Aims Clinical management of open fractures is challenging and frequently requires complex reconstruction procedures. The Gustilo-Anderson classification lacks uniform interpretation, has poor interobserver reliability, and fails to account for injuries to musculotendinous units and bone. The Ganga Hospital Open Injury Severity Score (GHOISS) was designed to address these concerns. The major aim of this review was to ascertain the evidence available on accuracy of the GHOISS in predicting successful limb salvage in patients with mangled limbs. Methods We searched electronic data bases including PubMed, CENTRAL, EMBASE, CINAHL, Scopus, and Web of Science to identify studies that employed the GHOISS risk tool in managing complex limb injuries published from April 2006, when the score was introduced, until April 2021. Primary outcome was the measured sensitivity and specificity of the GHOISS risk tool for predicting amputation at a specified threshold score. Secondary outcomes included length of stay, need for plastic surgery, deep infection rate, time to fracture union, and functional outcome measures. Diagnostic test accuracy meta-analysis was performed using a random effects bivariate binomial model. Results We identified 1,304 records, of which six prospective cohort studies and two retrospective cohort studies evaluating a total of 788 patients were deemed eligible for inclusion. A diagnostic test meta-analysis conducted on five cohort studies, with 474 participants, showed that GHOISS at a threshold score of 14 has a pooled sensitivity of 93.4% (95% confidence interval (CI) 78.4 to 98.2) and a specificity of 95% (95% CI 88.7 to 97.9) for predicting primary or secondary amputations in people with complex lower limb injuries. Conclusion GHOISS is highly accurate in predicting success of limb salvage, and can inform management and predict secondary outcomes. However, there is a need for high-quality multicentre trials to confirm these findings and investigate the effectiveness of the score in children, and in predicting secondary amputations. Cite this article: Bone Joint J 2023;105-B(1):21–28.

Objective: To determine the diagnostic accuracy of high-resolution ultrasonography for the diagnosis of rotator cuff tears considering magnetic resonance imaging as gold standard. Methodology: This correlational study was done using non-probability consecutive sampling technique, at the Department of Orthopaedic Surgery and the Department of Radiology, Services Hospital Lahore from 15th July 2013 till 14th January 2016. All the patients, age between 40 to 70 years, who presented with shoulder pain for last three month, that was not settled with oral analgesic, and were positive for Hawkin’s -Kennedy test, Jobe’s test and drop arm were included in the study. Patients who had fracture of the clavicle, scapula or proximal end of humerus, and patients with prosthetic implants and pacemakers were excluded in the study. All clinical test positive patients underwent ultrasonography (USG) and magnetic resonance imaging (MRI). We calculated specificity, sensitivity, positive predictive value (PPV), negative predictive value (NPV), accuracy and likelihood ratio for ultrasonography. Results: Out of the total 92 patients, on MRI there were 68 (73.9%) complete and 24 (26.1%) partial Rotator Cuff Tears. USG diagnosed 62 out of 68 complete tears accurately. There were 21 true negative and 03 false positive complete tears. USG showed sensitivity of 91%, specificity of 87% (p-value