Hamid Reza Aslani, MD; Mehdi Abooei Mehrizi, MD; Zohreh Zafarani, MD
Abstract
Background: Ganglion cyst is one of the common causes of wrist mass, presenting with weakness and pain in the wrist. Among the arrays of treatment options for this problem arthroscopic resection is probably the most recent treatment modality. We would like to review a short-term result of such a treatment ...
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Background: Ganglion cyst is one of the common causes of wrist mass, presenting with weakness and pain in the wrist. Among the arrays of treatment options for this problem arthroscopic resection is probably the most recent treatment modality. We would like to review a short-term result of such a treatment in a small group of patients.Methods: In a case series study, 13 patients (10 women, 3 men) with dorsal wrist ganglion treated with arthroscopic resection in a two-year period, were evaluated for post operative recurrence pain swelling or wrist motion limitation and grip strength. The mean age was 29.8 years old. The cases had an average of 12 months (7-19 months) follow-up.Results: In the all cases no intra-or post operative complication was encountered. The wrist range of motion, and grip strength showed improvement no scapholunate instability was seen. One recurrence after 6 months had occurred.Conclusion: Arthroscopic ganglionectomy is a swelling surgical alternative for dorsal wrist ganglion with less scar, and comparative results to open surgery.
Fereidoon M Jaberi, MD; Javad Parvizi, MD; C. Thomas Haytmanek, BS; Ashish Joshi, MD; James Purtill, MD
Abstract
Background: The association between wound drainage and subsequent periprosthetic infection is well known. However, the most appropriate treatment of wound drainage is not well understood. Methods: We retrospectively reviewed the records of 10325 patients (11785 procedures), among whom 300 patients (2.9%) ...
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Background: The association between wound drainage and subsequent periprosthetic infection is well known. However, the most appropriate treatment of wound drainage is not well understood. Methods: We retrospectively reviewed the records of 10325 patients (11785 procedures), among whom 300 patients (2.9%) developed persistent (greater than 48 hours postoperatively) wound drainage. Wound drainage stopped spontaneously between 2 and 4 days in 217 patients treated with local wound care and oral antibiotics. The remaining 83 patients (28%) underwent further surgery.Results: A single débridement resulted in cessation of drainage without subsequent infection in 63 of 83 patients (76%), whereas 20 (24%) patients continued to drain and underwent additional treatment (repeat débridement, resection arthroplasty, or long-term antibiotics). Timing of surgery and the presence of malnutrition predicted failure of the first débridement. There were no differences between the success and failure groups with regard to all other examined parameters, including demographic or surgical factors.Conclusions: We found patients who underwent débridement at a mean of 5 days following the onset of drainage were more likely to be infection free at one year postoperatively compared to patients who underwent debridement at a delayed time (mean, 10 days). Our data confirmed that malnourished patients (serum transferrin less than 200 mg/dL, serum albumin less than 3.5 g/dL, or total than 1500/mm3) undergoing total joint arthroplasty are lymphocyte count less more likely to develop deep infection and require further treatment after irrigation and débridement. Based on these findings, we recommend early (within 7 days) surgery for persistent wound drainage in general, and particularly for those with malnutrition
Babak Pourabbas Tahvildari; Saeed Solooki; Narges Ghamari; Mohammad Ahmadi Jafari
Abstract
Background: Giant cell tumor (GCT) is a benign bone tumor that may present with invasion and even metastasis in some cases. Despite several techniques for surgical excision of the tumor, its post-operative recurrence is still a critical challenge for orthopaedic surgeons. Therefore, this study ...
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Background: Giant cell tumor (GCT) is a benign bone tumor that may present with invasion and even metastasis in some cases. Despite several techniques for surgical excision of the tumor, its post-operative recurrence is still a critical challenge for orthopaedic surgeons. Therefore, this study aimed to evaluate the result of the surgical treatment of GCTby curettage, burring, alcohol and cementation to reduce the risk of recurrence.Methods: This cross-sectional study was conducted on participants referring to two university hospitals with the diagnosis of GCT in a 12 years period. The subjects underwent surgery using curettage, burring, alcohol irrigation, and cementation. Regular follow-ups were carried out every three months in the first year, and then every six months in the second year and annually from then on.. The recurrence-free survival rate was analyzed by the Kaplan-Meier method.Results: Surgery was performed on 28 patients. The most common tumor site was distal femur, and the most pre-operative and post-operative complaints were pain and limitation of motion, respectively. At the end of the study, local recurrence was observed in only four cases, and lung metastasis was found in one case. The results showed that recurrence-free survival was 91.7% in 21 and 76% in 108 months according to Kaplan-Meier analysis .Conclusion: Although using the above-mentioned protocol seems to reduce the risk of local recurrence in patients with GCTs, complete excision of the tumor is also a crucial factor influencing the rate of local recurrence.
Ahmad Dasht Bozorg; Seyed Saeed Tabatabaee; Tahmineh Ghalami
Abstract
Background: Acute Hematogenous Osteomyelitis (AHO) is a potentially dangerous disease of childhood which is often seen in boys and involves the metaphysis of lower extremity, especially tibia. The aim of this study is to review the common bones and common organisms involved in hematogenous osteomyelitis ...
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Background: Acute Hematogenous Osteomyelitis (AHO) is a potentially dangerous disease of childhood which is often seen in boys and involves the metaphysis of lower extremity, especially tibia. The aim of this study is to review the common bones and common organisms involved in hematogenous osteomyelitis in children.Methods: In this retrospective study, the data of 111 children with acute hematogenous osteomyelitis admitted between 1997 and 2006 in two training hospitals in Ahvaz, Iran was studied. The responsible organism and the involved bone are the cases of interest in this study. Results: Acute hematogenous osteomyelitis was 3.27 times more common in boys than girls. The most common site of involvement was distal tibia in boys and proximal femur in girls. In 68.89% of the patients the culture of the involved bone was positive and the most common organism was staphylococcus aureus in both sexes. Conclusions: Acute hematogenous osteomyelitis is more common in boys than girls. The most common site of involvement was different in boys and girls but the most common responsible organism for infection was staphylococcus aureus in both genders.
Ehsan Shakouri, MSc; Mohammad Hosseyn Sadeghi, PhD; Mohammadreza Karafi, PhD; Mahmood Farzin, PhD
Abstract
Background: Internal immobilization of bone fracture often requires drilling and screw fixation of implanted bone. During bone drilling, the temperature could increase above 47°C causing irreversible thermal necrosis. This study is an experimental bone drilling with ultrasonic-assist in evaluating the ...
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Background: Internal immobilization of bone fracture often requires drilling and screw fixation of implanted bone. During bone drilling, the temperature could increase above 47°C causing irreversible thermal necrosis. This study is an experimental bone drilling with ultrasonic-assist in evaluating the temperature increase in comparison with conventional drilling.Methods: An experimental study on a bovine femur specimen was performed by drilling holes with ultrasonic assisted drill. The generated temperature in different speeds was documented at the drilling site, and was compared with the conventional drilling technique.Results: Ultrasonic-assisted drilling at 1000 rpm produced less temperature elevation compared with conventional drilling. Furthermore, at rotational speed of 2000 rpm, the temperature raise was independent of “feed rate” of the drilling.Conclusions: Using ultrasonic vibration in drilling of bovine femur produces less temperature raise in drill site, and works independent “feed rate” when compared with conventional drilling.
Morteza Jannesari Ladani; Alireza Farahmandi; Mohammad Reza Guiti; Mohammad Reza Hedayati; Alireza Rahimnia; Farshad Safdari
Abstract
Background: Anterior glenohumeral instability is associated with anteroinferior rim defect of glenoid. Evaluation of such bony lesions may play a role in determining proper treatment and predicting recurrence of instability. The main purpose of the current study was to investigate the relation between ...
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Background: Anterior glenohumeral instability is associated with anteroinferior rim defect of glenoid. Evaluation of such bony lesions may play a role in determining proper treatment and predicting recurrence of instability. The main purpose of the current study was to investigate the relation between number of dislocations and extent of bony lesion of the glenoid and also determine the sensitivity and specificity of 3-D CT for detection of patients requiring bone-grafting surgery. Methods: Thirty patients with recurrent anterior shoulder dislocation contributed to this study. The patients underwent bilateral 3-D CT imaging to determine the glenoid index (GI). Then, the correlation between the number of dislocations and GI, and also sensitivity and specificity of CT were determined. Results: The bony lesion was present in 28(94%) of patients. There was no meaningful relationship between the number of dislocations and GI (p=.05). Based on the CT, 2 patients required open surgery and bone grafting and 28 patients only Bankart procedure. This was proved to have been wrong in 2 cases at surgery. So, the sensitivity and specificity of 3-D CT was 50% and 96% respectively. Conclusion: The number of dislocations cannot determine the extent of the bony glenoid defect in recurrent shoulder dislocation lesion. 3-D CT can help in knowing the expansion and location of the lesion, but is not a reliable tool for surgical technique.
Mohammad Haghpanahi; S Moradi
Abstract
Background:Characterization of mechanical behavior of meniscus is very important issue due to significant role of meniscus in load bearing within the knee joint and identifying mechanical change in meniscal tissue is of particular interest with respect to osteoarthritis (OA) research. Acl tear can also ...
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Background:Characterization of mechanical behavior of meniscus is very important issue due to significant role of meniscus in load bearing within the knee joint and identifying mechanical change in meniscal tissue is of particular interest with respect to osteoarthritis (OA) research. Acl tear can also have deep impression on the meniscus clinically. Meniscus injury is common in pations with tear Acl.
Objectives: The purpose of this study is to survey Longitudinal tear meniscus for analysis and a finite element analysis model to achieve tension on the knee with Acl stability during meniscus tear and unstability of this Acl used on determine the procedure distribution compared the processing the output of different models.
Methods & Materials: 3-dimensional finite element model of knee joint biomechanics with the help of CT scan images were made. Healthy hip bone structure were designed with mimics software. The obtained model to Abaqus software is compiled for analysis.
Result: The maximum shear stress on page medial meniscus 1.73 Mpa and lateral meniscus on the page is 1.48Mpa. As a result, the amount of tension in the meniscus is more internal than external meniscus. The medial meniscus will be damaged more. In cruciate ligament tear sustained maximum shear stress 8.33Mpa on page medial meniscus and cruciate ligament tears with instability maximum shear stress is on page medial meniscus 9.65Mpa.
Conclusion: The result confirmed that biomechanical response of meniscus tear and Acl tear an important role in the stability of the meniscus. A meniscus and ligament tears in the meniscus increased levels of stress and stress distribution diagram.
Ahmadreza Afshar; Karim Eivaziatashbeik
Abstract
Background: This study evaluated the long-term (>5 y) outcomes of radial shortening osteotomy and vascularized bone graft in Kienböck disease patients. Methods: In a retrospective study of 16 patients with early stage Kienböck disease, 9 patients with average follow-up of 6.4 years had radial shortening ...
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Background: This study evaluated the long-term (>5 y) outcomes of radial shortening osteotomy and vascularized bone graft in Kienböck disease patients. Methods: In a retrospective study of 16 patients with early stage Kienböck disease, 9 patients with average follow-up of 6.4 years had radial shortening osteotomy (group 1), and 7 with average follow-up of 6.5 years had pedicled vascularized bone graft (group 2). The 2 groups were similar in age, sex, operated side, initial Lichtman stage, and follow-up duration. There were significant differences in ulnar variance between the 2 groups. At the last follow-up, the patients were evaluated for pain, wrist motion, grip strength, functional status, and radiographic assessment. The overall results were evaluated by Cooney wrist function score and Nakamura scoring system for Kienböck disease. Results: The 2 groups had no significant difference in pain, motion, grip strength, and radiologic assessment however, grip strength percentage was better in group 2. There was no significant difference between the radiographic changes of the 2 groups. In group I, 7 patients had satisfactory Nakamura scores, and 5 patients had satisfactory Cooney scores. All of the patients in group 2 had satisfactory Cooney and Nakamura scores.The difference in the mean Cooney wrist function score in the 2 groups was significant. The difference of Nakamura scores in the 2 groups was not significant. Conclusions: Both groups had reasonable long-term outcomes. We were unable to recognize a substantial clinical or radiological difference between the 2 surgical treatments in long-term outcome.
Amir Reza Kachooei, MD; Shiva Razi, MD; Reza Mahdavian Naghashzargar, MD; Hadi Makhmalbaf, MD
Abstract
Background: Posterior cruciate ligament (PCL) injury is reported in 3% to 23% of knee injuries. Ligament rupture usually requires reconstructive surgery. Avulsion injuries in acute cases, however, are often treated by fixation of avulsed bone and ligament. Fixation of avulsions in chronic cases is somewhat ...
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Background: Posterior cruciate ligament (PCL) injury is reported in 3% to 23% of knee injuries. Ligament rupture usually requires reconstructive surgery. Avulsion injuries in acute cases, however, are often treated by fixation of avulsed bone and ligament. Fixation of avulsions in chronic cases is somewhat controversial.Methods: In a descriptive study, from 40 male patients with mean age of 27.87 years old who had undergone fixation of PCL avulsion with maleolar screw and washer through a posteromedial approach, 20 cases with a mean of 40±16.02 weeks follow-up were studied. Twelve cases had received early fixation and 8 had fixation 8 weeks or longer after the injury. The cases were evaluated with clinical evaluation of stability as well as assessment of patients’ satisfaction and return to sports or regular activities.Results: Improvement in “posterior drawer test” was observed in all the cases. The ones who had early surgery, as well as the ones with isolated PCL injury had better results in comparison with late avulsion fixation or combined ligament injuries. Eight cases had no problem in knee function, 7 cases had some limitation in sporting, and 5 in some regular daily activities. Conclusion: Screw fixation of PCL avulsion through a posterio-medial approach, even in delayed cases, is safe, easy and effective. Associated other knee injuries are detrimental for good results.
Fardin Mirzatolouei, MD; Hossein Alizadeh, MD
Abstract
Background: Wrong placement of the ACL transplant especially in femoral site can result in early graft failure. Anatomical placement of the femoral tunnel results in restoration of knee kinematics closer to those of the intact knee. This placement could be performed by either using “aimer device” ...
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Background: Wrong placement of the ACL transplant especially in femoral site can result in early graft failure. Anatomical placement of the femoral tunnel results in restoration of knee kinematics closer to those of the intact knee. This placement could be performed by either using “aimer device” or with “free hand” methods. We compare the geometric position of femoral canal created by these two techniques.
Methods: In a prospective study, 22 patients were devided into two groups (11 patients) and operated by using femoral aimer instrument and “Free hand” techniques. Intra-operative fluoroscopy for femoral guide pin position was performed to determine the guide pin position. Vertical and horizontal coordinates of guide pins in both groups were outlined and compared with standard anatomical point of guide pins.
Results: in “aimer” group the coordinates of the guide pin location was 41.33% vertically and 33.49% horizontally and the difference with anatomic location in both vertical (p < /em>=.03) and horizontal (p < /em>=.02) vectors was significant. The coordinates for the location of the guide pin in the “free hand” group were 35.33% and 33.07% respectively and the difference between anatomical location and guide pin width was significant (p < /em>=.04), and in this group, difference in the height was observed. The sum errors in width and height plane in “aimer” and “free hand” groups were 13.82 and 7.4 respectively.
Conclusions: Anatomic positioning of guide pin is possible through both free hand and instrument techniques. The percentage of error in instrument technique is more than free hand method.
Masoud Shayeste Azar; Esmael Mokhtarnejad Ganji; Soheil Osia,; Mohammad Hossein Karimi nasab; Mohammad Osia
Abstract
Abstract
Background & Aim: Septic arthritis is one of the important childhood infections with a high number of complications. Given the rare occurrence of this infection in neonates and its low number of symptoms, the diagnosis of septic arthritis in infants is difficult and its prognosis is mainly ...
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Abstract
Background & Aim: Septic arthritis is one of the important childhood infections with a high number of complications. Given the rare occurrence of this infection in neonates and its low number of symptoms, the diagnosis of septic arthritis in infants is difficult and its prognosis is mainly affected by early diagnosis and treatment. This study aimed to evaluate the results of neonatal hip septic arthritis treatment results in two training hospitals during 2001-2016.
Materials and Methods: This cross-sectional and descriptive research was performed on infants who were referred to hospitals in the North of Iran due to hip septic arthritis during 2001-2016. Medical information was two recorded in a checklist based on demographic indicators and clinical findings in the laboratory. In addition, the presence of complications in the participants was assessed via a phone call or by in-person visit.
Results: In this study, the left hip joint was the most involved joint in terms of septic arthritis (72.2%). In addition, the most common bacteria responsible for the infection were Klebsiella (50%), E.coli (22.2%), and Staphylococcus aureus (27.8%). According to the results, 50% of the subjects were treated completely with no complications, whereas 11% of the right and 38.9% of left hips had limping (p=o.615).
Conclusion: Given the high number of complications of neonatal hip infection, early diagnosis and timely treatment is needed to reduce the complications.
Babak Siavashi
Abstract
Abstract
Introduction: In some special situations during the revision total hip arthroplasty with well fixed, well oriented acetabular cementless cup, orthopedic surgeons may prefer to retain the well-fixed cementless cup. The aim of this study was to report the follow-up of some cases treated with ...
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Abstract
Introduction: In some special situations during the revision total hip arthroplasty with well fixed, well oriented acetabular cementless cup, orthopedic surgeons may prefer to retain the well-fixed cementless cup. The aim of this study was to report the follow-up of some cases treated with such a technique during a 10-year period.
Methods: During 2004-2014, all cases of revision total hip surgery performed in Sina Hospital, Tehran, Iran were evaluated. 14 of 82 cases (16.5%) had cemented polyethylene liner in cementless metal shell. The demographic data, reasons for use of such revision technique result was evaluated by Harris Hip Score.
Results: The most common reason was osteolysis (64%), and the most common cause was impaired locking mechanism (65%). There were few complications (one osteolysis and one infection). In five cases (36%) constrained liner was added and in 10 cases (72%) allograft was needed. The final Harris Hip Scores was good or excellent in 78%. Only one dislocation was seen.
Conclusion: Cemented cup in cementless shell can be used in revision hip arthroplasty in well-fixed Acetabular shell situations with acceptable outcom.
Mehran razavipour; salman ghaffari; masoud shayestehazar; abolfazl kazemi; Shayan Amjadi
Abstract
Introduction: One of the factors affecting the prognosis of distal radius fracture is anatomical correction. Several studies conducted in connection with the reconstruction of anatomical and functional consequences, which have had conflicted results. This study has been designed and implemented aimed ...
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Introduction: One of the factors affecting the prognosis of distal radius fracture is anatomical correction. Several studies conducted in connection with the reconstruction of anatomical and functional consequences, which have had conflicted results. This study has been designed and implemented aimed to investigate the relationship between radiological index (anatomical) after displaced distal radius fractures with function and clinical outcomes.Methods: This is a retrospective cohort study to assess the association of radiological indices with clinical and functional outcomes of distal radius fractures. In this study, radiological indices, including the radius, volar tilt, tear drop angle, articular cavity depth and AP Distance were investigated. Pinch and grip strength were measured and Quick DASH questionnaire evaluated the performance.Results: Pain score significantly correlated with radial shortening (P=0,038), but it was not independent of treatment method. Patients’ satisfaction rate was significantly lower in patients with abnormal articular depth, independent of age and treatment method (P=0.004). Quick-DASH score significantly correlated with radial shortening and articular cavity depth, independent of treatment method and age (P=0.006). Percutaneous pinning associated significantly with less pain, less disability and more satisfaction (P<0.05).Conclusion: Radial shortening, articular cavity depth had a correlation with the clinical and functional outcomes. While Some studies suggested radiological indices in the elderly is not necessarily have a correlation with functional outcomes, in this study correlation of radiologic indices with clinical and functional outcome was independent of age.
Mohammad Saleh Ganjavian, MD; Hamid Behtash, MD; Seyed Hossein Vahid Tari, MD; Ebrahim Ameri, MD; Bahram Mobini, MD; Marzieh Nojumi, MD
Abstract
Background: Bracing is the most common non-operative treatment for idiopathic adolescent scoliosis. Milwaukee brace is the best – known orthosis for this purpose. We wish to report our results with the use of this brace in idiopathic scoliosis.Methods: In a retrospective study, among 681 patients who ...
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Background: Bracing is the most common non-operative treatment for idiopathic adolescent scoliosis. Milwaukee brace is the best – known orthosis for this purpose. We wish to report our results with the use of this brace in idiopathic scoliosis.Methods: In a retrospective study, among 681 patients who had been treated for idiopathic scoliosis form 1994 to 2004 in two hospitals in Tehran, 335 cases had received non-operative treatment with Milwaukee brace. The radiographs of these patients were reviewed to evaluate the treatment outcome. These patients, who were 12.1 years old on average and had received no other prior treatment, had started with 23 hours per day bracing and continued in accordance with Scoliosis Research Society (SRS) protocol.Results: Milwaukee brace reduced the cobb ankle from an average of 32.8 to 30.6 degrees. The brace had no appreciable effect on curves of upper thoracic, double or triple curves. Initial thoracic kyphosis had no effect on final bracing outcome. Curve progression, while in brace, was more commonly seen in association with Risser signs "0" to "1". The best prognostic evidence in terms of control of progression was initial reduction of over 30 percent in curve magnitude in the first post-bracing visit. A reduction in curve magnitude of less than 17 percent after the first visit was associated with poor final outcome.Conclusions: Milwaukee brace can effectively reduce and control idiopathic scoliotic curves. However, good patient selection and close follow-up is mandatory.
Ahmad Ensafdaran, MD; Amir Reza Vosoughi, MD; Mohammad Reza Ensafdaran, MD; Amir Reza Vosoughi, MD
Abstract
Background: Osteoarthritis is common especially in over 50 years of age patients. There are several non–surgical treatment modalities such as non-steroid anti-inflammatory drugs, physiotherapy, and intra-articular injection of steroids and Hyaluronic Acid. Surgical procedures include arthroplasty, ...
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Background: Osteoarthritis is common especially in over 50 years of age patients. There are several non–surgical treatment modalities such as non-steroid anti-inflammatory drugs, physiotherapy, and intra-articular injection of steroids and Hyaluronic Acid. Surgical procedures include arthroplasty, osteotomy of tibia and arthroscopic débridement. Careful selection of patients in particular, for arthroscopic débridement is a very important point.Methods: In a prospective study, 88 patients with mean age of 55.28 (55-63 years) with knee osteoarthritis who had failed non-surgical treatments were selected for arthroscopic débridement. Radiographic inclusion criteria were presence of 3-4 millimeters of joint space, less than 10 degrees flexion contracture and varus/valgus malalignment, and at least 100 degrees of flexion. The treatment results were assessed annually in 3 successive years, using Lysholm knee Scale. Seventy-four patients (43 females, 31 males) had complete follow-up and are reported here.Results: The pre operative Lysholm score of 37.2 (range: 26-55) increased to 81.9 (range: 70-90) in first year, to 82.9 (range: 70-95) by the second year and to 78.5 (60-90) in the third year (p < /em>
Hadi Hamed Azimi, MD; Behzad Narouie, MD
Abstract
Background: Clubfoot is a common congenital deformity in babies occurring in 1 in 1000 live births. The more accepted procedure in the past was surgery in severe cases. Ponseti technique is a non-surgical treatment method. We are exploring our early results in a small group of children with this method ...
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Background: Clubfoot is a common congenital deformity in babies occurring in 1 in 1000 live births. The more accepted procedure in the past was surgery in severe cases. Ponseti technique is a non-surgical treatment method. We are exploring our early results in a small group of children with this method of manipulation and casting.Methods: We reviewed 24 patients (32 feet) with idiopathic clubfoot who were initially treated with ponseti method .The severity of deformity were classified according to the Pirani score system, before and after of correction phase. Pirani severity score and result was used in a 9 months (4-14 months) average follow-up.Results: Initial correction was achieved in 31 patients (96.8%). The patients, average of Pirani score before correction was 5.53 and after correction was 0.09 (p < /em>
Afshin Heshmaty, MD; Amir Reza Sadeghifar, MD ط Sadeghifar, MD; Alireza Saied, MD; Alia Ayatollahi Moussavi, MD; Mohsen Ostovar, MD; Fatemeh Arabnejhad
Abstract
Background: The aim of the present study was to compare two methods of plating and intramedullary nailing in treatmant of closed noncomminuted tibia fractures with intact fibulae.Methods: Utimately 69 patients were followed for at least one year. The patients were randomly devided into two groups of ...
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Background: The aim of the present study was to compare two methods of plating and intramedullary nailing in treatmant of closed noncomminuted tibia fractures with intact fibulae.Methods: Utimately 69 patients were followed for at least one year. The patients were randomly devided into two groups of plating and intramedullary nailing and operated on.Results: One case of non:::union::: and one case of superficial infection occurred in the intramedullary group. One of the patients in the intramedullary group developed late deep infection in the screws location (in both cases p < /em>>.05). In both of the groups the tibia fractures reached :::union::: in about 4 months, though the intramedulary group had underwent more operations for :::union::: achievement (dynamization in 4, 12.1%, p < /em>≥.05). The need for implant removal was not statistically significant in the two groups (p < /em>≥.05). Of the other variables, the diffence between the two groups was statistically significant only with regard to their complaints of the limb and the number of individuals with knee pain (p < /em>
Abstract
Background: Tea consumption and exercise loading may have favorable effects on risk of osteoporosis. However, effects of tea plus exercise training on bone density are not clear. The aim of this study was to clarify the influence of combined treatment with tea extract and treadmill exercise on bone mineral ...
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Background: Tea consumption and exercise loading may have favorable effects on risk of osteoporosis. However, effects of tea plus exercise training on bone density are not clear. The aim of this study was to clarify the influence of combined treatment with tea extract and treadmill exercise on bone mineral density in middle-aged rats.
Material and Method: Forty male Wistar rats (14 weeks old) were randomized into four groups: control, sham, exercise training and tea plus exercise training. Rats in the exercise groups were participated in a running exercise program (1 h/day, 5 times/ week for 8 weeks). Tea extract were intraperitoneally injected by 0.3 mg/kg. Body composition and bone mineral density of the whole body were assessed by dual-energy X-ray absorptiometry at baseline and after intervention. Data were analyzed using SPSS software using ANOVA and post hoc Tukey test.
Results: Running on treadmill significantly increased femur bone mineral density in rats compared to control group (P=0.04). On the other hand, it was observed that exercise plus tea consumption increased bone mineral density in whole body (P=0.01) and femur (P=0.03) of middle aged rats.
Conclusion: Tea enhanced the bone response to mechanical loading and a synergistic effect was observed in a rat model.
Kamran Mozafarian; Sousan Andalibi; Hamidreza Zemoodeh
Abstract
Background: Flexor and extensor
tendon laceration is very common. The evaluation of these injuries may help to
highlight the problem and put an end to missed diagnosis and mismanagement of
these injuries. Methods: In a retrospective
study, 852 patients who have been operated during one year (March ...
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Background: Flexor and extensor
tendon laceration is very common. The evaluation of these injuries may help to
highlight the problem and put an end to missed diagnosis and mismanagement of
these injuries. Methods: In a retrospective
study, 852 patients who have been operated during one year (March 2011 to March
2012) in a training hospital in Shiraz, Iran were evaluated. Results: The 16-30 years old
men were mostly affected. Flexor tendon injury was more common in zone IV and
extensor tendon laceration in zone V. Associated nerve and/or arterial lacerations
were detected in 22.6% patients. Digital nerve was the most commonly injured nerve
followed by ulnar nerve. Radial or ulnar artery lacerations were seen in 6.1%
of the patients. Conclusions: Digital nerve is the
most commonly injured nerve and should be examined precisely. The high number
of affected patients in short period and the
possibility of missed diagnosis by non orthopaedic physicians may signify the
importance of termination of mismanagement of these injuries by general
practitioners and specialists other than orthopaedic surgeons.
Mahmood Karimi Mobarakeh; Mohsen Mardani Kivi; Sohrab Keyhani; Hadi Safaee
Abstract
Background: High tibia osteotomy remains an acceptable method for prevention of medial comportment knee osteoarthritis. The conventional technique is a closing wedge osteotomy. We planned to study short-term results of a medial open wedge high tibia osteotomy using T-Buttress plate and a metal wedge. ...
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Background: High tibia osteotomy remains an acceptable method for prevention of medial comportment knee osteoarthritis. The conventional technique is a closing wedge osteotomy. We planned to study short-term results of a medial open wedge high tibia osteotomy using T-Buttress plate and a metal wedge. Methods: In this case series study, 60 patients (76 knees, 27 male and 33 female) underwent an open wedge high tibia osteotomy surgery using a T-Buttress plate and a metal wedge in a in a teaching hospital in Kerman-Iran. Patients were assessed clinically and radiographically including Modified Hospital for Special Surgery Knee Scoring System (HSSKS), anatomical and mechanical limb alignment, Insall-Salvati patellar height index and proximal tibia posterior slope angle. Results: The mean tibia-femoral angle changed from -6.8 to +4.33 degrees. 26(43.3%) patients needed iliac cancellous graft. The mean metal wedge size was 11.07 mm (8-15 mm). The mean Modified HSSKS promoted from 75.5 to 98.73. The observed complications were: fracture in five, intraarticular screw penetration in four (one in proximal tibia-fibular joint), infection in two and under-correction in one patient. There was no non-:::union:::, proneal nerve injury, over-correction, plate failure, deep vein thrombosis and bone graft donor site complication. The mean posterior tibia slope changed from 8.05±1.95 to 8.68±1.54 degrees and patellar height index changed from 1.06 to .97. Conclusion: This procedure is a safe and reliable technique and lessened the need for an autograft. Significant improvement in score of Modified HSSKS was seen post operatively.
Babak Siavashi, MD طSiavashi, MD; Abbas Abdoli Tafti, MD; Mohammadreza Golbakhsh, MD; Mir Mostafa Sadat, MD; Mohammad Javad Zehtab, MD; Dariush Gouran Savadkoohi, MD
Abstract
Background: Femoral neck non:::union::: could be a disaster in young and middle age patients. Conventional valgus osteotomy of femur is done without freshening of non:::union::: site. We would like to report our experience with valgus osteotomy of hip after freshening of the non:::union::: site.Methods: ...
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Background: Femoral neck non:::union::: could be a disaster in young and middle age patients. Conventional valgus osteotomy of femur is done without freshening of non:::union::: site. We would like to report our experience with valgus osteotomy of hip after freshening of the non:::union::: site.Methods: In a case-series study, from all young and middle-aged patients with non:::union::: femoral neck fracture who were treated with freshninig of non:::union::: site and valgus ostetomy, 22 patients (18 males, 4 females) with mean age of 34 (20-47) entered the study. There were 10 broken implants in the heads with a one year follow-up. The cases were evaluated for :::union:::, necrosis and also changes in Harris hip scores.Results: Preoperative Harris hip score was 63 and postoperative score increased to 89. The neck shaft angle was reached about 150 degrees. In 2 cases necrosis developed and in 3 cases collapse of neck occurred with intrusion of implant into the joint and the implants were removed immediately. Mean time to :::union::: was 4.5 months.Conclusion: Freshening of non:::union::: site before valgus osteotomy in non:::union::: femoral fracture produces high :::union::: rate with low complications.
Reza Shahryar Kamrani; Ehsan Vahedi; Behnam Panjavi
Abstract
Abstract
Scapholunate interosseous ligament injuries are common important conditions which include a wide range of pathologies in wrist joint. A lot of factors have significant role on clinical course or stage of disease. Treatment protocol depends on the stage of disease. Partial vs complete ...
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Abstract
Scapholunate interosseous ligament injuries are common important conditions which include a wide range of pathologies in wrist joint. A lot of factors have significant role on clinical course or stage of disease. Treatment protocol depends on the stage of disease. Partial vs complete lesion, reparability, radioscaphoid angle, radiolunate angle, reducibility and degenerative changes are modifiers of disease stage. Re-education and strengthening of supinator muscles, percutaneous pinning, arthroscopic debridement, open repair, capsulodesis, screw fixation and ligament reconstruction with local tendons are common treatment options used for scapholunate injuries. In this article we will review the stages of disease as well as the various treatment options. Some case series related to each treatment options will be discussed.
Hossein Aslani; Ali Sadighi; Ahmadreza Mirbolook; Ali Tabrizi; Nilsa Dourandish; Seyyed Amir Mahlisha Kazemi Shishavan
Abstract
Backgroud : Most pediatric open long bone fractures are the results of high energy trauma, and can lead to complications. The aim of this study is to compare the results of two commonly used operative techniques for tibial or femoral fractures namely external fixator and flexible intrameduly rods. Methods: ...
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Backgroud : Most pediatric open long bone fractures are the results of high energy trauma, and can lead to complications. The aim of this study is to compare the results of two commonly used operative techniques for tibial or femoral fractures namely external fixator and flexible intrameduly rods. Methods: In this clinical series, 42 children with 45 femoral or tibail open fractures from 2009 to 2011 who were treated by either external fixator (EF) (24 cases) or TEN (21 cases) were compared. In few cases combination of TEN and pin were used for more stability. The patients were evaluated and compared for infection, non:::union:::, mal:::union::: and refracture. Results: Bony :::union::: in the EF group was achieved in 3.8 months and in TEN group in 3.6 months (p < /i>≥.05). In each group, 2 fracture-site infections without any evidence of osteomyelitis was obsereved. Five pin site infection in EF group needed changing the pin site. In TEN group early nail removal was necessary because of painful bursitis in one case at nail insertion site. There were 4 femoral refractures in EF group after frame removal. In 10 patients with TEN and extra pin no symptom or problem was seen. Conclusions: In our study EF was effective as a definitive treatment. Flexible intramedullary nails were also effective and their results were similar to those of EF. Combination of TEN and pin caused more stability without any symptoms.
Mohammad Karim Golnari, MS; Amir Hossein Kahlaee, PhD; Abbas Rahimi, PhD; Seyyed Mahdi Tabatabaee, Ms; Jandark Eghlidi, MS; Ali Asghar Jamehbozorgi, MS
Abstract
Background: Hallux valgus is one of the most prevalent deformities which causes changes in the center of pressure (COP) and standing balance. This paper looks at the mechanical changes of spacer pads used for such a deformity.
Methods: In this quasi experimental study, 24 people suffering from hallux ...
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Background: Hallux valgus is one of the most prevalent deformities which causes changes in the center of pressure (COP) and standing balance. This paper looks at the mechanical changes of spacer pads used for such a deformity.
Methods: In this quasi experimental study, 24 people suffering from hallux valgus were reffered to a trainig hospital in Tehran, Iran. A Bertec force plate was used to collect data related to COP parameters. The balance tests of TUG and FR were used to evaluate the changes in balance. The tests were done without and with toe spacers in a 15 second period of time and the COP displacement in anteroposterior and mediolateral directions and also the path length of COP displacement, velocity of COP displacement and confidence ellipse of the COP were measured. The data were analyzed using statistical tests.
Results: Using the toe spacers did not cause a significant change in displacement of COP in anteroposterior and mediolateral directions, confidence ellipse, velocity of COP displacement and the path length of COP displacement (p < /em>≥.05). But the change in the results of FR and TUG tests was significant (p < /em><.05).
Conclusions: Using the toe spacers in hallux valgus causes no significant changes in COP displacement, path length, velocity and confidence ellipse, but shows improvement in results of balance tests in elderly suffering from hallux valgus deformity.
Mohammad Fakour; SH Mousavi; S Hatami
Abstract
Abstract
Background: Total knee arthroplasty (TKA) is widely used as an effective treatment for end-stage osteoarthritis and other knee diseases to relieve pain and improve quality of life. While the benefits of TKA are reduced pain and an improved function there are also risks, such as hemorrhage, ...
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Abstract
Background: Total knee arthroplasty (TKA) is widely used as an effective treatment for end-stage osteoarthritis and other knee diseases to relieve pain and improve quality of life. While the benefits of TKA are reduced pain and an improved function there are also risks, such as hemorrhage, thromboembolic events, infection and the need for additional surgical procedures. Tranexamic acid (TXA) is effective in reduction of hemorrhage after such major surgical procedure. Abundant literature confirms that intravenous (IV) and intra-articular (IA) administration of tranexamic acid (TXA) reduces blood loss in total knee arthroplasty (TKA).
Methods and Material:The study is a retrospective cross-sectional study of 152 male and female patients aged 45 to 85 years who underwent Total knee replacement. They were divided into two groups.72 patients received tranexamic acid during the operation and 80 patients did not.
Hemoglobin, transfused packed cell, hospital time, Visual analogue pain scale, Knee range of motion and cardiovascular accident were determined and compared between the two groups.
Results: Comparing the result of hemoglobin drop, post op hemoglobin, transfused packed cell and hospital stay time showed significant difference between experimental and control group when pre op hemoglobin, range of motion, VAS score for pain measurement and cardiovascular effects were not significantly different.
Conclusions: We found that the administration of tranexamic acid can reduce the complications of knee replacement surgery due to bleeding, as well as decreasing the need for blood transfusion. In addition, the administration of tranexamic acid can reduce the length of hospital stay after knee replacement surgery; that in turn significantly reduces the cost of hospitalization.
