Introduction: The stiffness of elbow joint severely interferes with functional ability of upper limb. Open arthrolysis, in young active patients were reported with inconsistent results may be due to its applications in injudiciously selected cases. The objective of this study was to analyse the pathological abnormalities of stiff elbows for their classification and appropriate planning of surgical management to get maximum benefit following the arthrolysis. Methods: 98 patients of ages varied from eight to 62 (mean 23.3) years with posttraumatic stiff elbows having nonfunctional arc less than 70o of flexion predominantly extra articular contracture with maintenance of radiological congruence of humeroulnar joint of five to 26 (mean 14.65) months duration were included . The ankylosed elbows based on their clinicoradiological assessment were divided into three groups and subjected to open arthrolysis. 84 patients were clinicoradiologically evaluated during 3.2 to 10.3 (mean 6.5) years follow up. Results: The patients of Group I & II having predominantly soft tissue contractures showed overall highly satisfactory and excellent results in majority. The patients of Group III having additional periarticular new bone formation with subchondral sclerosis obtained good results. The cause and duration of contractures did not seem to influence the outcome of arthrolysis. The judicious and sequential release of contracture structure is effective to regain satisfactory to elbow motion. Conclusion: Thus, judicious preoperative selection of stiff elbow is mandatory to obtain favorable functional outcome after arthrolysis.

Introduction: Fragility fracture from osteoporosis is a major challenging health problem in aging population in developing countries. In order to reduce the risk of development of osteoporotic fragility fractures authors made a study with high risk individuals, divided into two groups and a comprehensive management protocol had been offered in one group where as conventional management protocol had been offered in other to see the efficacy of such comprehensive management protocol to reduce the risk of occurring fragility fracture over at least three months period among the patients, attended in orthopaedic out patient department of state medical college, West Bengal. Methods: The authors selected 30 diagnosed osteoporosis clients of 50 to 90 years age as per inclusion and exclusion criteria, who attended in orthopaedic OPD in SSKM Hospital, Kolkata, West Bengal, India from 2021April to July2021, carrying highest risk factors of developing osteoporosis. Results: In experimental group, mean post test BMD score is higher than the mean pre test BMD, which is statistically significant as calculated t value is 3.666 at 14 df at 0.05 (p<0.05) level of significances. It indicates that comprehensive management protocol is effective to increase the bone strength. Conclusion: The study of comparison of mean difference values of two groups conclude that comprehensive management protocol can reduce the risk of osteoporotic fracture much efficiently in compared to standard pharmaceutical treatment in a short span of time which is applicable for long term management of osteoporosis.