eng
Mashhad University of Medical Sciences, Iranian Society of Knee Surgery, Arthroscopy and Sports Tramatology,Iranian Orthopaedic Association
The Archives of Bone and Joint Surgery
2345-4644
2345-461X
2016-01-01
4
1
2
9
10.22038/abjs.2016.4701
4701
Giant Cell Tumor of Bone - an Overview
Anshul Sobti
dranshulsobti@gmail.com
1
Pranshu Agrawal
pranshuorthodoc@gmail.com
2
Sanjay Agarwala
drsa2011@gmail.com
3
Manish Agarwal
anshulsobti@gmail.com
4
Department of Orthopaedics, P.D Hinduja National Hospital and Medical Research Centre, Veer Savarkar Marg, Mahim, Mumbai, India
Department of Orthopaedics, P.D Hinduja National Hospital and Medical Research Centre, Veer Savarkar Marg, Mahim, Mumbai, India
Head of Surgey & Orthopaedics, Consultant in Orthopaedics Trauma & Arthroplasty, P.D Hinduja National Hospital and Medical Research Centre, Veer Savarkar Marg Mahim, Mumbai, India
Consultant in Orthopaedic Oncology & Soft Tissue Tumors, Hinduja National Hospital and Medical Research Centre, Veer Savarkar Marg Mahim, Mumbai, India
Giant Cell tumors (GCT) are benign tumors with potential for aggressive behavior and capacity to metastasize. Although rarely lethal, benign bone tumors may be associated with a substantial disturbance of the local bony architecture that can be particularly troublesome in peri-articular locations. Its histogenesis remains unclear. It is characterized by a proliferation of mononuclear stromal cells and the presence of many multi- nucleated giant cells with homogenous distribution. There is no widely held consensus regarding the ideal treatment method selection. There are advocates of varying surgical techniques ranging from intra-lesional curettage to wide resection. As most giant cell tumors are benign and are located near a joint in young adults, several authors favor an intralesional approach that preserves anatomy of bone in lieu of resection. Although GCT is classified as a benign lesion, few patients develop progressive lung metastases with poor outcomes. Treatment is mainly surgical. Options of chemotherapy and radiotherapy are reserved for selected cases. Recent advances in the understanding of pathogenesis are essential to develop new treatments for this locally destructive primary bone tumor.
https://abjs.mums.ac.ir/article_4701_31e16a078c7ae219b67f454aee3c9d54.pdf
GCT
GCTB
Giant cell tumor of bone
Review of giant cell tumor
eng
Mashhad University of Medical Sciences, Iranian Society of Knee Surgery, Arthroscopy and Sports Tramatology,Iranian Orthopaedic Association
The Archives of Bone and Joint Surgery
2345-4644
2345-461X
2016-01-01
4
1
10
15
10.22038/abjs.2016.4364
4364
Operating Room Time Savings with the Use of Splint Packs: A Randomized Controlled Trial
Tyler Gonzalez
tagonzalez@partners.org
1
Eric Bluman
ebluman@partners.org
2
David Palms
dpalms@partners.org
3
Jeremy Smith
jsmith42@partners.org
4
Christopher Chiodo
cchiodo@partners.org
5
Harvard Combined Orthopaedic Surgery Resident PGY 3, Department of Orthopaedic Surgery, Massachusetts General Hospital, Brigham and Women’s Hospital Foot & Ankle Center, Boston, MA
Harvard Medical School, Brigham and Women’s Hospital Foot & Ankle Center, Boston, MA
Harvard Medical School, Brigham and Women’s Hospital Foot & Ankle Center, Boston, MA
Harvard Medical School, Brigham and Women’s Hospital Foot & Ankle Center, Boston, MA
Harvard Medical School, Brigham and Women’s Hospital Foot & Ankle Center, Boston, MA
Background: The most expensive variable in the operating room (OR) is time. Lean Process Management is being used in the medical field to improve efficiency in the OR. Streamlining individual processes within the OR is crucial to a comprehensive time saving and cost-cutting health care strategy. At our institution, one hour of OR time costs approximately $500, exclusive of supply and personnel costs. Commercially prepared splint packs (SP) contain all components necessary for plaster-of-Paris short-leg splint application and have the potential to decrease splint application time and overall costs by making it a more lean process. We conducted a randomized controlled trial comparing OR time savings between SP use and bulk supply (BS) splint application. Methods: Fifty consecutive adult operative patients on whom post-operative short-leg splint immobilization was indicated were randomized to either a control group using BS or an experimental group using SP. One orthopaedic surgeon (EMB) prepared and applied all of the splints in a standardized fashion. Retrieval time, preparation time, splint application time, and total splinting time for both groups were measured and statistically analyzed. Results: The retrieval time, preparation time and total splinting time were significantly less (p<0.001) in the SP group compared with the BS group. There was no significant difference in application time between the SP group and BS group. Conclusion: The use of SP made the process of splinting more lean. This has resulted in an average of 2 minutes 52 seconds saved in total splinting time compared to BS, making it an effective cost-cutting and time saving technique. For high volume ORs, use of splint packs may contribute to substantial time and cost savings without impacting patient safety.
https://abjs.mums.ac.ir/article_4364_6abeb467b8fedcde7758a0d3782d1a70.pdf
Ambulatory surgery
Economics
Efficiency
Foot and ankle
lower extremity
Operating room
Splinting
eng
Mashhad University of Medical Sciences, Iranian Society of Knee Surgery, Arthroscopy and Sports Tramatology,Iranian Orthopaedic Association
The Archives of Bone and Joint Surgery
2345-4644
2345-461X
2016-01-01
4
1
16
22
10.22038/abjs.2016.5271
5271
The Effect of the Silicone Ring Tourniquet and Standard Pneumatic Tourniquet on the Motor Nerve Conduction, Pain and Grip Strength in Healthy Volunteers
Georgios Drosos
drosos@otenet.gr
1
Georgios Kiziridis
gkisiridis@yahoo.gr
2
Cristina Aggelopoulou
angelopoulou_chr@yahoo.gr
3
Dimitrios Galiatsatos
dgaliatsatos2010@hotmail.com
4
George Anastassopoulos
5
Athanasios Ververidis
athanasios@ververidis.net
6
Konstantinos Kazakos
kazakosk@yahoo.gr
7
Department of Orthopaedic Surgery, Medical School, Democritus University of Thrace, University General Hospital of Alexandroupolis, Alexandroupolis, Greece
Department of Orthopaedic Surgery, Medical School, Democritus University of Thrace, University General Hospital of Alexandroupolis, Alexandroupolis, Greece
Department of Neurology, University General Hospital of Alexandroupolis, Alexandroupolis, Greece
Medical Informatics Laboratory, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
Medical Informatics Laboratory, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
Department of Orthopaedic Surgery, Medical School, Democritus University of Thrace, University General Hospital of Alexandroupolis, Alexandroupolis, Greece
Department of Orthopaedic Surgery, Medical School, Democritus University of Thrace, University General Hospital of Alexandroupolis, Alexandroupolis, Greece
Background: The pneumatic tourniquet (PT) is routinely used in upper and lower limb operations by most orthopaedic surgeons. The silicone ring tourniquet (SRT) was introduced in clinical practice the last decade. Clinical as well comparative studies in volunteers concerning its safety and efficacy have been published. The aim of this study was to investigate the postoperative effect of the silicone ring tourniquet (SRT), primarily on the motor nerve conduction, and secondarily on the pain and grip strength, in comparison to the effect of the pneumatic tourniquet (PT) in healthy volunteers. Methods: Both tourniquets were applied in the forearm of the dominant arm in 20 healthy volunteers and were kept on for 10 minutes. Pain was measured using the visual analogue scale and grip strength was measured with a hand dynamometer. We evaluated the following parameters of median nerve conduction: motor conduction velocity (MCV), latency (LAT) and amplitude (AMP). Results: Pain score at the time of tourniquet application was higher in SRT group but the alteration in pain scores in PT group was higher, with statistical significance (P<0.05). The grip strength was reduced by the application of both tourniquets; however there was a significantly higher reduction in the SRT group (P<0.05). The conduction impairment of the median nerve was worse in the PT group than in the SRT one, according to the changes in MCV (P<0.05). Conclusion: Median nerve conduction was affected more after PT application as compared to the SRT. Nevertheless, the reduction of grip strength was higher after the SRT application.
https://abjs.mums.ac.ir/article_5271_662d5ecb079776e6966e44a689e0df4a.pdf
Cuff
Nerve conduction
Pain
Silicone ring tourniquet
Tourniquet
eng
Mashhad University of Medical Sciences, Iranian Society of Knee Surgery, Arthroscopy and Sports Tramatology,Iranian Orthopaedic Association
The Archives of Bone and Joint Surgery
2345-4644
2345-461X
2016-01-01
4
1
23
28
10.22038/abjs.2016.5268
5268
Type II Intertrochanteric Fractures: Proximal Femoral Nailing (PFN) Versus Dynamic Hip Screw(DHS)
Cyril Jonnes
cyriljonnes@gmail.com
1
Shishir Suranigi
shishir100@gmail.com
2
Syed Najimudeen
syednajimudeen@yahoo.com
3
Department of Orthopaedics, Pondicherry Institute of Medical Sciences, Pondicherry, India
Department of Orthopaedics, Pondicherry Institute of Medical Sciences, Pondicherry, India
Department of Orthopaedics, Pondicherry Institute of Medical Sciences, Pondicherry, India
Background: Intertrochanteric fracture is one of the most common fractures of the hip especially in the elderly with osteoporotic bones, usually due to low-energy trauma like simple falls. Dynamic Hip Screw (DHS) is still considered the gold standard for treating intertrochanteric fractures by many. Not many studies compare the DHS with Proximal femoral nail (PFN), in Type II intertrochanteric fractures (Boyd and Griffin classification). This study was done to compare the functional and radiological outcome of PFN with DHS in treatment of Type II intertrochanteric fractures. Methods: From October 2012 to March 2015, a prospective comparative study was done where 30 alternative cases of type II intertrochanteric fractures of hip were operated using PFN or DHS. Intraoperative complications were noted. Functional outcome was assessed using Harris Hip Score and radiological findings were compared at 3, 6, and 12 months postoperatively. Results: The average age of the patients was 60 years. In our series we found that patients with DHS had increased intraoperative blood loss (159ml), longer duration of surgery (105min), and required longer time for mobilization while patients who underwent PFN had lower intraoperative blood loss (73ml), shorter duration of surgery (91min), and allowed early mobilization. The average limb shortening in DHS group was 9.33 mm as compared with PFN group which was only 4.72 mm. The patients treated with PFN started early ambulation as they had better Harris Hip Score in the early post-op period. At the end of 12th month, there was not much difference in the functional outcome between the two groups. Conclusion: PFN is better than DHS in type II inter-trochanteric fractures in terms of decreased blood loss, reduced duration of surgery, early weight bearing and mobilization, reduced hospital stay, decreased risk of infection and decreased complications.
https://abjs.mums.ac.ir/article_5268_b2ea4d355dfc67be22542259be5359f5.pdf
Dynamic Hip Screw (DHS)
Inter-trochanteric fractures
Harris Hip Score
Proximal Femoral Nail (PFN)
eng
Mashhad University of Medical Sciences, Iranian Society of Knee Surgery, Arthroscopy and Sports Tramatology,Iranian Orthopaedic Association
The Archives of Bone and Joint Surgery
2345-4644
2345-461X
2016-01-01
4
1
29
34
10.22038/abjs.2016.5819
5819
Supracondylar Osteotomy in Valgus Knee: Angle Blade Plate Versus Locking Compression Plate
Seyyed Morteza Kazemi
mortezakazemi737@yahoo.com
1
Reza Minaei
rezaminaeiortho@gmail.com
2
Farshad Safdari
f.safdari.to@gmail.com
3
Ali Keipourfard
keipourfard@gmail.com
4
Rozhin Forghani
rozhin.forghani@yahoo.com
5
Alemeh Mirzapourshafiei
aleme_mirza@yahoo.com
6
Bone Joint and Related Tissue Research Center, Akhtar Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Bone Joint and Related Tissue Research Center, Akhtar Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Bone Joint and Related Tissue Research Center, Akhtar Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Akhtar Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Bone Joint and Related Tissue Research Center, Akhtar Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Clinical Research Development Center, Babol University of Medical Sciences, Babol, Iran
Background: There are few studies comparing the biomechanical properties of angled blade plate and locking compression plates in supracondylar osteotomy. In the current randomized study, we prospectively compared the clinical and radiological outcomes of supracondylar osteotomy using these two plates. Methods: Forty patients with valgus knee malalignment were randomly assigned to two equal numbered groups: angled blade plate and locking compression plates. All of the patients underwent medial closing wedge supracondylar osteotomy and were followed for one year. Before and after the operation the valgus angle and mechanical lateral distal femoral angle were compared between groups. Also, the rate of complications were compared. Results: After the operation, the mean valgus angle and mechanical lateral distal femoral angle improved significantly in the two groups (P<0.001). Although, the preoperative amount of the valgus angle and mechanical lateral distal femoral angle were the same, at the last visit the valgus angle (5.4±2.1 versus 3.1±1.8; P=0.032) and mechanical lateral distal femoral angle (87.6±2 versus 89.7±3.2; P=0.041) were significantly lower and higher in the angled blade plate group, respectively. Nonunion occurred in four patients (20%) in the locking compression plates group (P=0.35). Conclusion: Based on having a larger valgus angle and mechanical lateral distal femoral angle correction in the angled blade plate group and considerable rate of nonunion in the locking compression plate group, the authors recommend using the angled blade plate for fixation of medial closing wedge supracondylar osteotomy for patients with valgus malalignment. However, more long-term studies are required.
https://abjs.mums.ac.ir/article_5819_a1630fd151ce49f3f116f7edb7b1f198.pdf
Angle blade plate
Locking compression late
Valgus knee
eng
Mashhad University of Medical Sciences, Iranian Society of Knee Surgery, Arthroscopy and Sports Tramatology,Iranian Orthopaedic Association
The Archives of Bone and Joint Surgery
2345-4644
2345-461X
2016-01-01
4
1
35
40
10.22038/abjs.2016.5247
5247
Sleep Disturbance and Upper-Extremity Disability
Rinne Peters
rinnepeters27@hotmail.com
1
Mariano Menendez
marianofurrer@gmail.com
2
Jos Mellema
jmellema@mgh.harvard.edu
3
David Ring
david.ring@austin.utexas.edu
4
Ana-Maria Vranceanu
avranceanu@mgh.harvard.edu
5
Hand and Upper Extremity Service, Department of Orthopaedic Surgery, Yawkey Center, Massachusetts General Hospital, Boston, USA
Hand and Upper Extremity Service, Department of Orthopaedic Surgery, Yawkey Center, Massachusetts General Hospital, Boston, USA
Hand and Upper Extremity Service, Department of Orthopaedic Surgery, Yawkey Center, Massachusetts General Hospital, Boston, USA
Hand and Upper Extremity Service, Department of Orthopaedic Surgery, Yawkey Center, Massachusetts General Hospital, Boston, USA
Department of Psychiatry, Massachusetts General Hospital, Boston, USA
Background: Although upper-extremity disability correlates with psychosocial aspects of illness the association with sleep disturbance in upper extremity disability is less certain. To evaluate whether sleep disturbance is associated with upper-extremity disability among patients with upper extremity illness, accounting for sociodemographic, condition-related, and psychosocial factors. Methods: A cohort of 111 new or follow-up patients presenting to an urban academic hospital-based hand surgeon completed a sociodemographic survey and measures of sleep disturbance (PROMIS Sleep Disturbance), disability (PROMIS Upper-Extremity Physical Function), ineffective coping strategies (PROMIS Pain Interference), and depression (PROMIS Depression). Bivariate and multivariable linear regression modeling were performed. Results: Sleep disturbance correlated with disability (r=-0.38; P<0.001) in bivariate analysis. Symptoms of depression (r=-0.44; P<0.001) and ineffective coping strategies (PROMIS Pain Interference: r=-0.71; P<0.001) also correlated with upper-extremity specific disability in bivariate analysis. Pain Interference was the only factor associated with disability in multivariable analysis. Conclusions: Sleep disturbance is not as strongly or directly associated with symptom intensity and magnitude of disability as ineffective coping strategies. Interventions to reduce pain interference (e.g. cognitive behavioral therapy) hold great potential to decrease musculoskeletal symptom intensity and magnitude of disability, and perhaps even sleep disturbance.
https://abjs.mums.ac.ir/article_5247_e4a0cfd32c0414b0af4bef493add6e95.pdf
Disability
Pain interference
Sleep disturbance
Upper extremity
eng
Mashhad University of Medical Sciences, Iranian Society of Knee Surgery, Arthroscopy and Sports Tramatology,Iranian Orthopaedic Association
The Archives of Bone and Joint Surgery
2345-4644
2345-461X
2016-01-01
4
1
41
46
10.22038/abjs.2016.5270
5270
Double-button Fixation System for Management of Acute Acromioclavicular Joint Dislocation
Ali Torkaman
alitorkaman@yahoo.com
1
Abolfazl Bagherifard
bagherifd@yahoo.com
2
Tahmineh Mokhtari
mohamad.qoreishy@gmail.com
3
Mohamadhossein Shabanpour Haghighi
mokhtari.tmn@gmail.com
4
Siamak Monshizadeh
siamak_monshizadeh@yahoo.com
5
Hamid Taraz
htaraz59@gmail.com
6
Amin Hasanvand
7
Firuzgar Hospital, Iran University of Medical Sciences, Tehran, Iran
Shafa Orthopedic Hospital, Iran University of Medical Sciences, Tehran, Iran
Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
Firuzgar Hospital, Iran University of Medical Sciences, Tehran, Iran
Firuzgar Hospital, Iran University of Medical Sciences, Tehran, Iran
Firuzgar Hospital, Iran University of Medical Sciences, Tehran, Iran
Department of Pharmacology, school of Medicine, International Campus, Tehran University of Medical Sciences (IC-TUMS), Tehran, Iran Departments of Pharmacology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
Background: Surgical treatments for acromioclavicular (AC) joint dislocation present with some complications. The present study was designed to evaluate the double-button fixation system in the management of acute acromioclavicular joint dislocation. Methods: This cross sectional study, done between February 2011 to June 2014, consisted of 28 patients who underwent surgical management by the double-button fixation system for acute AC joint dislocation. Age, sex, injury mechanism, dominant hand, side with injury, length of follow up, time before surgery, shoulder and hand (DASH), constant and visual analogue scale (VAS) scores, and all complications of the cases during the follow up were recorded. Results: The mean age of patients was 33.23±6.7 years. Twenty four patients (85.71%) were male and four (14.28%) were female. The significant differences were observed between pre-operation VAS, constant shoulder scores and post-operation measurements (P=0.001, P=0.0001, P=0.0001, respectively). There were not any significant differences between right and left coracoclavicular (P=0.238), but two cases of heterotrophic ossifications were recorded. The mean follow-up time was 16.17±4.38 months. Conclusion: According to the results, the double-button fixation system for management of acute acromioclavicular joint dislocation has suitable results and minimal damage to the soft tissues surrounding the coracoclavicular ligaments.
https://abjs.mums.ac.ir/article_5270_21c32ca07bd4fa3a7ef6528c5edb62cd.pdf
Acromioclavicular joint
Dislocation
Double-button fixation
eng
Mashhad University of Medical Sciences, Iranian Society of Knee Surgery, Arthroscopy and Sports Tramatology,Iranian Orthopaedic Association
The Archives of Bone and Joint Surgery
2345-4644
2345-461X
2016-01-01
4
1
47
51
10.22038/abjs.2016.4569
4569
Treatment Outcome of Intramedullary Fixation with a Locked Rigid Nail in Humeral Shaft Fractures
Mohsen Mardani-Kivi
dr_mohsen_mardani@yahoo.com
1
Mehran Soleymanha
drmehransoleymanha@gmail.com
2
zahra Haghparast-Ghadim-Limudahi
haghparastzahra1@gmail.com
3
Department of Orthopedic Surgery, Pursina Hospital, Guilan University of Medical Sciences, Rasht, Iran
Department of Orthopedic Surgery, Pursina Hospital, Guilan University of Medical Sciences, Rasht, Iran
Guilan University of Medical Sciences, Rasht, Iran
Background: The aim of this study was to determine the treatment outcome of humeral shaft fractures with a locked rigid intramedullary nail in patients indicated for surgical treatment. Methods: In this descriptive-cross sectional study, all patients were followed up for one, six, and 18 months post operatively. The Short Form Questionnaire (SF-36) and Constant Shoulder Score were applied. Results: Of 78 included patients (mean age: 35), one patient had a soft tissue infection, one had secondary radial nerve palsy, eight had non-union, one had elbow limited range of motion in extension, and three patients had decreased shoulder range of motion. The Constant Shoulder Score and Short Form Questionnaire Score (SF-36) increased in all patients, although aged women showed lower improvement. Conclusion: Intramedullary nail fixation in the humeral shaft fracture may be associated with high rates of non-union.
https://abjs.mums.ac.ir/article_4569_09f09bc621874a0cf94e5ab96c375d12.pdf
Humeral shaft fractures
Nailing
Orthopedic procedures
Treatment outcome
eng
Mashhad University of Medical Sciences, Iranian Society of Knee Surgery, Arthroscopy and Sports Tramatology,Iranian Orthopaedic Association
The Archives of Bone and Joint Surgery
2345-4644
2345-461X
2016-01-01
4
1
52
55
10.22038/abjs.2016.5248
5248
Prognostic Value of Impaired Preoperative Ankle Reflex in Surgical Outcome of Lumbar Disc Herniation
Farzad Omidi-Kashani
omidif@mums.ac.ir
1
Ebrahim Hasankhani
hasankhanie@mums.ac.ir
2
Atefe Zare
zarea851@mums.ac.ir
3
Orthopedic Research Center, Orthopedic Department, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
Orthopedic Research Center, Orthopedic Department, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
Orthopaedic Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
Background: Several prognostic factors exist influencing the outcome of surgical discectomy in the patients with lumbar disc herniation (LDH). The aim of this study is to evaluate the relationship between severity of preoperative impaired ankle reflex and outcomes of lumbar discectomy in the patients with L5-S1 LDH. Methods: We retrospectively evaluated 181 patients (108 male and 73 female) who underwent simple discectomy in our orthopedic department from April 2009 to April 2013 and followed them up for more than one year. The mean age of the patients was 35.3±8.9 years old. Severity of reflex impairment was graded from 0 to 4+ and radicular pain and disability were assessed by visual analogue scale (VAS) and Oswestry disability index (ODI) questionnaires, respectively. Subjective satisfaction was also evaluated at the last follow-up visit. Chi-square and Kruskal-Wallis tests were used to compare qualitative variables. Results: Reflex impairment existed in 44.8% preoperatively that improved to 10% at the last follow-up visit. Statistical analyses could not find a significant relationship between the severity of impaired ankle reflex and sex or age (P=0.538 and P=0.709, respectively). There was a remarkable relationship between severity of reflex impairment and preoperative radicular pain or disability (P=0.012 and P=0.002, respectively). Kruskal-Wallis test showed that a more severity in ankle reflex impairment was associated with not only less improvement in postoperative pain and disability but also less satisfaction rate (P Conclusions: In the patients with L5-S1 LDH, more severe ankle reflex impairment is associated with less improvement in postoperative pain, disability, and subjective satisfaction.
https://abjs.mums.ac.ir/article_5248_0abe22ddb94e5db467774b2b98ee0f1a.pdf
Ankle Reflex
Discectomy
Outcome
Prognosis
eng
Mashhad University of Medical Sciences, Iranian Society of Knee Surgery, Arthroscopy and Sports Tramatology,Iranian Orthopaedic Association
The Archives of Bone and Joint Surgery
2345-4644
2345-461X
2016-01-01
4
1
56
59
10.22038/abjs.2016.5816
5816
Influence of Sexuality in Functional Recovery after Spinal Cord Injury in rats
Mohammadreza Emamhadi
imamhady@yahoo.com
1
Bahram Soltani
bahram_s_t@yahoo.com
2
Parvin Babaei
p_babaei@yahoo.com
3
Hossein Mashhadinezhad
mashhadinejadh@mums.ac.ir
4
Shervin Ghadarjani
shervin.gh@gmail.com
5
Department of Neurosurgery, Guilan University of Medical Sciences, Rasht, Iran
Department of P harmacology, Cellular and Molecular Research Center, Guilan University of Medical Sciences, Rasht, Iran
Department of Physiology, Cellular and Molecular Research Center, Guilan University of Medical Sciences, Rasht, Iran
Department of Neurosurgery, Ghaem Hospital, Mashhad, Iran
Department of Neurosurgery, Guilan University of Medical Sciences, Rasht, Iran
Background: Spinal cord injury (SCI) is a major clinical condition and research is commonly done to find suitable treatment options. However, there are some degrees of spontaneous recovery after SCI and gender is said to be a contributing factor in recovery, but this is controversial. This study was done to compare the effects of sexual dimorphism on spontaneous recovery after spinal cord injury in Wistar Rats. Methods: Spinal cord lesions were made by compressing the cord at T9 level and making a spinal cord contusion. Routine care of each rat was done daily. The LSS scoring system was used to measure the locomotion of these rats and to compare the recovery rate between male and female rats. Results: The results suggested that there was no significant difference between the two sex in recovery. Conclusions: To be female does not seem to be a prognostic factor for recovery after SCI. However, this preliminary study should be repeated in other animals and in larger cohorts.
https://abjs.mums.ac.ir/article_5816_babc681d821730ffd4d790b0357921c2.pdf
Gender
Rat
Spinal cord injury
Spontaneous recovery
eng
Mashhad University of Medical Sciences, Iranian Society of Knee Surgery, Arthroscopy and Sports Tramatology,Iranian Orthopaedic Association
The Archives of Bone and Joint Surgery
2345-4644
2345-461X
2016-01-01
4
1
60
64
10.22038/abjs.2016.4583
4583
How Much are Emergency Medicine Specialists’ Decisions Reliable in the Diagnosis and Treatment of Pediatric Fractures?
Mohsen Mardani-Kivi
mardani.kivi@gmail.com
1
Behzad Zohrevandi
b.zohrevandi.md@gmail.com
2
Khashayar Saheb-Ekhtiari
dr.khashi@gmail.com
3
Keyvan Hashemi-Motlagh
dr.keyvan.hashemi@gmail.com
4
Guilan Road Trauma Research Center, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
Guilan Road Trauma Research Center, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
Guilan Road Trauma Research Center, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
Guilan Road Trauma Research Center, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
Background: Considering the importance of an early diagnosis and proper decision-making in regards to the treatment of pediatric distal radius and elbow fractures, this study examines emergency medicine specialists’ accuracy in the diagnosis and treatment of these patients. Methods: From 2012 and 2013, children less than 14 years old who were referred to an academic hospital emergency department with elbow or distal radius fractures were enrolled. Initially, patients were examined by an emergency medicine specialist and then they were referred to an orthopedic surgeon. Type of fracture and the proposed treatment of two specialists were compared. Results: In total, there were 108 patients (54 patients in each group) with a mean age of 8.1+3.3 years. Identical diagnosis in 48 cases (88.9%) of distal radius and 36 cases (66.7%) of elbow trauma were observed. We found a difference between diagnosis of the two specialists in diagnosing lateral condyle of the humerus fracture in the elbow group and growth plate fracture in the distal radius fracture group, but the differences were not significant. Among 108 patients, 70 patients (64.8%) received identical treatment. Conclusion: Although the emergency medicine specialists responded similarly to the orthopedic specialists in the diagnosis of pediatric distal radius and elbow fractures, diagnosis of more complicated fractures such as lateral condylar humoral fractures, distal radius growth plate and for choosing the proper treatment option, merits further education.
https://abjs.mums.ac.ir/article_4583_c198a22663b9e256c929678e7f37ff77.pdf
Distal radius fracture
Emergency Medicine
Elbow fracture
Orthopedics
Pediatrics
eng
Mashhad University of Medical Sciences, Iranian Society of Knee Surgery, Arthroscopy and Sports Tramatology,Iranian Orthopaedic Association
The Archives of Bone and Joint Surgery
2345-4644
2345-461X
2016-01-01
4
1
65
69
10.22038/abjs.2016.5422
5422
Which Route of Tranexamic Acid Administration is More Effective to Reduce Blood Loss Following Total Knee Arthroplasty?
Sohrab Keyhani
sohrab_keyhani4@yahoo.com
1
Ali Akbar Esmailiejah
aesmailiejah@yahoo.com
2
Mohammadreza Abbasian
mohammadreza.abbasian@gmail.com
3
Farshad Safdari
f.safdari.to@gmail.com
4
Orthopedic Surgeon, Akhtar Orthopedic Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Orthopedic Surgeon, Akhtar Orthopedic Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Orthopedic Surgeon, Akhtar Orthopedic Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Orthotist and Prosthetist, Bone Joint Related Tissues Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Background: The most appropriate route of tranexamic acid administration is controversial. In the current study, we compared the efficacy of intravenous (IV) and topical intra-articular tranexamic acid in reducing blood loss and transfusion rate in patients who underwent primary total knee arthroplasty. Methods: One hundred twenty 120 patients were scheduled to undergo primary total knee arthroplasty. Patients were randomly allocated to three equal groups: IV tranexamic acid (500 mg), topical tranexamic acid (3 g in 100 mL normal saline) and the control. In the topical group, half of the volume was used to irrigate the joint and the other half was injected intra-articularly. The volume of blood loss, hemoglobin (Hb) level at 24 hours postoperative, and rate of transfusion was compared between groups. Results: The blood loss and Hb level were significantly greater and lower in the control group, respectively (P<0.05). Also, the rate of transfusion was significantly greater in the control group (P<0.05). However, IV and topical groups did not differ significantly in terms of measured variables. No patient experienced a thromboembolic event in our study. Conclusion: Tranexamic acid is a useful antifibrinolytic drug to reduce postoperative blood loss, Hb drop, and rate of blood transfusion in patients undergoing total knee arthroplasty. The route of tranexamic acid administration did not affect the efficacy and safety.
https://abjs.mums.ac.ir/article_5422_41dd6622a5ec3041be044e4856ce981f.pdf
Blood loss
Blood transfusion
Hemoglobin
Total knee arthroplasty
Tranexamic acid
Route of administration
eng
Mashhad University of Medical Sciences, Iranian Society of Knee Surgery, Arthroscopy and Sports Tramatology,Iranian Orthopaedic Association
The Archives of Bone and Joint Surgery
2345-4644
2345-461X
2016-01-01
4
1
70
74
10.22038/abjs.2016.5820
5820
A Survey on Transfusion Status in Orthopedic Surgery at a Trauma Center
Mehran Soleimanha
drmehransoleymanha@gmail.com
1
mohammad haghighi
manesthesist@gmail.com
2
Ahmadreza Mirbolook
orthoresearchguilan@gmail.com
3
Abbas Sedighinejad
a_sedighinejad@yahoo.com
4
Mohsen Mardani-kivi
dr_mohsen_mardani@yahoo.com
5
Bahram Naderi-nabi
naderi_bahram@yahoo.com
6
Tahereh Chavoshi
t.chavoshi@yahoo.com
7
Mehrnoosh Ghandili Mehrnoosh
mehrnoosh.ghandili@gmail.com
8
Orthopaedic Research Center, Guilan University of Medical Sciences, Rasht, Iran
Anesthesiology Research Center, Guilan University of Medical Sciences, Rasht, Iran
Orthopaedic Research Center, Guilan University of Medical Sciences, Rasht, Iran
Anesthesiology Research Center, Guilan University of Medical Sciences, Rasht, Iran
Orthopaedic Research Center, Guilan University of Medical Sciences, Rasht, Iran
Anesthesiology Research Center, Guilan University of Medical Sciences, Rasht, Iran
Anesthesiology Research Center, Guilan University of Medical Sciences, Rasht, Iran
Orthopaedic Research Center, Guilan University of Medical Sciences, Rasht, Iran
Background: Increased costs and mortality associated with inappropriate blood transfusions have led to investigations about blood request and blood transfusion techniques. We investigated the transfusion status in patients who underwent orthopedic surgery in Poursina Hospital (Rasht, Iran) to optimizing blood usage and determine if a scheduled transfusion program for every orthopedic surgery could improve blood transfusion management. Method: In this descriptive-prospective study, all orthopedic surgeries in Poursina Hospital, Rasht, between April to June 2013 were reviewed. All patient information was recorded, including: demographics, type of surgery, hemoglobin level, cross-match test, duration of surgery, and blood loss, and transfusion. Based on the one-way ANOVA and independent samples test analysis, cross-match to transfusion ratio and transfusion possibility, the transfusion index, and maximal surgical blood order schedule were calculated to determine blood transfusion status. Results: Among 872 selected orthopedic surgery candidates, 318 of them were cross-matched and among those, 114 patients received a blood transfusion. In this study, the cross-match to transfusion ratio was 6.4, transfusion possibility 36.47%, transfusion index 0.6, and maximal surgical blood order schedule 0.9. Conclusion: We found that blood ordering was moderately higher than the standard; so it is highly recommended to focus on the knowledge of evidence based on transfusion and standard guidelines for blood transfusion to avoid over-ordering.
https://abjs.mums.ac.ir/article_5820_ee44a2453d9eaa85ea2581be4b22a8ed.pdf
Blood transfusion
Orthopedic surgery
Transfusion index
Transfusion possibility
eng
Mashhad University of Medical Sciences, Iranian Society of Knee Surgery, Arthroscopy and Sports Tramatology,Iranian Orthopaedic Association
The Archives of Bone and Joint Surgery
2345-4644
2345-461X
2016-01-01
4
1
75
79
10.22038/abjs.2016.4710
4710
A Survey of Blood Request Versus Blood Utilization at a University Hospital in Iran
Arash Peivandi Yazdi
peivandia@mums.ac.ir
1
Mohammad Alipour
alipoora@mums.ac.ir
2
Seyyed Saeed Jahanbakhsh
jahanbakhshs@mums.ac.ir
3
Mohammad Gharavifard
gharavim@mums.ac.ir
4
Mehryar Taghavi
taghavim@mums.ac.ir
5
Cardiac Anesthesia Research Center, Imam-Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
Cardiac Anesthesia Research Center, Imam-Reza Hospital,
Faculty of Medicine, Mashhad University of Medical
Sciences, Mashhad, Iran
Cardiac Anesthesia Research Center, Imam-Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
Cardiac Anesthesia Research Center, Imam-Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
Cardiac Anesthesia Research Center, Imam-Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
Background: Reservation of blood leads to blood wastage if the blood is not transfused. Therefore, in some centers only blood type and screen are evaluated. In this study, the efficacy of a blood crossmatch-to-transfusion ratio was measured and then compared with the standard levels. Methods: This prospective study was conducted during one year in a university hospital. During this period, 398 patients for whom blood had been requested were studied. In these patients, at the first surgical type, the laboratory tests (hematocrit, hemoglobin, platelet count, and prothrombin time) and the number of preoperative crossmatched and intraoperative transfused blood units were recorded. Then the crossmatch-to-transfusion ratio, transfusion probability, transfusion index, and correlation between related factors, and the transfusion ratio were evaluated. Results: In this cross-sectional study, blood was requested for 398 patients. According to available blood unit deficiency, from 961 blood unit requisitions, only 456 units were crossmatched and 123 units were transfused. The crossmatch-to-transfusion ratio, transfusion probability, and transfusion index were 3.71 (7.81 if all requisitions were crossmatched), 16.83%, and 0.31, respectively. The most unfavorable indexes were observed in patients who had ear, nose, and throat surgeries (0 transfused from 19 crossmatched blood units) and obstetric and gynecologic surgery (crossmatch-to-transfusion ratio was 18.6). The best indexes were related to thoracic surgery and neurosurgery (crossmatch-to-transfusion ratio was 1.53 and 1.54, respectively). There were no significant correlations between hemoglobin, hematocrit, platelet count, and prothrombin time with the number of transfused blood units (P = 0.2, 0.14, 0.26, and 0.06, respectively). Conclusion: The data for the crossmatch-to-transfusion ratio, transfusion probability, and transfusion index were suboptimal at this center, especially for ear, nose, and throat and obstetric and gynecologic surgeries. Further multidimensional studies and determination of a new model for blood requests and to decrease blood wastage are needed.
https://abjs.mums.ac.ir/article_4710_3d991bc4cdc820630ed8e164726e7a00.pdf
Blood grouping and crossmatching
Blood products
Blood transfusion
eng
Mashhad University of Medical Sciences, Iranian Society of Knee Surgery, Arthroscopy and Sports Tramatology,Iranian Orthopaedic Association
The Archives of Bone and Joint Surgery
2345-4644
2345-461X
2016-01-01
4
1
80
82
10.22038/abjs.2016.4678
4678
Intramuscular Lipoma of the Thenar: A Rare Case
Theodoros Papakostas
theopapk@gmail.com
1
Aristomenis E. Tsovilis
aristomenistsovilis@yahoo.gr
2
Emilios E. Pakos
epakos@yahoo.gr
3
Laboratory of Orthopaedics and Biomechanics, University of Ioannina, Medical School, Ioannina, Greece
Laboratory of Orthopaedics and Biomechanics, University of Ioannina, Medical School, Ioannina, Greece
Laboratory of Orthopaedics and Biomechanics, University of Ioannina, Medical School, Ioannina, Greece
Lipomas are the most common benign mesenchymal tumors. They are located either subcutaneously or under the investing fascia in intramuscular or intermuscular regions. The reported frequency of intramuscular lipomas among all benign adipocytic tumors is 1.0%–5.0% and for intermuscular lipomas is 0.3%–1.9%. The frequency of these lesions is the same in all age groups, but in adults deep seated-lipomas are most commonly discovered between the ages of 30 and 60. The most common sites of involvement of intramuscular lipomas are the large muscles of the extremities, especially those of the thigh, shoulder, and upper arm. Intramuscular lipomas of the hand are extremely rare and only few cases have been reported in the literature. In cases with hand location, they may present with functional deficit or neurovascular compromise due to the effect of the mass. We report an unusual case of a large intramuscular lipoma of the thenar that was treated with surgical excision due to the impairment of hand function.
https://abjs.mums.ac.ir/article_4678_ddc566d8ae65189f7db2b2630c9e6004.pdf
Intramuscular
Lipoma
Thenar
eng
Mashhad University of Medical Sciences, Iranian Society of Knee Surgery, Arthroscopy and Sports Tramatology,Iranian Orthopaedic Association
The Archives of Bone and Joint Surgery
2345-4644
2345-461X
2016-01-01
4
1
83
86
10.22038/abjs.2016.4802
4802
An Isolated Mass in the Palm, Starting Manifestation of Sarcoidosis
Mohammad GhorbanHoseini
dr.ghhoseini@gmail.com
1
Hamidreza Yazdi
yazdi.hr@iums.ac.ir
2
Hossein Naseh
h_naseh@yahoo.com
3
Poopak Hafezi
4
Research Scholar, Harvard Medical School, MA, USA
Iran University of Medical Science, Tehran, Iran
Mashhad University of Medical Sceinces, Mashhad, Iran
Tehran University of Medical Sciences, Tehran, Iran
Sarcoidosis is a systemic disease that is characterized with noncaseating granulomatous nodules which present in multiple organs specially lungs (90%) . Incidence of masses due to Sarcoidosis in upper extremity is low and most cases present in association with involvement of pulmonary hilary lymph nodes. In this article we present a rare case of Sarcoidosis which presented as a single soft tissue mass in hand without osseous or pulmonary hillary lymph node involvement. Incidence of involvement of musculoskeletal system is 1-5 % , mostly it occurs in small bones in hands and feet. In most cases involvement of soft tissue in extremities is accompanied with bone lesions. Those cases of soft tissue involvement are generally coincide with pulmonary lymph nodules. To the authors knowledge this is the first case of Sarcoidosis that presents without spreading in bones or pulmonary hilar lymph nodes.
https://abjs.mums.ac.ir/article_4802_2376657853eeebf2860659b723e11a12.pdf
Hand
Non-caseating Granulomas
Sarcoidosis
eng
Mashhad University of Medical Sciences, Iranian Society of Knee Surgery, Arthroscopy and Sports Tramatology,Iranian Orthopaedic Association
The Archives of Bone and Joint Surgery
2345-4644
2345-461X
2016-01-01
4
1
87
89
10.22038/abjs.2016.4321
4321
Compartment Syndrome of the Calf Due to Nicolau Syndrome
Ali Enshaei
alienshaei@yahoo.com
1
Ahmadreza Afshar
afshar_ah@yahoo.com
2
The Department of Orthopedics, Urmia University of Medical Sciences, Urmia, Iran
The Department of Surgery, Urmia University of Medical Sciences, Urmia, Iran
We report a case of Nicolau syndrome in a 15 months old girl following of an intramuscular injection of penicillin 6.3.3 in her left buttock. This case is unique because she developed compartment syndrome in her left calf far from her injection site. Her toe’s tips gangrened in the course of her ailment. We hypothesized that the compartment syndrome might be produced by a probable intra-arterial injection that had produced embolic obstruction of the small and medium size arteries in her leg or a probable perineural or periarteial injection had produced secondary sympathetic stimulation, extensive vasospasm, compromised microcirculation and the development of compartment syndrome.
https://abjs.mums.ac.ir/article_4321_e025b60acec326546536cfcc27c9bbd9.pdf
Compartment syndrome
Embolia cutis medicamentosa
Intramuscular injection
Livedoid dermatitis
Nicolau syndrome
eng
Mashhad University of Medical Sciences, Iranian Society of Knee Surgery, Arthroscopy and Sports Tramatology,Iranian Orthopaedic Association
The Archives of Bone and Joint Surgery
2345-4644
2345-461X
2016-01-01
4
1
90
93
10.22038/abjs.2016.6235
6235
Platelet-Rich Plasma for Frozen Shoulder: A Case Report
Hamidreza Aslani
hraslani1342@gmail.om
1
Seyed Taghi Nourbakhsh
2
Zohreh Zafarani
test1@yahoo.com
3
Monireh Ahmadi-Bani
test@yahoo.com
4
Mohammad Ebrahim Shahsavand Ananloo
test2@yahoo.com
5
Maani Beigy
test3@yahoo.com
6
Shahin Salehi
salehi2955@yahoo.com
7
Shahid Beheshti University of Medical Sciences, Tehran, Iran Knee and Sport Medicine Research and Education Center, Milad hospital, Tehran, Iran
Orthopedic Surgeon, Knee and Sport Medicine Research and Education Center, Milad hospital, Tehran, Iran
University of Social Welfare and Rehabilitation Science, Tehran, Iran
Knee and Sport Medicine Research and Education Center, Milad hospital, Tehran, Iran
Knee and Sport Medicine Research and Education Center, Milad hospital, Tehran, Iran
Knee and Sport Medicine Research and Education Center, Milad hospital, Tehran, Iran
Imam Hossein Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Frozen shoulder is a glenohumeral joint disorder that perturbs movement because of adhesion and the existence of fibrosis in the shoulder capsule. Platelet-rich plasma can produce collagen and growth factors, which increases stem cells and consequently enhances the healing. To date, there is no evidence regarding the effectiveness of platelet-rich plasma in frozen shoulder. A 45-year-old man with shoulder adhesive capsulitis volunteered for this treatment. He underwent two consecutive platelet-rich plasma injections at the seventh and eighth month after initiation of symptoms. We measured pain, function, and ROM by the visual analogue scale (VAS), and scores from the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire and goniometer; respectively. After the first injection, the patient reported 60% improvement regarding diurnal shoulder pain, and no night pains. Also, two-fold improvement for ROM and more than 70% improvement for function were reported. This study suggests the use of platelet-rich plasma in frozen shoulder to be tested in randomized trials.
https://abjs.mums.ac.ir/article_6235_e71457ec02418c90912da0b1553c9ea8.pdf
Disability
Frozen shoulder
Pain
Platelet-rich plasma
Range of motion