Hemophilic Pseudotumors: Diagnosis and Management
E. Carlos
RODRIGUEZ-MERCHAN
Department of Orthopaedic Surgery, La Paz University Hospital, Madrid, Spain
author
text
article
2020
eng
Prevention is essential for avoiding the complications of muscle hematomas (pseudotumors, compartment syndromesand peripheral nerve lesions) in hemophilic patients. This is achieved through early diagnosis of muscle hematomasand proper long-term hematological treatment until they have resolved (confirmed by image studies). Ultrasound-guidedpercutaneous drainage could be beneficial in terms of achieving better and faster symptom relief. When suspectinga hemophilic pseudotumor, biopsy will help us confirm the diagnosis and rule out true tumors (chondrosarcoma,liposarcoma, synovial sarcoma) that sometimes mimic hemophilic pseudotumor. Surgical removal of hemophilicpseudotumor is the best solution. As alternatives, there are curettage and filling with cancellous bone and radiotherapy(when surgery is contraindicated). Preoperative arterial embolization (ideally 2 weeks before surgery) helps controlintraoperative bleeding during surgery for giant pelvic pseudotumors.Level of evidence: III
The Archives of Bone and Joint Surgery
Mashhad University of Medical Sciences, Iranian Society of Knee Surgery, Arthroscopy and Sports Tramatology,Iranian Orthopaedic Association
2345-4644
8
v.
2
no.
2020
121
130
https://abjs.mums.ac.ir/article_13642_0f2557dfea09711e7701d81e560daa30.pdf
dx.doi.org/10.22038/abjs.2019.40547.2090
Measurement Properties of the Brief Pain Inventory- Short Form (BPI-SF) and the Revised Short McGill Pain Questionnaire-Version-2 (SF-MPQ-2) in Painrelated Musculoskeletal Conditions: A Systematic Review Protocol
Samuel
Jumbo
Department of Physiotherapy, Faculty of Health and
Rehabilitation Sciences, Western University, London,
Ontario, Canada
author
Joy
MacDermid
Department of Physiotherapy, Faculty of Health and
Rehabilitation Sciences, Western University, London,
Ontario, Canada----
Roth McFarlane Hand and Upper Limb Centre, St.
Joseph’s Hospital, London, Ontario, Canada
author
Michael E.
Kalu
School of Rehabilitation Science, McMasters University,
Hamilton, Ontario, Canada
author
Tara L.
Packham
School of Rehabilitation Science, McMasters University,
Hamilton, Ontario, Canada
author
George S.
Athwal
Roth McFarlane Hand and Upper Limb Centre, St.
Joseph’s Hospital, London, Ontario, Canada
author
Kenneth J.
Faber
Roth McFarlane Hand and Upper Limb Centre, St.
Joseph’s Hospital, London, Ontario, Canada
author
text
article
2020
eng
Background: The Brief Pain Inventory-Short Form (BPI-SF) and Revised Short-Form McGill Pain Questionnaire Version-2(SF-MPQ-2) are generic pain assessment tools used in research and practice for pain assessment in musculoskeletal(MSK) conditions. A comprehensive review that systematically analyses their measurement properties in MSK conditionshas not been performed. This review protocol describes the steps that will be taken to locate, critically appraise, compareand summarize clinical measurement research on the BPI-SF and SF-MPQ-2 in pain-related MSK conditions.Methods: Medline, EMBASE, CINAHL and Scopus will be searched for publications that examine the measurementproperties of the Brief Pain Inventory and Revised Short-Form McGill Pain Questionnaire Version-2. Two reviewerswill independently screen citations (title, abstract and full text) and extract relevant data. The extensiveness, rigor,and quality of measurement property reports will be examined with a structured measurement studies appraisal tool,and with the updated COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN)guidelines. Findings will be descriptively summarized, and when possible, a meta-analysis will be performed.Discussion: This review will summarize and compare the current level of evidence on the measurement properties of theBPI-SF and SF-MPQ-2 in a spectrum of musculoskeletal conditions. We expect clinicians/researchers dealing with MSKconditions to have synthesized evidence that informs their decision making and preferences. In addition, the review hopesto identify gaps and determine priorities for future research with or on the BPI-SF and SF-MPQ-2 in MSK conditions.Level of evidence: Not Applicable
The Archives of Bone and Joint Surgery
Mashhad University of Medical Sciences, Iranian Society of Knee Surgery, Arthroscopy and Sports Tramatology,Iranian Orthopaedic Association
2345-4644
8
v.
2
no.
2020
131
141
https://abjs.mums.ac.ir/article_14734_28eade8dd18f0c8ba97ea6523f2abba5.pdf
dx.doi.org/10.22038/abjs.2020.36779.1973
Transverse Anterior Approach to the Elbow for Pediatric Displaced Lateral Humeral Condyle Fractures
Francisco
Soldado F.
Pediatric Hand Surgery and Microsurgery, UCA Unit,
Vithas San Jose, Barcelona, Spain
author
Pedro
Domenech-Fernandez
Pediatric Hand Surgery and Microsurgery, UCA Unit,
Vithas San Jose, Barcelona, Spain
author
Sergi
Barrera-Ochoa
ICATMA Hand and Microsurgery Unit; ICATME,
Hospital Universitari Quiron-Dexeus, Barcelona, Spain
author
Josep M.
Bergua-Domingo
Pediatric Hand Surgery and Microsurgery, UCA Unit,
Vithas San Jose, Barcelona, Spain
author
Paula
Diaz-gallardo
Pediatric Hand Surgery and Microsurgery, UCA Unit,
Vithas San Jose, Barcelona, Spain
author
Felipe
Hodgson
Department of Orthopaedic Surgery, School of Medicine,
Pontificia Universidad Católica de Chile, Santiago, Chile
author
Jorge
Knorr
Pediatric Hand Surgery and Microsurgery, UCA Unit,
Vithas San Jose, Barcelona, Spain
author
text
article
2020
eng
Background: The anterior approach to the elbow for pediatric lateral condyle fractures (LCF) would provide a bettervisualization of the articular fracture resulting in better functional results, less complications and a more cosmeticallyappealingscar than usually seen with the lateral approach.Methods: Retrospective study of children undergoing an open reduction and internal fixation of a displaced LCFvia an anterior approach with a transverse incision. Bilateral elbow range of motion (ROM), upper limb alignmentand complications were registered. A 4-point ordinal Likert-type scale was employed for parents to rate their level ofsatisfaction with the cosmetic appearance of the scar.Results: Eighteen children of mean age 76 months (range 27 to 101 months) were included. Fractures were classifiedas Jackob’s Type II in 14 cases and Milch’s type II in all cases. Mean follow-up was 12 (range 4 to19) months.Successful condral fracture visualization and reduction was achieved in every case. No intra-operative or post-operativecomplications occurred. In all cases bone union was obtained 4 to 5 weeks after surgery and at final follow-up, activeelbow ROM of at least 90%, was obtained. All parents claimed to be “very satisfied” with their child’s scar. A lateral spurwas identified in 66.7% o patients.Conclusion: The anterior approach to the elbow was both a feasible and safe allowing full anatomical cartilagereduction. Complications after this technique might decrease compared to the lateral approach but need futurecomparative studies. The rate of lateral spur did not decreased. Cosmetic scar results seem to be a clear advantage ofthis approach compared to the classical lateral approach.Level of evidence: IV
The Archives of Bone and Joint Surgery
Mashhad University of Medical Sciences, Iranian Society of Knee Surgery, Arthroscopy and Sports Tramatology,Iranian Orthopaedic Association
2345-4644
8
v.
2
no.
2020
142
146
https://abjs.mums.ac.ir/article_12495_8475405e4bfd946337de582fdbab5337.pdf
dx.doi.org/10.22038/abjs.2019.30756.1797
Revision of Anatomic Total Shoulder Arthroplasty to Hemiarthroplasty: Does it work?
Mihir
Sheth
Sidney Kimmel Medical College at Thomas Jefferson
University, Philadelphia, PA, USA
author
Daniel
Sholder
Rothman Institute, Thomas Jefferson University,
Department of Orthopaedic Surgery, Philadelphia, PA,
USA
author
Joseph
Abboud
Rothman Institute, Thomas Jefferson University,
Department of Orthopaedic Surgery, Philadelphia, PA,
USA
author
Mark
Lazarus
Rothman Institute, Thomas Jefferson University,
Department of Orthopaedic Surgery, Philadelphia, PA,
USA
author
Gerald
Williams Jr
Rothman Institute, Thomas Jefferson University,
Department of Orthopaedic Surgery, Philadelphia, PA,
USA
author
Surena
Namdari
Rothman Institute, Thomas Jefferson University,
Department of Orthopaedic Surgery, Philadelphia, PA,
USA
author
text
article
2020
eng
Background: The projected increase in revision shoulder arthroplasty has increased interest in the outcomes of theseprocedures. Glenoid component removal and conversion to a hemiarthroplasty (HA) is an option for aseptic glenoidloosening after anatomic total shoulder arthroplasty (aTSA).Methods: We identified patients who had undergone revision shoulder arthroplasty over a 15-year period. 17 patientsmet inclusion and exclusion criteria, and a retrospective chart review was conducted for pre-surgical and operativedata. We contacted patients at a mean follow-up of 70 months from revision surgery for implant survival, reoperationsand functional outcomes scores.Results: Implant survival was estimated to be 88% at 2 years and 67% at 5 years. Mean ASES score for survivingimplants was 58 ± 22. Mean SANE score was 54 ± 24, and mean VAS pain score was 3.5 ± 2.8. Mean SF-12 Mentaland Physical scores were 46 ± 15 and 38 ± 10, respectively. Five patients (50% of those with surviving implants)reported being either very satisfied or satisfied with the status of their shoulder. There were complications in 6 patients(35%) and 5 patients (29%) required reoperation.Conclusion: HA following failed aTSA due to glenoid loosening produced modest clinical results and satisfaction rates.Reverse arthroplasty may be a more reliable treatment strategy in this patient population.Level of evidence: IV
The Archives of Bone and Joint Surgery
Mashhad University of Medical Sciences, Iranian Society of Knee Surgery, Arthroscopy and Sports Tramatology,Iranian Orthopaedic Association
2345-4644
8
v.
2
no.
2020
147
153
https://abjs.mums.ac.ir/article_12503_0346d80618046e210dedb5a81afaf370.pdf
dx.doi.org/10.22038/abjs.2019.34244.1897
Outcomes of Arthroscopic Biceps Tenodesis for the Treatment of Failed Type II SLAP Repair: A Minimum 2-Year Follow-Up
Alexander
kreines
Rowan University School of Osteopathic Medicine,
Stratford, NJ, USA
author
Manuel
Pontes
Rowan University School of Osteopathic Medicine,
Stratford, NJ, USA
author
Elizabeth
Ford
Rowan University School of Osteopathic Medicine,
Stratford, NJ, USA
author
Kristen
Herbst
Rowan University School of Osteopathic Medicine,
Stratford, NJ, USA
author
Jeff
Murray
Rowan University School of Osteopathic Medicine,
Stratford, NJ, USA
author
Brian
Busconi
University of Massachusetts Memorial Medical Center,
Worcester, MA, USA
author
Sean
McMillan
Rowan University
School of Osteopathic Medicine, Stratford, NJ, USA
author
text
article
2020
eng
Background: To retrospectively review surgical outcomes of prospectively collected data on a series of patients whounderwent revision of a type II SLAP repair to arthroscopic biceps tenodesis due to an unsuccessful outcome.Methods: A retrospective review was performed on a cohort of patients who underwent arthroscopic biceps tenodesisfor a failed type II SLAP repair from 2010 to 2014. Range of motion (ROM) in four planes was measured pre-andpostoperatively. In addition, all patients completed the American Shoulder Elbow Surgeons (ASES) standardizedshoulder assessment form, the Visual Analogue Scale (VAS) for pain, and the Short Form-12 (SF-12) scores.Results: Overall, 26 patients met inclusion criteria. All 26 patients were available for follow-up at a minimum of twoyears (100% follow-up). The mean age of the patients was 37(range 26-54), 85% were male, and 58% were overheadlaborers. Clinical as well as statistical improvement was noted following tenodesis across all outcome measurements(p <0.01). Additionally, ROM improved in all four planes (p <0.01). The rate of return to work was 85% with workers’compensation status leading to inferior outcomes. Two complications were noted which required an additional surgery.Conclusion: Arthroscopic biceps tenodesis demonstrates to be an effective treatment for a failed type II SLAP repairwith improved patient satisfaction, pain relief, and range of motion at two-years follow-up with a low complication rate.Level of evidence: III
The Archives of Bone and Joint Surgery
Mashhad University of Medical Sciences, Iranian Society of Knee Surgery, Arthroscopy and Sports Tramatology,Iranian Orthopaedic Association
2345-4644
8
v.
2
no.
2020
154
161
https://abjs.mums.ac.ir/article_13975_bde46b1d2870be1bdf1c71e4919d6c6a.pdf
dx.doi.org/10.22038/abjs.2019.40449.2087
Union Following Biological and Rigid Fixations of Distal Tibia Extra-articular Fractures
Abdallah
Abboud
Division of Orthopedic Surgery, Department of Surgery,
American University of Beirut Medical Center, Beirut,
Lebanon
author
Karim
Masrouha
Division of Orthopedic Surgery, Department of Surgery,
American University of Beirut Medical Center, Beirut,
Lebanon
author
Tammam
Hanna
Division of Orthopedic Surgery, Department of Surgery,
American University of Beirut Medical Center, Beirut,
Lebanon
author
Said
Saghieh
Division of Orthopedic Surgery, Department of Surgery,
American University of Beirut Medical Center, Beirut,
Lebanon
author
text
article
2020
eng
Background: Distal tibia fractures are among the most common bony injuries, with a significant rate of nonunion anddelayed union. There are multiple methods for the management of distal tibia fractures. Among the plating methods,there are bridge plating and compression plating techniques. There is still a lack of evidence about whether one methodhas a higher rate of union than the other. The present study aimed to assess the union rate of extra-articular distal tibiafractures using biological fixation with bridge plating and rigid fixation with compression plating.Methods: This retrospective analysis was performed on 41 adult patients with distal tibia fractures. The subjectswere divided into two groups based on the fixation method, namely bridge plating and compression plating. Baselinecharacteristics, fracture characteristics, and union status were analyzed and compared in this study.Results: Baseline and fracture characteristics were similar between the groups. Only higher translation in any planeswas noted in the bridge plating group (2.80±3.04 mm; p <0.001). As for union status, the rates of the union during 3months and delayed/no union were similar between the two groups (P=0.18). During a 6-month follow-up, 92% and93.8% of the patients achieved union in the bridge plating and compression plating groups, respectively.Conclusion: Rates of delayed union and nonunion are similar regarding extra-articular distal tibia fractures treatedwith either bridge plating or compression plating.Level of evidence: III
The Archives of Bone and Joint Surgery
Mashhad University of Medical Sciences, Iranian Society of Knee Surgery, Arthroscopy and Sports Tramatology,Iranian Orthopaedic Association
2345-4644
8
v.
2
no.
2020
162
167
https://abjs.mums.ac.ir/article_12517_dc56a148b8b1dabb8d99baee665d39ca.pdf
dx.doi.org/10.22038/abjs.2019.36760.1972
Ultrasound Measurements of the ECRB Tendon Shows Remarkable Variations in Patients with Lateral Epicondylitis
Renée
Keijsers
Department of Orthopaedic Surgery, Upper limb unit,
Amphia Hospital, Breda, the Netherlands
author
Koen L.M.
Koenraadt
Foundation for Orthopaedic Research, Care and
Education, Amphia Hospital, Breda, the Netherlands
author
Jeroen L.
Turkenburg
Department of Radiology, Amphia Hospital, Breda, the
Netherlands
author
Annechien
Beumer
Department of Orthopaedic Surgery, Upper limb unit,
Amphia Hospital, Breda, the Netherlands---
Coronel Institute of Occupational health, Amsterdam
University Medical Centers, the Netherlands
author
Bertram
The
Department of Orthopaedic Surgery, Upper limb unit,
Amphia Hospital, Breda, the Netherlands
author
Denise
Eygendaal
Department of Orthopaedic Surgery, Amsterdam
University Medical Centers, the Netherlands
author
text
article
2020
eng
Background: Lateral epicondylitis (LE) most commonly affects the Extensor Carpi Radialis Brevis (ECRB) tendon andpatients are generally treated with injection therapy. For optimal positioning of the injection, as well as an estimation ofthe surface area and content of the ECRB tendon to determine the volume of the injectable needed, it is important toknow the exact location of the ECRB in relation to the skin as well as the variation in tendon length and location. Theaim of this study was to determine the variation in location and size of the ECRB tendon in patients with LE.Methods: An observational sonographic evaluation of the ECRB tendon was performed in 40 patients with LE. Thelength of the ECRB tendon, distance from the cutis to the center of the ECRB tendon, the length of the osteotendinousjunction at the epicondyle and the distance from cutis to middle of the osteotendinous junction were measured.Results: The average tendon length was 1.68cm (range 1.27-1.98; SD 0.177). Compared to women, the ECRB tendonof men was on average 0.12cm longer. Overall, the average distance from cutis to the center of the ECRB was 0.75cm(range 0.50-1.46cm; SD 0.210), the average length of the junction was 0.55cm (range 0.35-0.87; SD 0.130), and thedistance from cutis to middle of the osteotendinous junction was 0.73cm (range 0.40-1.25cm; SD 0.210).Conclusion: The size and depth of the ECRB tendon in patients with LE is largely variable. While there are no studiesyet suggesting sono-guided injection to be superior to that of blind injection, the anatomic variability of this studysuggests that the accuracy of injection therapy for LE might be compromised when based solely on bony landmarksand therefore not fully reliable. As a result, there is value in further studies exploring the accuracy of the ultrasoundguided injection techniques.Level of evidence: IV
The Archives of Bone and Joint Surgery
Mashhad University of Medical Sciences, Iranian Society of Knee Surgery, Arthroscopy and Sports Tramatology,Iranian Orthopaedic Association
2345-4644
8
v.
2
no.
2020
168
172
https://abjs.mums.ac.ir/article_13640_e14cdf135e9c984a37bb447800d8f957.pdf
dx.doi.org/10.22038/abjs.2019.37767.1999
Medicare Compensation Rates for Hand and Shoulder/ Elbow Surgery by Operative Time: A Comparative Analysis
Suresh K.
Nayar
Department of Orthopaedic Surgery, The Johns Hopkins
University, Baltimore, MD, USA
author
Samir
Sabharwal
Department of Orthopaedic Surgery, The Johns Hopkins
University, Baltimore, MD, USA
author
Keith T.
Aziz
Department of Orthopaedic Surgery, The Johns Hopkins
University, Baltimore, MD, USA
author
Umasuthan
Srikumaran
Department of Orthopaedic Surgery, The Johns Hopkins
University, Baltimore, MD, USA
author
Aviram M.
Giladi
Curtis National Hand Center, Union Memorial Hospital,
Baltimore, MD, USA
author
Dawn M.
LaPorte
Department of Orthopaedic Surgery, The Johns Hopkins
University, Baltimore, MD, USA
author
text
article
2020
eng
Background: There is a high demand for shoulder/elbow experience among hand-fellowship trainees due to theperception that this exposure will improve their professional “marketability” in a subspecialty they perceive as havinghigher compensation.Methods: Using Medicare data, we investigated the most common surgeries from these fields and determinedwhich have the highest compensation [work relative value unit (wRVU), payment, charge, and reimbursement(payment-to-charge percentage] rates per operative time. We then determined whether the overall non-weightedand weighted (by surgical frequency/volume) compensation rates of shoulder/elbow surgery are greater than thatof hand surgery.Results: Among 30 shoulder/elbow procedures, arthroplasty and arthroscopic rotator cuff repair had the highest paymentand wRVU assignments. Among 83 hand procedures, upper-extremity flaps, carpal stabilization, distal radius openreduction internal fixation (ORIF), both-bone ORIF, and interposition arthroplasty had the greatest wRVU assignmentswith correspondingly high payments. A non-weighted comparison of the two subspecialties showed that hand surgeryhas a higher mean payment/min ($10.46±3.22 vs. $7.52±2.89), charge/min ($51.02±17.11 vs. $41.96±11.32), andreimbursement (21±4.7% vs. 18±5.1%) compared with shoulder/elbow surgery (all, p <0.01). Non-weighted meanwRVUs/min were similar (0.12±0.03 vs. 0.13±0.03, P = 0.12). When weighted by procedure frequency, hand surgeryhad greater wRVUs/min (0.15±0.036 vs. 0.13±0.032), payments/min ($14.17±4.50 vs. $6.97±2.26), charges/min($75.68±30.47 vs. $42.61±7.83), and reimbursement (20±5.0% vs. 17±6.0%) (all, p <0.01).Conclusion: According to Medicare compensation, and when weighted by procedure frequency, hand proceduresare associated with greater overall mean wRVUs/min, payments/min, charges/min, and reimbursement compared withshoulder and elbow procedures. Hand-surgery fellowship applicants should be aware that subspecialty compensationis complex in nature but should seek shoulder/elbow elective experience to acquire an additional surgical skill-set asopposed to primarily monetary reason.Level of evidence: III
The Archives of Bone and Joint Surgery
Mashhad University of Medical Sciences, Iranian Society of Knee Surgery, Arthroscopy and Sports Tramatology,Iranian Orthopaedic Association
2345-4644
8
v.
2
no.
2020
173
183
https://abjs.mums.ac.ir/article_13974_3af51e80fb0213a76a10aa9dab8718cb.pdf
dx.doi.org/10.22038/abjs.2019.39965.2072
Midterm Results of Arthroscopic Treatment for Recalcitrant Lateral Epicondylitis of the Elbow
Hossein
Saremi
Orthopedic Surgery Department, Faculty of Medicine,
Hamadan University of Medical Sciences, Hamadan, Iran
author
Mohammad A.
Seydan
Hamadan University of Medical Sciences, Hamadan,
Iran
author
Mohamad A.
Seifrabiei
Faculty of Medicine, Hamadan University of Medical
Sciences, Hamadan, Iran
author
text
article
2020
eng
Background: An effective treatment for the elbow recalcitrant lateral epicondylitis is arthroscopic surgery. This studyevaluated the midterm results of treating recalcitrant lateral epicondylitis with arthroscopic surgery.Methods: A total of 40 subjects with recalcitrant lateral epicondylitis prepared for arthroscopic surgery on their elbowsparticipated in this study. The elbow function was evaluated using the Quick disabilities of the arm, shoulder, and hand(Quick DASH) score. Pain intensity was assessed before and after the surgery by the visual analog scale (VAS). Grip and pinch strengths were assessed by a dynamometer.Results: In this study, the mean age of the participants was 42.9±6.4 years. The average follow-up time was 42months. The mean of VAS (pain intensities) were 7.05 and 3.20 before and after the surgery, respectively (P=0.001).The Quick DASH score decreased from 63.18 to 25.68 from before to after the surgery (P=0.001). The mean grip strength of the operated and nonoperated sides was not significantly different after the surgery.Conclusion: Arthroscopic surgery seems to be an effective method with few complications in patients suffering froman elbow recalcitrant lateral epicondylitis in the midterm follow-up.Level of evidence: II
The Archives of Bone and Joint Surgery
Mashhad University of Medical Sciences, Iranian Society of Knee Surgery, Arthroscopy and Sports Tramatology,Iranian Orthopaedic Association
2345-4644
8
v.
2
no.
2020
184
189
https://abjs.mums.ac.ir/article_14423_3bd0da7c9cc13775cbf4a2fb29169494.pdf
dx.doi.org/10.22038/abjs.2019.42016.2140
Clinical Outcomes of Intramedullary and Extramedullary Fixation in Unstable Intertrochanteric Fractures: A Randomized Clinical Trial
Ali
Andalib
Department of Orthopedics, Alzahra Hospital, Isfahan
University of Medical Sciences, Isfahan, Iran
author
Mohammadreza
Etemadifar
Department of Orthopedics, Alzahra Hospital, Isfahan
University of Medical Sciences, Isfahan, Iran
author
Pedram
Yavari
Department of Orthopedics, Alzahra Hospital, Isfahan
University of Medical Sciences, Isfahan, Iran
author
text
article
2020
eng
Background: The best method for repairing intertrochanteric fractures is still controversial. The fixation methods includeextramedullary (EM) and intramedullary (IM). Studies that compare IM and EM fixations for unstable hip fractures arerare. In this study, our goal was to compare the efficacy of EM and IM fixation in treatment of unstable intertrochantericfractures.Methods: A total of 113 patients with unstable intertrochanteric were randomized in this cohort study between March2016 and June 2018 in trauma center of Kashani and Alzahra Hospitals, Isfahan, Iran. The patients were followed for aperiod of 12 months with sequential clinical and imaging evaluations. Baseline data were recorded at the time of injury.Radiographs were evaluated immediately post-operatively and at the scheduled follow-up intervals.Results: A total of 20 of patients were excluded during the study and finally 93 patients (43 males and 50 females)with mean age of 62.74±16.4 completed the follow-up sessions. Mann-Whitney test indicated a significant difference intip-apex distance between the two groups. While the two groups were homogeneous in the baseline LEM score, it wasnot significantly different between two groups after 1 and 3 months of surgery as well. However, the LEM score wassignificantly higher in IM group after 6 and 12 months of surgery.Conclusion: According to our findings, IM nails (such as the cephalomedullary nail) afforded more advantages overEM devices (such as the DHS and DCS) in the treatment of unstable intertrochanteric fractures. Our results indicatedthat the final LEM scores as well as the time to union were better in IM fixation group.Level of evidence: I
The Archives of Bone and Joint Surgery
Mashhad University of Medical Sciences, Iranian Society of Knee Surgery, Arthroscopy and Sports Tramatology,Iranian Orthopaedic Association
2345-4644
8
v.
2
no.
2020
190
197
https://abjs.mums.ac.ir/article_13639_9f4e54b400ac76400ee2ede61fa8c3b0.pdf
dx.doi.org/10.22038/abjs.2019.34942.1919
The Continued Utility and Viability of Dakin’s Solution in Both High- and Low-resource Settings
Taylor D.
Ottesen
Yale School of Medicine, Department of Orthopaedics
and Rehabilitation, New Haven, Connecticut, USA
author
Rameez A.
Qudsi
Harvard Combined Orthopaedic Residency Program,
Harvard Medical School, Boston, Massachusetts, USA
author
Alexis K.
Kahanu
Tufts University School of Medicine, Boston,
Massachusetts, USA
author
Belychagard
Jean Baptiste
Hôpital de l’Université d’É tat d’Haïti (HUEH), Port-Au-
Prince, Haiti
author
Pierre Marie
Woolley
Hospital l’Universite de La Paix (HUP), Port-Au-Prince,
Haiti
author
Adrienne R.
Socci
Yale School of Medicine, Department of Orthopaedics
and Rehabilitation, New Haven, Connecticut, USA
author
George S.M.
Dyer
Harvard Medical School, Boston, Massachusetts;
Department of Orthopaedic Surgery, Brigham and
Women’s Hospital, Boston, Massachusetts, USA
author
text
article
2020
eng
Healthcare is expensive and often inaccessible to many. As a result, surgeons must consider simple, less expensiveinterventions when possible. For wound care, an older but quite effective cleaning agent is Dakin’s solution (0.5%sodium hypochlorite), an easily made mixture of 100 milliliters (ml) bleach with 8 teaspoons (tsp) baking soda into agallon of clean water or 25 ml bleach and 2 tsp baking soda into a liter of water. Gauze is then wet with this solution,placed on the wound, and replaced every 24 hours as needed. Our team of surgeons in Haiti and the United Statesis currently using Dakin’s solution for wound care following orthopedic surgery and finds it to be a low-cost, safe, andeffective treatment for post-surgical wound care for both resource-limited and non-resource strained environments.This report aims to update the current literature and encourage the consideration of Dakin’s solution for modernwound care.Level of evidence: III
The Archives of Bone and Joint Surgery
Mashhad University of Medical Sciences, Iranian Society of Knee Surgery, Arthroscopy and Sports Tramatology,Iranian Orthopaedic Association
2345-4644
8
v.
2
no.
2020
198
203
https://abjs.mums.ac.ir/article_13970_e2f7c20d6b170241463720b58a2aaf41.pdf
dx.doi.org/10.22038/abjs.2019.34372.1906
Intrathoracic Displacement of Fractured Right Humeral Head: A Case Report
Ali
Sadighi
Shohada Hospital, Tabriz University of Medical Science,
Tabriz, Iran
author
Touraj
Asvadi Kermani
Tabriz University of Medical Science, Tabriz, Iran
author
Parham
Maroufi
Shohada Hospital, Tabriz University of Medical Science,
Tabriz, Iran
author
Kosar
Tarvirdizade
Ostad Shahriyar Hospital, Tabriz University of Medical
Science, Tabriz, Iran
author
Atabak
A.Kermani
Cedar Rapids Medical Education Foundation, Iowa, USA
author
text
article
2020
eng
Intrathoracic displacement of the humeral head is a very uncommon condition and can be life threatening due to lungor heart injuries. There is a report of this condition where intrathoracic bone fragment was missed. Because of rareincidence there is no guideline for approach and treatment of this condition.We hereby present a case of intrathoracic displacement of fractured humeral head in a man due to a car roll-overaccident.This condition requires a concise team workup of trauma and orthopedic surgeons along with the physical therapistsfor the best possible decision making.Displaced fractured humoral head into the thorax is a rare condition that needs more punctuality for on time diagnosisand team approach.Level of evidence: V
The Archives of Bone and Joint Surgery
Mashhad University of Medical Sciences, Iranian Society of Knee Surgery, Arthroscopy and Sports Tramatology,Iranian Orthopaedic Association
2345-4644
8
v.
2
no.
2020
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