Objective: This study aims to observe the clinical outcomes associated with in situ single-stage suture repair for knee dislocation in patients suffering from multiple knee ligament injuries with the use of unabsorbable materials of the suture. Study design: A retrospective observational study Place and Duration this study was conducted in Gambat Medical College Pir Syed Abdul Qadir Shah Jellani Institute of Medical Science GIMS Gambat from May 2021 to May 2022. Methodology: In this study35 patients treated surgically with in situ suture repair were recruited. A retrospective analysis was done on 35 patients with a mean follow-up score of 3.8 ± 1.3 years. Patients were undergone in situ surgical procedures for all the ruptured ligaments followed by a proper rehabilitation protocol post-operatively. Outcome variables were assessed by Lysholm score, satisfactory score, Meyers functional rating score, VAS score, and Tegner score. Results: Results of the study states that the mean follow-up a score of VAS was recorded as 1.98 ± 0.4, Lysholm score was recorded as 82.5 ± 6.7, and the patient satisfaction score was recorded as 7.5 ± 0.9. Statistically, significant differences have been observed between the pre and post-scores of ranges of motion and Tegner activity scores with a p-value of < 0.001 for both activity and ROM scores. Final follow-up of these patients reported that patients were left with no ligament laxity except for two patients who were unable to restore back to work. Among 35 patients, 5 were unable to achieve full ROM and had stiffness whereas two had infections at the surgical site. Conclusion: In situ suture repair of multiple ligaments had shown significant improvement in terms of ligament repair and early rehabilitation and therefore can be considered an effective treatment approach for the management of multiple ligament injuries. Keywords: Multiple ligament injuries, in situ repair, knee dislocation, cruciate ligament injury, single-stage repair.

Volar Barton fracture is the fracture of distal radius bone associated with ventral displacement. It is an oblique intra-articular fracture. Objective: To investigate the results, both functional and radiological, of open reduction and internal fixation with locking compression plates of the volar Barton fracture. Methods: A total of fifteen patients were included in this study. All of the participants had volar fragment type B3 fractures of the wrist. All the patients underwent open reduction to treat the fracture. Internal fixation was done using a locking compression plate (LCP). Out of a total of 15 patients, 10 were male and 5 females. The most common cause, almost 67 %, of the fracture was a road traffic accident (RTA). The mean age of the patients was 33 years, ranging from 21 to 55 years. All the patients had their respective surgeries within 7 days of the fracture accident. Quick Dash score-, and Gartland and Werley score were used to assess the function of the hand and wrist. Results: All the fractures took the meantime of 8 weeks for the bone union. The mean Quick Dash score was 10, ranging from 0 to 60. According to Gartland and Werley’s score, 9 patients were excellent, 4 patients were good and 2 were fair. No postoperative complication occurred. Conclusions: Open reduction and internal fixation with locking compression plates of the volar Barton fracture is an effective treatment for functional and radiological restoration.

Aim: To make a comparison between functional results in intra-articular displaced calcaneus fractures which are treated conservatively and operative treatment Study design: A randomized controlled trial Place and Duration:This study was conducted at ward 17 JPMC Karachi from January 20221 to January 2022. Methodology: This study includes 32 individuals who had displaced intra-articular calcaneal fractures. These individuals were classified into two groups, each group with 16 individuals. They were randomly assigned to either operative or conservative treatment. Clinical results, as well as radiological results (Modified Rowe’s score), were assessed at a 1-year follow-up. Results: All results were measured using Modified Rowe’s score. With a 1-year follow-up of the operative group, according to Modified Rowe’s score, 6 individuals had excellent results representing 37.5%, 8 individuals had good results representing 50%, and only 2 individuals had satisfactory results representing 12.5%. On the other hand, with a 1-year follow-up of the conservative group, only 2 individuals had excellent results representing 12.5%, 7 individuals had good results representing 43.75%, 5 individuals had satisfactory results representing 31.25%, and 2 individuals had poor results representing 12.5%. A few challenges were seen in each group. In the operative group, delayed wound healing was a complication seen in 2 cases while in the conservative group, peroneal tendonitis, subtalar arthritis and malunion were seen as a complication. Conclusion: In conclusion, the operative group was seen to be more effective to cure displaced intra-articular calcaneus fractures rather than the comparative group. Only a few complications, better functional recovery, early rehabilitation, and early weight bearing were seen in the operative treatment. Keywords: Calcaneus fractures, functional outcome, rehabilitation, conservative treatment

Aim: To compare the effectiveness of autologous blood injection versus steroid injection, in the treatment of Plantar Fasciitis. Study Design: A Randomized Controlled Trial Place and Duration: This study was conducted at Alhada Armed Forces Hospital Taif KSA from January 2021 to July 2021. Methodology: A total of 44 participants who had plantar fasciitis, for more than 6 weeks were divided into two groups. Group A was treated with autologous blood injections and the other group with steroid injections. Those patients with plantar fasciitis who were gone through certain surgical (heel surgery, ankle dislocation, rupture of plantar fascia, calcaneal fracture, tarsal bone fracture, and metatarsal bone fracture) procedures prior to having the disease were excluded from the study. Result: The total number of males in Group A and Group B were 23 and 19 respectively. The total number of females in Group A and Group B were 21 and 25 respectively. Treatment through autologous blood was effective in 26 patients of Group A and treatment through steroids was effective in 31 patients of Group B. Group A and Group B consisted of individuals that had average ages of 37 years and 38 years respectively. Conclusion: Autologous blood injections were not more effective than steroid injections in the treatment of plantar fasciitis. Keywords: autologous blood injection, effectiveness, steroid injection, plantar fasciitis

Aim: The aim of this study was to compare the healing and functional outcomes of metacarpal bone fractures treated conservatively versus surgically. Study design: A longitudinal study Place and Duration: This study was conducted at Ghulam Mohammed Mahar Medical College Sukkur Pakistan. from June 2020 to June 2021 Methodology: The study comprised a total of 80 people with varied forms of metacarpal fractures. The fractures were treated conservatively or surgically in the orthopedic department. The Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire score, which was used to assess the ability to execute various tasks, inspired the creation of the questionnaire. The least level of disability was assigned a score of 0, and the most degree of disability was assigned a score of 100. Results: In the DASH questionnaire, a scale score ranging from Zero to 100 was calculated. The greater the score, the worse the scenario. The majority of the subject obtained a score of 21 to 25, suggesting that they were generally pleased with their therapy. The Michigan questionnaire was used to assess patient satisfaction as the next questionnaire. Patients' primary expectation is restoring maximum hand function, and the functional outcome is critical. Conclusion: Most metacarpal fractures have a satisfactory outcome with nonoperative therapy because there is a lot of tolerance for angulation and shortening. Physical therapy and mobilization are critical components of treating these fractures and are an important part of the rehabilitation process. More study is required to help develop a definite treatment regimen while maintaining our patients' quality of care and overall wellness. Keywords: Fracture, Metacarpals, Conservative Treatment,