Mohammad Taghi Peivandi, MD; Zahra Mostafavian, MD; Mohsen Nemati, MD; Morteza Balmeh, MD
Abstract
Background: Surgical wound infection is the most serious complication after surgical treatment and the second most common etiology in nosocomial infection. Nutritional status of the patients is one of the risk factors for surgical site infection (SSI). This study aims at investigating the relationship ...
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Background: Surgical wound infection is the most serious complication after surgical treatment and the second most common etiology in nosocomial infection. Nutritional status of the patients is one of the risk factors for surgical site infection (SSI). This study aims at investigating the relationship between the serum albumin level and pre-operative anemia with surgical site infection in patients with open tibial fracture.Methods: In a prospective study, 56 patients with open tibia fractures were studied in a teaching hospital in Mashhad-Iran. At the time of admission, serum albumin level, hemoglobin, and anthropometric values were measured. Surgical site infection during a one-year follow-up was recorded. The results were analyzed using statistical tests.Results: Nineteen patients (%33.9) were complicated by infection. The odd ration was 1.83 (p < /em>=.032) for anemia, 2.35 (p < /em>= .018) for hypoalbuminemia and 3.53 (p < /em>=.002) for type of open fracture.Conclusion: This study showed that SSI is a problem of great significance in orthopaedic tibia open fracture surgeries. It also showed that hypoalbuminemia and anemia before surgery resulted in a higher SSI occurrence in the patients.
Mohammad Taghi Peivandi, MD; Amir Reza Bidkhori, MD
Abstract
Background: Fracture of talus is a relatively rare disease, and treatment outcome is not always predictable. The aim of this study is to report our experience with the surgical treatment of fractures of talar body and neck.Methods: In a retrospective study, 16 patients (12 men, 4 women) with body and ...
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Background: Fracture of talus is a relatively rare disease, and treatment outcome is not always predictable. The aim of this study is to report our experience with the surgical treatment of fractures of talar body and neck.Methods: In a retrospective study, 16 patients (12 men, 4 women) with body and neck fractures of talus were evaluated in a teaching hospital in Mashhad. The mean age was 24.8 years (15-50 years). The fracture pattern, mechanism of trauma, associated injuries, :::union::: rate, avascular necrosis, pain and disability were evaluated in mean follow-up period of 18 months (12-24 months).Results: All the patients showed :::union::: during the follow-up. Five patients (31%) had avascular necrosis. The mean for Hawkins score system was 8.25. All the cases showed evidence of pain and some disability at the end of study.Conclusion: Talus fracture is a disabling injury and high incidence of pain and activity restriction should always be expected, even with surgical treatment.
Mohammad Taghi Peivandi, MD; Javad Sheikhian, MD; Hossein Ebrahimzadeh, MD; Farshid Bagheri, MD
Abstract
Background: Low back pain, in any community has a high prevalence. Acute sciatica does not usually have a very quick and effective non-operative remedy. Lingering disability and very slow return to work is a major finding in most cases. We aimed at testing the effect of early epidural steroid injection ...
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Background: Low back pain, in any community has a high prevalence. Acute sciatica does not usually have a very quick and effective non-operative remedy. Lingering disability and very slow return to work is a major finding in most cases. We aimed at testing the effect of early epidural steroid injection in pain relief and in shortening the disability period.Methods: Forty patients (25 male, 15 female) referring to two hospitals in Meshhad with acute radiculor pain during one-year period were enrolled in a prospective study. The cases had clinical and MRI proof of a disc herniation occurring within 6 weeks of their referral and had not responded to regular medical treatment for 2 to 3 weeks. After full evaluation and completing the “Prolo” scoring questionnaire, the patients were injected epidurally with 40mg of Triamcinolone and 2% Lidocaine for 3 times in two days intervals. The cases were then assessed shortly after injection and in 3 and 6 months.Results: Improvement in SLR positivity was statistically evident after the third injection. Dramatic reduction in pain and therefore, analgesic medication use was observed in second and third follow-up (p < /em>≥.05). Over all 27.5% of patients were fully satisfied and 62.5% were partially satisfied with the results.Conclusion: Epidural steroid injection following acute radicular back pain has short-term dramatic effect in pain control, but does not improve function or effectiveness of an individual to a significant degree.
Mohammad Taghi Peivandi, MD; Seyed Reza Sharifi, MD Sharifi, MD; Eghbal Sadri, MD
Abstract
Background: There are many different methods of treatment for Kienbock's disease or avascular necrosis of the carpal lunate. We are reporting our experience with lunate excision, capitate osteotomy and inter capitate bone grafting.Methods: Eleven male patients with stage III lunatomalacia treated by ...
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Background: There are many different methods of treatment for Kienbock's disease or avascular necrosis of the carpal lunate. We are reporting our experience with lunate excision, capitate osteotomy and inter capitate bone grafting.Methods: Eleven male patients with stage III lunatomalacia treated by lunate excision capitate osteotomy and intra-capitate bone grafting were assessed with a mean follow-up of 6 years (2-10 years). The cases were evaluated in terms of pain, function, grip power and return to pre-treatment activities.Results: Pain decreased significantly in all but one case. Grip strength had returned to above 70% of the strength of the opposite hand in all but one patient.Conclusions: Capitate osteotomy and inter-capitate bone graft without intercarpal arthrodesis in Kienbock disease is a safe and reliable technique for stage III disease.
Mohammad Taghi Peivandi, MD; Mohammad Bahremand, MD; Ebrahim Hasankhani, MD; Sara Amel farzad, MD
Abstract
Background: Treating open fracture of the femur is problematic. In this study the results of unreamed intramedullary (IM) nailing in this kind of fracture is reviewed.Methods: In a prospective study, 41 patients (40 males, 1 female) with open femur fractures were treated, using the above method, ...
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Background: Treating open fracture of the femur is problematic. In this study the results of unreamed intramedullary (IM) nailing in this kind of fracture is reviewed.Methods: In a prospective study, 41 patients (40 males, 1 female) with open femur fractures were treated, using the above method, in two hospitals in Meshhad from 2004 to 2006. Fifteen cases could not be followed. The remaining 26 patients, with 28 years mean age (16-45 years) were comprised of 6 type A, 9 B, and 11 type C fractures - according to AO classification. There were 2 type II, and 24 IIIA, Gustillo/Anderson open fractures, with a mean injury severity score (ISS) of 10.96. The cases were followed from 18 to 36 months, and the :::union::: rate, infection rate, and limb function were assessed.Results: Twenty three patients reached :::union::: in 156 days on average (84-250 days). Infection occurred in 2 patients. At the end of the follow-up period, the range of motion of the knee was 120 degrees. Shortening of 3 centimeters was observed in one case.Conclusions: Unreamed intramedullary titanium nailing is effective in treatment of type II and IIIA open femoral fractures.
Mohammad Taghi Peivandi, MD; Amir Reza Kachooei, MD; Sara Amel Farzad, MD
Abstract
Traumatic hip dislocation is rare in children. Ligamentous laxity is often a reason for this occurrence usually with a minor trauma.
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Traumatic hip dislocation is rare in children. Ligamentous laxity is often a reason for this occurrence usually with a minor trauma.
Mohammad Taghi Peyvandi, MD; Hossein Shobiri, MD, MPH; Sara Amel Farzad, MD
Abstract
Background: The likelihood of transmission of hepatitis C virus through a single skin perforation is 2.7 to 10 percent. The serologic test of “Elisa” is about 99 percent sensitive in detecting hepatitis C virus (HCV) infection. The aim of this study is to evaluate the possibility of disease transmission ...
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Background: The likelihood of transmission of hepatitis C virus through a single skin perforation is 2.7 to 10 percent. The serologic test of “Elisa” is about 99 percent sensitive in detecting hepatitis C virus (HCV) infection. The aim of this study is to evaluate the possibility of disease transmission to orthopaedic surgeons or orthopaedic assistants by serologic testing of orthopaedic trauma cases for HCV.Methods: In a one year period (2005-2006), 670 patients who had been admitted to the orthopaedic trauma center of a hospital in Meshhad were tested for HCV by serologic tests with “Elisa” technique.Results: From the 670 tested patients, 22 male and 3 female who had a mean age of 38.7 had positive serology for HCV. This would mean 3.9 percent male and 2.8 percent female prevalence.Conclusions: A worrisome number of patients with orthopaedic trauma are serologically positive for hepatitis C. Protective measures are, therefore, essential for all the people who handle orthopaedic trauma.
