Objective: To compare the outcomes between conventional versus Minimal invasive dynamic hip screw in fixation of intertrochanteric fracture of femur Materials and Methods: This is randomized control trial, conducted at Department of Orthopedic Surgery, Shaheed Mohtarma Benazir Bhutto Medical University (SMBBMU), Larkana, Pakistan from November 9, 2020 to May 8, 2021. All patients who fulfilled the inclusion criteria and visited to SMBBMU, Larkana were included in the study. After taken Informed consent, exclusion criteria were followed strictly. Results: Mean±SD of age in MIDHS group was 54.6±9.5 and CONDHS group was 55.8±9.8 years. Mean ± Standard Deviation of blood loss & duration of surgery was noted as (51.3±16.4 v/s 145.1±26.4; [P=0.0001] ml) and (54.5±11.4 v/s 76.2±17.7; [P=0.0001] mins) among MIDHS and CONDHS groups respectively. While duration of hospital stay was noted as 3.6±2.2 and 8.1±4.9 in MIDHS v/s CONDHS groups respectively with a highly significant difference i.e., (P=0.0001). Conclusion: It is to be concluded that highly significant difference was noted in comparison of outcomes between conventional v/s Minimally invasive dynamic hip screw for the fixation of intertrochanteric fractures of femur. Keywords: Conventional, Femur, Intertrochanteric Fractures, Hip Screw, Outcomes

Objective: To determine the effects of elastic intramedullary nails used for fixation of femur diaphyseal fractures in paediatric patients. Method: This prospective observational research was done from April 2020 to June 2021. 52 paediatric patients diagnosed with femur diaphyseal fractures with mean age from 6 to 12 years were enrolled in this study. All patients were admitted and subsequently operated for treatment of femur fracture using elastic intramedullary nail in retrograde fashion. Patients were in structured follow up till radiological union realized. Flynn scoring criteria was applied to evaluate the functional outcomes at 6 months after surgery. Results: The average age of patient enrolled was 9 years (6- 12 years), all 52 patients were in follow up for average 26 weeks (14-36 weeks). Fracture union was observed in all operated children in mean time of 9 weeks (range 6-12 weeks). Four participants suffered superficial skin infection at entry site. Two patients had limb length discrepancy upto1.5cm and two patients had varus angulations up to (10º) and in two patients proximal migration of nail was noted. According to Flynn Criteria outcome was excellent in 38 patients (73.1%), satisfactory in 12 patients (23.1%), poor in 2 patient (3.8%) respectively Conclusion: Fixation of femoral diaphyseal fracture with intramedullary elastic nail in paediatric patients is better option. One can achieve excellent results, satisfactory radiological and clinical bony union, with lowest complication rate, so it could be regarded as a favorable fixation implant for management of diaphyseal femur fractures in pediatric age group. Keywords: Fracture, femur shaft, elastic intramedullary Nail, Paediatric patients.

BACKGROUND & OBJECTIVE: Mental health is playing an important role in our daily life. Now a days depression is the second most common illness in the world. Online social networking is one of the risk factors to mental illness, and objective is to determine the usage of social networking sites (SNS) and level of depression among undergraduate students. METHODOLOGY: This cross-sectional study was conducted at Sindh Agriculture University Tandojam- Sindh with simple random sampling through self-administrated questionnaires. Sample size was calculated on a prevalence rate of 50%, students ranging from 17-28 years, using SNS were included while those having any chronic illness were excluded. Ethical approval was obtained from Health Services Academy Islamabad, anonymity confidentiality, and privacy was assured. SPSS version 20.0 was used, and chi-square was applied to find the association. RESULTS: Out of 212 students, the respondents consisted mainly of male students n=165 (77.8%), among them, 52 (24.5%) students were of age 19 years and 76 (35.8%) were in first-year class. Results reveal that the frequently used SNS was Facebook 169 (79.7%). The students using these sites for more than 4 years were 28 (13.2%). Among the SNS users, 142(67%) were having moderate depression, while 9 (4.2%) had severe depression. Male students have more online friends (p <0.001) and tend to login more times on SNS as compared to female students (p=0.023). CONCLUSION: The usage of social networking sites is more among undergraduate university students, especially males. Most of the students suffered from moderate depression. There may be a link between SNS usage and depression among undergraduate university students.

Aim: To determine the outcome of patients diagnosed with complex fractures of tibial plateau with associated soft tissue compromise treated by using Ilizarov fixator. Study design: Prospective observational study. Place and period of study: Orthopaedic unit, Chandka Medical College SMBBMU Larkana from January 2021 to December 2021 Methods: Patients diagnosed with complex tibial plateau fracture with associated soft tissue compromise fulfilling inclusion criteria were enrolled in study. All participants were managed with Ilizarov fixator and it was removed when fracture was united clinically and radiologically. Outcome of patients was evaluated on the basis aggregate score of knee society score and knee functional score at 6month follow up. Results: Twenty seven consecutive patients met the inclusion criteria, of which 19(70.37%) were male and 8(29.7%) were female. Average age of patients was 32.37 years. All fractures healed by the end of the 4th month. Ring fixator was removed routinely at 16th weeks after initial surgery in all patients. Transient peroneal nerve injury was found in 2 patients; no patients developed deep vein thrombosis, whereas pin site infection was most common complication and occurred in 5 patients (18.5%). According to knee society score results were excellent in 15(55.55%) patients, good in 08(29.62%) patients, fair in 03(11.11%) in patients and poor in 01(3.70%) patient. Practical implication most of proximal tibial plateau fractures with soft tissue compromise are kept under observation till the soft tissue status become favorable for open reduction and internal fixation, while fixing these type of fracture with Ilizarov fixator one can provide early relief to patients and results of this study will be help for operating surgeons while managing complex proximal tibia fractures. Conclusion: complex tibial plateau fracture can be effectively treated with Ilizarov fixation method without any complication, when exposed reduction and interior fixation with plate is contraindicated due to compromised soft tissue. Keywords: Tibial plateau, fractures, Ilizarov, fixation method, outcome, soft tissue compromise,

Objective To evaluate effectiveness of Ponseti technique in treatment of clubfoot in children from 2 years to 5 years of age Material and methods: Our study is Descriptive case series done at Department of Orthopedic Surgery, SMBBMU, Larkana, from April 15, 2019 to October 14, 2019. Patients fulfilling inclusion criteria attending Ponseti clinic of SMBBMU, Larkana were incorporated in our study. After getting consent, procedure was explained in detail with merits and demerits. Treatment was labeled effective if Pirani score after treatment ≤1/6. Bracing phase with Dennis Brown shoes was started for maintenance of the corrected foot after post tenotomy cast removal. Data was collected and entered into the performa attached. Results: Mean and standard deviation for age was 4.08±2.17 years. Among 71 patients, 48 (67.6%) patients were male and 23 (32.4%) were female. Positive family history was found to be in 8 (11.26%) patients. Modes of delivery shows that 46 (64.8%) patients had gone through C-Section while 25 (35.2%) had normal vaginal delivery. Efficacy of Ponseti technique was noted in 52 (73.2%) patients. Conclusion: From the studies it was shown that Ponseti technique for club foot in both presenting earlier or late is safe and effective. Keywords: Clubfeet, Congenital Talipes Equinovarus, Ponseti Technique, Pirani Score