Mahmood Bahari, MD; Hassan Rahimi, MD; Mohammad Gharedaghi, MD; Javad Afzali, MD
Abstract
Background: ِِDouble osteotomy of first metatarsal has been advocated as a procedure of choice for severe hallux valgus in adolescent age group. We would like to report our experience with such an osteotomy in Meshhad.Methods: Over a five year period (1999-2004), 26 feet in 17 adolescents - mean age ...
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Background: ِِDouble osteotomy of first metatarsal has been advocated as a procedure of choice for severe hallux valgus in adolescent age group. We would like to report our experience with such an osteotomy in Meshhad.Methods: Over a five year period (1999-2004), 26 feet in 17 adolescents - mean age of 15.5 years - with moderate to severe hallux valgus underwent double first metatarsal osteotomies. With a mean follow-up of 26 months, the cases were evaluated by American Orthopaedics Foot & Ankle Society Hallux Metatarso-phalangeal-interphalangeal scale (AOFAS/HMI). In this study pre and post hallux valgus (HVA), intermetatarsal (IMA), and distal metatarsal articular (DMAA) angles, and the relation between the angles and patient satisfaction were evaluated.Results: The mean angular corrections for hallux valgus (HVA), intermetatarsal (IMA) and distal metatarsal articualr (DMAA) angles were 26.65, 6.20 and 5.55 degrees respectively. Four cases could not be reached and from the remaining 13 patients, 2 cases had required second surgery for non-:::union::: and 3 cases had stiffness in MTP (metatarsophalangeal) joints. Sixteen cases reported good to excellent results.Conclusions: Double first metatarsal osteotomy for severe hallux valgus is a reasonable procedure in adolescents which maintains the correction. Non-:::union::: and first MTP joint contractures are the two main side effects.
Ahmad Shahla MD; Saeid Charehsaz MD
Abstract
Background: Combined arterial and skeletal trauma in lower limb imparts a substantially higher risk of limb loss and limb morbidity. Prompt diagnosis and rapid treatment is necessary for optimal limb salvage. The aim of this study was to evaluate the results of management of lower limb fracture, dislocations ...
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Background: Combined arterial and skeletal trauma in lower limb imparts a substantially higher risk of limb loss and limb morbidity. Prompt diagnosis and rapid treatment is necessary for optimal limb salvage. The aim of this study was to evaluate the results of management of lower limb fracture, dislocations with vascular injuries in a university hospital.Methods: 16 male patients with combined lower limb fracture, dislocations and vascular injuries were studied during a 2 year period in a prospective cross-sectional manner.Results: The mean age was 25±10.33 (15-50). More than half of the cases were 20 yr old or younger. Eleven cases had motorcycle accident. Eleven cases had 6 hour or more intervals between accident and surgery. Skeletal trauma in 7 cases was femoral, 3 cases proximal and 1 case supracondylar femoral fracture. Vascular injuries in 7 cases was popliteal, 3 cases femoral, and 4 cases tibial. The fracture treatment in 8 cases was external fixator, 3 cases internal fixation, and the rest conservative treatment. Popliteal artery and veins were repaired with resection of damaged part and autogenous reversed saphenous vein patch. Tibial vessels were repaired with end-to-end sutures.Conclusions: Amputation was done in 5 cases mainly due to long interval between accident and surgery.
Spine
Seyyed Mohammad Moein Fatemi; Mohammad Nikkhoo; Mostafa Rostami; Chih-Hsiu Cheng
Abstract
In recent years, spinal fusion surgery has become one of the most common treatments for spinal cord injuries, while the interbody cages, which replace the damaged interbody discs in the surgeries, have undergone extensive changes in design and material. These changes are quite visible, ranging from plain ...
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In recent years, spinal fusion surgery has become one of the most common treatments for spinal cord injuries, while the interbody cages, which replace the damaged interbody discs in the surgeries, have undergone extensive changes in design and material. These changes are quite visible, ranging from plain titanium cages made using the conventional manufacturing methods to customized porous titanium cages, which are made using additive manufacturing technology, or titanium-coated polymer cages. Among all the materials used in manufacturing the interbody cages, PolyEther Ether Ketone (PEEK) and titanium are the most common ones. Each of these two has its own advantages and disadvantages. Several studies have compared these two materials, mostly based on the two characteristics of subsidence and fusion rates. The present study performed a comprehensive review of the published clinical studies comparing the titanium and PEEK cages in order to make a comprehensive evaluation of these two. According to the reviewed studies, both materials had relatively similar results in subsidence rate, with no significant difference. However, it was shown that the titanium cages had a better fusion rate and subsequently were more likely to be successful in the clinical settings than the PEEK cages.
Keyghobad Ashouri; Ali Akbar Esmailijah; Farivar A Lahiji; Ali Akbar Esmailijah; Seyed Mehdi Hoseini Khameneh; Firooz Madadi; Farivar Bagheri; Mehdi Rahimi; Reza Zandi; Farshad Safdari
Abstract
Background: The prevalence of palmaris longus agenesis (PLA) has been variously reported to be from 1.5% to 64% in different ethnic groups. Finding the state of PLA among Iranian people was the aim of this study. Methods: 1008 participants were included in this descriptive study during a 6-month period ...
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Background: The prevalence of palmaris longus agenesis (PLA) has been variously reported to be from 1.5% to 64% in different ethnic groups. Finding the state of PLA among Iranian people was the aim of this study. Methods: 1008 participants were included in this descriptive study during a 6-month period in a teaching hospital in Tehran-Iran. The Schaeffer test was used to detect the presence or absence of palmaris longus. The role of gender and handedness was also assessed in PLA. Results: The prevalence of PLA was estimated at 22.8% - 10.2% agenesis on the right side, 5.9% on left side and 6.7% on both sides. The relationship between PLA and gender didn’t appear to be significant. Right handedness was seen in 90.9% of cases with PLA and 72.5% of those without PLA (p=.000, OR=3.8). Conclusion: The prevalence of PLA in Iranian people studied, were comparable to the average Caucasian values in the literature.
Amir Salari; Sadegh Saberi; Ramin Spandar; Mahmood Motamedi
Abstract
Background: The objective of this study was to evaluate the results of our experience in open reduction and internal fixation of fractures of calcaneus. Methods: In a quasi experimental study, 20 patients with mean age of 35.5 years (15-69 years) with calcaneus fracture - grade II and III- underwent ...
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Background: The objective of this study was to evaluate the results of our experience in open reduction and internal fixation of fractures of calcaneus. Methods: In a quasi experimental study, 20 patients with mean age of 35.5 years (15-69 years) with calcaneus fracture - grade II and III- underwent surgery with open reduction and fixation in a 5-year period in a training hospital in Tehran-Iran. The patients' profile, Bohler and Gysan angles before and after surgery were measured and statistically analyzed. Results: Post surgery Bohler and Gysan angles showed significant improvement (p=.000). Open surgery with internal fixation contributed to improving the angles. The questionnaire with a 4-6 months follow-up showed that the average American Orthopaedic Foot and Ankle Society (AOFAS) score and Food Function Index (FFI) score was good or excellent in 80% and fair in 20%. Overall, 7 patients had complications after surgery, which were controlled successfully painted patients have had good results after surgery. Conclusion: The results of calcaneus fractures treated with open reduction internal fixation surgery have a positive effect and are in line with previous studies.
Afshin Taheri Azam, MD; Afshin Taheri Azam, MD; Abolfazl Emamdadi, MD
Abstract
Background: Clavicle fracture, especially midshaft fractures is a common bone injury that happens after a fall onto the shoulder. It is uncommon to need surgical treatment. We would like to report on a selected group of cases that required open reduction and plate fixation.Methods: 53 consecutive adult ...
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Background: Clavicle fracture, especially midshaft fractures is a common bone injury that happens after a fall onto the shoulder. It is uncommon to need surgical treatment. We would like to report on a selected group of cases that required open reduction and plate fixation.Methods: 53 consecutive adult patients with severely displaced fresh fractures of the middle third of the clavicle, who were treated by open reduction and plate internal fixation, were studied in a one year period in Zahedan, Iran. :::union::: shoulder motion and complications were analyzed in 49 patients (29 women, 20 men) who referred for follow-up, with an average follow-up of 12 months.Results: The mean age of patients was 33.4 years (19-62 years). 48 cases (97.9%) obtained :::union::: and one case (2%) developed mal:::union::: and required corrective osteotomy. Dermatologic complications were observed in 2 cases. All the patients had full motion and function.Conclusion: Open reduction and plate fixation of severely displacement fresh clavicle fracture in well-selected cases can result into good :::union::: with minimal complications rate.
Sohrab Keyhani, MD; Arash Sherafat Vaziri, MD; Mohammad Hossein Nabian, MD
Abstract
Background: The objective of this study was to evaluate the results of repairing root and para-root radial tears of lateral meniscus during cruciate ligament reconstruction. Methods: In a retrospective study, from the 60 patients who had been treated for root or para-root injury of the lateral meniscus ...
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Background: The objective of this study was to evaluate the results of repairing root and para-root radial tears of lateral meniscus during cruciate ligament reconstruction. Methods: In a retrospective study, from the 60 patients who had been treated for root or para-root injury of the lateral meniscus from 2007 to 2011 in 3 centers in Tehran-Iran. Only 40 patients were studied with an average followe-up of 32.4 months (24-48 months). The patients were evaluated by International Knee Documentation Committee (IKDC), Lysholm and Tegner scoring systems subjectively, and by objective Lachman and McMurray tests. Results: 34 patients were operated for ACL reconstruction and 6 for ACL and PCL reconstruction and lateral meniscus tears were repaired simultaneously. On the final follow-up, all the patients had firm end-points tested by Lachman. None reported popping or clicking. The mean IKDC score was 75.25 (range: 54-92), the mean Lysholm score was 94.4 (excellent) in 22 patients and the mean Tegner score was 7.15. From the 16 patients who were professional soccer players, 14 were still playing competitively at the time of follow-up. Conclusions: The midterm results of lateral meniscus repair - at root or para-root level - in association with ACL or / and PCL reconstruction, are acceptable.
Firooz Madadi; Mahdi Bahari Mehrabani; Mohammad Ali Jalili; Farshad Safdari, MSc
Abstract
Background: The knowledge about acetabular version and angle changes in different conditions is important. The normal acetabular version may be different in various populations. We would like to report measurement of this value in a small sample of Iranains with non-orthopaedic conditions. Methods: One ...
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Background: The knowledge about acetabular version and angle changes in different conditions is important. The normal acetabular version may be different in various populations. We would like to report measurement of this value in a small sample of Iranains with non-orthopaedic conditions. Methods: One coronal pelvic CT film of 81 patients (54 male, 27 female) who had undergone CT scanning for non-orthopaedic reasons was examined in a retrospective cross-sectional study. The acetabular versions were measured and compared for different genders and different age decades. The patients were aged 41.5±14.1 years. Results: The acetabular version was 17.7±3.4 degrees (range: 8 to 32 degrees). There was no significant relationship between acetabular version and age or gender in this sample. Conclusions: The acetabular version in this Iranian group ranged from 17.4 to 19.4 degrees with 95% confidential intervals.
Mohammad Ali Hosseinian, MD; Tooraj Salimi, MD; Yalda Soleimanifard, MD; Kourosh Sheibani, MD
Abstract
Background: Thoracic oulet syndrome is treated using non-surgical or surgical approaches. Surgical treatment is necessary if non-surgical treatments fail. In this study we compared the supraclavicular and transaxillary approaches for surgery of the brachial plexus.Methods: We, retrospectively, studied ...
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Background: Thoracic oulet syndrome is treated using non-surgical or surgical approaches. Surgical treatment is necessary if non-surgical treatments fail. In this study we compared the supraclavicular and transaxillary approaches for surgery of the brachial plexus.Methods: We, retrospectively, studied 69 patients undergoing surgery to treat thoracic outlet syndrome from 2001 to 2008. Twenty six patients had bilateral thoracic outlet syndrome. Sixty three cases were operated with supraclavicular approach for the first time, 32 cases were operated with transaxillary approach for the first time, and 7 cases were reoperated with supraclavicular approach. The complications were evaluated for 24 months.Results: Pneumothorax, hemothorax, vessels injury in transaxillary and supraclavicular approach were the same but permanent and transient brachial plexus injury in transaxillay approach were more than supraclavicular approach.Conclusion: Supraclavicular approach for surgical treatment of thoracic outlet syndrome provides better access to braxial plexus and there is less need for reoperation compared to transaxillary method.
Ahmad Shahla, MD; Saeed Charehsaz, MD
Abstract
Background: Open reduction and internal fixation of intra-articular calcaneal fractures is technically difficult. Anatomical reduction is needed in order to obtain good subtalar motion and satisfactory clinical outcome. Reliable and accurate open reduction technique is needed for good results. We would ...
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Background: Open reduction and internal fixation of intra-articular calcaneal fractures is technically difficult. Anatomical reduction is needed in order to obtain good subtalar motion and satisfactory clinical outcome. Reliable and accurate open reduction technique is needed for good results. We would like to report on a modification of open reduction technique for such a fracture.Methods: A cross-sectional study on 6 male and 1 female patients, with mean age of 39±7.72 with intra-articular calcaneal fracture was performed from 2001 to 2002. The cases had articular surfacer with Bohler angles of zero degree or less. The Sander’s classification of CT images included 4 cases into type IV and 3 into type III fracture types. Open reduction using the modified technique was performed through a lateral approach. The cases were evaluated by AOFAS functional scoring system with a mean follow-up of 3 years (18-60) months.Results: All the cases were satisfied to full pre-fracture jobs and activities. The AOFAS score was 82 (good) in type IV and 89 (excellent) for type III Sander’s fractures.Conclusions: Accurate open reduction of complex intra-articular calcaneal fracture with the modified reduction technique gives good functional results.
Massoud Shayestehazar; MH Karimi nasab; M Razavi pour; S Jour Ebrahimian
Abstract
AbstractBackground: Osteoporosis is the most common bone metabolic disease. The purpose of this study was to evaluate the effect of anti-osteoporosis treatment with bisphosphonate and parathyroid on bone repair in patients with osteoporosis related fractures.Methods: This single-blind randomized controlled ...
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AbstractBackground: Osteoporosis is the most common bone metabolic disease. The purpose of this study was to evaluate the effect of anti-osteoporosis treatment with bisphosphonate and parathyroid on bone repair in patients with osteoporosis related fractures.Methods: This single-blind randomized controlled clinical trial was performed on three groups of 20 patients each (parathyroid hormone, alendronate and control) with osteoporosis fractures hospitalized in orthopedic ward of Emam Khomeini and Boali Sinaye Sari hospitals during 2016-2018. All the patients were assessed at the 4th, 8th, and 12th week in terms of union.Results: While no union was reported at the end of the fourth week, 20, 18, and 17 subjects respectively on CinnoPar, alendronate and control groups had union at the end of the eighth week. Furthermore, the complete union was achieved for all patients in the 12th week.Conclusions: According to the results of the study, no significant difference was observed in the repair of osteoporotic fractures of distal radius by alendronate and parathyroid hormone.
Mahmood Karimi Mobarakeh, MD; Mohsen Mardani-Kivi, MD; Ali Akbar Keikha, MD; Keyvan Hashemi-Motlagh, MD; Khashayar Saheb-Ekhtiari, MD
Abstract
Background: One of the common operations for lower limb mal-alignment below 50 years of age is proximal tibial osteotomy. In the open wedge technique, the superficial medial collateral ligament (MCL) usually needs to be released. This study seeks to evaluate the results of open wedge high tibial osteotomy ...
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Background: One of the common operations for lower limb mal-alignment below 50 years of age is proximal tibial osteotomy. In the open wedge technique, the superficial medial collateral ligament (MCL) usually needs to be released. This study seeks to evaluate the results of open wedge high tibial osteotomy with or without releasing MCL.Methods: In a prospective clinical trial, 59 patients with symptomatic genu varum between 16-50 years of age who were candidates of tibial osteotomy were divided into open wedge surgery with (30 patients, 40 knees) or without MCL release (29 patients, 36 knees). The outcome was studied comparing the stability in valgus, pattelar height slope of tibial plateau, and also the knee score (KSS) in a 17.4 months (3-24 months) follow-up.Results: The patients from MCL preserving group, with mean age of 26.7±9 improved their scores of 53.5±15.2 to 81.9±13.4. The cases from MCL-releasing group with mean age of 25.5±8.4 improved the score of 52.4±14.6 to 65.4+17.8. The rates of surgical complication and valgus instability were lower in MCL preserving ones, but tibial slope remained unchanged in either group.Conclusions: Both techniques lead to an improvement in the KSS score however it was more significant in MCL preserving group with lower complication and without valgus instability.
pegah khazaee nezhad; behrooz sepehri; alireza mousavian
Abstract
The foot quickly becomes a problem in diabetics, so it's important to diagnose problems and treat them early. One of these problems is the Charcot foots. Charcot problem is a type of deformity in the joint, also called neuropathic arthropathy. Because of this problem, the foot is removed from its natural ...
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The foot quickly becomes a problem in diabetics, so it's important to diagnose problems and treat them early. One of these problems is the Charcot foots. Charcot problem is a type of deformity in the joint, also called neuropathic arthropathy. Because of this problem, the foot is removed from its natural axis. To compensate for this abnormality, the surgeon removes some of the bone and places the other bones of the foot next to each other so that the foot returns to its normal position. To stabilize the bones next to each other, stabilizers such as plates on the two common surfaces of the medial and plantar or intramedullary nails are required. This study examines the biomechanical behavior of these three methods. One of the purpose of this study was to model and simulate as close as possible to the actual anatomy of the position of the study site. For this purpose, the images recorded by CT- Scan method were used by a 40-year-old woman and were transferred to mimics software to complete the geometric model. Then, the model was subjected to biomechanical analysis in abaqus19.0 software. By comparing the types of structures studied, in the nail model, more stress on the implant and less stress on the bone were observed. The plantar plate method is closer to the foot without implants in terms of maximum stress and is more suitable in this regard.
Hamidreza Arti; Javad Ebrahimi Dehghanpour; Arvin Najafi; Pejman Mansouri
Abstract
Background: The open fracture of femur and leg is one of the most common fracture of orthopedic injuries. Utilization of external fixator has worldward acceptance. Pin tract infection, neurovascular injuries, compartment syndrome are common complication of this injuries. In this research complication ...
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Background: The open fracture of femur and leg is one of the most common fracture of orthopedic injuries. Utilization of external fixator has worldward acceptance. Pin tract infection, neurovascular injuries, compartment syndrome are common complication of this injuries. In this research complication and other pitfall treatment of has external fixator insertion were studied.
Material and Method: Is this study the patients with open fracture of periarticular fracture of knee and ankle were studied. One day after surgery the neurovascular injury has studied and when patients referred for exchange of external fixator the pin tract infection has studied.After data gathering by observation and checklist they analyzed by means of independent t-test and spss20.
Results: The rate of infection was %52. The rate of neurovascular injuries was %6. The rate of compartment syndrome and vascular injury was zero and the rate of tendon injury was %5.7. In comparison between pin tract infection and neurovascular injuries and tendon injury in open and close fracture only the injury of nerve has meaningful differences( P=0/049). In our study the kind of dressing (with Betadine) and kind of pin (stainless steel) was appreciated.
Conclusion: External fixator placement for open or comminuted fractures of the femur and leg is associated with a considerable degree of pin tract infection, but neurovascular effects and complications of tendon muscle, compartment syndrome is uncommon.
Omer Ozel; DOGAC KARAGUVEN; ISMET TEOMAN BENLI
Abstract
AbstractBackground: Venous thromboembolism (VTE) increases patient's morbidity and mortality after orthopedic surgeries, and as such, prophylaxis is a routine practice after total joint replacement. Although there are many effective and safe prophylactic agents, clinical results are suboptimal. The aim ...
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AbstractBackground: Venous thromboembolism (VTE) increases patient's morbidity and mortality after orthopedic surgeries, and as such, prophylaxis is a routine practice after total joint replacement. Although there are many effective and safe prophylactic agents, clinical results are suboptimal. The aim of this study was to compare clinical and ultrasonographic results for the use of low molecule weight heparin (LMWH) and Rivaroxaban in patients undergoing total knee replacement.Methods: In a prospective cross-sectional study 325 patients were enrolled in receiving Enoxaparin or Rivaroxaban as thromboprophylaxis in their total knee replacement surgery. They had pre and post-operative doppler ultrasonography for diagnosis of thromboembolism. They were followed for a minimum of two years. The status and occurrence of VTE was evaluated . Patients were compared in terms of gender, body mass index (BMI), smoking, diabetes mellitus (DM) and previous VTE history.Results: The 325 eligible patients provided a sample of 130 (40%) male and 195 (60%) female. The average patient age (SD) was 63.2 (14.3).A total of 40 (12.3%) patients (27 on LMWH, and 13 on Rivaroxaban), had DVT at the lower extremity .15 (4.6 %) patients-11from LMWH and 4 from Rivaroxaban group had pulmonary embolism (PE). 5 patients (1.5%) -4 on LMWH, 1 on Rivaroxaban- had cerebrovascular thromboembolism. The incidence of thromboembolism was found to be similar in both prophylactic regimes. On the other hand, 2 patients (0.6%) had spontaneous retroperitoneal bleeding from LMWH group. The PE patients had history of DVT. DVT occurred in patients with risk factors of obesity, diabetes or smoking.Conclusion: There was no difference between the use of rivaroxaban and enoxaparin for thromboembolic prophylaxis in total knee replacement in terms of occurrence of venous thrombosis and PE. Long-term thromboembolic prophylactic is preferred in cases with smoking, diabetes and obesity. Patients with previous venous thromboembolism are at a high risk for pulmonary and cerebrovascular embolism. Progressive hematocrit drop should alert the surgeon towards spontaneous retroperitoneal bleeding in the patients taking enoxaparin for thromboprophylaxis after total knee replacement surgery.
Abstract
Background: Weaver-Dunn technique is one the prevalent methods for treating acute acromioclavicular joint (ACJ) dislocation. Until now, several modifications of this technique have been introduced. Regarding the drawbacks of the previous modifications and the importance of presence of an intact coracoacromial ...
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Background: Weaver-Dunn technique is one the prevalent methods for treating acute acromioclavicular joint (ACJ) dislocation. Until now, several modifications of this technique have been introduced. Regarding the drawbacks of the previous modifications and the importance of presence of an intact coracoacromial ligament (CAL), we introduced a new modification of Weaver-Dunn technique and investigated the preliminary results.
Materials and methods: There were 15 patients with acute ACJ enrolled in current study. In the modified surgical technique, the medial half of the CAL is dissected from the bone and passed through a hole made in the clavicle bone and tied on itself. Before the operation and at the last visit, CC distance was measured on both sides. At the last visit, Constant score and UCLA score were completed. The pain intensity was measured using visual analogue scale (VAS). The patients were followed for 4.2±2.6 years.
Results: Preoperatively, CC distance of injured side was significantly greater than the other side (19.5±1.6 mm Vs 7.1±0.5 mm; p<0.001). At the last visit, CC distance of the operated side was insignificantly greater than the healthy side (8.2±0.9 mm Vs 7.1±0.5 mm; p=0.318). Constant score averaged 93.3±13.2 and 95.1±10.8 for operated and healthy shoulders, respectively (p=0.118). UCLA averaged 32.6±3.3 and pain intensity was 1.4±0.8.
Conclusion: Treatment of acute ACJ dislocations using the modified technique was associated with favorable outcomes. Utilizing this method, the joint stability and function are preserved.
Abolfazl Rahimi, BSc, MSc; Mehdi Masoumi, MD; Mansoor Soroush, MD; Batool Mousavi, MD, MPH
Abstract
Background: Lower limb amputation is the most common type of amputation in veterans. The aim of the study was to assess the orthopaedic problems in war related bilateral lower limb amputees.Methods: In a cross-sectional study, 335 out of 578 survivors with bilateral lower limb amputation were assessed ...
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Background: Lower limb amputation is the most common type of amputation in veterans. The aim of the study was to assess the orthopaedic problems in war related bilateral lower limb amputees.Methods: In a cross-sectional study, 335 out of 578 survivors with bilateral lower limb amputation were assessed by three orthopaedic surgeons.Results: The mean age was 42.05±6.3 and 97.6% were male. The most common cause of amputation was land mine 89.7% (601 limbs). Both trans-tibia was the most common level of amputation 37.6% (126 people). The length of stump in about half of the survivors was short or tall. The most common orthopaedic problems were spasm of stump muscle 42.7% (281 limbs), which was followed by heterotypic ossification 11.55% (76 limbs), neuroma 10.2% (67 limbs), and inflammation 10.1% (67 limbs). About 10.9% of survivors needed stump revision.Conclusion: The study revealed that the prevalence of orthopaedic complications among the amputees was high. Regular and routine assessment, rehabilitation programs and treatment is necessary for the bilateral lower limb amputees.
Afsoon Nodehi Moghadam, PhD; Maryam Motamedi, BS
Abstract
Background: Myofascial trigger point is a tender point within a palpable taut band of skeletal muscle, with or without referred pain. The purpose of this study is to compare maximal isometric strength of upper, middle and lower trapezius muscles in healthy individuals with cases of myofascial trigger ...
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Background: Myofascial trigger point is a tender point within a palpable taut band of skeletal muscle, with or without referred pain. The purpose of this study is to compare maximal isometric strength of upper, middle and lower trapezius muscles in healthy individuals with cases of myofascial trigger point syndromes.Methods: In a case-control study, 15 myofascial trigger points-syndrome patients (mean age of 22.53 years) and 15 healthy persons (mean age of 22.46 years) were compared. Muscle strength of upper, middle and lower trapezius was measured with a digital myometer.Results: The persons with latent trigger points demonstrated a significantly lower isometric strength in upper trapezius muscles (p < /em>>0.05).Conclusions: Latent myofascial trigger points are pain free neuromuscular lesions that are associated with decreased muscular contractile efficiency.
Zahra Hassanzadeh Rostami, MSc; Mohammad Hassan Eftekhari, Ph.D; Mohammad Jafar Emami, MD; Abdolreza Rajaeefard, Ph.D
Abstract
Background: Phytoestrogens enhance bone integrity
through prevention of bone loss and stimulation of bone formation, and also facilitation
of bone healing. The aim of the present study was to evaluate the effect of vitex agnus castus extract, as a source of phytoestrogen on alkaline phosphatase and
VEGF ...
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Background: Phytoestrogens enhance bone integrity
through prevention of bone loss and stimulation of bone formation, and also facilitation
of bone healing. The aim of the present study was to evaluate the effect of vitex agnus castus extract, as a source of phytoestrogen on alkaline phosphatase and
VEGF (vascular endothelial growth factor) and also callus formation in women
with long bone fractures. Methods: In a double-blind randomized placebo
controlled trial, 32 women with long bone fracture, age 20-45 years old, were
randomly divided into the VAC (vitex agnus
castus), receiving 1 Agnugol tablet (containing 4 mg dried fruit
extract of vitex agnus castus)-daily for 8 weeks or a placebo group. Serum alkaline
phosphatase and VEGF were measured at the beginning and the end point, and also
callus formation was checked at the end of study. Results: Serum alkaline phosphatase was increased
in both groups compared to the baseline. Although the elevation of ALP
(Alkaline phosphatase) in placebo group was not significant, in treatment
group, ALP was considerably increased (p=.05). Comparison of the change of VEGF
showed that, only in VAC group, VEGF level was significantly increased (p < /i>=.01).
The callus formation which revealed the fracture healing, in VAC and control
groups was 71.4% and 53.8%, respectively. Conclusions: Treatment with vitex agnus castus extract for 2 months could enhance the VEGF
level, however, further studies are need to show the effects of vitex agnus castus extract on alkaline phosphatase
level and callus formation.
Ebrahim Ameri Mahabadi, MD; Hasan Ghandehari, MD; Mahyar Chehrazi, MD; Farshad Safdari, MSc
Abstract
Background: There are limited studies regarding the incidence of degenerative changes in asymptomatic adolescents. This study investigated the incidence of these changes in MRI and demographic factors affecting the presence of these changes.Methods: In a cross-sectional study, lumbar intervertebral disks ...
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Background: There are limited studies regarding the incidence of degenerative changes in asymptomatic adolescents. This study investigated the incidence of these changes in MRI and demographic factors affecting the presence of these changes.Methods: In a cross-sectional study, lumbar intervertebral disks of 84 asymptomatic adolescents aged between 12-18 years were evaluated using MRI in a educational training center in Tehran, Iran. The presence of degenerative changes in different levels was evaluated and demographic characteristics were compared between those with and without degenerative changes. The effects of these changes on mental and physical health were investigated using SF-36.Results: In total, 25.7% of disks were degenerated. The incidence of these changes was different in different levels. The incidence of degenerative changes was highest in L4-L5 level (45.2%) followed by L5-S1 (36.9%) and lowest in L1-L2 (5.9%). The mean of age of subjects with degenerative changes was significantly higher (p < /em>=.005). Gender and body mass index (BMI) had no effect on incidence of degenerative changes. The presence of these changes decreased the physical, mental and total score of SF-36 only at L3-L4 level, but not in other levels.Conclusions: The degenerative changes in lumbar disks occur at earlier ages and have no symptoms. These changes do not affect the quality of life. BMI has no role in development of degenerative changes in adolescents but increased age is associated with increased risk of disk degeneration.
Alireza Hootkani; Ali Moradi; Ehsan Vahedi; Hamideh Feiz Disfani
Abstract
Background: Supracondylar humerus Fracture is among the common upper extremity fractures in children. In certain types of fractures of circumstances that open reduction becomes necessary the best surgical approach is debatable. We would like to report our prospective study between posterior and lateral ...
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Background: Supracondylar humerus Fracture is among the common upper extremity fractures in children. In certain types of fractures of circumstances that open reduction becomes necessary the best surgical approach is debatable. We would like to report our prospective study between posterior and lateral surgical approaches in type III supracondylar fractures. Methods: In a case series study, 87 children from birth till 18 years old, with type III humerus fracture were randomly selected for open reduction and pinning 43 through lateral and 44 posterior approaches. With a 6-months follow-up, elbow range of motion, complications and radiographic parameters related to :::union::: type were evaluated. Results: Posterior approach was a faster surgery. Ranges of motion after 1 and after 6 months were more restricted in posterior approach. Baumann and carrying angles were closer to normal in a higher percentage in posterior approach. Varus and valgus mal:::union::: or joint stiffness rates or infection were similar in the two groups. Conclusion: The two approaches were similar for postoperative complications. Better range of motion was achieved in the lateral approach, and a more anatomical :::union::: in the posterior approach.
Alireza Saied, MD; Afshin Ahmadzadeh Heshmati, MD; Amir Reza Sadeghifar, MD; Ali Okati, MD
Abstract
Background: Tibia and femur fractures are among the most common fractures and intramedullary nailing is the standarad treatment. This study was performed to determine the best preoperative method for estimating the intramedullary nail length.
Methods: In a cross sectional study, 82 patients with tibia ...
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Background: Tibia and femur fractures are among the most common fractures and intramedullary nailing is the standarad treatment. This study was performed to determine the best preoperative method for estimating the intramedullary nail length.
Methods: In a cross sectional study, 82 patients with tibia and 25 patients with femur shaft fracture were studied in a training center of Kerman-Iran. The estimated preoperative intramedullary nail length and the length of used nail at operation were compared. The measurment methods for femur fractures were greatrer trochanter-patella, greater trochanter-lateral epicondyle and olecranon-fithe finegr tip; and for tibia fractures were medial malleolus-tuberosity, intact leg radiogram and olecranon fifth metacarp were assessed. Data was assesed by statistical methods.
Results: Almost all of the examined methods showed "good" interobserver and intraobserver reliability. In femur fracture, the greater to patella method showed the best ICC (0.876) and the lowest SEM (0.777). In tibia fracture, best ICC (0.860) and the lowest SEM (0.602) were for medial malleolus tubercle method. For femur fractures, 64% of the measurements in greater to patella, 93% in olecranon fifth finger, 100% of greater to epicondyle methods; and for tibia fractures 40.9% in medial malleolus tubercle, 37.3% of olecranon metacarp and 65.06% of radiogram method were larger than the nail used at operation.
Conclusions: The best method for estimation of nial length was medial malleolus to tuberosity for tibia fractures, and greater to patella method for femur fractures; however none of the examined methods was found completely suitable.
Abstract
AbstractBackground: Rheumatoid arthritis (RA) is a chronic inflammatory disease that reduces the quality of life inpatients. Stress is one of the important factors involved in the onset of the disease. The present study aimedto evaluate the effect of stress inoculation training on the quality of life ...
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AbstractBackground: Rheumatoid arthritis (RA) is a chronic inflammatory disease that reduces the quality of life inpatients. Stress is one of the important factors involved in the onset of the disease. The present study aimedto evaluate the effect of stress inoculation training on the quality of life of patients with RA.Methods: This randomized clinical trial had a control group and was performed on all patients with RA,referred to the specialized RA center in 2016. In total, 30 paents were selected by random sampling andwere divided into two intervention and control groups using a random allocation method. In addition, thedata collection tool was the SF-36 quesonnaire. The subjects in the intervenon group aended 10 stressinoculation training sessions, whereas the participants in the control group received no interventions. In theend, the two groups filled the SF-36 tool as a posest. Moreover, data analysis was performed usingindependent t-test and covariance.Results: In this study, the mean score of life quality significantly increased in the intervention group after theintervention. Therefore, the quality of life score increased after the intervention, which showed the impact ofthe intervenon on the decrease of stress (P<0.001) and an increase in the quality of life and its components(P<0.001).Conclusion: According to the results of the study, stress inoculation training was introduced as an effectiveapproach to increase the quality of life of patients with RA.
Firooz Madadi, MD; Mohammad Ali Okhovatpour, MD; Amir Mehrvarz Serkesheh, MD; Firoozeh Madadi; Majid Borairi, MD
Abstract
Background: The posterior of acetabular cup in total hip replacement can be affected by the central osteophytes in the acetabular fovea. We are proposing a classification of such osteophytes based on direct observation and CT scan of osteoarthritis hips.Methods: This study was composed of two sections: ...
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Background: The posterior of acetabular cup in total hip replacement can be affected by the central osteophytes in the acetabular fovea. We are proposing a classification of such osteophytes based on direct observation and CT scan of osteoarthritis hips.Methods: This study was composed of two sections: first, 276 cases with all clinical and radiographic evidence of osteoarthritis of hip–with no history of fracture or pelvic bony surgery – were studied by radiographs and CT Scans. The changes in the acetabular osteophytes were evaluated and categorized. Secondly, 57 cases of hip osteoarthirites who were undergoing hip arthroplasty received direct observation of the acetabular osteophytes and categorization of the acetabular fovea in accordance with the above classification system. The relation of primary etiology of hip osteoarthritis with the osteophyte classification was also studied.Results: According to radiographs, CT Scans and direct visualization, four types of acetabular osteophytes were identified. Type I: Normal acetabular with 5mm distance from rim to the floor type IIa: Evidence of sclerosis around fovea type IIb: Sclerosis forming a ceiling, like an umbrella over the fovea type IIc: The foveal osteophytes are almost touching in the center type III: Osteophytes have fully covered the fovea, making the acetubular look very shallow.Conclusion: Study and categorization of acetabular osteophytes with radiographs and CT scan would be a helpful pre-operative tool for more accurate reaming of the acetabular cavity and cup positioning in hip osteoarthrties.
Mina Iravani, MSc; Farzam Farahmand, PhD; Soheil Mehdipour, MD
Abstract
Background: High tibial osteotomy (HTO) is a common surgical procedure for treatment of patients with varus malalignment. The success rate of the procedure is strongly dependent on the quality of correction. The purpose of this study was to simulate the HTO in a patient with varus deformity in order ...
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Background: High tibial osteotomy (HTO) is a common surgical procedure for treatment of patients with varus malalignment. The success rate of the procedure is strongly dependent on the quality of correction. The purpose of this study was to simulate the HTO in a patient with varus deformity in order to explore the interactions between the wedge angle, the mechanical axis, and the knee joint configuration.
Methods: A finite-element model of the knee joint of a patient with varus deformity was developed. The geometry was obtained using the whole limb CT scans and the knee MR images. The bones were assumed as rigid bodies, the articular cartilage and the meniscus as elastic solids, and the ligaments as nonlinear springs. A 600N force was applied at the femoral head in the line of the mechanical axis and the resulting knee configuration was investigated. The HTO was simulated by insertion of wedges with different angles beneath the tibial plateau and application of the resulting alteration of the loading axis in the model.
Results: The results indicated that the actual change of the mechanical axes was always smaller than was predicted by a geometric pre-planning approach that does not consider the effect of soft tissue on the post-operative configuration of the knee joint.
Conclusions: It was suggested that subject-specific models can improve the results of the HTO by simulating the operation before surgery and determining the optimal wedge angle that locates the mechanical axis in the middle of the knee.
