Iranian Journal of Orthopedic Surgery

Abstract Abstract
Objective: Frozen Shoulder is a painful and debilitating illness that affects 2 to 5% of the general population, characterized with significant shoulder pain and reduced mobility, resulting in loss of passive and active movements.This is a cross-sectional study to evaluate serological factors in these patients and their relationship with Constant Shoulder Score (CSS) which may be of diagnostic benefit.
Material and Method: Frozen shoulder (Adhesive Capsulitis) cases referring within 4 months of the disease were considered for the study (referred sample). Diagnostic criteria for adhesive capsules included: 1) limited and painful shoulder for at least 4 weeks, 2) severe shoulder pain that interfered with daily life or work performance, 3) nocturnal pain, 4) painful limitation of raising active and passive to less than 100 degrees, and 5) limitation of at least 50% in external rotation. After primary clinical evaluations, a series of specific blood tests were requested and the shoulder range of motion and scores were recorded The mean levels of fasting blood glucose (FBS), Erythrocyte Sedimentation Rate (ESR) and C-Reactive Protein (CRP) CRP levels and associated with constant shoulder score (CSS) were documented.

Results: Fifty patients with frozen shoulder referred to the orthopedics clinic of a tertiary teaching hospital within one year period were included. A total of 29 patients with adhesive capsulitis were assigned to the study, of whom 22 were female (76%) and 7 male (24%). The mean levels of fasting blood glucose (FBS), Erythrocyte Sedimentation Rate (ESR) and C-Reactive Protein (CRP) were 100.61 ± 17.29 mg/dL, 16.89 ± 13.14 mm/h and 2.85 ± 6.88 mg/L, respectively. CRP levels were inversely associated with constant shoulder score (CSS).
Conclusion: The serum level of CRP might be a reliable biomarker for predicting the qualitative state of pain and range of motion in patients with adhesive capsulitis.

Abstract Background: Supracondylar humerus fracture is the most common elbow fracture in children and accounts for about 16% of pediatric fractures. To maintain stability in the reduced segment in medial and lateral columns is an important treatment concept. The aim of this study was to compare two methods of proximal distal lateral pinning with medial and lateral cross pinning. Methods: In a cross-sectional study, 140 children (63 boys, 77 girls) with supracondylar humerus fracture were evaluated in a training center in Tabriz, Iran. The mean age was 5.04 years. The cases were divided into two groups (each 70 patients), matched for age, sex and type of fracture and were treated with two above methods. Complications and outcomes were copmpared. Results: Ulnar nerve lesion in the medial and lateral cross technique was 4.3%, and none in the group done by all lateral pin technique. The need for further surgery and loss of stability was 2.9% and 1.4% respectively with no statistical difference. Pin site infection around the pins was 4.3% and 12.9% percent respectivly. Cubius varus deformity rate was 2.9% in lateral cross pinning and 4/1% in medial lateral cross pinning. Conclusions: Proximal distal cross pinning technique for suprocondylar humerus fracture is comparable to medial and lateral cross pinning in terms of stability in maintaining a good reduction. The possibility of ulnar injury is negated in cross-lateral technique.