Hip instability is one of the early complications following total hip arthroplasty. The aetiology of hip instability is often multi-factorial. The aim of this study was to assess the efficacy of prosthesis with dual mobility system in reducing hip instability in high risk cases at a short term follow up.

A retrospective analysis was performed covering 25 total hip arthroplasties on 24 patients (5 males and 19 females) between January 2007 and August 2008. Patient medical records and imaging were reviewed, and the indications for surgery and surgical outcome were analysed.

Among 25 procedures performed, 18 were revision procedure for dislocations, loosening, peri-prosthetic fractures. Seven patients have primary procedure, among which two were for acute hip fractures. One patient underwent conversion from previously failed screw fixation for hip fracture. The 25 patients were followed up for a mean period of 12 months (ranging from 4 to 24 months). At the last follow up, all patients were able to mobilise pain-free either independently, or with aids; no patients presented an episode of hip instability.

The result of our study demonstrated good early stability of total hip arthroplasty with dual mobility system (POLARCUP).

Intra-medullarly nail techniques for fracture fixation has gained Universal acceptance over the past 50 years. Closed interlocking nail fixation is the procedure of choice for femoral shaft fracture specially in poly trauma. Unlocked Nail can be considered when a non comminuted fracture occurs through the narrowest part of the medullarly canal. Unlocked Nail does not resist axial and rotational deformation of the fracture. Interlocking fixation controls bending and rotational deformation but allows nearly full axial load transfer by bone. Interlocking nails can be used in almost all long bones.

A total of 67 cases were stabilized by intra-medullarly interlocking nails. It was a prospective study done in SSMC & Private hospital from the period of January 2004 to February 2008. Total period of follow up was about 4 years. Both male & female were included in this series. Fresh, delayed fracture & Non Union all were included. Maximum cases were closed fracture but few were fresh but open fracture. Simple unstable fracture comminuted segmental fracture, implant failure was the selection criteria. Fracture, tibia femur and humerus were selected for this study. Both closed and open techniques were applied in this series without any support from C-arm.

In maximum cases bony union was achieved in expected time. In few cases healing process was delayed due to extensive soft tissue damage during the occurrence of fracture and non-cooperation of patients during post operative period. Excellent results were achieved in fresh cases. Over all result of this series is very satisfactory.

Breaking of screws was in 2 cases, bending of nail was in one case due to early weight bearing. Revision of surgery done in 2 cases.

Intra Modularly interlocking nail fixation is very simple device for unstable comminuted and segmental fracture shaft of long bones. If C-arm is available in that case procedure becomes more simple and easy. But without C-arm sometimes surgery becomes very lengthy and in that case expected results may not be achieved.

A total number of 428 patients underwent surgical procedure due to different acquired spinal disorders. Conservative approaches were tried where it was indicated. When there was no improvement with conservative treatment then surgical procedures were adopted

It was a prospective study which was done in both Govt. and private hospitals irrespective of age & sex. Total period was from August 2002 to February, 2008. Age of the patients ranged between from 8–65 years. In this series male was more dominant than female. In this series main causes were traumatic, infective, degenerative & neoplastic disorders. Prolapsed Lumber Inter-vertibral Disc 202, prolapse cervical disc 15, unstable spinal injuries 86, Pott’s paraplegia 68, degenerative disc disease 18, spondilolisthesis 12 and neoplastic both primary & secondary were 9 cases. Fenestration & disectomy done in PLID and decompression and stabilization done in unstable spinal injuries. Instrumentation done as adjuvant to achieve early biological union of bone. In Pott’s disease when conservative treatment failed to improve, decompression and stabilization was done by thoracotomy specially in at thoraco-lumber tuberculosis. Clowards operation done in cervical disc prolapse & spinal canal stenosis. Laminectomy done in lumber spinal canal stenosis. In spondilolisthesis, laminectomy followed by stabilization done by bilateral pedicular screw fixation with or without inter-body bony fusion.

Excellent and satisfactory results were achieved in incomplete unstable injuries. No neurological improvement detected in complete injuries. Maximum Pott’s paraplegia regained their neurological function and bowel bladder dysfunction except one who recovered her one limb function full but other limb become spastic. In PLID maximum patients improved immediately after surgery. Few patients required physiotherapy after surgery and improved later on. In Spondilolisthesis patients became symptoms free after decompression and in situ fusion by instrumentation.

In complete spinal injuries no improvements were detected. Breaking of pedicular screws observed in two cases. Mal-position of screws in 5 cases observed in traumatic spinal injuries. Post operative discitis developed in 2 cases after PLID operation 2 cases required surgery second time due to recurrent PLID.

Proper selection of cases is very important in spinal disorders. In incomplete spinal injuries satisfactory results can be achieved in maximum cases but in complete spinal injuries no neurological development are achieved but for early mobilization surgery is helpful. Maximum spinal disorders can be managed conservatively but surgical intervention should be done in earliest possible time when indicated.