Objectives: To determine functional outcome of percutaneous Kirschner wirefixation and short arm cast in intra-articular distal radius fractures in patients of 20-70 years.Study Design: Descriptive case series. Setting: Department of Orthopedic Surgery, DowUniversity of Health Sciences / Civil Hospital Karachi. Period: 1st April, 2013 to 30th September,2013. Methods: A total of 62 patients with closed type III distal fractures according to Frykmanclassification were included in this study. Patient lying in supine position and after generalanesthesia, closed reduction was done with the forearm in prone position, aiming to restorenormal anatomical position. Two Kirschner wires were inserted from radial styloid process inparallel and oblique fashion to the medial cortex of the radius and one transversely from lateralto medial for intra-articular fragments. Final functional outcome was assessed after 12 weeks ofsurgery and recorded on pre-designed Proforma. Results: Acceptable functional outcome ofpercutaneous Kirschner wire fixation and short arm cast in intra-articular distal radius fractureswas observed in 80.65% (50/62) cases. Conclusions: It is concluded that functional outcomeof percutaneous Kirschner wire fixation and short arm cast procedure is satisfactory in intraarticulardistal radius fractures and it appears to be an easy, technically less demanding andeffective method for stabilization, so this procedure can be applied for patients with thesefractures.

Introduction: In school going children surgical treatment is favoured with the introduction of elastic intramedullary nails. The aim of this study was to determine the management outcome of fracture shaft of femur in children between 7-14 years of age by intra medullary rush nail. Patients and Methods: This study was conducted at department of orthopedic surgery, Dow University of health science and civil hospital Karachi. Duration of study was 12 months from 01-09-2011 to 31-8-2012. Children with closed fracture shaft of femur age 7-14 years of either sex meeting the inclusion criteria were included. Children were diagnosed clinically and confirmed on X ray, open reduction and internal fixation with appropriate size rush nail was done by senior orthopedic surgeon. Thereafter patients were followed every month and the final outcome was measured at the end of third month post operatively. Results: male were 58% while female were 42%, the average age of the patients were 11.78±1.40 years. Management outcome of fracture shaft of femur in children by intra medullary rush nail showed that 100% children fracture were healed. Conclusions: We found a very high success rate in the management of closed fracture shaft femur with intramedullary rush nail. This surgical procedure is simple, technically less demanding, and suitable in peripheral rural hospital in developing countries.

Aim: To evaluate the functional outcomes of intramedullary interlocking nailing and minimally invasive percutaneous plate osteosynthesis. Study design: A longitudinal study Place and Duration: This study was conducted at Dow University of Health sciences Karachi Pakistan from January 2019 to January 2021. Methodology: A total of 100 patients were recruited for surgical procedures. All the patients were asked to visit the hospital at the 6th week, 3rd month, and 6th month of surgery for radiography assessment and for analyzing the knee and joint movements. When callus became visible on radiographs patients were allowed for partial weight-bearing. When callus was visible in 3 to 4 quadrants we considered it as fracture union on both anteroposterior and lateral views with no pain and mobility. Bone grafting was considered in case of fractures nonunion. Functional assessment was taken place after one year of surgery. Results: We observed that the IMIL group attained fracture union in an average duration of 25.90. But no statistical difference was observed between both groups. IMIL procedure has less duration of hospital stay when compared with MIPPO (6.40 (4–9) ± 1.19 vs 6.82 (5–10) ± 1.27. We observed 5° malunion in the MIPPO group whereas the IMIL group reported 10° malunion with a significant difference of 0.001. Conclusion: Our study concluded that the plating technique can better restore the distal tibia alignment but also has chances of postoperative complications which would be manageable. Keywords: Intramedullary interlocking nailing, minimally invasive percutaneous plate osteosynthesis, distal tibia

Unstable forearm both bones fracture in children more than 10 years of age aredifficult to manage with cast and surgical intervention is required. Objectives: To determine thefunctional outcome of patients with unstable forearm fractures managed with intramedullaryrush nail. Methods: This study was conducted at Department of Orthopedics, Civil HospitalKarachi from July 2011 to August 2013. All the patients with age in between 10 to 15 years, withclose radius ulna unstable fracture presenting within 7 days of trauma or fall were included inthe study. All the fractures were stabilized with intramedullary rush nails. Functional outcomewas assessed at 12 weeks. Results: There were 79 patients included in the study. Mean agewas 13.17±2 years. There were 52 male patients (65.8%) and 27 females (34.2%). There were24 patients with history of road traffic accident, 29 patients with fall and 26 patients with bluntinjury. Acceptable outcome was found in 64 (81%) patients and observed more in male children(p=0.001) and children above 13 years of age (p=0.027). Union was achieved in all the patients.Six patients had pin site irritation and 2 had superficial infection. Conclusions: Intramedullaryfixation with rush nail in unstable forearm fractures in the children appeared to be an effectivemethod of fixation and provided acceptable outcome in 64 (81%) patients.