The ankle and hindfoot arthritis, complex deformities, and failed ankle surgeries require arthrodesis for pain relief and to regain a good functional outcome. Tibiotalocalcaneal (TTC) arthrodesis using intramedullary nailing gives a stable, load-sharing construct that allows early mobilization and fusion, particularly in cases with poor bone stock or compromised soft tissue. This prospective study was conducted between January 2022 and April 2024 on five patients (three males, two females; mean age 52.4 years) with advanced ankle or hindfoot pathology. All patients undergo TTC arthrodesis using retrograde intramedullary nailing. Clinical and radiological assessments were performed using the American Orthopedic Foot and Ankle Society (AOFAS) hindfoot score and fusion grading on sequential radiographs at 6, 12, and 18 months. All five patients achieved good radiological fusion with significant postoperative improvement in AOFAS scores from 38.2 preoperatively to postoperative 81 at 6 and 12 months ( P < 0.05). Mean time of union was 15.4 weeks. Complications included one superficial wound infection and one case of screw back-out, but both were managed conservatively. TTC nailing is an effective and reliable method for ankle and hindfoot arthrodesis, providing high fusion rates, stable fixation, and functional improvement, especially in cases with poor bone quality or failed previous surgeries.
The management of extra-articular distal humerus fractures presents significant challenges due to the anatomical complexity of the elbow joint and associated risks. This study aims to compare the radiological and functional outcomes of different surgical modalities used in treating these fractures. A prospective study was conducted on 50 patients with extra-articular distal humerus fractures. Patients were divided into two groups: single plating (extra-articular distal humerus locking plate or DCP/LCP) and dual plating. Outcomes were assessed based on evidence of union by radiological evaluation, and functional recovery using the Disabilities of the Arm, Shoulder, and Hand (DASH) score and Mayo Elbow Performance Score (MEPS). The average age of patients was 40.3 years, with a male predominance (78%). Dual plating had a significantly longer mean duration of surgery compared to single plating, greater blood loss, and longer postoperative hospital stay. Despite these drawbacks, dual plating demonstrated superior functional outcomes initially, as evidenced by a lower DASH score and higher MEPS. The union rate was high, and postoperative complications were less in both the groups, with dual plating showing marginally better early mobilization outcomes. Dual plating for extra-articular distal humerus fractures provides better functional outcomes and greater stability than single plating despite longer surgical times and increased blood loss. However, the difference was not statistically significant in the 9 th month and the later follow-ups and has similar outcomes and range of motion. Single plating is suitable for younger patients with good bone quality. The study emphasizes the importance of choosing the appropriate surgical technique based on patient-specific factors to achieve optimal recovery and functionality.
Femoral suspension devices are widely used in arthroscopic reconstruction of anterior cruciate ligament (ACL) tears. They can be fixed or adjustable-loop devices. Only a few bio-mechanical studies comparing the efficacy of these two devices are available in the literature. Our study aims to compare clinical outcomes between the fixed-loop device (Group I) and the adjustable-loop device (Group II). This was a prospective randomized study. Sixteen patients were included in each group. One patient in each group was lost to follow-up. Assessment of clinical outcome was done with the International Knee Documentation Committee (IKDC) score and knee instability tests. Patient evaluation was performed preoperatively and 6 months postoperatively. The mean postoperative IKDC score for the fixed loop group at 6 months was 72.2% (standard deviation [SD] =4.8), and for the adjustable loop was 70.3% (SD = 5.2). The difference in the outcomes was statistically insignificant ( P > 0.05). Postoperatively, significant improvement was seen in all three instability tests. Anterior drawer and pivot shift tests were negative in all the patients in both groups. One patient in each group had Grade 1 positive Lachman test. Hence, no significant difference was found in terms of instability and clinical tests between patients in either group. ACL reconstruction with fixed- and adjustable-loop suspensory devices for graft fixation gives equivalent and satisfactory clinical results.
Kienbock disease is an idiopathic aseptic necrosis of the lunate, seen in adults of the younger age group. Although there are various surgical options, it is still controversial. The aim of this study was to evaluate functional outcomes after modified radial shortening osteotomy (RSO) for Kienbock. Prospective interventional study using a consecutive sampling technique. This prospective study was conducted at a tertiary care hospital. Our study was conducted between May 2022 and May 2023. Ten patients were treated by RSO, a lunate preserving extra-articular procedure, and followed up for 1 year. Range of movements (ROM), grip strength, and pain were evaluated in 10 patients. The outcome was measured by the Mayo wrist score. Statistical data were analyzed by IBM SPSS 20.0 version software. Collected data were spread on Excel sheet and prepared a master chart. Through the master chart, tables, graphs, and diagrams were prepared. Four males and six females with an average age group of 35.2 years with seven dominants and three nondominant were present in the study. After 1 year of follow-up, significant improvements in pain, grip strength, and ROM of the wrist were observed. Mayo wrist score was excellent in three, good in five, and fair in two. The mean Mayo score was 84.6. Conclusions: RSO, which is an extra-articular procedure, has good long-term clinical benefits and clinical improvement
Degenerative cervical spine disease remains a major cause of neck and arm pain, radiculopathy, and myelopathy in adults. Conventional anterior cervical discectomy and fusion (ACDF) often employs cage-plus-plate fixation, but standalone interbody cages are gaining popularity to minimize soft-tissue complications. This prospective observational study included 48 patients (mean age: 54.2 ± 9.6 years) with single- or two-level degenerative cervical disc disease who underwent ACDF using standalone interbody cages at IGIMS, Patna (2020–2022). Clinical outcomes (VAS, NDI, and mJOA) and radiological parameters (lordosis, disc height, fusion, and subsidence) were recorded preoperatively and at 3, 12, and 24 months. At a mean follow-up of 24.3 months, the mean VAS neck pain decreased from 7.4 to 2.1 ( P < 0.001), NDI improved from 38.5 to 14.2 ( P < 0.001), and mJOA improved from 13.2 to 15.6 ( P < 0.001). Global cervical lordosis improved from 16.8° to 22.3° ( P < 0.001); disc height increased from 4.6 to 6.2 mm ( P < 0.001). Fusion rate was 91.7%, and subsidence was 10.4%. Dysphagia occurred transiently in 6.3%. Standalone cage implantation provides significant clinical and radiological improvement with high fusion rates and low complication rates, serving as a reliable alternative to traditional cage-plus-plate ACDF.
Neurological complications are quite rare following posttraumatic heterotopic ossification. A 10-year-old boy presented 6 weeks after a fall with stiffness in the right elbow. He was subjected to massaging and bandaging by a bone setter after the injury. There was clawing of the ring and little fingers along with muscle wasting. X-rays revealed a type III medial epicondyle fracture and heterotopic bone around the elbow. He had a 40° flexion deformity and limited extension. Heterotopic bone excision, neurolysis, anterior ulnar nerve transposition, and internal fixation of the fracture were done. Indomethacin was given for 3 weeks, and physiotherapy was started. At 6 weeks, clawing disappeared, and flexion improved to 95°, with a 10° extension restriction. After 3 months, flexion reached 110°, with no limitation of extension. The patient was followed for 3 years and had an excellent outcome with no residual deformity. A full neurological assessment for elbow injuries is crucial for early intervention.
Neglected fractures of the femoral neck in middle-aged present unique challenge as there is no fixed method of management, and hence, decision regarding the choice of procedure is always a task. Being neglected, there is an increased risk of complications such as nonunion, avascular necrosis, and joint dysfunction. These fractures are often the result of high-energy trauma, particularly in developing countries where access to timely medical intervention may be limited. The objective of this study was to compare valgus osteotomy and hemiarthroplasty for neglected type 2 femoral neck fractures in middle-aged group. A prospective study was conducted involving 30 patients with neglected femoral neck fractures. Patients were divided into two groups based on the treatment received: hemiarthroplasty or valgus osteotomy with dynamic hip screw (DHS; hip salvage surgery). The study evaluated outcomes based on the Harris Hip Score (HHS), complication rates, full weight-bearing time, and incidence of complications such as infection, hip dislocation, and avascular necrosis. The study found that hemiarthroplasty led to faster recovery, with patients achieving full weight-bearing significantly earlier (mean 15.52 ± 2.952 days) compared to valgus osteotomy with DHS (mean 124.91 ± 12.204 days). However, both treatments achieved comparable long-term functional outcomes as measured by the HHS. Valgus osteotomy showed a higher incidence of infection compared to hip replacement. While hemiarthroplasty offers quicker recovery and early mobility, valgus osteotomy with DHS remains a valuable joint-preserving option, especially in more active patients, particularly in Indian setting where squatting and sitting cross legged in very common. The choice of treatment should be based on patient activity level and demands, and associated risks of complications.
Tendon injuries frequently result in impaired function due to the limited regenerative capacity of tendon tissue. Conventional therapeutic approaches often fail to restore normal tendon architecture. Mesenchymal stem cell–based therapies have emerged as a promising strategy to enhance tendon repair. To evaluate the effect of avian bone marrow mononucleated cells (A-BMNCs) on the histological healing of surgically induced supracoracoid tendon defects in Vanraja chickens. Twenty-four matured Vanraja chickens were used. A standardized supracoracoid tendon defect was created by incising two-thirds of the tendon width and repairing it using 4/0 polyamide in a modified Kessler pattern. Birds were randomly allotted into two groups (n = 12 each): Group A received Roswell Park Memorial Institute medium (RPMI-1640) medium (200 µL), and Group B received Avian bone marrow mononucleated cells (A-BMNCs). Tendon samples were collected at 2, 4, and 6 weeks post-repair. Histological evaluation assessed inflammatory response, collagen fiber organization, cellularity, and structural restoration. A-BMNC–treated birds (Group B) demonstrated markedly improved tendon healing characterized by reduced inflammation, diminished cellular infiltration, and progressive organization of collagen fibers, culminating in near-normal tendon architecture by six weeks. In contrast, control birds (Group A) showed delayed healing with persistent inflammation, disorganized collagen, and higher fibrocellular activity. A-BMNC therapy significantly enhances histological tendon healing following supracoracoid tendon injury in Vanraja chickens. These findings support the therapeutic potential of BMNCs as a regenerative option for improving tendon repair outcomes.
The anterior cruciate ligament (ACL) is the most commonly injured ligament of the knee joint, with various graft options available for its reconstruction. The aim of this study was to compare the functional outcome of ACL reconstruction using hamstring graft and peroneus longus graft. Single-center retrospective comparative study. International Knee Documentation Committee (IKDC), Tegner–Lysholm score of the hamstring graft and peroneus longus graft group compared at post-operative and on 1 year follow-up. Independent sample t -test, paired sample t -test, Mann–Whitney U -test. There is no statistically significant difference between the IKDC and Tegner Score on 1-year follow-up between peroneus longus and hamstring graft group. Peroneus longus can be considered an alternative and even as primary graft for ACL reconstruction with comparable results to the hamstring graft.
Knee arthrodesis is used for complex postinfective and failed total knee arthroplasty (TKA) cases. The Ilizarov circular external fixator gives stable fixation, deformity correction, and infection control. Six patients with postinfective knee destruction, or failed infected TKA, underwent arthrodesis using the Ilizarov circular fixator between 2018 and 2021. Outcomes assessed by fusion rate, time to union, infection control, limb length discrepancy (LLD), complications, and functional results. Fusion was achieved in five of six patients (83.3%) with a mean duration of 7.2 months. Infection was controlled in all cases. Mean postfusion LLD was 2.1 cm. Two patients developed pin-tract infection, and one had a nonunion requiring amputation. Functional results were excellent in two, good in three, and poor in one. Ilizarov circular fixation is an effective salvage procedure for infected knee or failed knee arthroplasty, it good fusion and infection control with acceptable complications.
Anterior cruciate ligament (ACL) injuries are usually treated with arthroscopic ACL reconstruction. There are many graft options used for the procedure. Most commonly used autograft options are hamstring, patella tendon and quadriceps. Recently, peroneus longus (PL) tendon harvest is gaining interest but for the additional donor site morbidity at the ankle. We compared the graft dimensions, donor site morbidities, and knee functional outcome of patients who underwent ACL reconstruction with either hamstring or PL tendon. We conducted a hospital based prospective observational study in our institute. Patients who underwent arthroscopic ACL reconstruction were divided into two groups randomly (Semitendinosus [ST] and PL). Graft length and diameter were recorded intraoperatively. The postoperative knee clinical and functional outcome were assessed at regular intervals postoperative till 1 year using International Knee Documentation Committee (IKDC) and Tegner Lysholm scores. Donor site morbidity was assessed with thigh circumference and ankle scoring was done with AOFAS and foot and ankle disability index (FADI) scoring systems. Fifty-two patients were enrolled in the study; 26 each in ST and PL groups. The mean tendon length and diameter was larger in PL group. Knee function based on Lysholm and IKDC scores did not show any significant differences across PL and ST tendon groups at 1-year follow-up. There was a significant improvement in AOFAS and FADI scores in the PL group at the end of 1 year. The decrease in thigh circumference was considerably more significant in the ST tendon group than in PL group at a minimum of 1-year follow-up. PL can be an excellent autograft option. The donor site morbidity was lesser, graft dimensions are larger and functional results are comparable with that of ST at the end of 1 year.
Background: Comminution of articular surfaces and metaphyseal region, extensive soft-tissue injuries, infection, and risk of compartment syndrome are the challenging factors for management of complex proximal bicondylar tibial fractures. Various modalities such as cast, traction, or open reduction and internal fixation using single to dual plating are available for treating such types of fractures. We studied the results of lateral locking plate fixation with TENS nailing from the medial side for complex bicondylar proximal tibial fracture without posterior column involvement using a minimally invasive surgical technique. Aim: The aim of this study was to evaluate the functional results of medial TENS nailing with lateral locking anatomical plate fixation for complex bicondylar proximal tibial extra-articular fracture. Materials and Methods: We evaluated 30 patients who underwent surgical intervention for complex proximal tibial fracture between May 2022 and May 2024. Thirty patients were selected and treated with lateral locking plate with TENS nailing from the medial side. Functional outcomes were observed according to the Knee Society Scoring System, Rasmussen functional and radiological score, and knee range of motion. Results: The mean follow-up time was 16.34 months. With regard to the Knee Society Scoring System, we found excellent results in 20 patients, good in 8 patients, and fair in 2 patients out of total 30 patients. The result is comparable with dual plating. Conclusion: In complex proximal tibial extra-articular fracture without posterior column involvement, lateral plating with TENS nailing from the medial side showed comparable functional outcomes as dual plating at final follow-up with less operating time and skin necrosis, wound dehiscence, and infection.
Introduction: This study’s objective is to treat intractable plantar fasciitis (PF) with platelet-rich plasma (PRP) or corticosteroid and compare the two treatments’ efficacy at 12 and 24 weeks. PF is a condition that causes a lot of people a great deal of pain and makes it difficult for them to carry out their daily activities. This research is being carried out because PF is a disorder that affects a significant number of people worldwide. Materials and Methods: “In this study, 120 patients with chronic PF who were not responding to the conventional conservative treatment were randomly assigned to receive either PRP, steroids, or normal saline (NS). To determine the level of pain experienced by each patient, both the American Orthopedic Foot and Ankle Society (AOFAS) score and the Visual Analog Scale (VAS) were utilized.” A comparison was made between the outcomes of prospective pretreatment and posttreatment analyses of the data gathered at 12 and 24 weeks. Results: Before the beginning of the therapy, the patient’s levels of pain were examined using the VAS and AOFAS scales. The results indicated that there were no statistically significant differences between the three groups of patients regarding their degrees of pain. After 12 weeks, the groups who got PRP injections, corticosteroid injections, and PRP injections all experienced statistically significant improvements in their Foot and Ankle Outcome Score (FAOS) and VAS ratings as compared to the group that received NS injections. “After 24 weeks, there is a statistically significant difference between the improvements in FAOS and VAS scores in the group that received PRP injections and the groups that received corticosteroid injections and NS injections, respectively. This difference is seen in the group that received PRP injections.” Conclusion: According to the findings of our study, a single injection of PRP is more effective than either triamcinolone or NS at reducing the discomfort brought on by chronic PF over a short period of follow-up time. This was determined by comparing the three treatments to one another.
Background and Purpose: Fracture of the radial head is a common orthopedic injury. The radial head is an important stabilizer of the elbow. To stabilize the injured elbow, the goals of treatment of radial head fractures have tended more and more toward preservation, restoring function and stability of the elbow. The present study aimed to evaluate the outcome of undisplaced or minimally displaced (displacement <4 mm) comminuted radial head fractures treated by arm sling. Materials and Methods: In this study of 75 cases, patients were included with ages ranging from 19 to 65 years (mean 41.9 years). All were treated by arm sling for 3 weeks, followed by elbow physiotherapy. They were followed up at 1, 3, 6, and 12 months for elbow range of movement. Broberg and Morrey Rating System, Mayo elbow performance score system, and disabilities of the arm, shoulder, and hand score were used for clinical outcome measures. Results: Of the patients, 68 (90.6%) had satisfactory recovery and full elbow flexion–extension and pronation – supination with no varus or valgus instability within 6 months. Seven patients (9.3%) developed restricted motion. Among these, one developed severe restriction of elbow motion because of myositis ossificans. Conclusion: Based on this study, the conservative treatment of undisplaced or minimally displaced comminuted fractures of the radial head using a sling provides favorable results, as well as maintaining the stability of the elbow with a good range of motion.
Background: One of the frequent causes of elderly morbidity and mortality is hip fractures. Young patients who encounter high-energy trauma or participate in sporting competitions may also experience it. To prevent threatening joint issues, it must be diagnosed and treated right away. Over 50% of all hip fractures are intracapsular femoral neck fractures. The lifetime risk of hip fracture is between 13% and 22% for males and between 40% and 50% for women. Materials and Methods: Thirty patients with intracapsular fracture neck of the femur were included in our study and treated with bipolar hemiarthroplasty. Preoperative functional assessment was done with Harris Hip Score (HHS), and radiologic assessment was done with X-ray pelvis with both hips anteroposterior (AP) view and X-ray of affected hip AP and lateral view. Results: Males were affected more than females with a mean age of 66.27 years. The maximum cause of injury was fall with the right hip more affected than the left. Maximum patients presented between 24 h and 72 h with a predominance of transcervical type of fracture. The study included patients who were treated with bipolar hemiarthroplasty. On regular follow-ups at the 6th week, 12th week, 18th week, and 6th month, HHS was recorded for functional outcomes, and plain AP and lateral X-ray of the operated hip were taken for radiological outcomes. Conclusions: At the end of the study, we found that there is a significant improvement of HHS (P < 0.05) from baseline preoperative HHS, and 83.34% of patients had no pain to mild pain. We also found that 93% of patients had excellent-to-good outcomes.
Background: Ankle fracture ranks second among lower limb fractures, accounting for about 10% of all fractures. It occurs in about 137 per 1 lakh people each year. Bimalleolar fractures are the most common fracture in outpatient as well as in emergency department which accounts for 1/4th of all ankle fractures. Treatment of this fracture is complicated and challenging as the outcome will influence the locomotive power. Improper and inadequate fixation will cause long term disability as the body weight is transmitted through the ankle joint. This study was conducted to evaluate the functional outcome of bimalleolar ankle fractures treated with various surgical modalities. We also try to delineate the types of fractures occurred and its outcome after surgical fixation and also to understand the advantages and disadvantages of various implants used along with its complications. Aims and Objectives: To determine the functional outcome of surgical management of bimalleolar ankle fractures and to know the risks and complications associated with surgical fixation of bimalleolar ankle fractures. Subjects and Methods: A prospective study is conducted among 40 patients who came to the Emergency Department and to Orthopaedics Outpatient Department in Sree Mookambika Institute of Medical Sciences between April 2021 and September 2022 were analyzed. We have included bimalleolar ankle fractures with Lauge–Hansen classification (SER4, SAD 2, PER 3, PAB 3), Danis–Weber Type (A2, B2, C2, C3) in this study and we have excluded patients with Lauge–Hansen classification (SER1,2,3, SAD1, PER1,2,4, PAB1,2), Danis-Weber Type (A1, A3, B1, B3, C1), Systemic infections, open injury, fracture with dislocation, skin diseases over the incision site Trimalleolar ankle fracture, previous arthrodesis at target level. Based on the fracture pattern, the patients were planned for surgical fixation with appropriate implants. Results: In our present study of 40 patients, we assessed the functional outcome based on Baird and Jackson’s scoring system. Based on which 21 patients (52.5%) had excellent outcome, 14 patients (35%) had good outcome, 3 patients (7.5%) had fair outcome, and 2 patients (5%) had poor outcome. Out of total population, 35 patients (87.5%) had no complications followed by 3 patients (7.5%) had superficial infection and 2 patient (5%) who had ankle stiffness. Conclusion: Medial malleolus fracture can be effectively treated by various modalities such as Screw fixation, tension band wiring (TBW) and K-wire fixation, giving excellent to good results. Among which TBW and Screw fixation are relatively better than K-wire fixation for medial malleolus fracture. Similarly, lateral malleolus fracture can be treated with plate fixation, screw fixation and K-wire fixation which gives excellent to good results. Among which plate fixation (locking compression plate) is better than K-wire and screw fixation for lateral malleolus fracture. Superficial skin infection is the most common complication we encountered in our study.
Humeral fractures in multiple myeloma patients are common and reported as the first clinical manifestation of the disease. Bone involvement occurs early in the course of disease, and destruction is usually extensive. Conservative management, even in terminally ill patients, has not resulted in satisfactory results. Surgical management of these pathological fractures is vital to improving the quality of life in these patients, as conservative treatment offers no reliable pain relief. The selection of implant determines the outcome and functional status of the patient. We here report a case of multiple myeloma patient with pathological fracture of the humerus shaft managed surgically with a combination of interlocking nails and a locking compression plate augmented with bone cement. The patient was followed up for more than 2½ years. There was no incidence of any recurrence. Regain of functional status and improvement in quality of life achieved through surgical management was apparent in the functional scorings measured during follow-up.
Introduction: Giant cell tumor (GCT) is a primary bone tumor that presents as a locally aggressive and potentially malignant lesion. For GCT around the knee, treatment is usually focused on surgical options. Limb-saving surgery is of two types, joint replacement and joint sacrificing. Objective: In the study, we will discuss the two popular methods of limb salvage, one is endoprosthetic replacement and another one is arthrodesis to ascertain the incidence and effectiveness of recurrence and to achieve the maximum possible range of motion in the knee joint. Materials and Methods: It is a prospective longitudinal study done over 32 months of duration from January 2018 to August 2020, with a total of 26 patients with GCT around the knee joint. The study population was divided into two groups by randomization technique for endoprosthetic reconstruction and knee arthrodesis using intramedullary nail fixation, and the results were compared on the basis of MSTS score between the two groups. Results: For comparison of MSTS score, the megaprosthesis (MP) group has a better outcome. In the MP group, the MSTS score was between 80% and 93%, with a mean of 87.13 and standard deviation of 5.489. Cases operated by Enneking nailing arthrodesis technique, the MSTS score was between 58 and 52 and mean of 54 with standard deviation of 3.082. Conclusion: From the study, it can be concluded that endoprosthesis replacement surgery is better than knee arthrodesis in many aspects although long-term follow-up should be continued.
Introduction: The incidence of multiple myeloma (MM) is increasing rapidly in Asian countries. MM is a malignancy involving terminally differentiated plasma cells. It accounts for 1.8% of all malignancies and is the second most common hematological malignancy. The aim of the study is to identify and categorize the presenting demographic profile, symptoms, blood parameters, and need of radiotherapy in MM patients in our hospitals both Mahavir Cancer Sansthan, Patna, and Patna Medical College Hospital, Patna, in Outpatient Department (OPD) basis. Materials and Methods: This retrospective descriptive study was conducted at Patna Medical College and Hospital, Department of Orthopedics and Mahavir Cancer Sansthan, Patna, Department of Radiation Oncology in an OPD basis. Newly diagnosed cases of MM as per the International Myeloma Working Group diagnostic criteria were included in the study. Patients of monoclonal gammopathy of undetermined significance, the absence of CRAB-Hypercalcimia, Renal insufficiency, Anaemia, Bony lesion features such as hypercalcemia, renal insufficiency, anemia, and bone lesions were excluded from the study. Results: A total of 58 cases were included in the study from January 2021 to December 2023. This shows maximum of 43.1% of patients belong to the 51–60 years of age group followed by the 61–70 years of age group. The majority of patients were male (74.1%), females were 25.8%. The male/female ratio was 2.86. Majority of patients presented with low backache 36.2% followed by bony pain 32.7%. Lytic lesions were present in more than one site in the same patients, the majority of lesions were seen in the pelvis (46.5%) and spine (44.8%). The majority of patients (53.4%) presented with M band. Lytic lesion in bone were seen in spine in 44.8%, Anaemia in 29.3%, increased creatine in 20.7%, Thrombocytopenia 18.9% and lytic lesion in skull were seen in 18.9% cases. Hypercalcimia in 12% cases. The most common indication of radiotherapy was palliation of bone pain 13.8%, involvement of neural foramina 12%, spinal cord compression 10.3%, and pathological fracture 8.6%. Majority of patients 22.4% received radiotherapy before chemotherapy and 18.9% received radiotherapy after chemotherapy. Conclusion: In this study, MM patients presented a maximum of 43.1% in 51–60 years of age. The majority of patients were male 74.1%, in our study, the majority of patients 36.2% presented with low backache followed by bony pain 32.7%. Radiotherapy is crucial in the management of patients with MM. Role of orthopedician lies in the management of pathological fracture in the form of internal fixation and emergency surgery in spinal cord compression.
