Background: The relationship of Common peroneal nerve (CPN) to the posterolateral corner of the knee joint is important for surgeons who perform total knee arthroplasty to avoid injury to the nerve during surgery. This relationship varies among different races on account of anthropometry. This study aims to evaluate the anatomical location of this nerve in Indian patients using an MRI based reference system. Methods: 213 knee magnetic resonance images (MRIs) were evaluated in axial plane 8 mm below the joint line for distance of the CPN from the closest posterolateral capsule. The angle of the CPN from the center of the tibial anteroposterior axis and relation of CPN with respect to the popliteus were evaluated. A comparative analysis of these measurements among Caucasian, Chinese and Indian patients was made to evaluate for any differences. Results: The mean distance between the CPN and the knee capsule was 15.55 mm (range, 7.8e26.2 mm). The mean angle of the CPN from the center of the AP axis was 50.1 (range, 38e63). CPN was found to be in line with the popliteus from center of the knee in 62% cases. There was no significant difference among the different races among the measured parameters (p > 0.005). Conclusion: This study establishes a "danger zone" and a "safe zone" to avoid CPN injury in total knee arthroplasty in Indian patients and identifies anatomic landmarks to localize the nerve before the softtissues release in order to avoid direct injury.

Introduction: The optimal method for fixation of extra-articular distal humerus fractures poses a management dilemma. Although various plate configurations have been proposed, anatomic shaped extra-articular distal humerus locking plates (EADHPs) have emerged as a viable solution for these complex injuries. We assessed functional and radiologic outcomes in our retrospective case series of extra-articular distal humerus fractures managed with these plates at different centers in Cuttack, Odisha. Materials and Methods: One hundred and ten patients of extra-articular distal humerus fractures, who were operated at various trauma centers between January 2012 and December 2020, were identified. After exclusion, 100 patients were available for the final assessment. All patients were operated with the triceps-reflecting modified posterior approach. Regular functional–radiologic follow-up was done evaluating elbow functionality, fracture union, secondary displacement, nonunion, implant failure, and any complications; Mayo Elbow Performance Score (MEPS) was used for the final functional assessment. Results: Sixty-seven percent of male and 33% of female patients constituted the study group, who had an average follow-up of 18 months. Preoperatively three patients and postoperatively one patient had radial nerve palsy; all had neurapraxia and recovered completely. Overall, 95% of patients were adjudged to have complete radiological union within 3 months; 6% of patients developed nonunion. The mean flexion achieved was 123 + 22, and the mean extension was 4.031 + 6.50; five patients with head injury developed flexion deformity of 45. The average MEPS at the final follow-up was 91 + 9.8. Conclusion: Stable reconstruction and early initiation of physiotherapy are utilitarian to envision optimal outcome; the use of precontoured EADHPs has yielded satisfactory results with minimal complications in our hands.

Introduction: Most of the implants used for total knee arthroplasty in Asian patients have been produced based on anthropometry of Western people. Anthropometric studies have shown that there are significant variations in knee morphology between the Asian and Western population. Data of Indian knee morphometry of healthy and non osteoarthritic knee was lacking. Objective of this study was to study the knee anthropometry of Indian population and its comparison with other ethnic groups and current TKA Implants. Materials and Methods: 60 patients, 29 female and 31 male with peri-articlar knee injuries from the period of June 2016 to November 2016 were studied. 3D reconstruction of normal knee of the patients undergoing CT scan for injured knee was done. Measurement of the mediolateral width, anteroposterior width and aspect ratio of distal femur and proximal tibia was done. Data was compared with other ethnic groups and currently available and commonly used knee systems. Results: Indian females were found to have significantly (p>0.01) smaller dimensions of femur and tibia than Indian males and both had smaller aspect ratios than the Western population. Also study suggests that there is a morphological mismatch between commonly used implants and Indian knees. Conclusion: Our study suggests that why Western implant mismatches when implanted in Indian patients. Also this study provides definite rationale for designing total knee prosthesis, especially a gender-specific design suitable for the Indian population.

Fracture shaft of the humerus is a common injury in orthopaedic practice. Conservative management with plaster gives good result but this method cannot be applied in situations which necessitates internal fixation. There always a question arises which kind of implant to be used for surgical intervention. A prospective comparative study for the management of acute diphyseal humeral shaft fractures with dynamic compression plate and antegrade interlocking nail fixation was undertaken over a period of three years. In each category Twenty five patients had undergone above implant fixation after considering the inclusion and exclusion criteria. Rate and time of union, functional scoring criteria (ASES) and complication rate were used for postoperative assessment with an average follow-up period of one year. A higher rate of union with excellent to good functional outcome was seen with the plating group in our series.