Background: The outcome of interlocking nailing of humeral shaft fractures is controversial Variations in implants, operative technique and follow-up parameters hinder comparative studies. The aim of this investigation was to evaluate the humeral nailing system according to clinical results, and to recognise advantages and disadvantages of interlocking. Methods: A total of 30 humeral shaft fractures were treated with an Antegrade interlocking humeral nail. Results: At 12-month follow-up, bone consolidation was present in 30 cases; in 1 case complications developed. Constant shoulder score, mean Morrey elbow score, SF-12 physical score or SF-12 mental score. Conclusion: Antegrade interlocking nailing of humeral shaft fractures can result in good functional outcome and unimpaired quality of life. Compression interlocking can minimise the fracture gap and increase the biomechanical stiffness. Potential disadvantages of compression interlocking include possible bending or loosening of the locking screw in the dynamic oblong hole.

BACKGROUNDSimultaneous bilateral femoral neck fractures are relatively rare injuries. They are usually associated with underlying metabolic bone disorders or systemic diseases. Long-term use of narcotics and bisphosphonates can also result in similar fracture patterns; however, association of this fracture type with long-term use of antiepileptic drugs is not very common. Only one such case has been reported in the literature. This article describes the second.CASE REPORTWe report a case of simultaneous displaced bilateral femoral neck fractures in a 50-year-old epileptic patient, who had taken phenytoin for the past 3 years. The fractures were a result of low-velocity injury following a fall from the bed. The fractures were managed with a bilateral hemi-replacement arthroplasty. Oral bisphosphonates were given to improve the bone quality in the post-operative period. The patient had a good post-operative outcome, that was sustained throughout the entire follow-up period of 1 year.CONCLUSIONAntiepileptic drugs should be supplemented with bisphosphonates and vitamin D to improve bone quality and prevent fractures in epileptic patients.

Introduction: Distal humeral fractures account for approximately 2%-6% of all fractures and for approximately 30% of all elbow fractures [1] . The complex anatomy of the distal end of the humerus, with its unique orientation of articular surfaces supported by a meager amount of cancellous bone, makes its fracture a constant challenge to orthopaedic surgeons [2] . Materials and Methods: A prospective study was conducted in Tertiary hospital for a period of 1 year. We studied 25 consecutive patients with distal humerus intercondylar (AO Type C) fracture, included in study as per inclusion criteria. Discussion: Regardless of the method of treatment, substantial damage to the distal humerus usually results in some limitation of motion, pain, weakness, and possibly instability. Even minor irregularities of the joint surface of the elbow usually cause some loss of function. This can usually be minimized by early, accurate open reduction with sufficiently rigid fixation to permit immediate motion. Conclusion:Delay in open reduction internal fixation with delayed soft tissue dissection leads to increased chances of elbow stiffness due to periarticular fibrosis. Use of conventional plates will suffice and more importance should be given to achieve good intercondylar reduction and pillar reconstruction.

Background Calcaneal fractures account for approximately 2% of all fractures, with displaced intra-articular fractures comprising 60% to 75% of these injuries1. Studies in fracture patterns, soft-tissue management, and outcomes of calcaneal fractures have led to the debate on the optimal management of calcaneal fractures. Several Prospective randomized studies have shown equivocal outcomes with operative and nonoperative treatment. However, recent trends in the literature suggest that restoration of physiologic parameters of length, height, and alignment of the calcaneus may lead to better long-term results. Initial studies using extensile approaches showed higher rates of wound complications with operative treatment; however, recent studies have shown lower complication rates with sinus tarsi and other minimally invasive techniques. Regardless of the mode of treatment, calcaneal fractures are associated with numerous complications and guarded outcomes with signicant longterm morbidity. Objectives 1. To comparatively study the functional outcome of calcaneum fracture when treated conservatively with that of operative management 2. To study complication when treated conservatively with that of operative management METHODS Study was conducted in Department of Orthopedics, Basaveshwara Teaching and General Hospital, Kalaburagi.30 patients with 30 calcaneum fracture were included in the study. Outcome of conservative and operative management was compared using Creighton Nebrasaka health foundation scoring system. Pre treatment and post treatment (at follow up) Bohler's angle was also compared. Chisquare analysis and paired t test was done to compare the results of conservative and operative management. Restoration of the RESULTS Bohler's angle was better with operative management as compared to conservative management. Functional outcome for type I fractures was better with conservative management. For type II and type III functional outcome was relatively better with operative management for type IV fractures the outcome was signicantly better with operative management. A signicant correlation was seen between the post treatment Bohler's angle and C-N scores. Interpretation & Conclusion Conservative management has better functional outcome for undisplaced fractures. Where as displaced and comminuted fractures anatomical reduction and restoration of Bohler's angle is very important. Bohler's angle has a prognostic importance and correlates well with the functional outcome

Background: Tremendous advance in mechanization and fastness of travel have been accompanied by steep increase in number and severity of fractures and those of tibial plateau are no exception. Knee being one of the major weight bearing joints of the body, fractures around it will be of paramount importance. Objective: 1. This study is to analyze the functional outcome of ORIF with plating with or without bone grafting in tibial plateau fractures in adults. 2. To study complication of operative management Methods: Conrmed cases of Tibial plateau fractures admitted in Department of Orthopaedics in Basaweshwara Teaching and General Hospital attached to Mahadevappa Rampure Medical College, Kalaburagi. The purpose of the study is to include with tibial plateau fractures diagnosed with history taking, Examination and investigations: knee X ray-AP and Lateral view. The need of operative intervention is assessed based on the Shatzker`s classication and intervention done by techniques like anterolateral plating bicondylar plating, posteromedial plating. Patients will be reviewed at 6 weeks, 3 months and 6 months interval and their assessment done by Rasmussens functional and radiological scoring. In our Results: series, majority of the patients were males, middle aged, with road trafc accident being the commonest mode of injury, Most of the cases were Type I fractures i.e., split fracture of lateral condyle according to Schatzker`s classication, Surgery was performed with in 6.48 average days, Union was noted clinically and radiologically and functional evaluation was done by Rasmussen functional and radiological score. Excellent results were present in 23 patients (76%), 4(20%) good and 1(4%) poor results. Achieving and maint Interpretation /Conclusion: aining anatomical reduction with plates with less soft tissue dissection helps in early mobilization and hence obtaining good functional and radiological outcomes of tibial plateau fractures early physiotherapy for rehabilitation