Iranian Journal of Orthopedic Surgery

Abstract Introduction: Hip osteoarthritis is a common condition affecting 10–15% of individuals over 60 years old, leading to significant pain and discomfort. Low back pain is also highly prevalent among the elderly. The hip-spine syndrome describes the relationship between spinal pain, hip disorders, and symptomatic changes following hip reconstruction surgeries, particularly total hip arthroplasty (THA). The impact of THA on the biomechanical structure of the spine and pelvis remains unclear. This study investigates changes in clinical and radiological sagittal spinal alignment parameters following THA.
Materials & Methods: This study included 15 patients who underwent THA at one hospital. Radiographic parameters (Sacral Slope, lumbar lordosis, and S1-L1 distance) and clinical parameters, including low back pain (PSFS questionnaire), daily activity level (PSEQ questionnaire), and hip flexion range of motion, were assessed before and three months after surgery.
Results & Discussion: Radiological changes after THA were not statistically significant. However, there was a significant reduction in low back pain (5.01±1.1-, P<0.001). An improvement in activity level (23.47±7.1, P<0.001), and an increase in hip flexion range of motion (38.66±19.62, P<0.001). Additionally, higher BMI was associated with a lower improvement in activity level (P=0.047).
Conclusion: THA leads to reduced low back pain, improved activity level, and increased hip flexion range of motion. However, these changes are not correlated with radiological sagittal alignment parameters.

Abstract Introduction: Elbow fractures are common in both pediatric and adult populations, and accurate diagnosis is crucial for proper treatment. While radiography is the standard method, alternative imaging techniques such as ultrasound are increasingly explored, especially when radiographic imaging is not ideal. This study evaluated the diagnostic accuracy of ultrasound in detecting elbow fractures, comparing it with radiography and computed tomography (CT) as reference standards.
Materials & Methods: Forty patients with suspected elbow fractures underwent imaging using ultrasound, radiography, and CT. Results from all three methods were compared to assess sensitivity, specificity, and agreement between ultrasound and the reference standards.
Results & Discussion: The mean patient age was 15.5 years (range: 4–49), with 72.5% male (n=29). Supracondylar fractures were most common in patients under 18, while radial head fractures predominated in those over 18. Ultrasound showed good diagnostic performance, with 88.9% sensitivity, 87% specificity, and a kappa value of 0.73 compared to radiography. Against CT, ultrasound demonstrated 94.8% sensitivity and 89.7% specificity.
Conclusion: Ultrasound is an accurate, non-invasive, and cost-effective alternative to radiography and CT for diagnosing elbow fractures, especially in emergency or resource-limited settings. Its strong diagnostic performance, particularly in children, supports its use as a reliable tool. Further studies with larger samples and follow-up are recommended.