Foot and Ankle
Seyed Alireza Aminjavaheri; Seyed Hossein Shafiei; Mohammad Ali Ghasemi; Alireza Moharrami; Mir Mansour Moazen Jamshidi; Seyed Mohammad Javad Mortazavi
Abstract
Introduction: The risk of femoral neck fracture increases in the End Stage Renal Disease (ESRD) patients who underge hemodialysis. The aim of this study was to describe our experience with the treatment of femoral neck fracture in this particular group of patients. Method: In a retrospective study, between ...
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Introduction: The risk of femoral neck fracture increases in the End Stage Renal Disease (ESRD) patients who underge hemodialysis. The aim of this study was to describe our experience with the treatment of femoral neck fracture in this particular group of patients. Method: In a retrospective study, between January 2010 to December 2015, there were 16 displaced femoral neck fracture in 12 haemodialytic ESRD patient. All patients underwent total hip arthroplasty via direct anterior approach (three cementless and 9 cemented). No closed suction drain was used. Follow up regime was at 3,6 and 12 month and annually thereafter. Result: All patients were satisfied with the results of total hip arthroplasty. At the time of the final follow-up of 22 months (2-47) months, all the hips in the 12 haemodialytic patients functioned well without any loosening, and with a Harris hip score (HHS) of 90(82–100). Of those patients who received cementless components: one patient showed loosening of femoral component on the right and then left hip one year after surgery. He underwent revision of femoral component to a cemented one. The other complications include one greater trochanteric fracture, one intraoperative distal femoral fracture, one postoperative hematoma formation and one superficial surgical site infection. Conclusion: In this small series, relatively high complication rate is observable in cases of ESRD with femoral neck fracture treated by hip Arthroplasty. The use of cemented femoral sterns is preferred and extra caution is advised to avoid fracture in such osteoporotic bones.
Javad Mortazavi; mohammad ali ghasemi; Alireza Amin Javaheri
Abstract
Leg Length Discrepancy (LLD) after Total Hip Arthroplasty (THA) is a prevalent complication that affects the patient's satisfaction with joint replacement surgery. It is the most common reasons for a patient's complaint of a doctor after a joint replacement. Patients will tolerate limb shortness more ...
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Leg Length Discrepancy (LLD) after Total Hip Arthroplasty (THA) is a prevalent complication that affects the patient's satisfaction with joint replacement surgery. It is the most common reasons for a patient's complaint of a doctor after a joint replacement. Patients will tolerate limb shortness more efficiently than their longevity. The LLD will create pain and limpness for the patients that result in premature aseptic loosening and back pain. Therefore, the surgeon should try to avoid this complication with the help of preoperative templating and various other methods during the operation. The present study examined the reasons for LLD and its preventive procedures in pre/intra-operation.
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.
SMJavad Mortazavi; Seyyedhossein Shafiei; M A Ghasemi
Abstract
Introduction: Nowadays, there is consensus regarding arthroplasty as the preferred treatment method for displaced femoral neck fracture among the elderly population. Although posterior and lateral surgical approaches are the most commonly used approaches for hip arthroplasty, direct anterior approach ...
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Introduction: Nowadays, there is consensus regarding arthroplasty as the preferred treatment method for displaced femoral neck fracture among the elderly population. Although posterior and lateral surgical approaches are the most commonly used approaches for hip arthroplasty, direct anterior approach (DAA) has become popular in many centres. Considering the many advantages of DAA, this study aimed to study the results of hemiarthroplasty via DAA for femoral hip fracture in the elderly people in our centre.Methods: All the femoral neck fractures that had received hemiarthroplasty via DAA between January 2010 and January 2013 in a teaching hospital were extracted from the database. The pre, intra, and post-operative information and clinical follow-up data were all collected and analysed. The Harris Hip Score and physical exam was used for functional assessment.Results: 45 patients (16 males and 29 females) with a mean age of 73.4 years and a mean follow-up of 76 months entered the study. There was no complication such as dislocation, wound problem or deep infection. The final mean Harris Hip Score was 87 (76-95).Conclusion: given that the patients with femoral neck fractures are often old, hemiarthroplasty treatment via direct anterior approach (DAA), has multiple advantages and is recommended for this population.