Ponseti Method After Walking Age - A Multi-Centric Study of 429 Feet: Results, Possible Treatment Modifications and Outcomes According to Age Groups.

Objective: Ponseti method is suitable to treat neglected clubfoot after the walking age. However, limited evidence exists on its effectiveness, outcomes and rate of relapse. Methods: 429 clubfeet in 303 patients with no previous treatment and older than one-year were treated with the Ponseti method in 15 centers from seven countries.

A Comparative Study of Salter Versus Pemberton Osteotomy in Open Reduction of Developmental Dysplastic Hips and Clinical Evaluation on Bhatti's Functional Score System.

Objective The study was aimed to compare the outcome of Salter's and Pemberton's osteotomy to achieve adequate acetabular coverage in the open reduction of developmental dysplastic hips (DDH). The functional outcome was evaluated as measured on Bhatti's Functional Score System (BFSS). Patients and methods The study includes 60 children with 82 hips of developmental dysplasia in walking-age children.

Does malnutrition in clubfoot patients affect Ponseti technique and its outcome?

Objectives: Malnutrition is a crucial health problem predominantly in the developing countries. Malnutrition in children is one of the main risk factors for diseases and mortality. Club foot or congenital talipes equinovarus (CTEV) is the most common form of congenital orthopaedic abnormality.

Functional and Radiological Outcome of Unstable Intertrochanteric Fracture Post Dynamic Hip Screw Fixation.

Introduction Intertrochanteric fractures are the most frequently operated fracture type and have the highest postoperative fatality rate. The most commonly used devices are the dynamic hip screw (DHS) with side plate assemblies and proximal femoral nail (PFN). The aim of this study was to determine the functional and radiological outcome of unstable intertrochanteric fracture post DHS fixation at a tertiary care hospital in Karachi, Pakistan.

Hydatid Cyst of Skeletal Muscle Presenting as Soft Tissue Tumour.

Hydatid disease is helminthic infection caused by tape worm echinococcus granulosis. It commonly involves liver (65-75%) and the lungs (25 to 30%). Involvement of bones and skeletal muscle is very rare, i.

Functional outcome following olecranon osteotomy approach for fixation of T/Y fractures of distal humerus.

Objective: To evaluate the functional outcome of fixation of T/Y fracture distal humerus through olecranon osteotomy.

Study Design: Quasi experimental study.

Place And Duration Of Study: Department of Orthopedics, Jinnah Postgraduate Medical Centre, Karachi from June 2011 to December 2011.

Difficulties in maintenance of clubfoot abduction brace and solutions - maintenance of clubfoot abduction brace, locks and keys.

Objective: To determine the frequency of early relapse after achieving good initial correction in children who were on clubfoot abduction brace.

Methods: The cross-sectional study was conducted at the Jinnah Postgraduate Medical Centre, Karachi, and included parents of children of either gender in the age range of 6 months to 3years with idiopathic clubfoot deformities who had undergone Ponseti treatment between September 2012 and June 2013, and who were on maintenance brace when the data was collected from December 2013 to March 2014. Parents of patients with follow-up duration in brace less than six months and those with syndromic clubfoot deformity were excluded.

"The role and ability of orthopaedic postgraduate resident's clubfoot treatment with ponseti's methodology." A comparative study of resident's versus consultant's directed treatment.

Objective: To evaluate the outcome of Ponseti treatment carried out by the Postgraduate Orthopaedic Trainees compared with the treatment given by their Mentors.

Methods: The prospective comparative case series study was conducted at Jinnah Postgraduate Medical Centre, Karachi, and comprised idiopathic Congenital Clubfoot Deformity patients treated from September 2012 to December 2013. Also included were a few cases treated between September 2006 and September 2012, who had complete record, serial photograph and updated follow-up.

Improvised explosive device bombing police bus: Pattern of injuries, patho-physiology and early management.

Objective: To understand the different types of blast injuries, their mechanisms, patho-physiology of wounds and clinical consequences caused by improvised explosive device detonation, and their early management.

Methods: The retrospective study related to 70 Special Security Unit personnel of police travelling on duty in a bus that was struck with an Improvised Explosive Device on February 13, 2014, at 7:48am.The data of triage, primary survey and resuscitation and secondary survey on arrival at the Accident and Emergency section of Jinnah Postgraduate Medical Centre, Karachi, were noted and later analysed.

Outcome of one stage combined open reduction, pelvic and derotation femoral osteotomy in congenital dislocated hips of children younger than three years age.

Objective: To determine the outcome of one-stage combined operative management of congenital dislocation of hips in children aged 18-36 months.

Methods: The descriptive case series study was conducted at the Department of Orthopaedic Surgery, Jinnah Postgraduate Medical Centre, Karachi, from January 2005 to December 2011. Children aged 18-36 months suffering from congenital dislocation of hips were included.

Giant cell tumour of proximal radius in a 48 years old lady.

Giant cell tumour is a locally aggressive tumour of long-bones of epiphyseal region commonly occurring in adults aged 20-40 years. Most common location is distal femur, proximal tibia and distal radius. Different treatment options being used are curettage with bone graft or bone cement, resection with arthrodesis, reconstruction, radiation and chemotherapy.

Total hip arthroplasty in a 6-month-old acetabulum fracture-dislocation of the hip: an 8-year follow-up.

Old unreduced acetabulum fracture-dislocation is common in developing countries due to various factors. Different options including arthrodesis, Girdlestone arthroplasty and total hip replacement (THR) are used for its treatment. THR with reconstruction of the acetabulum is recommended, but not much work has been reported so far in our country.

Posterior spinal fixation with pedicle screws and rods system in thoracolumbar spinal fractures.

Objective: To determine the effectiveness of posterior spinal fixation in maintaining the stability of spine and to determine mortality in 6 months after posterior spinal fixation.

Study Design: Quasi experimental study.

Place And Duration Of Study: Department of Orthopaedics, Jinnah Postgraduate Medical Centre, Karachi and Department of Orthopaedics, Postgraduate Medical Institute, Hayatabad Medical Complex, Peshawar, from April 2006 to April 2009.

Total hip arthroplasty for childhood fused hip.

The conversion of a painless fused hip of a long standing duration to a mobile hip is usually not demanded due to a number of per-operative problems, iatrogenic complications and a high demanding procedure. The conversion is, however, required when a patient develops chronic back pain or a painful pseudoarthrosis of the hip. Conversion due to pseudoarthrosis in a recent fracture through femoral neck of previously fused painless hip has never been reported.

Influence of age on the outcome of single stage reconstructive surgery for congenital dislocation of the hip joint.

Objective: This study was conducted to assess the effect of age on the ultimate outcome measures following single stage surgical procedure of soft tissue release, relocation, capsulorrhaphy, femoral shortening with varus/derotation osteotomy and pelvic osteotomy.

Study Design: A case series.

Place And Duration Of Study: The study with two groups of pretest-posttest design was conducted at Department of Orthopaedic Surgery, Jinnah Postgraduate Medical Centre (JPMC), Karachi, from 1993 to January 2008.

Intra pelvic total migration of sliding screw in intertrochanteric fracture.

A type of fixation failure of Dynamic Hip Screw system (DHS) is presented following a collapse of intertrochanteric fracture fixation. The patient presented three months after DHS fixation with severe lower abdominal pain, painful stiff hip and an uncontrolled diabetes mellitus. The radiographic examination of pelvis revealed intrapelvic presence of DHS sliding screw.

Transfer of extensor carpi radialis brevis as an extensor to extensor motor transfer (EEMT) in ulnar nerve palsy.

Objective: To evaluate functional outcome and correction of deformity with extensor carpiradialis brevis motor transfer to replace the intrinsic muscles as an extensor to extensor motor transfer (EEMT).

Method: This was a prospective observational study with one group pretest posttest design conducted from 1996 to 2004. Convenience sampling technique was used and the sample size was twenty one.

Bilateral treponema periostitis.

Symmetrical exuberant periostitis is a rare disease caused by variety of infectious and non-infectious causes. Treponematosis is one of the rare causes of this condition. We report a patient who presented with left arm swelling, secondary to onion peel periostitis of the humerus, which was caused by Treponema species.

Frequency, presentation and postintervention prognosis of chondroblastoma.

Objective: To evaluate the frequency of clinico-radiological presentation and the prognosis after treatment of chondroblastoma.

Design: A descriptive, observational study.

Place And Duration Of Study: The study was carried out at the Department of Orthopaedic Surgery, JPMC, Karachi over the period of 16 years, January 1986 to June 2002.

Malignant fibrous histiocytoma: vascular invasion and metastasis to heart.

Two cases of biopsy-proven malignant fibrous histiocytoma are presented which showed local as well as vascular spread resulting in cardiac metastasis and peri-and postoperative complications leaving palliative surgery as the prime management.