Objective: To investigate the clinical outcome of dorsal wrist ganglion treated with surgical excision. Methodology: It was a cross-sectional study performed at Kazi Hospital Lahore. Non-probability purposive sampling technique was used to enroll 50 patients of dorsal wrist ganglion who responded through a questionnaire / research proforma. Surgical excision was done under local anesthesia as day case. Results: We collected data of 55 patients. The mean age of the patients having dorsal wrist ganglion cyst was 31. Female patients were in a larger proportion than male patients. Right wrist was affected in n= 29 (58 %) of the individuals. At the end of our follow up only 2(45) patients had residual pain. Hypertrophic scar has been reported to be associated with the lower patient satisfaction (p = 0.001). Luckily in our study only two patients (4%) had this problem. Conclusion: This study concluded that the outcomes of surgical excision of dorsal wrist ganglion is effective technique with high patient satisfaction and cost effectiveness. Keywords: Dorsal wrist ganglion, aspiration, surgical excision, outcome, patient satisfaction.

Objective: To find out the incidence of surgical site infection in clean cases of orthopaedic surgery. Study design: Retrospective descriptive study. Setting: Trauma and orthopaedic unit Gulab Devi Hospital. Duration: April 2018 to November 2021 Methodology: Using non probability (purposive) sampling a total of 800 patients who underwent an invasive surgical procedure during the specified time period was included in the study. While all non-invasive procedures such as manipulations, application of plaster casts and image guided intra-articular injections were excluded from study. p-value< 0.05 was considered as significant Results: There were 504(63%) male patients and 296(37%) female patients. Age range was between 01 to 86 years. Mean age was 30±6.7 years. After performing surgery, all patients were followed up for minimum of four weeks to record SSIs. Post-operatively infection was detected in 17(2.12%) of our patients. SSI was 5.8% in clean cases, 23.5% in clean contaminated and 70.5% in dirty cases. The prevalence of SSI were significantly higher in those patients already having dirty wound before procedure as p<0.05 Conclusion: Surgical Site infection (SSI) rates reported in this study setting are are comparable to international standards. Keywords: Orthopedic, Surgical site infections, Trauma, Wound management

Introduction: Diabetes mellitus (DM) is a very common disease that results from the body’s inability to maintain blood glucose level within normal limits. Blood glucose levels are either too high or too low. One study shows that up-to 30% people with DM experience skin problems. If blood sugar levels are well controlled, the rate of wound healing and developing a severe infection is significantly less. Regarding management of wound in diabetic patients, keep wounds dry with meticulous dressing, limb elevation, protect the surgical fixation in splint or braces for an extended period of time and patient education to keep in touch wither consultant and promptly report any unusual discomfort, pain, wound discharge, soaking of dressing and systemic symptoms. Objectives: the objective of this study is to identify the risk of wound infection and rate of healing in diabetic patient. Materials and Methods: The study was conducted at orthopedic department of Gulab Devi hospital. It was a Cross sectional study. The data was collected from September 2021 to February 2022. Non–Probability purposive sampling technique was used. The data was collected from indoor of Gulab Devi Chest Hospital Lahore and informed consent was taken from all the patients. The target populations were those who have diabetes mellitus and treated in orthopedic ward at Gulab Devi hospital Lahore. Diabetic patients enrolled in the presented study n=60. Results: our patient population was 28 to 55 year old with mean age 40years. 83% were in 35 to 40 age group. Wound problems were frequently encountered in patients with uncontrolled diabetes and 50% (n=30) of these patients had at least one wound complication after operation. And 71% (n=43) patients had increased pain and delayed recovery of their surgical wounds. When it comes to the relationship between bone health and diabetes, 63% (n=38) patients had history of previous bone fracture and 61% (n=37) patients had deformity of bone. Due to diabetic neuropathy 68% (n=41) patient were weight bearing on fracture site without concern. And the risk of diabetes include slow wound healing 75%. Practical implication; we aim to raise awareness among treating surgeons and physicians of patients presenting with diabetes and planning to undergo surgical intervention. Meticulous wound care and strict control of blood sugar levels are paramount to successful outcome. Conclusion: Diabetes mellitus is a systemic disease associated with uncontrolled blood sugar levels with systemic manifestations. Our study has proved an association of high wound complication with DM patients. Strict diabetic control as well as extra vigilance and meticulous techniques are needed to prevent complications in this group of patients. Keywords: Diabetes mellitus, infected wound, diabetes complications, wound healing

Background: Mycobacterium Tuberculosis (TB) is a major global health concern and burden on developing countries economy. Pakistan ranks in top 10 countries of the world with high load of TB and a big chunk of this disease process is extra pulmonary TB (EPTB). Among extra pulmonary sites, is bone and joint TB is very common yet under reported. Recent literature has found up to 35% of all extra pulmonary cases are bone and joint TB. Purpose: We aim to do an analysis of frequency of bone and joint TB in our institution in all new patients getting registered for treatment of TB. Methodology: This was retrospective analysis 8 years of Data collected in Gulab Devi Hospital Lahore. Data was analyzed using Microsoft excel software and results are tabulated. Findings: Total number of new registered patients of Extra-pulmonary Tuberculosis (EPTB) were 13000 (20%). Out of these EPTB patients, bone and joint TB diagnosis was made in 690(5.3%) patients. Out of these 690 patients, 400 (58%) cases were recorded in Indoor facility and 290 (42%) cases were seen in outdoor facility. Most common site is Spine 340 cases (85%) followed by Hip joint 16 cases (4%), knee joint 12 cases (3%) and upper limb 16 cases (4%). Practical Implication: Regarding management of newly registered cases, Gulab Devi hospital is working in collaboration with world Health Organization TB control program and Provincial TB control Program Punjab (PTP). All new cases are managed by multi-disciplinary team and after initial registration are referred to their relevant specialties. Conclusion: Axial skeleton remains the most common site in al literature and so is the conclusion of our analysis. Detailed research work is still needed in several aspects of this ancient disease to reduce the morbidity and mortality associated with it. Keywords: Bone and joint TB, Pulmonary Tuberculosis, Extra pulmonary Tuberculosis

One of the most common injuries during sports is anterior cruciate ligament (ACL) injury. A number of surgical and rehabilitation techniques have been developed. ACL reconstruction is mainstay of treatment. Objective: In this study we are evaluating the outcome of ACL surgery. Design & Setting: Retrospective study Methodology: Data collection of all cases that underwent primary arthroscopic anterior cruciate ligament reconstruction performed. All patients were operated with same surgical technique using quadrupled hamstring autograft. Results: There was an overall male predominance (95.3%). Medical meniscal injury was found in 05 (24%) patients. Lateral Meniscus injury was found in 04(19%) patients. Adjustable length CSF device was used in 12 (57%) patients and fixed-loop CSF device in 9 (43%) patients. Conclusion: At two years, outcome of ACL reconstruction performed by one surgeon using same surgical technique with adjustable CSF device and absorbable tibial screw granted satisfactory clinical results in all patients. Rehabilitation played an important role in return to activities of daily living in all patients at final follow up. Keywords: Anterior Cruciate Ligament, Arthroscopy, Rehabilitation