ORIGINAL_ARTICLE
Surgical Management of Hip Problems in Myelomeningocele: A Review Article
Background: Children with myelomeningocele (MMC) develop a wide variety of hip deformities such as muscle imbalance, contracture, subluxation, and dislocation. Various methods and indications have been introduced for treatment of muscle imbalances and other hip problems in patients with MMC but there is no study or meta-analysis to compare the results and complications. This review aims to find the most acceptable approach to hip problems in patients with MMC. Methods: MEDLINE was searched up to April 2015. All study designs that reported on the outcomes of hip problems in MMC were included. From 270 screened citations, 55 were strictly focused on hip problem in MMC were selected and reviewed. Results: Complex osseous and soft tissue reconstructive procedures to correct hip dysplasia and muscle balancing around the hip are rarely indicated for MMC patients without good quadriceps power. Conclusion: Over the years a consensus on the best algorithm for treatment of hip dislocation in myelomeningocele has been missing, however, muscular balancing with/out osseous procedure seems a reasonable approach especially in unilateral mid-lumbar MMC.
https://abjs.mums.ac.ir/article_6468_52004c190829f77e97137240f5b67868.pdf
2016-07-01
197
203
10.22038/abjs.2016.6468
Hip Dislocation
Hip dysplasia
Myelomeningocele
Meningomyelocele
Spina bifida
Teratology
Taghi
Baghdadi
taghibaghdadi@hotmail.com
1
Emam Educational Hospital, Tehran University of Medical
Science, Tehran, Iran
AUTHOR
Reza
Abdi
reza1352abdi@gmail.com
2
Emam Educational Hospital, Tehran University of Medical Science, Tehran, Iran
LEAD_AUTHOR
Ramin
zargarbashi
ramin1352hajzargarbashi@gmail.com
3
Children’s Medical Center, Tehran University of Medical Science, Tehran, Iran
AUTHOR
Hossein
Aslani
dr_aslani73@yahoo.com
4
Shohada Educational Hospital, Golshahr Town, Tabriz,
Iran
AUTHOR
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ORIGINAL_ARTICLE
High Tibial Osteotomy: A Systematic Review and Current Concept
High tibia osteotomy is a common procedure in orthopedic surgery. A precise overview on indications, patients selection, pre-operative planning, surgical technique, methods of fixation, and complications have been presented. This paper focused on the points that should be considered to achieve good long-term outcomes. High tibia osteotomy is a common procedure in orthopedic surgery. A precise overview on indications, patients selection, pre-operative planning, surgical technique, methods of fixation, and complications have been presented. This paper focused on the points that should be considered to achieve good long-term outcomes.
https://abjs.mums.ac.ir/article_7149_e9c8406b79af03bb67f364ce34d45859.pdf
2016-07-01
204
212
10.22038/abjs.2016.7149
Tibia
Osteotomy
Systematic review
Soheil
Sabzevari
erfani@yahoo.com
1
1Department of Orthopedic Surgery, University of Pittsburgh Medical Center, Pittsburg, USA
AUTHOR
Adel
Ebrahimpour
erfani2@yahoo.com
2
2Department of Orthopedic Surgery, Shahid Beheshti University of Medical Science, Tehran, Iran
AUTHOR
Mostafa
Khalilipour Roudi
erfani3@yahoo.com
3
3Department of Orthopedic Surgery, Mashhad University of Medical Science, Mashhad, Iran 4Harvard Medical School, Boston, USA
AUTHOR
Amir R.
Kachooei
arkachooei@gmail.com
4
Mashhad University Of Medical Sciences, Mashhad, Iran
Department of Orthopedic Surgery, Mashhad University of Medical Science, Mashhad, Iran 4Harvard Medical School, Boston, USA
LEAD_AUTHOR
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ORIGINAL_ARTICLE
Discrete Pathophysiology is Uncommon in Patients with Nonspecific Arm Pain
Background: Nonspecific symptoms are common in all areas of medicine. Patients and caregivers can be frustrated when an illness cannot be reduced to a discrete pathophysiological process that corresponds with the symptoms. We therefore asked the following questions: 1) Which demographic factors and psychological comorbidities are associated with change from an initial diagnosis of nonspecific arm pain to eventual identification of discrete pathophysiology that corresponds with symptoms? 2) What is the percentage of patients eventually diagnosed with discrete pathophysiology, what are those pathologies, and do they account for the symptoms? Methods: We evaluated 634 patients with an isolated diagnosis of nonspecific upper extremity pain to see if discrete pathophysiology was diagnosed on subsequent visits to the same hand surgeon, a different hand surgeon, or any physician within our health system for the same pain. Results: There were too few patients with discrete pathophysiology at follow-up to address the primary study question. Definite discrete pathophysiology that corresponded with the symptoms was identified in subsequent evaluations by the index surgeon in one patient (0.16% of all patients) and cured with surgery (nodular fasciitis). Subsequent doctors identified possible discrete pathophysiology in one patient and speculative pathophysiology in four patients and the index surgeon identified possible discrete pathophysiology in four patients, but the five discrete diagnoses accounted for only a fraction of the symptoms. Conclusion: Nonspecific diagnoses are not harmful. Prospective randomized research is merited to determine if nonspecific, descriptive diagnoses are better for patients than specific diagnoses that imply pathophysiology in the absence of discrete verifiable pathophysiology.
https://abjs.mums.ac.ir/article_5373_36b54af62cba9cf63676e1e2a4552d80.pdf
2016-07-01
213
219
10.22038/abjs.2016.5373
Arm
Discrete
Nonspecific
Pain
Pathophysiology
Joost
Kortlever
joostkortlever@hotmail.com
1
Department of Orthopaedic
Surgery, Orthopaedic Hand and Upper Extremity Service
Boston, MA, USA, Massachusetts General Hospital,
Harvard Medical School
AUTHOR
Stein
Janssen
steinjanssen@gmail.com
2
Department of Orthopaedic Surgery,
Orthopaedic Hand and Upper Extremity Service, Boston,
MA, USA, Massachusetts General Hospital, Harvard
Medical School
AUTHOR
Jeroen
Molleman
jmolleman@live.nl
3
Department of Orthopaedic
Surgery, Orthopaedic Hand and Upper Extremity Service
Boston, MA, USA, Massachusetts General Hospital,
Harvard Medical School
AUTHOR
Michiel
Hageman
michielhageman@gmail.com
4
Department of Orthopaedic Surgery,
Orthopaedic Hand and Upper Extremity Service, Boston,
MA, USA, Massachusetts General Hospital, Harvard
Medical School
AUTHOR
David
Ring
david.ring@austin.utexas.edu
5
Orthopaedic Hand and Upper Extremity Service,
Orthopaedic Hand and Upper Extremity Service,
Massachusetts General Hospital, Harvard Medical School,
Boston, USA
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the treatment of chronic pain. Clin J Pain. 2001; 17(4
138
Suppl):S114-27.
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38. Sveinsdottir V, Eriksen HR, Reme SE. Assessing
140
the role of cognitive behavioral therapy in the
141
management of chronic nonspecific back pain. J Pain
142
Res. 2012; 2012(5):371-80.
143
39. Huisstede BM, Bierma-Zeinstra SM, Koes BW, Verhaar
144
JA. Incidence and prevalence of upper-extremity
145
musculoskeletal disorders. A systematic appraisal
146
of the literature. BMC Musculoskelet Disord. 2006;
147
40. Huisstede BM, Miedema HS, Verhagen AP, Koes
148
BW, Verhaar JA. Multidisciplinary consensus on the
149
terminology and classification of complaints of the
150
arm, neck and/or shoulder. Occup Environ Med.
151
2007; 64(5):313-9.
152
41. Ireland DC. Psychological and physical aspects
153
of occupational arm pain. J Hand Surg Br. 1988;
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13(1):5-10.
155
42. van Tulder M, Malmivaara A, Koes B. Repetitive strain
156
injury. Lancet. 2007; 369(9575):1815-22.
157
43. Vranceanu AM, Barsky A, Ring D. Less specific arm
158
illnesses. J Hand Ther. 2011; 24(2):118-22.
159
44. Ring D, Guss D, Malhotra L, Jupiter JB. Idiopathic arm
160
pain. J Bone Joint Surg Am. 2004; 86-A(7):1387-91.
161
ORIGINAL_ARTICLE
The Radiological Prevalence of Incidental Kienböck Disease
Background:To determine the prevalence of incidental Kienböck disease. Methods: A retrospective analysis of 150,912 radiological reports or images obtained over a five year period was performed of 76,174 patients who underwent a radiograph or computed tomography scan which included the wrist, in Edinburgh and Lothian, UK. Results: There were 5 cases of incidental Kienböck disease and 13 cases of symptomatic Kienböck disease. There were no significant differences in age, sex, ethnicity, comorbidities, smoking status, excess alcohol use or Lichtman stage between the incidental and symptomatic Kienböck groups. Conclusion: The radiological prevalence of incidental Kienböck disease was 0.0066% or 7 in 100,000 patients.
https://abjs.mums.ac.ir/article_5817_e7b48ba64520fa9320e7e486a91f8f70.pdf
2016-07-01
220
223
10.22038/abjs.2016.5817
Incidental
Kienböck disease
Lunate
Prevalence
Saroj K.
Golay
s.golay1@gmail.com
1
The Royal Infirmary of Edinburgh, The University of
Edinburgh, UK
LEAD_AUTHOR
Philippa
Rust
philippa.rust@nhslothian.scot.nhs.uk
2
The Royal Infirmary of Edinburgh, The University of
Edinburgh, UK
AUTHOR
David
Ring
dring@mgh.harvard.edu
3
Hand and Upper Extremity Service, Massachusetts General
Hospital, Harvard Medical School, USA
AUTHOR
1. Kienböck R. Ü ber traumatische Malazie des Mondbeins
1
und Ihre Folgezustände: Entartungsformen und
2
Kompressions frakturen. Fortschr Geb Rontgenstr
3
1910 Vol. 16:77–103.
4
2. Irisarri C. Aetiology of Kienbock’s disease. Journal of
5
hand surgery. 2004;29(3):281-7.
6
3. Lutsky K, Beredjiklian PK. Kienbock disease. The
7
Journal of hand surgery. 2012;37(9):1942-52.
8
4. Mennen U, Sithebe H. The incidence of asymptomatic
9
Kienbock’s disease. The Journal of hand surgery,
10
European volume. 2009;34(3):348-50.
11
5. Tsujimoto R, Maeda J, Abe Y, Arima K, Tomita M,
12
Koseki H, et al. Epidemiology of Kienbock’s disease
13
in middle-aged and elderly Japanese women.
14
Orthopedics. 2015;38(1):e14-8.
15
6. Pfitzner W. Beiträge zur Kenntnis des menschlichen
16
Extremitätenskeletts. Morphologische Arbeiten.
17
7. Taniguchi Y, Yoshida M, Iwasaki H, Otakara H, Iwata
18
S. Kienbock’s disease in elderly patients. The Journal
19
of hand surgery. 2003;28(5):779-83.
20
8. Palmer AK, Dobyns JH. The Wrist Diagnosis and
21
Operative Treatment Lunate Fractures: Kienböck’s
22
Disease. St Louis: Mosby 1998
23
9. Lee ML. The intraosseus arterial pattern of the carpal
24
lunate bone and its relation to avascular necrosis.
25
Acta orthopaedica Scandinavica. 1963;33:43-55.
26
10. Watson HK, Guidera PM. Aetiology of Kienbock’s
27
disease. Journal of hand surgery. 1997;22(1):5-7.
28
11. Chung KC, Spilson MS, Kim MH. Is negative ulnar
29
variance a risk factor for Kienbock’s disease? A metaanalysis.
30
Annals of plastic surgery. 2001;47(5):494-9.
31
12. Mirabello SC, Rosenthal DI, Smith RJ. Correlation
32
of clinical and radiographic findings in
33
Kienbock’s disease. The Journal of hand surgery.
34
1987;12(6):1049-54.
35
ORIGINAL_ARTICLE
Percutaneous Release of Trigger Fingers: Comparing Multiple Digits with Single Digit Involvement
Background: To evaluate safety and efficacy of percutaneous release of trigger finger in multiple digits involvement in comparison with single digit involvement. Method: A number of 100 patients (131 fingers) were treated by percutaneous release and divided into two groups: single digit (group A) and multiple digits (group B). They were followed up for one year. Success rate, pain, complications and duration of analgesic use were studied and then compared in both groups. Results: All patients in both groups were treated successfully without any recurrence in a one-year follow-up. No complication was observed, but postoperative duration of pain was significantly different between the two groups. Period of painkiller use was also different between the two groups. Conclusion: Percutaneous release is a safe and effective treatment for trigger fingers even if multiple digits are involved. It is also safe in thumb and index finger involvement and diabetic patients.
https://abjs.mums.ac.ir/article_6710_e4ddf766af061ec507cc5a9d809c5730.pdf
2016-07-01
224
227
10.22038/abjs.2016.6710
Multiple digits
Percutaneous release
Trigger Finger
Hossein
Saremi
h.saremi@umsha.ac.ir
1
Orthopaedic Department, School of Medicine, Hamadan
University of Medical Sciences, Hamadan, Iran
LEAD_AUTHOR
Elham
Hakhamaneshi
e.hakhamaneshi@gmail.com@gmail.com
2
Orthopaedic Department, School of Medicine, Hamadan
University of Medical Sciences, Hamadan, Iran
AUTHOR
Mohamad Ali
Seif Rabiei
seifrabiei@yahoo.com
3
Orthopaedic Department, School of Medicine, Hamadan
University of Medical Sciences, Hamadan, Iran
AUTHOR
1. Freiberg A, Mulholland RS, Levine R. Nonoperative
1
treatment of trigger fingers and thumbs. J Hand Surg
2
Am. 1989; 14(3);553-8.
3
2. Ha KI, Park MJ, Ha CW. Percutaneous release of
4
trigger digits. J Bone Joint Surg Br. 2001; 83(1):75-7.
5
3. Eastwood DM, Gupta KJ, Johnson DP. Percutaneous
6
release of the trigger finger: an office procedure. J
7
Hand Surg Am. 1992; 17(1):114-7.
8
4. Colbourn J, Health N, Manary S, Pacifico D.
9
Effectiveness of splinting for the treatment of trigger
10
finger. J Hand Ther. 2008; 21(4):336-43.
11
5. Newport ML, Lane LB, Stuchin SA. Treatment of
12
trigger finger by steroid injection. J Hand Surg Am.
13
1990; 15(5):748-50
14
6. Patel MR, Bassini L. Trigger fingers and thumb: when
15
to splint, inject, or operate. J Hand Surg Am. 1992;
16
17(1):110-3.
17
7. Marks MR, Gunther SF. Efficacy of cortisone injection
18
in treatment of trigger fingers and thumbs. J Hand
19
Surg Am. 1989; 14(4):722-7.
20
8. Griggs SM, Weiss AP, Lane LB, Schwenker C, Akelman
21
E, Sachar K. Treatment of trigger finger in patients
22
with diabetes mellitus. J Hand Surg Am. 1995;
23
20(5):787-9.
24
9. Kolind-Sorensen V. Treatment of trigger fingers. Acta
25
Orthop Scand. 1970; 41(4):428–32.
26
10. .Marks MR, Gunther SF. Efficacy of cortisone injection
27
in treatment of trigger fingers and thumbs. J Hand
28
Surg Am. 1989; 14(4):722–7.
29
11. Newport ML, Lane LB, Stuchin SA. Treatment of
30
trigger finger by steroid injection. J Hand Surg Am.
31
1990; 15(5):748–50.
32
12. Benson LS, Ptaszek AJ. Injection versus surgery in
33
the treatment of trigger finger. J Hand Surg Am. 1997;
34
22(1):138–44.
35
13. Sato ES, dos Santos JB, Belloti JC, Albertoni WM,
36
Faloppa F. Percutaneous release of trigger fingers.
37
Hand Clin. 2014; 30(1):39-45.
38
14. Kachooei AR, Nota SP, Menendez ME, Dyer GS, Ring
39
D. Factors associated with operative treatment of
40
de quervain tendinopathy. Arch Bone Jt Surg. 2015;
41
3(3):198-203.
42
15. Carrozzella J, Stern PJ, Von Kuster LC. Transection
43
of radial digital nerve of the thumb during trigger
44
release. J Hand Surg Am. 1989; 14(2 Pt 1):198-200
45
16. Heithoff SJ, Millender LH, Helman J. Bowstringing as
46
a complication of trigger finger release. J Hand Surg
47
Am. 1988; 13(4):567-70.
48
17. Turowski GA, Zdankiewicz PD, Thomson JG. The
49
results of surgical treatment of trigger finger. J Hand
50
Surg Am. 1997; 22(1):145-9.
51
18. Thorpe AP. Results of surgery for trigger finger. J
52
Hand Surg Br. 1988; 13(2):199–201.
53
19. Gilberts EC, Beekman WH, Stevens HJ, Wereldsma
54
JC. Prospective randomized trial of open versus
55
percutaneous surgery for trigger digits. J Hand Surg
56
Am. 2001; 26(3):497-500.
57
20. Chao M, Wu S, Yan T. The effect of miniscalpel-needle
58
versus steroid injection for trigger thumb release. J
59
Hand Surg Eur Vol. 2009; 34(4):522–5.
60
21. Zyluk A, Jagielski G. Percutaneous A1 pulley release
61
vs steroid injection for trigger digit: the results of a
62
prospective, randomized trial. J Hand Surg Eur Vol.
63
2011; 36(1):53–6.
64
22. Ragoowansi R, Acornley A, Khoo CT. Percutaneous
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trigger finger release: the ‘lift-cut’ technique. Br J
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Plast Surg. 2005; 58(6):817–21.
67
23. Wolfe Hotchkiss Pederson kozin. Green’s operative
68
Hand Surgery. 6 th ed. Philadelphia: Elsevier
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Churchill Livingstone, 2011. P. 2076
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24. Maneerit J, Sriworakun C, Budhraja N, Nagavajara P.
71
Trigger thumb: results of a prospective randomised
72
study of percutaneous release with steroid injection
73
versus steroid injection alone. J Hand Surg Br. 2003,
74
28(6):586–9
75
25. Park MJ, Oh I, Ha KI. A1 Pulley release of locked
76
trigger digit by percutaneous technique. J Hand Surg
77
Br. 2004; 29( 5): 502-5.
78
ORIGINAL_ARTICLE
Progression of Heterotopic Ossification around the Elbow after Trauma
Background: This study addresses the null hypothesis that there is no expansion of heterotopic ossification (HO) in the elbow beyond what can be seen early on. Methods: The area of HO was measured on lateral radiographs of 38 consecutive patients that had operative treatment of HO between 2000 and 2013. Measurements from radiographs obtained between 3 to 7 weeks were compared to measurements from radiographs made 3 months or more after injury. Results: There was no significant difference between the average area of HO on the first (median 2.8 square centimeters, Q1: 1.5, Q3: 5.1) and later radiographs (median of 2.8 square centimeters, Q1: 1.4, Q3: 5.0) (P = 0.99). Discussion: According to our results the area of HO does not expand beyond what can be seen early in the disease process.
https://abjs.mums.ac.ir/article_7147_b596595d54c93b14f8a30f87b6647b93.pdf
2016-07-01
228
230
10.22038/abjs.2016.7147
Disease progression
Elbow
Heterotopic
Injuries
Ossification
Dirk P.
ter Meulen
d.p.termeulen@olvg.nl
1
Orthopaedic Hand and Upper Extremity Service,
Massachusetts General Hospital, Boston, MA
AUTHOR
Sjoerd
Nota
s.p.f.t.nota@olvg.nl
2
Orthopaedic Hand and Upper Extremity Service,
Massachusetts General Hospital, Boston, MA
AUTHOR
Michiel
Hageman
m.g.j.s.hageman@olvg.nl
3
Orthopaedic Hand and Upper Extremity Service,
Massachusetts General Hospital, Boston, MA
AUTHOR
David
Ring
dring@mgh.harvard.edu
4
Orthopaedic Hand and Upper Extremity Service,
Massachusetts General Hospital, Boston, MA
LEAD_AUTHOR
1. Foruria AM, Augustin S, Morrey BF, Sanchez-Sotelo
1
J. Heterotopic ossification after surgery for fractures
2
and fracture-dislocations involving the proximal
3
aspect of the radius or ulna. J Bone Joint Surg Am.
4
2013; 95(10):e66.
5
2. Wiggers JK, Helmerhorst GT, Brouwer KM, Niekel
6
MC, Nunez F, Ring D. Injury complexity factors
7
predict heterotopic ossification restricting motion
8
after elbow trauma. Clin Orthop Relat Res. 2014;
9
472(7):2162-7.
10
3. Potter BK, Forsberg JA, Davis TA, Evans KN,
11
Hawksworth JS, Tadaki D, et al. Heterotopic
12
ossification following combat-related trauma. J Bone
13
Joint Surg Am. 2010; 92(Suppl 2):74-89.
14
4. Abrams GD, Bellino MJ, Cheung EV. Risk factors for
15
development of heterotopic ossification of the elbow
16
after fracture fixation. J Shoulder Elbow Surg. 2012;
17
21(11):1550-4.
18
5. Brownley RC, Agarwal S, Loder S, Eboda O, Li J,
19
Peterson J, et al. Characterization of heterotopic
20
ossification using radiographic imaging: evidence for
21
a paradigm shift. PloS One. 2015; 10(11):e0141432.
22
6. Murnaghan M, Li G, Marsh DR. Nonsteroidal antiinflammatory
23
drug-induced fracture nonunion: an
24
inhibition of angiogenesis? J Bone Joint Surg Am.
25
2006; 88(Suppl 3):140-7.
26
7. Hamid N, Ashraf N, Bosse MJ, Connor PM, Kellam
27
JF, Sims SH, et al. Radiation therapy for heterotopic
28
ossification prophylaxis acutely after elbow trauma:
29
a prospective randomized study. J Bone Joint Surg
30
Am. 2010; 92(11):2032-8.
31
8. McAuliffe JA, Wolfson AH. Early excision of
32
heterotopic ossification about the elbow followed
33
by radiation therapy. J Bone Joint Surg Am. 1997;
34
79(5):749-55.
35
9. Salazar D, Golz A, Israel H, Marra G. Heterotopic
36
ossification of the elbow treated with surgical resection:
37
risk factors, bony ankylosis, and complications. Clin
38
Orthop Relat Res. 2014; 472(7):2269-75.
39
ORIGINAL_ARTICLE
Economic Effects of Anti-Depressant Usage on Elective Lumbar Fusion Surgery
Background: It has been suggested, although not proven, that presence of concomitant psychiatric disorders may increase the inpatient costs for patients undergoing elective surgery. This study was designed to test the hypothesis that elective lumbar fusion surgery is more costly in patients with under treatment for depression. Methods: This is a retrospective case-control study of 142 patients who underwent elective lumbar fusion. Of those 142 patients, 41 patients were chronically using an antidepressant medication that considered as a "study group", and 101 patients were not taking an antidepressant medication that considered as a "control group". Data was collected for this cohort regarding antidepressant usage patient demographics, length of stay (LOS), age-adjusted Charlson comorbidity index scores and cost. Costs were compared between those with a concomitant antidepressant usage and those without antidepressant usage using multivariate analysis. Results: Patients using antidepressants and those with no history of antidepressant usage were similar in terms of gender, age and number of operative levels. The LOS demonstrated a non-significant trend towards longer stays in those using anti-depressants. Total charges, payments, variable costs and fixed costs were all higher in the antidepressant group but none of the differences reached statistical significance. Using Total Charges as the dependent variable, gender and having psychiatric comorbidities were retained independent variables. Use of an antidepressant was independently predictive of a 36% increase in Total Charges . Antidepressant usage as an independent variable also conferred a 22% increase in cost and predictive of a 19% increase in Fixed Cost . Male gender was predictive of a 30% increase in Total Charges . Conclusion: This study suggests use of antidepressant in patients who undergo elective spine fusion compared with control group is associated with increasing total cost and length of hospitalization, although none of the differences reached statistical significance.
https://abjs.mums.ac.ir/article_6697_62dadc802a09f028f228d19b432754bf.pdf
2016-07-01
231
235
10.22038/abjs.2016.6697
Antidepressants
Costs
Comorbidities
Elective lumbar fusion surgery
Length of hospitalization
Amirali
Sayadipour
asayadip@psych.umaryland.edu
1
Department of Psychiatry, University of Maryland Medical
Center, Baltimore, MD, USA
LEAD_AUTHOR
Chrisopher K.
Kepler
chris.kepler@gmail.com
2
Rothman Institute of Orthopaedics, Thomas Jefferson
University, Philadelphia, PA, USA
AUTHOR
Rajnish
Mago
rajnish.mago@jefferson.edu
3
Department of Psychiatry, Thomas Jefferson University,
Philadelphia, PA, USA
AUTHOR
Kenneth M.
Certa
kenneth.certa@jefferson.edu
4
Department of Psychiatry, Thomas Jefferson University,
Philadelphia, PA, USA
AUTHOR
Mohammad R.
Rasouli
parvj@aol.com
5
Rothman Institute of Orthopaedics, Thomas Jefferson
University, Philadelphia, PA, USA
Sina Trauma and Surgery Research Center, Tehran
University of Medical Sciences, Tehran, Iran
AUTHOR
Alexander R.
Vaccaro
alexvaccaro3@aol.com
6
Rothman Institute of Orthopaedics, Thomas Jefferson
University, Philadelphia, PA, USA
AUTHOR
Todd J.
Albert
tjsurg@aol.com
7
Sina Trauma and Surgery Research Center, Tehran
University of Medical Sciences, Tehran, Iran
AUTHOR
David G.
Anderson
davidgreganderson@comcast.net
8
Rothman Institute of Orthopaedics, Thomas Jefferson
University, Philadelphia, PA, USA
AUTHOR
1. Walid MS, Robinson JS Jr. Economic impact of
1
comorbidities in spine surgery. J Neurosurg Spine.
2
2011; 14(3):318-21.
3
2. Walid MS, Zaytseva NV. Prevalence of mood-altering
4
and opioid medication use among spine surgery
5
candidates and relationship with hospital cost. J Clin
6
Neurosci. 2010; 17(5):597-600.
7
3. Rasouli MR, Menendez ME, Sayadipour A, Purtill JJ,
8
Parvizi J. Direct cost and complications associated
9
with total joint arthroplasty in patients with
10
preoperative anxiety and depression. J Arthroplasty.
11
2016; 31(2): 533–6.
12
4. Charlson ME, Pompei P, Ales KL, MacKenzie CR. A
13
new method of classifying prognostic comorbidity in
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longitudinal studies: development and validation. J
15
Chronic Dis. 1987; 40(5):373–83.
16
5. Deyo RA, Cherkin DC, Ciol MA. Adapting a
17
clinical comorbidity index for use with ICD-9-CM
18
administrative databases. J Clin Epidemiol. 1992;
19
45(6):613-9.
20
6. George SZ, Coronado RA, Beneciuk JM, Valencia
21
C, Werneke MW, Hart DL. Depressive symptoms,
22
anatomical region, and clinical outcomes for
23
patients seeking outpatient physical therapy for
24
musculoskeletal pain. Phys Ther. 2011; 91(3):358-72.
25
7. Sinikallio S, Aalto T, Airaksinen O, Herno A, Kröger H,
26
Savolainen S, et el. Depression and associated factors
27
in patients with lumbar spinal stenosis. Disabil
28
Rehabil. 2006; 28(7):415-22.
29
8. Sinikallio S, Aalto T, Airaksinen O, Lehto SM, Kröger
30
H, Viinamäki H. Depression is associated with a
31
poorer outcome of lumbar spinal stenosis surgery:
32
a two-year prospective follow-up study. Spine (Phila
33
Pa 1976). 2011; 36(8):677-82.
34
9. Zatzick DF, Kang SM, Kim SY, Leigh P, Kravitz R, Drake
35
C, et al. Patients with recognized psychiatric disorders
36
in trauma surgery: incidence, inpatient length of stay,
37
and cost. J Trauma. 2000; 49(3):487-95.
38
10. Ebrahimzadeh MH, Shojaee BS, Golhasani-Keshtan
39
F, Moharari F, Kachooei AR, Fattahi AS. Depression,
40
anxiety and quality of life in caregiver spouses
41
of veterans with chronic spinal cord injury. Iran J
42
Psychiatry. 2014; 9(3):133-6.
43
11. Von Korff M, Crane P, Lane M, Miglioretti DL, Simon
44
G, Saunders K, et al. Chronic spinal pain and physicalmental
45
comorbidity in the United States: results
46
from the national comorbidity survey replication.
47
Pain. 2005; 113(3):331–9.
48
12. Baumeister H, Knecht A, Hutter N. Direct and indirect
49
costs in persons with chronic back pain and comorbid
50
mental disorders--a systematic review. J Psychosom
51
Res. 2012; 73(2):79-85.
52
13. Borckardt JJ, Madan A, Barth K, Galloway S, Balliet W,
53
Cawley PJ, et al. Excess health care service utilization
54
and costs associated with underrecognition of
55
psychiatric comorbidity in a medical/surgical
56
inpatient setting. Qual Manag Health Care. 2011;
57
20(2):98-102.
58
14. Konnopka A, Heinrich S, Zieger M, Luppa M, Riedel-
59
Heller SG, Meisel HJ, et al. Effects of psychiatric
60
comorbidity on costs in patients undergoing disc: a
61
cross-section study. Spine J. 2011; 11(7):601-9.
62
15. Hochlehnert A, Niehoff D, Wild B, Jünger J, Herzog W,
63
Löwe B. Psychiatric comorbidity in cardiovascular
64
inpatients: costs, net gain, and length of
65
hospitalization. J Psychosom Res. 2011; 70(2):135-9.
66
ORIGINAL_ARTICLE
Evaluation of Clinical Results and Complications of Structural Allograft Reconstruction after Bone Tumor Surgery
Background: Massive bone allograft is an option in cases of limb preservation and reconstruction after massive benign and malignant bone tumor resection. The purpose of this study was to analyze the outcome of these procedures at Imam Reza Hospital, Mashhad University of Medical Sciences. Methods: In this study, 113 cases have been presented. Eleven cases were excluded (patients has a traumatic defect or they passed away before the completion of the study’s two-year follow up period). Each patient completed a questionnaire, went through a physical examination and, if indicated, X-ray information was collected. The patients were divided into three groups: chemotherapy, chemotherapy plus radiation therapy, and no-adjuvant-therapy. Results: Fifty-four cases were male and the mean age was 24.5±5.39. The number of cases and indications for surgery were: 33 cases of aggressive benign tumors or low grade malignant bone tumors (large bone defects) including 16 germ cell tumors, eight aneurysmal bone cysts, five low grade osteosarcomas, and four chondrosarcomas. Another 69 cases were high-grade malignant bone tumors including 42 osteosarcomas, 21 Ewing’s sarcoma, and six other high grade osteosarcomas. Patients were divided into three groups: the first group received no adjuvant therapy, the second group received chemotherapy, and the third group received chemotherapy plus radiotherapy. The location of tumors were as follows: eight cases in the pelvic bone, 12 in the proximal femur, 18 in the femoral shaft, 36 in the distal femur, 12 in the proximal tibia, and 16 in the humeral bone. The 12 cases of proximal femoral defects were reconstructed by allograft composite prosthesis, 18 diaphyseal defects with intercalary allograft, and 36 distal femoral defects were reconstructed using osteoarticular allograft. The rate of deep infection was 7:8% (eight patients) and in this regard, we found a significant difference among the three groups, such that most cases of infection occurred in the adjuvant chemotherapy plus radiation therapy group. Allograft fracture occurred in six patients and prevalence was the same in all groups. Only in six cases of radio-chemotherapy nonunion occurred, so we used autogenous bone graft for union. Local recurrence was observed in six patients: three belonged to the adjuvant chemotherapy group and the other three were in the chemo-radiotherapy group; no significant difference was observed between these two groups. However, there was a significant difference between these two and the group that received no adjuvant therapy. Also, there were 11 cases of metastases and Restriction of knee joint motion occurred in 48 cases of osteo-cartilaginous grafts of the distal femur and proximal tibia. Conclusion: Although structural allograft is an appropriate choice in limb reconstruction after massive resection of involved tissues in malignant and invasive bone tumors, the risk of complications such as nonunion and infection in massive allograft increases in cases of adjuvant (chemotherapy and radiotherapy) modalities of treatment. Whereas the rate of tumor recurrence, metastasis, and restrictions in range of motion during a short term follow up after implantation showed no significant difference among the evaluated groups. Consequently, further attention and constant periodic visits of the patients and checking for local recurrence and distant metastasis should be done after surgery.
https://abjs.mums.ac.ir/article_6320_58b046ee25e3012f8a92577122deb91f.pdf
2016-07-01
236
242
10.22038/abjs.2016.6320
Allograft
Bone tumor
chemotherapy
Limb-salvage
Radiotherapy
Mohammad
Gharedaghi
gharahdaghim@mums.ac.ir
1
Orthopedic Research Center, Mashhad University of Medical
Sciences, Mashhad, Iran
AUTHOR
Mohammad Taghi
Peivandi
peivandimt@mums.ac.ir
2
Orthopedic Research Center, Mashhad University of Medical
Sciences, Mashhad, Iran
AUTHOR
Mehdi
Mazloomi
test@yahoo.com
3
Orthopedic Research Center, Mashhad University of Medical
Sciences, Mashhad, Iran
AUTHOR
Hasan
Rahimi Shoorin
rahimih@mums.ac.ir
4
Department of Orthopedic Surgery, Kamyab Hospital, Mashhad, Iran Department of Orthopedic Surgery, Emam Reza Hospital, Mashhad, Iran
LEAD_AUTHOR
Mohammad
Hasani
test3@yahoo.com
5
Department of Orthopedic Surgery, Kamyab Hospital, Mashhad, Iran Department of Orthopedic Surgery, Emam Reza Hospital, Mashhad, Iran
AUTHOR
Parham
Seyf
parham_s2000@yahoo.com
6
Orthopedic Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
AUTHOR
Fatemeh
khazaee
tsat4@yahoo.com
7
Mashhad University of Medical Sciences, Mashhad, Iran
AUTHOR
1. Jamshidi KH, Jabal Ameli M, Ameri Mahabadi E. The
1
results of limb-salvage procedures for high grade
2
osteosarcoma of the limbs. Razi J Med Sci. 2004;
3
10(38):835-43.
4
2. Anract P, Coste J, Vastel L, Jeanrot C, Mascard
5
E, Tomeno B. Proximal femoral reconstruction
6
with megaprosthesis versus allograft prosthesis
7
composite. A comparative study of functional results,
8
complications and longevity in 41 cases. Rev Chir
9
Orthop Reparatrice Appar Mot. 2000; 86(3):278-88.
10
3. Bullens PH, Minderhoud NM, de Waal Malefijt MC,
11
Veth RP, Buma P, Schreuder HW. Survival of massive
12
allografts in segmental oncological bone defect
13
reconstructions. Int Orthop. 2009; 33(3):757-60.
14
4. Tuominen T, JämsäT, Tuukkanen J, Nieminen P,
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Lindholm TC, Lindholm TS, et al. Native bovine bone
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morphogenetic protein improves the potential of
17
biocoral to heal segmental canine ulnar defects. Int
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Orthop. 2000; 24(5):289-94.
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5. Mankin HJ, Doppelt S, Tomford W. Clinical experience
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with allograft implantation. The first ten years. Clin
21
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allograft implantation following radical resection of
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high-grade tumors requiring adjuvant chemotherapy
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treatment. Clin Orthop Relat Res. 1985; 197:88-95.
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7. Glasser DB, Lane JM. Stage IIB osteogenic sarcoma.
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8. Deijkers RL, Bloem RM, Petit PL, Brand R, Vehmeyer
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SB, Veen MR. Contamination of bone allografts:
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analysis of incidence and predisposing factors. J
31
Bone Joint Surg Br. 1997; 79(1):161-6.
32
9. Farfalli GL, Aponte-Tinao L, Lopez-Millan L, Ayerza
33
MA, Muscolo DL. Clinical and functional outcomes
34
of tibial intercalary allografts after tumor resection.
35
Orthopedics. 2012; 35(3):e391-6.
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10. Jamshidi K, Jabalameli M, Ameri E. The early results
37
of massive osteoarticular allograft in the surgical
38
treatment of lower limb bone tumors. J Kerman Univ
39
Med Sci. 1998; 5(3):117-22.
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11. Mankin HJ, Gebhardt MC, Jennings LC, Springfield
41
DS, Tomford WW. Long-term results of allograft
42
replacement in the management of bone tumors. Clin
43
Orthop Relat Res. 1996; 324:86-97.
44
12. Nekouei A, Solouki S. The results of treatment of
45
bone allograft transplantation in the treatment of
46
primary malignant bone tumors in Namazi and
47
Chamran Hospital. Shiraz: Shiraz University of
48
Medical Sciences; 2013.
49
13. Donati D, Biscaglia R. The use of antibioticimpregnated
50
cement in infected reconstructions
51
after resection for bone tumours. J Bone Joint Surg
52
Br. 1998; 80(6):1045-50.
53
14. Rodl RW, Ozaki T, Hoffmann C, Bottner F, Lindner N,
54
Winkelmann W. Osteoarticular allograft in surgery
55
for high-grade malignant tumours of bone. J Bone
56
Joint Surg Br. 2000; 82(7):1006-10.
57
15. Donati D, Di Liddo M, Zavatta M, Manfrini M, Bacci G,
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Picci P, et al. Massive bone allograft reconstruction in
59
high-grade osteosarcoma. Clin Orthop Relat Res. 2000;
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377:186-94.
61
16. Vander Griend RA. The effect of internal fixation on
62
the healing of large allografts. J Bone Joint Surg Am.
63
1994; 76(5):657-63.
64
17. Masterson EL, Masri BA, Duncan CP, Rosenberg A,
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Cabanela M, Gross M. The cement mantle in femoral
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impaction allografting. A comparison of three
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systems from four centres. J Bone Joint Surg Br. 1997;
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79(6):908-13.
69
18. Friedlaender GE, Tross RB, Doganis AC, Kirkwood
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JM, Baron R. Effects of chemotherapeutic agents on
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bone. I. Short-term methotrexate and doxorubicin
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(adriamycin) treatment in a rat model. J Bone Joint
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Surg Am. 1984; 66(4):602-7.
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19. Kumta SM, Leung PC, Griffith JF, Roebuck DJ, Chow
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LT, Li CK. A technique for enhancing union of
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80(6):994-8.
78
ORIGINAL_ARTICLE
Factors Associated with Pain, Disability and Quality of Life in Patients Suffering from Frozen Shoulder
Background: Frozen shoulder is resulting in limb disability and reduction of quality of life but the factors associated with patients’ disability and quality of life is not clear. To assess pain, disability, the quality of life and factors associated with them in patients suffering from frozen shoulder. Methods: We enrolled 120 patients (37 men and 83 women) with phase-II idiopathic frozen shoulder in our cross-sectional study. Demographic data were collected and shoulder range of motion was measured in four different directions (elevation, abduction, external and internal rotation) in both upper limbs. Patients were asked to fill out Visual Analog Scale for pain (VAS) and, Short-Form Health Survey questionnaire (SF-36) as well as Disabilities of the Arm, Shoulder and Hand (DASH) questionnaires. We asked the patients to fill out the Hamilton anxiety and depression questionnaires. Results: The mean of VAS pain, DASH, PCS, and MCS scores were 69(18), 53(17), 35(8.0), and 42(10) respectively. All the domains of SF36 questionnaires where below the normal population except physical function. VAS pain score was correlated to Hamilton depression scores in both bivariate and mulivarilable analysis. DASH score were correlated to sex, age, ROM, and both Hamilton anxiety and depression scores; However, DASH score only impact with Hamilton anxiety and ROM independently. PCS is correlated to age and MCS to Hamilton depression. Conclusion: Patient with frozen shoulder are more suffering from pain and disability secondary to psychiatric parameters such as depression and anxiety than demographic features or even restriction of range of motion.
https://abjs.mums.ac.ir/article_7148_84edfc1b746e352863069e4fc9a06cc7.pdf
2016-07-01
243
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10.22038/abjs.2016.7148
Adhesive capsulaitis
Disability
Frozen shoulder
Pain
Quality of life
shoulder
Farshid
Bagheri
bagherif@mums.ac.ir
1
Orthopedic Research Center, Shahid Kamyab Hospital,
Mashhad University of Medical Sciences, Mashhad, Iran
AUTHOR
Mohammad Hosein
Ebrahimzadeh
ebrahimzadehmh@mums.ac.ir
2
Orthopedic Research Center, Ghaem Hospital, Mashhad
University of Medical Sciences, Mashhad, Iran
LEAD_AUTHOR
Ali
Moradi
moradial@mums.ac.ir
3
Orthopedic Research Center, Ghaem Hospital, Mashhad
University of Medical Sciences, Mashhad, Iran
AUTHOR
Hamid
Farahpour Bidgoli
ebrahimih2@mums.ac.ir
4
Orthopedic Research Center, Ghaem Hospital, Mashhad
University of Medical Sciences, Mashhad, Iran
AUTHOR
1. Carette S. Adhesive capsulitis--research advances
1
frozen in time? J Rheumatol. 2000; 27(6):1329-31.
2
2. Constant CR, Murley AH. A clinical method of
3
functional assessment of the shoulder. Clin Orthop
4
Relat Resh. 1987; 214:160-4.
5
3. Bunker TD. Frozen shoulder: unravelling the enigma.
6
Ann R Coll Surg Engl. 1997; 79(3):210-3.
7
4. Goldberg BA, Scarlat MM, Harryman Li DT.
8
Management of the stiff shoulder. J orthop sci. 1999;
9
4(6):462-71.
10
5. Vastamäki H, Kettunen J, Vastamäki M. The natural
11
history of idiopathic frozen shoulder: a 2-to 27-
12
year followup study. Clin Orthop Relat Res. 2012;
13
470(4):1133-43.
14
6. Ebrahimzadeh MH, Moradi A, Pour MK, Moghadam
15
MH, Kachooei AR. Clinical outcomes after
16
arthroscopic release for recalcitrant frozen shoulder.
17
Arch Bone Jt Surg. 2014; 2(3):220-4.
18
7. Lundberg BJ. The frozen shoulder. Clinical
19
and radiographical observations. The effect of
20
manipulation under general anesthesia. Structure
21
and glycosaminoglycan content of the joint capsule.
22
Local bone metabolism. Acta orthop Scand Suppl.
23
1969; 119:1-59.
24
8. Wolf JM, Green A. Influence of comorbidity on selfassessment
25
instrument scores of patients with
26
idiopathic adhesive capsulitis. J Bone Joint Surg Ame.
27
2002; 84-A(7):1167-73.
28
9. Hazleman BL. The painful stiff shoulder. Rheumatol
29
Phys Med. 1972; 11(8):413-21.
30
10. Harris AH, Youd J, Buchbinder R. A comparison of
31
directly elicited and pre-scored preference-based
32
measures of quality of life: the case of adhesive
33
capsulitis. Qual Life Res. 2013; 22(10):2963-71.
34
11. Alizadehkhaiyat O, Fisher AC, Kemp GJ, Frostick SP.
35
Pain, functional disability, and psychologic status in
36
tennis elbow. Clin J Pain. 2007; 23(6):482-9.
37
12. Cho CH, Seo HJ, Bae KC, Lee KJ, Hwang I, Warner
38
JJ. The impact of depression and anxiety on selfassessed
39
pain, disability, and quality of life in patients
40
scheduled for rotator cuff repair. J Shoulder Elbow
41
Surg. 2013; 22(9):1160-6.
42
13. Ding H, Tang Y, Xue Y, Yang Z, Li Z, He D, et al. A report
43
on the prevalence of depression and anxiety in
44
patients with frozen shoulder and their relations to
45
disease status. Psychol Health Med. 2014; 19(6):730-
46
14. Hodkinson B, Maheu E, Michon M, Carrat F,
47
Berenbaum F. Assessment and determinants of
48
aesthetic discomfort in hand osteoarthritis. Ann
49
Rheum Diss. 2012; 71(1):45-9.
50
15. Ring D, Kadzielski J, Fabian L, Zurakowski D, Malhotra
51
LR, Jupiter JB. Self-reported upper extremity health
52
status correlates with depression. J Bone Joint Surg
53
Am. 2006; 88(9):1983-8.
54
16. Bair MJ, Wu J, Damush TM, Sutherland JM, Kroenke
55
K. Association of depression and anxiety alone and
56
in combination with chronic musculoskeletal pain
57
in primary care patients. Psychosom Med. 2008;
58
70(8):890-7.
59
17. Wolkind SN. Psychiatric aspects of low back pain.
60
Physiotherapy. 1974; 60(3):75-7.
61
18. Ebrahimzadeh MH, Moradi A, Vahedi E, Kachooei AR,
62
Birjandinejad A. Validity and reliability of the Persian
63
version of shortened disabilities of the arm, shoulder
64
and hand questionnaire (quick-DASH). Int J Prev
65
Med. 2015; 6:59.
66
19. Montazeri A, Vahdaninia M, Ebrahimi M, Jarvandi S.
67
The hospital anxiety and depression scale (HADS):
68
translation and validation study of the Iranian
69
version. Health Qual Life Outcomes. 2003; 1(1):14.
70
20. Griggs SM, Ahn A, Green A. Idiopathic adhesive
71
capsulitis. A prospective functional outcome study of
72
nonoperative treatment. J Bone Joint Surg Am. 2000;
73
82-A(10):1398-407.
74
21. Buchbinder R, Hoving JL, Green S, Hall S, Forbes
75
A, Nash P. Short course prednisolone for adhesive
76
capsulitis (frozen shoulder or stiff painful shoulder):
77
a randomised, double blind, placebo controlled trial.
78
Ann Rheum Dis. 2004; 63(11):1460-9.
79
ORIGINAL_ARTICLE
Effects of Hip Geometry on Fracture Patterns of Proximal Femur
Background: Some studies have previously shown that geometry of proximal femur can affect the probability of fracture and type of fracture. It happens since the geometry of the proximal femur determines how a force is applied to its different parts. In this study, we have compared proximal femur’s geometric characteristics in femoral neck (FNF), intertrochanteric (ITF) and Subtrochanteric (STF) fractures. Methods: In this study, 60 patients who had hip fractures were studied as case studies. They were divided into FNF, ITF and STF groups based on their fracture types (20 patients in each group). Patients were studied with x-ray radiography and CT scans. Radiological parameters including femoral neck length from lateral cortex to center of femoral head (FNL), diameter of femoral head (FHD), diameter of femoral neck (FND), femoral head neck offset (FHNO), neck-shaft angle (alpha), femoral neck anteversion (beta) were measured and compared in all three groups. Results: Amount of FNL was significantly higher in STF group compared to FNF (0.011) while ITF and STF as well as FNT and ITF did not show a significant different. Also, FND in FNF group was significantly lower than the other two groups, i.e. ITF and STF. In other cases there were no instances of significant statistical difference. Conclusion: Hip geometry can be used to identify individuals who are at the risk of fracture with special pattern. Also, it is important to have more studies in different populations and more in men.
https://abjs.mums.ac.ir/article_6993_655badfa7b817873787b2886fcb5bf76.pdf
2016-07-01
248
252
10.22038/abjs.2016.6993
Femur
Fracture
geometry
Hip
Seyyed Morteza
Kazemi
mortezakazemi737@yahoo.com
1
Akhtar Orthopedic Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
AUTHOR
Mohamad
Qoreishy
mohamad.qoreishy@gmail.com
2
Akhtar Orthopedic Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
LEAD_AUTHOR
Ali
Keipourfard
alikeypour@gmail.com
3
Akhtar Orthopedic Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
AUTHOR
Mohammadreza
Minator Sajjadi
arashsajjadi55@gmail.com
4
Taleghani Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
AUTHOR
Shahram
Shokraneh
shokraneh@gmail.com
5
Akhtar Orthopedic Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
AUTHOR
1. Karlsson KM, Sernbo I, Obrant KJ, Redlund-Johnell I,
1
Johnell O. Femoral neck geometry and radiographic
2
signs of osteoporosis as predictors of hip fracture.
3
Bone. 1996; 18(4):327-30.
4
2. Chappard C, Bousson V, Bergot C, Mitton D,
5
Marchadier A, Moser T, et al. Prediction of femoral
6
fracture load: cross-sectional study of texture
7
analysis and geometric measurements on plain
8
radiographs versus bone mineral density. Radiology.
9
2010; 255(2):536-43.
10
3. Pulkkinen P, Jamsa T, Lochmuller EM, Kuhn V,
11
Nieminen MT, Eckstein F. Experimental hip fracture
12
load can be predicted from plain radiography by
13
combined analysis of trabecular bone structure and
14
bone geometry. Osteoporos Int. 2008; 19(4):547-58.
15
4. Thevenot J, Pulkkinen P, Kuhn V, Eckstein F, Jamsa
16
T. Structural asymmetry between the hips and its
17
relation to experimental fracture type. Calcif Tissue
18
Int. 2010; 87(3):203-10.
19
5. Gnudi S, Ripamonti C, Lisi L, Fini M, Giardino R,
20
Giavaresi G. Proximal femur geometry to detect and
21
distinguish femoral neck fractures from trochanteric
22
fractures in postmenopausal women. Osteoporos
23
Int. 2002; 13(1):69-73.
24
6. Crabtree N, Lunt M, Holt G, Kroger H, Burger H, Grazio
25
S, et al. Hip geometry, bone mineral distribution, and
26
bone strength in European men and women: the
27
EPOS study. Bone. 2000; 27(1):151-9.
28
7. Hassankhani EG, Omidi-Kashani F, Hajitaghi H,
29
Hassankhani GG. How to Treat the Complex Unstable
30
Intertrochanteric Fractures in Elderly Patients? DHS
31
or Arthroplasty. Archives of Bone and Joint Surgery.
32
2014 Sep;2(3):174-9. PubMed PMID: 25386578. eng.
33
8. Beck TJ, Looker AC, Ruff CB, Sievanen H, Wahner
34
HW. Structural trends in the aging femoral neck and
35
proximal shaft: analysis of the third national health
36
and nutrition examination survey dual-energy
37
X-ray absorptiometry data. J Bone Miner Res. 2000;
38
15(12):2297-304.
39
9. Faulkner KG, Cummings SR, Black D, Palermo L,
40
Gluer CC, Genant HK. Simple measurement of
41
femoral geometry predicts hip fracture: the study
42
of osteoporotic fractures. J Bone Miner Res. 1993;
43
8(10):1211-7.
44
10. Gregory JS, Testi D, Stewart A, Undrill PE, Reid
45
DM, Aspden RM. A method for assessment of the
46
shape of the proximal femur and its relationship
47
to osteoporotic hip fracture. Osteoporos Int. 2004;
48
15(1):5-11.
49
11. Keyak JH, Rossi SA, Jones KA, Les CM, Skinner HB.
50
Prediction of fracture location in the proximal femur
51
using finite element models. Med Eng phys. 2001;
52
23(9):657-64.
53
12. Gregory JS, Testi D, Stewart A, Undrill PE, Reid
54
DM, Aspden RM. A method for assessment of the
55
shape of the proximal femur and its relationship
56
to osteoporotic hip fracture. Osteoporos Int. 2003;
57
15(1):5-11.
58
13. Pulkkinen P, Eckstein F, Lochmuller EM, Kuhn
59
V, Jamsa T. Association of geometric factors and
60
failure load level with the distribution of cervical vs.
61
Trochanteric hip fractures. J Bone Miner Res. 2006;
62
21(6):895-901.
63
14. Bouxsein ML, Szulc P, Munoz F, Thrall E, Sornay-
64
Rendu E, Delmas PD. Contribution of trochanteric
65
soft tissues to fall force estimates, the factor of risk,
66
and prediction of hip fracture risk. J Bone Miner Res.
67
2007; 22(6):825-31.
68
15. Rudman KE, Aspden RM, Meakin JR. Compression
69
or tension? The stress distribution in the proximal
70
femur. Biomed Eng online. 2006; 5(1):12-9.
71
16. Flicker L, Faulkner KG, Hopper JL, Green RM,
72
Kaymacki B, Nowson CA, et al. Determinants of hip
73
axis length in women aged 10-89 years: a twin study.
74
Bone. 1996; 18(1):41-5.
75
17. Bowey A, Andrew B. Proximal femoral geometry and
76
hip fracture patterns. A multi-centre comparative
77
radiological study from southern Australia and
78
western Scotland. J Bone Joint Surg. 2010; 92(SUPP
79
II):271-2.
80
18. Karasik D, Dupuis J, Cupples LA, Beck TJ, Mahaney MC,
81
Havill LM, et al. Bivariate linkage study of proximal
82
hip geometry and body size indices: the framingham
83
study. Calcif Tissue Int. 2007; 81(3):162-73.
84
19. Martens M, van Audekercke R, de Meester P, Mulier
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JC. The mechanical characteristics of the long bones
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of the lower extremity in torsional loading. J Biomech.
87
1980; 13(8):667-76.
88
20. Alonso CG, Curiel MD, Carranza FH, Cano RP, Perez
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AD. Femoral bone mineral density, neck-shaft angle
90
and mean femoral neck width as predictors of hip
91
fracture in men and women. Multicenter Project
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for Research in osteoporosis. Osteoporos Int. 2000;
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11(8):714-20.
94
21. Woodhead HJ, Kemp AF, Blimkie CJR, Briody JN,
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Duncan CS, Thompson M, et al. Measurement of
96
midfemoral shaft geometry: repeatability and
97
accuracy using magnetic resonance imaging and
98
dual-energy X-ray absorptiometry. J Bone Miner Res.
99
2001; 16(12):2251-9.
100
22. Nakamura T, Turner CH, Yoshikawa T, Slemenda
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CW, Peacock M, Burr DB, et al. Do variations in hip
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geometry explain differences in hip fracture risk
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between Japanese and white Americans. J Bone
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Miner Res. 1994; 9(7):1071-6.
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23. Greendale GA, Young JT, Huang MH, Bucur A, Wang
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Y, Seeman T. Hip axis length in mid-life Japanese and
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Caucasian U.S. residents: no evidence for an ethnic
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difference. Osteoporos Int. 2003; 14(4):320-5.
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24. Partanen J, Jamsa T, Jalovaara P. Influence of the upper
110
femur and pelvic geometry on the risk and type of
111
hip fractures. J Bone Miner Res. 2001; 16(8):1540-6.
112
ORIGINAL_ARTICLE
Anatomical Variations of Brachial Plexus in Adult Cadavers; A Descriptive Study
Background: Variations of the brachial plexus are common and a better awareness of the variations is of crucial importance to achieve successful results in its surgical procedures. The aim of the present study was to evaluate the anatomical variations of the brachial plexus in adult cadavers. Methods: Bilateral upper limbs of 32 fresh cadavers (21 males and 11 females) consecutively referred to Guilan legal medicine organization from November 2011 to September 2014, were dissected and the trunks, cords and terminal nerves were evaluated. Results: Six plexuses were prefixed in origin. The long thoracic nerve pierced the middle scalene muscle in 6 cases in the supra clavicular zone. The suprascapular nerve in 7 plexuses was formed from posterior division of the superior trunk. Five cadavers showed anastomosis between medial brachial cutaneous nerve and T1 root in the infra clavicular zone. Terminal branches variations were the highest wherein the ulnar nerve received a communicating branch from the lateral cord in 3 cases. The median nerve was formed by 2 lateral roots from lateral cord and 1 medial root from the medial cord in 6 cadavers. Some fibers from C7 root came to the musculocutaneous nerve in 8 cadavers. Conclusion: The correlation analysis between the variations and the demographic features was impossible due to the small sample size. The findings of the present study suggest a meta-analysis to assess the whole reported variations to obtain a proper approach for neurosurgeons.
https://abjs.mums.ac.ir/article_6491_c9d164b1c54917eed19babd879a7376c.pdf
2016-07-01
253
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10.22038/abjs.2016.6491
Anatomical variations
Brachial Plexus
Cords
Peripheral nerves
Trunks
Mohammadreza
Emamhadi
mr.emamhadi@ggmail.com
1
Department of Neurosurgery, Brachial Plexus and Peripheral
Nerve Injury Center, Guilan University of Medical Science,
Rasht, Iran
AUTHOR
Shahrokh
Yousefzadeh Chabok
baggins25@yahoo.com
2
Department of Neurosurgery, Guilan University of Medical
Sciences, Rasht, Iran
AUTHOR
Fariborz
Samini
saminif@mums.ac.ir
3
Orthopedic Research Center, Mashhad University of Medical
Science, Department of Neurosurgery, Mashhad, Iran
AUTHOR
babak
Alijani
babak.alijani1394@gmail.com
4
Department of Neurosurgery, Guilan University of Medical
Sciences, Rasht, Iran
LEAD_AUTHOR
Hamid
Behzadnia
dr.hbehzadnia@yahoo.com
5
Department of Neurosurgery, Guilan University of Medical
Sciences, Rasht, Iran
AUTHOR
Fariborz
Ayati Firozabadi
ayatifirozabadi@gmail.com
6
Legal Medicine Organization, Rasht, Iran
AUTHOR
Zoheir
Reihanian
zoheir.reihanian@gmail.com
7
Department of Neurosurgery, Guilan University of Medical
Sciences, Rasht, Iran
AUTHOR
1. Butz JJ, Shiwlochan DG , Brown KC , Prasad AM,
1
Murlimanju BV, Viswanath S. Bilateral variations
2
of brachial plexus involving the median nerve and
3
lateral cord: an anatomical case study with clinical
4
implications. Australas Med J. 2014; 7(5):227-31.
5
2. Parchand MP, Patil ST. Absence of musculocutaneous
6
nerve with variations in course and distribution of
7
the median nerve. Anat Sci Int. 2013; 88(1):58-60.
8
3. Aydin ME, Kale A, Edizer M, Kopuz C, Demir MT,
9
Corumlu U. Absence of the musculocutaneous nerve
10
together with unusual innervation of the median
11
nerve. Folia Morphol (Warsz). 2006; 65(3):228-31.
12
4. Soleymanha M, Mobayen M, Asadi K, Adeli A,
13
Haghparast-Ghadim-Limudahi Z. Survey of 2582
14
cases of acute orthopedic trauma. Trauma Mon.
15
2014; 19(4):e16215.
16
5. Chaudhary P, Singla R, Arora K, Kalsey G. Formation
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and branching pattern of cords of brachial plexus-a
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cadaveric study in north Indian population. Int J Ana
19
Res. 2014; 2(1):225-33.
20
6. Budhiraja V, Rastogi R, Asthana AK. Variations in
21
the formation of the median nerve and its clinical
22
correlation. Folia Morphol (Warsz). 2012; 71(1):28-
23
7. Uysal II, Seker M, Karabulut AK, Buyukmumcu M,
24
Ziylan T. Brachial plexus variations in human fetuses.
25
Agur AM, Dalley AF. Grant’s atlas of anatomy. 13th ed.
26
Philadelphia: Lippincott Williams & Wilkins; 2012.
27
9. Peter L. Williams. Gray’s Anatomy. 40th ed. Great
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Britain: Churchill Livingstone; 2008. P. 1266-74.
29
10. Orebaugh SL, Williams BA. Brachial plexus anatomy:
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normal and variant. Sci World J. 2009; 9:300-12.
31
11. Snell RS. Clinical anatomy. 7th ed. Philadelphia:
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Lippincott Williams and Wilkins; 2004. P. 477.
33
12. Hollinshead W. General survey of the upper limb-the
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back and limbs. Anatomy for Surgeons. New York:
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Hoeber-Harper; 1958. P. 225-8.
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13. Kerr AT. The brachial plexus of nerves in man the
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variations its formation and branches. Am J Ana.
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1918; 23(2):285-395.
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14. Aggarwal A, Puri N, Aggarwal AK, Harjeet K, Sahni
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D. Anatomical variation in formation of brachial
41
plexus and its branching. Surg Radiol Anat. 2010;
42
32(9):891-4
43
15. Lee HY, Chung IH, Sir WS, Kang HS, Lee HS, Ko JS, et al.
44
Variations of the ventral rami of the brachial plexus. J
45
Korean Med Sci. 1992; 7(1):19-24.
46
16. Aktan ZA, Ӧ ztürk L, Bilge O, Ӧ zer MA, Pinar YA. A
47
cadaveric study of the anatomic variations of the
48
brachial plexus nerves in the axillar region and arm.
49
Turk J Med Sci. 2001; 31(2):147-50.
50
17. Fazan VP, Amadeu AD, Caleffi AL, Rodrigues Filho OA.
51
Brachial plexus variations in its formation and main
52
branches. Acta Cir Bras. 2003; 18(5):14-8.
53
18. Uzel AP, Bulla A, Steinmann G, LaurentJoye M, Caix
54
P. Absence of the musculocutaneous nerve and its
55
distribution from median nerve: about two cases and
56
literature review. Morphology. 2011; 95(311):146-
57
19. Bala A, Sinha P, Tamang BK, Sarda RK. Anatomical
58
variation: median nerve formation - a case vignette. J
59
Clin Diagn Res. 2014; 8(6):AD03–4.
60
20. Radunovic M, Vukasanovic-Bozaric A, Radojevic
61
N, Vukadinovic T. A new anatomical variation
62
of the musculocutaneous and the median nerve
63
anastomosis. Folia Morphol (Warsz). 2013;
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72(2):176-9.
65
21. Rastogi R, Budhiraja V, Bansal K. Posterior cord
66
of brachial plexus and its branches: anatomical
67
variations and clinical implication. ISRN Anat. 2013;
68
22. Fazan VP, Amadeu AD, Caleffi AL, Filho OA. Brachial
69
plexus variations in its formation and main branches.
70
Acta Cir Bras. 2003; 18(5):14-8.
71
23. Kirazlı Ö , Tatarlı N, Ceylan D, Hacıoğlu H, Uygun S,
72
Şeker A, et al. A variation of the cords of the brachial
73
plexus on the right and a communication between
74
the musculocutaneous and median nerves on the left
75
upper limb: a unique case. J Neurol Surg A Cent Eur
76
Neurosurg. 2013; 74(Suppl 1):e176-9.
77
24. El Falougy H, Selmeciova P, Kubikova E, Stenova J,
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Haviarova Z. The variable communicating branches
79
between musculocutaneous and median nerves:
80
a morphological study with clinical implications.
81
Bratisl Lek Listy. 2013; 114(5):290-4
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25. Hoogbergen MM, Kauer JM. An unusual ulnar nervemedian
83
nerve communicating branch. J Anat. 1992;
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181(Pt 3):513-6.
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26. Nakatani T, Tanaka S, Mizukami S. Two rare anomalies
86
of the brachial plexus. J Anat. 1998; 192(Pt 2):303-4.
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27. Sargon MF, Uslu SS, Celik HH, Akşit D. A variation of
88
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90
ORIGINAL_ARTICLE
Epithelialization Over a Scaffold of Antibiotic-Impregnated PMMA Beads: A Salvage Technique for Open Tibial Fractures with Bone and Soft Tissue Loss When all Else Fails
The management of soft tissue defects in tibial fractures is essential for limb preservation. Current techniques are not without complications and may lead to poor functional outcomes. A salvage method is described using three illustrative cases whereby a combination of flaps and antibiotic-impregnated polymethylmethacrylate beads are employed to fill the bony defect, fight the infection, and provide a surface for epithelial regeneration and secondary wound closure. This was performed after the partial failure of all other options. All patients were fully ambulatory with no clinical, radiographic or laboratory sign of infection at their most recent follow-up. Although our findings are encouraging, this is the first report of epithelialization of the skin on a polymethylmethacrylate scaffold. Further studies investigating the use of this technique are warranted.
https://abjs.mums.ac.ir/article_6850_c465bc6b19cd5105af1044b43abd59da.pdf
2016-07-01
259
263
10.22038/abjs.2016.6850
Infection
Open tibial fracture
Polymethylmethacrylate
Soft tissue defect
Karim Z.
Masrouha
km34@aub.edu.lb
1
Infection, Open tibial fracture, Polymethylmethacrylate, Soft tissue defect
AUTHOR
Youssef
El-Bitar
youssef-el-bitar@uiowa.edu
2
Infection, Open tibial fracture, Polymethylmethacrylate, Soft tissue defect
AUTHOR
Marc
Najjar
marknajjar@gmail.com
3
Infection, Open tibial fracture, Polymethylmethacrylate, Soft tissue defect
AUTHOR
Said
Saghieh
ss15@aub.edu.lb
4
Infection, Open tibial fracture, Polymethylmethacrylate, Soft tissue defect
LEAD_AUTHOR
1. Gustilo RB, Anderson JT. Prevention of infection
1
in the treatment of one thousand and twenty-five
2
open fractures of long bones: retrospective and
3
prospective analyses. J Bone Joint Surg Am. 1976;
4
58(4):453-8.
5
2. Templeman DC, Gulli B, Tsukayama DT, Gustilo RB.
6
Update on the management of open fractures of the
7
tibial shaft. Clin Orthop Relat Res. 1998; 350:18-25.
8
3. Caudle RJ, Stern PJ. Severe open fractures of the tibia.
9
J Bone Joint Surg Am. 1987; 69(6):801-7.
10
4. Shepherd LE, Costigan WM, Gardocki RJ, Ghiassi AD,
11
Patzakis MJ, Stevanovic MV. Local or free muscle
12
flaps and unreamed interlocked nails for open tibial
13
fractures. Clin Orthop Relat Res. 1998; 350:90-6.
14
5. Gopal S, Majumder S, Batchelor AG, Knight SL, De
15
Boer P, Smith RM. Fix and flap: the radical orthopaedic
16
and plastic treatment of severe open fractures of the
17
tibia. J Bone Joint Surg Br. 2000; 82(7):959-66.
18
6. Paley D, Maar DC. Ilizarov bone transport treatment
19
for tibial defects. J Orthop Trauma. 2000; 14(2):76-85.
20
7. Tulner SA, Schaap GR, Strackee SD, Besselaar PP,
21
Luitse JS, Marti RK. Long-term results of multiplestage
22
treatment for posttraumatic osteomyelitis of
23
the tibia. J Trauma. 2004; 56(3):633-42.
24
8. Arnold PG, Yugueros P, Hanssen AD. Muscle flaps
25
in osteomyelitis of the lower extremity: a 20-year
26
account. Plast Reconstr Surg. 1999; 104(1):107-10.
27
9. Ring D, Jupiter JB, Gan BS, Israeli R, Yaremchuk MJ.
28
Infected nonunion of the tibia. Clin Orthop Relat Res.
29
1999; 369:302-11.
30
10. Musharrafieh R, Osmani O, Saghieh S, Elhassan B,
31
Atiyeh B. Microvascular composite tissue transfer for
32
the management of type IIIB and IIIC fractures of the
33
distal leg and compound foot fractures. J Reconstr
34
Microsurg. 1999; 15(7):501-7.
35
11. Rozbruch SR, Pugsley JS, Fragomen AT, Ilizarov S.
36
Repair of tibial nonunions and bone defects with
37
the Taylor Spatial Frame. J Orthop Trauma. 2008;
38
22(2):88-95.
39
12. Khanna SC, Speiser P. In vitro release of
40
chloramphenicol from polymer beads of alphamethacrylic
41
acid and methylmethacrylate. J Pharm
42
Sci. 1970; 59(10):1398-401.
43
13. Adams K, Couch L, Cierny G, Calhoun J, Mader JT. In
44
vitro and in vivo evaluation of antibiotic diffusion from
45
antibiotic-impregnated polymethylmethacrylate
46
beads. Clin Orthop Relat Res. 1992; 278:244-52.
47
14. Wenke JC, Owens BD, Svoboda SJ, Brooks DE.
48
Effectiveness of commercially-available antibioticimpregnated
49
implants. J Bone Joint Surg Br. 2006;
50
88(8):1102-4.
51
15. Penn-Barwell JG, Murray CK, Wenke JC. Local
52
antibiotic delivery by a bioabsorbable gel is superior
53
to PMMA bead depot in reducing infection in an open
54
fracture model. J Orthop Trauma. 2014; 28(6):370-5.
55
16. Kretlow JD, Shi M, Young S, Spicer PP, Demian N,
56
Jansen JA, et al. Evaluation of soft tissue coverage over
57
porous polymethylmethacrylate space maintainers
58
within nonhealing alveolar bone defects. Tissue Eng
59
Part C Methods. 2010; 16(6):1427-38.
60
17. Nguyen C, Young S, Kretlow JD, Mikos AG, Wong M.
61
Surface characteristics of biomaterials used for space
62
maintenance in a mandibular defect: a pilot animal
63
study. J Oral Maxillofac Surg. 2011; 69(1):11-8.
64
18. Masquelet AC, Fitoussi F, Begue T, Muller GP.
65
Reconstruction of the long bones by the induced
66
membrane and spongy autograft. Ann Chir Plast
67
Esthet. 2000; 45(3):346-53.
68
19. Gouron R, Petit L, Boudot C, Six I, Brazier M, Kamel S, et
69
al. Osteoclasts and their precursors are present in the
70
induced-membrane during bone reconstruction using
71
the Masquelet technique. J Tissue Eng Regen Med. 2014.
72
20. Gruber HE, Riley FE, Hoelscher GL, Bayoumi
73
EM, Ingram JA, Ramp WK, et al. Osteogenic and
74
chondrogenic potential of biomembrane cells from
75
the PMMA-segmental defect rat model. J Orthop Res.
76
2012; 30(8):1198-212.
77
21. Pelissier P, Masquelet AC, Bareille R, Pelissier SM,
78
Amedee J. Induced membranes secrete growth
79
factors including vascular and osteoinductive factors
80
and could stimulate bone regeneration. J Orthop Res.
81
2004; 22(1):73-9.
82
ORIGINAL_ARTICLE
Subchondral Insufficiency Fracture of the Femoral Head Treated with Core Decompression and Bone Void Filler Support
Subchondral insufficiency fracture of the femoral head (SIFFH) is characterized by acute onset hip pain without overt trauma. It appears as a low intensity band with bone marrow edema on T1-weighted MRI. The most common course of treatment is protected weight bearing for a period of several weeks. Total hip arthroplasty (THA) has been commonly used if the patient does not respond to the initial protected weight bearing treatment. We present a case of a 48-year-old male with SIFFH who was treated with core hip decompression and bone void filler as a hip-preserving alternative to THA. The patient has an excellent clinical and radiographic result at final follow up. Core hip decompression with bone void filler is a less invasive alternative to THA, and may be a preferred initial treatment strategy for SIFFH in the young and active patient who has failed conservative measures.
https://abjs.mums.ac.ir/article_6302_de8a300b0ced504ae7a078e81624f9fd.pdf
2016-07-01
264
268
10.22038/abjs.2016.6302
FEMORAL HEAD INSUFFICIENCY FRACTURE TREATED WITH BONE VOID SUPPORT
Hiren
Patel
hiren.patel@uphs.upenn.edu
1
Perelman School of Medicine at the University of
Pennsylvania, Philadelphia, USA
AUTHOR
Atul
Kamath
akamath@post.harvard.edu
2
Perelman School of Medicine at the University of
Pennsylvania, Philadelphia, USA
LEAD_AUTHOR
1. Yamamoto T. Subchondral insufficiency fractures of the
1
femoral head. Clin. Orthop Surg. 2012; 4(3):173-80.
2
2. Yamamoto T, Karasuyama K, Iwasaki K, Doi T,
3
Iwamoto Y. Subchondral insufficiency fracture of the
4
femoral head in males. Arch Orthop Trauma Surg.
5
2014; 134(9):1199-203
6
3. Yoon PW, Kwak HS, Yoo JJ, Yoon KS, Kim HJ.
7
Subchondral insufficiency fracture of the femoral
8
head in elderly people. J Korean Med Sci. 2014;
9
29(4):593-8.
10
4. Bangil M, Soubrier M, Dubost JJ, Rami S, Carcanagues
11
Y, Ristori JM, et al. Subchondral insufficiency fracture
12
of the femoral head. Rev Rhum Engl Ed. 1996;
13
63(11):859-61.
14
5. Yamamoto T, Iwamoto Y, Schneider R, Bullough
15
PG. Histopathological prevalence of subchondral
16
insufficiency fracture of the femoral head. Ann
17
Rheum Dis. 2008; 67(2):150-3.
18
6. Iwasaki K, Yamamoto T, Nakashima Y, Mawatari
19
T, Motomura G, Ikemura S, et al. Subchondral
20
insufficiency fracture of the femoral head after liver
21
transplantation. Skeletal Radiol. 2009; 38(9):925-8.
22
7. Buttaro M, Della Valle AG, Morandi A, Sabas M, Pietrani
23
M, Piccaluga F. Insufficiency subchondral fracture of
24
the femoral head: report of 4 cases and review of the
25
literature. J Arthroplasty. 2003; 18(3):377-82.
26
8. Ikemura S, Yamamoto T, Motomura G, Nakashima Y,
27
Mawatari T, Iwamoto Y. The utility of clinical features
28
for distinguishing subchondral insufficiency fracture
29
from osteonecrosis of the femoral head. Arch Orthop
30
Trauma Surg. 2013; 133(12):1623-7
31
9. Iwasaki K, Yamamoto T, Motomura G, Ikemura S,
32
Mawatari T, Nakashima Y, et al. Prognostic factors
33
associated with a subchondral insufficiency fracture of
34
the femoral head. Br J Radiol. 2012; 85(1011):214-8.
35
10. Hassankhani EG, Omidi-Kashani F, Hajitaghi H,
36
Hassankhani GG. How to Treat the Complex Unstable
37
Intertrochanteric Fractures in Elderly Patients? DHS or
38
Arthroplasty. Archives of Bone and Joint Surgery. 2014
39
Sep;2(3):174-9. PubMed PMID: 25386578. eng
40
11. Miyanishi K, Ishihara K, Jingushi S, Torisu T. Risk
41
factors leading to total hip arthroplasty in patients
42
with subchondral insufficiency fractures of the
43
femoral head. J Orthop Surg (Hong Kong). 2010;
44
18(3):271-5
45
12. Yamamoto T, Iwasaki K, Iwamoto Y. Transtrochanteric
46
rotational osteotomy for a subchondral insufficiency
47
fracture of the femoral head in young adults. Clin
48
Orthop Relat Res. 2010; 468(12):3181-5.
49
13. Mazloumi SM, Ebrahimzadeh MH, Kachooei AR.
50
Evolution in diagnosis and treatment of Legg-
51
Calve-Perthes disease. Arch Bone Jt Surg. 2014 Jun;
52
2(2):86-92
53
ORIGINAL_ARTICLE
Extensive Osteochondroma of Talus Presenting as Tarsal Tunnel Syndrome: Report of a case and Literature Review
Osteochondroma or exostosis is the most common benign bone tumor, and occurring frequently in the proximal humerus, tibia, and distal femur. It rarely affects talus. Osteochondroma of talus is a very rare etiology of tarsal tunnel syndrome (TTS). We report a rare case of extensive osteochondroma of the talus in a 60 year old female presenting with multiple swellings around the ankle and symptoms suggestive of tarsal tunnel syndrome. En-block excision of the multiple masses was done. Histopathological examination confirmed the diagnosis of osteochondroma. Although most of the osteochondromas are being treated conservatively, those presenting with multiple swellings, restriction of movements and compressive neuropathies should be treated with surgical excision. Excision is a successful method of treatment for symptomatic osteochondromas with low recurrence.
https://abjs.mums.ac.ir/article_4709_9c88f1e9c7b9bf18d5a0d7143a2f64a9.pdf
2016-07-01
269
272
10.22038/abjs.2016.4709
Exostosis
osteochondroma
Talus
Tarsal tunnel syndrome
Shishir
Suranigi
shishir100@gmail.com
1
Department of Orthopaedics, Pondicherry Institute of Medical Sciences, Pondicherry, India
LEAD_AUTHOR
Kanagasabai
Rengasamy
rengasamykanagam@hotmail.com
2
Department of Orthopaedics, Pondicherry Institute of Medical Sciences, Pondicherry, India
AUTHOR
Syed
Najimudeen
syednajimudeen@yahoo.com
3
Department of Orthopaedics, Pondicherry Institute of Medical Sciences, Pondicherry, India
AUTHOR
James
Gnanadoss
jamesjawahar@yahoo.com
4
Department of Orthopaedics, Pondicherry Institute of Medical Sciences, Pondicherry, India
AUTHOR
1. Herrera-Perez M, Aciego De Mendoza M, De Bergua-
1
Domingo JM, Pais-Brito JL. Osteochondromas around
2
the ankle: Report of a case and literature review. Int J
3
Surg Case Rep. 2013; 4(11):1025–7.
4
2. Kim SH, Chung WY, Kim SH, Lee WS. Osteochondroma
5
of the Talus - A Report of Two Cases. J Korean Orthop
6
Assoc. 2008;43(1):135–8.
7
3. Takakura Y, Kitada C, Sugimoto K, Tanaka Y, Tamai
8
S. Tarsal tunnel syndrome. Causes and results of
9
operative treatment. J Bone Joint Surg Br. 1991;
10
73(1):125-8.
11
4. Atik OS, Sarikaya B, Kunat C, Muradi R, Ocaktan
12
B, Topçu H. Osteochondroma of the talus. Eklem
13
Hastalik cerrahisi. 2010; 21(2):116–7.
14
5. Schnirring-Judge M, Visser J. Resection and
15
reconstruction of an osteochondroma of the hallux: a
16
Review of benign bone tumors and a description of an
17
unusual case. J Foot Ankle Surg. 2009; 48(4):495–505.
18
6. Schajowicz F. Tumor and tumorlike lesions of bones
19
and joints. 1st ed. New York: Spinger-Verlag; 1981. p.
20
7. Fuselier CO, Binning T, Kushner D, Kirchwehm
21
WW, Rice JR, Hetherington V, et al. Solitary
22
osteochondroma of the foot: an in-depth study with
23
case reports. J Foot Surg. 1984; 23(1):3-24.
24
8. Chioros PG, Frankel SL, Sidlow CJ. Unusual
25
osteochondroma of the foot and ankle. J Foot Surg.
26
1986; 26(5):407-11.
27
9. Erler K, Oguz E, Komurcu M, Atesalp S, Basbozkurt
28
M. Ankle swelling in a 6-year-old boy with unusual
29
presentation: report of a rare case. J Foot Ankle Surg.
30
2003; 42(4):235-9.
31
10. Boya H, Ozcan O, Tokyol C. Osteochondroma of the
32
talus: an unusual location. Acta Orthop Traumatol
33
Turc. 2014; 48(2):236-9.
34
ORIGINAL_ARTICLE
Extra-Articular Diffuse Giant Cell Tumor of the Tendon Sheath: A Report of 2 Cases
Two rare cases of extra-articular diffuse variant giant cell tumor of the tendon sheath are presented, at the elbow of a 68-year-old female and the foot of a 56-year-old male. Both patients presented with a palpable masses and marginal excision was performed; histological sections confirmed the diagnosis of extra-articular giant cell tumor. No adjuvant therapy was administered. At the last follow-up, minimum 24 months after excision both patients were disease-free.
https://abjs.mums.ac.ir/article_4660_c028c69d82042e7ab3596077b2a1ae7e.pdf
2016-07-01
273
276
10.22038/abjs.2016.4660
Diffuse variant
Giant cell tumor of the tendon sheath
Pigmented villonodular synovitis (PVNS)
Olga D.
Savvidou
olgasavvidou@gmail.com
1
The First Department of Orthopaedic Surgery, University of Athens School of Medicine, “ATTIKON” Hospital, Athens, Greece
LEAD_AUTHOR
Andreas F.
Mavrogenis
andreasfmavrogenis@yahoo.gr
2
The First Department of Orthopaedic Surgery, University of Athens School of Medicine, “ATTIKON” Hospital, Athens, Greece
AUTHOR
Vassilios
Sakellariou
b_sakellariou@yahoo.com
3
The First Department of Orthopaedic Surgery, University of Athens School of Medicine, “ATTIKON” Hospital, Athens, Greece
AUTHOR
George D.
Chloros
gchlorosdoc@gmail.com
4
The First Department of Orthopaedic Surgery, University of Athens School of Medicine, “ATTIKON” Hospital, Athens, Greece
AUTHOR
Thomas
Sarlikiotis
thomassarlikiotis@yahoo.gr
5
The First Department of Orthopaedic Surgery, University of Athens School of Medicine, “ATTIKON” Hospital, Athens, Greece
AUTHOR
Panayiotis J.
Papagelopoulos
pjp@hol.gr
6
The First Department of Orthopaedic Surgery, University of Athens School of Medicine, “ATTIKON” Hospital, Athens, Greece
AUTHOR
1. Somerhausen NS, Fletcher CD. Diffuse-type giant cell
1
tumor: clinicopathologic and immunohistochemical
2
analysis of 50 cases with extraarticular disease. Am J
3
SurgPathol. 2000; 24(4):479–92.
4
2. Ferrer J, Namiq A, Carda C, López-Ginés C, Tawfik O,
5
Llombart-Bosch A. Diffuse type of giant-cell tumor of
6
tendon sheath: an ultrastructural study of two cases
7
with cytogenetic support. Ultrastruct Pathol. 2002;
8
26(1):15–21.
9
3. De Benedittis M, Turco M, Petruzzi M, Cortelazzi R.
10
Extra-articular diffuse-type giant cell tumour of the
11
temporomandibular joint. Int J Oral Maxillofac Surg.
12
2013; 42(3):380–5.
13
4. Simon SL, Inneh IA, Lee MS, Sullivan S, Ennis F.
14
Tenosynovial giant cell tumor of the thigh: positron
15
emission tomography findings. Am J Orthop. 2011;
16
40(6):E115–7.
17
5. Masuzawa N, Kishimoto M, Houshimaru M.
18
Extraarticular paravertebral diffuse-type giant cell
19
tumor. Skeletal Radiol. 2007; 36(4):321–5.
20
6. Gong ZC, Lin ZQ, Moming A, Ling B, Liu H, Hu M, et
21
al. Extra-articular diffuse tenosynovial giant cell
22
tumour of the infratemporal fossa: report of a case
23
and literature review. Int J Oral Maxillofac Surg.
24
2010; 39(8):820–4.
25
7. Mankin H, Trahan C, Hornicek F. Pigmented
26
villonodular synovitis of joints. J Surg Oncol. 2011;
27
103(5):386–9.
28
8. Flandry FC, Hughston JC, Jacobson KE, Barrack RL,
29
McCann SB, Kurtz DM. Surgical treatment of diffuse
30
pigmented villonodular synovitis of the knee. Clin
31
Orthop Relat Res. 1994; 300(2):183–92.
32
9. Wan JM, Magarelli N, Peh WC, Guglielmi G, Shek TW.
33
Imaging of giant cell tumour of the tendon sheath.
34
Radiol Med. 2010; 115(1):141–51.
35
10. Abdul-Karim FW, el-Naggar AK, Joyce MJ, Makley JT,
36
Carter JR. Diffuse and localized tenosynovial giant
37
cell tumor and pigmented villonodular synovitis: a
38
clinicopathologic and flow cytometric DNA analysis.
39
Hum Pathol. 1992; 23(7):729–35.
40
11. Enzinger W. Benign fibrohistiocytic tumors. In:
41
Enzinger W, editors. Soft tissue tumors. 3rd ed. St.
42
Louis: Mosby; 1995. p. 293–323.
43
12. Van der Heijden L, Gibbons CL, Dijkstra PD, Kroep
44
JR, van Rijswijk CS, Nout RA, et al. The management
45
of diffuse-type giant cell tumour (pigmented
46
villonodular synovitis) and giant cell tumour of
47
tendon sheath (nodular tenosynovitis). J Bone Joint
48
Surg Br. 2012; 94(7):882–8.
49
13. Murphey MD, Rhee JH, Lewis RB, Fanburg-Smith JC,
50
Flemming DJ, Walker EA. Pigmented villonodular
51
synovitis: radiologic-pathologic correlation.
52
Radiographics. 2008; 28(5):1493–518.
53
14. Middleton WD, Patel V, Teefey SA, Boyer MI. Giant cell
54
tumors of the tendon sheath: analysis of sonographic
55
findings. AJR Am J Roentgenol. 2004; 183(2):337–9.
56
15. Sanghvi DA, Purandare NC, Jambhekar NA, Agarwal
57
MG, Agarwal A. Diffuse-type giant cell tumor of
58
the subcutaneous thigh. Skeletal Radiol. 2007;
59
36(4):327–30.
60
16. Kuhnen C, Müller KM, Rabstein S, Kasprzynski A,
61
Herter P. [Tenosynovial giant cell tumor]. Pathologe.
62
2005; 26(2):96–110.
63
ORIGINAL_ARTICLE
Intramuscular Injection Abscess Due to VRSA: A New Health Care Challenge
Abscess formation following intramuscular injections is rare and they are most commonly seen in immunocompromised individuals. In this case series we present a cohort of three patients presented to us in a critically ill condition with an abscess due to intramuscular injection. Vancomycin resistant staphylococcus aureus was isolated from all three patients. These patients posed a major challenge to the healthcare system and the treating physician because of the: severity of illness, virulence and resistance of the organism, rarity of the situation, immune state of the patient, and lack of supporting evidence to properly guide management in the use of health resources. To the best of our knowledge, there is no report available in the English literature on vancomycin resistant staphylococcus aureus associated with intramuscular injection abscess.
https://abjs.mums.ac.ir/article_6022_6fbbca405f71c8ca8f0c19e92792fa9b.pdf
2016-07-01
277
281
10.22038/abjs.2016.6022
Immunocompromised patients
Intramuscular injection
VRSA
Senthil
Sambandam
sambandamortho@gmail.com
1
Department of Orthopaedics, K.G. Hospital and Postgraduate Medical Institute, Arts College Road, Coimbatore, Tamil Nadu, India
LEAD_AUTHOR
Ganeshkumar Jayasree
Rohinikumar
drgk2k2@gmail.com
2
Department of Orthopaedics, K.G. Hospital and Postgraduate Medical Institute, Arts College Road, Coimbatore, Tamil Nadu, India
AUTHOR
Arif
Gul
kghors@gmail.com
3
Princess Alexandra Hospital, Harlow, UK
AUTHOR
Varatharaj
Mounasamy
vmounasa@yahoo.com
4
VCU Medical Center Ambulatory Care Center. 417 North 11th Street, Richmond, Virginia, USA
AUTHOR
1. VelissarisD, Matzaroglou C, Kalogeropoulou C,
1
Karamouzos V, Filos K, Karanikolas M. Sepsis requiring
2
intensive care following intramuscular injections: two
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case reports. Cases J. 2009; 2(1):7365-70.
4
2. Moran GJ, Krishnadasan A, Gorwitz RJ, Fosheim GE,
5
McDougal LK, Carey RB, et al. Methicillin-resistant S.
6
aureus infections among patients in the emergency
7
department. N Engl J Med. 2006; 355(7):666-74.
8
3. Abdulla Hawramy T, Saeed KA, Salih Ahmed BH. Gluteal
9
abscess, different intramuscular drug injections as
10
causative agents. 3rd International Conference of
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Medical Sciences, Dubai; 2012.
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4. Greenblatt DJ, Allen MD. Intramuscular injection-site
13
complications. JAMA. 1978; 240(6):542-4.
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5. Hare R, Thomas CG. The transmission of
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Staphylococcus aureus. Br Med J. 1956;
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2(4997):840-4.
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6. Srinivasan A, Dick JD, Perl TM. Vancomycin
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resistance in staphylococci. Clin Microbiol Rev. 2002;
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15(3):430–8.
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7. Hiramatsu K, Hanaki H, Ino T, Yabuta K, Oguri T, Tenover
21
FC. Methicillin-resistant Staphylococcus aureus
22
clinical strain with reduced vancomycin susceptibility.
23
J Antimicrob Chemother. 1997; 40(1):135-6.
24
8. Smith TL, Pearson ML, Wilcox KR, Cruz C, Lancaster
25
MV, Robinson-Dunn B, et al. Emergence of vancomycin
26
resistance in Staphylococcus aureus. Glycopeptide-
27
Intermediate Staphylococcus aureus Working Group.
28
N Engl J Med. 1999; 340(7):493-501.
29
9. Tenover FC, Lancaster MV, Hill BC, Steward CD, Stocker
30
SA, Hancock GA, et al. Characterization of Staphylococci
31
with reduced susceptibility to vancomycin and other
32
glycopeptides. J Clin Microbiol. 1998; 36(4):1020-7.
33
10. Tiwari HK, Sen MR. Emergence of vancomycin
34
resistant Staphylococcus aureus (VRSA) from a
35
tertiary care hospital in northern parts of India. BMC
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Infect Dis. 2006; 6:156-62.
37
11. D’Agata EM. Antimicrobial-resistant, Gram-positive
38
bacteria among patients undergoing chronic
39
hemodialysis. Clin Infect Dis. 2002; 35(10):1212-8.
40
12. Lobo SM, Lobo FR, Bota DP, Lopes-Ferreira F, Soliman
41
HM, Mélot C, et al. C-reactive protein levels correlate
42
with mortality and organ failure in critically ill
43
patients. Chest. 2003; 123(6):2043-9.
44
13. Moise PA, Forrest A, Birmingham MC, Schentag JJ.
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The efficacy and safety of linezolid as treatment for
46
Staphylococcus aureus infections in compassionate
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use patients who are intolerant of, or who have failed to
48
respond to, vancomycin. J Antimicrob Chemotherapy.
49
2002; 50(6):1017-26.
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14. Woodford N, Livermore DM. Infections caused
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by Gram-positive bacteria: a review of the global
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challenge. J Infect. 2009; 59(Suppl 1):S4-16.
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15. Morykwas MJ, Simpson J, Punger K, Argenta A,
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Kremers L, Argenta J. Vacuum-assisted closure: state
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of basic research and physiologic foundation. Plast
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Reconstr Surg. 2006; 117(7 Suppl):121S-6.
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16. Rossi L, Conen D. Intramuscular injections--
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an outdated form of administration? 6 cases of
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Staphylococcus aureus sepsis following intramuscular
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injections. Schweiz Med Wochenschr. 1995; 125(31-
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32):1477-82.
62
multidisciplinary approach from various specialists for
63
satisfactory outcome.
64
ORIGINAL_ARTICLE
Aberrant Radial Artery Causing Carpal Tunnel Syndrome
Anatomical vascular variations are rare causes of carpal tunnel syndrome. An aberrant medial artery is the most common vascular variation, while an aberrant radial artery causing carpal tunnel syndrome is even more rare, with an incidence ranging less than 3%. This article reports a patient with compression of the median nerve at the carpal tunnel by an aberrant superficial branch of the radial artery. An 80- year- old man presented with a 5-year history of right hand carpal tunnel syndrome; Tinel sign, Phalen test and neurophysiological studies were positive. Open carpal tunnel release showed an aberrant superficial branch of the radial artery with its accompanying veins running from radially to medially, almost parallel to the median nerve, ending at the superficial palmar arterial arch. The median nerve was decompressed without ligating the aberrant artery. At the last follow-up, 2 years after diagnosis and treatment the patient is asymptomatic.
https://abjs.mums.ac.ir/article_6852_9af3da0ca774df8ab5c990ecb0e6c2ff.pdf
2016-07-01
282
284
10.22038/abjs.2016.6852
Aberrant radial artery
Carpal tunnel syndrome
Vascular variations
Zinon T.
Kokkalis
zinonkokkalis@yahoo.gr
1
Department of Orthopaedics, National and Kapodistrian
University of Athens, ATTIKON University Hospital,
Athens, Greece
AUTHOR
Konstantinos E.
Tolis
konstantinostolis@yahoo.gr
2
Department of Orthopaedics, National and Kapodistrian
University of Athens, ATTIKON University Hospital,
Athens, Greece
AUTHOR
Panayiotis D.
Megaloikonomos
panmeg@yahoo.gr
3
Department of Orthopaedics, National and Kapodistrian
University of Athens, ATTIKON University Hospital,
Athens, Greece
AUTHOR
Georgios N.
Panagopoulos
panagopoulos@gmail.com
4
Department of Orthopaedics, National and Kapodistrian
University of Athens, ATTIKON University Hospital,
Athens, Greece
AUTHOR
Vasilios G.
Igoumenou
vasigou@yahoo.gr
5
Department of Orthopaedics, National and Kapodistrian
University of Athens, ATTIKON University Hospital,
Athens, Greece
AUTHOR
Andreas F.
Mavrogenis
afm@otenet.gr
6
Department of Orthopaedics, National and Kapodistrian
University of Athens, ATTIKON University Hospital,
Athens, Greece
LEAD_AUTHOR
1. Ibrahim I, Khan WS, Goddard N, Smitham P. Carpal
1
tunnel syndrome: a review of the recent literature.
2
Open Orthop J. 2012; 6(1):69-76.
3
2. Uchiyama S, Itsubo T, Nakamura K, Kato H, Yasutomi T,
4
Momose T. Current concepts of carpal tunnel syndrome:
5
pathophysiology, treatment, and evaluation. J Orthop
6
Sci. 2010; 15(1):1-13.
7
3. Tountas CP, MacDonald CJ, Meyerhoff JD, Bihrle DM.
8
Carpal tunnel syndrome. A review of 507 patients.
9
Minn Med. 1983; 66(8):479-82.
10
4. Olave E, Prates JC, Gabrielli C, Pardi P. Median artery
11
and superficial palmar branch of the radial artery in
12
the carpal tunnel. Scand J Plast Reconstr Surg Hand
13
Surg. 1997; 31(1):13-6.
14
5. Weinand C, Akbari C, O’Donnell S. A high bifurcation
15
of the dorsal branch with dominant superficial
16
palmar branch of the radial artery: a case report of
17
an aberrant radial artery with traumatic aneurysm. J
18
Hand Microsurg. 2011; 3(2):78-81.
19
6. Singer E. Embryological patterns persisting in the
20
arteries of the arm. Anat Rec. 1933; 55(4):403-9.
21
7. Shenoy S. Surgical anatomy of upper arm: what is needed
22
for AVF planning. J Vasc Access. 2009; 10(4):223-32.
23
8. Phalen GS. Spontaneous compression of the median
24
nerve at the wrist. J Am Med Assoc. 1951; 145(15):1128-
25
9. Olave E, Prates JC, Gabrielli C, Del Sol M, Mandiola E.
26
Abnormal course of the superficial palmar branch of
27
the radial artery. Surg Radiol Anat. 1996; 18(2):151-3.
28
10. Walton NP, Choudhary F. Idiopathic radial artery
29
aneurysm in the anatomical snuff box. Acta Orthop
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Belg. 2002; 68(3):292-4.
31
11. Gwynne-Jones DP, Hartnett NI. Aberrant radial
32
artery seen in the carpal tunnel at carpal tunnel
33
decompression: Case Report. J Hand Surg Am. 2008;
34
33(6):885-7.
35
ORIGINAL_ARTICLE
Total Ankylosis of the Upper Left Limb: A Case of Progressive Osseous Heteroplasia
Progressive osseous heteroplasia is a rare inherited disease that begins with skin ossification and proceeds into the deeper connective tissues. The disease should be distinguished from other genetic disorders of heterotopic ossification including fibrodysplasia ossificans progressiva (FOP) and Albright hereditary osteodystrophy (AHO). We report a case of progressive osseous heteroplasia in a twenty four years old male with a complaint of ankylosis of the entire upper left limb and digital cutaneous lesions and sparing of the other limbs and the axial skeleton. Absence of great toe malformation, presence of cutaneous ossification, dermal bone spicules extruding in fingers, and involvement of just left upper limb were unique findings in contrast with FOP diagnosis in this case. There is no effective treatment or prevention for POH. Awareness of diagnostic features is necessary in early diagnosis of POH.
https://abjs.mums.ac.ir/article_7176_e5d818265eed8c79aa336da7beddf9ec.pdf
2016-07-01
285
288
10.22038/abjs.2016.7176
Congenital abnormalities
Heterotopic ossification
Progressive osseous heteroplasia
Ali
Birjandinejad
birjandinejada@mums.ac.ir
1
Orthopedic research center, Shahid Kamyab Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
AUTHOR
Mohammad-Hossein
Taraz-Jamshidi
jamshidimh@mums.ac.ir
2
Associated Professor of Orthopedic surgery, Orthopedic Research Center, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
AUTHOR
Sayyed-Hadi
Sayyed-Hosseinian
shhoseinian@gmail.com
3
Orthopedic Research Center, Shahid Kamyab Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
LEAD_AUTHOR
1. Kaplan FS, Craver R, MacEwen GD, Gannon FH, Finkel
1
G, Hahn G, et al. Progressive osseous heteroplasia: a
2
distinct developmental disorder of. J Bone Joint Surg
3
Am. 1994; 76(3):425-36.
4
2. Pignolo RJ, Ramaswamy G, Fong JT, Shore EM, Kaplan
5
FS. Progressive osseous heteroplasia: diagnosis,
6
treatment, and prognosis. Appl Clin Genet. 2015;
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3. Seror R, Job-Deslandre C, Kahan A. Progressive
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osseous heteroplasia: a rare case of late onset.
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Rheumatology (Oxford). 2007; 46(4):716 -7.
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heteroplasia. Arch Dermatol. 1996; 132(7):787-91.
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5. Elli FM, Barbieri AM, Bordogna P, Ferrari P, Bufo
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R, Ferrante E, et al. Screening for GNAS genetic
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and epigenetic alterations in progressive osseous
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heteroplasia: first Italian series. Bone. 2013;
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56(2):276-80.
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6. Aynaci O, Mujgan Aynaci F, Cobanoglu U, Alpay K.
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review of the literature. J Pediatr Orthop B. 2002;
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11(4):339 -42.
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7. Singh GK, Verma V. Progressive osseous heteroplasia
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in a 10-year-old male child. Indian J Orthop. 2011;
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45(3):280-2.
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8. Santiago F, Vieira R, Cordeiro M, Tellechea O,
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Figueiredo A. Unilateral progressive osseous
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heteroplasia. Eur J Dermatol. 2009; 19(3):214-5.
27
9. Rodriguez-Jurado R, Gonzalez-Crussi F, Poznanski
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AK. Progressive osseous heteroplasia, uncommon
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cause of soft tissue ossification: a case report and
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1995; 15(5):813-27.
32
10. Lin MH, Numbenjapon N, Germain-Lee EL,
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Pitukcheewanont P. Progressive osseous
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heteroplasia, as an isolated entity or overlapping
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with Albright hereditary osteodystrophy. J Pediatr
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Endocrinol Metab. 2015; 28(7-8):911-8.
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11. Pgnolo RJ, Shore EM, Kaplan FS. Fibrodysplasia
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ossificans progressiva: clinical and genetic aspects.
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Orphanet J Rare Dis. 2011; 6(1):80.
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12. Adegbite NS, Xu M, Kaplan FS, Shore EM, Pignolo RJ.
41
Diagnostic and mutational spectrum of progressive
42
osseous heteroplasia (POH) and other forms of
43
GNAS-based heterotopic ossification. Am J Med
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Genet A. 2008; 146A(14):1788-96.
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13. Schrander DE, Welting TJ, Caron MM, Schrander JJ,
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van Rhijn LW, Körver-Keularts I, et al. Endochondral
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ossification in a case of progressive osseous
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heteroplasia in a young female child. J Pediatr Orthop
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B. 2014; 23(5):477-84.
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14. Goto M, Mabe H, Nishimura G, Katsumata N.
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Progressive osseous heteroplasia caused by a novel
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nonsense mutation in the GNAS1 gene. J Pediatr
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Endocrinol Metab. 2010; 23(3):303-9.
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15. Schimmel RJ, Pasmans SG, Xu M, Stadhouders-Keet
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SA, Shore EM, Kaplan FS, et al. GNAS-associated
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disorders of cutaneous ossification: two different
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clinical presentations. Bone. 2010; 46(3):868-72.
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16. Kumagai K, Motomura K, Egashira M, Tomita M,
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Suzuki M, Uetani M, et al. A case of progressive
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osseous heteroplasia: a first case in Japan. Skeletal
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17. Hou JW. Progressive osseous heteroplasia controlled
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by intravenous administration of pamidronate. Am J
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Med Genet A. 2006; 140(8):910-3.
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2004; 29(1):77-80.
69