This study was done to identify how well clinical scores and their sub-scores correlate with the radiographic parameters in idiopathic clubfoot. We studied 76 patients of idiopathic clubfoot who are from 5 months to 12 months of age. Deformity was assessed clinically with Pirani and Dimeglio scores and radiologically using eight parameters. Correlation between clinical and radiological scores was studied. All the eight radiological parameters were showing statistically significant correlation with clinical scores -both Pirani and Dimeglio scores. The mean total Pirani score at the time of X-ray was 2.31 with a SD of 1.58 (N = 118 minimum score = 0 and maximum score = 5.5), whereas the mean radiographic score was 3.67 with a SD of 2.1 (N = 118, minimum score = 0, maximum score = 8). The mean total Dimeglio score at the time of X-ray was 9.03 with a SD of 3.54 (N = 118, minimum score = 4 and maximum score = 15), whereas the mean total radiographic score was 3.67 with a SD of 2.1 (N = 118, minimum score = 0, maximum score = 8). Clinical scores correlate well with radiological parameters in infants with idiopathic clubfoot and hence the routine use of radiographs can be avoided in evaluation and follow-up thereby avoiding exposure to radiation.

ccccccThus improving the outcome for function and quality of life of patients with fractures. While the healing progress of bone fractures clearly benefitted by the method of plate and screw fixation construct, a new application of plate fixation started Introduction of the locking compression plate was a revolution in the evolution of management of fractures where prolonged bed rest is avoided and return to work is satisfactorily helpful. Local examination of the injured extremity revealed swelling, deformity and loss of function. Palpation revealed abnormal mobility and crepitus at the fracture site. Distal neurovascular status was assessed by the posterior tibial artery and dorsalispedis artery pulsations, capillary filling, local temperature, pallor and paraesthesia. The closed reduction not only helps in achieving reduction in difficult situations, but also in rapid union, because it facilitates preservation of the blood supply to the fragment and helps to achieve near normal anatomical reduction of the fracture.

A 58-year old female patient presented to us with a three months’ old fracture of the neck of femur. She underwent bipolar hemiarthroplasty. In the immediate postoperative period, she developed deep vein thrombosis for which she was started on anticoagulant therapy. Patient had persistent discharge from the wound since then and underwent regular dressings. On the eighth post-op day, she developed sciatic nerve palsy secondary to wound haematoma. The haematoma was decompressed immediately and she had a dramatic improvement in pain but her neurological deficit persisted. The wound healed completely without any complications. At three months follow up, she had recovered completely with grade 5/5 power in ankle and foot and full sensory recovery in the sciatic nerve distribution. She was ambulating comfortably with a walker. At final follow up around 20 months post-operation, she was pain-free and walking without any support. The wound had healed completely.

Biological' internal fixation avoids the need for precise reduction, especially of the intermediate fragments, and takes advantage of indirect reduction. This principle applies equally to locked nailing, bridge plating, and internal fixator-like devices. Indirect reduction aims only to align the fragments. It avoids exposure of the bone thus reducing the surgical trauma. Flexible fixation is advocated to induce formation of callus and is achieved by using wide bridging of the area of the fracture. The patients were followed up at intervals of three weeks for up to 6-10 months to assess the radiological union. After the 1st follow up of 4 weeks patient is allowed to partially bear weight. The fracture was designated as united, when there was periosteal bridging callus at the fracture site at least in three cortices in the anteroposterior and lateral views. Trabeculations extending across the fracture site was also taken into consideration. Partial and full weight bearing were allowed. Two of the patients developed superficial skin infections, which were treated with daily dressings and appropriate antibiotics according to the culture and sensitivity reports. All the infections subsided on the above said treatment. We had 1 patient with ankle stiffness. Probably due to the lack of compliance to the advised physiotherapy at home after discharge of the patient. Ankle stiffness ranged from restriction of ankle movement from 20-40%.