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 ...
Read More
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.
Javad Afzali B, MD; Yoosef Sarvari, MD; Mohammad Gharedaghi, MD; Seyed Reza Sharifi, MD; Javad Mozafari, MD
Abstract
Background: The term “floating knee” is used to describe the flail knee separated from the ipsilateral hip and ankle. Its various forms are expressed in the classification framework. The objective of this research was to review the authenticity of previous floating knee classifications.Methods: In ...
Read More
Background: The term “floating knee” is used to describe the flail knee separated from the ipsilateral hip and ankle. Its various forms are expressed in the classification framework. The objective of this research was to review the authenticity of previous floating knee classifications.Methods: In a retrospective study, 74 patients (64 males, 10 females) with floating knee, the epidemiology of this trauma and the prevalence of its various kinds of fractures were studied in relation to the five existing classifications. The study was done in two educational trauma centers in Mashhad, in a two year period at one and 3 year period at the other hospital. The mean age of the patients was 25.6 years.Results: In classification of patients, there was some non-conformity with the previous classifications. In previous classifications there are some weaknesses such as not to have location for open fractures, cases with both injured epiphyses and cases that have more than two fractures around the knee. In the new classification ''the floating knee'' has been divided into three types: Conventional floating knee (A,B,C), Complex knee fractures (D,E) and variant floating knee (the hip and ankle ipsilateral fractures). Each subgroup is marked with one of the numerical codes (0,I,II) which determines the open or closed status of the fracture(s). In this research 12% of injuries were complex knee fractures.Conclusions: In the new classification, fractures’ types are classified as relatively comprehensive and simple and are coded.
Mahmood Bahari, MD; Hasan Rahimi, MD; Mohammad Gharedaghi, MD; Alireza Hootkani, MD
Abstract
Background: Distal radius is the most common site of fracture in older postmenopausal women, with a lifetime risk of 15%. Evidence exists for its association with osteoporosis. Osteoporosis can be detected by measuring the bone mineral density (BMD) of the lumbar spine with dual energy X-ray absorptiometry. ...
Read More
Background: Distal radius is the most common site of fracture in older postmenopausal women, with a lifetime risk of 15%. Evidence exists for its association with osteoporosis. Osteoporosis can be detected by measuring the bone mineral density (BMD) of the lumbar spine with dual energy X-ray absorptiometry. Low BMD of the lumbar spine or hip is a strong predictor for future vertebral deformity and hip fracture. Elderly women with distal radial fracture are not investigated for osteoporosis on a routine basis. The aim of the present study is to evaluate the relationship between distal radius fracture and the BMD of the lumbar spine, and to investigate the need for osteoporosis screening in elderly women with a distal radius fracture.Methods: A prospective study was performed in a hospital in Mashhad in 2004-2005. In 104 women (mean age, 66.9 years) with a distal radius fracture, BMD of the lumbar spine was assessed. A biosphosphonate was prescribed when osteoporosis was diagnosed, and the BMD was reassessed after 2 years of treatment.Results: A low BMD was found in 87 patients (83.65%). Osteoporosis was diagnosed in 46 (44.23%) and osteopenia in 41(39.42%) patients. Only 17 cases (16.23%) had normal bone density. The mean T-score of the lumbar spine was –2.10 (±1.06). The BMD in patients treated with bisphosphonate medication increased from T-score of -2.88 to -2.55 in 2 years (p < /em>
Mahmood Bahari, MD; Hassan Rahimi, MD; Mohammad Gharedaghi, MD; Javad Afzali, MD
Abstract
Background: ِِDouble osteotomy of first metatarsal has been advocated as a procedure of choice for severe hallux valgus in adolescent age group. We would like to report our experience with such an osteotomy in Meshhad.Methods: Over a five year period (1999-2004), 26 feet in 17 adolescents - mean age ...
Read More
Background: ِِDouble osteotomy of first metatarsal has been advocated as a procedure of choice for severe hallux valgus in adolescent age group. We would like to report our experience with such an osteotomy in Meshhad.Methods: Over a five year period (1999-2004), 26 feet in 17 adolescents - mean age of 15.5 years - with moderate to severe hallux valgus underwent double first metatarsal osteotomies. With a mean follow-up of 26 months, the cases were evaluated by American Orthopaedics Foot & Ankle Society Hallux Metatarso-phalangeal-interphalangeal scale (AOFAS/HMI). In this study pre and post hallux valgus (HVA), intermetatarsal (IMA), and distal metatarsal articular (DMAA) angles, and the relation between the angles and patient satisfaction were evaluated.Results: The mean angular corrections for hallux valgus (HVA), intermetatarsal (IMA) and distal metatarsal articualr (DMAA) angles were 26.65, 6.20 and 5.55 degrees respectively. Four cases could not be reached and from the remaining 13 patients, 2 cases had required second surgery for non-:::union::: and 3 cases had stiffness in MTP (metatarsophalangeal) joints. Sixteen cases reported good to excellent results.Conclusions: Double first metatarsal osteotomy for severe hallux valgus is a reasonable procedure in adolescents which maintains the correction. Non-:::union::: and first MTP joint contractures are the two main side effects.
