ABSTRACT
Background: Intertrochanteric fractures of the femur are common hip fractures, particularly among elderly patients with osteoporotic bones, and are associated with substantial morbidity and mortality due to prolonged immobilization and related complications. Therefore, this study aimed to compare the functional outcomes of intertrochanteric fractures treated with proximal femoral nail antirotation (PFNA) and dynamic hip screw (DHS). Methods: This comparative observational study was conducted at the Department of Orthopaedic Surgery, Uttara Adhunik Medical College, Dhaka, Bangladesh, and selected private clinics within and outside Dhaka, from July 2024 to June 2026. Forty patients were included, with 20 treated by PFNA and 20 by DHS. Functional outcomes were assessed using HHS preoperatively and at 3 and 6 months, along with operative parameters and postoperative complications. Statistical significance was set at p<0.05. Results: Among 40 patients, PFNA showed shorter operative time (78.5 vs. 92.3 min; p=0.003), lower blood loss (105.0 vs. 148.5 mL; p<0.001), and higher HHS at 3 and 6 months (78.4 vs. 72.6, p=0.04; 86.7 vs. 81.9, p=0.03) than DHS. Excellent/good outcomes were 85.0% vs. 70.0% (p=0.45), while complications were 15.0% vs. 30.0% (p=0.45), respectively. Conclusion: PFNA provided satisfactory functional outcomes with shorter operative time, lower blood loss, and higher follow-up Harris Hip Scores compared with DHS.

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Background: Total knee arthroplasty (TKA) is an established treatment for advanced knee disease, but functional recovery varies among patients. Identifying factors associated with postoperative function may help improve patient assessment and rehabilitation planning. Methods: This hospital-based observational study included 90 patients who underwent TKA from July 2024 to June 2026 at the Department of Orthopaedic Surgery, Uttara Adhunik Medical College, Dhaka, Bangladesh and selected private clinics within and outside Dhaka. Demographic and clinical characteristics, including age, sex, BMI, comorbidities, preoperative range of motion (ROM), deformity and functional status, were recorded. Postoperative functional outcome, pain improvement, ROM and walking ability were assessed. Data were analyzed using SPSS version 25, with p<0.05 considered statistically significant. Results: Good functional outcome was observed in 48 (53.3%) patients, moderate in 29 (32.2%) and poor in 13 (14.4%). Satisfactory pain improvement occurred in 67 (74.4%), while 43 (47.8%) achieved postoperative ROM >110°. Age was significantly associated with outcome (p=0.041), with good outcome in 66.7% of patients aged <60 years versus 44.4% aged ≥60 years. BMI (p=0.047), preoperative ROM (p=0.031) and comorbidity (p=0.006) were also significantly associated with functional outcome. Sex was not significantly associated (p=0.248). Conclusion: Functional recovery after TKA was generally favorable. Younger age, lower BMI, better preoperative ROM and absence of comorbidity were associated with better functional outcomes.

ABSTRACT
Background: Artificial intelligence (AI) is increasingly being integrated into total hip arthroplasty (THA), particularly in preoperative planning, predictive modeling, and postoperative imaging analysis. However, current evidence remains heterogeneous regarding methodology, validation, and clinical applicability. Purpose: To systematically review the current applications, clinical utility, limitations, and future perspectives of AI in THA. Methods: A systematic review was conducted according to PRISMA 2020 guidelines. PubMed/MEDLINE, Scopus, and Web of Science were searched for studies published between January 2015 and May 2026. Original studies evaluating AI-based applications in THA were included. Results: Thirteen studies were included in the qualitative synthesis. The principal AI application domains identified were: (1) preoperative planning and implant templating, (2) prediction of complications and functional outcomes, and (3) implant identification and postoperative imaging analysis. AI-assisted three-dimensional planning systems consistently demonstrated improved implant sizing accuracy and planning reproducibility compared with conventional templating techniques. Machine learning algorithms showed promising performance for prediction of postoperative complications, patient-reported outcomes, and periprosthetic joint infection. Deep learning-based imaging systems also demonstrated high accuracy for automated implant recognition using radiographic imaging. Conclusion: Current evidence suggests that AI-assisted technologies may improve planning accuracy, perioperative risk stratification, and workflow optimization in THA. Nevertheless, the available literature remains predominantly retrospective and heterogeneous, with limited external validation and insufficient prospective clinical evaluation.

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Background: The anatomical and biomechanical factors render shoulder joint the most unstable and frequently dislocated joint. Anterior instability is common and glenoidal bony defect result in recurrence. Effective surgical treatment is crucial to restore the normal functioning shoulder and return to the preinjury state The aims of this study were to assess the functional outcome of recurrent anterior shoulder instability with Hill-Sachs lesion following Latarjet procedure by ROWE score and report complications if any. Method: This prospective observational study included 30 patients diagnosed with recurrent anterior shoulder instability following sports injury from January 2025 to December 2025 in NITOR. Convenient sampling technique was applied and patients underwent open Latarjet procedure and followed up at 3rd week, at 6th week, at 3rd month and 6 monthly intervals for 1 year. In each postoperative follow-up, ROWE score of the operated shoulder was done and complications were noted. Results: The median age of the patients was 23.7 years; 63% were between 18-23 years age group. 26(87%) were male and 4(13%) females. Majority of the patients were students. High intensity contact sports, football and kabaddi, resulted in 60% cases of instability. 24(80%) had right shoulder involvement. The median number of dislocations before surgery was approximately 7 and interval between 1st episode and surgery was approximately 18 months. Range of motion and ROWE score had significant improvement (p< 0.001) after surgery and 77% did not present with any complications till last follow-up. Conclusion: Recurrent anterior shoulder instability with Hill-Sachs lesion is common in young individuals involved in contact sports. Surgical treatment with open Latarjet procedure improved range of motion and functional status of the patients with minimal complications.

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Objective: To analyse the epidemiological, clinical, and injury patterns associated with motorcycle-related trauma. Patients and Methods: This was a retrospective descriptive study conducted over a two-year period, from May 2023 to May 2025. Results: During the study period, 2,818 motorcycle accident cases were recorded out of 3,723 road traffic accidents, representing a frequency of 76%. The victims were predominantly male (76%), with a mean age of 29 ± 17 years. Drivers were the most affected occupational group (34%), and motorcycle–car collisions were the leading mechanism of injury (47%). Limb injuries were the most frequent lesions (45%), followed by traumatic brain injuries (24%), predominantly mild forms (63%). Facial bone fractures, thoracic contusions, and open fractures of the lower limb were the most common injuries within their respective categories. The outcome was favourable in 94% of cases, while the mortality rate was 6%. Conclusion: Motorcycle accidents represent a major public health problem, particularly affecting young people. Strengthening prevention strategies and improving trauma management are essential to reduce morbidity and mortality.

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Background: Chaff cutter is a device used in farms to cut maize stalks into small pieces and feed to livestock. There has been increase in number of cases of upper limb injuries due to use of the device in Kenya. However, there is little published or documented research in this area, hence the need for the study. Objective: To discuss the management of patients with upper limb chaff cutter injuries at Moi Teaching and Referral Hospital (MTRH), Eldoret, Kenya. Methods: A prospective study conducted at MTRH, involving census of 44 patients being managed for upper limb injuries caused by chaff cutters, after satisfying inclusion criteria (all ages and gender, specifically injured by the device, and consented to participate). Structured questionnaires were used for data collection on sociodemographic factors, clinical characteristics and treatment modalities, while validated Quick Disabilities of the Arm, Shoulder and Hand (QDASH) questionnaires were used for data collection on the assessed patient reported short- term outcome measures during the follow up at 2, 6 and 12 weeks. Data was analyzed for variables listed in both the Structured and the QDASH questionnaires using SPSS version 21. Kruskal Wallis test was used to assess QDASH scores. Results: Chaff cutter injuries patients were 44 out of 214 who had upper limbs injured due to other causes, giving a burden of 20.56% of all in-patient upper limb injuries. Mean age was 29.42 (SD: 9.27) years. Males were 42 while females were 2. Full- time farmers were 45.5%. Right upper limb injuries were 59.1% and no formal training had been done for 97.7%. There were a total of 102 different types of injuries with about two-thirds being traumatic amputation/disarticulation with 50% of the participants having injury up to the fingers level. Tetanus toxoid injection, analgesics and antibiotics were administered before surgery to all and 90.9% had formal amputation/disarticulation.

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Background: Kinesiophobia can significantly impact physical function and dynamic balance in patients with lower limb pathologies. Understanding the relationships between these variables is crucial for developing effective rehabilitation strategies. Objective: The aim of this study was to assess the relationship among kinesiophobia, physical function, and dynamic balance in patients with lower limb pathologies. Method: 114 participants with lower limb pathologies, were recruited for the Cross-sectional survey study. The variables were assessed using the Tampa Scale for Kinesiophobia (TSK), WOMAC scale, and standardized balance assessment tools (TUG test) respectively. Descriptive and Inferential statistics of Pearson’s Correlation coefficiency were used to analyse the data obtained. Results: Descriptives of the population (age and gender) were done using the mean score for Kinesiophobia on the Tampa Scale. Mean score for kinesophobia on the Tampa scale was 40.40 +/- 7.78. Physical function of the patients on WOMAC scale was 47.53 +/- 18.49 while the dynamic balance 32.93 +/- 42.80 Seconds. There was significant correlation between age and physical function (r = 0.34, p = 0.001). There was also significant correlation between kinesophobia and physical function of the patients with lower limb pathologies (r = 0.21, p = 0.03) and dynamic balance (r = 0.22, p = 0.03). Conclusion: Patients with lower limb pathologies had high level of kinesiophobia, moderate to severe limitations in physical functions, and significant limitations in dynamic balance. Also, higher kinesiophobia scores were associated with lower physical function. Age had significant correlation with physical function but not with kinesiophobia and dynamic balance.