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To report a proximal femoral osteotomy with retention of bone ledges in a reciprocal position to increase bone contact and stability. The method was applied to 5 patients over a 3-year period. All patients had coxa vara. The average length gained was 1.5 cm, and the average neck shaft angle improvement was 30°. The Harris hip score improved from an average of 63 to 82. The reciprocal ledge osteotomy is technically less demanding and also allows conversion of normal shear forces around the upper femur to stabilizing forces. This method allows easier use of the DHS implant as potential rotation about the axis of the screw is negated by the ledges and the dynamic forces.

Background Fractures of the subtrochanteric region of the femur provide several challenges to the operating surgeon due to anatomic and biomechanical peculiarities inherent to this region. These challenges are compounded several times in a severely porotic bone. Case presentation We report a case with severe osteoporosis who sustained a subtrochanteric fracture and was managed with a Dynamic condylar screw DCS. Three years after the surgery the patient is pain free and has a full range of motion. Conclusion This highlights the fact that the DCS provides a viable alternative in the management of fractures of the subtrochanteric region in severe osteoporosis. This advantage is particularly manifest in settings where the image intensifier is not easily available.

IntroductionHigh energy tibial plateau fractures along with calcaneal fractures individually produce several challenges for the orthopaedic surgeon. The principles of bony reconstruction include anatomic reduction and rigid internal fixation of intra-articular fractures and accurate restoration of the coronal, sagittal and transverse mechanical axes. Due to the tenuous nature of the soft tissue and devitalisation of the comminuted fragments with open reduction, external fixation of type 6 tibial plateau fractures is recommended. We report a case with ipsilateral high energy tibial plateau and calcaneal fractures both of which were managed with an ilizarov ring fixator.Case presentationA 55-year-old Kashmiri female presented to our department with an ipsilateral fracture of the tibial plateau and the calcaneum. Both were closed reduced and stabilized with an ilizarov ring fixator.ConclusionThe circular wire fixator provides a viable method to manage such fractures especially if they are co existent. This is especially true in situations where the soft tissue is compromised.