Iranian Journal of Orthopedic Surgery

Abstract Abstract
Orthopedic screws play a crucial role in internal fixation for fracture stabilization, joint fusion, and osteotomy procedures. Recent advancements in material science and biomechanics have led to the development of various screw designs aimed at optimizing fixation strength and reducing postoperative complications. Understanding the biomechanical properties, classifications, and technological innovations of orthopedic screws is essential for improving surgical outcomes. This study presents a comprehensive review of the classification, design, biomechanical characteristics, and clinical applications of orthopedic screws. A systematic analysis of scientific literature was conducted to evaluate different screw types based on their material composition, mechanical properties, and fixation techniques. Additionally, emerging technologies, including bioabsorbable screws, locking screws, and smart implants, were examined for their potential impact on modern orthopedic surgery. The findings indicate that locking screws provide superior fixation in osteoporotic bone and complex fractures, reducing implant failure risks. Bioabsorbable screws have shown promise in eliminating the need for secondary implant removal surgeries; however, challenges such as degradation rate control remain unresolved. Drug-releasing screws have demonstrated effectiveness in lowering post-surgical infection rates, yet further studies are needed to determine optimal drug dosage and release kinetics. Advancements in orthopedic screw technology, including material innovation and improved mechanical design, have significantly enhanced clinical outcomes. However, challenges remain regarding the long-term stability of bioabsorbable screws, the optimization of mechanical properties, and the reduction of implant-related complications. Future research should focus on developing patient-specific implants and refining biomechanical designs to further improve surgical success rates.

Abstract Abstract Fracture fixation using plates has evolved over time. This progress is evident both in the types of devices used—such as the development of locking plates—and in the conceptual approach of orthopedic surgeons, including greater respect for soft tissue and minimal manipulation of it. In summary, locking plates function as internal fixators, where the plate acts as a rod and the screws play the role of Schanz pins. This structure, which functions as a solid, unified unit, is less dependent on bone quality, making it especially useful in the fixation of articular surface fractures and metaphyseal fractures, particularly when using minimally invasive approaches. Numerous advancements in the evolution of these plates—such as Variable Angle Plates and Locking Compression Plates (LCP)—offer surgeons significant intraoperative flexibility. Understanding concepts such as working length and screw density greatly assists surgeons in screw placement. Although there are no absolute contraindications for the use of locking plates, their use is not recommended for simple diaphyseal fractures. Through ongoing evaluation of design, biomechanics, and surgical concept comprehension, it is anticipated that newer and more advanced locking plates will be developed in the near future through the collaboration of orthopedic surgeons and engineers. This continuous improvement reflects the dynamic nature of orthopedic technology and surgical techniques in fracture management.

Abstract Object: Correlation between Diabetes Mellitus (DM) and musculoskeletal problem has been established in many of the past studies. There are reports of high prevalence (up to 63%) of upper extremity impairment in diabetic patients. The main aim was to conduct a study to determine the prevalence of diabetes and prediabetes in patients with shoulder complaints. It may help the treating physician in managing patients with shoulder problems.
Methods: During a period of six months from February 2018 to August 2018, patients who consulted shoulder clinic with complain of shoulder pain were included in this cross sectional study. Eligible patients were enrolled after informed consent was obtained. A uniform checklist was completed for every patient. The key components of the checklist were: demographic data, fasting blood glucose(FBS), diagnosis, body mass index( BMI).Diagnosis of diabetes and prediabetes was done by FBS level( FBS between 100 to 126 considered prediabetes and more than 126 as diabetes.
Results: 564 eligible patients were enrolled in the study. Of the 564 patients, 18.8% had DM, 25.9% had pre-diabetes, and 55.3% had normal fasting blood glucose. A higher proportion of men had abnormal fasting glucose compared to women (54% and 33.9% respectively). There was no significant difference in blood glucose levels in respect to different shoulder pathologies (P = 0.191).
Conclusion: This study shows that population with shoulder complaint have a higher prevalence of DM than the normal population. This high proportion of patients with impaired blood glucose levels and shoulder pain necessitates further research in this course and advancement towards risk factors of DM. It is more important in community areas where routine screening of diabetes is not performed.