Iranian Journal of Orthopedic Surgery

Abstract 1-Abstract
Metacarpal fractures are common hand injuries that often require surgical intervention for significant displacement or instability. Various fixation methods such as Kirschner wires, plates, external fixators, and intramedullary screws are used, each with potential complications. Understanding the anatomy and biomechanics of the metacarpal is crucial for successful management. We present a case of a 36-year-old man with a second metacarpal fracture following a motorcycle accident. After initial pinning failed, open reduction with internal fixation was performed, later replaced by an intramedullary headless screw. Subsequent physiotherapy led to a successful outcome with normal function and union. Surgical techniques for metacarpal fractures include pinning, plating, and intramedullary devices, each with specific indications and considerations. While pinning is cost-effective and minimally invasive, plating is preferred for certain fracture patterns, and intramedullary devices allow early mobilization. In our case, the intramedullary screw proved effective for delayed Union treatment after previous failures. Larger studies are needed to validate its efficacy and explore potential complications. This case highlights the importance of individualized treatment strategies in complex metacarpal fractures.

Abstract Background: To improve the education of orthopaedic residents and enhance patient care in the Iran's healthcare system, it is necessary to gather information about the current status of scientific, practical, and research-based education for residents.
Methods: The research project initially focused on examining the executive curriculum in 14 centers affiliated with 6 different medical universities. Subsequently, an investigation was conducted into human resources, infrastructure, operating room facilities, educational and research outcomes, as well as the regular implementation of practical examinations to evaluate the performance of residents during their residency years. All the aforementioned aspects were covered using a comprehensive questionnaire, which was distributed via the "Formafzar.com" website as a link to the heads of departments in these centers by the Iranian Orthopaedic Association. The relationship between facilities and equipment and passing the future specialized orthopaedic board examination was also evaluated.
Results: Among the examined centers, only 20% adhered to the criteria of Iran educational curriculum in all aspects of human resources, education, and research.
Conclusion: a regular evaluation of teaching methods used by international centers and the national curriculum is necessary for orthopaedic training centers in Iran. Additionally, regulatory systems should monitor the training process of orthopaedic residents to standardize services, equipment, and educational programs in the country.