Alireza Saied, MD; Seyed Mohammad Sabet Jahromi, MD
Abstract
Background: Fracture of phalanx is common upper extremity fracture. Two pining methods are used for fixation of extraarticular proximal phalanx transverse fractures: transarticular parallel pins passing through (MCP) joint and extraarticular cross pining of fracture with out going through MCP joint. ...
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Background: Fracture of phalanx is common upper extremity fracture. Two pining methods are used for fixation of extraarticular proximal phalanx transverse fractures: transarticular parallel pins passing through (MCP) joint and extraarticular cross pining of fracture with out going through MCP joint. The purpose of this study was to comparie these two fixation methods.
Methods: This clinical trial study was done on proximal phalanx transvers fracture using two methods in a training center in Kerman-Iran. In first method, two parallel pins were used from metacarpal head passing through MCP joint into proximall phalanx. In second method two cross pins were used from proximall phalangeal condyles across the fracture. The active range of motion for MCP, PIP and DIP joints, the duration of resuming patients their daily activities, and post operation complications were evaluated.
Results: The mean active range of motion for MCP, PIP and DIP joints, 3 and 6 months after surgery showed no significant difference between the two methods of surgery. There was no significant difference between the two methods in age, gender and the duration of returining to work.
Conclusions: There was no difference in the results for using cross pining or parallel transarticular pin fixation for proximal phalanx fractures. Since intramedullary method is easier with less use of C-ARM, less damage to soft tissue damage and less distraction of fracture, using transarticular intramedullary parallel pins fixation for proximal phalanx fracture is suggested.
Mohammadreza Etemadifar, MD; Mohammadhossein Jamalaldini, MD; Bahador khaleghi, MD
Abstract
Background: Pedicle screw instrumentation has many advantages for correction of adolescent idiopathic scoliosis (AIS) deformity, but screw insertion in AIS could be challenging due to distorted anatomy of pedicles and also rotation and tilt of the vertebrae. In “Free hand” technique, the ...
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Background: Pedicle screw instrumentation has many advantages for correction of adolescent idiopathic scoliosis (AIS) deformity, but screw insertion in AIS could be challenging due to distorted anatomy of pedicles and also rotation and tilt of the vertebrae. In “Free hand” technique, the surgeon locates the pedicle with anatomical landmarks. The purpose of this study was to evaluate the accuracy of pedicle screw position in correction of adolescent idiopathic scoliosis in “free hand” technique.
Methods: In a prospective study, 38 consecutive AIS cases who underwent corrective surgery with free-hand technique from 2013 to 2015 in a training hospital in Isfahan-Iran, were studied. Deformity corrections were evaluated with multislice CT-scan. In terms of position, pedicle screws were devided into “excellent” and “misplacement”. Misplaced pedicles were considered as medial, lateral, inferior, superior and anterior vertebral body and the dis-placement as grades 0 to 4.
Results: A total of 720 screws were inserted. 623 screws (86.5%) were perfect and 97 (13.5%) were misplaced. In all the misplaced cases, 39 screws (40.2%) were medial and 58 (59.8%) were lateral and the deviation of screw was less than 2 mm (grade 1). There was no misplacement in the inferior or superior directions. Only one screw with 4 mm anterior misplacement associated with abdominal pain.
Conclusions: Pedicle screw insertion in adolescent idiopathic scoliosis with the “free hand” technique is a safe and reliable method with acceptable accuracy; if obviates time and radiation exposure.
Ehsan Shakouri, PhD; Fatemeh Zareh, MSc; Ahmad Majd, PhD; Hossein Haghigh Hassanali Deh, MSc
Abstract
Background: Drilling of bone is used to fix the fractures with screws, wires or plates. The interaction between hole surface surface and fracture stabilization components is effective in the bonding strength of the stabilization process. During bone drilling, the temperature could increase above 47 °C ...
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Background: Drilling of bone is used to fix the fractures with screws, wires or plates. The interaction between hole surface surface and fracture stabilization components is effective in the bonding strength of the stabilization process. During bone drilling, the temperature could increase above 47 °C and cause irreversible thermal necrosis. The surface roughness can be considered as a sign of damage of the bone cells.
Methods: This study looks at the effect of rotational speed of drilling of bone on production of surface defects to determine the best processing condition for minimizing the osteonecrosis and surface defects. Seven different rotational speeds in drilling beef femur were used-in non-cooling and liquid cooling phases. In all tests the temperature was measured. After cutting samples, using hematoxylin-eosin staining were stained for detection of surface defects.
Results: The lowest heat prodution was with use of liquid cooling. The drill speed of 1500 rpm with liquid cooling showed the maximum temperature of 48.5°C without production of surface debris and defects as witnessed in stained bone segment.
Conclusions: Cooling application in bone drilling process avoids over and thus less thermal necrosis, which gives the lowest number of surface defects and highest quality wall surface hole.
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.
giti Borzooeian; Nader Tanideh; Mehrzad Lotfi; Maral Mokhtari; Habibollah Nazem; Mahsa Sani; Mahin Salman-nezhad; omid koohi-hosseinabadi; sajad daneshi
Abstract
Background: Osteoarthritis is a progressive joint disease. Mastic fruit has antioxidant and anti-inflammatory properties. Bone marrow stem cells have the ability to differentiate into chondrocyte. The purpose of this study is evaluation the effect of Pistacia atlantica hydro alcoholic extract with bone ...
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Background: Osteoarthritis is a progressive joint disease. Mastic fruit has antioxidant and anti-inflammatory properties. Bone marrow stem cells have the ability to differentiate into chondrocyte. The purpose of this study is evaluation the effect of Pistacia atlantica hydro alcoholic extract with bone marrow- derived stem cells on induced knee osteoarthritis in rat.
Methods: Firstly, 50 male Wistar rats were divided into 5 groups of 10. Then, on days zero and 3, fifty μl collagenase type 2 under anesthesia was injected in the left knee. After 10 weeks, osteoarthritis was induced and rats based on the type of treatment were divided into 5 groups including: control, treatment by stem cell and Pistacia atlantica hydro alcoholic extract, Pistacia atlantica hydro alcoholic extract therapy, stem cell therapy and treatment with hyalgan. At the end of study, radiographic and histopathology surveys and also measured of antioxidant properties as MDA-TAC was done.
Results: After 12 weeks of treatment, radiographic and histopathological evaluation showed that the results of the cell with extract group was significantly different compared to other treatment groups and the control group (P <0.05). Also, based on biochemical evaluation of MDA-TAC in cell with extract group significant reduction in oxidative stress is observed compared to other treatment groups and control (P <0.05).
Conclusions: It seems that Pistacia atlantica hydro alcoholic extract with bone marrow- derived stem cells are effective in knee cartilage repair.
Mohammad Taghi Karimi; Mahsa Kaviani Boroojeni
Abstract
The use of orthosis in many musculoskeletal conditions and neurologic defects is mandatory.
The making of orthosis is usually, with thermoplastic material. Such material can be divided into 3 categories depending on the amount of heat necessary for its making. It may require no heat, some heat or ...
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The use of orthosis in many musculoskeletal conditions and neurologic defects is mandatory.
The making of orthosis is usually, with thermoplastic material. Such material can be divided into 3 categories depending on the amount of heat necessary for its making. It may require no heat, some heat or a lot of heat for making an orthosis. The use of each type of thermoplastic material is, therefore, dependent on its strength, malleability and also on what type of person or disease it will be used for.
