Background The pandemic of COVID-19 virus had led to another pandemic of avascular necrosis. Aim To evaluate the altered clinical and radiological presentation of COVID-19-related AVN of the hip. Methods This study included 42 patients with AVN of the head of the femur who were presented to the outpatient clinic of Kafr El Sheikh University Hospital. Patients were classified into three main groups. The first group included patients who had COVID infection and received steroid therapy for their pulmonary manifestations. The second group included patients who had COVID infection without receiving steroid therapy. The final group included patients who had AVN of the hip after receiving COVID vaccination without taking any steroid therapy. Results The study included 42 patients who had AVN related to COVID-19 infection. Patients who had COVID-19 infection were more susceptible to AVN development at (a) lower threshold dose of steroid (900 g) and (b) earlier onset of presentation (less than a month). Conclusions To conclude, there is a silent epidemic of cases presenting daily in our clinics with COVID-19-related AVN.
背景2019冠状病毒病大流行导致了另一次缺血性坏死大流行。目的探讨新型冠状病毒感染症(covid -19)相关髋关节AVN的临床和影像学改变。方法本研究纳入在Kafr El Sheikh大学医院门诊就诊的42例股骨头部AVN患者。患者主要分为三组。第一组包括感染COVID并因肺部症状接受类固醇治疗的患者。第二组包括未接受类固醇治疗的COVID感染患者。最后一组包括接受COVID疫苗接种后未接受任何类固醇治疗的髋关节AVN患者。结果纳入42例与COVID-19感染相关的AVN患者。在(a)较低的类固醇阈值剂量(900 g)和(b)较早的发病时间(不到一个月)下，感染COVID-19的患者更容易发生AVN。结论与covid -19相关的AVN病例每天在我们的诊所出现，这是一种无声的流行。
{"title":"Just as the virus can mutate, so can coronavirus disease 2019-related bone necrosis!","authors":"Hany Hamed, H. Gawish","doi":"10.4103/eoj.eoj_47_22","DOIUrl":"https://doi.org/10.4103/eoj.eoj_47_22","url":null,"abstract":"Background The pandemic of COVID-19 virus had led to another pandemic of avascular necrosis. Aim To evaluate the altered clinical and radiological presentation of COVID-19-related AVN of the hip. Methods This study included 42 patients with AVN of the head of the femur who were presented to the outpatient clinic of Kafr El Sheikh University Hospital. Patients were classified into three main groups. The first group included patients who had COVID infection and received steroid therapy for their pulmonary manifestations. The second group included patients who had COVID infection without receiving steroid therapy. The final group included patients who had AVN of the hip after receiving COVID vaccination without taking any steroid therapy. Results The study included 42 patients who had AVN related to COVID-19 infection. Patients who had COVID-19 infection were more susceptible to AVN development at (a) lower threshold dose of steroid (900 g) and (b) earlier onset of presentation (less than a month). Conclusions To conclude, there is a silent epidemic of cases presenting daily in our clinics with COVID-19-related AVN.","PeriodicalId":171084,"journal":{"name":"The Egyptian Orthopaedic Journal","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121834657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mohammad Daher, A. Ghoul, Bendy Salameh, Joe Ghanimeh, Joanna Sabbagh, Ziad Zalaquett, Sami Roukoz
Malunions are fractures that have healed with a deformity. Multiple abnormalities can coexist, but only one usually takes the lead causing symptoms, such as bone shortening, finger scissoring, etc. It is mainly caused by insufficient reduction. Malunions of the metacarpals are usually apex dorsal, while malunions of the phalanx tend to angulate volarly. Each patient with malunion should be assessed individually and treated conservatively if there is little to no functional impairment. Surgeries can be used to treat individuals with angular and rotational deformity.
{"title":"Metacarpals and phalanges malunion: a narrative review","authors":"Mohammad Daher, A. Ghoul, Bendy Salameh, Joe Ghanimeh, Joanna Sabbagh, Ziad Zalaquett, Sami Roukoz","doi":"10.4103/eoj.eoj_69_22","DOIUrl":"https://doi.org/10.4103/eoj.eoj_69_22","url":null,"abstract":"Malunions are fractures that have healed with a deformity. Multiple abnormalities can coexist, but only one usually takes the lead causing symptoms, such as bone shortening, finger scissoring, etc. It is mainly caused by insufficient reduction. Malunions of the metacarpals are usually apex dorsal, while malunions of the phalanx tend to angulate volarly. Each patient with malunion should be assessed individually and treated conservatively if there is little to no functional impairment. Surgeries can be used to treat individuals with angular and rotational deformity.","PeriodicalId":171084,"journal":{"name":"The Egyptian Orthopaedic Journal","volume":"45 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125875153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mohammad Daher, A. Ghoul, Bendy Salameh, Bryan Youssef, Joanna Sabbagh, Ziad Zalaquett, Sami Roukoz
Mass casualty incidents (MCI) are rare, large-scale events that result in heavy damage to people and infrastructure. These types of incidents result in a high influx of patients in local hospitals. In Beirut, this was witnessed on the 4th of August. A massive explosion took place in Lebanon’s capital city Beirut. Although Hotel-Dieu de France Hospital was damaged, it played a crucial role in the management of numerous injured, especially in the orthopedics department. Six months later, the hospital contacted all patients that had been hospitalized during that night and the following 2 days for musculoskeletal injuries. The contact was done for feedback purposes as the event was considered one of the largest non-nuclear explosions in international history. Accordingly, most of the patients that were contacted gave a credible and positive rating. There were few who had suggestions for management improvement. MCIs are rare, but it is crucial to be prepared to face any edging situation. Having effective communication and an organized plan in any risk management process are essential tools to foster for the well of the community and to scale down the losses of the locals in the area.
{"title":"Management of the 4th of August explosion in an orthopedics department","authors":"Mohammad Daher, A. Ghoul, Bendy Salameh, Bryan Youssef, Joanna Sabbagh, Ziad Zalaquett, Sami Roukoz","doi":"10.4103/eoj.eoj_68_22","DOIUrl":"https://doi.org/10.4103/eoj.eoj_68_22","url":null,"abstract":"Mass casualty incidents (MCI) are rare, large-scale events that result in heavy damage to people and infrastructure. These types of incidents result in a high influx of patients in local hospitals. In Beirut, this was witnessed on the 4th of August. A massive explosion took place in Lebanon’s capital city Beirut. Although Hotel-Dieu de France Hospital was damaged, it played a crucial role in the management of numerous injured, especially in the orthopedics department. Six months later, the hospital contacted all patients that had been hospitalized during that night and the following 2 days for musculoskeletal injuries. The contact was done for feedback purposes as the event was considered one of the largest non-nuclear explosions in international history. Accordingly, most of the patients that were contacted gave a credible and positive rating. There were few who had suggestions for management improvement. MCIs are rare, but it is crucial to be prepared to face any edging situation. Having effective communication and an organized plan in any risk management process are essential tools to foster for the well of the community and to scale down the losses of the locals in the area.","PeriodicalId":171084,"journal":{"name":"The Egyptian Orthopaedic Journal","volume":"362 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124555936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Abdelmoneim, Yasser Abdel Fatah Radwan, Basem Adel Elghonaimy, M. Abo-Elsoud
Introduction Charcot arthropathy is a destructive inflammation, which may affect any joint, especially joints of the ankle and foot. Bony fragmentation, fracture, and dislocation will progress to deformity, bony prominence, and instability. This often causes ulceration and deep infection that may necessitate amputation. The objective of the study is to assess the results of treating Charcot ankle with fusion by retrograde intramedullary femoral nail. Patients and methods Twenty patients were prospectively studied, all of them were clinically diagnosed to have Charcot ankle arthropathy. Preoperative Assessment of all patients by the American Orthopedic Foot and Ankle Scale (AOFAS) was done. In postoperative follow up, the modified AOFAS score was used with a maximum score of 86, as hind foot motion and ankle motion were blocked by arthrodesis. Results Significant improvement in functional score for the series’ patients was encountered. There is increase in the mean score from 33.6 to 73.2 (P<0.001), which considered clinically and statistically significant. Conclusion Tibiotalocalcaneal arthrodesis with retrograde intramedullary nail is a successful method for ankle fusion with good clinical and functional scores.
{"title":"The use of retrograde intramedullary femoral nail for tibiotalocalcaneal fusion in charcot ankle & foot joints","authors":"M. Abdelmoneim, Yasser Abdel Fatah Radwan, Basem Adel Elghonaimy, M. Abo-Elsoud","doi":"10.4103/eoj.eoj_24_23","DOIUrl":"https://doi.org/10.4103/eoj.eoj_24_23","url":null,"abstract":"Introduction Charcot arthropathy is a destructive inflammation, which may affect any joint, especially joints of the ankle and foot. Bony fragmentation, fracture, and dislocation will progress to deformity, bony prominence, and instability. This often causes ulceration and deep infection that may necessitate amputation. The objective of the study is to assess the results of treating Charcot ankle with fusion by retrograde intramedullary femoral nail. Patients and methods Twenty patients were prospectively studied, all of them were clinically diagnosed to have Charcot ankle arthropathy. Preoperative Assessment of all patients by the American Orthopedic Foot and Ankle Scale (AOFAS) was done. In postoperative follow up, the modified AOFAS score was used with a maximum score of 86, as hind foot motion and ankle motion were blocked by arthrodesis. Results Significant improvement in functional score for the series’ patients was encountered. There is increase in the mean score from 33.6 to 73.2 (P<0.001), which considered clinically and statistically significant. Conclusion Tibiotalocalcaneal arthrodesis with retrograde intramedullary nail is a successful method for ankle fusion with good clinical and functional scores.","PeriodicalId":171084,"journal":{"name":"The Egyptian Orthopaedic Journal","volume":"93 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114212433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background Fractures of the tibial plateau usually result from high-energy trauma. Motor vehicle accidents seem to be the predominant cause worldwide. The objective of treating displaced fractures is to restore the articular surface anatomy and repair soft tissue injuries. We aim to improve the functional and radiological results of the arthroscopically assisted fixation of the tibial plateau fractures using Ilizarov fixator. Methods The study was carried out on patients attending to Orthopedic Surgery Department at a major metropolitan hospital in Egypt, between March 2019 to September 2020. Forty-five patients with tibial plateau fractures of Schatzker classification type II to type VI were operated on. Results The results indicate that the Ilizarov method is a valuable alternative in treating Schatzker II-VI fracture types. The mean time from injury to partial weight bearing (PWB) and full weight bearing (FWB) were 12.75 and 22.73 weeks, respectively. The mean Knee Society Score was 75.42 ± 9.91. Over 70% of self-reported Overall Functional Grades were deemed ‘good’ (n=21, 47.6%) or ‘excellent’ (n=12, 26.7%) at the end of the follow-up period. Pin tract infection was reported in 31(68.9%) cases, and delayed union developed in 7 (15.6%) cases. Conclusion Early and definite fixation is achieved with the Ilizarov and arthroscopic technique, allowing intra-articular assessment of the reduction, and management of associated intra-articular soft tissue injuries with immediate PWB. It is believed that this minimally invasive method does not lead to the additional morbidity and the combined advantages of arthroscopy and Ilizarov allows successful fixation and early activity.
{"title":"Outcomes of arthroscopic-assisted fixation of intra-articular proximal tibial fractures by circular external fixator","authors":"A. Toreih, Mohammed I Rakha","doi":"10.4103/eoj.eoj_9_23","DOIUrl":"https://doi.org/10.4103/eoj.eoj_9_23","url":null,"abstract":"Background Fractures of the tibial plateau usually result from high-energy trauma. Motor vehicle accidents seem to be the predominant cause worldwide. The objective of treating displaced fractures is to restore the articular surface anatomy and repair soft tissue injuries. We aim to improve the functional and radiological results of the arthroscopically assisted fixation of the tibial plateau fractures using Ilizarov fixator. Methods The study was carried out on patients attending to Orthopedic Surgery Department at a major metropolitan hospital in Egypt, between March 2019 to September 2020. Forty-five patients with tibial plateau fractures of Schatzker classification type II to type VI were operated on. Results The results indicate that the Ilizarov method is a valuable alternative in treating Schatzker II-VI fracture types. The mean time from injury to partial weight bearing (PWB) and full weight bearing (FWB) were 12.75 and 22.73 weeks, respectively. The mean Knee Society Score was 75.42 ± 9.91. Over 70% of self-reported Overall Functional Grades were deemed ‘good’ (n=21, 47.6%) or ‘excellent’ (n=12, 26.7%) at the end of the follow-up period. Pin tract infection was reported in 31(68.9%) cases, and delayed union developed in 7 (15.6%) cases. Conclusion Early and definite fixation is achieved with the Ilizarov and arthroscopic technique, allowing intra-articular assessment of the reduction, and management of associated intra-articular soft tissue injuries with immediate PWB. It is believed that this minimally invasive method does not lead to the additional morbidity and the combined advantages of arthroscopy and Ilizarov allows successful fixation and early activity.","PeriodicalId":171084,"journal":{"name":"The Egyptian Orthopaedic Journal","volume":"177 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115302841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Purpose To assess the effect of arthroscopic rotator cuff repair on sexual function, desire, and satisfaction, in addition to the shoulder function. Methods We did arthroscopic rotator cuff repair for 55 sexually active married individuals with rotator cuff tears. Shoulder and sexual function were assessed using: 1- the Constant-Murley score (CMS), 2- two visual analog scales (VAS) questionnaires, one to evaluate pain level during daily activities and the second to assess the pain level only during sexual activity, 3- Change in Sexual Functioning Questionnaire (CSFQ), 4- Sexual Desire Inventory (SDI) Questionnaire, 5- the Index of Sexual Satisfaction (ISS) Questionnaire, and 6- the study-specific short questionnaires. Assessment parameters were done before surgery and at 1 month (1M), 3 months (3M), 6 months (6M), 12 months (12M), 18 months (18M), and 24 months (24M) after surgery. Results Only 49 subjects were included in the final analysis (6 were excluded from the last follow-up). 77% of the study subjects found that their sexual life was affected by their shoulder condition, with 65% reporting that this was due to increased pain.75% needed to adjust their sexual position to accommodate their shoulder problem. 55% found that below the partner position is the most comfortable position during the sexual act. Additionally, we found a significant improvement over time in the CMS score, two VAS questionnaires, CSFQ, and ISS. Conclusion Arthroscopic rotator cuff repair improved shoulder function, pain level, sexual function, satisfaction, and mobility during sexual engagements. it did not affect the level of sexual desire.
{"title":"The effects of arthroscopic rotator cuff repair on human sexual activity","authors":"Ibrahim Amr, Ghandour Tarek Mohamed","doi":"10.4103/eoj.eoj_55_23","DOIUrl":"https://doi.org/10.4103/eoj.eoj_55_23","url":null,"abstract":"Purpose To assess the effect of arthroscopic rotator cuff repair on sexual function, desire, and satisfaction, in addition to the shoulder function. Methods We did arthroscopic rotator cuff repair for 55 sexually active married individuals with rotator cuff tears. Shoulder and sexual function were assessed using: 1- the Constant-Murley score (CMS), 2- two visual analog scales (VAS) questionnaires, one to evaluate pain level during daily activities and the second to assess the pain level only during sexual activity, 3- Change in Sexual Functioning Questionnaire (CSFQ), 4- Sexual Desire Inventory (SDI) Questionnaire, 5- the Index of Sexual Satisfaction (ISS) Questionnaire, and 6- the study-specific short questionnaires. Assessment parameters were done before surgery and at 1 month (1M), 3 months (3M), 6 months (6M), 12 months (12M), 18 months (18M), and 24 months (24M) after surgery. Results Only 49 subjects were included in the final analysis (6 were excluded from the last follow-up). 77% of the study subjects found that their sexual life was affected by their shoulder condition, with 65% reporting that this was due to increased pain.75% needed to adjust their sexual position to accommodate their shoulder problem. 55% found that below the partner position is the most comfortable position during the sexual act. Additionally, we found a significant improvement over time in the CMS score, two VAS questionnaires, CSFQ, and ISS. Conclusion Arthroscopic rotator cuff repair improved shoulder function, pain level, sexual function, satisfaction, and mobility during sexual engagements. it did not affect the level of sexual desire.","PeriodicalId":171084,"journal":{"name":"The Egyptian Orthopaedic Journal","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127278703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background This study assessed the clinical outcomes of total knee replacement with and without synovectomy among patients with osteoarthritis. Methods A randomised controlled trial of 70 patients with advanced knee osteoarthritis was conducted by individually randomizing (simple randomization) patients to either no synovectomy (group 1 n=35) or synovectomy (group 2 n=35). Clinical outcomes were assessed by Western Ontario and McMaster Universities Arthritis Index, WOMAC score, knee pain by visual analogue score, health related quality of life by Short Form 12, postoperative blood loss, and hemoglobin levels immediately after surgery and one year postoperative. Results Postoperatively, The WOMAC score was 87 (82, 97) in group 1 and 84 (76, 96) in group 2. The VAS score was 6 (5.00, 8.00) and 7 (5.00, 8.00) in group 1 and 2 respectively. The physical composite score (PCS) of the SF-12 score was 52 (46, 56) in group 1 and 50 (43, 54) in group 2. The mental composite score of the SF-12 was 58(55, 61) and 51 (45, 57) in group 1 and 2 respectively with significant difference between groups. The median hemoglobin drop was 1.7 (1.35, 2.00) grams in group 1 and 3 (2.45, 3.30) grams in group 2. The median drain blood loss was 250 ml (200, 350) and 800 ml (450, 1200) in group 1 and 2 respectively. Patients in group 1 had a better flexion range than group 2. Conclusion Total knee arthroplasty performed without synovectomy reduces postoperative blood loss, improves the flexion range and patients’ quality of life scores.
本研究评估了骨关节炎患者行全膝关节置换术伴和不伴滑膜切除术的临床结果。方法对70例晚期膝关节骨性关节炎患者进行随机对照试验，将患者单独随机(简单随机化)分为不切除滑膜组(1组n=35)和切除滑膜组(2组n=35)。临床结果通过西安大略和麦克马斯特大学关节炎指数、WOMAC评分、膝关节疼痛视觉模拟评分、Short Form 12健康相关生活质量、术后出血量和术后1年血红蛋白水平进行评估。结果1组术后WOMAC评分为87分(82,97分)，2组术后WOMAC评分为84分(76,96分)。VAS评分1、2组分别为6分(5.00、8.00)、7分(5.00、8.00)。SF-12评分的物理综合评分(PCS)在1组为52分(46,56分)，在2组为50分(43,54分)。第一组和第二组的SF-12心理综合得分分别为58分(55,61分)和51分(45,57分)，组间差异有统计学意义。血红蛋白中位数下降1组为1.7 (1.35,2.00)g, 3组为2.45,3.30)g。1组和2组中位排血量分别为250 ml(200、350)和800 ml(450、1200)。1组患者屈曲幅度优于2组。结论不切除滑膜的全膝关节置换术减少了术后出血量，提高了患者的屈曲幅度和生活质量评分。
{"title":"No-synovectomy improves the health-related quality of life after total knee arthroplasty: A randomised clinical trial","authors":"S. Abdeldayem, A. S. Younis","doi":"10.4103/eoj.eoj_36_23","DOIUrl":"https://doi.org/10.4103/eoj.eoj_36_23","url":null,"abstract":"Background This study assessed the clinical outcomes of total knee replacement with and without synovectomy among patients with osteoarthritis. Methods A randomised controlled trial of 70 patients with advanced knee osteoarthritis was conducted by individually randomizing (simple randomization) patients to either no synovectomy (group 1 n=35) or synovectomy (group 2 n=35). Clinical outcomes were assessed by Western Ontario and McMaster Universities Arthritis Index, WOMAC score, knee pain by visual analogue score, health related quality of life by Short Form 12, postoperative blood loss, and hemoglobin levels immediately after surgery and one year postoperative. Results Postoperatively, The WOMAC score was 87 (82, 97) in group 1 and 84 (76, 96) in group 2. The VAS score was 6 (5.00, 8.00) and 7 (5.00, 8.00) in group 1 and 2 respectively. The physical composite score (PCS) of the SF-12 score was 52 (46, 56) in group 1 and 50 (43, 54) in group 2. The mental composite score of the SF-12 was 58(55, 61) and 51 (45, 57) in group 1 and 2 respectively with significant difference between groups. The median hemoglobin drop was 1.7 (1.35, 2.00) grams in group 1 and 3 (2.45, 3.30) grams in group 2. The median drain blood loss was 250 ml (200, 350) and 800 ml (450, 1200) in group 1 and 2 respectively. Patients in group 1 had a better flexion range than group 2. Conclusion Total knee arthroplasty performed without synovectomy reduces postoperative blood loss, improves the flexion range and patients’ quality of life scores.","PeriodicalId":171084,"journal":{"name":"The Egyptian Orthopaedic Journal","volume":"10 7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134258919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Purpose To present the management of unstable proximal humeral fractures with percutaneous pinning augmented by an external Ilizarov cubes in elderly patients with poor general condition. Patients and methods Between October 2021 and December 2021, 7 patients (mean age: 56.7, range 53–62) with three-part proximal humeral fracture with 2 or more co-morbidities were surgically managed by percutaneous pinning augmented by an external cube. Functional results were evaluated through measuring shoulder range of motion. Radiological evaluation was done by antero-posterior and lateral radiograms of the treated humerus. Results The patients were followed up for an average period of 6 months. The external cube and the pins were removed at about the 6 weeks mark. The average range of motion at the final follow up was Abduction 110°, forward flexion 140°, internal rotation 60°, external rotation 58°. All patients achieved full radiological union. Conclusion Percutaneous fixation of unstable humeral fractures is an effective method of treatment especially in elderly patients with multiple co-morbidities. Adding external Ilizarov cubes to the construct is an easy, affordable, and quick method of improving results and minimizing complications of early pin loosening that give the ability of early range of motion and rapid bone union.
{"title":"Percutaneous fixation of unstable proximal humeral fractures augmented with external Ilizarov cubes: a new simple technique","authors":"O. Metwally, Yehia Elbromboly","doi":"10.4103/eoj.eoj_78_22","DOIUrl":"https://doi.org/10.4103/eoj.eoj_78_22","url":null,"abstract":"Purpose To present the management of unstable proximal humeral fractures with percutaneous pinning augmented by an external Ilizarov cubes in elderly patients with poor general condition. Patients and methods Between October 2021 and December 2021, 7 patients (mean age: 56.7, range 53–62) with three-part proximal humeral fracture with 2 or more co-morbidities were surgically managed by percutaneous pinning augmented by an external cube. Functional results were evaluated through measuring shoulder range of motion. Radiological evaluation was done by antero-posterior and lateral radiograms of the treated humerus. Results The patients were followed up for an average period of 6 months. The external cube and the pins were removed at about the 6 weeks mark. The average range of motion at the final follow up was Abduction 110°, forward flexion 140°, internal rotation 60°, external rotation 58°. All patients achieved full radiological union. Conclusion Percutaneous fixation of unstable humeral fractures is an effective method of treatment especially in elderly patients with multiple co-morbidities. Adding external Ilizarov cubes to the construct is an easy, affordable, and quick method of improving results and minimizing complications of early pin loosening that give the ability of early range of motion and rapid bone union.","PeriodicalId":171084,"journal":{"name":"The Egyptian Orthopaedic Journal","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121955934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objectives Various surgical approaches were described for excision of the subungual glomus tumors of the nail bed, including transungual, periungual, and nail-plate-preserving or nail plate non-preserving approaches. This study aims to assess the clinical outcomes, recurrence rate, and postoperative complications of our modified trapdoor technique, compared with complete nail removal approach. Patients and methods A retrospective study was conducted on 42 patients with subungual glomus tumor of the nail bed of the hand with a minimum follow-up period of 24 months. Twenty-two patients underwent modified trapdoor excision of the tumor. Twenty patients underwent excision of the tumor through complete nail-plate removal. Outcome measures included the 100-mm visual analog scale, cold sensitivity, nail discoloration, nail regrowth rate, infection, and local recurrence. Results A significant reduction in pain and cold intolerance was observed postoperatively for all patients. The mean postoperative visual analog scale was similar in both groups. Two patients with postoperative split nail deformity were noted in the nail removal group. Other two patients with severe nail deformation due to recurrence were observed, one in each group, in addition to other two patients with nail plate deformity due to infection, one in each group. Three patients with recurrence were reported in the nail removal group, and two patients in the trapdoor group. Conclusions Both techniques are safe and effective. The modified trapdoor procedure is better reserved for patients with small tumors, while complete nail removal is indicated for those with larger and aggressive tumors, especially in the presence of preoperative nail deformity. Level of evidence Therapeutic level III.
{"title":"Modified trapdoor procedure versus complete nail removal for subungual glomus tumor excision at minimum 2 years follow-up","authors":"Asser A. Sallam, Mohamed I Rakha","doi":"10.4103/eoj.eoj_8_23","DOIUrl":"https://doi.org/10.4103/eoj.eoj_8_23","url":null,"abstract":"Objectives Various surgical approaches were described for excision of the subungual glomus tumors of the nail bed, including transungual, periungual, and nail-plate-preserving or nail plate non-preserving approaches. This study aims to assess the clinical outcomes, recurrence rate, and postoperative complications of our modified trapdoor technique, compared with complete nail removal approach. Patients and methods A retrospective study was conducted on 42 patients with subungual glomus tumor of the nail bed of the hand with a minimum follow-up period of 24 months. Twenty-two patients underwent modified trapdoor excision of the tumor. Twenty patients underwent excision of the tumor through complete nail-plate removal. Outcome measures included the 100-mm visual analog scale, cold sensitivity, nail discoloration, nail regrowth rate, infection, and local recurrence. Results A significant reduction in pain and cold intolerance was observed postoperatively for all patients. The mean postoperative visual analog scale was similar in both groups. Two patients with postoperative split nail deformity were noted in the nail removal group. Other two patients with severe nail deformation due to recurrence were observed, one in each group, in addition to other two patients with nail plate deformity due to infection, one in each group. Three patients with recurrence were reported in the nail removal group, and two patients in the trapdoor group. Conclusions Both techniques are safe and effective. The modified trapdoor procedure is better reserved for patients with small tumors, while complete nail removal is indicated for those with larger and aggressive tumors, especially in the presence of preoperative nail deformity. Level of evidence Therapeutic level III.","PeriodicalId":171084,"journal":{"name":"The Egyptian Orthopaedic Journal","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130676686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Purpose This study aims to evaluate the results of patellar fracture fixation using cannulated screws and FiberWire tension band. Patients and methods A prospective study was held in Benha University Hospital that included 30 patients with transverse patellar fractures fixed with cannulated screws with FiberWire tension band. All of the patients were followed up for a minimum period of 12 weeks, and the maximum period of follow-up was 24 weeks. Postoperatively, these patients were assessed clinically by the Levack’s score. Fracture union was confirmed radiologically. All patients were evaluated and assessed using the questionnaires at 3 and 6 months after surgery. Subjective evaluation consisted of recording pain using (visual analog scale), with categorization of pain into five levels: none, mild, moderate, severe, and unbearable. Results The mean age of the studied patients was 32 ± 9 years, and there was a male predominance (70%). More than half of the patients had right-sided affection (56.7%). The mechanisms of injury were direct (30%), falling (46.6%), or road traffic accidents (RTA) (23.3%). The affected side was the right side in 56.7% and the left side in 43.3%. The median time from injury was 3 days, and it ranged from 1 to 6 days. The mean time of surgery was 41 ± 18 min. All patients showed radiological union at 8 weeks, passive range of motion (ROM) at 4 weeks, active ROM at 6 weeks, start of weight-bearing as tolerated within brace at 4 weeks, and start of weight-bearing and ROM without restrictions at 8 weeks. At the final follow-up at 3 months, the median total Levack’s score was 12, and it ranged from 9 to 12. At 6 months, the median was 12, and the range significantly increased (11–12) (P<0.001). The reported complications were skin infection (13.3%), stiffness (6.7%), and mild pain (53.3%). Conclusion The use of cannulated screws with FiberWire tension band technique is a successful efficient treatment of transverse patellar fractures.
{"title":"Patellar fracture fixation using cannulated screws and Fiber Wire tension band","authors":"E. Bayomy, M. Shaheen","doi":"10.4103/eoj.eoj_40_22","DOIUrl":"https://doi.org/10.4103/eoj.eoj_40_22","url":null,"abstract":"Purpose This study aims to evaluate the results of patellar fracture fixation using cannulated screws and FiberWire tension band. Patients and methods A prospective study was held in Benha University Hospital that included 30 patients with transverse patellar fractures fixed with cannulated screws with FiberWire tension band. All of the patients were followed up for a minimum period of 12 weeks, and the maximum period of follow-up was 24 weeks. Postoperatively, these patients were assessed clinically by the Levack’s score. Fracture union was confirmed radiologically. All patients were evaluated and assessed using the questionnaires at 3 and 6 months after surgery. Subjective evaluation consisted of recording pain using (visual analog scale), with categorization of pain into five levels: none, mild, moderate, severe, and unbearable. Results The mean age of the studied patients was 32 ± 9 years, and there was a male predominance (70%). More than half of the patients had right-sided affection (56.7%). The mechanisms of injury were direct (30%), falling (46.6%), or road traffic accidents (RTA) (23.3%). The affected side was the right side in 56.7% and the left side in 43.3%. The median time from injury was 3 days, and it ranged from 1 to 6 days. The mean time of surgery was 41 ± 18 min. All patients showed radiological union at 8 weeks, passive range of motion (ROM) at 4 weeks, active ROM at 6 weeks, start of weight-bearing as tolerated within brace at 4 weeks, and start of weight-bearing and ROM without restrictions at 8 weeks. At the final follow-up at 3 months, the median total Levack’s score was 12, and it ranged from 9 to 12. At 6 months, the median was 12, and the range significantly increased (11–12) (P<0.001). The reported complications were skin infection (13.3%), stiffness (6.7%), and mild pain (53.3%). Conclusion The use of cannulated screws with FiberWire tension band technique is a successful efficient treatment of transverse patellar fractures.","PeriodicalId":171084,"journal":{"name":"The Egyptian Orthopaedic Journal","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131914303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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