Iranian Journal of Orthopedic Surgery

Abstract Introduction: Intertrochanteric fractures are among the most common hip fractures, especially in the elderly population. DHS and PFNA, remain the main fixation methods for these fractures. This study compares the long-term results of these methods in fractures classified as OTA/AO A1 & A2.1.
Materials & Methods: A retrospective cohort study was conducted. 154 patients treated with DHS, PFNA, within 10 years in a teaching hospital were studied. Outcomes, such as infection, reoperation rate, and mortality were assessed based on age and sex in different subgroups.
Results & Discussion: Analysis of the 154 patients revealed no significant differences in infection rates, need for reoperation, or 5-year mortality between DHS and PFNA methods. However, women and patients older than 70 years treated with DHS showed a higher need for reoperation.
Conclusion: Except for women and individuals over 70 years old who had higher reoperation rates with DHS, no significant difference was observed between the two 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 Background: Several studies have compared surgical and conservative methods for the treatment of fingertip injuries. However, there are few studies on the effect of phenytoin dressing and its efficiency in treating the fingertips compared to other common treatments. The aim of this study was to compare phenytoin dressing, surgical treatment with VY flap technique and conservative treatment with Vaseline in patients afflicted with fingertip injuries. Methods: This prospective cohort research was conducted on all patients referred to the Emergency Department of Gorgan Hospital during 2016-17 who suffered from fingertip injuries. The eligible patients were selected for further intervention and follow up and were divided into three groups including phenytoin dressing, surgical treatment with VY flap technique and Vaseline conservative treatment. The collected Data was analyzed using Chi-squared test and independent sample t-test and the significance level was considered below 0.05. Results: After 12 months, subjective, objective, and cosmetic complaints were evaluated based on the Allen Impairment Scale. According to the statistical evaluations, no significant difference was found between the three groups in subjective, objective, and cosmetic complaints after one year (P<0.05). Conclusion: The results of this study for the first time showed that phenytoin dressing has a similar effect to Vaseline dressing for the treatment of fingertip injuries and is not superior to it. Furthermore, the findings of this study, in agreement with previous studies, showed that clinical results are similar to conservative and surgical treatments and are not superior to each other.