Foot and Ankle
Sayyed-Hadi Sayyed-Hosseinian; Farshid Bagheri; Reza pourali; Ehsan Vahedi; Ali Birjandinejad; Mohammad Hosein Ebrahimzadeh
Abstract
Background: Ankle arthrodesis is one of the major surgeries for the treatment of advanced osteoarthritis of the ankle joint. There are various techniques available for ankle arthrodesis and each technique has unique advantages and disadvantages. The aim of the present study was to evaluate the results ...
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Background: Ankle arthrodesis is one of the major surgeries for the treatment of advanced osteoarthritis of the ankle joint. There are various techniques available for ankle arthrodesis and each technique has unique advantages and disadvantages. The aim of the present study was to evaluate the results of ankle arthrodesis with two this different approaches.Methods: The medical records of the patients who were admitted for ankle arthrodesis and treated by a single surgeon from January 2015 to January 2020 were reviewed. The patients were recalled for re-evaluation after a mean follow-up of 19 months. Functional outcomes were assessed using validated AOFAS Ankle-Hind foot score, Manchester-Oxford Foot Questionnaire (MOXFQ) and visual analog scale (VAS) score for pain. The collected data were recorded in a pre-designed checklist and then analyzed using SPSS software.Results: A total of 32 patients, 18 men and 14 women with a mean age of 46.7 years were included in the study. 67.6% had history of ankle fractures. Anterior approach was used in 24 patients, 75%, and the rest of the patients had surgery with lateral approach (25%). The most common instrument for arthrodesis was concomitant use of plate and screws in 18 patients (56%). Union occurred in 28 patients (87.5%) within 11.1 weeks after the surgery. The AOFAS score increased significantly and MOXFQ and VAS scores decreased significantly following the surgery (p<0.001 for each). Advanced age and intramedullary nail were related to prolonged time to union (p<0.05). Surgical approaches (either anterior or lateral) had no association with AOFAS, MOXFQ, and VAS scores. Non-union was seen in 4 patients (12.5%) and deep infection in 3 patients (9.3%) after ankle arthrodesis.Conclusion: The study results showed that, this surgery could improve patients’ pain and function with relatively low post-operative complications.
Other
Adel Ebrahimpour; Mohammad Razi; SM Javad Mortazavi; Mohammad Hosein Ebrahimzadeh; Roshanak Moradi; Farsad Biglari; Seyyed Saeed Khabiri; Mohammad Fakoor; Mohammad Ali Sazegari; Farshid Bagheri
Abstract
Background: To improve the education of orthopaedic residents and enhance patient care in the Iran's healthcare system, it is necessary to gather information about the current status of scientific, practical, and research-based education for residents.Methods: The research project initially focused on ...
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Background: To improve the education of orthopaedic residents and enhance patient care in the Iran's healthcare system, it is necessary to gather information about the current status of scientific, practical, and research-based education for residents.Methods: The research project initially focused on examining the executive curriculum in 14 centers affiliated with 6 different medical universities. Subsequently, an investigation was conducted into human resources, infrastructure, operating room facilities, educational and research outcomes, as well as the regular implementation of practical examinations to evaluate the performance of residents during their residency years. All the aforementioned aspects were covered using a comprehensive questionnaire, which was distributed via the "Formafzar.com" website as a link to the heads of departments in these centers by the Iranian Orthopaedic Association. The relationship between facilities and equipment and passing the future specialized orthopaedic board examination was also evaluated.Results: Among the examined centers, only 20% adhered to the criteria of Iran educational curriculum in all aspects of human resources, education, and research.Conclusion: a regular evaluation of teaching methods used by international centers and the national curriculum is necessary for orthopaedic training centers in Iran. Additionally, regulatory systems should monitor the training process of orthopaedic residents to standardize services, equipment, and educational programs in the country.
Hand
Mehrnoush Nakhaei; Nafiseh Jirofti; Ali Moradi; Mohammad Hosein Ebrahimzadeh
Abstract
Background: Pulley is a synovial tissue that attaches the flexor tendons to the dorsal portions of the fibro-osseous tunnel near the tendon attachment. Pulley type A with ring structure is one of the most important pulleys in fingers. Two-stage reconstruction by silicon is the common treatment in damaged ...
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Background: Pulley is a synovial tissue that attaches the flexor tendons to the dorsal portions of the fibro-osseous tunnel near the tendon attachment. Pulley type A with ring structure is one of the most important pulleys in fingers. Two-stage reconstruction by silicon is the common treatment in damaged tendon which has long recovery time and the tendency of the repaired tendon to adhere to the fibrous-bone tunnel around it. Accordingly, the one-stage reconstruction by synthetic pulley is a promising approach to resolve the mentioned problems.
Methods: In the present research, the polyurethane (PU) nanofiber scaffolds have been designed for synthetic pulley applications, and their mechanical and structural properties have been evaluated.
Results: The structural properties of nanofiber scaffolds show similar properties to protein and polysaccharide fibers in the extracellular matrix (ECM). The Fourier transform infrared spectroscopy (FTIR) results confirmed the functional groups of PU without any unwanted reactions. The amount of stress (3.19 ± 0.54) and Young's modulus (1.20 ± 0.39) in PU nanofiber scaffolds show similar mechanical properties to natural pulley.
Conclusion: The obtained results showed that the PU nanofibers scaffolds can be proposed as a suitable candidate for fabrication of synthetic pulley in flexor tendon injuries.
Javad Esmaeilzadeh; saeed hesaraki; mohammad-mehdi Hadavi; mohammad hosein Ebrahimzadeh
Abstract
Background: To study the creep behavior for a series of biodegradable nanocomposites, which are used as implantable devices in the body such as bioscrews, is a crucial factor. In the current paper, we are investigating these biomaterials -short-time creep and creep recover manners- in several classic ...
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Background: To study the creep behavior for a series of biodegradable nanocomposites, which are used as implantable devices in the body such as bioscrews, is a crucial factor. In the current paper, we are investigating these biomaterials -short-time creep and creep recover manners- in several classic models.Methods: The creep and creep recovery behaviors of nanocomposites composed of biodegradable polymer blends, poly (D/L) lactic acid (PDLLA) and polycaprolactone (PCL) reinforced with three different contents of 1, 3 and 6 percent weight percentage (Full name?)% bioactive glass nanoparticles (m-BGn) were modeled. Several theoretical models including Findley power law, Burgers and Weibull models were used to establish the relations between m-BGn dispersion and final creep and creep-recovery behaviors of nanocomposites.Results: The Findley power law model confirmed that the lowest ‘A’ and highest ‘n’ parameters ( A is the amplitude of the transient creep strain and n is the time exponent) belong to the sample with the highest young modulus and the nanocomposites compared to PDLLA/PCL blends have the lower ‘A’ and higher ‘n’ which can be related to retardation effect of m-BGn on creep strains. Besides, the burgers model results illustrated that all viscoelastic and viscoplastic parameters for nanocomposites possess higher values than those of the neat PDLLA/PCL blend. It means that the addition of glass nanoparticles leads to decrease creep strain , increasing the Burgers model prediction values which have inverse trend with . Moreover, the weibull distribution model results acknowledge that the introduction of m-BGn into PDLLA/PCL polymeric blends cause decrease in the viscoelastic strain recovery values. This is due to hindering effects of m-BGn on creep recovery behavior of nanocomposites.Conclusion: The results obtained from modeling of creep-recovery manners of PDLLA/PCL blend and its nanocomposites approved that the bioactive glass reinforcement nanoparticles play impeding role on creep and creep recovery behaviors. Level of evidence: I
Seyed Hadi Seyed Hoseinian; Farshid Bagheri; Ali Birjandi Nejad; Mohammad Taghi Peivandi; Mohammad-Hosien Ebrahimzadeh
Abstract
AbstractAbstractBackground: The aim of this study was to investigate the prevalence of Hepatitis B(HBV),Hepatitis C( HCV),and Human immunodeficiency virus(HIV)in a large trauma center in northeast of Iran.Methods: In a descriptive cross sectional study, 27252 consecutive patients admitted in a trauma ...
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AbstractAbstractBackground: The aim of this study was to investigate the prevalence of Hepatitis B(HBV),Hepatitis C( HCV),and Human immunodeficiency virus(HIV)in a large trauma center in northeast of Iran.Methods: In a descriptive cross sectional study, 27252 consecutive patients admitted in a trauma hospital in Mashhad, Iran during March 2012 to March 2017 who required surgery for their traumatic injuries were screened for the presence of Hepatitis B surface antigen (HBsAg), anti HCV Ab and anti HIV Ab.Results: In 926 patients at least one of the serologic tests was positive, showing an incidence of 3.3% seropositivity among study population. HBsAg was positive in 523 patients (1.9%), HCV Ab in 388 (1.4%) and HIV Ab in 15 patients (0.05%) respectively. 19 patients (0.06%) were simultaneously infected by more than one virus.Conclusion: The results of this study demonstrate that seroprevalence of blood born-pathogens among trauma patients, especially HCV and HIV, are higher than general population and it emphasized that health care workers in trauma centers must adhere to standard precautions to prevent viral transmission.Level of Clinical Evidence:4
Behzad Aminzadeh; Motahare Ebrahimnezhad; Mohammad H Ebrahimzadeh; Hasan Mehrad Majd; Ali Moradi
Abstract
Background: This study aimed to evaluate the relationship between changes observed in an ultrasonography before and after the surgical release of carpal tunnel syndrome (CTS).Methods: This prospective study was performed on 15 candidates of CTS surgery during 2017-2018 who underwent an ultrasonography ...
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Background: This study aimed to evaluate the relationship between changes observed in an ultrasonography before and after the surgical release of carpal tunnel syndrome (CTS).Methods: This prospective study was performed on 15 candidates of CTS surgery during 2017-2018 who underwent an ultrasonography before and three months after the surgery. The structural changes in the median nerve and their correlation with the carpal tunnel were analized.Results: According to ultrasonography results, the findings related to height, diameter and cross-sectional area of the median nerve decreased in the pisiform region of carpal tunnel while they increased in the area of hamate hook (P=0.002 in pisiform and P=0.001 in hamate hook), which might be due to the elimination of nerve dysfunction in the pisiform and effective decrease of pressure on nerve in hamate hook.Conclusion: In terms of evaluation of changes in the area of the median nerve, ultrasonography of the median nerve could be an effective and accurate technique to recognize the compression and follow up the nerve status in patients with CTS after surgery.
Gholamreza Rouhi; Azadeh Ghouchani; Mohammad Hossein Ebrahimzadeh
Abstract
Background: Distal femur is the most frequently affected site by giant cell tumor (GCT). Surgery including tumor curettage and defect reconstruction with bone cement is a widely-used treatment. While post-operative fracture is a common complication, no criteria and/or biomechanical data are available ...
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Background: Distal femur is the most frequently affected site by giant cell tumor (GCT). Surgery including tumor curettage and defect reconstruction with bone cement is a widely-used treatment. While post-operative fracture is a common complication, no criteria and/or biomechanical data are available to identify patients at high risk of fracture.Methods and materials: Since there is a strong correlation between bone strength and its fracture risk, in this study, bone strength following GCT surgery was predicted using quantitative computed tomography (QCT)-based finite element method (FEM). Mechanical properties of bone-cement interface, along with non-linear and non-homogeneous, as well as post-yield properties of bone were taken into account in the FE models. The accuracy and precision of FE models in predicting bone strength were evaluated using statistical tests by comparing the FE results with the results obtained using in-vitro mechanical tests on 14 cadaveric specimens and an independent data set.Results: According to paired t-test analysis, no significant difference was observed between the bone strengths predicted by FEM and those calculated by in-vitro tests . In addition, based on the results of regression analysis, there was a linear relationship between and with a slope not different from 1.Discussion: The obtained results show the capability of QCT-based FEM in predicting bone strength in distal femur following GCT surgery, and thus they can be employed to investigate various features of the bone-cement construct with the hope of shedding light on the obscure aspects of the problem.
Soheila Ali Akbari Ghavimi; Mehran Solati Hashjin; Mohammad Hossein Ebrahimzadeh
Abstract
Tissue engineering is a science to generate biological substitutes for regeneration, preservation and better operation of damaged tissues. Main components of tissue engineering are scaffolds, cells and growth factors. Also, bioreactors seem to be one of the fundamental parts. Scaffold is a 3D structure ...
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Tissue engineering is a science to generate biological substitutes for regeneration, preservation and better operation of damaged tissues. Main components of tissue engineering are scaffolds, cells and growth factors. Also, bioreactors seem to be one of the fundamental parts. Scaffold is a 3D structure as a framework to support cell growth and extra cellular matrix deposition. Cells penetrate to scaffolds and grow, differentiate, proliferate and migrate according to physical and chemical signals. If the environment is appropriate for cells, they deposit ECM and new tissue will be formed. Tissue engineering science is to fabricate scaffolds which are suitable for cellular homing, to create and retain appropriate environment for cell maintenance and to control all the parameters which is important to generate new tissues.
Mehdi Mazloomi, MD; Mohammad Hossein Ebrahimzadeh, MD; Farzad Omidi Kashani, MD
Abstract
Epiphysealis dysplasia heminelica (Trevor’s syndrome) is a rare disease which is the result of abnormal development of cartilaginous external or internal segments of epiphysis. It is usually a single lesion. But with breakage of outgrowing cartilaginous masses, it may present as several free pieces ...
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Epiphysealis dysplasia heminelica (Trevor’s syndrome) is a rare disease which is the result of abnormal development of cartilaginous external or internal segments of epiphysis. It is usually a single lesion. But with breakage of outgrowing cartilaginous masses, it may present as several free pieces in the joint. The abnormal cartilaginous outgrowths would stop with termination of child’s growth. The articular surface incongruity, however, can lead to early osteoarthritis. We are reporting this case because of rarity of this pathology, and also because of the presence of lesions on both sides of an ankle.
Ali Birjandinejad, MD; Mohammad Hossein Ebrahimzadeh, MD; Eghbal Sadri Mahvelati, MD
Abstract
Background: Proximal tibial fractures are complex injuries and are, historically associated with high complication rates. The purpose of this study is to evaluate the clinical usefulness of locking compression plates (LCP) in comparison with T-buttress plates in treating proximal tibial fractures.Methods: ...
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Background: Proximal tibial fractures are complex injuries and are, historically associated with high complication rates. The purpose of this study is to evaluate the clinical usefulness of locking compression plates (LCP) in comparison with T-buttress plates in treating proximal tibial fractures.Methods: In a prospective study, 62 patients (51 men, 11 women) with proximal tibial fracture referring to Mashhad Medical University Trauma Center were treated with T-buttress plate fixation in 35 and LCP in 27 cases. The treatment outcome was evaluated clinically and radiographically with 24 months (18-36 months) average follow-up.Results: In LCP group, there were 3 cases of Knee motion limitation, 1 mal:::union:::, 1 infection and no non-:::union::: and in T-plate group, 4 cases of knee motion limitation, 6 mal:::union:::s, 2 non-:::union:::s and 4 infections. There was, therefore, no significant difference in terms of joint range of motion between the two groups. Mal:::union::: and infection were, however, more common in T-plate fixation group.Conclusions: Locking compression plating in proximal tibial fractures provides stronger fixation and is associated with less mal:::union::: and infection as compared to T-plate fixation.
