Background: Humeral shaft fracture accounts for approximately 3% of all the types of fractures and is the most common type of fracture occurring in adults. A surgical intervention for a humeral shaft fracture is controversial whether as to intervene or not but for other types of fractures like multiple fractures, severely displaced fractures, a comminuted fracture and fractures where there is vascular and nerve injury surgical intervention is definitely required. Aim: Outcomes of comparison between I/M interlocking nail and plating in fractures of humerus shaft in adult patients. Methodology: A randomized clinical trial was conducted at the Department of Orthopedic Surgery, Sh. Zayed Hospital, Lahore over a period of six months. 190 patients (divided in two equal groups by lottery method) were included. Informed consent was taken. Demographics like age, gender, duration of fracture were obtained. In group A patients underwent surgery by using IMN fixation. In group B, patients underwent surgery by using plate. Patients were followed-up in OPD of 10 days. Then patients were followed-up further in OPD for 24 weeks. If union achieved in 24 weeks, then success was labeled. Results: Total of 190 patients, mean age was calculated as 39.57±8.09 years in group A and 40.01±8.79 years in group B. There were 62(32.6%) males whereas 48(25.3%) were females in group A and that 63(33.2%) were male whereas 32(16.8%) were females in group B. Frequency of success was 94(49.5%) in group A and 92(49.4%, in group B. Frequency of infection was 1(0.5%) in group A and 2(1.1%) in group B Conclusion: It is concluded that there was no significant difference in both groups. Intramedullary nail and plate provides good outcome with no complications in the treatment of humerus shaft fractures. Keywords: Humerus shaft Fracture, Intramedullary nail, Plate.

The facial looks have an impact on self-esteem and emotional well-being, playing an important role in social interactions. Changing in these functions will therefore affect the standard of living of children. Objective: The purpose of the study was to evaluate the effect of malocclusion on psychological well-being on school going children using the OASIS aged between 13-17 years attending government high schools in Mardan District. Methods: This was a Descriptive Cross-Sectional Survey conducted at the government schools of Mardan. It was carried out within a period of six month from December, 2021 till May 2022 after consent from Institutional Review Board (IRB) of Bacha Khan Medical College, Mardan vide No. 39/2021/ERB. The sample was chosen using a random cluster sampling technique with probability related to size. The design effect was taken into account as the cluster sampling approach was applied, and a sample size of 850 was achieved. (600 boys and 250 girl participants were involved respectively from government high schools). Results: A total of 850 subjects were included in the study of which there were 600 (70%) males and 250 (30%) were females. The age range was 13-17 years with a mean age 15 years +1.37 (S.D) years. Conclusions: Angle’s malocclusion was established in 73.1% of the subjects. The least affected psychologically was normal occlusion with (100%) good psychological well-being followed by Angle’s class I malocclusion having good psychological well-being (76.8%).

Aim: To determine the outcome of extra-articular distal radius fracture treated with plaster splintage. Methodology: This descriptive case series study was done in the Department of Orthopaedic Surgery, at Jinnah Hospital, Lahore from 01-08-210 to 31-01-2011 which includes 50 patients who fulfill the inclusion criteria of age 40-80 years of either sex. After the approval of Hospital Ethical Committee, informed consent taken from every patient. Results: The average age was 63.70±11.64 years. Seventeen (34%) patients were male and 33 (66%) patients were female. On visual analogue scale of pain, 23 (46%) patients had no pain and 27 (54%) patients had mild pain. Forty six percent patients shows excellent results and 54% patient shows good results. Conclusion: Closed reduction and plaster splintage was used to assess the functional outcome in distal radius extraarticular fractures. Overall results were excellent in 64% cases and good in 54% cases in the distal radial extraarticular fractures treated with plaster splintage. Keywords: Distal radius extraarticular fractures, Plaster splintage, Visual deformity, Pain and grip strength.

Background: Complex proximal tibial fractures caused by high energy trauma classified as Schatzker type V and VI pose a management challenge due to associated extensive soft tissue damage.Though open reduction and dual plating is considered a gold standard treatment option in these fractures but associated with wound breakdown and infection. Aim: To evaluate the radiological and functional outcomes of percutaneous hybrid fixator as alternative treatment option in these fractures. Methodology: This study designed as prospective case series was conducted in Sheikh Zayed Hospital Lahore between May 2019 to May 2021.Twenty four patients fulfilling the inclusion criteria were operated using a hybrid external fixator in schatzkerV and VI tibial plateu fractures with compromised soft tissue.On follow upradiological and functional outcomes were being evaluated. Results: At Six months follow up after surgery Rasmussen knee score was graded as excellent in 13, good in 8, fair in 3 and poor in 0 patients.In radiological outcome mean time to bony union was 13.5 weeks.One case of varus malunion and no case case of non union was observed in our study. Conclusion: Hybrid external fixator is a well found fixation alternative as compared to conventional open reduction and internal fixation in Complex tibial plateau fractures with extensive soft tissue disruption achieving satisfactory radiological and functional outcomes. Keywords: Schatzker, Tibial plateau, Hybrid fixator.

Background: Posterolateral knee dislocation rarely occur and might not reduce due to buttonholing of the Femoral condyle into the anteromedial knee joint capsule. These are complex injuries without any clear guidelines in terms of management. Case presentation: 40-year-old male presented with posterolateral knee dislocation due to a road traffic accident. Patient was having posterior cruciate ligament (PCL) injury along with posterolateral corner instability supported by clinical examination and confirmed with radiologic investigations. Management and Results: Patient was managed with single-stage arthroscopic reconstruction of PCL followed by open posterolateral corner ligaments reconstruction. Postoperatively patient had positive functional outcomes with satisfactory international knee documentation committee subjective knee form (IKDC) scores. Conclusion: Posterolateral Corner Injury (PLC) injury with associated PCL injury showed positive results when managed in a single-stage procedure.