Background: Arthroscopic Bankart repair and open Latarjet procedures are the most frequent surgical treatments for shoulder instability and recurrent shoulder dislocation. Objectives: Therefore, we performed research to assess the clinical outcomes and recurrence rate of instability between both Arthroscopic Bankart repair and open Latarjet techniques. Methods: A cross-sectional study was performed at Lahore General Hospital, Lahore from 2021-23, comprising 74 patients, managed surgically for the condition of recurrent shoulder dislocation. The patients were allocated into two groups viz Group A and B comprising 37 patients in each, who were managed through Arthroscopic Bankart repair and open Latarjet techniques, respectively. Post-operative complications, re-occurrence and success rate were measured in terms of SSV scores. Results: Average age of patients in Arthroscopic Bankart group was 28.34+5.31 years while in open Latarjet group; it was 29.09+6.19 years. 14 (37.83%) patients of Arthroscopic Bankart repair group revealed recurrent shoulder dislocation, while no such complaint was found in the open Latarjet technique. Twenty-seven patients of Arthroscopic Bankart group showed satisfaction with the procedure and 33 out of 37 patients (89.18%) were satisfied with open Latarjet technique. Patients in open Latarjet technique group showed successful recovery of shoulder dislocation and their SSV was 87.91%, while the patients in Arthroscopic Bankart repair group showed less SSV score of 59.76%. Conclusion: Open Latarjet group patients had a greater rate of functional satisfaction, while the arthroscopic Bankart repair group showed a trend for more recurrence. Open Latarjet operation had a higher success rate and patients had a better rate of return to previous top-level sports than Arthroscopic Bankart technique. Keywords: Latarjet; Re-occurrence; Shoulder dislocation; Sports medicine; Surgical complications.

Background: Metacarpal bone plays vital role in supporting motor functions of the human palm and is subjected to frequent stress. If a fracture of the metacarpal bone occurs, it can destabilize the palm, disrupt muscular-tendon tension, impair functions of palm joints, and have adverse impacts on the daily life and work of the patient. Objectives: To compare early range of motion (ROM) in hand following K-wire fixation versus mini plate fixation in patients with multiple metacarpal shaft fractures. Methods: Cross-sectional analysis of patients with multiple metacarpal shaft fractures was done at Mufti Mehmood Memorial Teaching Hospital, between 2021 and 2022, and comprised 108 patients managed with K-wire Fixation and mini plate fixation. The success rate as well as clinical outcome of both techniques was measured as early ROM in the hand, which was assessed at eight weeks post-surgery using DASH scores. Results: Majority of patients (p<0.05) were males (73.14%), common fractures (p<0.05) were closed type (75.03%), right sided (62.96%) and common cause of injury (p<0.05) was traffic accidents (n=48), industrial accidents (n=13), fall (n=12), agriculture accidents (n=12) and assault (n=10). Our findings revealed that occurrence of complications was significantly higher among the patients of group K-wire fixation (11.11%) than mini wire fixation (6.48%) and assessment of ROM through DASH score system of mini plate fixation was better than K-wire fixation. Practical implication The surgeons will confidently apply mini plate fixation in patients with multiple shaft fractures rather than K-wire fixation after reading this article. Conclusion: Mini plate fixation may be more effective than K-wire fixation in restoring early ROM in the hand following surgery for multiple metacarpal shaft fractures. Keywords: DASH scoring; Palm fracture; Range of motion; Shaft fracture.

Background: Scaphoid fractures are common and account for 60-70 % of all carpal fractures. The objectives of this study were to determine the demographic and clinical profiles of adult patients with scaphoid fractures in population of District D.I.Khan, Pakistan. Materials & Methods: This cross-sectional study was conducted in Department of Orthopedics, Gomal Medical College, D.I.Khan, Pakistan from January 2015 to December 2019. Sample size was 40. Demographic variables were sex, age groups and time to presentation in weeks. Research variables were; cause, laterality, site, management options, time to union in months and presence of infection. All variables were categorical and analyzed by count and percentages for sample and as CI at 80% CL for proportion for population using Wilson score for binomial distribution. Results: Forty patients included 34 (85%) men & 16 (15%) women, 24 (60%) in 17-30 and 16 (40%) in age group 31-50 years. Time to presentation was ≤1 week of injury in 19 (47.5%) patients and 21 (52.5%) presented later. Cause was fall on out-stretched hand in 27 (67.5%) and RTA in 13 (32.5%) patients. Right hand was involved in 29 (72.5%), left in 9 (22.5%) while bilateral in 2 (5%) patients. Site of fracture was waist in 24 (60%), proximal pole 11 (27.5%) and distal pole 5 (12.5%) cases. Conservative treatment was done in 7 (17.50%) patients, percutaneous screw fixation 7 (17.50%), open reduction and internal fixation through palmar in 11 (27.50%) and though dorsal 15 (37.50%) cases. Time to union was ≤3 in 7 (17.50%), >3-6 months 29 (72.5%), while >6 months in 4 (10%) patients. Presence of infection was 1/40 (2.38%). Conclusion: Scaphoid fractures are more common in men and younger adults and most are presented within a week of injury. These are caused mostly by fall on outstretched hand, involving right hand and involving waist. Substantial number of cases requires open reduction with internal fixation. Mostly unite in 3-6 months.

Background: Unstable proximal femoral fracture occurs at the top of femur bone, typically in elderly people or those involved in high-impact accidents. The fracture can occur in different ways, including intertrochanteric, subtrochanteric, or femoral neck fractures. The two most common techniques implied for its repair are Proximal Femoral Nail (PFN) and Dynamic Hip Screw (DHS). Objectives: The research was conducted to evaluate these both techniques and compare their clinical outcome in terms of Harris Hip Score, clinical assessment and clinical complications. Methods: Cross-sectional study was completed in 2020-2022 and comprised 104 patients equally divided into Group A (DHS) and Group B (PFN). Both techniques were comparatively analyzed and the outcomes were evaluated using Harris Hip Score and clinical assessment. Results: Group A and B had mean surgery duration of 76.78+13.40 and 57.09+11.67 minutes, mean intra-operative blood loss of 239+32.98 and 149+17.29 ml, mean weight bearing time was 3.13+0.56 and 2.98+0.39 months, average incision length was 8.78+2.81 and 5.12+1.94 cm, radiological union of the fractured bones took 3.27+0.78 and 3.11+0.82 months, respectively. Harris Hip Scores were recorded on monthly basis and revealed that 1st monthly scores of Group A and B were 71 and 74, 2nd month had 77 and 81, 3rd month had 80 and 84, 4th month had 83 and 88, 5th month had 84 and 89 and 6th month revealed 86 and 90 scores, respectively. Practical implication: The surgeons would prefer PFN technique while surgery of unstable femoral fracture to avoid complications and achieve better results. Conclusion: PFN technique was associated with less blood loss, lower complications and a higher Harris Hip Score. It has marginally superior results to DHS. Thus PFN is a minimally invasive technique that necessitates less tissue dissection, resulting in negligible blood loss. In treating unstable femoral fractures, an analysis of clinical indicators revealed that PFN has superior clinical manifestation than DHS. Keywords: Femoral fractures; Harris Hip Scores; Intramedullary device; Osteoporosis.