Background: The objective of the study is to study the Functional outcome and factors influencing the outcome in Floating Knee Injuries. Methods: The study was conducted on patients in department of orthopaedics in S.C.B medical college & hospital from December 2018 to December 2020 who are admitted with Floating Knee Injuries. Detailed history were obtained using study proforma a thorough musculoskeletal examination of both the knees will be done including neuro-vascular status and appropriate radiographs and if necessary CT scan will be done. Collection of Data of the patients were by brief history of injury, systemic and musculoskeletal examination, radiography of thigh with hip and knee and leg with knee and ankle in standard antero-posterior and Lateral View, follow up with radiological and clinical parameters. Clinical follow-up will be done at 2 weeks, 4 weeks, 8 weeks, 4 months, 6 months, 12 months intervals regarding union of fractured bone, assessment of range of motion of knee, pain on weight bearing. Results: In our study we found males are affected in 33 out of 34 patients (97%), right lower limb was involved in 28 out of 34 patients (82%),majority of the patients were of young age group between 16-40 years (60%),twenty five out of 34 patients (73%) had type I floating knee injury and 9out of 34 (27%) had type II floating knee injury, in most of the cases (70%) surgery was performed within 1 week of trauma. Knee stiffness was more common in older patients, communited fractures, Poor articular reduction. The communited fractures and poor articular reduction correlated significantly with malunion of fractures. Communited fractures were a statistically significant variable for Shortening. Open fractures, communited fractures and segmental fractures are statistically significant for non-union and delayed union. Conclusion: Floating knee injuries are due to high velocity motor vehicle accident. Men are affected more than women. The right-side injury is more frequent than the left side. 55% of patients in this study had an excellent and good functional outcome and 45% of patients had a fair or poor functional outcome. Local complications like wound infection seen in 17.1% of patients A communited fracture is the most common predictor affecting the functional outcomes like Knee stiffness, shortening, and time to union. The other predictors affecting the functional outcomes are poor articular reduction, open fractures, segmental fractures, older age and. The time to union of tibia is more than that of femur. Revision fixation for tibial fractures was more frequent than femoral fractures. Keywords: Floating knee, Knee injury, Functional outcome

Our editorial team has always endeavoured not just to improve the quality of the manuscripts but also to help the authors improve their writing skills. Depending upon the type of manuscript we recommend standard guidelines like the CONSORT, PRISMA, STROBE, CARE and STARD. We also recommend IMRaD format while writing the manuscript. The Introduction, which is around 3-4 paragraphs, should be structured from generalities to the specific elaborating what the shortcomings are in published literature and what void the current research would fill. The authors must understand that the “aim” is the broader intent, while the “objectives” are the more specific steps which one plans to achieve. The Material and Methods section needs to be detailed to such an extent that any researcher planning to replicate the study can do so with accuracy. In this section, the study design, the study setting, inclusion and exclusion criteria, sample size, interventions, outcome measures and statistics are elaborated. The results section provides outcome data about primary and secondary measures as well as the contrast between groups wherever applicable. Avoid presenting same result data in multiple formats as well as interpreting the results in this section. The discussion part compares the results with existing literature, analyses the strengths and limitations of the study and at the same time explain the practical implications as well as future research directions. Finally, at the end a summary of the concluding findings should be provided and whether they support your initial research hypothesis. Last but not the least, the author must remember the criticality of the abstract. Most reviewers and editors as well as readers base their initial judgement based on this short paragraph. Structured abstracts are preferred with relevant subsections. Authors must understand the significance of keywords, MeSH terms as well as how to do proper referencing. Writing medical literature is an art which needs to be groomed at an early stage. Competency develops as one writes more & more. We hope this editorial will help authors understand how to ensure that their article is selected, printed, and finally appreciated by the readers. We end this editorial with a remembrance to a few of our dearest fellow Orthopaedicians whose demise shall leave a lasting void in Odisha Orthopaedics. Dr Prabhakar Mohanty, Dr Bijay Kumar Sadangi, Dr Binay Aggarwal and Dr Smarajit Pattnaik will always be in our cherished memories. Dr Satya Ranjan Patra Editor – In – Chief

Our editorial team has always endeavoured not just to improve the quality of the manuscripts but also to help the authors improve their writing skills. Depending upon the type of manuscript we recommend standard guidelines like the CONSORT, PRISMA, STROBE, CARE and STARD. We also recommend IMRaD format while writing the manuscript. The Introduction, which is around 3-4 paragraphs, should be structured from generalities to the specific elaborating what the shortcomings are in published literature and what void the current research would fill. The authors must understand that the “aim” is the broader intent, while the “objectives” are the more specific steps which one plans to achieve. The Material and Methods section needs to be detailed to such an extent that any researcher planning to replicate the study can do so with accuracy. In this section, the study design, the study setting, inclusion and exclusion criteria, sample size, interventions, outcome measures and statistics are elaborated. The results section provides outcome data about primary and secondary measures as well as the contrast between groups wherever applicable. Avoid presenting same result data in multiple formats as well as interpreting the results in this section. The discussion part compares the results with existing literature, analyses the strengths and limitations of the study and at the same time explain the practical implications as well as future research directions. Finally, at the end a summary of the concluding findings should be provided and whether they support your initial research hypothesis. Last but not the least, the author must remember the criticality of the abstract. Most reviewers and editors as well as readers base their initial judgement based on this short paragraph. Structured abstracts are preferred with relevant subsections. Authors must understand the significance of keywords, MeSH terms as well as how to do proper referencing. Writing medical literature is an art which needs to be groomed at an early stage. Competency develops as one writes more & more. We hope this editorial will help authors understand how to ensure that their article is selected, printed, and finally appreciated by the readers. We end this editorial with a remembrance to a few of our dearest fellow Orthopaedicians whose demise shall leave a lasting void in Odisha Orthopaedics. Dr Prabhakar Mohanty, Dr Bijay Kumar Sadangi, Dr Binay Aggarwal and Dr Smarajit Pattnaik will always be in our cherished memories. Dr Satya Ranjan Patra Editor – In – Chief

Background: Fractures of distal femur are very complex injuries and there is significant difficulty to manage. These injuries are severe and have a potential to produce long term disability. These fractures often are unstable and comminuted and tend to occur in elderly or multiply-injured patients. The fractures of distal femur account for 7% of all femoral fractures. If Hip fractures are excluded, 31% of fractures involve the distal femur. The fractures involving distal 15 cm of femur including distal femoral metaphysis (supracondylar) and articular surface (intercondylar) are classified as distal femur fractures [1]. Distal femur fractures exhibits bimodal age distribution. In young adults it occurs due to high velocity trauma like road traffic accidents. These patients often sustain multiple and compound injuries. Older patients sustain distal femur fractures mostly due to trivial fall occurring in elderly osteoporotic bone. In 1960’s most of these fractures were treated conservatively and documented better outcome than operative treatment. But with the advent of newer implants and modern techniques, these fractures are best treated with surgical stabilization. The newer modalities of treatment include minimally invasive plate osteosynthesis (MIPO) and Less invasive skeletal stabilization (LISS). Aim of this study: To evaluate twenty cases of distal femur fractures fixed with locking compression plate by minimally invasive plate osteosynthesis (MIPO) technique in the Department of Orthopaedic Surgery at SCB Medical College and Hospital, Odisha between July 2018 to November 2020. To prospectively analyse the clinical and radiological outcome of the above procedure. Keywords: Minimally Invasive Plate Osteosynthesis (MIPO), Distal Femoral Fractures, Radiological Outcome, Locking Compression Plate

Background: Osteoblastoma is a rare bone forming neoplasm and it is very rare to present with secondary cystic changes that too in the heel bone. The incidence is <0.6 % among all and its prevalence is yet to be reported in our population. owing to its rare presentation the early diagnosis of Osteoblastoma of calcaneum with secondary aneurysmal cyst like changes are difficult and hence affects the outcome. Material: In this report we detailed the diagnostic methods and surgical management of osteoblastoma of calcaneum associated with secondary aneurysmal cyst like changes in a 12year old boy with 2 year follow up. Result: It shown that the expansile lytic lesion was healed at appropriate time period and ankle & subtalar range of movements were satisfactory with no limitation in inversion and eversion. Conclusion: Benign expansile bone tumors in heel bone are difficult to find in the literature. This study addresses the diagnostic modality, proper surgical management in terms of approach and using sandwich bone grafting technique to improve the long term functional outcome. Keywords: Osteoblastoma of calcaneum, Secondary aneurysmal cyst like changes, Curettage and bone grafting.

Background: Fractures of the distal radius remain the most common fractures approximately one-sixth of all fractures treated in emergency departments. There are three main peaks of fracture distribution: the first peak is in children ages 5 to 14, the second is in males under age 50 and the third peak is in females over the age of 40 years. Risk factors are – decreased bone mineral density, female gender, ethnicity, heredity & early menopause have all been shown to be risk factors for this injury. The outcome of these fractures is not uniformly good regardless the treatment instituted. A thorough understanding of the anatomy & biomechanics of the wrist is a prerequisite when treating these lesions. There is a strict relationship between the quality of anatomical reconstruction & the long-term functional outcome. No single treatment is the solution for every type of fracture in every kind of patient. Based on the functional anatomy, we analyze the actual treatment possibilities & try to develop strategies in the choice of treatment for different fracture types in different patient groups. Materials and Methods: 92 Patients with extra-articular distal radius fractures were studied retrospectively. 30 were treated with conservative management and 62 with surgical management. Out of 62 cases treated surgically, 11 were managed by Plate osteosynthesis, 27 with Ligamentotaxis with External fixator & 24 with K wire fixation using Kapandji method at Department of Orthopaedics, Sri Rama Chandra Bhanja Medical College and Hospital, Cuttack, Odisha, since July 2018 to November 2020. Results: The association of individuals anatomical parameters with the functional results was measured by Chi-square test of association and Odds ratio with the criteria of Stewart et al. taken as base line for comparison. This study showed a significant association of dorsal angulation < 10° and loss of radial inclination of < 9° with functional results, P < 0.001 also with loss of radial height < 6 mm, P < 0.001 (0.005). On reviewing literature only few articles were found determining values of individual radiological parameters for better functional outcome specially Smilovic et al. (2003) and few of them noted which parameters affect the function most but not determining the values for them. Conclusion: There was no significant difference in the functional outcome of conservative treatment in comparison to various surgical modalities namely plate osteosynthesis, ligamentotaxis and k wire reduction with Kapandji method in case of extra articular and partial articular fractures of distal radius. Therefore, we cannot generalize one treatment method for all fracture patterns and treatment should be individualized to a particular fracture. Keywords: Distal radius fracture, Radiological outcome, Functional outcome

Introduction: The study has been designed with all perseverance’s, to observe and evaluate the results of single stage transpedicular decompression and posterior fixation in Dorso Lumbar Spinal Tuberculosis. Material and Methods: The present study “Evaluation of Single Stage Posterolateral Decompression and Posterior Fixation in Dorsolumbar Spinal Tuberculosis: A Prospective Study” was conducted on clinicopathologically diagnosed cases of spinal tuberculosis of dorsal and lumbar region during a period of two years from “October 2018 to October 2020” in the Department of Orthopaedics, S.C.B. Medical College and Hospital, Cuttack, Odisha. Method of Collection of Data: This is a clinical and prospective study conducted on patients admitted to S.C.B. Medical College, Cuttack after obtaining ethical clearance from the institutional ethical committee. A total of 25 cases of tuberculosis of spine in thoracic and lumbar region were selected for this procedure after obtaining proper informed and written consent.Patients were admitted based on clinical presentation such as prolonged back pain usually with tender gibbus, with/ without neurologic deficit. Objective of the Study: The objective of the study is to evaluate the efficacy of single stage posterolateral decompression and posterior fixation in spinal tuberculosis. The patients are to be evaluated postoperatively regarding following parameters: – • Postoperative neurological status and its improvement • Degree of pain relief • Radiological fusion of vertebra • Correction of angle of kyphosis Discussion: This piece of work conducted in Department of Orthopaedics, SCB Medical College, Cuttack, is meant for an analytical study of transpedicular decompression and debridement of spinal cord and fixation of the unstable spine by means of screws & rod system in a single stage posterior approach surgery. In our study we followed Tuli’s Middle Path Regimen in the management. Hence, all clinicoradiological diagnosed TB spine cases were administered ATT drugs under govt. sponsored DOTS Therapy Schedule. The pts who didn’t show signs of improvement, or deteriorating neural deficit, or progressive and gross kyphosis, or patients with severe pain were taken up for surgery and then followed up regularly at 3 months interval for a minimum average follow up period of 1 year. In our study, out of 25, 11 patients recovered completely from neurological deficit and was found to have Frenkel grade E. Another 12 patients had recovered to Frenkel grade D. Hence almost 92 percent of patients had satisfactory neurological recovery. In our study fusion was seen in 64 percent of cases which was significant and comparable with the studies of Gueven et al, Lee et al, and Chacko et al. Pain reduced in all cases. Conclusion: There was neurological recovery in all cases except one, indicating debridement by transpedicular approach is still effective though not radical. Pain was significantly reduced in all cases. Another vital observation was a correction in kyphotic deformity which was significant and also quite stable. There was fusion in more than half of the cases Keywords: Single Stage Posterolateral Decompression, Posterior Fixation in Dorsolumbar Spinal Tuberculosis, Potts Paraplegia

Background: Osteoblastoma is a rare bone forming neoplasm and it is very rare to present with secondary cystic changes that too in the heel bone. The incidence is <0.6 % among all and its prevalence is yet to be reported in our population. owing to its rare presentation the early diagnosis of Osteoblastoma of calcaneum with secondary aneurysmal cyst like changes are difficult and hence affects the outcome. Material: In this report we detailed the diagnostic methods and surgical management of osteoblastoma of calcaneum associated with secondary aneurysmal cyst like changes in a 12year old boy with 2 year follow up. Result: It shown that the expansile lytic lesion was healed at appropriate time period and ankle & subtalar range of movements were satisfactory with no limitation in inversion and eversion. Conclusion: Benign expansile bone tumors in heel bone are difficult to find in the literature. This study addresses the diagnostic modality, proper surgical management in terms of approach and using sandwich bone grafting technique to improve the long term functional outcome. Keywords: Osteoblastoma of calcaneum, Secondary aneurysmal cyst like changes, Curettage and bone grafting.

Introduction: Total knee arthroplasty is a procedure that can improve quality of life, and it is performed in increasing numbers every year because of the increase in the elderly population due to improved medical technology. However, the problem is that patients avoid this operation because of postoperative pain, which affects patient satisfaction and delays recovery and rehabilitation. There are many modalities to improve operative pain control, such as femoral nerve blocks, epidural anaesthesia, and periarticular injections. These modalities have been shown to reduce post-operative pain and increase patient satisfaction. Periarticular injection was reported to have good efficacy in controlling pain, cost-effectiveness, a few side effects, and ease of use. This method can be used by every surgeon without further training, unlike techniques like epidural anaesthesia or femoral nerve blocks, which require experience and further training. Material and Methods: The study was conducted in the Department of Orthopaedics at SCB Medical College & Hospital, Cuttack, Odisha. All the IPD patients who got admitted to the Dept. of Orthopaedics were taken as the study subject total of 30 cases were selected during study period out of which 15 were cases and 15 controls. Observation and Discussion: In Group A, R/L TKA was done in 3/12 patients and in Group B, R/L TKA was done in 8/7. All the Group A patients experienced less pain than the baseline parameters(p<0.05) following TKA. Post-operative evaluation of Range of motion in between 2 Groups there was significant difference in between the two Groups A and B as it was comparatively more in POD1, POD2, POD3, POD7, DOD AND 3 months after follow up in Cocktail Group A. Knee Society Score in POD3 was found to be 100 and 90 in Group A and Group B respectively. Conclusion: This study has several strengths. First, it is a well powered, randomized study. Second, we included follow-up beyond the initial hospitalization. Third, the injection medications we used are available through any hospital pharmacy and are easily administered during the surgical procedure, so our findings could be generalized for any joint reconstruction surgeon. Keywords: Total knee replacement, Periarticular injection, Pain management