Iranian Journal of Orthopedic Surgery

Abstract Abstract
Introduction: A delay in diagnosis and inadequate treatment of Benign bone tumors may lead to malignant transformation or damage to other internal organs with time. We decided to Survey the frequency of benign bone tumors and its related factors in patients in a ten-year period referred to Orthopaedic ward of Poursina Hospital, Rasht.
Materials and Methods: A descriptive retrospective study was designed on bone tumors collected from medical records of 2007 – 2017 patients referred to Guilan university of medical sciences. All the demographic data were collected and analyzed.
Results: The mean age of patients with benign tumors of bone in this investigation was the 43.5 ± 12.93 years. The highest percentage of patients with benign tumors of bone were males (63.9%). The highest percentage of benign tumor of bone was multiple exostosis 25% followed by osteochondroma 22.2% and then osteoid stoma by 16.7%. Using Fisher's exact test showed a statistically significant relationship between gender, age, educational level and location of the benign tumors of bone seen in this study (P=0.001).
Conclusion: Exotosis and osteochondroma are the most common benign bone tumors, and are more in the lower limb in the male gender -Blood pressure and higher education level were the common associated findings.
 

Abstract This is a report on simultaneous dislocation of the left shoulder and elbow resulting in a 16 years old boy. Bipolar dislocation of Luxatio Erecta and posterior dislocation of the elbow is extremely rare. After clinical examinations (attention to pain, swelling, and deformity of the shoulder and elbow joints and neurovascular examinations), the necessary radiography was performed for the patient at the level of his tolerance: AP of the shoulder and side imaging of the elbow. Closed reduction was carried out with emergency maneuvers, followed by physiotherapy. Good result was obtained in the 6 weeks follow-up the examination of the adjacent joints of a dislocated limb is an important issue and must be emphasized.
 

Abstract  Background: Bleeding from proximal screw drill-site in femoral neck fractures may have the ability to predict the occurance of avascular necrosis of femoural head. In this study the relationship of bleeding from proximal screw drill-site during internal fixation of femoral neck fractures with rate of avascular necrosis was studied. Methods: This study is a cross-sectional study that was carried out on 19 to 60 year patients with femoral neck fracture that referred to health care centers in Rasht, Iran during the year 2008. The age, sex, type of fracture based on Garden Category were recorded. Then, presence or absence of bleeding from the proximal screw holes within the first 5 minutes was recorded.  Results: In this study, 40 patients were enrolled with mean age of 39.78±14.4. Twenty two patients (55%) had bleeding from the proximal end of the screw, and 18 (45%) did not have any bleeding. Bleeding from proximal screw hole in patients without avascular necrosis was seen in 11 cases (61.1%). This difference was statistically significant (p < /i>=.005). Conclusions: Presence of bleeding from proximal screw hole in femoral neck fracture reduces odds of AVN in femoral head fracture and can help deciding between internal fixation or arthroplasty for treatment of such a fracture.  

Abstract Background: Cementless total hip replacement is an accepted alternative to total hip replacement with cement in younger patients, but it remains controversial for elderly patients. This study evaluated the functional results and complications of cemented and cementless methods in old patients. Methods: In this cross-sectional study, all the patients aged 65 years or older who had been hospitalized for total replacement of hip joint because of femoral neck fracture or osteoarthritis of hip were studied during a 3-year period in three educational hospitals in Iran. "Harris hip score" was used to assess the functional consequences. The early complications -thrombophlebitis of lower limbs, dislocation, hematoma and infection - and late complications - aseptic loosening, dislocation, and reoperation, were documented. Results: 209 eligible patients, including 96 (45.9%) cemented and 113 (54%) cementless were studied. Patients were followed for a mean period of 5 years and 2 months (51-82 months). The overall rate of early complication was 8 cases (3.8%): five in the cemented and three in cementless group, respectively. Late complications were seen in two cases -one loosening in cemented group and one dislocation in cementless group. The final Harris hip score at the final follow-up was 84.01±4.71 in cemented and 85±5.02 in the cementless groups (p≥.05). Conclusion: Cementless hip replacement can have a satisfactory functional result like cemented hip replacement procedure in the elderly patients over 65 years of age.

Abstract Traumatic hip dislocation represents an orthopaedic emergency. Given the severity of associated complications, every effort should be made to ensure prompt diagnosis and treatment. Bilateral traumatic dislocation of the hip is rare and simultaneous asymmetric traumatic dislocation even more unusual. This is a report on 17-year-old male patient with asymmetric bilateral dislocation of the hip joint with no bony fracture, following a motor-cycle accident. The right hip was reduced by closed manipulation, but the left hip required open reduction through a posterior approach. After 3 months there was a local osteoporosis in left hip which had an anterior dislocation initially.