Gholamhossein Kazemian; Gholamhossein Kazemian; Reza Tavakoli Darestani; Mohammad Emami Tehrani Moghaddam; Alireza Manafi Rasi; Behrouz Asghari; Ali Nemati; Farshad Safdari
Abstract
Two patients with iatrogenic femoral neck fracture following intramedullary fixation of the diaphyseal fractures are reported. This is a rare complication of intramedullary nailing (IMN), has poor prognosis and is preventable. It seems that choosing the piriformis fossa as the entry point, increased ...
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Two patients with iatrogenic femoral neck fracture following intramedullary fixation of the diaphyseal fractures are reported. This is a rare complication of intramedullary nailing (IMN), has poor prognosis and is preventable. It seems that choosing the piriformis fossa as the entry point, increased neck-shaft angle (coxa valga) and excessive nail insertion increased the risk of the iatrogenic neck fracture.
Alireza Manafi Rasi; Gholamhossein Kazemian; Gholamhossein Kazemian; Amir Hossein Fallahi; Mohammad Mahdi Bagherian Lemraski,; Ali Nemati; Farshad Safdari
Abstract
Background: The use of prophylaxis for deep vein thrombosis (DVT) in patients with ankle trauma treated with below knee cast is a controversial issue. The purpose of current study was to investigate the incidence of DVT to look into the necessity of thromboprophylaxis in these patients. Methods: Ninty ...
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Background: The use of prophylaxis for deep vein thrombosis (DVT) in patients with ankle trauma treated with below knee cast is a controversial issue. The purpose of current study was to investigate the incidence of DVT to look into the necessity of thromboprophylaxis in these patients. Methods: Ninty five patients with stable fractures of the foot or ankle or ankle sprains contributed in this cross-sectional study. The level of D-dimer was determined between 7-14 days post-casting. If the level of D-dimer was higher than 0.2 µg/mL, the result of the test was considered positive and patient was referred for further examination for DVT using doppler ultrasonography. The role of risk factors in the development of DVT was evaluated. Results: There were 46 patients with at least one DVT risk factor. The D-dimer test was positive in 21 patients (22.1%). Based on the doppler ultrasonography, 3 patients developed DVT. There was a statistically significant relation between the presence of multiple risk factors (≥3) and increased risk of DVT development (p=.01). Conclusion: DVT is not a common complication in below knee casting and routine thromboprophylaxis is not necessary in patients with less than 3 risk factors.
Mahmood Karimi Mobarakeh, MD; Alireza Saeed, MD; Ali Nemati, MD
Abstract
Background: Knee replacement is one of the final remedies for severe, symptomatic knee destruction. The results of this surgery are usually excellent. The number of reports from Iran on this subject is very few. We would like to report our experience with knee replacement in Kerman.Methods: In a clinical ...
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Background: Knee replacement is one of the final remedies for severe, symptomatic knee destruction. The results of this surgery are usually excellent. The number of reports from Iran on this subject is very few. We would like to report our experience with knee replacement in Kerman.Methods: In a clinical trial and prospective study, 54 patients (11 males, 43 females) with knee disease who underwent joint replacement from 2001 to 2006 in a Teaching hospital in Kerman, were studied. Mean age was 65 years (41-80) and mean follow-up 34.4 months (3 months to 5 years). 46 cases had osteoarthritis and 8 rheumatoid arthritis. The pre and post operative findings were assessed using the ‘Knee Society’ evaluation system. The opposite knees were used to compare the patients’ satisfaction from the procedure.Results: In a study on 54 cases, the pain score of ‘Knee Society’ improved from 33 to 77 and the functional score improved from 41 to 72. Ninety six percent of the cases were satisfied with their surgeries. The complications included 1 deep and 1 superficial infection, 2 wound healing problem and one patellar dislocation. Three revisions become necessary: 2 due to infection, one for loosening and deformity in tibial component.Conclusions: Knee replacement in Kerman is associated with high satisfaction rate in short-term. Early failure is mostly related to infection or technical errors in surgery.