Aim: To assess the epidemiological aspects of fractures sustained during bike accidents. Study design: Retrospective study Place and duration of study: Department of Orthopaedic, M Islam Medical & Dental College Gujranwala from 1st June 2020 to 31st December 2021. Methodology: Five hundred patients of bike accidents were assessed through severity scoring system. Various bike types, fractures sustained, rate of mortality, helmet usage was assessed. Results: There were 54.6% males and 45.4% females. The mean age of the patients was 33.5±5.75 years. Ninety percent of patients wear no helmet. The presentation of the injuries showed that majority of the cases as 28.2% had facial injuries. Spinal and thoracic injury was common in multi trauma injuries. Conclusion: Bike accidents cause severe life threatening injuries which can be reduced through wearing helmets. Keywords: Bike accidents, fractures, multi trauma

Objective: To find the frequency of destructive hip disease in post intra-articular corticosteroid hip Injection. Study Design: Retrospective study Place and Duration of Study: Department of Orthopaedic, Sahara Medical College Narowal from 1st January 2021 to 31st December 2021. Methodology: One hundred and twenty cases of corticosteroid injection in intra-articular region were analyzed. The radiological imaging within 6-12 months was used for finding frequency of rapidly destructive arthrosis. Narrowing of joint space greater than fifty percent with a loss of cartilage up to 2mm within a year was used for rapidly destructive arthrosis diagnosis. Kallgren and Lawrence scoring system ranged between 0-4 was used. Results: There were 73.3% and 26.7% males and mean was 53.1±3.3 years. The steroidal injection was placed as 40mg triamcinolone-acetonide with 4 mL 1% lidocaine in 77.5% of cases. 20.8% rapidly destructive arthrosis in all the patients who were injected with corticosteroid. The progression of total hip arthroplasty was noticeable in 22.5%. Conclusion: A high frequency of destructive hip disease is observed in intra-articular corticosteroid hip injections. Keywords: Frequency, Destructive hip disease, Intra-articular corticosteroid hip injection

Objective: To evaluate the outcome of patients in term of range of motion after total knee arthroplasty with all poly implants. Study Design: Retrospective study Place and Duration of Study: Department of Orthopaedics, Sahara Medical College, Narowal from 1st April 2021 to 31st March 2022. Methodology: Sixty various patients who came for total knee arthroplasty were selected on the basis of their conditions. Patients were divided into two inserts groups for understanding the better outcome results in terms of range of motion (ROM). Thirty patients having fixed bearing and other 30 patients having mobile bearing inserts will all poly implants. A standardized medial-parapatellar approach was taken for surgical procedure and resection of primary tibia was done. Pain function and evaluation was performed through knee society scoring (KSS) as well as VAS score and goniometer was used for analyzing range of motion which was defined as degree of flexion of knee subtracting from number of extension-defect. Results: There was no significant difference in either the gender or ages of both implants selected patients However the mobile bearing group patients has a better BMI value than the fixed bearing implant patients. In term of range of motion mobile bearing group patients had a higher ROM value than the fixed bearing operated patients in case of overall change in range of motion analysis. The Western Ontario and McMaster Universities Osteoarthritis (WOMAC) Index, score showed a significant change with an increased value observed in mobile bearing implant patients. Conclusion: Visual analogue pain score show significant difference in mobile and fixed bearing group. In terms of range of motion, mobile implants show better outcome in contrast to fixed bearing group. Keywords: Knee implants, Mobile, Fixed bearing, Outcomes, Osteolysis

Objective: To assess the outcome of dynamic hip screw fixation in intertrochanteric femur fractures. Study Design: Prospective cohort study. Place and Duration of Study: Department of Orthopaedics, Pak Red Crescent Medical & Dental College, Dina Nath from 1st October 2020 to 31st March 2022. Methodology: Fifty Patients suffering from intertrochanteric femur fractures were enrolled. The operational time as well as incision length, measurement of blood loss during surgery was recorded. The chance of re operating on a patient and post-operative infection was also observed and documented. A complete follow up for assessing the outcomes of dynamic hip screws were continued until 18 months. Results: The mean age of the patients was 58.05±7.58 year. There were 64% males in this study while only 36% females. The ASA grade presented 32% cases within grade II while grade I and IV had equal number of cases in it. The Harris hip score presented outcome scores at 1 then 2 followed by 12 then 15 and 18 months as mean 75.37, 85.40, 88.25, 88.76 and 87.53 respectively. Conclusion: Dynamic hip screw fixation is reliable surgical procedure for treating intertrochanteric femur fractures with decreased complication rate and improved Harris hip scoring. Keywords: Proximal femoral nail technique, Distal hip, Hip fracture

Aim: To determine the significance of total knee arthroplasty in patients with Parkinson's disease. Study design: Retrospective study. Place and duration of study: Department of Orthopaedics, Sahara Medical College, Narowal and CMH Kharian Medical College Kharian from 1st July 2020 to 30th September 2022. Methodology: Fifty patients suffered from Parkinson disease which was already diagnosed and the patients attended the Orthopaedic Ward for knee arthroplasty were included. Patients were then followed up till 12 weeks for the clinical analysis of the preoperative and postoperative outcomes of the procedure. Western-Ontario and McMaster-Universities Osteoarthritis Index, Short Form Health Survey-scale, physical component-summary as well as mental-component summary were used for the critical analysis of the patients underwent knee arthroplasty. Knee Society-Score and Knee Society-Function Score determined the deformity, stability, pain and functional analysis. Results: The mean age of the cases was 66.91 ± 6.62 years. There were more females than males in this study with a comparative percentage of 20% vs 80% respectively. There were 60% left knee arthroplasty with 22% in grade IV. Range of motion as well as stability of the patients was also improved. SF-12 also showed a significant improvement in the Physical component-summary and mental-component summary levels. There was a reduction in pain and stiffness analyzed through Western-Ontario and McMaster-Universities Osteoarthritis Index scoring and more flexion as analyzed by range of motion. Conclusion: There is better scoring of patients from pre to postoperative state although still towards lower side and with poor motor functional outcomes. Key words: Ganglion, Neurodegenerative, Arthroplasty, Significance, Analysis