Objective: The aim of the study is to evaluate the effectiveness of belfast protocol in Flexion tendon injury of zone v through TAM scoring. Methodology: A prospective study will be directed to find out the outcome of Belfast protocol in flexor tendon injury in the premises of plastic surgery ward civil hospital Karachi, we were use non probability sampling technique to enlist the patient .we were systematized a well-designed questionnaire and through TAM scoring to measure the intervention outcome in term of functional ADL. Results: The results showed that there were 76% male and 24% female patients were affected. Most of the injury happened at work in 29% and at home 21% patients.44% patients were (21-30 ) years of age , 36% patients were (31-40) 4% of patients were (41-50) , 2% of patients were (51-60). TAM Score was observed that total 22 patients had excellent outcome (Score 100), 19 patients had good outcome (Score 75-99), 4 patients had fair outcome (score50-74 ) and only 5 patients had poor outcome. It was observed that treatment was effective in 45 patients because their TAM Score was >50 and in only 5 patients the treatment was ineffective because their TAM Score was <50. Conclusion: We concluded that belfast regime (early passive and active range of motion of fingers the rate of tendon adhesion and rupture rate was very low and gave good result , most commonly men was affected with the injury that’s 76% and commonly injury happened at work place by accident . There is no standard protocol and therapist must communicate with the surgeon and patients before selecting an appropriate therapy program.. Keywords : Rehabilitation ,Flexor injury , Zone V, Early mobilization ,Belfast technique.

Treatment by mirror therapy (MT) restores motion in injured limbs without invasive procedures. This process is widely accepted for rehabilitating patients with phantom limb pain, stroke victims, or patients who need therapy after nerve damage. The procedure is specifically useful in restoring motion to the hand after surgical repairs to the extensor muscle and tendons. Mirror therapy rewires the brain by making the restored limb remember hand motions by observing the motions of a normal hand. The concept of a mirror image is that the movement of the uninjured arm forms the illusion of the same movement in the affected arm. Efforts to repeat hand movements elicit the same reaction in the affected hand in what is referred to as Hebbian learning. This case study evaluated MT's effectiveness in motion restoration after a glass injury. This case study showed restoration of normal hand motions in a patient following surgery to repair a glass cut to the arm. Surgery repaired the lacerated extensor tendon and radial nerve. The muscle belly was repaired, and a graft fixed the nerve gap. Once the arm healed, the patient underwent rehabilitation in mirror therapy to restore normal function in his hand. After conducting mirror therapy, the pain was eliminated, and the patient restored normal function of moving the hand and finger extension. In addition, the therapy could be conducted at home without needing a professional. The effectiveness of mirror therapy was seen in the functional restoration of hand and finger movement. The process is also less complicated as it can be performed at home.

Burn injuries are common in Pakistan. However, most people are reluctant to have infrared treatment for their wounds. This study investigated the efficacy of infrared treatment on burn wounds. The procedure involved a burn victim who had sustained acid burns to the neck and face. Nectrotomy was done to remove dead tissue from the burn wound, and after treatment, Low-Level Light was used to reduce pain and enhance healing in the patient. Initial results showed mild hypertrophic scars, no stiffness. Post-operation therapy included physical training regimens and massage. The patient showed satisfactory results and felt less tightness in neck movements by the following treatment. The article concludes by showing that infrared light promoted repair and regrowth at a cellular level.

Some diseases require medical mitigation following the diagnosis, and sometimes the situation means that the patient has to undertake strong medication. However, this medicine is designed pharmacodynamically to interact with other organs before they reach the intended organ. Some mitigation imposes challenges on the involved organ. While the main organ will be healed, some drugs' footprints will be left out to other organs. These are called iatrogenic injuries. In the case of anastomosis, it requires the alteration of surgical methods or the origin of iatrogenic injury in the arm; thus, the knowledge of anastomosis is very important to the field of medical practice. In addition, carpal tunnel release becomes vital in curing carpal tunnel syndrome. The paper focuses on a case of a 42-year-old woman found to have a complication to her middle finger. This case becomes important for studying Berrettini anastomosis iatrogenic injury, which relates to carpal tunnel syndrome. The Berrettini branch is a complication that facilitates communication between the superficial ulnar and median nerve. The analysis also provides the electro-diagnostic evidence of Berrettini anastomosis on how it can give a position three-finger and thus contribute to a force explanation of the median neuropraxia. Lastly, the paper provides information on the implication of the Berrettini branch for surgical use. The implication of pictures in the digital era can be used to analyze the varied connection and length between the median nerve and ulnar section. It's easy to locate the position of high risk of iatrogenic injury in the palm due to the consistent location of Berrettini communication branches. The precaution is that operations have to be conducted moderately for a clear vision as the carefully mitigated practice ensures protection from the destruction and injury of the surrounding structures.

To determine the dynamic physical strain exerted on an individual during work, an evaluation of all physical performances is necessary. For surgeons, sustaining healthy ergonomics is essential, particularly for cases requiring long standing hours. Indeed, the absence of proper ergonomics may lead to multiple musculoskeletal issues. Failure to check these problems may lead to future degenerative changes and eventually career-ending damages. Pain among surgeons is expected since they spend many hours caring for patients that they ignore their health, standing for prolonged hours. Lack of attention to work ergonomics often leads to work-related muscle pain and increased risk of problems.