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Background: Meniscal injury is one of the most common knee injuries. It is known that loss of meniscus increases the risk of subsequent development of degenerative changes in the knee This research aimed to evaluate the clinical and functional outcomes of arthroscopic treatment of meniscal tear using the All-inside technique. Methods: This prospective study was conducted on 18 patients with meniscal tears admitted to the Orthopedic Surgery Department, at Zagazig University hospitals. The patients treated with the all-inside repair technique, the range of the patient ages from 18 to 40 years old (mean 26.50 years), with the majority being male (77.8%) and female (22.2%). Results: The mean operative time of all cases was 73.33 ± 26.67 (range 40-100 minutes). The mean operative time of isolated meniscal repair cases was 41.42 ± 5.56 (40-45 minutes). The mean operative time of associated ACL reconstruction cases was 93.63 ± 5.04 (90 - 100 minutes). Fifteen (83.3%) cases had moderate pre-operative pain and three (16.7%) cases had severe pain. while postoperative, 11 cases (61.1%) had no pain, five cases (27.8%) had mild pain, one had moderate pain, and one had severe pain. the test value is 29.250. there is a highly statistically significant difference between pre-operative and post-operative pain. Eighteen (100.0%) cases had painful limited flexion or extension pre-operative, while postoperative, 14 (77.8%) cases had full range, two (11.1%) cases had less than 20 degrees' loss of flexion, one case (5.6%) had loss of 30degree flexion. and one case had a loss of 40 degrees of flexion. There is a highly statistically significant difference between preoperative and post-operative IKDC score. There was a highly statistically significant difference between pre-operative and post-operative Lysholm score. According to the post-operative Lysholm score, there were two poor cases (11.1%), three (16.7%) good cases & 13 (72.2%) excellent cases. Conclusions: Arthroscopic All-inside meniscal repair could be an effective, safe, rapid surgical management with reliable and predictable outcomes and avoid the risks of nerve and vessel injury. [ABSTRACT FROM AUTHOR]

Background: Shaft fractures account for 20% and 1-3% of all humerus fractures, respectively. Open dynamic compression plate fixation (Open fixation with DCP) with absolute stability is the current gold standard for treating shaft humerus fractures. The goal of MIPO was to provide a more stable fixation, which would increase the union rate and decrease open plating side effects including infection and radial nerve palsy. Aim: The purpose of this study was to assess the clinical and radiological outcomes of the MIPPO technique in the treatment of humeral shaft fractures. Patients and methods: thirty cases of shaft humerus fractures were examined during the period from August 2022 to March 2023. The history, clinical examination, and radiographic (X-ray) examination were used to select cases. According to UCLA score, the result was noted and filled up. Results: Union was achieved in 17 to 22 weeks with the mean 19.4±4.1. Only 5% nonunion was seen in our cases. It was observed that the median UCLA score was excellent (34). Conclusion: In shaft humerus fractures, results from minimally invasive plate osteosynthesis with anterior bridge plating were favorable. They offer the fracture site some support, and the fracture hematoma is not disturbed. MIPO keeps the blood vessels healthy, which lowers the danger of infection and wound disintegration. [ABSTRACT FROM AUTHOR]

Background: The use of closed reduction and percutaneous K-wires, with or without external fixation, is a common surgical solution for patients with an unstable distal radius fracture. Objective: To detect effectiveness of K-wiring as an efficient method for treating distal radius fractures in adults and elderly in Zagazig University Hospitals. Patients and Methods: At Orthopedic Departments of Zagazig University Hospitals, 24 cases with distal radius fractures were treated by percutaneous K-wiring with six months follow-up. Results: Most of the participants met the Mayo wrist score criteria in 13 of the cases where they were evaluated clinically as outstanding. One patient had Sudeck atrophy, seven patients had superficial skin infection, and two patients had stiffness. Conclusion: In adults and the elderly, distal radius fractures can be effectively treated by percutaneous K-wiring. The surgery is safe, has a low rate of complications, and requires only a brief stay in the hospital. By sticking to the fundamental principles and technical features, most of the complications can be avoided. [ABSTRACT FROM AUTHOR]

Background: Distal radius fracture is one of the most common fractures in adults, predominantly in white and older populations in high income countries. Patient usually reports falling on outstretched hand (FOSH). Other mechanisms include: RTA (road traffic accident), direct trauma, and FFH (fall from height). Specific mechanisms imply greater or lesser degrees of injury. After (FOSH) the prominent thenar eminence takes most of the force, and the fracture of the distal end radius occurs, while the TFCC is still intact, unless there is a rotatory element. If radius rotates into supination and if the force continues the ulnar styloid is avulsed There are numerous treatment modalities available to orthopedic surgeons for distal radius fracture; these include closed reduction and casting, closed reduction and percutaneous pinning. [ABSTRACT FROM AUTHOR]

Background. Humeral shaft fractures are commonly encountered in casualties. There are different methods of operative internal fixation with no consensus on the best technique. The objective of this study was to assess shoulder function and rate of complications among two different options of fixation, intramedullary nailing, and minimal invasive plate osteosynthesis (MIPO) in young adults. Methods. Forty-two patients with humeral shaft fractures were included in the study and divided into two equal groups: group A treated with antegrade intramedullary locked nails (IMN) and group B with MIPO. Fracture union was evaluated with serial X-rays, and shoulder function was assessed in both groups using the scale of the American Shoulder and Elbow Surgeons (ASES), University of California at Los Angeles Shoulder Scale (UCLA), and visual analog score (VAS). The mean differences between groups were recorded and considered significant if the P value was ˂0.05. Results. The results were reported prospectively with no significant differences in mean age, sex, side of injury, type of fracture, mechanism of injury, and the follow-up period between the groups studied. Group A had shorter operative time and minimal blood loss than group B. Regarding shoulder function scores (ASES, UCLA, and VAS), the results in the MIPO group were better than the IMN group with shorter time of union and fewer complications. Conclusion. Despite a shorter operative time and lower blood loss during locked intramedullary nail fixation in the management of humeral shaft fractures, MIPO enables more superior shoulder function with better fracture healing and lower morbidities. [ABSTRACT FROM AUTHOR]

Background: Paralytic foot-drop is a disabling deformity that results from nerve or direct muscle injuries. Palliative surgeries such as tendon transfer and ankle arthrodesis are reserved for permanent deformity, with the arthroscopic technique had not been widely studied before. This study aims to evaluate the clinical outcome and quality of life after arthroscopic ankle fusion of paralytic foot-drop deformity. Materials and Methods: The patients who were retrospectively enrolled in this study underwent arthroscopic ankle fusion for paralytic foot-drop deformity between March 2017 and December 2021. The American Orthopedic Foot and Ankle Society (AOFAS) ankle–hindfoot score and Cumberland Ankle Instability Tool (CAIT) were the measures used for clinical assessment. To judge the union, serial plain radiographs of the ankle were obtained. The preoperative and postoperative means were analyzed utilizing a two-tailed paired t-test, with a p value of less than 0.05 indicating statistical significance. Results: This study included 21 consecutive patients with a mean follow-up of 35.09 ± 4.5 months and a mean age of 41.5 ± 6.1 years. Highly significant improvements were observed between the preoperative and final follow-up means of the AOFAS score (from 57.6 ± 4.6 to 88.3 ± 2.7) and CAIT (from 12.1 ± 2.2 to 28.9 ± 1.01; p ˂ 0.00001 for both). All patients attained radiographic union and resumed their previous occupations without reporting serious adverse effects. Conclusions: Arthroscopic ankle fusion is an effective, minimally invasive palliative surgery for patients suffering from permanent paralytic foot-drop deformity. This technique was shown to provide good functional and radiologic outcomes without significant complications. Level of evidence: Retrospective cohort; level of evidence (IV). [ABSTRACT FROM AUTHOR]

Objectives: To determine the efficacy of Tibialis Anterior Tendon Transfer in treatment of cases of Dynamic Foot Supination in Relapsed Clubfoot. Methods: Pediatric Unit of Orthopedic Surgery Department, Zagazig University Hospitals. All patients fulfilling the inclusion criteria included in the study in a time period of 6 months were 12 patients. A total of 12 patients (9 males and 3 females) with 1 bilateral, 7 right feet and 4 left feet. The 9 males were (1 bilateral, 5 right foot and 3 left foot). The 3 females were (2 right foot and 1 left foot). Results: We studied 12 cases 9 males and 3 females with mean age of 4.83±0.71 to assess outcome of Tibialis Anterior Tendon Transfer in Management of Relapsed Clubfoot. Conclusion: Tibialis anterior tendon transfer has been the treatment of choice for cases of relapsed CTEV in the form of dynamic supination for years. It has a high success rate and very low post-operative complications and very low incidence of residual deformity if done correctly. [ABSTRACT FROM AUTHOR]

Background: Congenital clasped thumb is a deficiency of active extension of the thumb with flexion and adduction deformity after the age of 3 months. In distal arthrogryposis, congenital clasped thumb is characterized by global metacarpo-phalangeal (MCP) joint instability; severe narrow 1st web space and palmar contracture. Objective: The present study aimed to describe patients' characteristics, and the results of treatment of congenital clasped thumb in distal arthrogryposis. Patients and Methods: A total of 24 congenital clasped thumbs in 14 patients (9 boys and 5 girls) underwent release of tight first web space structures, Ghani flap, and MCP joint chondrodesis with or without flexor pollicis longus lengthening. There were 10 bilateral and 4 unilateral cases. The mean age of the patients was 4 years old (ranging from 3 to 5). Results: According to the parent parents of the participants, all patients were fulfilled with the thumb function and appearance. Union of the chondrodesis was achieved in 21 thumbs. There was statistically significant improvement of thumb abduction, rotation and opposition. Conclusions: The 1st web space contracture release, Ghani flap and MCP chondrodesis is a good surgical option for management of congenital clasped thumb in distal arthrogryposis. [ABSTRACT FROM AUTHOR]

Background: Several techniques were utilized for internal fixation of patellar fractures which include the AO modified tension band wiring, interfragmentary screws or figure of eight wiring using the cannulated screws. This research aimed to assess the outcomes of fixation of patellar fractures using cannulated screws with tension band wiring. Methods: This prospective clinical study was carried out in orthopedic surgery department of Zagazig University Hospitals on 18 cases who had fracture patella. Patellar fractures fixation was done utilizing cannulated screws with tension band with follow up period of at least 2 years. Postoperative evaluation was performed according to range of motion, radiological evaluation and Bostman's score. Results: Progressive improvement of range of motion of knee in both flexion and extension at each follow-up was noted. 94.4% (17 cases) had flexion of > 120° and 100% (18 cases) had extension = 15° by the end of 24 weeks. Radiological union occurred at the 6th postoperative week in 15 patients (83.3%) and after 12 weeks in 17 patients (94.4%). At the follow-up all patients achieved union. Regarding the Bostman's score, at the end of final follow up, it was excellent in 15 patients (83.3%), good in 2 patients (11.1%) and poor in one patient (5.6%). Conclusions: The use of cannulated screws in conjunction with anterior tension band wire to treat transverse patellar fractures is an effective, reliable, and reproducible procedure, Improvements in radiological and functional outcomes, as well as curative effects on patella fracture, complication rates, and the timing of postoperative functional activity, are all benefits of this procedure. [ABSTRACT FROM AUTHOR]

Background: The Scaphoid bone is the tmost commonly fractured carpal bone. Proper clinical examination and radiological imaging is essential for early diagnosis and management. The management of scaphoid fractures varies from cast immobilization to open reduction and internal fixation. This paper explores the outcome of using headless cannulated screws in minimally displaced scaphoid fractures. Objective: Aim of this study is to assess the functional and clinical outcome of using cannulated headless screws in management of acute scaphoid fractures. Methods: A prospective study held between February 2019 and January 2020, where eighteen patients included with acute scaphoid fractures of Herbert B1, B2 and B3 classification. Fixation was done using both volar and dorsal percutaneous technique. Patients were evaluated postoperatively clinically using modified Mayo wrist score (MMWS). Results: Of mean age 34.5±8.37 years, the majority were with excellent final outcome (83.3%), good (5.6%), fair one case (5.6%) and only one poor (5.6%) and mean time of union was 9.66±1.9 months. Conclusion: All active young individuals with acute non-displaced or minimally displaced scaphoid fractures should be offered percutaneous internal fixation, for the sake of earlier gain of motion of the wrist, earlier time to union, quicker return to activity of daily living, and a lower complication rate. [ABSTRACT FROM AUTHOR]

Anterior Cruciate Ligament (ACL) reconstruction is a common ligament reconstruction to restore functional knee stability. However, the site of graft harvesting is vulnerable to have donor site complications of management occurs in a number of cases, in this review we aimed to evaluate treatment of anterior cruciate ligament by reconstructed with peroneus longs autograft. [ABSTRACT FROM AUTHOR]

Background: Common knee injuries pertaining to the anterior cruciate ligament (ACL) have traditionally been treated with a variety of graft repair techniques involving groups of grafts for bone, patellar tendon, and hamstrings. Objective: The aim of the current study was to assess the donor site and functional outcome morbidity of single bundle ACL Peroneus tendon grafting for reconstruction. Patients and Methods: At the Orthopedic Department of Zagazig University Hospitals, a prospective cohort study was carried out, on 18 patients with ACL tear during the period from January 2022 to July 2022. Arthroscopic Peroneus longus tendon autograft was used for anatomic single bundle ACL repair on all patients. Results: IKDC score considerably increased from 45.83 (SD 7.46) to 78.12 (SD 6.04); 15 (83.3%) patients had excellent score and 3 (16.7%) patients had good score in AOFAS. complications 13 (72.2%) cases were non-complicated and 27.8% were complicated (hemarthrosis 5.6%, loss of terminal flexion 5.6%, pain 5.6%, superficial infection 5.6% and Transient apraxia sural nerve 5.6%). Conclusion: Peroneus longus tendon is effective and secure autograft for arthroscopic anterior cruciate ligament reconstruction; restoration of knee function is adequate, with few donor site morbidities. [ABSTRACT FROM AUTHOR]

Background: Extra-articular supracondylar fracture of the humerus is 3% in children and 60% in all elbow fractures. The highest incidence of ligament laxity and the weakening of distal humerus at this era are at present in the first decade of existence. The aim of the present study was to assess the results of cross lateral ascending and descending pinning in pediatric supracondylar fractures humerus. Patients and methods: This study consisted of 18 children with supracondylar humerous fractures who underwent lateral pinning in the Zagazig University, and Ibnsina hospitals. Results: The age of the studied group was (6.6±2.1) years ranged from 6 to 10 years, half of the group (50 %) had aged less than 6.5 years and (50%) from 6.5 to 11 years. More than half of the studied group (61.1%) were males and (38.9%) of them were females. Regarding side affected, 55.6%) of the studied group were right sided affected and (44.4%) of them were left sided. The commonest mechanism of injury was FD among (83.3%) of the studied group followed by RTA was among (16.7%) of the studied group. Regarding displacement, postero-medial was the commonest displacement among (61.1%) of the studied group followed by postero-lateral was among (22.2%) of the studied group and lastly posterior one (16.7%). More than half of the studied group (55.6%) had excellent cosmetic score, (27.7%) of them had good cosmetic score and (11.1%& 5.6%) had fair and poor cosmetic score respectively. More than half of the studied group (55.6%) had excellent functional outcome, (27.7%) of them had good functional outcome and (11.1%& 5.6%) had fair and poor functional outcome respectively. Conclusion: Possibly the best mechanical stability is provided by a cross pin fixation. The lateral cross-pinning technique has been found to be excellent for stability with crossed pins and to prevent damage to the ulnar nerve. [ABSTRACT FROM AUTHOR]