Perilunate injuries are rare and quite often missed. We present our experience and outcomes, surgically managing these difficult injuries. We analysed data from 14 patients who underwent open reduction and internal fixation of perilunate injuries. All patients underwent open reduction and fixation through the dorsal approach. Fractures were fixed with either K-wires or Headless compression screws. At regular intervals radiographs, range of motion, grip strength, modified Mayo score, Quick DASH score and Lyon wrist scores were collected. The average age of our patients was 29.2. Average time to surgical intervention was 11.3days. The mean follow-up period was 42.3months. modified Mayo wrist score, QuickDASH score and Lyon wrist scores were 77.86, 1.62 and 80.86, respectively. Wrist flexion/extension arc was 101.43. Wrist radial/ulnar deviation was 50.0. Mean grip strength was 69.93% of the opposite side. Radiological evidence of wrist arthritis and lunate avascular necrosis was seen in 8 (57.14%) and 4 (28.6%) cases, respectively. Early open reduction of perilunate injuries gives reliable results, in spite of radiological evidence of wrist arthritis in a majority of the cases. Early open reduction of perilunate injuries gives reliable results, in spite of radiological evidence of wrist arthritis in a majority of the cases. Complex elbow fractures are common injuries in young adults. Results in recent studies with various operative treatment protocols are equivocal. We compared the results of radial head arthroplasty, excision with osteosynthesis in such injuries at two follow-ups 1year apart. Thirty-five patients of complex elbow fracture-dislocations including, posterior/anterior olecranon dislocation of elbow, terrible triad injury, anteromedial facet of coronoid fracture, Type IV Monteggia fracture-dislocation and unclassified elbow dislocation were enrolled. They were managed operatively by standardized protocol similar to McKee et al. radial head reconstruction with miniplates, lag screws or non-operative treatment for undisplaced fractures. Arthroplasty of radial head with cemented prosthesis + LCL repair with suture anchor/transosseous tunnel was done. Coronoid and olecranon fixation was always performed. Patients were evaluated as follows Q-DASH score, MEPI, pain according to VAS, range of motion, complications and t-related outcomes as compared to arthroplasty, although not statistically significant. Radial head excision though has acceptable outcomes but there is a restriction of movements especially flexion-extension. Acceptable rate of complications major or minor warrants need of secondary surgical procedures or a staged treatment. The combination of posterior elbow dislocation, radial head fracture, and coronoid fracture has been named "terrible triad" as this injury is difficult to treat and yield poor outcomes. Some studies compared the results of radial head fixation to replacement in isolated radial head fractures, very few reports have tried to compare both treatment modalities in the setting of a terrible triad injury.The aim of this study was to compare the functional outcome of radial head fixation vs replacement in terrible triad injuries of the elbow. A single-center, prospective cohort study was conducted at an academic Level 1 Trauma Center from April 2016 to April 2019.A total of 30 patients with terrible triad injury of the elbow were enrolled. The primary outcome was the Quick Disability of Arm, Shoulder and Hand (Quick-DASH) at 1year. The secondary outcomes were to report the Mayo Elbow Performance Score (MEPS)at 1 year and elbow range of motion. At final follow up for each patient (13.4 ± 1.2months) The Quick-DASH score at 1year for fixation group was 5 ± 2.3, for the replacement group it was 7.1 ± 7.1. The MEPS at 1year for fixation group was 93.6 ± 8.4, for the replacement group it was 90.9 ± 9.4.Loss of elbow extension at 1year for fixation group was 17.1° ± 10.7°, for replacement group it was 18.75° ± 11.5°. A systematic approach to address the bony and soft tissue components of terrible triad elbow injury is crucial to obtain satisfactory outcome. Our study shows that radial head repair andreplacement, in the setting of terrible triad injury,yields comparable results. Level II, Therapeutic study. Level II, Therapeutic study. The Trochanteric Fixation Nail-Advanced (TFN-A) is offered as a "next-generation" solution to the ever-increasing incidence of pertrochanteric and intertrochanteric fractures. It aims to build upon the success of earlier-generation proximal femur implants, while at the same time attempting to address complications, like varus collapse, cut-out, implant failure and anterior cortical perforation/impingement. It also aims to provide the surgeon with flexibility by offering varied options under a single implant system. This descriptive study looked at the early outcomes of the TFN-A as used in a single trauma centre. It attempts to shed light on the question of whether the TFN-A is at least equivalent to more established proximal femur implants in terms of fixation while reducing complication rates. Thirty-four patients who underwent fixation using the TFN-A at a single centre from October 2016 to July 2018 were retrospectively reviewed for this study. https://www.selleckchem.com/products/gant61.html All surgeries were done by experienced orthopaedic surgl devices in terms of fixation. Absence of anterior cortical impingement or perforation suggests that the TFN-A shows promise in addressing this issue. The incidence of "retrograde cement filling" is a previously unreported point of interest for head-neck element augmentation which requires further study. Early experience with the TFN-A appears to suggest that it is at least comparable to preceding proximal femur nail devices in terms of fixation. Absence of anterior cortical impingement or perforation suggests that the TFN-A shows promise in addressing this issue. The incidence of "retrograde cement filling" is a previously unreported point of interest for head-neck element augmentation which requires further study.