ABSTRACT
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.

ABSTRACT
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.

ABSTRACT
Rotator cuff tears are one of the most common causes of painful shoulder disability in adults. This retrospective study evaluates the anatomical and functional outcomes of open rotator cuff repair associated with acromioplasty in seven patients. Clinical assessment was performed using the Constant score, pain evaluation, and range of motion analysis. Open repair remains a valuable surgical technique, especially for massive and retracted tears.

ABSTRACT
Periprosthetic femoral fractures following total hip arthroplasty (THA) are increasingly encountered in orthopedic practice due to the growing number of arthroplasties performed worldwide and the aging population. These fractures are associated with substantial morbidity and require complex surgical management. Locking plate fixation has become a cornerstone in the treatment of fractures with stable femoral stems. This study presents a detailed retrospective analysis of five cases treated at CHU Rabat using locking compression plates with or without cerclage wiring. Clinical presentation, radiological findings, surgical techniques, postoperative rehabilitation, and outcomes are discussed in detail.

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Background: Guillain-Barre Syndrome (GBS) is an acute, rapidly progressing immune-mediated polyneuropathy characterized by symmetrical muscle weakness, diminished or absent reflexes, and variable sensory impairment. Early diagnosis and a combination of medical and physiotherapeutic interventions are crucial in mitigating the long-term sequelae of the disease. Case Summary: A 25-year-old previously healthy female presented with progressive bilateral limb weakness and sensory disturbances following a febrile illness. Diagnostic workup confirmed the AIDP variant of GBS. She received standard IVIG therapy followed by a structured 30-day physiotherapy program emphasizing neuromuscular re-education, strength restoration, functional mobility, and pain management. Functional and clinical outcomes were documented pre- and post-intervention. Results: Marked improvements were observed in muscle strength (MMT from 1/5 to 4/5), functional independence (FIS from 65/120 to 105/120), and pain intensity (NPRS from 8 to 5). The Hughes Functional Grading Scale improved from grade 4 (bedridden) to grade 2 (ambulatory with assistance). Conclusion: This case highlights the vital role of timely, individualized physiotherapy in facilitating recovery in GBS. A structured, phased approach significantly enhanced motor performance, reduced pain, and improved quality of life.

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Objectives: Acromioclavicular (AC) joint disruptions are common shoulder injuries, often requiring surgical intervention for high-grade (Rockwood types IV and V) instability. Traditional fixation methods, such as K-wire stabilization, are associated with high complication rates, including hardware migration and post-traumatic arthritis. This study aims to detail an anatomic surgical technique utilizing suture anchor fixation and evaluate its clinical and functional outcomes. Materials and Methods: A retrospective analysis was conducted on 10 consecutive patients (mean age 32 years) with acute Rockwood Type IV or V AC joint dislocations treated at a tertiary care center in Bangalore. All patients underwent reconstruction using suture anchor fixation supplemented by coracoacromial (CA) ligament transfer. Functional outcomes were assessed using the Constant-Murley Shoulder Score (CMS), and maintenance of reduction was monitored through standardized radiographic protocols. Results: The mean follow-up duration was 12 months (range: 9–23 months). Immediate postoperative radiographs confirmed anatomical reduction in 100% of cases. At final follow-up, the mean Constant-Murley score was 93.2, with 80% of patients achieving full, unrestricted range of motion. Complications were limited to two superficial wound infections; notably, no instances of hardware migration, neurovascular injury, or secondary AC joint arthrosis were observed. Conclusion: Suture anchor fixation, combined with CA ligament transfer, provides a stable, non-rigid construct that effectively restores the anatomy of the AC joint. This technique avoids the catastrophic risks associated with metallic hardware migration and offers excellent functional recovery, making it a viable alternative to traditional transarticular fixation.

ABSTRACT
Knee osteoarthritis (OA) is a chronic degenerative joint disease characterized by progressive cartilage breakdown, joint pain, stiffness, and reduced mobility. It is a leading cause of disability worldwide, particularly among older adults. This study aimed to determine the prevalence of knee osteoarthritis among patients attending Rivers State University Teaching Hospital (RSUTH), Port Harcourt, Nigeria, between January 2020 and December 2022, and to assess its association with selected socio-demographic factors. A retrospective cross-sectional hospital-based study design was adopted. Data were obtained from patients’ medical records in the orthopedic and medical records departments of RSUTH. A total of 606 cases diagnosed with knee osteoarthritis within the study period were included in the study. Relevant information such as age, sex, occupation, marital status, religion, body mass index (BMI), and year of diagnosis were extracted using a structured data collection form. Data were analyzed using Statistical Package for Social Sciences (SPSS) version 25. Descriptive statistics and chi-square tests were used, with a p-value of less than 0.05 considered statistically significant. The overall prevalence of knee osteoarthritis was 8.51%. The condition was more prevalent among females (64.3%) compared to males (35.6%). Prevalence increased with age, peaking in the 60–69 years age group (32.5%). Higher prevalence was observed among homemakers (44.5%), married individuals (67.1%), and those with higher BMI levels, indicating a strong association with obesity. Statistical analysis revealed significant relationships between knee osteoarthritis and socio-demographic variables such as age, sex, occupation, BMI, religion, and marital status (p < 0.05). In conclusion, knee osteoarthritis is prevalent among adults attending RSUTH, with higher occurrence in females, older individuals, and those with increased body weight. The findings highlight the need for early diagnosis, publi