ABSTRACT
Introduction: Fractures of the neck and head of the radius in children are relatively uncommon, constituting 4% to 7% of elbow fractures and dislocations. A child with a fracture of the radial neck and proximal ulna with complete medial displacement of the radial shaft is presented and the classification of the injury is discussed. Objective: To assess the medial displacement of the radial shaft with fracture of the radial neck and proximal ulna. Materials & Methods: This was a retrospective study conducted at Dept. of Ortho-Surgery, Patuakhali Medical College Hospital, Patuakhali, Bangladesh from January 2018 to December 2021. Twelve patients who had displaced radial neck fractures (Judet type III and type IV) treated. Patients were assessed for functional outcome by Mayo elbow performance score (MEPS), the Tibone and Stoltz functional criteria, and for complications with the average follow-up of four years (range: six months to seven years). Inclusion criteria were Judet type III and type IV radial neck fractures, open physis of radial neck at the time of fracture, minimum follow up time of six months. Exclusion criteria were open fractures and Judet type I and type II radial neck fractures. Results: The mean age of the patients was 9.12±2.2 years (range: 4 to 14 years). Nine (75%) patients were males and three (25%) patients were females. The right side was the most commonly injured side (right at 68% and left at 32%). 60% cases were of Judet type III and IV 40% cases were of Judet type IV. The mean fracture angulation of the series was 56.5 degrees (range 33.2 degrees to 79.2 degrees). Five patients had isolated radial neck fractures and five patients had associated proximal ulna fractures and two patients had associated posterolateral elbow dislocation. Six cases required open reduction and K-wire fixation as closed and percutaneous pin leverage techniques did not achieve acceptable reduction. The mean follow-up of all patients was four years ............

ABSTRACT
Musculoskeletal disorders (MSD) are a category of work-related diseases affecting the dentists. The aim of this work is to investigate among dentists from Constanta the prevalence and characteristics of MSD, their posture during working and the adoption of ergonomic standards. Methods: A sample of 280 dentists working in private practice in Constanta were invited to participate to this study. The response rate was 65% (n=182). The participants filled a 35-items questionnaire including personal data, working position, MSD characteristics and treatment. The level of significance was set at p<0.05. Results: 67% of the dentists reported the presence of MSD and 71% consider that symptoms are related to the dental activity. MSD were located mostly in cervical area and neck (41%), followed by lower back (24%). No statistical correlation was found between presence of MSD and body weight (p=0,7). A sitting position was always used by 27% of subjects, 46% are using both sitting and standing working postures. No statistical significant correlation was found among the presence of MSD pathology and the activity of the dentists during Covid-19 pandemic (p=0,8). Conclusion: A high percentage of dentists reported MSDs. The main location is the spine, the cervical and lower back area. It is concluded postural problems leading to neck and back reported from the dentists in Constanta are comparable to those from other countries. Adoption of correct posture, sport and stretching exercises could prevent or minimize the effect of static dental activity.

ABSTRACT
Background: The incidence of nonunion of humerus has been as high as 15% of all humeral fractures. Majority of humeral shaft fractures were treated by conservative treatment using splints, hanging arm cast, braces compromising anatomical reduction in view of wide range of movement of shoulder and elbow joint. Methods: The prospective study was conducted at Dept. of Ortho-Surgery, Sheikh Sayera Khatun Medical College & Hospital, Gopalgonj, Bangladesh from January 2021 to June 2022. Total 20 patients with fracture shaft humerus, who were treated with locking compression plate from the period were study. All patients are admitted and subjected to clinical & radiological examination, necessary lab investigations are carried out for proposed surgery. Regular follow up will be carried out by clinical examination and with X-rays at interval of 6 weeks, 3 months than 6 months and study will be conducted on a minimum of 20 patients. Results: Total 20 patients with fracture shaft humerus, who were treated with locking compression plate from the period of study. The age group of the patients in our study ranged from 15 years to 65 years. Most of the patients belong to 21- 40 years. 65% with male predominance (70%), with type A3 as the commonest fracture (50%) involving the mid shaft (70%) of humerus, underwent open reduction and internal fixation using locking compression plate. Conclusion: The age of the patient ranged from 15 years to 65. Majority of the patients were males. (M: F = 14: 6). In our series, left humerus was involved in 50% cases, while right was involved in the other 50% of cases.

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Background: Clinical weight bearing provocation tests, like to determine the sensitivity and specificity of the childress’ test (duck walk test) and joint line tenderness in diagnosing meniscal tears and to determine whether the location of tear and severity of injury is important. However, evidence of the diagnostic accuracy of the childress’ test (duck walk test) and joint line tenderness test are lacking and the cause of tear (traumatic versus degenerative), and ACL insufficiency were associated with differences in the sensitivity and specificity of the test. Objectives: The aim of this study was to assess the clinical improvement regarding joint line tenderness and childress’ test (duck walk test) in a tertiary care hospital. Methods: This is a prospective interventional study. The study used to be carried out in the admitted patient’s Department of Orthopedic, National Institute of Traumatology and Orthopedic Rehabilitation (NITOR) Sher-E-Bangla Nagar, Dhaka, Bangladesh. In Bangladesh for the duration of the period from January 2013 to December 2014. Results: This study conducted on 20 patients aged 16 to 40 years, Childress test (Duck walk test) was positive in case of 80% patients and post operatively the test became negative in all patients Out of 20 patients 90% regained normal to near-normal knee function and stability after surgery. Pain and swelling were also significantly reduced. Conclusions: Meniscus injury frequently takes place in young adult population who are very active, which reduces their endeavor level and ultimately become an economic burden. So, early intervention and partial meniscectomy, which offers very accurate momentary result, is imperative to make them healthy and return to their normal activity.

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The term congenital pseudo-arthrosis of the tibia is a misnomer, as it is usually not present at birth but clinically manifest within the first decade of life. It is nonetheless a rare disease with yet a poorly understood natural history having varying presentations, which possess a great challenge of both diagnosis and management. It is however, a documented fact that 50% of these patients have neurofibromatosis type 1 and thus, a careful study and understanding of this condition as it present in patients with neurofibromatosis type 1 will also expose more about the disease entity itself, aid clinicians in making early diagnosis and tailor down a definitive treatment scheme which will help in limb salvage and prevent subsequent limb amputations amongst other complications. Here, we present a case series of two patients each with features of neurofibromatosis type 1, presenting with pseudo-arthrosis of the tibia. First patient is a 14-year old girl who presented with right leg deformity, multiple skin freckles and café au lait macula lesions on the body. Lower limb deformity was noticed since patient was 6-years of age following a minor fall at home, she has had multiple trial of local splinting of the limb and conservative non-surgical management of the limb deformity/fracture also in a peripheral hospital which has also failed and the deformity has persisted since then, she subsequently develops freckles which was noticed initially from the hand and progresses to cover the whole body including the palms and sole of the foot. On examination, she was stunted for age, not in any distress, anicteric not pale, with freckles covering the whole body, and macula café au lait spots around the upper back and thoracic region. There is an obvious deformity of the right leg, pseudo-arthrosis above the ankle joint and the right foot is under developed compared to the left foot. The second patient is a 4-year old.

ABSTRACT
Introduction: Femoral shaft fracture is the most common major paediatric orthopaedic. For generations traction and casting was the standard treatment for all femoral shaft fractures in children. Elastic stable intramedullary nailing is one for treating these fractures and has a reliable methodology. Over the past two decades the advantages of fixation and rapid mobilisation have been increasingly recognised. Objective: To evaluate the short term clinical, functional and radiological outcome of intramedullary fixation of displaced femoral shaft fractures in skeletally immature children using titanium elastic nails. Methods: A prospective study was conducted in the Department of Ortho Surgery, National Institute of traumatology and orthopedic rehabilitation (NITOR), Dhaka, Bangladesh from July to December 2020. 52 femoral shaft fractures in child aged 6-14 years were fixed with titanium intramedullary elastic nail in the department of Orthopaedics, NITOR, Bangladesh. Two nails of proper and equal diameter were used for fracture fixation. No external splint was used after surgery. Outcomes assessed on the basis of Flynn et al., scoring criterion. Results: The results of the 52 included in our study. All patients achieved complete healing at a mean of 9.1 (Range 8- 10) weeks. 44 fractures were reduced by closed means but 8 needed open reduction. No major complication was recorded. Most common minor complication was entry site skin irritation recorded in 8 patients. 84.61% had excellent result and 15.38% had satisfactory. Conclusion: The treatment of paediatric shaft femur fracture has been drastically changed over the last two decades to internal fixation by elastically stable intra- medullary nail (ESIN). It allows early ambulation and shorter hospital stay and higher parent satisfaction. It also provides flexural, translational and rotational stability as well.

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Introduction: Total knee replacement (TKR) is commonly carried out in patients with advanced osteoarthritis to reduce pain and increase. The study aimed to investigate functional outcomes after Total Knee Replacement (TKR) among orthopedic patients at Babcock University Teaching Hospital, Ogun, South West, Nigeria. Methods: Registry data of patients who underwent TKR between January 1st, 2021 to December 30th, 2021 were collected and retrospectively reviewed. Sociodemographic and anthropometric data together with the Oxford Knee Score (OKS) were collated both preoperatively and postoperatively (12 weeks after surgery). Results: There was significant increase in the OKS postoperatively, which was statistically significant. There was significant difference between pre-operative OKS and post-operative OKS (p=0.0049). Conclusion: Overall, there was clinically significant change in the OKS after surgery. This implies greater reduction in pain and increase functional outcomes.