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Background: Tibial plateau fractures are commonly seen fractures of lower limb. They are challenging to manage since they are mostly associated with soft tissue injuries. Deep vein thrombosis (DVT) is a significant cause of morbidity and pulmonary embolism can even cause mortality in all hospitalized patients, especially after trauma and lower extremity fracture, which further carries risk of significant morbidity and mortality. We aim to evaluate the epidemiological characteristics of postoperative DVT in tibial plateau fractures.Method: A prospective observational randomized study was performed. A total of 79 patient were included in this study who had proximal tibia fractures. Pre-op ultrasonography was done and post operative ultrasonography was done following proximal tibia plating surgery on day 2. Successive evaluation with USG was done at week 2, week 3 and week 4 for DVT. If DVT is diagnosed it will be managed medically.Result: A total of 79 patients were included in the study, 28 were females and 51 males. 4 out of 79 patients were diagnosed with DVT following surgery of tibial plateau fracture. Predominantly DVT was seen in male patient of elderly age group who had high energy trauma operated by open reduction with duration of surgery of more than 1 hour. 3 out of 4 patients had distal DVT and 1 had proximal DVT.Conclusions: Six risk factors were found to be strongly associated with DVT i.e., old age, male gender, high energy trauma, increased preoperative interval, open reduction and prolonged duration of surgery. These epidemiologic data will be helpful in individual assessment, risk categorisation and development of targeted prevention programs.

Background: The study was conducted to evaluate the outcome of orthogonal plating system in distal humerus intraarticular fracture. Material and Methods: 15 patients of age between 18 to 60 yrs with fracture distal end of humerus with intraarticular extension were evaluated, with the mean age group of 37 to find the functional outcome of Orthogonal plating using olecranon osteotomy approach. Results: The mean union time was 9.53 weeks. The arc of flexion was 99.66o. Average mayo elbow performance score (MEPS) was 83. There were 2 case of infection. One case of implant failure noted secondary to infection leading to implant removal. Discussion and Conclusion: The following results were assessed: operating time, arc of flexion and extension, time to fracture union, functional recovery, and complications. By using proper principles of stable fracture fixation and appropriate exposure in intraarticular fracture (with transolecrenon approach) a good reduction can be achieved which leads to good union, which helps in early mobilization and restoring elbow functions with early intensive physiotherapy.

Introduction: Tibial plateau fractures occur due to a combination of axial loading and varus/valgus applied forces leading to articular depression, malalignment and an increased risk of posttraumatic osteoarthritis (OA). Various treatment modalities have been used over the years, with mixed results. We present a study to report the functional results of tibial plateau fractures and to evaluate the association of proximal fibula fractures with respect to final outcome. Methods: Patients diagnosed with tibial plateau fractures from July 2012 to March 2016 were included in the study. Patients with open injuries or neurovascular compromise were excluded. Patients were divided into subgroups on the basis of presence or absence of proximal fibula fracture. 124 patients were managed by either conservative or operative means and followed for an average of 19 months and clinically monitored for functional outcome using Knee Injury and Osteoarthritis Score. Results: The study population consisted of 65 males and 59 females. Mean patient age was 46 years (range, 24-67 years). Mechanism of injury included road traffic accident (56), fall from height (14), and falls (54). Functional outcome as assessed by Knee Injury and Osteoarthritis Outcome Score was comparable to previous studies. Role of proximal fibula in supporting the lateral condyle was evident from better functional outcomes seen in patients with intact fibula and lateral condyle fracture. Conclusion: An intact fibula contributes to the mechanical stability of the lateral tibial plateau. Therefore, the knee joint will be affected by injury of the bone or soft tissue that may occur in fibula fractures. A consideration to presence of proximal fibula fractures should be given while classifying tibial plateau fractures.

Introduction: Proximal humeral fractures are extremely common injuries, and are one of the true osteoporotic fractures. For those that have moderate to severe displacement, the optimal treatment for the patient has not been fully elucidated. The purpose of this study was to evaluate the functional outcome of a modification of percutaneous K-wire fixation technique. Material and methods: A prospective study was performed on all patients diagnosed with intra-articular proximal humerus fracture presenting to us from June 2013 to June 2016. Only patients with closed, displaced two or three part fractures as per Neer’s classification were included in the study. Fractures were managed by close reduction and percutaneous pinning with K wires which were linked by a fixator rod using clamps. Patients were evaluated for functional outcome using the Constant score. Results: Twenty seven patients comprising of 18 females and 9 males were followed for an average period of 14 months. Mean age of the patients was 56 years. Fall while walking was the most common mode of injury followed. Mean Constant Score of patients was 77.2. All patients achieved full functional range of motion by the end of 4 months. No nerve injury was reported. Conclusion: Modified technique for percutaneous Kwire fixation using the fixator mini clamps and rods is an effective and economical method allowing biological preservation with good results.

Unobtrusive observations of bicyclists were conducted at two-way, three-way, and four-way stop-controlled intersections. Consistent with previous reports, most cyclists did not stop at the stop sign. However, most cyclists did exhibit safety-related behaviors by making accommodations for traffic conditions. It was found that the cyclists conducted precautionary visual search when approaching stop signs, and that they were more likely to slow substantially or stop if cross traffic was not controlled by stop signs or if there were potential conflicts from other road users. Implications for safety interventions are discussed.