The aim of this study was to compare the results of humerus intramedullary nail(IMN) and dynamic compression plate DCP) for the management of diaphyseal fractures of humerus.

Material & Methods- 47 patients with diaphyseal fracture of shaft humerus were randomised prospectively and treated by open reduction and internal fixation with IMN or DCP. The criteria for inclusion was Grade 1,2a compound fractures, polytrauma, early failure of conservative treatment, unstable fracture. The patient with pathological fracture, Grade 3 open fracture, refracture, old neglected fracture of humerus were excluded from the study. 23 patients underwent internal fixation by IMN and 24 by DCP. Reamed antegrade nailing was done in all cases. DCP was done through an anterolateral or posterior approach.

Results -The outcome was assessed in terms of functional outcome and the incidence of complications. Functional outcome was assessed using the Americans Shoulder and Elbow Surgeons Score (ASES). On comparing the results, there was no significant difference in ASES score between the two groups. The rate of complications was found to be higher in patients treated with IMN than with DCP. The complications that were encountered with IMN were non union, shortening of the arm, impingement of the shoulder, implant failure. The rate of secondary surgery was also found to be significantly higher with IMN.

Conclusion – There is sufficient evidence to suggest that DCP still remains to be the operative treatment of choice for diaphyseal fractures of humerus. IMN may be indicated only in specific situations like segmental fractures, pathological fratures though this study did not aim to look into that aspect.

Introduction and Aims: This prospective study was conducted in our institution to evaluate the effect of valgus osteotomy in the treatment of neglected intracapsular fracture of neck of femur in younger patients and the time since injury was three or more than three weeks. There were 20 patients, age ranging from 17 to 50 years.

Method: All the osteotomies were fixed by 120-degree double-angled blade plate.

Results: Eighteen fractures united. The average time for union was 14.4 weeks. Two went in to non-union, in which one of them had intra-articular penetration of the implant. Fourteen patients had noticeable lengthening of the limb. All the patients with united fractures were able to sit cross-legged, squat and do one leg stance.

We conclude by stating that this procedure should be considered in neglected intracapsular fractures of neck of femur in young adults as the head preserving procedure.

Conclusion: Patients with vertical shear fractures represent the spectrum of high-energy pelvic disruption. The functional outcome is significantly better in patients with APC III and LC III fractures when compared to vertical shear and complex acetabular fractures thus reflecting the severity of the injury. Secondary osteoarthritis and neurologic injury appear to contribute to the poor outcome of acetabular fractures. Sound reconstruction of the pelvic ring is not always associated with good results probably due to the extensive pelvic floor trauma.