Aim:To assess the potency of unilateral external fixation as a proper cure for tibial fractures. Study design: A retrospective longitudinal study Place and duration: This study was conducted at Pakistan Institute of Medical Sciences (PIMS) Islamabad Pakistan from August 2020 to August 2021. Methodology:Treatment of 225 tibial shaft fractures was done, in which closed fractures took 22 weeks and open 26 weeks for complete fusion. All fractures were fixed with AO fixator Results:Data of 210 patients was evaluated. Treatment of 225 tibial shaft fractures was done, in which closed fractures took 22 weeks and open 26 weeks for complete fusion. A total of 17 nonunion patients were observed while there were 22 delayed fusions, 5 malunion, 59 pin infections, and 4 osteomyelitis, 43 patients went through the re-operation process. Conclusion:Four patients had fat embolism while pulmonary embolism was present in six and venous thrombosis in 15 patients. The ultimate treatment in 88.0% of patients was external fixation. If there is a no formation of callus formation, reoperation should be carried out so unilateral external fixation is the preferred treatment for tibial fractures. Keywords: External Fixation, Tibial Diaphyseal Fractures, treatment

Aim: Assessment of the consequences of arthroscopic repair of large and massive rotator cuffs. Study design: Retrospective analysis Place and duration: This study was conducted at Shaheed Zulifqar Ali Bhutto Medical University/PIMS Islamabad Pakistan from August 2020 to August 2021. Methodology: In the current study, 50 patients were included out of which 37 patients had large tears and 13 had massive tears which were repaired arthroscopically. Average follow up was of 32 months. Modified UCLA shoulder rating scale was used to evaluate the function, strength, range of motion and the pain before and after surgery. Results: Among the included 50 patients, 21 patients were female, and 29 were male. The range of their ages was between 41 and 76 years. The dominant extremity was affected in majority of patients. The average preoperative time of patients was 10 months. According to UCLA, 98% patients experienced satisfactory results, and only 1 patient had to undergo second surgery for the repair. Conclusion: The study concluded that arthroscopic repair of tears in rotator cuffs is the best technique which can be used for repairing large and massive tears in rotator cuff. Keywords: tears, outcome, arthroscopy, rotator cuff

Objective: The purpose of this study is to determine the functional and radiological outcomes of modified stoppa approach for fixation of acetabular fractures. Study Design: Descriptive Study Place and Duration: Study was conducted at Orthopaedic department of Ayub Teaching Hospital Abbottabad, Fauji Foundation Hospital, Rawalpindi and Islamabad International Hospital E-11/4, Islamabad for duration of two years form July 2019 to June 2021. Methods: There were thirty patients of both genders who had acetabular fractures were presented. Included patients were aged between 18-55 years. Patients' age, sex, body mass index and cause of fractures were recorded after taking informed written consent. Types of acetabular fractures were also recorded. Modified stoppa approach was used to operate acetabular fractures. Outcomes were operative time, radiological and functional outcomes were assessed in terms of excellent, good, fair and poor results. Post-operative complications and patients' satisfaction was also calculated. We used SPSS 24.0 version to analyze complete data. Results: Among 30 cases, majority of the patients 20 (66.67%) were males and 10 (33.33%) were females with mean age 29.4±10.37 years. Mean body mass index of the presented patients was 23.7±7.25 kg/m2. RTA was the most common cause found in 17 (56.67%), followed by fall from height in 8 (26.67%) and 5 (16.67%) fractures had other causes. Anterior wall fracture was the most common type found in 14 (46.67%) cases. Mean operative time was 3.87±13.18 hours. As per radiological outcomes, frequency of anatomical reduction found in 21 (73.3%) cases, not perfect found in 5 (16.67%) cases and poor results found in 4 (13.3%) patients. Majority of the cases 18 (60%) had good results in functional outcomes, excellent results in 7 (23.3%), fairs results in 3 (10%) cases and poor in 2 (6.67%) cases. Post-operative complications found in 2 (6.67%) cases. Satisfaction rate among patients was 86.67%. Conclusion: We found in this study that the use of stoppa approach for fixation of acetabular fractures was effective and safe method in terms of good radiological and functional outcomes. Except this less operative time and less number of complications were calculated with high number of customer’s satisfaction. Keywords: Acetabular Fractures, MSA, Complications, RTA