Iranian Journal of Orthopedic Surgery

Abstract Introduction
Malnutrition is an underestimated problem in the general hospitalized population. Although most physicians are aware of the risk of malnutrition, half of malnourished patients are not identified during their hospitalization. The aim of this study was to investigate the prevalence of malnutrition in traffic injured trauma patients referred to Kashani Hospital affiliated to Isfahan University of Medical Sciences.
Methods
Sixty patients were selected by simple random sampling from injured trauma patients. Required variables such as age, sex, height, weight, albumin, lymphocytes were extracted and recorded by asking the patient or the patient's file. In addition, malnutrition of patients was assessed using SGA (Subjective global assessment - Diagnosing Malnutrition) questionnaire.
Results
About 28% of traumatic patients admitted to Kashani Hospital were assessed as having proper nutritional status. However, about 72% of patients with mild to severe malnutrition were classified. Also, the nutritional status of patients was not significantly different between men and women (P-value = 0.838).
Discussion
In this study, 26.7% of patients (95% CI: 15.0-38.3) had mild to moderate malnutrition and 45% of patients (95% CI: 31.7-56.7) had severe malnutrition. Serum albumin was statistically significantly associated with malnutrition (P-value, 0.004).
Conclusion
To improve treatment outcomes and reduce hospitalization costs, nutritional screening and identification of patients in need of nutritional therapy, especially in patients with severe trauma, is emphasized.

Abstract Background: Distal radius fractures are among the most common fractures. They can happen at any age group, and there are several treatment options and several classification systems for these fractures. One of these classifications is that of Fernandez. In this study, we evaluated the results of treatment of distal radius fractures by bridging external fixator and percutaneous pinning.
Methods: In a cross-sectional study, 72 patients with Fernandez type 3, 4 and 5 that underwent external fixation and percutaneous pinning for comminuted distal radius fractures were followed and assessed after 3 and 6 months.
Results: The 72 patients had mean age of 44.2 years. 55% were male. The most common cause of fractures was vehicle accidents. 4 cases of malunion, 4 radial nerve injuries, 2 fixator loosening and 6 cases of infection were encountered.
Conclusion: External fixator supplemented by percutaneous pinning is an efficient technique for treatment of unstable distal radius fractures. It has low rate of complication and high rate of patient's satisfaction.

Abstract Background: Pulley is a synovial tissue that attaches the flexor tendons to the dorsal portions of the fibro-osseous tunnel near the tendon attachment. Pulley type A with ring structure is one of the most important pulleys in fingers. Two-stage reconstruction by silicon is the common treatment in damaged tendon which has long recovery time and the tendency of the repaired tendon to adhere to the fibrous-bone tunnel around it. Accordingly, the one-stage reconstruction by synthetic pulley is a promising approach to resolve the mentioned problems.
 Methods: In the present research, the polyurethane (PU) nanofiber scaffolds have been designed for synthetic pulley applications, and their mechanical and structural properties have been evaluated.
Results: The structural properties of nanofiber scaffolds show similar properties to protein and polysaccharide fibers in the extracellular matrix (ECM). The Fourier transform infrared spectroscopy (FTIR) results confirmed the functional groups of PU without any unwanted reactions. The amount of stress (3.19 ± 0.54) and Young's modulus (1.20 ± 0.39) in PU nanofiber scaffolds show similar mechanical properties to natural pulley.
Conclusion: The obtained results showed that the PU nanofibers scaffolds can be proposed as a suitable candidate for fabrication of synthetic pulley in flexor tendon injuries.
 

Abstract Background: Hip hemiarthroplasty is a common method in treating femoral neck fractures in patients older than 70 years old. Depending on the severity of bone destruction, and bone stock, two methods either cemented or non-cement bipolar prosthesis may be used.
Methods: In a prospective study, 60 patients with femoral neck fractures who were referred to the university hospitals of Isfahan, Iran, were divided into two treatment groups: 30 patients were treated with cemented bipolar method and 30 with non-cement bipolar hip arthroplasty surgery. In a 6-month follow-up, the surgical outcomes were assessed using the VAS pain scale, SF36 general health instrument score, and Harris hip score (HHS).
Results: The pain scale (VAS), SF36 and Harris scores showed non- significant differences in the two groups: pain=3.63 out of 10 in 3 months and 2.6 out of 10 in 6 months; SF36= 69 and 86 in 3 and 6 months ,respectively; HHS=78 in both in 3 and 6 month in the cemented group .In non-cemented group the pain scores were 3.91and 3.12 in 3 and 6 months; SF36=67 and 83, and HHS=82 in 3 and 6 months respectively.
Conclusion: It seems that the two methods of cemented and non-cemented bipolar hemiarthroplasty, in elderly hip fractures, would have similar pain, quality of life, and hip function in short term follow-ups.