Mohammad Gharedaghi; Alireza Hootkani; Ali Moradi; Tamara Tamamgar
Abstract
Background: The final diagnosis of the tumors depends on the biopsy and the pathology result. The musculoskeletal tumor biopsy can be performed either by core needle biopsy or by open biopsy technique. The procedural cost is lower and the technique is simpler in core needle biopsy, but tissue sample ...
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Background: The final diagnosis of the tumors depends on the biopsy and the pathology result. The musculoskeletal tumor biopsy can be performed either by core needle biopsy or by open biopsy technique. The procedural cost is lower and the technique is simpler in core needle biopsy, but tissue sample may not be enough. In this study, we will compare the results of core needle biopsy with open biopsy in musculoskeletal tumors. Methods: In a prospective study, 75 patients with skeletal lesions were scheduled for open biopsy. A needle biopsy was also done before starting the operation in the same operating session. The pathology reports of core needle biopsy and open biopsy were then compared. The final pathology report following the definitive surgery was also compared with either of those two biopsy techniques. Results: The diagnostic accuracy of core needle biopsy for skeletal tumors was 77.2%. The value for benign tumors was 69.2%, for primary malignant tumors 82.7%, for tumor-like benign lesions 50%, and for metastatic tumors 100%. The accuracy of open biopsy was 100% for all tumors. Conclusion: Needle biopsy is an accurate and low cost method for diagnosis of skeletal tumors, but possibility of failure is present in very few cases.
Alireza Hootkani; Ali Moradi; Ehsan Vahedi; Hamideh Feiz Disfani
Abstract
Background: Supracondylar humerus Fracture is among the common upper extremity fractures in children. In certain types of fractures of circumstances that open reduction becomes necessary the best surgical approach is debatable. We would like to report our prospective study between posterior and lateral ...
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Background: Supracondylar humerus Fracture is among the common upper extremity fractures in children. In certain types of fractures of circumstances that open reduction becomes necessary the best surgical approach is debatable. We would like to report our prospective study between posterior and lateral surgical approaches in type III supracondylar fractures. Methods: In a case series study, 87 children from birth till 18 years old, with type III humerus fracture were randomly selected for open reduction and pinning 43 through lateral and 44 posterior approaches. With a 6-months follow-up, elbow range of motion, complications and radiographic parameters related to :::union::: type were evaluated. Results: Posterior approach was a faster surgery. Ranges of motion after 1 and after 6 months were more restricted in posterior approach. Baumann and carrying angles were closer to normal in a higher percentage in posterior approach. Varus and valgus mal:::union::: or joint stiffness rates or infection were similar in the two groups. Conclusion: The two approaches were similar for postoperative complications. Better range of motion was achieved in the lateral approach, and a more anatomical :::union::: in the posterior approach.
Alireza Hootkani, MD; Hassan Rahimi, MD; Ali Moradi, MD; Ehsan Vahedi, MD; Abolfazl Kazemi
Abstract
Background: Traumatic hand injuries can lead to major disabilities. Due to high number of young active people who can be affected with such disabilities, finding the results of emergency tendon and nerve repairs would give us a guideline in managing such injuries.Methods: In a prospective study, 91 patients ...
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Background: Traumatic hand injuries can lead to major disabilities. Due to high number of young active people who can be affected with such disabilities, finding the results of emergency tendon and nerve repairs would give us a guideline in managing such injuries.Methods: In a prospective study, 91 patients (87 males, 4 females) were randomly selected among the referrals to an orthopaedic emergency of a hospital in Mashhad, Iran. The patients had a mean age of 26.6 years. Demographic information and details of the injuries were recorded before surgery and also in the post operative period with 18 months follow-up.Results: The average size of the skin wounds was 4.4 centimeters, and the majority had sharp edges. The most commonly injured tendons were flexor digitorom superficialis, flexor carpi radialis, extensor digitorom communis and extensor policis longus. The most common complication was joint stiffness which had a direct relation with inadequate physiotherapy. Ulnar nerve repair had a worse outcome compared with median nerve repair. None of the repaired nerves obtained full sensory and motor recovery.Conclusion: Repair of tendon and nerve injuries in emergency settings does not uniformly give good results. It is best not to attempt repair of nerve injury, or more than three extensor flexor tendon injuries in emergency room.
