Iranian Journal of Orthopedic Surgery

Abstract Backgrounds: several tests are used to assess the presence of Palmaris longus tendon. In the present study we attempted to assess the interobserver and intraobserver reliability of five of the most famous ones and also the examination of fifth superficial flexor function. Methods: Two observers, who had been trained about the tests and had practiced on them, examined 105 volunteers on two separate occasions and in one-month interval and the results were recorded. The reliability of each method was assessed with Kappa measurement. Results: Kappa ranged from 0.541 (moderate reliability) to 0.813 (almost complete agreement) for Palmaris. The highest interobserver and intraobserver reliability and also the best agreement with other tests was of Schaeffer. The lowest Kappa was for Thompson and the others had good to excellent reliability. Kappa for interobserver and intraobserver reliability for fifth flexor was respectively 0.415 and 0.500 (moderate reliability). Conclusion: the tests that were assessed have good reliability except for Thompson that has a moderate one. It seems that the standard test (Schaeffer) is the best method for assessment of Palmaris Longus absence or presence. The method assessed for evaluation of fifth superficial flexor variations assessment has a moderate interobserver and intraobserver reliability.

Abstract Background: Osteoarthritis is a physiological response to the longitudinal and repeated forces applied to the joint which is associated with an increase in energy consumption and changes in the rate of  displacement of the center of pressure in these patients. The purpose of the present study was to investigate the effect of 8 degree lateral wedge in medial compartment knee osteoarthritis energy consumption and displacement of the center of pressure in frontal plane. Methods: The research design was quasi-experimental with a pretest - posttest. In this study, 26 patients with medial compartment knee osteoarthritis in the age (range of 40 to 60 years) were selected through available sampling. In order to measure the energy consumption the polar electro and measure displacement of the center of pressure the force plate apparatus were used. Participants were evaluated in two conditions with/without of using   lateral wedge during walking. Results: The results showed that the mean of energy consumption and the displacement of the center of pressure decreased after using the lateral wedge. The average range of energy consumption before and after using the lateral wedge was respectively 0/381, 0/318 (p< 0/001), and displacement of the center of pressure was respectively 26/99, 17/23 (p< 0/001). Conclusion: Use therapeutic interventions such as 8 degree lateral wedge may reduce energy consumption and displacement of the center of pressure of patients with medial compartment knee osteoarthritis.  

Abstract Botulinum toxin is produced by clostridum botulinum bacteria , and has seven serotypes ,some of which are pharmacologically active in human. An inactive protein is bound to this toxin , as toxin contains two distinct chains, each one with a specific characteristic . The mechanism of action is acetyle choline inhibition at the synapses. The general pharmacological and practical points for the use of this toxin will be discussed in this article without emphasis on its use in any specific field.

Abstract Introduction: Hip dysplasia can be associated with early degenerative changes. Different values have been reported for incidence of hip dysplasia in different countries. In the current study, we are reporting on the incidence of hip dysplasia in a group of normal Iranians evaluated by measuring the morphologic parameters of acetabulum on radiographs. Materials and Method: 586 hips (293 person) were enrolled in this study. On anteroposterior hip radiographs, the following 5 parameters were measured: Central edge angle (CEA), acetabular angle (AA), acetabular depth (AD), acetabular roof obliquity (ARO) and roof angle (RA). The normal and abnormal values were obtained in different sexes and compared with the known normal values in orthopaedic literature. Furthermore, the correlation between the above measurements was investigated. Results: Based on CEA, 15 (2.6%) of hips were dysplastic:-0.7% definite and 1.9% mild. 19 hips (3.2%) were dysplastic when using AA values. AD and RA were significantly higher in males. Except for lack of correlation between AA and AD, the other parameters -in particular, CEA and AA- were closely correlated. CEA, AA, ARO and RA were significantly different between dysplastic and non-dysplastic hips. Conclusion: Definite or mild dysplasia was recognized in 0.7% and 1.9% of the “normal” population that was studied. Since CEA was the same between males and females and was correlated with all other morphologic parameters, it seems that CEA is a useful measurement to evaluate presence of hip dysplasia.

Abstract Background: The knee joint is one of the most important joints of the body that is affected by various diseases. Osteoarthritis is the most common disease involving the knee and causes symptoms including pain, swelling, limited mobility and disability. Several therapeutic approaches, including drug therapy, physiotherapy, and surgical treatments such as arthroscopic debridement and knee replacement have been used for this disease. Knee replacement is one of the most effective treatments for this disease. Method: In a clinical trial and prospective study, 57 patients who underwent knee replacement surgery at Yazd Shahid Sadoughi Hospital in 2016, were evaluated. All patients were examined before and after the surgery, and the VAS, WOMAC, KSS, and SF-36 questionnaires were completed. Also, postoperative radiography was analyzed using KSRE form. Results: Of the 57 patients studied, 51 were female and 6 were male. The mean age of the patients was 65.32 years. Patients have been evaluated on average 7.31 months after the operation. Based on the KSS form, the mean" Function score" of patients'  increased from 15.27 ± 24.03 before surgery to 69.96 ± 8.93 after surgery, and the mean "Knee score" of patients increased from 7.58 ± 40.43 before surgery to 82.38 ± 7.03 after surgery. The mean score of WOMAC decreased from 69.02 ± 11.02 before surgery to 25.73 ± 5.92 and the pain score in patients was decreased from 8.89±0.77 before surgery to 1.54±1.00 after surgery. The mean scores of SF-36 quality of life questionnaire increased from 45.75±18.85 before surgery to 65.26±17.86 after surgery. In the study of postoperative imaging, the mean alpha angle was 97.8 ± 0.98, the mean beta angle was 89.7 ± 1.11, the mean gamma angle was 2.57±1.62 and the mean delta angle was 86.38 ± 0.81. Conclusion: Due to the significant improvement in pain, WOMA score, function score, knee score, range of motion and improvement in the quality of life, knee replacement surgery is an effective and curative treatment for osteoarthritis of the knee.