SUMMARYBackground. The aim of treatment of frozen shoulder is to regain a painless and functional shoulder range of shoulder motion. In this study we evaluated the results of using the arthroscopic technique for the release of the shoulder joint capsule in patients with a diagnosis of frozen shoulder.Material and methods. The study included 40 patients with frozen shoulder. They were operated upon with the use of electrocautery for the release of the shoulder joint capsule. The group consisted of 29 women and 11 men with a mean age of 48.2 years (range 38-62).Results. Preoperatively, the mean Constant and Murly shoulder score was 36.35 (range 21-51). At the end of the follow up period, the mean score was 85.8 (range 62 to 98). The difference between the means of preand postoperative total score was statistically significant (t =10.85 and p=0.0001). 22 patients (55%) had excellent results, 14 patients (35%) had good results, 4 patients (10%) had fair results and none had poor results. The 4 cases with fair results were all female, all had insulin-dependent diabetes mellitus and were > 50 years old.Conclusions. 1. Arthroscopic capsular release is an effective and safe method for the treatment of refractory frozen shoulder. 2. It achieves dramatic pain and motion improvement post-operatively, allowing very early postoperative rehabilitation.

Background. Fractures of the hand are the most common fractures in the skeletal system and phalangeal fractures constitute about 46% of all hand fractures. Operative treatment of unstable phalangeal fractures should aim at anatomic fracture reduction and stable fixation that allows early mobilization of the affected finger’s joints . This study evaluates the results of fixation of unstable shaft fractures of finger proximal or middle phalanges using a non-spanning external minifixator. Material and methods. 32 men and 8 women aged 17 to 60 (median, 31.25) years suffering from fractures of 44 phalanges in 40 hands were included in the study. Four of the fractured phalanges were middle phalanges and 40 were proximal phalanges .All fractures were fixed using a mini external fixator. All procedures were done under regional anaesthetic block. The fixator was applied after closed reduction of fractures. Additional procedures included wound debridement in open fractures, and tendon repair was needed in 4 cases. We excluded fractures where intraarticular fracture extension mandates open reduction and internal fixation. Results. At the end of the follow-up period (mean follow-up 11.5 months), patients were assessed clinically and radiologically. 26 fingers (59.1 %) had “excellent” results , 14 fingers (31.8 %) had “good” results and 4 fingers (9.1%) had “poor” results as their P.I.P. flexion ranges were < 80˚. Conclusion. External fixation of displaced phalangeal shaft fractures is an effective method of treatment in terms of a minimally invasive technique with rigid fracture fixation allowing early mobilization after surgery.

1. Trans-osseous limited lateral approach is an effective method for management of intra articular calcaneal fractures. 2. Anatomical reduction for intra articular calcaneal fractures is essential. 3. Functional outcome of intra articular calcaneal fractures depends upon the initial damage of the articular cartilage. 4. There is a need for multi-center prospective randomized study for accurate assessment of the results of operative management of intra articular calcaneal fractures involving pre and post-operative CT for assessment of reduction and using a rational scoring system and a long period of follow up.

Background. Pragmatic review of outcomes for single stage revision ACL reconstruction performed in a single center and the reasons for failure in primary surgery. Material and methods. Retrospective study included 59 patients with revision ACL reconstruction done by one surgeon from 2007 to 2017.Clinical records, operative notes and x-rays were assessed to find the reasons of failure. Results. The cause of failure was traumatic in 26 (44.1%) patients after primary reconstruction, incorrect tunnel position in 18(30.5%) and biological failure in 15 (25.4%). All ACL revisions were done using autografts; patellar tendon grafts in 33 patients (55.9%), ipsilateral hamstrings in 12 (20.3%), contralateral hamstrings in 9 (15.3%) and quadriceps tendons in 5 (8.5%). Twenty-one patients were contactable as regards postoperative functional outcome scores. There was an average 18 point improvement in Oxford knee score (OKS) post-operatively, 1.6 point improvement in Tegner scores and 30 point improvement in Lysholm scores. One patient (1.7%) developed septic arthritis, 4 (6.8%) had superficial infection, while 6 (10.2%) had residual instability after revision but did not have further surgery. There was lack of full extension in 4 (6.8%) patients. In BTB grafts, 2 (6.1%) patients sustained a post-traumatic patellar fracture. Conclusions: 1. Good outcomes of single stage revision ACL reconstruction surgery are achievable as de­monstrated in our cohort. 2. There is need for good quality research to identify whether BTB, hamstrings or quadriceps autografts are better for ACL Reconstruction.