Introduction: Achilles tendinopathy (AT) is the most common over use syndrome of the lower limb. One of the simple operations performed for this condition is “Multiple longitudinal tenotomies”. This can be performed by either percutaneous or open methods. We compared the outcome of percutaneous versus open method of multiple longitudinal tenotomies for this condition.

Methods and materials: It is a retrospective study of patients operated for AT in our hospital from 1997 to 2008. Total of 43 patients. Twenty had percutaneous and 23 had open tenotomies. All of them had a trial of non-operative treatment prior to surgery, in the form of analgesia, physiotherapy, heel inserts, and ultrasound therapy. Data was collected from patient records and by telephonic questionnaire of the patients. Data collected includes pre and postoperative pain scores on a scale of 0–10, duration of symptoms, patient satisfaction scores (0–10) and complications. This questionnaire also included limitation to walk, run, going up/down the stairs, work and sporting activities.

Results: In the percutaneous group the mean pre and postoperative pain scores were 8.79 and 2.07 (p value 0.000). In the open group the values were 8.65 and 1.75 (p value 0.000). The mean satisfaction scores in the percutaneous and open groups were 8.25 (range 3–10) and 8.14(range2–10) respectively. The patient satisfaction scores were not significantly different between the two groups (p value 0.942). In the percutaneous group there was one recurrence and in one patient there was no symptomatic relief. In the open group there were 2 superficial infections, which settled with antibiotics and a wound breakdown, which in addition required debridement and eventually healed by secondary intension.

Conclusions: Both percutaneous and open methods of longitudinal tenotomies resulted in significant symptomatic relief and good patient satisfaction scores. Although the outcomes of both groups were comparable the percutanous method has an added advantage of less complications and simplicity of the procedure.

Aim: Retrospective analysis of paediatric supracondylar fractures treated by various closed and open methods of management and study co-relation between type of treatment and outcome.

Method: Retrospective review of children with displaced supracodylar fractures of humerus consecutively treated between January 1999 and December 2003. We included all the patients (63 children) admitted to hospital and had closed or open surgical procedure. Medical records and radiographs were reviewed to identify type of management, pre or postoperative complications, including loss of fracture reduction, infection, loss of motion of elbow and the need for additional surgery. 13 cases were excluded as insufficient records available and patients have either moved from area or treated on injury on holidays.

Results: In this study 70% of children were less than 8 year old. Except for one all the patients had extension type of injury and 58% of total cases had Gartland type III fracture configuration. 38% of patients were treated with closed reduction and immobilisation, 24% had closed reduction and percutaneus k-wires fixation and remaining had open reduction and internal fixation. All the patients underwent procedure with in 12 hrs of admission to hospital. Six patients had pre-operative neuro-vascular compromise and all of these patients recovered completely post-operatively. Loss of position was noted in 20% of children who had only manipulation and required re-manipulation and stabilisation with percutaneus k-wire fixation. All percutaneus fixations were with two lateral entry pin fixation and Open reduction were fixed with cross pin fixation. There was no clinically evident hyperextension or loss of motion but one patient (Gartland type III) who was treated with MUA and immobilisation required corrective osteotomy for cubitus varus. One patient had pin track infection but there was no iatrogenic nerve palsy.

Conclusion: Lateral entry pin fixation is very safe mode of fixation for percutaneus treatment and gives excellent results. Treatment with Manipulation and immobilisation for Gartland type III fractures does not give satisfactory results. We suspect early treatment of these fractures reduces comorbidity and early complications.