Iranian Journal of Orthopedic Surgery

Abstract Abstract
Introduction: The patella has an important role in knee extension and shock absorption. This retrospective study assessed factors influencing surgical outcomes of patellar fractures over ten years at a single center.
Methods: A descriptive-correlational design was applied to patellar fracture cases treated at a university center over a decade. Patients were stratified into follow-ups of <5 or ≥5 years. Data included demographics, medical history, functional outcomes (Koo’s and WOMAC indices), pain, range of motion, and osteoarthritis severity (Kallgren/Lawrence classification). Census sampling was used. Analyses were performed in SPSS, with visualizations in Excel and GraphPad Prism.
Results: Among 53 patients (mean age 60.45 ± 16.00; 90.6% male), 62.3% had <5-year and 37.7% had ≥5-years follow-up. Follow-up duration did not correlate with outcomes. Treatment complications significantly correlated with degenerative arthritis. Functional scores were higher (p < 0.05) and pain scores lower (p < 0.05) in patients without complications.
Conclusion: Patellar fracture surgery yielded favorable mid-term outcomes, with complications linked to poorer function and higher pain. Reoperation rates were low, supporting surgical efficacy.

Abstract Abstract
Introduction: In some cases of major lower limb trauma, either amputation or limb preservation is performed. The aim of this study was to compare the quality of life in patients undergoing amputation versus limb preservation.
Materials & Methods: In a cross-sectional comparative study, patients with major lower limb trauma who underwent either lower limb amputation or limb preservation were evaluated at least six months post injury. Quality of life was assessed and compared between the two groups using SF-36 questionnaire.
Results & Discussion: A total of 94 patients, including 80.9% male and 0.9% female, with mean age of 41.5 years (range 18 to 64), with the mean study period of 6 months, were included in the study. There was no statistically significant difference between the two study groups regarding age, gender, marital status, number of children, education level, smoking, or substance and alcohol abuse. The sub-scales of general health (P = 0.001) and vitality (energy) (P = 0.002) were significantly higher in the amputation group in comparison with the limb-preservation group within the six- months post injury.
Conclusion: In patients with major trauma, attempts to preserve the limb, instead of immediate amputation results into longer hospital stays, increased incidence of infections, and higher rates of re-operation. Amputation, within a minimum of six months, leads to improved quality of life, particularly in the domains of general health and vitality.

Abstract Background & Aim: Orthopedic trauma is a common injury in children and may cause deep and permanent psychological and physical damages for the patients and their families. Recognition of the incidence rate of these injuries can help design effective treatment plans. This study aimed to identify various dimensions of orthopedic trauma in children in Abu Ali Sina Hospital of Sari, Northern Iran.
Materials and Methods: In this prospective descriptive study, patients under the age of 16 years with orthopedic injuries, hospitalized in Bu Ali Sina Hospital during 2015-2016 were entered into the research. Information related to the age, gender, and mechanism trauma was collected. Data analysis was performed in SPSS using Chi-square, as well as paired and one-sample t-tests.
Results: In total, 525 patients below the age of 16 years were assessed, (65.3%) with a mean age of 9.7±4.4 were male years and the rest were female (34.7%) with the mean age of 7.7±6.4 years. While most injuries in male subjects were in the age range of 14-16 years, for female participants two poaks in the age ranges of 2-4 and 14-16 years was seen. Moreover, 81.7% of the fractures were related to the upper limbs while 18.3% of the traumas were observed in the lower limbs. Furthermore, the most common location of incidents was home, and most frequent mechanism in both genders was falling (42.3%). In addition, the most common time of injuries was the fall season (44.6%). According to the results, most orthopedic trauma (56.7%) were observed in children and adolescents with normal body mass indexes, and only 8.29% of fracture cases were related to obese or overweight patients aged 2-16 years.
Conclusion: Children are at risk of severe orthopedic trauma, which is due to lack of information, awareness, and education. Examining the safety of children and keeping them away from such injuries is essential and must be stadied in other large cities in other the developing countries.
 

Abstract Background: congenital foot deformities are among the most common congenital abnormalities causing morbidities, disturbing the normal gait and affecting patients’ quality of life. The aim of our study was to find out the prevalence of such abnormalities in neonates born at a referral center in northern Iran. Methods: This study was a descriptive cross-sectional study on the neonates born in Imam Khomeini hospital of Sari in a two-year period. The variables considered in our study were gestational age at the time of delivery, medical conditions complicating the pregnancy including diabetes, chronic hypertension, obstetrical complications like olygohydramnios, polyhydramnios, and malpresentations, mothers' age, chronic diabetes, hypertension, mothers' addiction, sex and birth weight of the newborn, history of having a child with congenital limb anomaly and the type of delivery. Photography of newborns' feet was taken on first day of birth to be assessed by an orthopaedic surgeon. In addition, the babies were examined the day after birth by one of the two neonatologists and the suspicious cases were referred to the orthopedic surgeon. Statistical analysis was performed by SPSS software. Results: From 2025 neonates studied, 210(10.4%) calcaneovalgus, 7 (0.3%) clubfoot, 156(7%) cases of ''PesVarus'', 22 cases of (1.1%) metatarsus adductus, and 1 case of polydactyl were recognized. Among all variables, only mothers' age and cigarette smoking during pregnancy had association with congenital foot abnormalities. Conclusion: The most prevalent congenital abnormalities in our study was Pes Calcaneovalgus and a positional mild ''Pes Varus''. The low rate of club foot, polydactyly and metatarsus adductus are notable,