Median nerve neuropathy, often known as carpal tunnel syndrome (CTS), is a pathological condition that develops when the median nerve becomes entrapped within the carpal tunnel, resulting in pain, numbness, and tingling sensations. The most popular non-surgical procedure right now is splinting the wrist with a rigid splint, mainly at night and occasionally in conjunction with other therapies. Objective: To determine mean change in pain score before and after wrist splinting for carpal tunnel syndrome presenting to orthopedic department Hayatabad Medical Complex, Peshawar. Methods: This Quasi Experimental Study (Uncontrolled Trial) was held in the Orthopedic Department Hayatabad Medical Complex Peshawar for six months duration from 5th September 2020 to 6th March 2021 after approval of synopsis. A total of 60 patients with CTS were included in the study in a consecutive manner and subjected to wrist splinting. Baseline and follow up pain scores were measured at 6th post splinting week. Results: The mean age of the sample was 42.3 + 12.8 years. While distributing the patients with regards to gender, we observed that in our study 65% of the sample was male and 35% were female gender. The mean BMI was 25.2 + 3.4kg/m2 and 13.3% of sample was diabetic. Mean use of splint / day was 5.3 + 2.2 hours and 43.3% used ibuprofen as analgesic. Mean baseline pain score of the sample was 8.9 + 0.9 and mean follow up pain score at 6th week of splint use was 4.2 + 1.5 (p < 0.001). Conclusion: Wrist splinting is an effective conservative treatment for CTS in terms of significant pain relief after 6 weeks and is not dependent upon BMI, gender, diabetes or type of NSAIDs used. However, our study sample size was too small to draw conclusions there is no evidence of functional improvement after splinting. We recommend more studies (interventional) on large sample size and taking into account pain as well as functional assessment to develop future guidelines for the treatment of CTS using wrist splinting Keywords: Carpal tunnel syndrome, Splinting, diabetes, Body mass index, Pain, Visual analogue scale

Adhesive capsulitis (AC) is a painful frozen shoulder disease that continues for more than 3 months, is also known as frozen shoulder. The glenohumeral joint capsule fibrosis that results from this inflammatory disease is accompanied by substantial range of motion limitation and gradually advancing stiffness (typically external rotation). The findings of this study will support better outcomes for adhesive capsulitis patients in our local population in terms of pain reduction and a decline in SPADI score. Objective: To compare functional outcome of steroid injection vs intra-articular steroid injection in rotator interval in the treatment of early frozen shoulder. Place and Duration of study: Department of Orthopedic Surgery, MTI-HMC, Peshawar from 27 Feb, 2021 to 27 Aug, 2021. Study Design: Randomized Control Trial. Methods: Patients were randomly allocated to both groups through blocked randomization. Patients in Group A was subjected to intra-articular steroid injections whereas patients in Group B were subjected to steroid Injection in rotator interval. Results: As per functional outcome in both groups, in Group A, 51 (85.0%) patients were showed effective results while in Group B, 42 (70.0%) patients showed effective results.

Dislocations of the shoulder are a serious and expensive issue. Younger males are more likely than older men to experience shoulder dislocations, with overall incidence rates ranging between 23.91 and 23.12 per 100,000 person/years. After initial closure reduction and sling immobilization of the traumatic anterior shoulder dislocation, this study will give us the most recent and accurate information about the severity of recurrence of dislocation. Aim: The goal is to determine the frequency of recurrent shoulder dislocation occurs following conservative treatment. Place and Duration: In the Orthopaedics Department, Khyber Teaching Hospital, Peshawar for six months duration from 28/6/2012 to 28/12/2018. Methods: A total of 172 patients were observed during this study. All patients had conservative treatment, which included manual shoulder reduction and three weeks of immobilization with a sling. In order to reduce bias, all treatments were carried out by a consultant orthopedic surgeon with at least seven years of experience, assisted by a senior postgraduate resident. To check for the recurrence of the dislocation, all patients were instructed to maintain regular follow-up for the following three months.

In the USA alone, osteoarthritis affects > 3 billion people, making it the most predominant type of joint disorder. It costs the US more than $185 billion a year and is the primary cause of persistent disability in older persons. The results of our cases will help encourage local health researchers to continue this procedure and review the available resources thereof. Objective: To determine efficacy of arthroscopic debridement with proximal fibular osteotomy in early medial joint osteoarthritis of the knee in patients presented to tertiary care hospital. Methods: This descriptive Case Series was held in the Orthopedic Surgery department, MTI-Hayatabad Medical Complex, Peshawar from 30 Dec, 2020 to 30 Jun, 2021. Patients with medial knee osteoarthritis were treated by proximal fibular osteotomy combined with arthroscopic debridement. The efficacy of the knee function was evaluated by VAS score, AKSS, and ML ratio at 1 week and 3 months after operation. Results: As per frequencies and percentages for efficacy, 114 (69.1%) patients showed effective results of arthroscopic debridement. Conclusion: This study demonstrated that arthroscopic debridement with proximal fibular osteotomy is an effective procedure in the management of early medial joint osteoarthritis of the knee in terms of improved knee function.