Hanon Sadoni; Saeed Tabatabaei; Hamidreza Arti; Mohammadreza Ghasemi; Shahab Yousefifar
Abstract
AbstractBackground: Developmental dysplasia of the hip (DDH) includes a wide range of abnormalities of the hip that can emerge at any time including embryonic period, infancy, or childhood. The purpose of this study was to examine the clinical and radiographic outcomes of patients with DDH, treated with ...
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AbstractBackground: Developmental dysplasia of the hip (DDH) includes a wide range of abnormalities of the hip that can emerge at any time including embryonic period, infancy, or childhood. The purpose of this study was to examine the clinical and radiographic outcomes of patients with DDH, treated with adductor tenotomy and closed reduction.Methods: The study was retrospectively performed on 30 children (33 joints) with DDH,who were treated with adductor tenotomy, closed reduction and SpicaCast in Ahvaz Razi Hospital during 2015-2017. Inclusion criteria were patients diagnosed with DDH and below 2 years of age. Exclusion criteria were connective tissue diseases, secondary dislocation due to previous infection and acetabulum dysplasia in the context of specific syndrome. After the operation, the patients were evaluated for the severity of injuries associated with dislocation or subluxation of hip joint and hip joint congruity. Theradiographic results were studiedbased on Severin, Tonnis grading, McKay and acetabularindices.Results: The preoperative mean acetabular index of36.54 ± 3.27 degrees significantly dropped to postoperativeof 27.06 ± 2.15 degrees. According to McKay criteria, 90.9% of the patients had excellent and good therapeutic results after the surgery. According to Tonnis criteria, 93.9% of patients were in Class I and II after the surgery. Moreover, in radiographic evaluations,96.9% of the patients were in Class Ia and Ib based on Severin criteria.In 1 patient (3.03%), osteonecrosis of the head was found, in 2 patients (6.06%), walking and lameness impaired walking, and in 3 patients (9.09%), sitting was reported. All patients were female in this study.Conclusion: According to the clinical results and evaluations of this study, closed reduction along with adductor tenotomy can be used as an appropriate technique for the treatment of patients with DDH at an early age.
Saeid Tabatabaei, MD; Miremad Miremarati, MD
Abstract
Background: Rupture of the anterior cruciate ligament (ACL) is the most common knee injury during sport activities. The purpose of this study was to investigate the results of ACL reconstruction using middle 1/3 of the autologous patellar ligament by miniarthrotomy approach in young patients.
Methods: ...
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Background: Rupture of the anterior cruciate ligament (ACL) is the most common knee injury during sport activities. The purpose of this study was to investigate the results of ACL reconstruction using middle 1/3 of the autologous patellar ligament by miniarthrotomy approach in young patients.
Methods: In a descriptive study, 57 patients (55 male, 2 female) at age of 20 to 45 years old, who were referred with ACL rupture and treated with ACL reconstruction using autograft bone-patellar-bone during a 2-year period in a training hospital in Ahvaz, Iran, were studied. The clinical results were investigated with an 11.7 months (7-28 months) follow-up, using Lysholm Knee Score, and physical re-evaluation.
Results: In 33 cases, right knee and in 24 left knee was affected. Eighty-six percent of the patients had no limitation in knee motion after surgery, and 82 percent had no knee instability. Ninety-six percent of the patients could return to the pre-injury sport activity. The mean Lysholm knee score was 83.63 (69-93).
Conclusions: Reconstruction of the anterior cruciate ligament using autograft bone-patellar-tendon with miniarthrotomy has clinically acceptable results.
Saeid Tabatabaei; Ahmad Dashtbozorg; Ahmad Dashtbozorg
Abstract
Background: In patients with late diagnosis of DDH after open reduction of the hip joint, we can use pelvic osteotomy or varus-derotational osteotomy (VDO) of the femur to make the open reduction more stable. The goal of the present study is to report on redirection of the femoral head towards acetabulum ...
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Background: In patients with late diagnosis of DDH after open reduction of the hip joint, we can use pelvic osteotomy or varus-derotational osteotomy (VDO) of the femur to make the open reduction more stable. The goal of the present study is to report on redirection of the femoral head towards acetabulum by femoral osteotomy. Methods : In this prospective study we performed only VDO in 67 hips in 46 patients (36 females, 10 males) after open reduction of the hip in cases of 18 months to 10 years of age whom Salter innominate osteotomy was needed in a hospital in Ahvaz, Iran. The patients were followed up until complete weight bearing and plate removal. Results : Concentric reduction was achieved in 67 hips. Acetabular index showed 6 degrees of reduction after 26 months. No redislocation was seen after plate removal in 61 hips (91%) but pelvic osteotomy was done in 6 hips (9%) due to redislocation or residual displasia. Ninety percent of patients were classified as group 1 or 2 in "severin" classification. Conclusions : VDO is a simple operation with low complication rate. Although more than 90% success rate was observed in these patients, in order to see possible residual dysplasia in these patients longer follow-ups are needed.
Seyed Abdolhossein Mehdinassab, MD; Saeid Saeid Tabatabaei, MD; Ali Asghar Haddadpoor, MD; Saeid Saeid Tabatabaei, MD; Nasser Sarrafan, MD; Seyed Mohammad Seyedi, MD
Abstract
Background: Fracture dislocation of the hip is a result of high energy trauma and can lead to hip dysfunction and patient disability. Stable and perfect reduction of the femoral head and acetabular wall are the two most important prognostic factors. The aim of this study was to compare the results of ...
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Background: Fracture dislocation of the hip is a result of high energy trauma and can lead to hip dysfunction and patient disability. Stable and perfect reduction of the femoral head and acetabular wall are the two most important prognostic factors. The aim of this study was to compare the results of surgical treatment with nonsurgical treatment in this injury.Methods: In a period of 2 years, the cases of posterior hip dislocation with acetabular rim fracture were studied. Two groups were recognized after closed reduction of dislocation. First group (18 patients) received open reduction and plating of acetabular fracture followed by 3-5 weeks of skeletal traction. The second group (14 patients) was treated by skeletal traction of 5-6 weeks. The patients were evaluated for hip motion, stability, complications or nerve injury and early osteoarthritis, and acetabular fracture index in average one year follow-up. The results were compared in the two groups.Results: Restriction of hip motion was more common in nonsurgical patients. Sciatic nerve injury was noted in 3 patients of surgical group with recovery in 2 of them. Perfect reduction was seen in 17 (94.4%) of surgical and 9 (64.3%) of nonsurgical patients. Primary osteoarthritis was seen in 7 patients (38.9%) of surgical and 8 patients (57%) of nonsurgical group. AFI in surgical and nonsurgical groups were 55.2% and 32.5% respectively. Surgical patients had better functional results.Conclusion: Articular damage by initial trauma, perfect reduction of the hip and stable anatomic fixation of the acetabular wall are the important prognostic factors. The patients with surgical treatment obtain better functional outcome.
