Objective: To study the role of anterior spinal surgery in scoliosis in Indian settings and to discuss the complications.

Study Design: Prospective study

Subjects: The present study comprises of forty patients of scoliosis in growing age group (10–25 years) with Cobbs angles ranging from 52”–98”. They were treated with Leeds procedure which is by anterior loosening followed by Posterior Harrington fixation + Luque derotation + Fusion and Costoplasty.

Results: Average correction of the deformity after surgery was 45%. Satisfaction level of patients and parents was good in 60% of the cases. Majority of the curves were thoracic (60%), and right sided (72%). The modality of treatment was decided on the basis of personality of each case, its demand and requirement, time of presentation and the potential for increasing severity. Anterior spinal surgery for scoliosis is an effective procedure in hands of experienced surgeons and it reduces stiffness of the curve, shortens the anterior column, and decreases thoracic lordosis that leads to some improvement of pulmonary function. But there is greater risk of damage to vital structures with higher risks of cardio-respiratory failure. The potential risks have to be balanced with the expected rewards. The optimum method of correction has to be decided by careful preoperative evaluation.

Conclusions: This study reaffirms the role of anterior spinal surgery in India as the patients due to lower levels of health awareness present late and with severe deformities. Combined procedure of anterior and posterior surgery causes lesser decrease in pulmonary functions than costoplasty alone, and achieves better cosmetic correction.

Open reduction and internal fixation was employed in the treatment of 25 severely displaced fractures and fracture-dislocations of the proximal humerus. Our aims were accurate reduction and stable fixation to allow early mobilisation and to achieve full functional recovery. In 15 fractures an AO T-plate was used and in 10 a bent semitubular plate was employed as a blade plate. Excellent or satisfactory results were obtained in all six patients with two-part fractures involving the surgical neck; in four of the five patients with three-part fractures involving the surgical neck and tuberosities; in nine of the 11 patients with fracture-dislocation; and in two of the three patients with split fractures of the humeral head. Overall results were good or satisfactory in 21 of the 25 cases. Unsatisfactory results were associated with rotator cuff damage.