Reza Shahryar Kamrani, MD; Ahmad Mohebbi Ashtiani, MD; Shayan Abdollah Zadegan, MD; Mohammad Hossein Nabian, MD; Masoumeh Firouzi, PhD
Abstract
Background: Electroporation of cells for cancer ablation has gained popularity. The aim of this study was to evaluate the effect of electroporation in nerve injury and neuroma formation.Methods: In an experimental study, the sciatic nerves cut in 38 rats and the repair was studied by dividing them in ...
Read More
Background: Electroporation of cells for cancer ablation has gained popularity. The aim of this study was to evaluate the effect of electroporation in nerve injury and neuroma formation.Methods: In an experimental study, the sciatic nerves cut in 38 rats and the repair was studied by dividing them in 3 groups each group receiving a different treatment. Sixteen rats received electroporation, 16 received end-to-end repair, and 6 “control” rats received no electroporation. The repair and possible formation of neuroma was evaluated by light-microscopy and the function of the nerve was assessed with sciatic functional index (SFI).Results: Complete nerve injury was demonstrated by SFI in the 3 groups, in the first-week evaluation. After 2 weeks, significant recovery of function was seen in the electroporation group and in 4 weeks it was similar to control group. This group reached normal SFI in 5 weeks. The cut and repaired group never reached a normal SFI.Conclusions: The electroporation in the sciatic nerve of rat produces complete functional improvement after nerve injury and possibly could be useful for treating symptomatic neuromas.
Marzieh Ebrahimi; Amin Bigham-Sadegh; Iraj Karimi; Farzaneh Hosseini
Abstract
Background: Bone grafts have been used to stimulate the fracture healing in orthopaedic surgery. Allograft and xenograft are more used because of auto graft use problems. Royal jelly is the principal food source of the queen honey bee. Royal jelly has pharmacological activities such as anti-bacterial, ...
Read More
Background: Bone grafts have been used to stimulate the fracture healing in orthopaedic surgery. Allograft and xenograft are more used because of auto graft use problems. Royal jelly is the principal food source of the queen honey bee. Royal jelly has pharmacological activities such as anti-bacterial, antioxidant, antitumor and anti-inflammatory effects. This research was designed to evaluate the effects of royal jelly on bone healing and restoration in the rabbit model.Materials and Methods: In this study, we used 10 New Zealand white rabbits with an approximate weight of 2 kg. They were divided into two groups (N=5) midradius bone defect created and filled with royal jelly and in the second group (N=5) the defected filled with nothing. The radiological evaluation performed on days 14th, 28th and 42nd after the operation. Histopathological evaluation was done on 42 days after the operation.Results: Radiological result has not shown the significant difference in days 14th and 42nd (p>0.05) and only on day 28, there was a meaningful division (p<0.05). There was no significant difference between the two groups in histopathological evaluation.Conclusion: This study indicates using of royal jelly could accelerate bone healing process in rabbit and has the potential for use in medicine.
Mohammad Gharedaghi; Alireza Hootkani; Ali Moradi; Tamara Tamamgar
Abstract
Background: The final diagnosis of the tumors depends on the biopsy and the pathology result. The musculoskeletal tumor biopsy can be performed either by core needle biopsy or by open biopsy technique. The procedural cost is lower and the technique is simpler in core needle biopsy, but tissue sample ...
Read More
Background: The final diagnosis of the tumors depends on the biopsy and the pathology result. The musculoskeletal tumor biopsy can be performed either by core needle biopsy or by open biopsy technique. The procedural cost is lower and the technique is simpler in core needle biopsy, but tissue sample may not be enough. In this study, we will compare the results of core needle biopsy with open biopsy in musculoskeletal tumors. Methods: In a prospective study, 75 patients with skeletal lesions were scheduled for open biopsy. A needle biopsy was also done before starting the operation in the same operating session. The pathology reports of core needle biopsy and open biopsy were then compared. The final pathology report following the definitive surgery was also compared with either of those two biopsy techniques. Results: The diagnostic accuracy of core needle biopsy for skeletal tumors was 77.2%. The value for benign tumors was 69.2%, for primary malignant tumors 82.7%, for tumor-like benign lesions 50%, and for metastatic tumors 100%. The accuracy of open biopsy was 100% for all tumors. Conclusion: Needle biopsy is an accurate and low cost method for diagnosis of skeletal tumors, but possibility of failure is present in very few cases.
Mohammad Fakoor, MD; Shahnam Moosavi, MD
Abstract
Background: Treatment of femoral shaft fracture in children depends on age and condition of patient, and may consist of spica casting, traction followed by casting, external fixator, plate fixation and intramedullary nailing. Leg length discrepancy is a common complication after this fracture. Growth ...
Read More
Background: Treatment of femoral shaft fracture in children depends on age and condition of patient, and may consist of spica casting, traction followed by casting, external fixator, plate fixation and intramedullary nailing. Leg length discrepancy is a common complication after this fracture. Growth stimulation following this fracture has been known for years but precise cause remains unknown. This is a report on leg length discrepancy obsereved in a group of younger children who had been treated with casing, and an older group who received plate fixation for their femoral shaft fractures.Methods: In a cross sectional study, 233 children under 12 years with femoral shaft fracture who had been treated between years 1993 and 1997 in two hospitals in Ahvaz-Iran, were studied. Patients were studied in two groups of surgery or plate fixation (125 patients) and non-surgery or casting (108 patients). With a mean follow of 49 months (22-82 months) clinical and radiographic evaluation of leg lengths was performed, and possible factors responsible for discrepancy were assessed.Results: The mean leg length discrepancy in plate fixation was 6.6 mm, and with casting was 1.93 mm. Gender or side of fracture had no significant relationship with post treatment leg length discrepancyConclusion: Leg length discrepancy is more likely to be observed in childrens' femoral fractures treated with plate fixation. The discrepancy, however, is not a significant amount.
Mohammad Fakor; S Shahnam Mousavi; Payam Mohammad Hosseini; Mohsen Saeidi Garaghani
Abstract
Background: Anterior cruciate ligament (ACL) is one of the key ligaments that help stabilize the knee joint. Considering the high rate of ACL ruptures, especially in athletes, reconstruction of this ligament is of paramount importance. The present study aimed to compare the level of function improvement ...
Read More
Background: Anterior cruciate ligament (ACL) is one of the key ligaments that help stabilize the knee joint. Considering the high rate of ACL ruptures, especially in athletes, reconstruction of this ligament is of paramount importance. The present study aimed to compare the level of function improvement and satisfaction of patients with ACL reconstruction by two-stranded and four-stranded hamstring autografts (HAs) with the diameter above six millimeters.
Methods: In total, 60 patients with ACL ruptures, who referred to healthcare centers in a four-year period (2013-2017) and underwent arthroscopic ACL reconstruction via two-stranded and four-stranded HAs, were called to the clinic to assess their satisfaction with the surgery, time to return to unrestricted sports and work activities, the number of postoperative physiotherapy sessions, postoperative complications, range of motion of the injured knee after the surgery, and Lysholm score. Moreover, data analysis was performed using independent sample t-test.
Results: In this study, both groups were homogenous in terms of the evaluated parameters. In addition, the four-stranded and two-stranded HA groups had excellent and good grades, respectively, and their mean Lysholm scores were 91.05 and 88.98, respectively. While significantly different lysholm scores were obtained by the groups, no significant difference was observed between the research groups with regard to a slight numerical difference between the two means (P=0.585).
Conclusion: According to the results of the study, no significant difference was observed in the functional and clinical outcomes of the participants, thereby confirming the equal effectiveness of the two-stranded and four-stranded HAs in arthroscopic ACL reconstruction. It seems that both surgery methods, provided that the graft diameter is equal to or above six millimeters, will have a similar success rate with close acceptable results.
Fatemeh Farshidi; Nasser Fatouraee; Soheil Mehdipoor; Mahmood Borhan Shams
Abstract
Background: The knee anterior cruciate ligament (ACL) rupture is one of the common damages among athletes. To compensate for ACL deficiency, ligament reconstruction is done to recreate the function of ACL. The aim of this study was to investigate the effect of single bundle and double bundle ACL reconstruction ...
Read More
Background: The knee anterior cruciate ligament (ACL) rupture is one of the common damages among athletes. To compensate for ACL deficiency, ligament reconstruction is done to recreate the function of ACL. The aim of this study was to investigate the effect of single bundle and double bundle ACL reconstruction on the compression stresses of menisci. Methods: We simulated 4 cases with geometrical modeling: intact knee sectioned ACL, single and double bundle ACL reconstruction. We then built a three dimensional finite element geometrical model of knee from MRI images of normal knee. First, the bone and soft tissue points cloud models and then the geometrical models were built. The bones were modeled as rigid bodies, articular cartilage, menisci as linear elastic and ligaments as nonlinear springs. The loading condition was application of a 50 N anterior load to tibia. Results: The maximum compression stress was similar to intact knee and was lower than two reconstruction cases. Distribution of compression stress wasn’t similar to intact knee but in reconstruction cases, it was similar. The contact areas in intact knee were higher in lateral section, while in reconstructed knees were higher in medial section of the knee. Conclusions: ACL removal changes the distribution of compression stress of menisci in comparison with intact knee, single bundle and double bundle reconstruction. Furthermore evaluating contact areas in these four cases showed that removing the ACL may lead to decrease in the contact area but reconstruction may compensate for this.
Alireza Saied, MD; Mohammadreza Baneshi, PhD; Afshin Heshmaty, MD; Amir Reza Sadeghifar, MD; Saman Ghiassi; Ali Okati, MD
Abstract
Background: There have been investigations on the effect of absence or presence of Palmaris longus tendon on pinch and grip strength of the hand. In the same way the effect of presence of fifth superficial flexor digitorum on grip strength of the hand has been investigated. The aim of the present study ...
Read More
Background: There have been investigations on the effect of absence or presence of Palmaris longus tendon on pinch and grip strength of the hand. In the same way the effect of presence of fifth superficial flexor digitorum on grip strength of the hand has been investigated. The aim of the present study was to assess the combined effect of these anatomical variations on pinch and grip strength.
Methods: In a cross sectional study, 1046 hands in 523 volunteers were enrolled. Each hand was assessed for the presence or absence of palmaris longus tendon and also variations of fifth superficial flexor digitorum function. Then the grip and pinch power of the hands were measured with Jammar Dynamometer.
Results: Presence or absence of Palmaris longus had no effect on grip strength of the individuals. In the same way, variations of fifth superficial flexor digitorum function had no effect on the grip and pinch strengths. But the positive and statistically significant effect of presence of palmaris longus on pinch strength (25.38 in hands with palmaris present v/s 24.43 in hands without it) was evident (p < /em>=.03). Grip and pinch powers were higher in men compared to women (p < /em><.0001) and in right compared to left hands (p < /em>=.013).
Conclusions: Based upon the findings of the present study, it seems that absence of palmaris longus tendon is associated with a reduction in pinch strength, but has no effect on grip strength and the variations of fifth superficial flexor digitorum have no effect on pinch and grip strengths.
M Seifi; A Ghomeishi; Sh Khoshnam; Y Khorami; M Bouazar
Abstract
Background: Different medicines are utilized in giving nerve block. The different drugs are usually discussed concerning efficacy and persistence of pain relief. The present study aimed to compare the use of lidocaine alone with granisetron/lidocaine combination in terms of the efficacy and persistence ...
Read More
Background: Different medicines are utilized in giving nerve block. The different drugs are usually discussed concerning efficacy and persistence of pain relief. The present study aimed to compare the use of lidocaine alone with granisetron/lidocaine combination in terms of the efficacy and persistence of the analgesic effect, in the axillary block used in patients requiring elbow or below elbow surgery. Methods: A double-blind randomized clinical trial was performed on 90 patients who were candidates for elbow surgery. In this regard, an ultrasonography-guided axillary block was performed by a linear transducer using a short-axis in-plane technique. The first group was given lidocaine, whereas the second group received granisetron/lidocaine combination. First, five mg/kg of lidocaine %0.5 was diluted to 40 ccs with 0.9% saline. In the first group, 40ml of lidocaine solution was injected after dipping the syringe in epinephrine. In the second group, 2 mg of granisetron was injected simultaneous with lidocaine solution.Results: In total, 90 patients entered the study and were divided into two equal groups of 45. The mean age of the patients was 34.48±9.0 years (18-58 years). 61 (67.8%) participants were male and 29 (32.2%) female. The onset time of sensory and motor block in the second group (granisetron/lidocaine combination) was significantly lower, compared to the lidocaine -alone group . Moreover, the continuity of sensory and motor block was significantly higher in the second group. Furthermore, the first analgesic requirement time was significantly lower in the granisetron/lidocaine combination group, compared to the lidocaine- alone group (P<0.001).Conclusion: The concomitant use of granisetron with lidocaine improved all pain indicators and also led to faster and more continuous sensory and motor blocks .
Seyed Mohammad Jazayeri, MD; Gholamhossein Kazemian, MD; Gholamhossein Kazemian, MD; Farivar Abdollahzadeh Lahiji, MD; Hamid Hesarikia, MD
Ehsan GhobadiHa; Mohammad Nikkhoo; Sadegh NaserKhaki
Abstract
Background: About 80% of the population will experience back pain in their lifetime; however, although many patients have low back pain associated with disc degeneration, the exact course of degeneration is still unclear. The disc degeneration disorder has affected one-third of the world's young population. ...
Read More
Background: About 80% of the population will experience back pain in their lifetime; however, although many patients have low back pain associated with disc degeneration, the exact course of degeneration is still unclear. The disc degeneration disorder has affected one-third of the world's young population. During degeneration, the disc undergoes morphological and biochemical changes, which in turn alter the tissue hydration, permeability, and ultimately the load-bearing capacity of the disc. Therefore, the finite element model, designed to study the relationship between frequent loading and disk degeneration, must be able to analyze the complex loading in the in-vivo conditions. The aim of this study was to construct and update models of finite element components with the prolastic properties so that different quasi-static loads could be investigated by presenting a personalized model in different individuals and applied in clinical studies to simulate the daily biomechanical behavior for accurate diagnosis and treatment.Method: This study simulated three different modes of finite element modeling, including axial symmetry method, parametric model and precision model with poroelastic mechanical properties and its results were compared with experimental in-vivo experiments.Results: To validate the constructed models, the results of three different quasi-static creep experiments were performed, including short-term creep, long-term creep and creep under regular daily activities, the results of which predicted changes. The results predicted height changes, axial displacement of the spine and the intradiscal pressure of the nucleus.Conclusion: All the proposed results indicated that the models presented in quasi-statistic behavior predicted acceptable results and have sufficient validity to be examined in other quasi-statistic experiments. Therefore, it is possible to take a step forward in examining the results of clinical activities in determining the process of intervertebral disc degeneration.
Amin Bigham-Sadegh, PhD; Iraj Karimi, PhD; Mohammad Shadkhast, PhD; Mohammad Hossein Mahdavi, DVM
Abstract
Background: Synthetic hydroxyapatite (HAP), beta-tricalcium phosphate (ß-TCP) and their composite are promising biomaterials specifically in the orthopaedic and dental fields, as their chemical composition is similar to that of bone. Due to the need for safer bone graft applications, these bone graft ...
Read More
Background: Synthetic hydroxyapatite (HAP), beta-tricalcium phosphate (ß-TCP) and their composite are promising biomaterials specifically in the orthopaedic and dental fields, as their chemical composition is similar to that of bone. Due to the need for safer bone graft applications, these bone graft substitutes are gradually gaining increased acceptability. The purpose of this study was the evaluation of concurrent use of hydroxyapatite with demineralized calf foetal growth plate (DCFGP) effects on bone healing process.Methods: Mid radii bone defect was created in fifteen female New Zealand white rabbits. They were divided into 3 equal groups: In group I the defect filled with DCFGP, in group II was with hydroxyapatite and DCFGP, and in group III with hydroxyapatite alone. Radiographic and histopathologic evaluations were performed blindly and results scored and analyzed statistically.Results: There was a significant difference in bone formation and remodeling at the 56th post-operative day (p < /em>=.03). Group II was superior to group I and III. Histopathologic evaluation revealed significant difference between group II with group I and III.Conclusions: The combination of osteoconductive effect of hydroxyapatiter and osteoinduction of DCFGP will lead to superior bone healing process in comparison with any of those agents when used alone.
Ali Akbar Esmailiejah, MD طEsmailiejah, MD; Ali Akbar Esmailiejah, MD طEsmailiejah, MD; Manoochehr Vahid Farahmandi, MD; Mohammadreza Abbasian, MD; Ali Moazamipour, MD; Farshad Safdari, MSc
Abstract
Background: Forefoot fractures are the most common orthopaedic injuries. In this study the outcomes of nonoperative treatment of forefoot fractures using off-loading shoes was studied and compared with those of casting.Methods: In this case-control study, 60 patients with forefoot fractures in two hospitals ...
Read More
Background: Forefoot fractures are the most common orthopaedic injuries. In this study the outcomes of nonoperative treatment of forefoot fractures using off-loading shoes was studied and compared with those of casting.Methods: In this case-control study, 60 patients with forefoot fractures in two hospitals in Tehran, Iran, who were not surgical candidates, were divided into two treatment groups: casting and off-loading shoe. The rate of bone healing was investigated. Also, patients' satisfaction and the pain severity were measured before and after treatment. The AFAOS (American Orthopaedic Foot and Ankle Society) was completed. The treatment results were compared between the two groups. The patients were followed for 36.5±4.2 days in group C and 33.3±4.7 days in OS group (p < /em>≥.05). Results: Clinical and radiolographic success were achieved in all of the cases and all the patients returned to their previous activities. At final visit, the pain intensity was as follows: 5.4±1.4 in group C versus 5.9±1.1 in group OS (p < /em>≥.05). The AOFAS was 92.3±14.7 points in group C and 94.5±12.3 in group OS Two patients developed skin problems and another one developed symptoms of deep venous thrombosis, all in group C. Conclusions: Off-loading shoes are suitable tools to treat forefoot fractures. Although no significant difference was found between the two groups, but due to satisfactory outcome and lack of complication, off-loading shoes are recommended in non-operative treatment of forfoot fractures.
Hossein Akbari Agdam; Mohammadreza gholamrezaei; Paria Rouhi; Amirhosein Farrokhzad
Abstract
Background: There is increasing trend of orthopaedic surgeons for closed pinning of type II supracondylar fractures. In this study, the result of treatment of closed reduction and casting in comparison with pinning is evaluated.Method: In a retrospective cross-sectional study, 39 children aged 3-11 years ...
Read More
Background: There is increasing trend of orthopaedic surgeons for closed pinning of type II supracondylar fractures. In this study, the result of treatment of closed reduction and casting in comparison with pinning is evaluated.Method: In a retrospective cross-sectional study, 39 children aged 3-11 years with Gartland type II supracondylar fracture who were treated with closed reduction and pinning were compared with closed reduction and casting by using demographic information and measurement of Baumann’s angle, and in hospital stay, by easy non-random sampling method and in 4 weeks follow-up.Result: By using the independent sample T-Test, there was a significant difference between the time duration of hospital stay and type of treatment and it was significantly lower in the group who had undergone treatment with closed reduction and casting [p value < 0.005, Mean, SD: 37.43 +- 6.42]. There was no significant difference between the Baumann’s Angle in the two groups.Conclusion: No significant difference in the radiographic outcome of the two types of treatment was observed after four weeks of follow-up.
Seyed Abdolhossein Mehdinassab, MD; Nasser Sarrafan, MD; Behzad Pedarpoor, MD
Abstract
Background: Tibial shaft fracture is one of the most common fractures in the lower limb which, in the case of displacement or instability, may need internal fixation. The aim of this study was to compare the results of plating and intramedullary nailing (IMN) for the treatment of closed tibial shaft ...
Read More
Background: Tibial shaft fracture is one of the most common fractures in the lower limb which, in the case of displacement or instability, may need internal fixation. The aim of this study was to compare the results of plating and intramedullary nailing (IMN) for the treatment of closed tibial shaft fractures.Methods: In a prospective study, 106 cases of closed tibial shaft fractures admitted to two of the teaching hospitals of Ahwaz, during a 15 months period, were treated alternatively with plating or intramedullary rod fixation. The :::union::: and complication rates were compared with a 12-months follow-up.Results: From 50 cases treated by intramedullary rod and 56 who received plating, 48 (96%) and 52 (92.9%) patients respectively achieved :::union:::. Non-:::union::: was observed in 4% of intramedullary rod, and 7.8% of plate fixation cases. The infection rate in the plated tibias was significantly more than the intramedullary fixation cases (p < /em>=.034). The rodded cases had a shorter time to :::union::: than the plated ones (p < /em>=.006).Conclusion: :::union::: of closed tibial fracture is similar whether fixed by intramedullary rod or plate. A higher infection rate and a slower time to :::union::: are, however, to be expected with plating.
Mohammad Ali Hosseinian; Tooraj Salimi
Abstract
Background: Fibrin glue can be used for nerve repair. This study is to evaluate the repair of severed sciatic nerve in rats done by fibrin glue, comparing with an untreated group. Methods: In an interventional case series study, 18 Sprague rats had their sciatic nerve cut in the intervertebral canal. ...
Read More
Background: Fibrin glue can be used for nerve repair. This study is to evaluate the repair of severed sciatic nerve in rats done by fibrin glue, comparing with an untreated group. Methods: In an interventional case series study, 18 Sprague rats had their sciatic nerve cut in the intervertebral canal. Fourteen rats were repaired by graft-repairing of nerve using fibrin glue and single suture. Four rats were left untreated as controls. The recovery of motor function was assessed after 4 months. Results: Lower extremity muscle atrophy and absence of motor function recovery was observed in the untreated rats. Full functional recovery in lower limbs was observed in the 12 treated rats, while 2 rats walked with limp. Conclusion: The cut sciatic nerve repair in rat's spinal canal, using fibrin glue and a microsurgical suture would result in good function motor recovery of lower extremity.
Firooz Madadi, MD; Jaafar Tavakolian, MD; Arash Maleki, MD; Mehdi Rahimi, MD; Reza Zandi, MD; Mohammad Reza Bigdeli, MD
Abstract
Background: The anterior cruciate ligament is the primary structure that controls anterior displacement in the unloaded knee. Anterior cruciate ligament reconstruction may return normal functions of the knee. The aim of the present study was to compare three different femoral fixation techniques in anterior ...
Read More
Background: The anterior cruciate ligament is the primary structure that controls anterior displacement in the unloaded knee. Anterior cruciate ligament reconstruction may return normal functions of the knee. The aim of the present study was to compare three different femoral fixation techniques in anterior cruciate ligament reconstruction.Methods: In a clinical trial study, 120 patients that were candidates for ACL reconstraution were randomly divided into 3 groups of 40 individuals. The femoral fixations were by the three methods of "Aperfix", "Rigidfix" or "Endobutton". The cases were re-examined 12 months after surgery and evaluated by Lysholm score as well as with KT-1000 machine. The results were compered together for the three above methods.Results: The Lysholm score showed improvement from pre-operative values in all three techniques: From 63.21±18.59 to 90.64±9.47 in "Endobutton" group, from 65.72±18.74 to 96.22±5.35 in "Aperfix" and from 69.21±17.45 to 90.64±9.47 in the "Rigifix" group. There were 6 failures in "Endobutton", 4 in "Rigidfix" and one in "Aperfix" group. The anterior displacement tibia was 3.96±1.58 millimeters in "Endobutton", 4.28±1.48 in "Rigidfix", and 4.03±1.79 millimeters in "Aperfix" group. There was no significant difference in the operating time in the 3 groups.Conclusion: Regarding the instant stability of the graft, the "Aperfix" method seemed stranger. Further investigations with larger number of cases and longer duration of follow up are recommended.
Shafiq Shahban; Ahmed Saad; Tarek El-Gamal
Abstract
Introduction: Unstable ankle fractures are a common presentation and operative intervention has proven to improve patient outcomes. Each stage of patient management can have an impact on patient length of stay and clinical outcome. The aim of the present study is to assess how we manage the patient at ...
Read More
Introduction: Unstable ankle fractures are a common presentation and operative intervention has proven to improve patient outcomes. Each stage of patient management can have an impact on patient length of stay and clinical outcome. The aim of the present study is to assess how we manage the patient at each stage from their presentation right through to discharge, and if/how variation in practice differed significantly.
Methods: From April 2017 to December 2017, in the Heart of England NHS Foundation Trust (HEFT), we retrospectively analysed the data of 49 patients with a diagnosis of an unstable ankle fracture. The patient journey was assessed from presentation to the Emergency Department (ED) right through to discharge. Post-operative notes were also reviewed. Data was obtained through our Trauma Audit and Research Network (TARN).
Results: 49 patients had surgical fixation for their ankle fracture. Whilst in the ED, less than 50% of the patients had a radiographic diagnosis of an ankle fracture within 30 minutes of arrival.25 patients were admitted to the ward within 4 hours, with some patients having to wait more than 9 hours.27 patients (more than 50%) had their surgery within 2 days after being admitted, in comparison to 6 patients who had to wait more than 6 days for their operation. The former were found to have shorter hospital length of stay post-operatively.47 out of the 49 patients were given chemical thromboprophylaxis, all patients were advised to not weight bear for a minimum of 6 weeks, and no post-operative morbidity or mortality was encountered.
Conclusion: We found an association between early ankle fracture fixation, and reduced post-operative hospital Length of Stay (LOS).
Conflict of interest: None to declare
Seyed Aref Hosseini Faradonbeh; Nima Jamshidi, Ph.D
Abstract
Background: One of the most important challenges after vertebroplasty (VP) and kyphoplasty (KP) is the stress concentration at the junction of bone and cement which would cause not only pain, but also new microfractures or osteonecrosis. We would like to present a new concept of using hexagonal porous ...
Read More
Background: One of the most important challenges after vertebroplasty (VP) and kyphoplasty (KP) is the stress concentration at the junction of bone and cement which would cause not only pain, but also new microfractures or osteonecrosis. We would like to present a new concept of using hexagonal porous structure. This model is tested biomechanically in comparison with vertebrae treated with VP and KP.
Methods: Ten Ovine vertebrae were divided into 5 groups - 2 in each group: the groups included normal vertebrae, VP, KP and vertebrae treated by hexagonal porous structure as metal pearls (steel or brass). These vertebrae were all put under mechanical static pressure. The displacement and yield points were compared in the 5 groups.
Results: The hexagonal metal treated vertebrae showed a displacement of 5.5-6 mm before reaching the ultimate strength of 3.5-4.5 KN. This displacement for VP and KP was 2.5-3 mm. The improvement of mechanical behavior was observed in vertebrae treated by hexsgonal metal pearls compared to those treated by the VP and KP.
Conclusions: The toughness vertebrae by hexsgonal metal pearl treatment increases and this will reduce the stress in vertebral end plates and interdiscal pressure. This would reduce the chance of fracture in the adjacent vertebrae.
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 ...
Read More
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.
Majid Asadi-Shekaari; Alireza Saied; Mohammad Mahdi Molaei; Jalil Abshenas; Omid Gholipoor Bashiri; Alia Ayatollahi Moussavi
Abstract
Background: The
standard method for repair of an injured peripheal nerve is epineural repair
with separate sutures. In this article, we described a method of continuous
running epineural suturing in an animal model, and compared
it with the standard interrupted technique. Methods: In a clinical ...
Read More
Background: The
standard method for repair of an injured peripheal nerve is epineural repair
with separate sutures. In this article, we described a method of continuous
running epineural suturing in an animal model, and compared
it with the standard interrupted technique. Methods: In a clinical trial study, the sciatic nerve of 25 dogs was cut by a sharp blade
under general anesthesia. The dogs were randomly divided in 3 groups. The 10
dogs received simple interrupted suturing of the cut sciatic nerve (control
group), another 10 had continuous suturing technique, and the remaining 5 were
left unrepaired. After 6 weeks the dogs were sacrificed and the nerves were
studied by light and electron microscopy. The amount of consumed suture
material, time of repair, myelin thickness and axon diameter were examined.
Ultrastructural studies were performed to assess the degeneration and
regeneration process. Results: The time of suturing and the amount
of consumed suture material were significantly lower in the continous group (p < /i>
Seyed Mohammad Jalil Abrisham, MD; Saeed Kargar, MD; Mohammad Hossein Akhavan Karbassi, MD; Jalil Zare Mehrjardi, MD; Mohammad Reza Haji Esmaeili, MD; Atefeh Zare Mehrjardi
Abstract
Background: Mechanical articulated devices can replace the intervertebral disc in patients with chronic back degenerated pain. We would like to report our short-term experience with a disc prosthesis in a small group of L5-S1 disc degeneration.Methods: In a cohort study, 21 consecutive patients (17 males, ...
Read More
Background: Mechanical articulated devices can replace the intervertebral disc in patients with chronic back degenerated pain. We would like to report our short-term experience with a disc prosthesis in a small group of L5-S1 disc degeneration.Methods: In a cohort study, 21 consecutive patients (17 males, 4 females) with degenerative L5-S1 disc disease with over 6 months history of disabling back symptoms non-responsive to conservative treatment were treated by disc prosthesis. The mean age was 36±5.7 years (22-48 years) at surgery and the average follow-up was 11 months (13-24 months). The cases were evaluated by visual analogue scale (VAS) for pain, Oswestry disability index (ODI) for disability, and also for personal satisfaction at 3, 6, 12 and 24 months post surgery.Results: Early improvement with pain control and return to function were seen in all patients (p < /em>
Parvindokht bayat; Mahdi hamzeh tofigh; Mohadeseh rahimi
Abstract
Background: Nutritional arteries are the main source of blood supply to long bones. These foramina enable the blood vessels and nerves to pass through the cortex of the bone. The exact location and distribution of nutrient foramina are important for preventing damage to blood vessels and maintaining ...
Read More
Background: Nutritional arteries are the main source of blood supply to long bones. These foramina enable the blood vessels and nerves to pass through the cortex of the bone. The exact location and distribution of nutrient foramina are important for preventing damage to blood vessels and maintaining blood circulation during various surgical procedures. While inheritance and race are among the most effective factors in the distribution of these foramina, no relevant study has been conducted in Iran. Therefore, we aimed to evaluate this issue in Iran and find differences in comparison with other studies.Methods: This study was performed on 157 lower limb bones present in moulage hall in the school of medicine, including long bones of the femur (N=65), tibia (N=65) and fibula (N=27).Results: In this study, 39.09% of the femurs had two nutrient foramina, 90.78% of the tibia had a nutrient foramen, and 66.67% of the fibulas lacked a nutrient foramen. The location of the nutrient foramen in the femur was 95.35% at the lower two-thirds. In the tibia, the nutrient foramina were mainly in the upper third (72.15%). In the fibula, the nutrient foramina were mostly in the middle third (66.67%).Conclusion: This study provides more information on morphological and topographic anatomy of the nutrient foramina of long bones of the lower extremity. While techniques such as microvascular bone transfer have become more popular, further research is required to determine the effect of inheritance and race for an anatomical description of bone nutrition.
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 ...
Read More
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.
Iman Farhangnia; Amin Bigham-Sadegh; Sadegh Shirian; Moosa Javdani
Abstract
Background: The destruction of articular cartilage is the major cause of articular problems. The articular cartilage has little repair postertial due to lack of perichondrium and direct blood circulation. It is, therefore important to consider this phenomena in surgical treatments. One of the articular ...
Read More
Background: The destruction of articular cartilage is the major cause of articular problems. The articular cartilage has little repair postertial due to lack of perichondrium and direct blood circulation. It is, therefore important to consider this phenomena in surgical treatments. One of the articular cartilage reconstructive surgeries is using Osteo-Chondral graft. The main purpose of this research was to investigate the use of Xenogenic (calf foetal) Osteo-Chondral graft in repairing articular cartilage defect on Rabbit’s model.Methods: Osteo-Chondral pieces were prepared under aseptic condition from the joints by skin punch device and kept at a temperature of 70ºc below zero. Ten male New Zealand rabbits of one year old were randomly divided into two groups of five, as control and transplantation groups calf's fetal. The skin and joint capsule were opened by surgery and articular cartilage was exposed. After defect creation by drill, in the transplanted group an Osteo-Chondral piece was inserted in the defected area; however, in the control group the defect was created but left empty. Joint capsule and skin were sutured in both groups. During 60 days of study, radiographs were taken from rabbits of each group randomly to evaluation of osteoarthritis signs on days 14, 28 and 42. Finally all rabbits were euthanized for histopathological sampling and evaluated on day 60.Results: The result of the clinical evaluations did not show any sing of inflammation nor limping. In radiological evaluation there was no evidence of arthritis complications but showed defect filling signs in experimental group. In the histopathologic evaluations, the defect of transplanted group was filled with fibro-cartilage tissues and without any signs of graft rejection. In two samples of five specimens of transplanted group Fibrous tissue was the dominant tissue and in other two as the dominant tissue. Only in one sample of this group the integrity of the cartilage tissue was completely formed. But in the control group, the lesions were observed without any restorative tissue and only filled by red blood cells.Conclusion: The study suggests that Xenogenic Foetal Osteo-Chondral tissue is an effective tissue for repairing articular cartilage defects.
Soheil Mehdipour, MD; Sohrab Keihani, MD; Seyed Mohammad Jazayeri, MD; Mohammad Reza Abbasian, MD
Abstract
Background: Treatment of recurrent shoulder dislocation with open technique has a long successful history in orthopaedic surgery. Arthroscopic repair, however, has a much shorter history especially in Iran. This is a short-term follow-up study of such an operation in Iran.Methods: Forty patients (39 ...
Read More
Background: Treatment of recurrent shoulder dislocation with open technique has a long successful history in orthopaedic surgery. Arthroscopic repair, however, has a much shorter history especially in Iran. This is a short-term follow-up study of such an operation in Iran.Methods: Forty patients (39 males, 1 female) with recurrent anterior shoulder dislocation who had undergone arthroscopic stabilization over a two-year period were evaluated in a retrospective study. The cases had a mean age of 25.3 years, and had 15.5 months (6-30 months) average follow-up. The assessment scores were “The University of California-Los Angeles” (UCLA), “Rowe” and “American Shoulder and Elbow Society Scores” (ASES).Results: Mean Rowe score was 95.5 (77-100) with excellent scores in 32 patients, good in 4, fair in 3 and poor in one. Mean UCLA score was 33.3 (25-35), with good and excellent results in all but 4 cases. ASES was 2-3 in 3 patients, and the rest being painless and without any symptoms. Thirty six patients returned to their previous levels of activity, and achieved good results the results were fair in 3, and poor in one patient who had recurrent instability.Conclusions: Short-term results of arthroscopic repair of anterior shoulder instability are encouraging.
