Background: The role of laparoscopy in abdominal trauma has increased in the last years in diagnosis as well as therapeutic interventions. It is a viable alternative for the diagnosis of intra-abdominal injury in both penetrating and blunt trauma. The number of negative laparotomies decreased since the use of laparoscopy in trauma patients. Methods: A retrospective study of twenty eight patients with abdominal trauma (22 penetrating trauma, 6 blunt trauma) were laparoscopic intervention done by general surgery department at Aljazeera Hospital for Orthopedic and Specialized Surgery from January 2017 to March 2019. All patients underwent clinical assessment and FAST-Scan, CT-scan done for twenty patients and unavailable for eight patients. All of the patients included for the research were stable with normal blood pressure. Results: In our series twenty-eight patients with abdominal trauma, 22 penetrating trauma (78.57%) all were shotgun injuries, and 6 blunt trauma (21.43%). In penetrating trauma therapeutic laparoscopy for seven patients (31.8%), diagnostic laparoscopy for 10 patients (45.5%), and negative laparoscopy for 5 cases (22.7%). In blunt trauma therapeutic laparoscopy for 2 cases (33.3%), diagnostic laparoscopy for 3 cases (50%), and negative laparoscopy for 1 case (16.7%). The rate of conversion to laparotomies was 8 cases (28.5%) for both penetrating and blunt trauma. Conclusion: Laparoscopy can be safely performed in hemodynamically stable patients with abdominal trauma for both diagnostic and therapeutic purposes; also it helps to cut down the number of non-therapeutic laparotomies.

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A total of 90 hands belonging to 80 patients were included in the study. They were mostly female (70) and the rest were male (10). There were 30 endoscopic releases, 60 open releases, and 2 endoscopic converted to open release. There were 15 hands complications in 90 hands. The overall complication rate was 12.2%. Complications noted were pillar pain, open tendonitis presenting as De Quervain disease or trigger finger (1 endoscopic surgeries, 1 open surgeries), infection (1 endoscopic surgeries, 3 open surgeries), wound adhesion (3 open surgeries), nerve injury (2 open surgery, 1 endoscopic), complex regional pain syndrome (4 open surgery), and scheduled returns to the operating room (OR) for recurrent, ongoing, or worsening symptoms (1 endoscopic surgeries, 5 open surgeries). In carpal tunnel syndrome, endoscopic surgery was associated with less postoperative pain than open surgery, but the small size of the benefit and similarity in other outcomes make its cost effectiveness uncertain. There were 12 patients (out of 90) in the surgery group had painful or hypertrophic scar or pillar pain. Wound adhesion and pillar pain was the only statistically significant complication found in the study when comparing open with endoscopic carpal tunnel release. This can potentially be prevented in future patients by delaying the removal of sutures and prolonging the use of a protective dressing in patients who undergo open release. There was not a statistically significant increase in overall complications when using the minimally invasive method of release, which is consistent with existing literature.

Congenital dysplasia of hip Ultrasonographic examination of hip joint ,Clinical examination of hip joint. Background: Congenital dysplasia of hip joint (CDH) is one of the congenital anomalies in newborn that if not diagnosed and treated on time can lead to a severe instability. Although clinical examination is very useful way for screening, but in some patients a confirmatory diagnostic method such as Ultrasonography is needed. The aim of the present study is to compare the sensitivity and specificity of clinical examination and ultrasonography in early detection of CDH. Material and Methods: A total of 1000 newborn were examined by orthopedic surgeons as screening method. The newborns with risk factors or suspicious on clinical examinations were introduced to repeat clinical and ultrasonographic examination of hip joint. The results were collected and recorded by a check list and their sensitivity and specificity of clinical examination were calculated. Results: There were about 980 newborns (1,960 hips) who were studied by two methods of clinical examination and ultrasonography (by Graf Method), the overall incidence of CDH was 33 per 1000. Only 13.5% of the disordered hips according to clinical examination were involved on ultrasonographic evaluation and the remaining 72% involved hips according to ultrasonography (Graf Type IIIb or Merze) were diagnosed Normal on clinical examination. Considering ultrasonography as gold standard method of evaluating CDH, the sensitivity and specificity of clinical examination were calculated 29% and 93% respectively. Conclusion: According to present study, ultrasonographic examination has high valuable in screening of CDH and clinical examination done by experienced orthopedic surgeon has an acceptable value in primary screening of CDH in developing countries for detecting healthy neonates, but if the newborn has a risk or is suspicious on clinical examination, it will be necessary to have assistance from ultrasonography by an experienced sonographer.