Iranian Journal of Orthopedic Surgery

Abstract Abstract Introduction: Considering the importance of growth plate fractures in quality of life and the complications caused by it and the lack of information about the prevalence of this type of fracture in the target society, this study was conducted with the aim of evaluating the prevalence of this type of fracture in an Iranian society. Materials & Methods: The information of 41 patients with fracture of growth plate including; age, gender, open and closed fracture, single and multiple fractures, type of fracture, location of fracture and presence of fracture on the right or left side of the limb were extracted from the operating room records, radiographs of the patients and their files. After collecting the data, the data were subjected to statistical analysis. Results & Discussion: 32 boys and 9 girls with an average age of 8.24±2.48. 32 years were included the distal radius fracture was the most common (26 cases) and the medial malleolus and distal metatarsal (1 person) were the least common sites of fracture. Most of the fractures were on the left side (22 people), closed (33 people) and single injury (29 people) and Salter-Harris type 2 physeal fractures were the most common fracture patterns (35 people). Conclusion: the growth plate fracture in children was more common in boys, left side, single fracture, and the majority of those were Salter-Harris type 2 fractures.

Abstract Abstract Introduction: Delays in diagnosing musculoskeletal injuries in patients who have suffered polytraumas can lead to long-term functional and aesthetic disorders. This study investigates the undiagnosed cases of fractures and soft tissue damage in multiple trauma patients in a teaching trauma centre within 6 months. Materials & Methods: This cross-sectional descriptive study was conducted on polytraumas patients referred to a teaching trauma centre within 6 months. Results & Discussion: In 339 polytrauma patients, 21(6.2%) had undiagnosed injuries: 15 (71.4%) men and 6 (28.6%) women with mean age of 39.3 ± 8.5 years (11 to 82 years) were studied. The average duration of hospitalization for undiagnosed fractures and soft tissue injuries in polytraumas patients was 4.4 ± 2.3 days. The most common sites of undiagnosed injuries were the clavicle (22.2%), followed by metacarpal and femoral neck (16.7%), acetabulum and intertrochanteric (11.1%), and distal fibular fractures (8.3%). Conclusion: Late diagnosis of fractures in trauma hospitals is not uncommon, Middle age of 40-60 years and clavicular and femoral neck fractures are important and common ones to remember.

Abstract Background: Osteoporosis, referred to as a " silent epidemic," is a skeletal disease with decreased bone density. This problem has no symptoms, but the most common result is fracture. According to the reported result, this disorder in Iran is more than 4% in men and more than 7% in women, while in the age of over 50 years, this statistic is significant and reaches more than 10% in both sexes. Considering this problem and the need to predict the conditions to change and treat it, it was decided to investigate this study of osteoporosis in people in a tertiary trauma center.
Materials and methods: In this study, 113 patients over 65 year old age admitted to the emergency room of Sina Hospital were examined by and subjected to BMD osteoporosis examination, and also the demographic examinations of the patients were recorded through interviews and examination of hospital records, and were finally subjected to statistical analysis
Findings: The age of the examined patients was 75.8 years and 67.3% were in the group over 70 years old. 44.2% of the studied population were women and 57.8% were men. 31 patients (27.4%) had a history of fracture. Alcohol consumption and smoking were reported in 3.5% and 31.9% of cases, respectively. In addition, there are 6 patients (3.5 percent) taking drugs on bone density, which in some cases were from the corticosteroid group.
The fracture status of the patients was in 61 cases (54%) in the lower limb and in 52 cases (46%) in the upper limb. A total of 76 patients (67.3%) have osteoporosis
Conclusion: This study found that about two-thirds of the patients who suffer limb fractures in old age have osteoporosis.

Abstract Background: Essex-Lopresti injury (ELI) is one of the rare injuries of the elbow area, which includes fracture of radius head, disruption in the interosseous membrane of the forearm (IOM), and distal radio-ulnar joint dislocation. This happens as a result of transverse pressure on the elbow and forearm when falling down or when high energy is applied.
Methods: In this study, we introduced a 40-year-old patient who suffered both bone forearm fracture in addition to the above injuries. First, the patient underwent both bone forearm ORIF surgery, and then fixation of radius head and distal radio-ulnar joint reduction and fixation.
Results: After six months, the patient has 20 degrees of motion limitation only in the pronation state, and the joint’s motion range in other joints is complete.
Conclusion: In general, the Essex-Lopresti injury (ELI) is one of the rare hand injuries that are difficult to diagnose with simple radiographs and requires great care.
 
 

Abstract Background: The purpose of this study was to investigate possible correlation between vitamin D in 13-36 month old children with tibial bone fracture. Methods: This cross-sectional study was conducted on children aged 18 to 36 months who referred to a medical center in South-East of Iran with tibial fracture. All the demographic information was collected and vitamin-D levels were measured and statistically analyzed. Results: A total of 30 children were included in the study, and the mean vitamin D level in these subjects was 31.6±6.1. This study showed no significant relationship between low vitamin D levels with increase in the risk of tibia fracture in children who had recently started walking. Conclusion: The present study revealed a significant association between vitamin D level and its deficiency with an elevated risk of tibia bone fracture in toddlers between 18-36 months.    

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.