumb with respect to index finger, the relative girth of IP joint of thumb with respect to PIP joint of index finger and Intermetacarpal distance was calculated. The 1 st web space arc radius was calculated by the "best arc fit" with the thumb in maximum radial abduction using a radius gauge. The data collected was analysed by age, gender, laterality of the hand and the height and weight of the child. Hands of subjects of which with a mean age of years were analysed. The relative Thumb length, girth and nail width remained independent of age. It has been observed that the reliability of the measurements between the right and left web space arc radius measurement is significant . The provided would help reconstructive surgeons analyse aesthetic outcomes of reconstructive surgeries intraoperatively and post operatively. A correlation between the 1 st web space arc radius of right and left hands would help predict the expected post-operative outcome.