Mohsen Movahedi Yeganeh
Abstract
Background: The syndesmotic sprains account for 1% to 11% of all ankle injuries. Good understanding of the mechanism of injury, physical examination, new imaging techniques and ankle arthroscopy help to improve assessment and management of high grade ankle sprains with a normal mortise relationship. ...
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Background: The syndesmotic sprains account for 1% to 11% of all ankle injuries. Good understanding of the mechanism of injury, physical examination, new imaging techniques and ankle arthroscopy help to improve assessment and management of high grade ankle sprains with a normal mortise relationship. Methods: Eleven patients (9 men, 2 women) with average age of 26 years (22-38 years), who had syndesmotic sprain confirmed by ankle arthroscopy, were studied by the clinical symptoms and imaging assessments. The treatment results were evaluated by American Orthopaedic Foot and Ankle Society (AOFAS) score. The mean duration of injury was 9 months, and the follow up was 12 months Results: Postoperatively, 7 ankles obtained excellent and 4 good results according to AOFAS score. Impingement of syndemotic scar tissue in the ankle joint was the main cause of persistent pain. These cases had no diastasis on the plain radiography and no obvious sign of instability during the ankle arthroscopy. In some cases, chondral softening and lesion were seen at the medial ridge of the Talus, which could be due to subtle instability and change in the ankle biomechanics. Conclusions: Syndesmosis ankle injury could produce chronic pain. Arthroscopic debridement, in the absence of ankle instability could be an effective tool.
A Mavian; F Biglari; S Shabani; H Mahdavi Mohtasham; S M Kazemi
Abstract
Background: The outcome of ankle fractures treatment is great importance. The purpose of the present study was to investigate the outcome of ankle fractures treatment by open reduction method and internal fixation.
Material and Methods: The method of study was cross-sectional. A total of 169 patients ...
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Background: The outcome of ankle fractures treatment is great importance. The purpose of the present study was to investigate the outcome of ankle fractures treatment by open reduction method and internal fixation.
Material and Methods: The method of study was cross-sectional. A total of 169 patients with ankle fracture who underwent open surgical and internal fixation surgery were the statistical sample. Patients were evaluated by a Clinical rating system for the ankle and hindfoot and eventually gave them a point from 100.
Results: Of the 169 samples, 53 were female and 116 were male. The average a Clinical rating system for the ankle and hindfoot was 51 (95% CI 49-53). The most common fractures type was bimalleoalr fracture. The majority of patients suffering from daily dysfunction and pain, their gait pattern was also changed.
Conclusions: According to the results and available studies, the results of surgical treatment of ankle fractures were not optimal and further investigation and finding more appropriate intervention methods were needed in order to obtain the desired results. To achieve optimal surgical outcome, it is recommended that the time interval between injury and surgery should not exceed 4 days.
Mohammad Fakoor; Hanoon Sadoni; Payam Mohammad Hosseini; Saeed Bastan
Abstract
AbstractIntroduction: This study aimed to find a statistical relationship between clinical and functional findings based on the Lysholm scoring scale in the success rate of surgery and patient satisfaction with the arthroscopic reconstruction of the anterior cruciate ligament (ACL).Method: This prospective ...
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AbstractIntroduction: This study aimed to find a statistical relationship between clinical and functional findings based on the Lysholm scoring scale in the success rate of surgery and patient satisfaction with the arthroscopic reconstruction of the anterior cruciate ligament (ACL).Method: This prospective and cross-sectional study was performed on 38 patients (42 knees) aged 17 to 45 years who underwent anterior cruciate ligament (ACL) reconstruction during 2018-2019 due to ACL rupture at Imam Khomeini Hospital in Ahvaz.6 and 12 months after surgery, clinical trials of "anterior drawer" and "Lachman test" were performed, and the standard Lysholm questionnaire for patients was completed. Then, the compatibility of the test results with the results of the Lysholm questionnaire and MRI was assessed.Results: In the diagnosis of ACL rupture, 6 months after surgery, the highest sensitivity was related to the anterior drawer and Lysholm scale tests, and the highest specificity was related to the Lachman test. Also, the highest positive predictive value was related to the Lachman test and the highest negative predictive value was related to the anterior drawer and Lysholm scale tests. 12 months after surgery, the highest sensitivity was related to the Lysholm scale and the highest specificity was related to the Lachman test. The highest positive predictive value was for the Lachman test and the highest negative predictive value was for the Lysholm scale. In the first 6 months, graft failure was observed in 13.6% of patients, but the percentage of patients with“Fair” and “Poor”Lysholm scale was 28.95%. In the second 6 months, graft failure was observed in 7.14% of patients, but the percentage of patients with“Fair” and “Poor”Lysholm scale was 19.05%.Conclusion: Since in some cases, such as excessive knee diameter due to obesity or swelling, the examination may be limited and citation of clinical test results may be erroneous, it is recommended that in addition to mechanical tests such as the Lachman test and the anterior drawer test, standard questionnaires such as Lysholm be used to more accurately assess the success of surgery and treatment, as well as to help identify more accurate lesions.
S Morteza Kazemi; Shahin Salehi; S Mohamad Qoreishi; Mehrshad Poursaeid Esfahani; Mohammad Hassbi; Jila Sharghi; Farshad Safdari
Abstract
Introduction: Hip dysplasia can be associated with early degenerative changes. Different values have been
reported for incidence of hip dysplasia in different countries. In the current study, we are reporting on the incidence
of hip dysplasia in a group of normal Iranians evaluated by measuring ...
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Introduction: Hip dysplasia can be associated with early degenerative changes. Different values have been
reported for incidence of hip dysplasia in different countries. In the current study, we are reporting on the incidence
of hip dysplasia in a group of normal Iranians evaluated by measuring the morphologic parameters of acetabulum on
radiographs.
Materials and Method: 586 hips (293 person) were enrolled in this study. On anteroposterior hip radiographs,
the following 5 parameters were measured: Central edge angle (CEA), acetabular angle (AA), acetabular depth (AD),
acetabular roof obliquity (ARO) and roof angle (RA). The normal and abnormal values were obtained in different
sexes and compared with the known normal values in orthopaedic literature. Furthermore, the correlation between
the above measurements was investigated.
Results: Based on CEA, 15 (2.6%) of hips were dysplastic:-0.7% definite and 1.9% mild. 19 hips (3.2%) were
dysplastic when using AA values. AD and RA were significantly higher in males. Except for lack of correlation
between AA and AD, the other parameters -in particular, CEA and AA- were closely correlated. CEA, AA, ARO and
RA were significantly different between dysplastic and non-dysplastic hips.
Conclusion: Definite or mild dysplasia was recognized in 0.7% and 1.9% of the “normal” population that was
studied. Since CEA was the same between males and females and was correlated with all other morphologic
parameters, it seems that CEA is a useful measurement to evaluate presence of hip dysplasia.
Dehghani, MD Mohammad; Fanian, MD Hossein
Abstract
Background: Soft tissue or bony injury especially fracture-dislocations can cause stiffness resulting in decrease finger and hand function. In this study dynamic traction was used for restoration of alignment and fixation of fractures.Methods: A cross-sectional study was done in a hospital in Isfahan. ...
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Background: Soft tissue or bony injury especially fracture-dislocations can cause stiffness resulting in decrease finger and hand function. In this study dynamic traction was used for restoration of alignment and fixation of fractures.Methods: A cross-sectional study was done in a hospital in Isfahan. Eighteen patients with 10 forth finger, 5 fifth and 3 third finger injuries were treated with dynamic traction for fracture dislocation of proximal interphalangeal joints between 2001-2006. Two fine k-wires were used – each on one side of the broken joint. Rubber bands were used to connect the pin and maintain traction on the fracture. All the fractures had involvement of more than 40% of articular surfaces. While active motion was started the next day, the fixator was left in place for 4-6 weeks. The mean age of patients was 24 (18-39 years). They were assessed clinically and rediographically nine months (8-23 months) after surgery.Results: All the patients achieved :::union::: with an average joint motion of 92 degrees (82 to 98). Four patients had 10 degrees extension lag and 3 cases had 10 degrees of flexion contracture. Joint congruity was obtained all but two cases who have decrease in joint space.Conclusions: Dynamic traction with pins and robber band permit early motion with early soft tissue and bone healing in complex proximal interphalangeal joint soft finger.
Abstract
Background: Clavicle is a common bone to fracture, and is most often treated with nonsurgical methods. Surgery may become indicated in occasional case of irreducible fracture with considerable displacement, open fracture, floating shoulder, and associated neurovascular injury, non:::union:::. There ...
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Background: Clavicle is a common bone to fracture, and is most often treated with nonsurgical methods. Surgery may become indicated in occasional case of irreducible fracture with considerable displacement, open fracture, floating shoulder, and associated neurovascular injury, non:::union:::. There is still uncertainty about the best surgical method for this condition. In this study, we evaluated the results of intra-medullary screw fixation of clavicle fracture.Methods: In a prospective study between March 2005 and March 2007, 20 clavicular fracture (13 males,7 females) with mean age of 32 years old (20-55), that had indication for surgery, were fixed with intra-medulary cannulated screw through a mini incision. We evaluated time to :::union:::, shoulder range of motion, side effects and patient satisfaction with a mean follow-up of 6 months (4-10 months).Results: The mean time to :::union::: was 10 weeks. The :::union::: was uncomplicated in 19 (95%) patients, while 1 case (5%), the bending of cannulated screw after a new trauma, required replacement by a thicker screw. There was no significant complication after surgery. All the patients were satisfied with the surgery.Conclusions: Cannulated screw is an effective fixation method for the claviclular fractures that are amenable to surgical treatment. Supplemental studies are necessary.
Mohammad Jafar Emami; Fereidoon Mojtahed Jaberi; Negar Azarpira; Amir Reza Vosoughi; Nader Tanideh, DVM, MPH, PhD
Abstract
Background: Prevention of arthrofibrosis by different drugs and surgical techniques is an essential issue in modern orthopaedics. This study investigated the effect of bevacizumab on intra-articular fibrosis in a rabbit animal model.Methods: Arthrofibrosis was induced in right stifle joint of thirty ...
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Background: Prevention of arthrofibrosis by different drugs and surgical techniques is an essential issue in modern orthopaedics. This study investigated the effect of bevacizumab on intra-articular fibrosis in a rabbit animal model.Methods: Arthrofibrosis was induced in right stifle joint of thirty male white rabbits by removing the cortical bone of femoral condyle in medial gutter under general anesthesia. The rabbits were randomly divided into three equal groups. The control group received intra-articular injection of saline the "one-injection" group received a single dose of bevacizumab (2.5 mg/kg), and the" two-injection" group received two intra-articular injections on the day of operation and 14 days later. Forty five days after the surgery, the animals were sacrificed. The severity of fibrosis was assessed by range of motion of the stifles, macroscopic adhesion score, and histopathologic variables.Results: Although no statistical difference was seen between the control group and the "one-injection" group in terms of range of motion and macroscopic evaluation, the histopathologic variables in prevention of arthrofibrosis, except for the granulation tissue, were significantly better in the "one-injection" group. The "two-injection" group in comparison to the "one-injection" group was better not only in range of motion evaluation (p < /em>=.001) and visual adhesion score (p < /em>=.012), but also in most of the histopathologic variables, except for the cell count and granulation tissue.Conclusions: Two injections of bevacizumab for prevention of arthrofibrosis resulted in better outcome than single injection.
Abstract
Background & Aim: Brachymetatarsia is a rare condition of the foot characterized by a shortening of the metatarsal bones. Brachymetatarsia may be congenital and idiopathic in etiology, or caused by trauma, and may be associated with systemic diseases. This deformity is recognized with a wide ...
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Background & Aim: Brachymetatarsia is a rare condition of the foot characterized by a shortening of the metatarsal bones. Brachymetatarsia may be congenital and idiopathic in etiology, or caused by trauma, and may be associated with systemic diseases. This deformity is recognized with a wide range of clinical patterns, from aesthetic dissatisfaction to severe pain. Various surgical methods have been proposed to treat the disease, which could be associated with different complications such as stiffness, lack of union, and deviation from the axis. The present study aimed to evaluate the result of ''over the pin'' surgical method for patients with brachymetatarsia.Methods: This case series research was performed in a training hospital on the patients referred to the orthopedic clinic, with congenital brachymetatarsia confirmed by foot radiographs. Data related to the demographic characteristics of patients, the obtaince length, and the duration between treatment onset and removal of the fixator were obtained using a checklist and the medical files of the participants. In this study, the exclusion criteria were non-metatarsal involvement, trauma, secondary foot surgeries, genetic syndromes, syndactyly, and polydactyly.Results: There were women and one male, with the mean age of 12.3 years. Bilateral involvement was detected in two female subjects, and a total of 11 surgeries were assessed. According to the results, there was a total length increase of 16.58 millimeters over a mean duration of 96.5 days. In addition, metatarsal length increased by 48.23% during treatment, and no malunion was observed in the patients. Conclusion: ''Lengthening over a ping'' for brachymetatarsia, of fourth ray is superior to other techniques, which avoids malunion, and higher length gain is possible.to the results of the study, malunion was reported in none of the participants after the surgery, which showed an apparent superiority of the method, compared to other techniques. However, a higher length increase was detected in the current research, compared to other studies.
Amirreza Sadeghifar, MD; Morteza Hashemiyan, MD; Jamasb Moghaddam, MD
Abstract
Background: Rotator cuff tear is one of the major causes of shoulder pain and disability especially in over 60 year old age people. The problems with arthroscopic repair and also failure to repair with strong and valuable sutures in massive tears have increased the trend towards open surgery. This study ...
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Background: Rotator cuff tear is one of the major causes of shoulder pain and disability especially in over 60 year old age people. The problems with arthroscopic repair and also failure to repair with strong and valuable sutures in massive tears have increased the trend towards open surgery. This study was done to assess repair of rotator cuff tear by open surgery.Methods: In this cross-sectional study, 14 candidates (8 female, 6 male) for rotator cuff surgery, were assessed for shoulder function by the use of ASES and SST scoring systems, before and after surgery, by the same observing orthopaedic surgeon.Results: Mean age of patients was 57.94±14.04 years old. The mean SST score before surgery and 6 and 9 months after surgery were 10.17, 10.67 and 10.81, respetively with a significant post-operative improvement (p < /em>=.026). The mean ASES score before surgery, 6 and 9 months post surgery were 42.82, 47.95 and 57.43, respectively showing significant improvement after surgery (p < /em>=.025).Conclusions: The open surgical repair of rotator cuff tear is effective and shoulder function improves and pain decreases significantly. This is with the technique of constructing a surface, rather than making a trough, and also using of interoseous suture rather than anchor suture.
Alireza Manafi Rasi; Gholamhossein Kazemian; Gholamhossein Kazemian; Amir Hossein Fallahi; Mohammad Mahdi Bagherian Lemraski,; Ali Nemati; Farshad Safdari
Abstract
Background: The use of prophylaxis for deep vein thrombosis (DVT) in patients with ankle trauma treated with below knee cast is a controversial issue. The purpose of current study was to investigate the incidence of DVT to look into the necessity of thromboprophylaxis in these patients. Methods: Ninty ...
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Background: The use of prophylaxis for deep vein thrombosis (DVT) in patients with ankle trauma treated with below knee cast is a controversial issue. The purpose of current study was to investigate the incidence of DVT to look into the necessity of thromboprophylaxis in these patients. Methods: Ninty five patients with stable fractures of the foot or ankle or ankle sprains contributed in this cross-sectional study. The level of D-dimer was determined between 7-14 days post-casting. If the level of D-dimer was higher than 0.2 µg/mL, the result of the test was considered positive and patient was referred for further examination for DVT using doppler ultrasonography. The role of risk factors in the development of DVT was evaluated. Results: There were 46 patients with at least one DVT risk factor. The D-dimer test was positive in 21 patients (22.1%). Based on the doppler ultrasonography, 3 patients developed DVT. There was a statistically significant relation between the presence of multiple risk factors (≥3) and increased risk of DVT development (p=.01). Conclusion: DVT is not a common complication in below knee casting and routine thromboprophylaxis is not necessary in patients with less than 3 risk factors.
Alireza Hootkani, MD; Hassan Rahimi, MD; Ali Moradi, MD; Ehsan Vahedi, MD; Abolfazl Kazemi
Abstract
Background: Traumatic hand injuries can lead to major disabilities. Due to high number of young active people who can be affected with such disabilities, finding the results of emergency tendon and nerve repairs would give us a guideline in managing such injuries.Methods: In a prospective study, 91 patients ...
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Background: Traumatic hand injuries can lead to major disabilities. Due to high number of young active people who can be affected with such disabilities, finding the results of emergency tendon and nerve repairs would give us a guideline in managing such injuries.Methods: In a prospective study, 91 patients (87 males, 4 females) were randomly selected among the referrals to an orthopaedic emergency of a hospital in Mashhad, Iran. The patients had a mean age of 26.6 years. Demographic information and details of the injuries were recorded before surgery and also in the post operative period with 18 months follow-up.Results: The average size of the skin wounds was 4.4 centimeters, and the majority had sharp edges. The most commonly injured tendons were flexor digitorom superficialis, flexor carpi radialis, extensor digitorom communis and extensor policis longus. The most common complication was joint stiffness which had a direct relation with inadequate physiotherapy. Ulnar nerve repair had a worse outcome compared with median nerve repair. None of the repaired nerves obtained full sensory and motor recovery.Conclusion: Repair of tendon and nerve injuries in emergency settings does not uniformly give good results. It is best not to attempt repair of nerve injury, or more than three extensor flexor tendon injuries in emergency room.
Fatemeh Valipoor Godarzi; Majid Baghaee nejad
Abstract
Background: The burst fractures of the vertebrae include about 15% of spinal column injuries, and the most common location is in the lumbar back area. The diagnosis of fracture types and associated injuries is usually done by using simple radiography, CT scan, and MRI. In this research, we ...
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Background: The burst fractures of the vertebrae include about 15% of spinal column injuries, and the most common location is in the lumbar back area. The diagnosis of fracture types and associated injuries is usually done by using simple radiography, CT scan, and MRI. In this research, we tried to present a new method for fracture detection with the thermographic images.
Methods: The present study was a preliminary study, which was conducted on a set of thermal images obtained from a Clinical Center in California. The diagnosis (detection) of unstable burst fractures of the lumbar spinal column was performed based on the thermal pattern using the Fuzzy C-Means (FCM) clustering method and recursive connected components algorithm. In this study, the procedure was validated and confirmed by examinations and evaluation previously made by an orthopedic surgeon on the same patients
Results: After applying the preprocessing steps and FCM clustering on the image, the clusters belonging to the lumbar spine, which center was at the first and second places of the clusters centers matrix, were gathered together. Then, the unstable lumbar spinal burst fractures were diagnosed based on the components labeling technique. From the 130 thermographic images, 93 showed fracture and in 33 no fracture was seen. This confers with the CT scan images, and shows 95% accuracy.
Conclusion: The method presented in this article is a non-invasive and cost-effective approach for the diagnosis of unstable burst fractures of lumbar spinal column. The techniques and tips derived empirically, based on the scientific principles of this research, can help the physicians to quickly diagnose the burst fractures of lumbar spinal column based on the analysis of thermal images.
Ahmadreza Afshar; Afshin Aminzadeh Gohari; Zahra Yekta
Abstract
Background: This study presents the distribution of ulnar variance among Iranian patients with Kienbock’s disease and a control group of normal adults of Iranian population. We evaluated the relationship between ulnar negative variance and Kienbock’s disease in our patients. Methods: This study included ...
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Background: This study presents the distribution of ulnar variance among Iranian patients with Kienbock’s disease and a control group of normal adults of Iranian population. We evaluated the relationship between ulnar negative variance and Kienbock’s disease in our patients. Methods: This study included two groups. In the first group, we, retrospectively, reviewed our orthopaedic department clinic charts in two hospitals in Urmia-Iran, and collected the distribution of ulnar variances in 60 patients with Kienbock’s disease. The second group comprised the distribution of ulnar variances in 400 standard wrist radiographies of normal adult population. Comparisons were made between the findings of the two groups. Results: The mean ulnar variance of the Kienbock’s group was negative 1.1±1.7 and the mean ulnar variance of the general population was positive 0.7±1.5. The difference of the ulnar variance means was statistically significant (p < /i>=.027). There were 56 (14%) ulnar negative, 160 (40%) neutral and 184 (46%) ulnar positive variance in the control group and there was no correlation with age or sex. There was an association between ulnar negative variance and development of Kienbock’s disease in this study (p < /i>
Armin Nikzad, BSc; Farid Abbaszade, MSc; Zahra Saghaei, MSc; Soheil Mehdipoor, MD; Firooz Madadi, MD; Morad Karimpoor, PhD
Abstract
Background: Total knee arthroplasty is an accepted method for treatment of osteoarthritis of the knee. Measuring the distal femoral rotation is one of the most important problems in such operations. In the conventional 2D method, measuring the angle is based on CT scan images but these methods usually ...
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Background: Total knee arthroplasty is an accepted method for treatment of osteoarthritis of the knee. Measuring the distal femoral rotation is one of the most important problems in such operations. In the conventional 2D method, measuring the angle is based on CT scan images but these methods usually contain errors. In this study, the three-dimensional measurement of the aforementioned angle was investigated.
Methods: In this research, using CT scans and 3D modeling, 3D lower extremity models of 40 patients were extracted. The rotation of distal femur was measured for plane perpendicular to the anatomical and the plane of mechanical axis of femur. Four axes were drawn on these planes using anatomical landmarks: posterior condylar line (PCL), anatomical and surgical transepicondylar line (ATEA+STEA), and the Whiteside line (WL).
Results: The mean difference of these measurements on the plane perpendicular to the mechanical axis of the femur, between PCL and WL, STEA, ATEA was 3.41, -1.31, 5.53; and angles on the plane perpendicular to the anatomical axis of femur were -0.74, -1.26, and 5.67, respectively. In addition, Bland-Altman diagram was plotted between every two measurements and no relationship found, except for STEA and ATEA.
Conclusions: The measurements between PCL, ATE, and STEA are not affected by the plane on which these measurements are carried out on, except for the 4 degrees difference present in WL axis. With a greater sample size and proper grouping, some relationship might be found between the aforementioned axes.
Siavash Sharifi; Amin Bigham-Sadegh; Ahmad Oryan; Yasamin Alavi
Abstract
AbstractBackground: Nowadays, bone grafts are used in both veterinary and human orthopaedics to stimulate fracture healing and to accelerate the restoration of bone defects. Autografts are still a high standard for comparing different bone-building stimuli. Autografts not only include healing stimulants ...
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AbstractBackground: Nowadays, bone grafts are used in both veterinary and human orthopaedics to stimulate fracture healing and to accelerate the restoration of bone defects. Autografts are still a high standard for comparing different bone-building stimuli. Autografts not only include healing stimulants but also contains cells that do not stimulate immune responses and do not transmit infectious diseases. However, bone grafting is not without side effects such as pain, infection, fracture, blood loss and increased surgical stages, besides the amount of bone removed is limited.Tarantula cubensis venom has an anti-inflammatory and re-epithelialization effect in bovine wound healing on the 14th day; it also plays a role in infection prevention since Theranekron can alter the process of inflammation. This study aims to examine the effect of hydroalcoholic extract of tarantula cubensis on the distal radius fracture healing in rabbitsMethods: This study was conducted on 20 male rabbits, in four study groups of five rabbits. A bone se was extracted from the distal radius. The first group was administrated with one microgram per kilogram of Theranekron injection at the site of the bone defection. The second and third (or negative control) groups were administrated with normal saline injection and no substance (no intervention), respectively. Lastly, the fourth group (or autograft group), the extracted bone segment was returned in its place, and the skin and muscles were sutured. Lateral view radiographs images were taken from rabbits on days of 14, 28, 42 and 56 after surgery.On the eighth week, a bone biopsy was performed to evaluate histopathology. Radiographs and biopsies were statistically examined for fusion rate, ossification activity and remodelling.Results and Conclusion: Both Theranekron and autograft group had similar behaviour and outperformed the normal saline and negative control group; therefore it is concluded that hydroalcoholic extract of tarantula cubensis was effective in distal radius fracture healing.
Dehghani, MD Mohammad
Abstract
Background: Fracture of metacarpal and phalangeal bones of hand are common sport and industrial injuries in the upper extremity. Mini-plate fixation is one of the techniques used in fixation of unstable kind of fractures in hand. We would like to report our experience with such fractures treated ...
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Background: Fracture of metacarpal and phalangeal bones of hand are common sport and industrial injuries in the upper extremity. Mini-plate fixation is one of the techniques used in fixation of unstable kind of fractures in hand. We would like to report our experience with such fractures treated with titanium mini-platesMethods: In a clinical trial study, 29 patients with 48 unstable hand fractures (21 metacarpal, 27 phalanges) received titanium mini-plate fixation during 1999-2006. The mean age was 27 years (14-53). Twenty eight cases were periarticular and 20 shaft fractures. The cases were evaluated with an average follow-up of 17 months (6-52), and range of motion and function were assessed.Results: The results, based on total active motion, were considered excellent in 39 (³221 degrees), good in 8 (121-220 degrees) and poor in1case (
Mohammadreza Guiti, MD; Arash Sherafat Vaziri, MD; Leila Oryadi Zanjani, MD; Amirreza Farhoud, MD
Abstract
Background: The aim of this study was to assess the isokinetic measures of surgically repaired ruptures of the pectoralis major muscle in contrast to non-injured side of the patients and specify the most affected movement of the injured side.Methods: Nine pectoralis major muscle tears in nine patients ...
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Background: The aim of this study was to assess the isokinetic measures of surgically repaired ruptures of the pectoralis major muscle in contrast to non-injured side of the patients and specify the most affected movement of the injured side.Methods: Nine pectoralis major muscle tears in nine patients were studied.They were all operated by the same surgeon and after 2.4 years (1-4 years) of follow up they were clinically examined. They completed a standard questionair and isokinetic dynamometry were carried out bilaterally. There was also a group of six non-injured bodybuilders who were assessed by isokinetic dynamometry to give us normal differences in the values of both limbs.Results: In the patient group, the mean torque of flexion was not different between the injured and uninjured sides (p < /em>≥.05). For the extension movements, the difference was significant (p < /em>
ADEL EBRAHIMPOUR; alireza manafi rasi; bahamin attar; ahmadreza mirblok
Abstract
Background: Spinal fusion is a surgical method to treat degenerative diseases of the spine. We studied the effect of bone graft soaked with zolendronic acid (ZA) on spinal fusion.Method: 60 patients with degenerative disease, scheduled for spinal fusion were randomly divided into 2 equal groups, ...
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Background: Spinal fusion is a surgical method to treat degenerative diseases of the spine. We studied the effect of bone graft soaked with zolendronic acid (ZA) on spinal fusion.Method: 60 patients with degenerative disease, scheduled for spinal fusion were randomly divided into 2 equal groups, receiving either local bone graft or local bone graft plus topical zoledronic acid. The cases were studied with visual analogue scale (VAS), Oswestry low back disability questionnaire, and radiographic bone bridge formation with a 12-months follow-up.Results: 57 patients completed the study: 27 patients in “control group” and 30 patients in “case group”. VAS Score was significantly lower in case group in comparison with control one after 12 months (P value:0.00).In the point of Oswestry low back disability questionnaire score(ODI)score the mean score was decreased significantly in “case group” in comparison with “control group”(P value =0.006). Radiographic grades A or B bone bridging was more frequently observed in Zoledronic acid group at 12 months post-operation compared with the control group (p value=0.00). Conclusion: This study demonstrates that addition of Zolendronic Acid to bone grafting in the spinal fusion of elderly people increases the fusion rate and is associated with better clinical and functional outcome.
Mohammad Foroozeshfard, MDر; Mohammad Mirzayikhah طMirzayikhah; Ahmad Sheikhi; Naimolsadat Kia, MD; Majid Mirmohammadkhani, MD; Mohsen Poorazizi
Abstract
Background: Hip fracture is very common orthopaedic fracture in elderly. The present study investigates the outcome after surgical treatment.Methods: The hip fractures of over 65-year old patients that had undergone surgery in a 5-year period were retrospectively studied in a hospital in Semnan, Iran. ...
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Background: Hip fracture is very common orthopaedic fracture in elderly. The present study investigates the outcome after surgical treatment.Methods: The hip fractures of over 65-year old patients that had undergone surgery in a 5-year period were retrospectively studied in a hospital in Semnan, Iran. The information of 259 patients (120 male, 139 women) were collected including demographic data, medical history, history of surgery (type of anesthesia, technique of surgery), length of hospitalization before and after surgery, and death in hospital.Results: From all the operated cases, 174 (67.2%) received spinal, 68% (26.3), epidural and 17% (6.6) general anesthesia. 185 pateints (71.4%) had no complication and 74% (28.6) had at least one complication. 12 patients (6.4) died while in hospital. 56 cases (21.6%) were walking with no problem 32 (12.4%) required walking and 9 patients (3.5%) were not able to walk.Conclusions: Complications after surgery for hip fracture are relatively high. To recover faster and reduce more serious complications, it is recommended to change the strategies on how to care for the elderly during and after surgery.
Hamid Hesarikia; Alireza Rahimnia; Gholamreza Farzanegan; Musa Reza Anbarloui; Amin Hamidzadeh Khiyavi
Abstract
Background: The application of Tranexamic Acid (TA) is one of the methods to control and reduce bleeding in spinal surgery. The aim is to compare systemic (TA) with local (TA) administration for reduction of blood loss during spinal surgery in order to promote health economics.Method: The research schema ...
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Background: The application of Tranexamic Acid (TA) is one of the methods to control and reduce bleeding in spinal surgery. The aim is to compare systemic (TA) with local (TA) administration for reduction of blood loss during spinal surgery in order to promote health economics.Method: The research schema was cross-sectional and retrospective in the community of patients undergoing spinal surgery in the Baqiyatallah Hospital. The inclusion criteria were elective spinal surgeries of three levels or more. The exclusion criteria were bleeding disorder. The required analyses are performed using SPSS software. Moreover, the significance level of the statistical test is 0.05 The intravenous dose is selected to be 10 mg/kg. The maintenance is also 1 mg/kg/h. The topical dosage is one gram in300 ml at the beginning and 500 mg in 50 ml at the end. The amount of calculated bleeding is the volume of blood in the drain.Results: In this research, 22 patients (44.9% of 49 patients) received TA intravenously and 27 patients (55.1% of 49 patients) received local TA. There was no remarkable relationship between the amount of bleeding in different groups with the surgery type (p: 0.48), surgery level number (p: 0.48), and the amount of total bleeding (p: 0.14). The local TA group’s intra-operative and post-operative bleeding amounts were 563.89 ± 367.48ml and 116.30 ± 71.37ml, respectively. These intra-operative and post-operative bleeding amounts were 496.64 ± 296.84ml and 75.84 ± 120ml for the case of the intravenous (TA) group.Conclusion: The results do not confirm the effectiveness of the local administration compared with the intravenous administration. However, the average amount of bleeding in the local application of tranexamic acid is similar to the systemic one.
Hamid Reza Aslani, MD; Khalil Alizadeh, MD; Amin Karimi, MD; Mohammad Hossein Karimi, MD; Zohreh Zaferani, MD
Abstract
Background: Carpal tunnel syndrome is one of the most common compression neuropathies in the upper limb and requires surgery if conservative treatment fails. This article compares the result of regular open incision, midpalmar mini incision and endoscopic technique in carpal tunnel release.Methods: This ...
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Background: Carpal tunnel syndrome is one of the most common compression neuropathies in the upper limb and requires surgery if conservative treatment fails. This article compares the result of regular open incision, midpalmar mini incision and endoscopic technique in carpal tunnel release.Methods: This is a clinical trial study on 53 patients (5 males, 48 females) within one year, who were surgical candidates. The surgery was done by arthroscopy, with regular open incision or with mid palmar small incision. The clinical outcomes were evaluated one week, 4 weeks and 4 months post surgery.Results: Relief and satisfaction were better in the first month in the arthroscopic and mini-incision group. All 3 techniques had similar outcomes after 4 months. In 4-months follow-up, night pain relief, followed by parasthesia relief were the ones with the best improvement. Weakness was the symptom with the least improvement. Longer incision cases were associated with more delay to return to work.Conclusion: Carpal tunnel release with endoscopic and mini incision techniques have a better early satisfaction rates compared to regular open incision, but no difference is seen between the two groups after four months.
Mohsen Mardani-Kivi; Farivar A Lahiji; Farivar A Lahiji; Ali Babaei Jandaghi; Khashayar Saheb-Ekhtiari; Keyvan Hashemi-Motlagh
Abstract
Background: Entrapment of flexor pollicis longus at the level of A1 pulley is the most common cause of snapping or painful thumb upon flexion and extension motion the so called which is called "Trigger Thumb". The aim of this study is to assess the efficacy of sonographically-guided intra tendon sheath ...
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Background: Entrapment of flexor pollicis longus at the level of A1 pulley is the most common cause of snapping or painful thumb upon flexion and extension motion the so called which is called "Trigger Thumb". The aim of this study is to assess the efficacy of sonographically-guided intra tendon sheath corticosteroid injection in the management of trigger thumb. Methods: In a prospective study 104 patients (7 males, 97 females, 112 trigger thumbs) with the mean age of 52.11±7.63 who had trigger thumb underwent intra flexor sheath corticosteroid injection under the guide of ultrasound in a 2 year period in Rasht-Iran. Improvement was measured using the "Quinnell" grading system before and in intervals after 3 and 6 weeks 3, 6 and 12 months after injection. Results: From the 112 thumbs, 15 (13.4%) required reinjection and/or surgery. Twelve (80%) of these 15 thumbs were simply re-injected, 2 (13.3%) underwent surgery without re-injection but because of no improvement, underwent surgery. Reduction in Quinnell grade after the first injection was significant (p < .0001). One year after the first injection, 111 of 112 thumbs (99.1%) were symptom-free. Conclusion: Sonographically guided intra flexor sheath corticosteroid injectionis an effective method in the management of trigger thumb and would reduce the need for surgical release.
Mehdi Motififard, MD; Mehdi Teimouri, MD
Abstract
Background: Treatment of displaced femoral neck fracture in active, elderly people is a major undertaking with still unsolved issues. The aim of this study is to determine if primary total hip arthroplasty would have as good an outcome as primary internal fixation of the fracture.Methods: In a clinical ...
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Background: Treatment of displaced femoral neck fracture in active, elderly people is a major undertaking with still unsolved issues. The aim of this study is to determine if primary total hip arthroplasty would have as good an outcome as primary internal fixation of the fracture.Methods: In a clinical trial study, 80 cases of displaced femoral neck fracture who referred to the university hospitals of Isfahan, Iran were enrolled into two treatment groups. Group I of 40 patients received screw fixation, and the group II of remaining 40 underwent primary hip arthroplasty surgery. In a 2 year follow-up the surgical outcomes were assessed using VAS pain scale, SF36 general health instrument score, and Harris hip score (HHS).Results: The pain scale (VAS), SF36 and Harris scores showed significantly better results is arthroplasty group compared with fixation group. The values were as follows: Group 1: pain=4.5 (from 10), SF36=68, HHS=61 group II: pain=3.38, SF36=92, HHS=86. Complications were encountered in 16 cases (40%) in group I, and 3 cases (7%) in group II.Conclusions: Displaced femoral neck fractures in 60-70 years old patients treated with primary total hip arthroplasty will have better outcomes in first 2 years, with less complication rates.
MJ Emami; Amirreza Vosoughi; Ali Hakimi nejad
Abstract
Background: Mitchell osteotomy is one of first metatarsal distal corrective osteotomies for hallux valgus deformity. The purpose of this study was to evaluate the outcome of Mitchellosteotomy.
Methods: Eighteen patients underwent Mitchell corrective osteotomy using screw fixation for hallux valgus ...
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Background: Mitchell osteotomy is one of first metatarsal distal corrective osteotomies for hallux valgus deformity. The purpose of this study was to evaluate the outcome of Mitchellosteotomy.
Methods: Eighteen patients underwent Mitchell corrective osteotomy using screw fixation for hallux valgus deformities from 2011 to 2015 were included. Clinical outcome was assessed using American Orthopedic Foot and Ankle Score, Hallux metatarsophalangeal-interphalangeal scale, (AOFAS Hallux), visual analogue score, and changes in hallux valgus and intermetatarsal angles based on standard weight-bearing radiographs, at least one year after surgery.
Results: About 95 % of patients were completely satisfied. Mean of AOFAS score was 86.7 at final follow-up. The mean of changes in intermetatarsal and hallux valgus angles were 5.6 ± 3.1 and 17.0 ± 5.2 respectively. Pain of the cases based on visual analogue score decreased from 5.8 ± 0.8 preoperatively to 1.3 ± 1.2 postoperatively. There were no deep infections, non::union:: or osteonecrosis of first metatarsal head.
Conclusion: Mitchell corrective osteotomy with screw fixation could bea simple and effective procedure to correct hallux valgus deformity with high levels of patient satisfaction.
Mohammad Ali Erfani, MD; Hormoz Nooraee, MD; Omidreza Momenzadeh, MD
Abstract
Background: Most investigations agree that unstable thoracolumbar fractures require surgical treatment. There is, however, debate on the best approach-anterior, posterior or combined. We are reporting our short and mid-term results on a «posterior only» approach with ligamentotaxis-dependent canal ...
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Background: Most investigations agree that unstable thoracolumbar fractures require surgical treatment. There is, however, debate on the best approach-anterior, posterior or combined. We are reporting our short and mid-term results on a «posterior only» approach with ligamentotaxis-dependent canal decompression with a segmental instrumentation system.Methods: 37 consecutive patients with thoracic and lumbar vertebrae fractures over 4 year period, with a mean follow-up of 30 months, (12-46 months) were studied. The cases underwent subjective and objective evaluation, using the Denis back pain scale, functional independent measure, employment status, neurologic Frankel grading and radiographic indices of vertebral angles and height change.Results: Twenty patients were pain-free, 35 were functionally independent. Frankel neurological grading showed 1.6 points average recovery. The mean preoperative kyphoitc angle of 19.1º improved 1.1º post surgery and to 5.1º at final follow-up. There were 3 minor infections and one hardware failure.Conclusions: Posterior spinal decompression and instrumentation for unstable thoracic and lumbar fractures is safe, effective and is associated with effective, achievement of radiographic correction, and is easier than anterior approach.
