Iranian Journal of Orthopedic Surgery

Abstract Introduction: Anterior Cruciate Ligament is an extra synovial element, and the fibroblasts are involved in its ongoing renewal and maintenance. It seems that opium addiction and smoking have destructive effects on the healing process of the rehabilitation of anterior cruciate ligament. Thus, the purpose of the present study is to investigate the clinical outcomes of ACL reconstruction surgery in the opium-addicted patients, smokers, nicotine- and opium-addicted patients, and non-addicted patients.
Materials and Methods: This study is a prospective cohort study. The patients were divided into four groups: Smokers, opium-addicted, nicotine- and opium-addicted, and healthy. Then, the results of the ligament reconstruction in these four groups were evaluated according to the KOOS and Lysholm questionnaires as well as the KT-2000 system. The Chi-square test and independent sample t-test were used for analyzing the data, and a significant level was considered under 0.05.
Results: The rate of displacement based on the KT-2000 system in the non-addicted group was significantly lower than that of the exposed groups. The severity of knee pain and the amount of difficulty in daily activities and exercise on the basis of KOOS-criteria in non-addicted subjects were significantly lower than those of the exposed groups. According to the Lysholm questionnaire, the patient's lameness score, support score, instability score, stair-climbing score, and squatting score in the non-addicted group were significantly higher than each of the exposed groups. The level of locking and swelling did not differ significantly.
Conclusion: The results of the current study generally showed that the clinical results of anterior cruciate ligament reconstruction in the opium-addicted patients and smokers were significantly worse than the non-addicted patients. The results of following up the patients after 12 months showed that the displacement rate based on the KT-2000 system in the non-addicted group was significantly lower than in the exposed groups.

Abstract Abstract
Introduction: Distal radius fractures are the most common fractures in the upper limb, and many studies have been conducted on its treatment. There is, as yet, no consensus on which treatment method is preferable. This paper compares the use of plate alone with plate + external fixator in this fracture.
Materials & Methods: In a randomized clinical trial (RCT), patients with type C2 and C3.1(AO/OTA classification) distal radius fracture, were randomly divided into two groups of fixation with locking plate alone (control) and fixation with plate and additional external fixator (intervention). Then patients were evaluated in terms of radiographs and clinical outcomes in first, third and, sixth weeks, and also 6 and 9 months after surgery by Quick Disabilities of the Arm, Shoulder and Hand questionnaire (qDASH) and visual analogue score (VAS). SPSS software was used for data analysis. Informed consent was obtained from the patients.
Results & Discussion: 52 patient (26 in each group) were enrolled in the study. The mean age was 42 years in the control and 41 years in the intervention group. The qDASH score in the control group was 35 and 38 in the intervention group and this difference was not significant between the two groups. No significant difference was observed between the two groups in terms of pain level according to the (VAS) score either. Also, the radiographic criteria including radius height and palmar tilt, did not differ significantly between the two groups (p<0.05).
Conclusion: In general, with similar results of plating, and plating with addition of external fixator in fixation of distal radius fracture, the method of “plate alone” is preferred.

Abstract Abstract
This case report outlines the situation of a young woman suffering from intense back pain, along with pelvic tilt and rotation. Due to the extent of her postural deformity and the profound effect on her quality of life, a spinopelvic fixation was performed to, halt any progression of the deformity, and relieve her pain. During the procedural process, a mass was detected in the sacral area. It was, later found that her vagina had two separate openings, putting the case in the syndromic sacral agenesis group. The importance of genetic testing, multi-disciplinary evaluation and significance of continued follow-u and care is high-lighted.