Joints
Mehdi Teimouri; Mohammad Dehghani; Fatemeh Mazarei
Abstract
Background: Distal radius fractures are among the most common fractures. They can happen at any age group, and there are several treatment options and several classification systems for these fractures. One of these classifications is that of Fernandez. In this study, we evaluated the results of treatment ...
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Background: Distal radius fractures are among the most common fractures. They can happen at any age group, and there are several treatment options and several classification systems for these fractures. One of these classifications is that of Fernandez. In this study, we evaluated the results of treatment of distal radius fractures by bridging external fixator and percutaneous pinning.Methods: In a cross-sectional study, 72 patients with Fernandez type 3, 4 and 5 that underwent external fixation and percutaneous pinning for comminuted distal radius fractures were followed and assessed after 3 and 6 months.Results: The 72 patients had mean age of 44.2 years. 55% were male. The most common cause of fractures was vehicle accidents. 4 cases of malunion, 4 radial nerve injuries, 2 fixator loosening and 6 cases of infection were encountered.Conclusion: External fixator supplemented by percutaneous pinning is an efficient technique for treatment of unstable distal radius fractures. It has low rate of complication and high rate of patient's satisfaction.
Mohammad Dehghani, MD
Abstract
Background: Fractures of distal radius are common injuries. Unstable distal radius fractures present a challenge to the treating orthopaedic surgeon. One of the therapeutic methods is Ilizarov hybrid external fixator. In this study short-term result of this method in a small group is reported.Methods: ...
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Background: Fractures of distal radius are common injuries. Unstable distal radius fractures present a challenge to the treating orthopaedic surgeon. One of the therapeutic methods is Ilizarov hybrid external fixator. In this study short-term result of this method in a small group is reported.Methods: 18 consecutive patients with unstable fracture of distal radius were treated with non-bridging hybrid Ilizarov external fixator for 7 weeks. Clinical and radiological evaluation was performed at one and 7 days, and at 6 weeks and 6 months after surgery.Results: All fractures united but anatomic reduction was achieved in only 16 cases (90%). The achieved range of motion was: 80% flexion, 85% extension and 90% supination and pronation. Compared to the normal side, no extensor tendon injury and tendonitis of pin loosening occurred. Only 5 mild pin track infection was observed that resolved by findings of oral antibiotic therapy.Conclusion: The technique of hybrid non bridging external fixator is safe and reliable option method for unstable intra and extra-articular distal radius fractures. It permits free wrist motion during treatment preventing joint stiffness.
Mohammad Dehghani, MD; Seyed Hadi Seyed Hosseinian, MD
Abstract
Volar radioulnar dislocation without fracture in ulna or radius is rare. This is a report of an old volar dislocation of distal ulna that required open reduction and ligament reconstruction with free tendon graft.
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Volar radioulnar dislocation without fracture in ulna or radius is rare. This is a report of an old volar dislocation of distal ulna that required open reduction and ligament reconstruction with free tendon graft.
Dehghani, MD Mohammad
Abstract
Background: Fracture of metacarpal and phalangeal bones of hand are common sport and industrial injuries in the upper extremity. Mini-plate fixation is one of the techniques used in fixation of unstable kind of fractures in hand. We would like to report our experience with such fractures treated ...
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Background: Fracture of metacarpal and phalangeal bones of hand are common sport and industrial injuries in the upper extremity. Mini-plate fixation is one of the techniques used in fixation of unstable kind of fractures in hand. We would like to report our experience with such fractures treated with titanium mini-platesMethods: In a clinical trial study, 29 patients with 48 unstable hand fractures (21 metacarpal, 27 phalanges) received titanium mini-plate fixation during 1999-2006. The mean age was 27 years (14-53). Twenty eight cases were periarticular and 20 shaft fractures. The cases were evaluated with an average follow-up of 17 months (6-52), and range of motion and function were assessed.Results: The results, based on total active motion, were considered excellent in 39 (³221 degrees), good in 8 (121-220 degrees) and poor in1case (
Dehghani, MD Mohammad; Fanian, MD Hossein
Abstract
Background: Soft tissue or bony injury especially fracture-dislocations can cause stiffness resulting in decrease finger and hand function. In this study dynamic traction was used for restoration of alignment and fixation of fractures.Methods: A cross-sectional study was done in a hospital in Isfahan. ...
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Background: Soft tissue or bony injury especially fracture-dislocations can cause stiffness resulting in decrease finger and hand function. In this study dynamic traction was used for restoration of alignment and fixation of fractures.Methods: A cross-sectional study was done in a hospital in Isfahan. Eighteen patients with 10 forth finger, 5 fifth and 3 third finger injuries were treated with dynamic traction for fracture dislocation of proximal interphalangeal joints between 2001-2006. Two fine k-wires were used – each on one side of the broken joint. Rubber bands were used to connect the pin and maintain traction on the fracture. All the fractures had involvement of more than 40% of articular surfaces. While active motion was started the next day, the fixator was left in place for 4-6 weeks. The mean age of patients was 24 (18-39 years). They were assessed clinically and rediographically nine months (8-23 months) after surgery.Results: All the patients achieved :::union::: with an average joint motion of 92 degrees (82 to 98). Four patients had 10 degrees extension lag and 3 cases had 10 degrees of flexion contracture. Joint congruity was obtained all but two cases who have decrease in joint space.Conclusions: Dynamic traction with pins and robber band permit early motion with early soft tissue and bone healing in complex proximal interphalangeal joint soft finger.
Mohammad Dehghani, MD; Farshad Maleki, MD
Abstract
Background: Defects in elbow extensors usually occur with severe trauma and more in young or middle age people. The acute injuries can be repaired by direct suturing and bone anchorage. Such a repair is not feasible in chronic cases (a few weeks old) and in massive defects often seen in patients with ...
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Background: Defects in elbow extensors usually occur with severe trauma and more in young or middle age people. The acute injuries can be repaired by direct suturing and bone anchorage. Such a repair is not feasible in chronic cases (a few weeks old) and in massive defects often seen in patients with head injuries. Use of Achilles tendo allograft is a good repair alternative, allowing earlier motion and producing more powerful extension. We would like to report our experience with four such cases.Methods: Four cases of chronic post traumatic in triceps brachi rupture, age range of 25-49 years, were treated with Achilles tendon allograft attached to a piece of calcaneous. Progressively increasing elbow motion was started after the second week. The patients were clinically evaluated with 14 months average follow-up, using Mayo Elbow Performance Score (MEPS). Each elbow was compared with the opposite side.Results: Excellent performance scores was seen in 3, and good in one patient. Elbow range of motion was 85 percent (82-96%) of the healthy side, and elbow extension power was 80% of the normal elbow. Transient uluar neuroparaxia in one case was the only complication which recoverd fully in 3 months.Conclusions: Massive chronic post traumatic tricep brachi defects can be effectively managed by bone/tendon allograft from Achilles tendon.
Mohammad Dehghani, MD; Arsalan Mahmoodian, MD; Abolghasem Zarezadeh, MD
Abstract
Background: Finger injuries are very common and the majority can be treated under digital block anesthesia. Traditional digital block is one of the most commonly blocks performed by care providers in several medical fields. There is another less known method, Transthecal (Pulley) block, in which local ...
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Background: Finger injuries are very common and the majority can be treated under digital block anesthesia. Traditional digital block is one of the most commonly blocks performed by care providers in several medical fields. There is another less known method, Transthecal (Pulley) block, in which local anesthesia is injected into the flexor tendon sheat. This manuscript compares the effectivenss of these two techniques.Methods: A prospective randomized clinical trial was performed comparing Transthecal pulley block with digital block anesthesia in terms of length of achieved anesthesia and possible need for supplemental anesthesia. 100 consecutive patients who required surgery for their finger injuries randomly received Traditional digital block or Transthecal pulley block. The achieved finger anesthesia was assessed in terms of time and need for additional medication.Results: The mean achieved anesthesia was 34.2 minutes in Transthecal and 33.8 minutes in digital blocks. A repeat infiltration of local anesthesia became necessary in 5 instances in the Traditional digital block and none in Transthecal technique.Conclusions: Because of fewer needs for repeat local anesthetic injection, and lesser risk of neurovascular bundle damage, Transthecal block is suggested as a more suitable local block for finger surgery.
