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Introduction: Patients with Developmental dysplasia of hip many a times present later in the age due to missed or delayed diagnosis. The treatment of DDH is mainly dependent upon the age of the child at the time of presentation and varies according to it. In the late presenting cases it is mostly surgical with open reduction alone or in combination with pelvic and femoral osteotomies. Materials and Methods: This study between October 2012 and October 2014 includes 21 patients with unilateral dysplastic hips, surgically treated with a single stage procedure of open reduction and Acetabuloplasty of Pemberton, along with Varus derotation osteotomy and femoral shortening when necessary. Preoperatively they were classified according to Tonnis grade. Clinical assessment was done using Modified McKay’s criteria; Radiological evaluation was done using Severin’s radiographic criteria. Results: The mean follow up period was 15.14 months and the mean age at surgery was 66.86 months. McKay’s grades were excellent in 8 hips, good in 11 hips, fair in 1 hip and poor in 1 hip. Severin’s score was excellent in 4 hips, good in 15 hips, fair in 1 hip and poor in 1 hip. Conclusions: Every case of DDH is unique. The type of surgery chosen depends on the clear understanding of each hip after using the available resources. The combination of open reduction with pelvic and/ or femoral osteotomy when needed gives good immediate stability and promotes remodelling. This surgery is a technically demanding procedure but when performed properly by an experienced surgeon, it does give satisfactory results. Keywords: Developmental dysplasia of hip, Late presentation, Open reduction, Pelvic and/ or femoral osteotomy.

Introduction: One of the most common fractures an orthopaedic surgeon encounters is Malleolar fractures. As with all intra articular fractures accurate reduction and stable internal fixation of malleolar fractures is desirable. The present study aimed at analyzing the factors influencing the outcome of operative management of malleolar fractures. Materials and Methods: In this prospective study 25 patients with Malleolar fractures who were surgically treated between 2014 to 2016 were included. All patients were treated in accordance with A.O. principles. Patients aged above 18 years, with unstable fractures were included in this study. Post op protocol was below knee POP cast with a dorsal window for ankle mobilization and non-weight bearing walking with walker for 4 weeks post operatively. Baird and Jackson ankle scoring system was used to analyze the results. The follow up period for all patients was 60 weeks. Results: In this series of fixation of malleolar fractures with various techniques had Fair results in 84% and poor results in 16% as per Baird and Jackson Score. The average time to union was 12 weeks. The complications leading poor result were instability, Pain at rest, arthritic changes. Conclusion: Open reduction and internal fixation guaranty high standard of reduction besides eliminating the chances of loss of reduction. In our study, the Extent of anatomical reduction achieved in the surgery and Post-operative ankle mobilization and patients’ compliance influenced the outcome. Restoration of fibular length and rotation is critical in re-establishing a stable ankle mortise and perfect talar alignment. We conclude tension band wiring is the preferred method for small fracture fragments and osteoporotic bones of both medial and lateral malleolus. Keywords: Malleolar fractures, Anatomical reduction, Baird and Jackson score.

Osteophytes in knee are a common feature of degenerative osteoarthritis. They do have negative effects like deformities of knee (varus, valgus and fixed flexion deformities), loose bodies (sudden and painful obstruction of knee movements), and pain during movements of knee. They do bring stability to knee by increasing the joint surface area. Here by presenting a case of bilateral osteoarthritis knee, with a large anterior-lateral osteophyte complex, with range of motion 0-90o. Total Knee Replacement surgery was done. Pre, per and post operative period was uneventful, with restoration of normal range of motion 0-900 without any pain. Patient was able to carry-out daily activities of living, thereafter normally. Keywords: Keywords: Bilateral osteoarthritis knee, Osteophytes stabilize, Palpable bony hard swelling.

BACKGROUND The field of orthopaedic surgery has been creating new information, establishing new principles of treatment, and solving both new and old problems of the musculoskeletal system. Fractures of proximal humerus are still unsolved fractures in many ways. Disagreement exists regarding reliability of classification system. The indication for surgical management continues to be modified. Fixation techniques are myriad, and none is ideal for all cases. Fractures of proximal humerus are not uncommon especially in older age group. They have been reported to account for 4% - 5% of all fractures. We wanted to study the clinical profile, pattern, and functional outcome of fracture proximal humerus. METHODS This is a cross sectional study on the surgical management of proximal humerus fractures by using proximal humeral locking compression plate. Convenient sampling technique was used for this study. A total of 25 cases were included for the study after careful observation of inclusion criteria. Pre-structured questionnaires were adapted to collect the details from the study individuals. Data was entered in the MS Excel and analysed by means and proportions with appropriate statistics. RESULTS Proximal humerus fractures were found to have high incidence in the 40 - 60 years age group. Out of these 25 cases, there were 20 (80%) males and 5 (20%) females, ratio of males to female was 4:1. The age incidence of the study was as follows- almost equal number of study subjects reported with right 13 (52%) and left 12 (48%) sided shoulder (humerus) involvement. None had both the sides involved. CONCLUSIONS The proximal humerus fractures are a result of trauma and road traffic accidents are major causes of trauma. Proximal humerus fractures are seen in all age groups from 3 rd decade to 8 th decade and the major cause was road traffic accidents (high energy injury). It was more common in males; whereas in women, proximal humerus fractures are due to osteoporosis mostly seen in 5 th decade and above. Locking Proximal Humeral Plate (LPHP)/PHILOS-Plate allows stable fixation in all Neer’s fracture types of proximal humerus fracture and dislocation of proximal humerus. Satisfactory reduction of the fracture and optimal positioning of the plate under image control is of paramount importance for obtaining good results. In the medial comminuted fractures of the proximal humerus there is a need for additional fixation with inferomedial locking screws.