Journal of Orthopedic Education

Fractures that involve the mid-shaft of the humerus are relatively common. Early surgical correction of such patients helps in early mobilization and improved patient comfort but carries an increased risk of post-operative complications. Such fractures are usually managed by 4.5 mm limited contact dynamic compression plates (DCP). In recent studies, it has been proposed that narrow, longer implants have better mechanical benefits with improvement in handling of fracture fragments and the surrounding soft tissue support. TENS provides a three-point bony fixation, hence retaining adequate bony alignment. This prevent micromotion at the fracture site, thereby improving the callus formation and bony union. As TENS is flexible, insertion is easier than rigid intramedullary implants. Here we present an interesting case of Humerus mid-shaft fracture originally managed with 4.5 mm locking DCP, which later required re-do surgery with Bone grafting and a TENS nail. Keywords: Dynamic compression plate; TENS (Titanium elastic nail system); Humerus fracture.

The reconstructive ladder discusses progressively more difficult soft tissue coverage methods for wound coverage and healing. Regenerative medicine modalities can be added to conventional reconstructive methods, making it a hybrid reconstruction ladder, which may make it easier to achieve wound coverage at a lower 'rung'. We have used the hybrid reconstruction ladder in a patient with post traumatic degloving injury of lower limb with significant clinical improvement. Keywords: Hybrid reconstructive ladder, Degloving injury.

Lower limb abnormalities are common after traumatic injury or treatment of infected lesions on the lower limbs. The keystone flap is a novel treatment for limb deformities. It is a simple, less timeconsuming, long-lasting, and easily repeatable method of reconstructing most limb abnormalities. The purpose of this paper is to investigate the utility of the keystone flap in the reconstruction of a variety of upper and lower limb deformities. Keywords: Keystone flap; Lower limb defects; Local island flaps.

Hypertrophic scars and keloids are fibroproliferative disorders in the reticular dermis layer: this layer exhibits continuous inflammation, excessive angiogenesis, and abundant collagen accumulation.Scars can be prevented and managed in a variety of ways. Scar massage with emollients, compression garments, intralesional steroids, surgical scar revision, and laser therapy are all common scar treatment techniques. In this article, we are applying the updated 2020 algorithm for treatment and prevention of scar in our subject. Keywords: Scar; Algorithm; Laser.