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Background: Inter-condylar fractures represent one of the most complicated and challenging fractures in the upper extremity. The results of managing these fractures non-operatively are limited by failure to get anatomical reduction and early mobilization, which often results in painful stiff elbow and/or pseudo-arthrosis. The objective of this study was to evaluate and analyse the role of open reduction and internal fixation in inter-condylar fractures of distal humerus.Methods: The present study was done in Malla Reddy Institute of Medical Sciences between June 2014 and June 2017. Out of 34 cases of intercondylar fractures of humerus admitted during the period, 25 patients were selected for the study that satisfied our inclusion criteria. Three patients out of those selected could not be included in the study as one had cardiac issues pre-operatively, one refused surgery and one was lost to follow up.Results: Our study included 22 patients, 14 male and 8 female patients. Their average age was 41.4 years. The fractures were classified as per the AO classification. There were B1-3, B2-1, C1-6, C2-5, C3-7 fractures. Both compound and closed fractures were included. All the patients were operated by posterior olecranon Chevron osteotomy approach by a senior faculty member. Twenty two patients who satisfied our inclusion criteria were treated, followed up and the results analyzed using Cassabaum’s scale of elbow function we had 86% of excellent to good results. Our results are comparable with other similar studies.Conclusions: Posterior olecranon approach was found to be of most satisfactory approach by us. It allows good exposure of the joint and the ulnar nerve.

Background: The incidence of the intertrochanteric fractures is increasing in recent times. It is found that more and more of these fractures are seen in elderly. The treatment of these fractures was historically non surgical. The use of dynamic hip screw and angled blade plate in the surgical management of these fractures is a recent practice. The objective of the study was to analyse the role of cemented hemi-arthroplasty in the treatment of unstable inter trochanteric fractures in elderly.Methods: This study was conducted between June 2014 to June 2016. Results were analysed prospectively. From a total 94 inter trochanteric fractures admitted during this period 20 patients were chosen who fulfilled our inclusion criteria. All the patients were treated in Malla Reddy Institute of Medical Sciences. Primary cemented hemiarthroplasty was done in the entire patient by a senior faculty member. The results were assessed according to Harris hip score.Results: There were 13 females and 7 males in our study. The average age was 69.2 years. There was Evan’s type 1-c 11, 1-d 7 and 1-e 2 in numbers all the patients were followed up for a period of 18 months.Conclusions: In our short study, it is concluded that the primary cemented hemi arthroplasty is a good option in unstable inter trochanteric fractures in elderly.

Background: Acute injury to dorso-lumbar spine is the second most frequent site after cervical spine in adults. The injury, although not associated with high mortality, causes severe morbidity. The management of the traumatic dorso-lumbar spine injuries has improved considerably in the last few years. The objective of the study was to evaluate correction of kyphotic deformity in dorso-lumbar spinal injuries by posterior stabilization with pedicular screw rod fixation.Methods: The study includes 52 patients with dorso-lumbar spinal injuries with or without neurological deficit treated between 2006 and 2014. Pre and postoperative kyphosis was measured by Cobb’s method on plain radiographs. Pre and postoperative neurological status was evaluated based on Frankel’s classification. All un-stable dorso-lumbar spine injuries where two or more columns are involved on X-ray and CT scan were included in the present study.Results: Majority of the patients were in the age group of 20-30 years (38.5%) followed by 31-40 years (30.8%). Males were more than females. The most common mode of injury was road traffic injury in 71.2% of the cases. The most common level of injury was at L1 in 28.8% of the cases followed by at level D12 in 25% of the cases. In all the groups the mean kyphosis angle is reduced significantly. Overall the improvement rate was 94.2% and failure rate was only 5.8%.Conclusions: In conclusion the posterior reduction and internal fixation is a useful procedure in the treatment of the acute injuries of the dorsolumbar spine.

This is a case report of suicidal ingestion of chlorfenapyr, presenting with neurological complications after a latent period of more than a week, and rapidly progressing to death within days of symptoms. Chlorfenapyr is a moderately hazardous pesticide according to World Health Organization toxicity classification, and kills target organism by depriving it of energy through interference with oxidative phosphorylation at mitochondrial level. A pro-pesticide, chlorfenapyr takes time to convert to its active form and either this active form or a toxic metabolite causes delayed neurological symptoms. It causes significant neurotoxicity in rat models. This case report provides for the first time from India (second worldwide), clinical and “radiological evidence” (magnetic resonance imaging showing demyelinating/oedematous changes) of “chlorfenapyr neurotoxicity in humans.” It also highlights the “latent period” between ingestion and onset of fatal manifestations. Earlier, similar case reports of human deaths with delayed onset neurological symptoms, due to chlorfenapyr poisoning have been reported, from Japan, Columbia, and Korea.