Mashhad University of Medical Sciences, Iranian Society of Knee Surgery, Arthroscopy and Sports Tramatology,Iranian Orthopaedic Association
The Archives of Bone and Joint Surgery
2345-4644
2345-461X
4
1
2016
01
01
Giant Cell Tumor of Bone - an Overview
2
9
EN
Anshul
Sobti
Department of Orthopaedics, P.D Hinduja National
Hospital and Medical Research Centre, Veer Savarkar
Marg, Mahim, Mumbai, India
dranshulsobti@gmail.com
Pranshu
Agrawal
Department of Orthopaedics, P.D Hinduja National
Hospital and Medical Research Centre, Veer Savarkar
Marg, Mahim, Mumbai, India
pranshuorthodoc@gmail.com
Sanjay
Agarwala
Head of Surgey & Orthopaedics, Consultant in
Orthopaedics Trauma & Arthroplasty, P.D Hinduja
National Hospital and Medical Research Centre, Veer
Savarkar Marg Mahim, Mumbai, India
drsa2011@gmail.com
Manish
Agarwal
Consultant in Orthopaedic Oncology & Soft Tissue
Tumors, Hinduja National Hospital and Medical
Research Centre, Veer Savarkar Marg Mahim, Mumbai,
India
anshulsobti@gmail.com
10.22038/abjs.2016.4701
<br/><span style="font-size: xx-small;">Giant Cell tumors (GCT) are benign tumors with potential for aggressive behavior and capacity to metastasize. Although rarely lethal, benign bone tumors may be associated with a substantial disturbance of the local bony architecture that can be particularly troublesome in peri-articular locations. Its histogenesis remains unclear. It is characterized by a proliferation of mononuclear stromal cells and the presence of many multi- nucleated giant cells with homogenous distribution. </span><br/><span style="font-size: xx-small;">There is no widely held consensus regarding the ideal treatment method selection. There are advocates of varying surgical techniques ranging from intra-lesional curettage to wide resection. As most giant cell tumors are benign and are located near a joint in young adults, several authors favor an intralesional approach that preserves anatomy of bone </span><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">in lieu of resection. Although GCT is classified as a benign lesion, few patients develop progressive lung metastases </span></span><span style="font-size: xx-small;">with poor outcomes. Treatment is mainly surgical. Options of chemotherapy and radiotherapy are reserved for selected cases. Recent advances in the understanding of pathogenesis are essential to develop new treatments for this locally destructive primary bone tumor. </span>
GCT,GCTB,Giant cell tumor of bone,Review of giant cell tumor
https://abjs.mums.ac.ir/article_4701.html
https://abjs.mums.ac.ir/article_4701_31e16a078c7ae219b67f454aee3c9d54.pdf
Mashhad University of Medical Sciences, Iranian Society of Knee Surgery, Arthroscopy and Sports Tramatology,Iranian Orthopaedic Association
The Archives of Bone and Joint Surgery
2345-4644
2345-461X
4
1
2016
01
01
Operating Room Time Savings with the Use of Splint Packs: A Randomized Controlled Trial
10
15
EN
Tyler
Gonzalez
Harvard Combined Orthopaedic Surgery Resident PGY
3, Department of Orthopaedic Surgery, Massachusetts
General Hospital, Brigham and Women’s Hospital Foot &
Ankle Center, Boston, MA
tagonzalez@partners.org
Eric
Bluman
Harvard Medical School, Brigham and Women’s Hospital
Foot & Ankle Center, Boston, MA
ebluman@partners.org
David
Palms
Harvard Medical School, Brigham and Women’s Hospital
Foot & Ankle Center, Boston, MA
dpalms@partners.org
Jeremy
Smith
Harvard Medical School, Brigham and Women’s Hospital
Foot & Ankle Center, Boston, MA
jsmith42@partners.org
Christopher
Chiodo
Harvard Medical School, Brigham and Women’s Hospital
Foot & Ankle Center, Boston, MA
cchiodo@partners.org
10.22038/abjs.2016.4364
<strong><span style="font-size: xx-small;">Background: </span></strong><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">The most expensive variable in the operating room (OR) is time. Lean Process Management is being </span></span><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">used in the medical field to improve efficiency in the OR. Streamlining individual processes within the OR is crucial to a comprehensive time saving and cost-cutting health care strategy. At our institution, one hour of OR time costs approximately $500, exclusive of supply and personnel costs. Commercially prepared splint packs (SP) contain all components necessary for plaster-of-Paris short-leg splint application and have the potential to decrease splint application time and overall costs by making it a more lean process. We conducted a randomized controlled trial comparing OR time savings between SP use and bulk supply (BS) splint application. </span></span><br/><span style="font-size: xx-small;"><br/><strong>Methods: </strong></span><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">Fifty consecutive adult operative patients on whom post-operative short-leg splint immobilization was indicated were randomized to either a control group using BS or an experimental group using SP. One orthopaedic surgeon (EMB) prepared and applied all of the splints in a standardized fashion. Retrieval time, preparation time, splint application time, and total splinting time for both groups were measured and statistically analyzed. </span></span><br/><span style="font-size: xx-small;"><br/><strong>Results: </strong></span><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">The retrieval time, preparation time and total splinting time were significantly less (</span></span><em><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">p<0.001</span></span></em><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">) in the SP group compared with the BS group. There was no significant difference in application time between the SP group and BS </span></span><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">group. </span></span><br/><span style="font-size: xx-small;"><br/><strong>Conclusion: </strong></span><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">The use of SP made the process of splinting more lean. This has resulted in an average of 2 minutes 52 seconds saved in total splinting time compared to BS, making it an effective cost-cutting and time saving technique. For high volume ORs, use of splint packs may contribute to substantial time and cost savings without impacting patient safety. </span></span>
Ambulatory surgery,Economics,Efficiency,Foot and ankle,lower extremity,Operating room,Splinting
https://abjs.mums.ac.ir/article_4364.html
https://abjs.mums.ac.ir/article_4364_6abeb467b8fedcde7758a0d3782d1a70.pdf
Mashhad University of Medical Sciences, Iranian Society of Knee Surgery, Arthroscopy and Sports Tramatology,Iranian Orthopaedic Association
The Archives of Bone and Joint Surgery
2345-4644
2345-461X
4
1
2016
01
01
The Effect of the Silicone Ring Tourniquet and Standard Pneumatic Tourniquet on the Motor Nerve Conduction, Pain and Grip Strength in Healthy Volunteers
16
22
EN
Georgios
Drosos
0000-0003-4296-1750
Department of Orthopaedic Surgery, Medical School,
Democritus University of Thrace, University General
Hospital of Alexandroupolis, Alexandroupolis, Greece
drosos@otenet.gr
Georgios
Kiziridis
Department of Orthopaedic Surgery, Medical School,
Democritus University of Thrace, University General
Hospital of Alexandroupolis, Alexandroupolis, Greece
gkisiridis@yahoo.gr
Cristina
Aggelopoulou
Department of Neurology, University General Hospital of
Alexandroupolis, Alexandroupolis, Greece
angelopoulou_chr@yahoo.gr
Dimitrios
Galiatsatos
Medical Informatics Laboratory, Medical School, Democritus
University of Thrace, Alexandroupolis, Greece
dgaliatsatos2010@hotmail.com
George
Anastassopoulos
Medical Informatics Laboratory, Medical School, Democritus
University of Thrace, Alexandroupolis, Greece
Athanasios
Ververidis
0000-0002-0125-7233
Department of Orthopaedic Surgery, Medical School,
Democritus University of Thrace, University General
Hospital of Alexandroupolis, Alexandroupolis, Greece
athanasios@ververidis.net
Konstantinos
Kazakos
Department of Orthopaedic Surgery, Medical School,
Democritus University of Thrace, University General
Hospital of Alexandroupolis, Alexandroupolis, Greece
kazakosk@yahoo.gr
10.22038/abjs.2016.5271
<br/><strong><span style="font-size: xx-small;">Background: </span></strong><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">The pneumatic tourniquet (PT) is routinely used in upper and lower limb operations by most orthopaedic surgeons. The silicone ring tourniquet (SRT) was introduced in clinical practice the last decade. Clinical as well </span></span><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">comparative studies in volunteers concerning its safety and efficacy have been published. The aim of this study was </span></span><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">to investigate the postoperative effect of the silicone ring tourniquet (SRT), primarily on the motor nerve conduction, and secondarily on the pain and grip strength, in comparison to the effect of the pneumatic tourniquet (PT) in healthy volunteers. </span></span><br/><span style="font-size: xx-small;"><br/><strong>Methods: </strong></span><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">Both tourniquets were applied in the forearm of the dominant arm in 20 healthy volunteers and were kept on for 10 minutes. Pain was measured using the visual analogue scale and grip strength was measured with a hand dynamometer. We evaluated the following parameters of median nerve conduction: motor conduction velocity (MCV), latency (LAT) and amplitude (AMP). </span></span><br/><span style="font-size: xx-small;"><br/><strong>Results: </strong></span><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">Pain score at the time of tourniquet application was higher in SRT group but the alteration in pain scores in </span></span><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">PT group was higher, with statistical significance (</span></span><em><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">P</span></span></em><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;"><0.05). The grip strength was reduced by the application of both </span></span><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">tourniquets; however there was a significantly higher reduction in the SRT group (</span></span><em><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">P</span></span></em><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;"><0.05). The conduction impairment of the median nerve was worse in the PT group than in the SRT one, according to the changes in MCV (</span></span><em><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">P</span></span></em><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;"><0.05). </span></span><br/><span style="font-size: xx-small;"><br/><strong>Conclusion: </strong></span><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">Median nerve conduction was affected more after PT application as compared to the SRT. Nevertheless, the reduction of grip strength was higher after the SRT application. </span></span>
Cuff,Nerve conduction,Pain,Silicone ring tourniquet,Tourniquet
https://abjs.mums.ac.ir/article_5271.html
https://abjs.mums.ac.ir/article_5271_662d5ecb079776e6966e44a689e0df4a.pdf
Mashhad University of Medical Sciences, Iranian Society of Knee Surgery, Arthroscopy and Sports Tramatology,Iranian Orthopaedic Association
The Archives of Bone and Joint Surgery
2345-4644
2345-461X
4
1
2016
01
01
Type II Intertrochanteric Fractures: Proximal Femoral Nailing (PFN) Versus Dynamic Hip Screw(DHS)
23
28
EN
Cyril
Jonnes
Department of Orthopaedics, Pondicherry Institute of
Medical Sciences, Pondicherry, India
cyriljonnes@gmail.com
Shishir
Suranigi
Department of Orthopaedics, Pondicherry Institute of
Medical Sciences, Pondicherry, India
shishir100@gmail.com
Syed
Najimudeen
Department of Orthopaedics, Pondicherry Institute of
Medical Sciences, Pondicherry, India
syednajimudeen@yahoo.com
10.22038/abjs.2016.5268
<br/><strong><span style="font-size: xx-small;">Background: </span></strong><span style="font-size: xx-small; font-family: Arial,Arial;"><span style="font-size: xx-small; font-family: Arial,Arial;">Intertrochanteric fracture is one of the most common fractures of the hip especially in the elderly with osteoporotic bones, usually due to low-energy trauma like simple falls. Dynamic Hip Screw (DHS) is still considered the gold standard for treating intertrochanteric fractures by many. Not many studies compare the DHS with Proximal femoral </span></span><span style="font-size: xx-small; font-family: Arial,Arial;"><span style="font-size: xx-small; font-family: Arial,Arial;">nail (PFN), in Type II intertrochanteric fractures (Boyd and Griffin classification). This study was done to compare the </span></span><br/><span style="font-size: xx-small; font-family: Arial,Arial;">functional and radiological outcome of PFN with DHS in treatment of Type II intertrochanteric fractures. </span><br/> <br/>Methods: <br/><strong><span style="font-size: xx-small;"><span style="font-size: xx-small; font-family: Arial,Arial;"><span style="font-size: xx-small; font-family: Arial,Arial;">From October 2012 to March 2015, a prospective comparative study was done where 30 alternative cases of type II intertrochanteric fractures of hip were operated using PFN or DHS. Intraoperative complications were noted. </span></span><span style="font-size: xx-small; font-family: Arial,Arial;"><span style="font-size: xx-small; font-family: Arial,Arial;">Functional outcome was assessed using Harris Hip Score and radiological findings were compared at 3, 6, and 12 </span></span><span style="font-size: xx-small; font-family: Arial,Arial;"><span style="font-size: xx-small; font-family: Arial,Arial;">months postoperatively. </span></span></span></strong><br/>Results: <br/><strong><span style="font-size: xx-small;"><span style="font-size: xx-small; font-family: Arial,Arial;"><span style="font-size: xx-small; font-family: Arial,Arial;">The average age of the patients was 60 years. In our series we found that patients with DHS had increased </span></span><span style="font-size: xx-small; font-family: Arial,Arial;"><span style="font-size: xx-small; font-family: Arial,Arial;">intraoperative blood loss (159ml), longer duration of surgery (105min), and required longer time for mobilization while patients who underwent PFN had lower intraoperative blood loss (73ml), shorter duration of surgery (91min), and allowed early mobilization. The average limb shortening in DHS group was 9.33 mm as compared with PFN group which was only 4.72 mm. The patients treated with PFN started early ambulation as they had better Harris Hip Score in the early post-op period. At the end of 12th month, there was not much difference in the functional outcome between the two groups. </span></span></span></strong><br/>Conclusion: <br/><strong><span style="font-size: xx-small;"><span style="font-size: xx-small; font-family: Arial,Arial;"><span style="font-size: xx-small; font-family: Arial,Arial;">PFN is better than DHS in type II inter-trochanteric fractures in terms of decreased blood loss, reduced duration of surgery, early weight bearing and mobilization, reduced hospital stay, decreased risk of infection and decreased complications. </span></span></span></strong>
Dynamic Hip Screw (DHS),Inter-trochanteric fractures,Harris Hip Score,Proximal Femoral Nail (PFN)
https://abjs.mums.ac.ir/article_5268.html
https://abjs.mums.ac.ir/article_5268_b2ea4d355dfc67be22542259be5359f5.pdf
Mashhad University of Medical Sciences, Iranian Society of Knee Surgery, Arthroscopy and Sports Tramatology,Iranian Orthopaedic Association
The Archives of Bone and Joint Surgery
2345-4644
2345-461X
4
1
2016
01
01
Supracondylar Osteotomy in Valgus Knee: Angle Blade Plate Versus Locking Compression Plate
29
34
EN
Seyyed Morteza
Kazemi
Bone Joint and Related Tissue Research Center, Akhtar
Hospital, Shahid Beheshti University of Medical Sciences,
Tehran, Iran
mortezakazemi737@yahoo.com
Reza
Minaei
Bone Joint and Related Tissue Research Center, Akhtar
Hospital, Shahid Beheshti University of Medical Sciences,
Tehran, Iran
rezaminaeiortho@gmail.com
Farshad
Safdari
0000-0001-5508-0624
Bone Joint and Related Tissue Research Center, Akhtar
Hospital, Shahid Beheshti University of Medical Sciences,
Tehran, Iran
f.safdari.to@gmail.com
Ali
Keipourfard
Akhtar Hospital, Shahid Beheshti University of Medical
Sciences, Tehran, Iran
keipourfard@gmail.com
Rozhin
Forghani
Bone Joint and Related Tissue Research Center, Akhtar
Hospital, Shahid Beheshti University of Medical Sciences,
Tehran, Iran
rozhin.forghani@yahoo.com
Alemeh
Mirzapourshafiei
Clinical Research Development Center, Babol University
of Medical Sciences, Babol, Iran
aleme_mirza@yahoo.com
10.22038/abjs.2016.5819
<br/><strong><span style="font-size: xx-small;">Background: </span></strong><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">There are few studies comparing the biomechanical properties of angled blade plate and locking compression plates in supracondylar osteotomy. In the current randomized study, we prospectively compared the clinical and radiological outcomes of supracondylar osteotomy using these two plates. </span></span><br/><span style="font-size: xx-small;"><br/><strong>Methods: </strong></span><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">Forty patients with valgus knee malalignment were randomly assigned to two equal numbered groups: angled blade plate and locking compression plates. All of the patients underwent medial closing wedge supracondylar osteotomy and were followed for one year. Before and after the operation the valgus angle and mechanical lateral distal femoral angle were compared between groups. Also, the rate of complications were compared. </span></span><br/><span style="font-size: xx-small;"><br/><strong>Results: </strong></span><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">After the operation, the mean valgus angle and mechanical lateral distal femoral angle improved significantly in the two groups (</span></span><em><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">P</span></span></em><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;"><0.001). Although, the preoperative amount of the valgus angle and mechanical lateral distal femoral angle were the same, at the last visit the valgus angle (5.4±2.1 versus 3.1±1.8; </span></span><em><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">P</span></span></em><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">=0.032) and mechanical lateral distal femoral angle (87.6±2 versus 89.7±3.2; </span></span><em><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">P</span></span></em><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">=0.041) were significantly lower and higher in the angled blade plate group, respectively. Nonunion occurred in four patients (20%) in the locking compression plates group (</span></span><em><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">P</span></span></em><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">=0.35). </span></span><br/><span style="font-size: xx-small;"><br/><strong>Conclusion: </strong></span><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">Based on having a larger valgus angle and mechanical lateral distal femoral angle correction in the angled blade plate group and considerable rate of nonunion in the locking compression plate group, the authors recommend using the angled blade plate for fixation of medial closing wedge supracondylar osteotomy for patients with valgus malalignment. However, more long-term studies are required. </span></span>
Angle blade plate,Locking compression late,Valgus knee
https://abjs.mums.ac.ir/article_5819.html
https://abjs.mums.ac.ir/article_5819_a1630fd151ce49f3f116f7edb7b1f198.pdf
Mashhad University of Medical Sciences, Iranian Society of Knee Surgery, Arthroscopy and Sports Tramatology,Iranian Orthopaedic Association
The Archives of Bone and Joint Surgery
2345-4644
2345-461X
4
1
2016
01
01
Sleep Disturbance and Upper-Extremity Disability
35
40
EN
Rinne
Peters
0000-0002-1484-4226
Hand and Upper Extremity Service, Department of
Orthopaedic Surgery, Yawkey Center, Massachusetts
General Hospital, Boston, USA
rinnepeters27@hotmail.com
Mariano
Menendez
Hand and Upper Extremity Service, Department of
Orthopaedic Surgery, Yawkey Center, Massachusetts
General Hospital, Boston, USA
marianofurrer@gmail.com
Jos
Mellema
Hand and Upper Extremity Service, Department of
Orthopaedic Surgery, Yawkey Center, Massachusetts
General Hospital, Boston, USA
jmellema@mgh.harvard.edu
David
Ring
0000-0002-6506-4879
Hand and Upper Extremity Service, Department of
Orthopaedic Surgery, Yawkey Center, Massachusetts
General Hospital, Boston, USA
david.ring@austin.utexas.edu
Ana-Maria
Vranceanu
0000-0003-3994-6488
Department of Psychiatry, Massachusetts General
Hospital, Boston, USA
avranceanu@mgh.harvard.edu
10.22038/abjs.2016.5247
<br/><strong><span style="font-size: xx-small;">Background: </span></strong><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">Although upper-extremity disability correlates with psychosocial aspects of illness the association with sleep disturbance in upper extremity disability is less certain. </span></span><br/>To evaluate whether sleep disturbance is associated with upper-extremity disability among patients with upper extremity illness, accounting for sociodemographic, condition-related, and psychosocial factors. <br/><span style="font-size: xx-small;"><br/><strong>Methods: </strong></span><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">A cohort of 111 new or follow-up patients presenting to an urban academic hospital-based hand surgeon completed a sociodemographic survey and measures of sleep disturbance (PROMIS Sleep Disturbance), disability (PROMIS Upper-Extremity Physical Function), ineffective coping strategies (PROMIS Pain Interference), and depression (PROMIS Depression). Bivariate and multivariable linear regression modeling were performed. </span></span><br/><span style="font-size: xx-small;"><br/><strong>Results: </strong></span><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">Sleep disturbance correlated with disability (r=-0.38; </span></span><em><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">P</span></span></em><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;"><0.001) in bivariate analysis. Symptoms of depression (r=-0.44; </span></span><em><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">P</span></span></em><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;"><0.001) and ineffective coping strategies (PROMIS Pain Interference: r=-0.71; </span></span><em><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">P</span></span></em><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;"><0.001) also correlated with </span></span><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">upper-extremity specific disability in bivariate analysis. Pain Interference was the only factor associated with disability </span></span><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">in multivariable analysis. </span></span><br/><span style="font-size: xx-small;"><br/><strong>Conclusions: </strong></span><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">Sleep disturbance is not as strongly or directly associated with symptom intensity and magnitude of disability as ineffective coping strategies. Interventions to reduce pain interference (e.g. cognitive behavioral therapy) hold great potential to decrease musculoskeletal symptom intensity and magnitude of disability, and perhaps even sleep disturbance. </span></span>
Disability,Pain interference,Sleep disturbance,Upper extremity
https://abjs.mums.ac.ir/article_5247.html
https://abjs.mums.ac.ir/article_5247_e4a0cfd32c0414b0af4bef493add6e95.pdf
Mashhad University of Medical Sciences, Iranian Society of Knee Surgery, Arthroscopy and Sports Tramatology,Iranian Orthopaedic Association
The Archives of Bone and Joint Surgery
2345-4644
2345-461X
4
1
2016
01
01
Double-button Fixation System for Management of Acute Acromioclavicular Joint Dislocation
41
46
EN
Ali
Torkaman
0000-00030-2532-5111
Firuzgar Hospital, Iran University of Medical Sciences,
Tehran, Iran
alitorkaman@yahoo.com
Abolfazl
Bagherifard
Shafa Orthopedic Hospital, Iran University of Medical
Sciences, Tehran, Iran
bagherifd@yahoo.com
Tahmineh
Mokhtari
Department of Anatomy, School of Medicine, Tehran
University of Medical Sciences, Tehran, Iran
mohamad.qoreishy@gmail.com
Mohamadhossein
Shabanpour Haghighi
Firuzgar Hospital, Iran University of Medical Sciences,
Tehran, Iran
mokhtari.tmn@gmail.com
Siamak
Monshizadeh
Firuzgar Hospital, Iran University of Medical Sciences,
Tehran, Iran
siamak_monshizadeh@yahoo.com
Hamid
Taraz
Firuzgar Hospital, Iran University of Medical Sciences,
Tehran, Iran
htaraz59@gmail.com
Amin
Hasanvand
Department of Pharmacology, school of Medicine,
International Campus, Tehran University of Medical Sciences
(IC-TUMS), Tehran, Iran
Departments of Pharmacology, School of Medicine, Tehran
University of Medical Sciences, Tehran, Iran
10.22038/abjs.2016.5270
<br/><strong><span style="font-size: xx-small;">Background: </span></strong><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">Surgical treatments for acromioclavicular (AC) joint dislocation present with some complications. The </span></span><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">present study was designed to evaluate the double-button fixation system in the management of acute acromioclavicular </span></span><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">joint dislocation. </span></span><br/><span style="font-size: xx-small;"><br/><strong>Methods: </strong></span><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">This cross sectional study, done between February 2011 to June 2014, consisted of 28 patients who underwent </span></span><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">surgical management by the double-button fixation system for acute AC joint dislocation. Age, sex, injury mechanism, </span></span><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">dominant hand, side with injury, length of follow up, time before surgery, shoulder and hand (DASH), constant and visual analogue scale (VAS) scores, and all complications of the cases during the follow up were recorded. </span></span><br/><span style="font-size: xx-small;"><br/><strong>Results: </strong></span><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">The mean age of patients was 33.23±6.7 years. Twenty four patients (85.71%) were male and four (14.28%) </span></span><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">were female. The significant differences were observed between pre-operation VAS, constant shoulder scores and post-</span></span><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">operation measurements (</span></span><em><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">P</span></span></em><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">=0.001, </span></span><em><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">P</span></span></em><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">=0.0001, </span></span><em><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">P</span></span></em><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">=0.0001, respectively). There were not any significant differences between </span></span><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">right and left coracoclavicular (</span></span><em><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">P</span></span></em><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">=0.238), but two cases of heterotrophic ossifications were recorded. The mean follow-up </span></span><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">time was 16.17±4.38 months. </span></span><br/><span style="font-size: xx-small;"><br/><strong>Conclusion: </strong></span><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">According to the results, the double-button fixation system for management of acute acromioclavicular joint </span></span><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">dislocation has suitable results and minimal damage to the soft tissues surrounding the coracoclavicular ligaments. </span></span>
Acromioclavicular joint,Dislocation,Double-button fixation
https://abjs.mums.ac.ir/article_5270.html
https://abjs.mums.ac.ir/article_5270_21c32ca07bd4fa3a7ef6528c5edb62cd.pdf
Mashhad University of Medical Sciences, Iranian Society of Knee Surgery, Arthroscopy and Sports Tramatology,Iranian Orthopaedic Association
The Archives of Bone and Joint Surgery
2345-4644
2345-461X
4
1
2016
01
01
Treatment Outcome of Intramedullary Fixation with a Locked Rigid Nail in Humeral Shaft Fractures
47
51
EN
Mohsen
Mardani-Kivi
0000-0002-9437-5756
Department of Orthopedic Surgery, Pursina Hospital,
Guilan University of Medical Sciences, Rasht, Iran
dr_mohsen_mardani@yahoo.com
Mehran
Soleymanha
0000-0002-7603-7091
Department of Orthopedic Surgery, Pursina Hospital,
Guilan University of Medical Sciences, Rasht, Iran
drmehransoleymanha@gmail.com
zahra
Haghparast-Ghadim-Limudahi
Guilan University of Medical Sciences, Rasht, Iran
haghparastzahra1@gmail.com
10.22038/abjs.2016.4569
<br/><strong><span style="font-size: xx-small;">Background: </span></strong><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">The aim of this study was to determine the treatment outcome of humeral shaft fractures with a locked rigid intramedullary nail in patients indicated for surgical treatment. </span></span><br/><span style="font-size: xx-small;"><br/><strong>Methods: </strong></span><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">In this descriptive-cross sectional study, all patients were followed up for one, six, and 18 months post operatively. The Short Form Questionnaire (SF-36) and Constant Shoulder Score were applied. </span></span><br/><span style="font-size: xx-small;"><br/><strong>Results: </strong></span><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">Of 78 included patients (mean age: 35), one patient had a soft tissue infection, one had secondary radial nerve palsy, eight had non-union, one had elbow limited range of motion in extension, and three patients had decreased shoulder range of motion. The Constant Shoulder Score and Short Form Questionnaire Score (SF-36) increased in all patients, although aged women showed lower improvement. </span></span><br/><span style="font-size: xx-small;"><br/><strong>Conclusion: </strong></span><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">Intramedullary nail fixation in the humeral shaft fracture may be associated with high rates of non-union. </span></span>
Humeral shaft fractures,Nailing,Orthopedic procedures,Treatment outcome
https://abjs.mums.ac.ir/article_4569.html
https://abjs.mums.ac.ir/article_4569_09f09bc621874a0cf94e5ab96c375d12.pdf
Mashhad University of Medical Sciences, Iranian Society of Knee Surgery, Arthroscopy and Sports Tramatology,Iranian Orthopaedic Association
The Archives of Bone and Joint Surgery
2345-4644
2345-461X
4
1
2016
01
01
Prognostic Value of Impaired Preoperative Ankle Reflex in Surgical Outcome of Lumbar Disc Herniation
52
55
EN
Farzad
Omidi-Kashani
0000-0002-6964-3982
Orthopedic Research Center, Orthopedic Department,
Imam Reza Hospital, Mashhad University of Medical
Sciences, Mashhad, Iran
omidif@mums.ac.ir
Ebrahim
Hasankhani
Orthopedic Research Center, Orthopedic Department,
Imam Reza Hospital, Mashhad University of Medical
Sciences, Mashhad, Iran
hasankhanie@mums.ac.ir
Atefe
Zare
Orthopaedic Research Center, Mashhad University of
Medical Sciences, Mashhad, Iran
zarea851@mums.ac.ir
10.22038/abjs.2016.5248
<br/><strong><span style="font-size: xx-small;">Background: </span></strong><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">Several prognostic factors exist influencing the outcome of surgical discectomy in the patients with lumbar disc herniation (LDH). The aim of this study is to evaluate the relationship between severity of preoperative impaired ankle reflex and outcomes of lumbar discectomy in the patients with L5-S1 LDH. </span></span><br/><span style="font-size: xx-small;"><br/><strong>Methods: </strong></span><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">We retrospectively evaluated 181 patients (108 male and 73 female) who underwent simple discectomy in our orthopedic department from April 2009 to April 2013 and followed them up for more than one year. The mean age of the patients was 35.3±8.9 years old. Severity of reflex impairment was graded from 0 to 4+ and radicular pain and disability were assessed by visual analogue scale (VAS) and Oswestry disability index (ODI) questionnaires, respectively. Subjective satisfaction was also evaluated at the last follow-up visit. Chi-square and Kruskal-Wallis tests were used to compare qualitative variables. </span></span><br/><span style="font-size: xx-small;"><br/><strong>Results: </strong></span><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">Reflex impairment existed in 44.8% preoperatively that improved to 10% at the last follow-up visit. Statistical analyses could not find a significant relationship between the severity of impaired ankle reflex and sex or age (</span></span><em><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">P</span></span></em><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">=0.538 and </span></span><em><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">P</span></span></em><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">=0.709, respectively). There was a remarkable relationship between severity of reflex impairment and preoperative radicular pain or disability (</span></span><em><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">P</span></span></em><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">=0.012 and </span></span><em><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">P</span></span></em><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">=0.002, respectively). Kruskal-Wallis test showed that a more severity in ankle reflex impairment was associated with not only less improvement in postoperative pain and disability but also less satisfaction rate (</span></span><em><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">P</span></span></em><span style="font-family: Arial,Arial; font-size: xx-small;"> <br/><span style="font-size: xx-small;"><br/><strong>Conclusions: </strong></span><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">In the patients with L5-S1 LDH, more severe ankle reflex impairment is associated with less improvement in postoperative pain, disability, and subjective satisfaction. </span></span></span>
Ankle Reflex,Discectomy,Outcome,Prognosis
https://abjs.mums.ac.ir/article_5248.html
https://abjs.mums.ac.ir/article_5248_0abe22ddb94e5db467774b2b98ee0f1a.pdf
Mashhad University of Medical Sciences, Iranian Society of Knee Surgery, Arthroscopy and Sports Tramatology,Iranian Orthopaedic Association
The Archives of Bone and Joint Surgery
2345-4644
2345-461X
4
1
2016
01
01
Influence of Sexuality in Functional Recovery after Spinal Cord Injury in rats
56
59
EN
Mohammadreza
Emamhadi
Department of Neurosurgery, Guilan University of Medical
Sciences, Rasht, Iran
imamhady@yahoo.com
Bahram
Soltani
Department of P harmacology, Cellular and Molecular
Research Center, Guilan University of Medical Sciences,
Rasht, Iran
bahram_s_t@yahoo.com
Parvin
Babaei
Department of Physiology, Cellular and Molecular Research
Center, Guilan University of Medical Sciences, Rasht, Iran
p_babaei@yahoo.com
Hossein
Mashhadinezhad
0000-0002-1080-3611
Department of Neurosurgery, Ghaem Hospital, Mashhad,
Iran
mashhadinejadh@mums.ac.ir
Shervin
Ghadarjani
Department of Neurosurgery, Guilan University of Medical
Sciences, Rasht, Iran
shervin.gh@gmail.com
10.22038/abjs.2016.5816
<br/><strong><span style="font-size: xx-small;">Background: </span></strong><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">Spinal cord injury (SCI) is a major clinical condition and research is commonly done to find suitable treatment options. However, there are some degrees of spontaneous recovery after SCI and gender is said to be a contributing factor in recovery, but this is controversial. This study was done to compare the effects of sexual dimorphism on spontaneous </span></span><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">recovery after spinal cord injury in Wistar Rats. </span></span><br/><span style="font-size: xx-small;"><br/><strong>Methods: </strong></span><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">Spinal cord lesions were made by compressing the cord at T9 level and making a spinal cord contusion. Routine care of each rat was done daily. The LSS scoring system was used to measure the locomotion of these rats and to compare the recovery rate between male and female rats. </span></span><br/><span style="font-size: xx-small;"><br/><strong>Results: </strong></span><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">The results suggested that there was no significant difference between the two sex in recovery. </span></span><br/><span style="font-size: xx-small;"><br/><strong>Conclusions: </strong></span><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">To be female does not seem to be a prognostic factor for recovery after SCI. However, this preliminary study should be repeated in other animals and in larger cohorts. </span></span>
Gender,Rat,Spinal cord injury,Spontaneous recovery
https://abjs.mums.ac.ir/article_5816.html
https://abjs.mums.ac.ir/article_5816_babc681d821730ffd4d790b0357921c2.pdf
Mashhad University of Medical Sciences, Iranian Society of Knee Surgery, Arthroscopy and Sports Tramatology,Iranian Orthopaedic Association
The Archives of Bone and Joint Surgery
2345-4644
2345-461X
4
1
2016
01
01
How Much are Emergency Medicine Specialists’ Decisions Reliable in the Diagnosis and Treatment of Pediatric Fractures?
60
64
EN
Mohsen
Mardani-Kivi
Guilan Road Trauma Research Center, School of Medicine,
Guilan University of Medical Sciences, Rasht, Iran
mardani.kivi@gmail.com
Behzad
Zohrevandi
Guilan Road Trauma Research Center, School of Medicine,
Guilan University of Medical Sciences, Rasht, Iran
b.zohrevandi.md@gmail.com
Khashayar
Saheb-Ekhtiari
Guilan Road Trauma Research Center, School of Medicine,
Guilan University of Medical Sciences, Rasht, Iran
dr.khashi@gmail.com
Keyvan
Hashemi-Motlagh
Guilan Road Trauma Research Center, School of Medicine,
Guilan University of Medical Sciences, Rasht, Iran
dr.keyvan.hashemi@gmail.com
10.22038/abjs.2016.4583
<br/><strong><span style="font-size: xx-small;">Background: </span></strong><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">Considering the importance of an early diagnosis and proper decision-making in regards to the treatment of pediatric distal radius and elbow fractures, this study examines emergency medicine specialists’ accuracy in the diagnosis and treatment of these patients. </span></span><br/><span style="font-size: xx-small;"><br/><strong>Methods: </strong></span><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">From 2012 and 2013, children less than 14 years old who were referred to an academic hospital emergency department with elbow or distal radius fractures were enrolled. Initially, patients were examined by an emergency medicine specialist and then they were referred to an orthopedic surgeon. Type of fracture and the proposed treatment of two specialists were compared. </span></span><br/><span style="font-size: xx-small;"><br/><strong>Results: </strong></span><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">In total, there were 108 patients (54 patients in each group) with a mean age of 8.1+3.3 years. Identical diagnosis in 48 cases (88.9%) of distal radius and 36 cases (66.7%) of elbow trauma were observed. We found a difference between diagnosis of the two specialists in diagnosing lateral condyle of the humerus fracture in the elbow </span></span><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">group and growth plate fracture in the distal radius fracture group, but the differences were not significant. Among 108 </span></span><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">patients, 70 patients (64.8%) received identical treatment. </span></span><br/><span style="font-size: xx-small;"><br/><strong>Conclusion: </strong></span><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">Although the emergency medicine specialists responded similarly to the orthopedic specialists in the </span></span><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">diagnosis of pediatric distal radius and elbow fractures, diagnosis of more complicated fractures such as lateral condylar humoral fractures, distal radius growth plate and for choosing the proper treatment option, merits further education. </span></span>
Distal radius fracture,Emergency Medicine,Elbow fracture,Orthopedics,Pediatrics
https://abjs.mums.ac.ir/article_4583.html
https://abjs.mums.ac.ir/article_4583_c198a22663b9e256c929678e7f37ff77.pdf
Mashhad University of Medical Sciences, Iranian Society of Knee Surgery, Arthroscopy and Sports Tramatology,Iranian Orthopaedic Association
The Archives of Bone and Joint Surgery
2345-4644
2345-461X
4
1
2016
01
01
Which Route of Tranexamic Acid Administration is More Effective to Reduce Blood Loss Following Total Knee Arthroplasty?
65
69
EN
Sohrab
Keyhani
0000-0002-4455-5214
Orthopedic Surgeon, Akhtar Orthopedic Hospital, Shahid
Beheshti University of Medical Sciences, Tehran, Iran
sohrab_keyhani4@yahoo.com
Ali Akbar
Esmailiejah
Orthopedic Surgeon, Akhtar Orthopedic Hospital, Shahid
Beheshti University of Medical Sciences, Tehran, Iran
aesmailiejah@yahoo.com
Mohammadreza
Abbasian
0000-0002-4791-9925
Orthopedic Surgeon, Akhtar Orthopedic Hospital, Shahid
Beheshti University of Medical Sciences, Tehran, Iran
mohammadreza.abbasian@gmail.com
Farshad
Safdari
0000-0001-5508-0624
Orthotist and Prosthetist, Bone Joint Related Tissues
Research Center, Shahid Beheshti University of Medical
Sciences, Tehran, Iran
f.safdari.to@gmail.com
10.22038/abjs.2016.5422
<br/><strong><span style="font-size: xx-small;">Background: </span></strong><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">The most appropriate route of tranexamic acid administration is controversial. In the current study, we </span></span><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">compared the efficacy of intravenous (IV) and topical intra-articular tranexamic acid in reducing blood loss and transfusion </span></span><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">rate in patients who underwent primary total knee arthroplasty. </span></span><br/><span style="font-size: xx-small;"><br/><strong>Methods: </strong></span><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">One hundred twenty 120 patients were scheduled to undergo primary total knee arthroplasty. Patients were randomly allocated to three equal groups: IV tranexamic acid (500 mg), topical tranexamic acid (3 g in 100 mL normal saline) and the control. In the topical group, half of the volume was used to irrigate the joint and the other half was injected intra-articularly. The volume of blood loss, hemoglobin (Hb) level at 24 hours postoperative, and rate of transfusion was compared between groups. </span></span><br/><span style="font-size: xx-small;"><br/><strong>Results: </strong></span><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">The blood loss and Hb level were significantly greater and lower in the control group, respectively (</span></span><em><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">P</span></span></em><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;"><0.05). Also, the rate of transfusion was significantly greater in the control group (</span></span><em><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">P</span></span></em><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;"><0.05). However, IV and topical groups did not differ significantly in terms of measured variables. No patient experienced a thromboembolic event in our study. </span></span><br/><span style="font-size: xx-small;"><br/><strong>Conclusion: </strong></span><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">Tranexamic acid is a useful antifibrinolytic drug to reduce postoperative blood loss, Hb drop, and rate of blood transfusion in patients undergoing total knee arthroplasty. The route of tranexamic acid administration did not affect the efficacy and safety. </span></span>
Blood loss,Blood transfusion,Hemoglobin,Total knee arthroplasty,Tranexamic acid,Route of administration
https://abjs.mums.ac.ir/article_5422.html
https://abjs.mums.ac.ir/article_5422_41dd6622a5ec3041be044e4856ce981f.pdf
Mashhad University of Medical Sciences, Iranian Society of Knee Surgery, Arthroscopy and Sports Tramatology,Iranian Orthopaedic Association
The Archives of Bone and Joint Surgery
2345-4644
2345-461X
4
1
2016
01
01
A Survey on Transfusion Status in Orthopedic Surgery at a Trauma Center
70
74
EN
Mehran
Soleimanha
0000-0002-7603-7091
Orthopaedic Research Center, Guilan University of
Medical Sciences, Rasht, Iran
drmehransoleymanha@gmail.com
mohammad
haghighi
0000-0003-0331-1683
Anesthesiology Research Center, Guilan University of
Medical Sciences, Rasht, Iran
manesthesist@gmail.com
Ahmadreza
Mirbolook
Orthopaedic Research Center, Guilan University of
Medical Sciences, Rasht, Iran
orthoresearchguilan@gmail.com
Abbas
Sedighinejad
Anesthesiology Research Center, Guilan University of
Medical Sciences, Rasht, Iran
a_sedighinejad@yahoo.com
Mohsen
Mardani-kivi
0000-0002-9437-5756
Orthopaedic Research Center, Guilan University of
Medical Sciences, Rasht, Iran
dr_mohsen_mardani@yahoo.com
Bahram
Naderi-nabi
Anesthesiology Research Center, Guilan University of
Medical Sciences, Rasht, Iran
naderi_bahram@yahoo.com
Tahereh
Chavoshi
Anesthesiology Research Center, Guilan University of
Medical Sciences, Rasht, Iran
t.chavoshi@yahoo.com
Mehrnoosh
Ghandili Mehrnoosh
Orthopaedic Research Center, Guilan University of
Medical Sciences, Rasht, Iran
mehrnoosh.ghandili@gmail.com
10.22038/abjs.2016.5820
<br/><strong><span style="font-size: xx-small;">Background: </span></strong><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">Increased costs and mortality associated with inappropriate blood transfusions have led to investigations about blood request and blood transfusion techniques. We investigated the transfusion status in patients who underwent orthopedic surgery in Poursina Hospital (Rasht, Iran) to optimizing blood usage and determine if a scheduled transfusion program for every orthopedic surgery could improve blood transfusion management. </span></span><br/><span style="font-size: xx-small;"><br/><strong>Method: </strong></span><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">In this descriptive-prospective study, all orthopedic surgeries in Poursina Hospital, Rasht, between April to June 2013 were reviewed. All patient information was recorded, including: demographics, type of surgery, hemoglobin level, cross-match test, duration of surgery, and blood loss, and transfusion. Based on the one-way ANOVA and independent samples test analysis, cross-match to transfusion ratio and transfusion possibility, the transfusion index, and maximal surgical blood order schedule were calculated to determine blood transfusion status. </span></span><br/><span style="font-size: xx-small;"><br/><strong>Results: </strong></span><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">Among 872 selected orthopedic surgery candidates, 318 of them were cross-matched and among those, 114 patients received a blood transfusion. In this study, the cross-match to transfusion ratio was 6.4, transfusion possibility 36.47%, transfusion index 0.6, and maximal surgical blood order schedule 0.9. </span></span><br/><span style="font-size: xx-small;"><br/><strong>Conclusion: </strong></span><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">We found that blood ordering was moderately higher than the standard; so it is highly recommended to focus on the knowledge of evidence based on transfusion and standard guidelines for blood transfusion to avoid over-ordering. </span></span>
Blood transfusion,Orthopedic surgery,Transfusion index,Transfusion possibility
https://abjs.mums.ac.ir/article_5820.html
https://abjs.mums.ac.ir/article_5820_ee44a2453d9eaa85ea2581be4b22a8ed.pdf
Mashhad University of Medical Sciences, Iranian Society of Knee Surgery, Arthroscopy and Sports Tramatology,Iranian Orthopaedic Association
The Archives of Bone and Joint Surgery
2345-4644
2345-461X
4
1
2016
01
01
A Survey of Blood Request Versus Blood Utilization at a University Hospital in Iran
75
79
EN
Arash
Peivandi Yazdi
0000-0002-8274-6783
Cardiac Anesthesia Research Center, Imam-Reza Hospital,
Faculty of Medicine, Mashhad University of Medical
Sciences, Mashhad, Iran
peivandia@mums.ac.ir
Mohammad
Alipour
Cardiac Anesthesia Research Center, Imam-Reza Hospital,
Faculty of Medicine, Mashhad University of Medical
Sciences, Mashhad, Iran
alipoora@mums.ac.ir
Seyyed Saeed
Jahanbakhsh
Cardiac Anesthesia Research Center, Imam-Reza Hospital,
Faculty of Medicine, Mashhad University of Medical
Sciences, Mashhad, Iran
jahanbakhshs@mums.ac.ir
Mohammad
Gharavifard
Cardiac Anesthesia Research Center, Imam-Reza Hospital,
Faculty of Medicine, Mashhad University of Medical
Sciences, Mashhad, Iran
gharavim@mums.ac.ir
Mehryar
Taghavi
0000-0002-3572-9200
Cardiac Anesthesia Research Center, Imam-Reza Hospital,
Faculty of Medicine, Mashhad University of Medical
Sciences, Mashhad, Iran
taghavim@mums.ac.ir
10.22038/abjs.2016.4710
<br/><strong><span style="font-size: xx-small;">Background: </span></strong><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">Reservation of blood leads to blood wastage if the blood is not transfused. Therefore, in some centers </span></span><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">only blood type and screen are evaluated. In this study, the efficacy of a blood crossmatch-to-transfusion ratio was </span></span><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">measured and then compared with the standard levels. </span></span><br/><span style="font-size: xx-small;"><br/><strong>Methods: </strong></span><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">This prospective study was conducted during one year in a university hospital. During this period, 398 </span></span><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">patients for whom blood had been requested were studied. In these patients, at the first surgical type, the laboratory </span></span><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">tests (hematocrit, hemoglobin, platelet count, and prothrombin time) and the number of preoperative crossmatched and </span></span><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">intraoperative transfused blood units were recorded. Then the crossmatch-to-transfusion ratio, transfusion probability, </span></span><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">transfusion index, and correlation between related factors, and the transfusion ratio were evaluated. </span></span><br/><span style="font-size: xx-small;"><br/><strong>Results: </strong></span><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">In this cross-sectional study, blood was requested for 398 patients. According to available blood unit deficiency, from 961 blood unit requisitions, only 456 units were crossmatched and 123 units were transfused. The crossmatch-to-</span></span><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">transfusion ratio, transfusion probability, and transfusion index were 3.71 (7.81 if all requisitions were crossmatched), 16.83%, and 0.31, respectively. The most unfavorable indexes were observed in patients who had ear, nose, and throat </span></span><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">surgeries (0 transfused from 19 crossmatched blood units) and obstetric and gynecologic surgery (crossmatch-to-transfusion ratio was 18.6). The best indexes were related to thoracic surgery and neurosurgery (crossmatch-to-transfusion ratio was 1.53 and 1.54, respectively). There were no significant correlations between hemoglobin, hematocrit, platelet </span></span><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">count, and prothrombin time with the number of transfused blood units (</span></span><em><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">P </span></span></em><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">= 0.2, 0.14, 0.26, and 0.06, respectively). </span></span><br/><span style="font-size: xx-small;"><br/><strong>Conclusion: </strong></span><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">The data for the crossmatch-to-transfusion ratio, transfusion probability, and transfusion index were suboptimal </span></span><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">at this center, especially for ear, nose, and throat and obstetric and gynecologic surgeries. Further multidimensional studies and determination of a new model for blood requests and to decrease blood wastage are needed. </span></span>
Blood grouping and crossmatching,Blood products,Blood transfusion
https://abjs.mums.ac.ir/article_4710.html
https://abjs.mums.ac.ir/article_4710_3d991bc4cdc820630ed8e164726e7a00.pdf
Mashhad University of Medical Sciences, Iranian Society of Knee Surgery, Arthroscopy and Sports Tramatology,Iranian Orthopaedic Association
The Archives of Bone and Joint Surgery
2345-4644
2345-461X
4
1
2016
01
01
Intramuscular Lipoma of the Thenar: A Rare Case
80
82
EN
Theodoros
Papakostas
Laboratory of Orthopaedics and Biomechanics, University of Ioannina, Medical School, Ioannina, Greece
theopapk@gmail.com
Aristomenis
E. Tsovilis
Laboratory of Orthopaedics and Biomechanics, University of Ioannina, Medical School, Ioannina, Greece
aristomenistsovilis@yahoo.gr
Emilios
E. Pakos
Laboratory of Orthopaedics and Biomechanics, University
of Ioannina, Medical School, Ioannina, Greece
epakos@yahoo.gr
10.22038/abjs.2016.4678
<br/><span style="font-size: xx-small;">Lipomas are the most common benign mesenchymal tumors. They are located either subcutaneously or under the investing fascia in intramuscular or intermuscular regions. The reported frequency of intramuscular lipomas among all benign adipocytic tumors is 1.0%–5.0% and for intermuscular lipomas is 0.3%–1.9%. The frequency of these lesions is the same in all age groups, but in adults deep seated-lipomas are most commonly discovered between the ages of 30 and 60. The most common sites of involvement of intramuscular lipomas are the large muscles of the extremities, especially those of the thigh, shoulder, and upper arm. Intramuscular lipomas of the hand are extremely rare and only few cases </span><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">have been reported in the literature. In cases with hand location, they may present with functional deficit or neurovascular </span></span><span style="font-size: xx-small;">compromise due to the effect of the mass. We report an unusual case of a large intramuscular lipoma of the thenar that was treated with surgical excision due to the impairment of hand function. </span>
Intramuscular,Lipoma,Thenar
https://abjs.mums.ac.ir/article_4678.html
https://abjs.mums.ac.ir/article_4678_ddc566d8ae65189f7db2b2630c9e6004.pdf
Mashhad University of Medical Sciences, Iranian Society of Knee Surgery, Arthroscopy and Sports Tramatology,Iranian Orthopaedic Association
The Archives of Bone and Joint Surgery
2345-4644
2345-461X
4
1
2016
01
01
An Isolated Mass in the Palm, Starting Manifestation of Sarcoidosis
83
86
EN
Mohammad
GhorbanHoseini
Research Scholar, Harvard Medical School, MA, USA
dr.ghhoseini@gmail.com
Hamidreza
Yazdi
Iran University of Medical Science, Tehran, Iran
yazdi.hr@iums.ac.ir
Hossein
Naseh
Mashhad University of Medical Sceinces, Mashhad, Iran
h_naseh@yahoo.com
Poopak
Hafezi
Tehran University of Medical Sciences, Tehran, Iran
10.22038/abjs.2016.4802
<br/><span style="font-size: xx-small;">Sarcoidosis is a systemic disease that is characterized with noncaseating granulomatous nodules which present in multiple organs specially lungs (90%) . Incidence of masses due to Sarcoidosis in upper extremity is low and most cases present in association with involvement of pulmonary hilary lymph nodes. In this article we present a rare case of Sarcoidosis which presented as a single soft tissue mass in hand without osseous or pulmonary hillary lymph node involvement. Incidence of involvement of musculoskeletal system is 1-5 % , mostly it occurs in small bones in hands and feet. In most cases involvement of soft tissue in extremities is accompanied with bone lesions. Those cases of soft </span><span style="font-family: Arial,Arial; font-size: xx-small;"><span style="font-family: Arial,Arial; font-size: xx-small;">tissue involvement are generally coincide with pulmonary lymph nodules. To the authors knowledge this is the first case </span></span><span style="font-size: xx-small;">of Sarcoidosis that presents without spreading in bones or pulmonary hilar lymph nodes. </span>
Hand,Non-caseating Granulomas,Sarcoidosis
https://abjs.mums.ac.ir/article_4802.html
https://abjs.mums.ac.ir/article_4802_2376657853eeebf2860659b723e11a12.pdf
Mashhad University of Medical Sciences, Iranian Society of Knee Surgery, Arthroscopy and Sports Tramatology,Iranian Orthopaedic Association
The Archives of Bone and Joint Surgery
2345-4644
2345-461X
4
1
2016
01
01
Compartment Syndrome of the Calf Due to Nicolau Syndrome
87
89
EN
Ali
Enshaei
The Department of Orthopedics, Urmia University of
Medical Sciences, Urmia, Iran
alienshaei@yahoo.com
Ahmadreza
Afshar
0000-0002-3676-5932
The Department of Surgery, Urmia University of Medical
Sciences, Urmia, Iran
afshar_ah@yahoo.com
10.22038/abjs.2016.4321
<span style="font-size: xx-small;">We report a case of Nicolau syndrome in a 15 months old girl following of an intramuscular injection of penicillin 6.3.3 in her left buttock. This case is unique because she developed compartment syndrome in her left calf far from her injection site. Her toe’s tips gangrened in the course of her ailment. We hypothesized that the compartment syndrome might be produced by a probable intra-arterial injection that had produced embolic obstruction of the small and medium size arteries in her leg or a probable perineural or periarteial injection had produced secondary sympathetic stimulation, extensive vasospasm, compromised microcirculation and the development of compartment syndrome. </span>
Compartment syndrome,Embolia cutis medicamentosa,Intramuscular injection,Livedoid dermatitis,Nicolau syndrome
https://abjs.mums.ac.ir/article_4321.html
https://abjs.mums.ac.ir/article_4321_e025b60acec326546536cfcc27c9bbd9.pdf
Mashhad University of Medical Sciences, Iranian Society of Knee Surgery, Arthroscopy and Sports Tramatology,Iranian Orthopaedic Association
The Archives of Bone and Joint Surgery
2345-4644
2345-461X
4
1
2016
01
01
Platelet-Rich Plasma for Frozen Shoulder: A Case Report
90
93
EN
Hamidreza
Aslani
0000-0002-3257-8312
Shahid Beheshti University of Medical Sciences, Tehran, Iran
Knee and Sport Medicine Research and Education Center,
Milad hospital, Tehran, Iran
hraslani1342@gmail.om
Seyed Taghi
Nourbakhsh
Orthopedic Surgeon, Knee and Sport Medicine Research
and Education Center, Milad hospital, Tehran, Iran
Zohreh
Zafarani
University of Social Welfare and Rehabilitation Science,
Tehran, Iran
test1@yahoo.com
Monireh
Ahmadi-Bani
Knee and Sport Medicine Research and Education Center,
Milad hospital, Tehran, Iran
test@yahoo.com
Mohammad Ebrahim
Shahsavand Ananloo
Knee and Sport Medicine Research and Education Center,
Milad hospital, Tehran, Iran
test2@yahoo.com
Maani
Beigy
Knee and Sport Medicine Research and Education Center,
Milad hospital, Tehran, Iran
test3@yahoo.com
Shahin
Salehi
0000-0002-2874-0436
Imam Hossein Medical Center, Shahid Beheshti University
of Medical Sciences, Tehran, Iran
salehi2955@yahoo.com
10.22038/abjs.2016.6235
<br/><span style="font-size: xx-small;">Frozen shoulder is a glenohumeral joint disorder that perturbs movement because of adhesion and the existence of fibrosis in the shoulder capsule. Platelet-rich plasma can produce collagen and growth factors, which increases stem cells and consequently enhances the healing. To date, there is no evidence regarding the effectiveness of platelet-rich plasma in frozen shoulder. A 45-year-old man with shoulder adhesive capsulitis volunteered for this treatment. He underwent two consecutive platelet-rich plasma injections at the seventh and eighth month after initiation of symptoms. We measured pain, function, and ROM by the visual analogue scale (VAS), and scores from the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire and goniometer; respectively. After the first injection, the patient reported 60% improvement regarding diurnal shoulder pain, and no night pains. Also, two-fold improvement for ROM and more than 70% improvement for function were reported. This study suggests the use of platelet-rich plasma in frozen shoulder to be tested in randomized trials. </span>
Disability,Frozen shoulder,Pain,Platelet-rich plasma,Range of motion
https://abjs.mums.ac.ir/article_6235.html
https://abjs.mums.ac.ir/article_6235_e71457ec02418c90912da0b1553c9ea8.pdf