Background: For unstable spinal injuries such flexion fractures, unstable fractures, and fracture dislocation, surgical therapy is often indicated. Early surgery may include stabilization of fracture with pedicle screws and connecting rods, reduction of fracture- dislocations and decompression of spinal cord by doing laminectomy at appropriate site. The purpose of this study was to understand better the role of surgical decompression ie laminectomy in thoraco lumber traumatic paraplegia. Materials and Methods: A randomized study was conducted after approval by institutional ethics committee of the hospital. We included 40 patients with history of traumatic spinal cord injury attended emergency department of department of orthopaedic surgery of our institution. All patients were then divided in to two groups group A and group B. A standard surgical procedure of posterior pedicle screw fixation with connecting rod were done in all patients in both groups while group B patients also received surgical decompression by doing laminectomy. Results: 26 patients were included in group A and 14 patients in group B. At Post Op, ASIA A grade level was same while B grade was removed. No At 3 months, the slight shifting to improved grades was seen. No significant difference was found in proportion of various grades of ASIA between the groups (p=0.186). The same results were found at 6 month and 1 year as observed in 3 months. Conclusion: Early surgical decompression after a severe spinal cord injury increased neurological recovery. Complete spinal cord injury, on the other hand, was linked to a worse neurological prognosis.

Background Total hip arthroplasty (THA) is the most successful orthopedic elective surgical procedure for end-stage hip arthritis. THA is linked with significant blood loss, ranging from 1,188 to 1,651 mL, and a transfusion rate of 16-37%, which frequently results in postoperative blood transfusions. Postoperative blood transfusions can be avoided by using autologous blood transfusion, intraoperative blood saving, local anesthetic, hypotensive anesthesia, and antifibrinolytic medications such as tranexamic acid (TXA) administration. Methodology A double-blinded, placebo-controlled, randomized, controlled study was conducted with three prospective groups to investigate the efficacy of topical and systemic routes of a single intraoperative dose (1.5 g) of TXA. Patients were recruited from our center between October 2021 to March 2022 who were undergoing primary total hip replacement. Estimated blood loss was calculated and compared in groups, and a p-value of <0.05 was taken as significant. Results A total of 60 patients were recruited in our study. Estimated blood loss was similar in both treatment groups, 816.8 ± 219.9 mL in the systemic TXA group and 775.5 ± 107.2 mL in the topical TXA group. The placebo group had 1,066.3 ± 150.4 mL estimated blood loss, which was significantly higher compared to the treatment groups. Conclusions Administration of TXA (1.5 g) significantly lowers blood loss without increasing problems, which can eliminate concerns about intravenous TXA use. TXA reduces blood loss by 270 mL on average.

Background: Intertrochanteric femur fractures are one amongst the most common hip fracture presenting to our centre. Clinical efficacy and safety of PFNA and DHS in the treatment of unstable intertrochanteric fractures in elderly patients and found that compared with the control group (DHS), the observation group (PFNA) experienced shorter operation time and fracture healing time and less intraoperative blood loss, and suffered a shorter incision. The purpose of this study was to compare the functional outcomes and related complications between DHS and PFNA in treatment of unstable intertrochanteric femur fracture. Methodology: Total of 60 patients having unstable intertrochanteric femur fracture were included in this study and was equally divided into two groups. Group-P included patients with unstable intertrochanteric femur fracture managed by PFN-A II while Group-D patients managed by DHS. The result was analysed using descriptive statistics and making comparisons among various groups. Categorial data were summarized as in proportions and percentage (%) while discrete as mean ± SD. Results: At final follow-up; it was found that 72.4% of the cases of PFNA have achieved excellent union as compared to 44.4% for DHS group, 24.1% cases of PFNA have good union as compared to 51.9% in DHS group and the difference of mean DHS was significantly higher for PFNA group (p=0.001). Conclusion: PFNA-II have benefits like minimally invasive procedure, less soft tissue dissection, less amount of blood loss and provides better result in terms of union. Therefore PFNA-II is recommended as a better choice as compared to DHS in management of unstable intertrochanteric fractures in terms of functional outcome.

Background: Bone tumors remain a formidable challenge for orthopedic surgeons. In developing countries, the challenge is exacerbated by limited diagnostic, therapeutic, and management facilities and ignorance. Patients with upper and lower-extremity muscle and skeletal tumors are candidates for amputation or surgical rescue of the limbs. Traditionally, limb rescue surgery by neo-adjuvant chemotherapy is the preferred surgery method for localized carcinoma. Amputations are usually reserved for patients with increased tumor size. The purpose of this study is to investigate health-related quality of life (HRQOL) and physical disability, focusing on surgical care, gender, and age, in adolescent and young adult survivors of malignant bone tumors treated surgically. Methods: This cross-sectional study consists of 38 long-term survivors who underwent amputation or limb-salvage surgery at King George's Medical University, Lucknow, from 2019 to 2022. After obtaining ethical clearance and informed consent, 38 patients which included 26 patients treated with limb salvage in Group A and 12 patients treated with amputation in Group B were included in the study. The SF-36 and HUI3 scores were used to assess the functional outcome and health-related QoL of these patients. Results: After minimal six months of interventions, we have found a significant improvement in all the following factors: physical functioning (P=0.000), role limitations due to physical health (P=0.000) and emotional problems (P=0.001), energy/fatigue (P=0.000), emotional well-being (P=0.000), social functioning (P=0.000), pain (P=0.000), and general health (P=0.000). Group A showed a higher degree of significance than Group B through SF-36 (Short Form-36, patient-reported outcome), whereas HUI-3 did not show any significant outcomes (P=0.347). Conclusion: The overall quality of life of patients with salvaged limbs appears to be higher than that of the quality of life of amputee patients in tumor survivor patients. Further analyses must be carried out to verify the results and focus on areas that have a major impact on the overall quality of life using other assessment tools. The impact of therapy on the quality of life depends on maintaining the necessary structures for functional functions, adjusting patient expectations to cancer treatments, and designing long-term rehabilitation programs to support functional functions.

Isolated Hoffa fractures of the femur are often missed on initial radiographic evaluations. Routine CT scans for intraarticular fractures in suburban populations are not routinely done. Nonunion of medial condyle Hoffa fracture of the distal femur is a rare finding and presents late with pain in weight-bearing and painful flexion. This is a case report of a 21-year-old male who sustained trauma as a result of a motorcycle-car collision and was managed elsewhere conservatively on an above-knee slab. He presented after five months to our side with a limited range of movement at the knee and pain during ambulation. After radiological work diagnosis of isolated non-union of medal condyle Hoffa fracture of the distal femur was made, the patient was managed by freshening of fracture followed by rigid fixation with cancellous screws and reconstruction plate. At postoperative six weeks, the patient had a painless full range of motion at the knee joint.