Hossein Khatibi, MD; Ali Asghar Kousari, MD
Abstract
Background: Calcaneal fracture is the most common tarsal bone fracture, and is often associated with a high complication rate and disfunction. Open surgical treatment of calcaneal fracture is one of the most challenging orthopaedic procedures with somewhat vague functional outcome.Methods: In a retrospective ...
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Background: Calcaneal fracture is the most common tarsal bone fracture, and is often associated with a high complication rate and disfunction. Open surgical treatment of calcaneal fracture is one of the most challenging orthopaedic procedures with somewhat vague functional outcome.Methods: In a retrospective study, the clinical and radiographic results of 18 calcaneal fractures in 17 patients (13 males, 4 females) with mean age of 31 years (21-53 years) that had undergone open reduction during a 4-year period (2002-2006) were evaluated with an average follow-up of 19 months (9-48 months). The Amerian Orthopaedic Foot ad Ankle Society (AOFAS) scoring system was used to assess the treatment outcomeResults: Thirteen fractures were type II and 5 type II Sander's class.The preoperative average Bohler's angle of 7 degrees changed to 21.8 degrees in follow-up. The collective average AOFAS score was 89.05. This score was 93.3 for type II and 78 for type III Sander's fractures. Subtalar osteoarthritis was observed in 4 patients.Conclusion: Open reduction and internal fixation of intra-articular calcaneal fractures, with achievement of good reduction of posterior articular facet, can result in good or excellent outcome.
Amir Reza Kachooei, MD; Shiva Razi, MD; Reza Mahdavian Naghashzargar, MD; Hadi Makhmalbaf, MD
Abstract
Background: Posterior cruciate ligament (PCL) injury is reported in 3% to 23% of knee injuries. Ligament rupture usually requires reconstructive surgery. Avulsion injuries in acute cases, however, are often treated by fixation of avulsed bone and ligament. Fixation of avulsions in chronic cases is somewhat ...
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Background: Posterior cruciate ligament (PCL) injury is reported in 3% to 23% of knee injuries. Ligament rupture usually requires reconstructive surgery. Avulsion injuries in acute cases, however, are often treated by fixation of avulsed bone and ligament. Fixation of avulsions in chronic cases is somewhat controversial.Methods: In a descriptive study, from 40 male patients with mean age of 27.87 years old who had undergone fixation of PCL avulsion with maleolar screw and washer through a posteromedial approach, 20 cases with a mean of 40±16.02 weeks follow-up were studied. Twelve cases had received early fixation and 8 had fixation 8 weeks or longer after the injury. The cases were evaluated with clinical evaluation of stability as well as assessment of patients’ satisfaction and return to sports or regular activities.Results: Improvement in “posterior drawer test” was observed in all the cases. The ones who had early surgery, as well as the ones with isolated PCL injury had better results in comparison with late avulsion fixation or combined ligament injuries. Eight cases had no problem in knee function, 7 cases had some limitation in sporting, and 5 in some regular daily activities. Conclusion: Screw fixation of PCL avulsion through a posterio-medial approach, even in delayed cases, is safe, easy and effective. Associated other knee injuries are detrimental for good results.
Mohammad Fakoor, MD; Zahed Safikhani, MD; Shiva Razi, MSc
Abstract
Background: The alignment of lower limbs change with growth and accurate knowledge of such a change in any particular geography is necessary to differentiate the pathologic conditions from normal variations. We are reporting the normal variations in tibiofemoral alignment in young people in a region ...
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Background: The alignment of lower limbs change with growth and accurate knowledge of such a change in any particular geography is necessary to differentiate the pathologic conditions from normal variations. We are reporting the normal variations in tibiofemoral alignment in young people in a region of Iran.Methods: A cross-sectional study on 853 children (455 girls, 398 boys) of 3 to 16 years age was performed. Tibiofemoral angles and intermalleolar distances were measured in standing position. Normal limits of tibiofemoral angles and intermalleolar distances were separately determined based on age and sex.Results: A valgus alignment was observed in all. The tibiofemoral angles in boys between ages 3 to 7 years were 7.1±0.35 and 4.97±0.36 between 8 to 16 years of age. The tibiofemoral angle in girls aged 3 to 7 years were 7.1± 0.38 and in girls of 8 to 16 years were 4.95±0.37 degrees. There was no significant difference between the tibiofemoral angle in girls and boys. The internalleolar distance in boys of 3 to 7 years old was 2.7±0.9 and in boys of 8 to 16 years were 1.4±0.86 centimeters. The intermalleolar distance was 2.6±0.88 centimeters in 3 to 7 year old girls and 2.29±0.93 centimeters in 8 to 16 year old girls. Pierson correlation coefficient showed a reverse relationship between tibiofemoral angle and intermalleolar distance.Conclusion: The tibiofemoral alignment in Iranian children is similar to that of Europe, North America and Turkey but different from Chinese children.
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.
Hamid Reza Seyyed Hosseinzadeh, MD; Ali Akbar Esmaieliejah, MD; Seyyed Morteza Kazemi, MD; Mohammad Reza Bigdeli, MD; Mohammad Ali Jalili, MD; Farivar Baghery, MD; Reza Zandi, MD; Seyyed Reza Aghapoor, MD;; Ali Akbar Esmaieliejah, MD; Alireza Eajazi, MD; Farshad Safdari, MSc
Abstract
Background: Unstable pelvic fractures are major orthopaedic injuries with high rates of morbidity and mortality. Open surgical stabilization is the standard treatment for a great number of them. Percutaneous surgical fixation has become an accepted treatment method in last several years. We would like ...
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Background: Unstable pelvic fractures are major orthopaedic injuries with high rates of morbidity and mortality. Open surgical stabilization is the standard treatment for a great number of them. Percutaneous surgical fixation has become an accepted treatment method in last several years. We would like to report our experience with this relatively, newer technique in a small mixed group of unstable pelvic ring fractures.Methods: This is a report of 16 cases (13 males, 3 females) with mean age of 31±8 years of pelvic and acetabular fractures who received percutaneous iliosacral or iliopubic screw fixation, under C-arm imaging control, and had a 6 months period of clinical and radiographic follow-up.Results: All 16 cases had healed their fractures at follow-up and had full weight-bearing status. 12 cases returned to their pre-fracture activities. One screw break and one wound infection were the complications list. There was no neurological deficit, and average blood loss was 10 milliliters.Conclusion: Percutaneous iliosacral or iliopubic screw fixation for, respectively, posterior pelvic ring or anterior column acetabular injuries are useful surgical treatment options with low complication rates.
Nasser Sarrafan, MD; Seyyed Abdolhossein Mehdinassab, MD; Pouyan Alavinejad, MD
Abstract
Background: Acetabular fracture is usually due to severe trauma and it is often accompanied with other comorbidities. Most often the treatment of choice is open reduction and internal fixation. There are early and late complications of surgical treatment. In this study we tried to investigate early ...
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Background: Acetabular fracture is usually due to severe trauma and it is often accompanied with other comorbidities. Most often the treatment of choice is open reduction and internal fixation. There are early and late complications of surgical treatment. In this study we tried to investigate early complications including nerve injury, infection, heterotopic ossification and thromboembolism among our patients.Methods: In this prospective descriptive epidemiologic study, 46 patients (39 men, 7 women) with the mean age of 34.3 years old (range of 17–71 years) who had undergone open reduction and internal fixation of acetabular fracture in a 3 year period in two teaching hospitals in Ahwaz were studied for their early complications. The follow ups had a range of 3 to 35 months (mean: 11 months).Results: From 46 patients, 34 had type A and 12 type B acetabular fractures (based on AO classification). There were 5 cases (10.9%) of iatrogenic peroneal nerve injury, 6 (13%) infection, and 12 (26.1%) heterotopic ossification. There was no case of thromboembolism.Conclusion: Acetabular fracture fixation is generally associated with high complication rate. Our cases had unexpectedly, more complications in comparsion to similar reports.
Jaafar Soleimanpoor, MD; Mirbahram Safari, MD; Aisan Nozad, MD
Abstract
Ipsilateral postetior dislocation of radial head with radial shaft fracture is an uncommon injury in adults. We present an unusual case of 20 year old man with such a lesion. Our management was operative treatment with open reduction and plate internal fixation. The patient had limited motion in forearm ...
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Ipsilateral postetior dislocation of radial head with radial shaft fracture is an uncommon injury in adults. We present an unusual case of 20 year old man with such a lesion. Our management was operative treatment with open reduction and plate internal fixation. The patient had limited motion in forearm and elbow.
Ali Ghafouri, MD; Anooshirvan Hedayat, MD; Amir Reza Honarmand, MD; Mohammad Hashemi, MD; Saadat Molanaie, MD
Abstract
Colorectal carcinoma metastases are mostly seen in liver. Almost half of the patients with colorectal cancer have liver metastasis or develop liver metastasis during the disease. Any metastasis outside the liver is rarely seen and if present, it is usually seen in lungs, brain, skin and skeletal system ...
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Colorectal carcinoma metastases are mostly seen in liver. Almost half of the patients with colorectal cancer have liver metastasis or develop liver metastasis during the disease. Any metastasis outside the liver is rarely seen and if present, it is usually seen in lungs, brain, skin and skeletal system with the same probability. Skeletal metastases mostly involve weight bearing bones. Meanwhile skeletal involvement rarely occurs in clavicle. In this paper we report a case of colorectal cancer metastasis to medial head of clavicle.
