Pub Date : 2024-05-21DOI: 10.18502/jost.v10i2.15517
Reza Zandi, S. Talebi, Amir Mehrvar, S. Nodehi, Akbar Ehsani
Background: A variety of options including titanium elastic nails (TENs) and locking plates (LPs) are available for the internal fixation of subtrochanteric fractures (STFs). However, the preferred treatment option among children and adolescents is still controversial. Methods: We report four cases of STFs in school-aged pediatric patients, treated with an adult proximal humerus LP. Results: Based on the Flynn scoring system at the last follow-up visit, all patients exhibited excellent clinical outcomes, along with satisfactory radiological outcomes based on the Beaty scoring system. There were no complications. Conclusion: Our findings suggest the efficacy of using adult proximal humerus LPs in treating pediatric STFs. The advantage of these plates lies in their ability to accommodate many screws at appropriate positions and angles without damaging the physis. This approach holds promise for the management of pediatric STFs.
{"title":"Pediatric Subtrochanteric Fracture Treated with Adult Proximal Humerus Locking Plate: A Case Series and Literature Review","authors":"Reza Zandi, S. Talebi, Amir Mehrvar, S. Nodehi, Akbar Ehsani","doi":"10.18502/jost.v10i2.15517","DOIUrl":"https://doi.org/10.18502/jost.v10i2.15517","url":null,"abstract":"Background: A variety of options including titanium elastic nails (TENs) and locking plates (LPs) are available for the internal fixation of subtrochanteric fractures (STFs). However, the preferred treatment option among children and adolescents is still controversial. \u0000Methods: We report four cases of STFs in school-aged pediatric patients, treated with an adult proximal humerus LP. \u0000Results: Based on the Flynn scoring system at the last follow-up visit, all patients exhibited excellent clinical outcomes, along with satisfactory radiological outcomes based on the Beaty scoring system. There were no complications. \u0000Conclusion: Our findings suggest the efficacy of using adult proximal humerus LPs in treating pediatric STFs. The advantage of these plates lies in their ability to accommodate many screws at appropriate positions and angles without damaging the physis. This approach holds promise for the management of pediatric STFs.","PeriodicalId":34870,"journal":{"name":"Journal of Orthopedic and Spine Trauma","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141116492","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: As operative techniques and the quality of implants are improving, surgical management of diaphyseal fractures of forearm bones in elderly patients is gaining widespread acceptance. Titanium elastic nailing system (TENS) provides flexural, axial, translational, and adequate rotational stability. This study aims to analyze the outcomes of the treatment of diaphyseal forearm bone fracture with TENS nail. Methods: Elderly patients with both-bone forearm (BBFA) fractures in diaphysis were evaluated clinically and radiologically and followed for an average of six months. The outcome was assessed using the Grace-Eversmann scoring system. We followed up with all 25 patients and evaluated them every two weeks until the fracture united. Results: After approval of the ethics committee, twenty-five elderly patients with AO type 22A3 and 22B3 fractures of the forearm bone who fulfilled the inclusion and exclusion criteria were taken for the study. The mean age of the participants was 65 years. The average time to bone union was 12 weeks, and the average surgery time was 35 minutes. There was a superficial infection in one case. Most patients had a full range of elbow and wrist movements after the union. Conclusion: The TENS is an acceptable and good tachnique for displaced BBFA diaphyseal fractures in elderly patients. It is easy, cheap, and convenient and gives elastic mobility, promoting a rapid union of fractures and stability, which is ideal for early mobilization. It provides a lower complication rate, shorter surgery time, good cosmetic outcome, and easy implant removal.
{"title":"Study of Titanium Elastic Nailing in Forearm Fractures in Elderly Patients","authors":"Ashok Sharma, Tarachand Suthar, Saksham Sharma, Shiv Bhagwan sharma","doi":"10.18502/jost.v10i2.15539","DOIUrl":"https://doi.org/10.18502/jost.v10i2.15539","url":null,"abstract":"Background: As operative techniques and the quality of implants are improving, surgical management of diaphyseal fractures of forearm bones in elderly patients is gaining widespread acceptance. Titanium elastic nailing system (TENS) provides flexural, axial, translational, and adequate rotational stability. This study aims to analyze the outcomes of the treatment of diaphyseal forearm bone fracture with TENS nail. \u0000Methods: Elderly patients with both-bone forearm (BBFA) fractures in diaphysis were evaluated clinically and radiologically and followed for an average of six months. The outcome was assessed using the Grace-Eversmann scoring system. We followed up with all 25 patients and evaluated them every two weeks until the fracture united. \u0000 Results: After approval of the ethics committee, twenty-five elderly patients with AO type 22A3 and 22B3 fractures of the forearm bone who fulfilled the inclusion and exclusion criteria were taken for the study. The mean age of the participants was 65 years. The average time to bone union was 12 weeks, and the average surgery time was 35 minutes. There was a superficial infection in one case. Most patients had a full range of elbow and wrist movements after the union. \u0000 Conclusion: The TENS is an acceptable and good tachnique for displaced BBFA diaphyseal fractures in elderly patients. It is easy, cheap, and convenient and gives elastic mobility, promoting a rapid union of fractures and stability, which is ideal for early mobilization. It provides a lower complication rate, shorter surgery time, good cosmetic outcome, and easy implant removal.","PeriodicalId":34870,"journal":{"name":"Journal of Orthopedic and Spine Trauma","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141113466","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: Dynamic nailing by placing only one screw on one side of the nail shortens the surgical time and reduces the complications during surgery and secondary dynamization. This study aimed to investigate the healing of dynamic intramedullary nailing (IMN) of tibial fractures. Methods: This cross-sectional study was done on 67 patients with dynamic IMN in 5th Azar Hospital, Gorgan, Iran, in 2015-2018. Complications, union time, Radiographic Union Score of Tibia Fracture (RUST) score, and Johner-Wruhs criteria were analyzed based on their grouping in AO classification. Results: The average age of the patients was 33.2 ± 13.0 years. Most of the fractures were closed type (71.6%), type C (43.4%). The mean healing time was 14.62 ± 4.38 weeks and RUST score was 8.90 ± 1.26. There was no significant difference between locations of fracture and the healing time or RUST score (P > 0.05). The healing time in the comminuted fractures (e.g., type C) and open tibial fractures was statistically longer than the simpler type (e.g., type A or B) and the mean radiological score in type C fractures was significantly lower (P < 0.05). The mean Johner-Wruhs criteria score of fractures was 46.31 ± 4.49, so that 61 patients had excellent results, four patients had good results, and two patients had fair results. Conclusion: Dynamic IMN of closed and middle third tibial fractures and simpler types of fractures (e.g., type A or B) have faster healing. Nevertheless, it is better to be more cautious for fixation of open or comminuted fracture (e.g., type C).
背景：动态髓内钉只需在钉子的一侧放置一颗螺钉，从而缩短了手术时间，减少了手术和二次动力治疗过程中的并发症。本研究旨在探讨胫骨骨折动态髓内钉（IMN）的愈合情况。方法：本横断面研究于2015-2018年在伊朗戈尔甘的阿扎尔第五医院对67名动态髓内钉患者进行了研究。根据其在 AO 分类中的分组，对并发症、结合时间、胫骨骨折放射学结合评分（RUST）和 Johner-Wruhs 标准进行了分析。结果：患者平均年龄为（33.2 ± 13.0）岁。大多数骨折为闭合型（71.6%）和 C 型（43.4%）。平均愈合时间为（14.62±4.38）周，RUST评分为（8.90±1.26）分。骨折部位与愈合时间或 RUST 评分无明显差异（P > 0.05）。据统计，粉碎性骨折（如 C 型）和开放性胫骨骨折的愈合时间长于较简单的类型（如 A 型或 B 型），且 C 型骨折的平均放射学评分明显较低（P < 0.05）。骨折的平均 Johner-Wruhs 标准评分为（46.31±4.49）分，因此 61 例患者的治疗效果极佳，4 例患者的治疗效果良好，2 例患者的治疗效果一般。结论闭合性胫骨第三中段骨折和较简单类型骨折（如 A 型或 B 型）的动态 IMN 愈合较快。然而，对于开放性或粉碎性骨折（如 C 型）的固定，最好更加谨慎。
{"title":"Study of the Healing of Tibial Fractures Treated with Dynamic Intramedullary Nailing","authors":"Afshin Sahebjamei, Habibollah Gorgani-Firoozjah, Omid Momen, Ozone Davaji Setare","doi":"10.18502/jost.v10i2.15516","DOIUrl":"https://doi.org/10.18502/jost.v10i2.15516","url":null,"abstract":"Background: Dynamic nailing by placing only one screw on one side of the nail shortens the surgical time and reduces the complications during surgery and secondary dynamization. This study aimed to investigate the healing of dynamic intramedullary nailing (IMN) of tibial fractures. \u0000Methods: This cross-sectional study was done on 67 patients with dynamic IMN in 5th Azar Hospital, Gorgan, Iran, in 2015-2018. Complications, union time, Radiographic Union Score of Tibia Fracture (RUST) score, and Johner-Wruhs criteria were analyzed based on their grouping in AO classification. \u0000Results: The average age of the patients was 33.2 ± 13.0 years. Most of the fractures were closed type (71.6%), type C (43.4%). The mean healing time was 14.62 ± 4.38 weeks and RUST score was 8.90 ± 1.26. There was no significant difference between locations of fracture and the healing time or RUST score (P > 0.05). The healing time in the comminuted fractures (e.g., type C) and open tibial fractures was statistically longer than the simpler type (e.g., type A or B) and the mean radiological score in type C fractures was significantly lower (P < 0.05). The mean Johner-Wruhs criteria score of fractures was 46.31 ± 4.49, so that 61 patients had excellent results, four patients had good results, and two patients had fair results. \u0000Conclusion: Dynamic IMN of closed and middle third tibial fractures and simpler types of fractures (e.g., type A or B) have faster healing. Nevertheless, it is better to be more cautious for fixation of open or comminuted fracture (e.g., type C).","PeriodicalId":34870,"journal":{"name":"Journal of Orthopedic and Spine Trauma","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141117351","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}
Pub Date : 2024-05-21DOI: 10.18502/jost.v10i2.15511
Mir Mansour Moazen Jamshidi, Mohammad Mirahmadi Eraghi, Milad Salehi, Sadulla Sharifpour, A. Moharrami
The current study aims to evaluate the potential role of extracorporeal shock wave therapy (ESWT) in functional status, physical disability, and pain in patients suffering from low back pain (LBP). ESWT may provide superior therapeutic outcomes in reducing pain and ameliorating the patient's functional status regarding LBP.
{"title":"The Role of Extracorporeal Shockwave Therapy (ESWT) in Treating Low Back Pain: Current Concept Review","authors":"Mir Mansour Moazen Jamshidi, Mohammad Mirahmadi Eraghi, Milad Salehi, Sadulla Sharifpour, A. Moharrami","doi":"10.18502/jost.v10i2.15511","DOIUrl":"https://doi.org/10.18502/jost.v10i2.15511","url":null,"abstract":"The current study aims to evaluate the potential role of extracorporeal shock wave therapy (ESWT) in functional status, physical disability, and pain in patients suffering from low back pain (LBP). ESWT may provide superior therapeutic outcomes in reducing pain and ameliorating the patient's functional status regarding LBP.","PeriodicalId":34870,"journal":{"name":"Journal of Orthopedic and Spine Trauma","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141118089","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}
Pub Date : 2024-05-21DOI: 10.18502/jost.v10i2.15514
Saeed Abbasi, Majid Ghodsipoor, D. Farsi, Mahdi Rezai, P. Hafezimoghadam, Mani Mofidi, Mobina Yarahmadi, Nazanin Alaei Faradonbeh
Background: Orthopedic procedures are one of the most common medical procedures in the emergency department (ED) and are also among the most painful procedures performed on the conscious patient. This study aimed to compare different doses of ketofol in procedural sedation and analgesia (PSA) in patients referred to the EDs. Methods: In this double-blinded clinical trial, 296 patients aged 18 years or over who presented with the need for orthopedic procedures in the three academic EDs in 2020 were studied. After completing the written consent, the patients were randomly assigned to four treatment groups. Demographic information, underlying diseases, patients' physical condition, type of orthopedic injuries requiring intervention, and patients' vital signs were recorded in a checklist for each patient. Results: In this study, the mean age, gender, level of education, addiction, patients' physical condition, type of procedures performed, apnea, hypoventilation, bradycardia, hypotension, and agitation in all four treatment groups were not statistically different, but hallucination and hypoxia in group C (propofol 1 mg/kg plus ketamine 0.33 mg/kg) were much less than other groups; thus, oxygen administration was more common in other groups. Conclusion: By testing different doses of ketamine, we concluded that doses of 1 mg and 0.5 mg were associated with more side effects. A dose of 0.33 mg of ketamine has fewer side effects while causing analgesia and sedation as in the above doses. A dose of 0.25 mg of ketamine increases the likelihood of requiring subsequent doses. Therefore, it seems that 0.33 mg of ketamine is the best dose of choice.
{"title":"Comparison of Different Ketofol Procedural Sedation and Analgesic Doses during Orthopedic Procedures in Patients Referred to the Emergency Department: A Double-Blind Randomized Clinical Trial","authors":"Saeed Abbasi, Majid Ghodsipoor, D. Farsi, Mahdi Rezai, P. Hafezimoghadam, Mani Mofidi, Mobina Yarahmadi, Nazanin Alaei Faradonbeh","doi":"10.18502/jost.v10i2.15514","DOIUrl":"https://doi.org/10.18502/jost.v10i2.15514","url":null,"abstract":"Background: Orthopedic procedures are one of the most common medical procedures in the emergency department (ED) and are also among the most painful procedures performed on the conscious patient. This study aimed to compare different doses of ketofol in procedural sedation and analgesia (PSA) in patients referred to the EDs. \u0000Methods: In this double-blinded clinical trial, 296 patients aged 18 years or over who presented with the need for orthopedic procedures in the three academic EDs in 2020 were studied. After completing the written consent, the patients were randomly assigned to four treatment groups. Demographic information, underlying diseases, patients' physical condition, type of orthopedic injuries requiring intervention, and patients' vital signs were recorded in a checklist for each patient. \u0000Results: In this study, the mean age, gender, level of education, addiction, patients' physical condition, type of procedures performed, apnea, hypoventilation, bradycardia, hypotension, and agitation in all four treatment groups were not statistically different, but hallucination and hypoxia in group C (propofol 1 mg/kg plus ketamine 0.33 mg/kg) were much less than other groups; thus, oxygen administration was more common in other groups. \u0000Conclusion: By testing different doses of ketamine, we concluded that doses of 1 mg and 0.5 mg were associated with more side effects. A dose of 0.33 mg of ketamine has fewer side effects while causing analgesia and sedation as in the above doses. A dose of 0.25 mg of ketamine increases the likelihood of requiring subsequent doses. Therefore, it seems that 0.33 mg of ketamine is the best dose of choice.","PeriodicalId":34870,"journal":{"name":"Journal of Orthopedic and Spine Trauma","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141114926","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}
Pub Date : 2024-05-21DOI: 10.18502/jost.v10i2.15512
Sina Ramtin, Amirreza Fatehi, David Ring, Sean Gallagher, Anthony Johnson
Background: There is evidence that unhelpful thoughts and distress regarding symptoms are associated with more frequent care utilization. Among people seeing a musculoskeletal specialist in person, we sought relationships between mental and social health factors and the number of 1) self-reported in-person healthcare contacts, 2) remote healthcare contacts, and 3) total healthcare contacts during the 6-week period prior to the visit. Methods: We enrolled 148 adult patients in a cross-sectional study of people visiting a musculoskeletal specialist for a new or return visit. Patients indicated the number of self-reported remote and in-person healthcare contacts, and completed measures of social health, unhelpful thoughts regarding symptoms, general distress, and demographics. Results: Accounting for potential confounding in multivariable analysis, more pre-visit self-reported in-person care episodes were independently associated with more unhelpful thoughts about symptoms [higher score on Negative Pain Thoughts Questionnaire (NPTQ), regression coefficient: 0.05, P < 0.05] and household income between $15000 and $29999 or $30000 and $49999. No factors were associated with the total number of pre-visit remote and in-person care contacts. Conclusion: The observation that patients with greater unhelpful thinking seek out more in-person care episodes for musculoskeletal symptoms supports the concept that comprehensive care strategies attentive to common unhelpful thoughts regarding symptoms could limit resource utilization.
{"title":"Do Psychological and Social Factors Correspond with Health Care Utilization?","authors":"Sina Ramtin, Amirreza Fatehi, David Ring, Sean Gallagher, Anthony Johnson","doi":"10.18502/jost.v10i2.15512","DOIUrl":"https://doi.org/10.18502/jost.v10i2.15512","url":null,"abstract":"Background: There is evidence that unhelpful thoughts and distress regarding symptoms are associated with more frequent care utilization. Among people seeing a musculoskeletal specialist in person, we sought relationships between mental and social health factors and the number of 1) self-reported in-person healthcare contacts, 2) remote healthcare contacts, and 3) total healthcare contacts during the 6-week period prior to the visit. \u0000Methods: We enrolled 148 adult patients in a cross-sectional study of people visiting a musculoskeletal specialist for a new or return visit. Patients indicated the number of self-reported remote and in-person healthcare contacts, and completed measures of social health, unhelpful thoughts regarding symptoms, general distress, and demographics. \u0000Results: Accounting for potential confounding in multivariable analysis, more pre-visit self-reported in-person care episodes were independently associated with more unhelpful thoughts about symptoms [higher score on Negative Pain Thoughts Questionnaire (NPTQ), regression coefficient: 0.05, P < 0.05] and household income between $15000 and $29999 or $30000 and $49999. No factors were associated with the total number of pre-visit remote and in-person care contacts. \u0000Conclusion: The observation that patients with greater unhelpful thinking seek out more in-person care episodes for musculoskeletal symptoms supports the concept that comprehensive care strategies attentive to common unhelpful thoughts regarding symptoms could limit resource utilization.","PeriodicalId":34870,"journal":{"name":"Journal of Orthopedic and Spine Trauma","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141115036","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}
Pub Date : 2024-05-21DOI: 10.18502/jost.v10i2.15528
Omid Salkhori, Seyed Hadi Kalantar, Salma Yaghoubi, Shahabedin Beheshti Fard, Ali Asadifar, Milad Salehi, A. Moharrami
Background: Radial head and neck fractures are one of the common fractures of the elbow in adult patients. There are controversies in the treatment of nondisplaced head and neck fractures. However, nonoperative treatment remains a treatment choice for nondisplaced radial head fracture without motion block. Case Report: We presented a 23-year-old patient who had a bilateral nondisplaced radial head fracture. The patient was managed with conservative treatment and early elbow range of motion (ROM). Finally, the patient had a full ROM without pain in both elbows. Conclusion: Conservative management with early mobilization remains an effective approach for treating bilateral nondisplaced radial head fracture, yielding satisfactory outcomes.
{"title":"Bilateral Radial Head and Neck Nondisplaced Fracture, a Challenge for Treatment: A Case Report","authors":"Omid Salkhori, Seyed Hadi Kalantar, Salma Yaghoubi, Shahabedin Beheshti Fard, Ali Asadifar, Milad Salehi, A. Moharrami","doi":"10.18502/jost.v10i2.15528","DOIUrl":"https://doi.org/10.18502/jost.v10i2.15528","url":null,"abstract":"Background: Radial head and neck fractures are one of the common fractures of the elbow in adult patients. There are controversies in the treatment of nondisplaced head and neck fractures. However, nonoperative treatment remains a treatment choice for nondisplaced radial head fracture without motion block. \u0000Case Report: We presented a 23-year-old patient who had a bilateral nondisplaced radial head fracture. The patient was managed with conservative treatment and early elbow range of motion (ROM). Finally, the patient had a full ROM without pain in both elbows. \u0000Conclusion: Conservative management with early mobilization remains an effective approach for treating bilateral nondisplaced radial head fracture, yielding satisfactory outcomes.","PeriodicalId":34870,"journal":{"name":"Journal of Orthopedic and Spine Trauma","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141114115","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}
Pub Date : 2024-05-21DOI: 10.18502/jost.v10i2.15510
A. Moharrami, Mohammad Mirahmadi Eraghi, Shahabaldin Beheshti Fard, Ali Asadifar, Ehsan Fallah, Sadulla Sharifpour, S. M. J. Mortazavi
The request for total knee arthroplasty (TKA) is increasingly being raised and imposes an enormous burden on the healthcare system. Most subjects represent symptomatic concomitant low back pain (LBP) at baseline, interfering with functional outcomes with little or no improvement in mental health following TKA. Orthopedics should notify the patients suffering from concomitant LBP about the likelihood of unfavorable recovery. The authors describe the functional outcomes and satisfaction following TKA in patients suffering from concomitant LBP.
{"title":"Total Knee Arthroplasty in Patients with Concomitant Low Back Pain, Its Effects on Pain, Functional Outcomes and Satisfaction, a Narrative Review","authors":"A. Moharrami, Mohammad Mirahmadi Eraghi, Shahabaldin Beheshti Fard, Ali Asadifar, Ehsan Fallah, Sadulla Sharifpour, S. M. J. Mortazavi","doi":"10.18502/jost.v10i2.15510","DOIUrl":"https://doi.org/10.18502/jost.v10i2.15510","url":null,"abstract":"The request for total knee arthroplasty (TKA) is increasingly being raised and imposes an enormous burden on the healthcare system. Most subjects represent symptomatic concomitant low back pain (LBP) at baseline, interfering with functional outcomes with little or no improvement in mental health following TKA. Orthopedics should notify the patients suffering from concomitant LBP about the likelihood of unfavorable recovery. The authors describe the functional outcomes and satisfaction following TKA in patients suffering from concomitant LBP.","PeriodicalId":34870,"journal":{"name":"Journal of Orthopedic and Spine Trauma","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141115175","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}
Pub Date : 2024-05-21DOI: 10.18502/jost.v10i2.15519
Omid Kohandel, Mohammad Sajjad Mirhoseini, Seyede Sanaz Mirrahimi
Background: Hip dislocations, constituting 2-5 percent of all joint dislocations, predominantly present as posterior dislocations. Bilateral hip dislocations are rare, accounting for 1.25% of cases. Associated fractures often involve the proximal femur and acetabulum. Case Report: A 60-year-old man with no prior hip trauma history sustained bilateral hip dislocations after a 6-meter fall. Initial assessments and a hip computed tomography (CT) scan confirmed posterior dislocation of the right hip and anterior dislocation of the left hip. The patient underwent a successful closed pelvic reduction operation four hours post-injury, as confirmed by a post-reduction CT scan. Conclusion: The study, encompassing 11 relevant studies and 208 patients, predominantly men (81%), revealed that asymmetrical bilateral hip dislocations were exceptionally rare (0.01-0.02 percent). Contrary to expectations, this study challenges the presumed stronger association of traffic accidents with bilateral dislocations, presenting a statistically significant association between the type of dislocation and trauma mechanism. Associated fractures, such as acetabulum fractures in unilateral cases and posterior edge fractures in bilateral cases, varied. Avascular necrosis (AVN), a common complication, was not observed in the current case, where reduction occurred within the critical 6-hour timeframe. This report contributes valuable insights into the characteristics and associations of asymmetric bilateral hip dislocations, emphasizing the importance of prompt intervention to mitigate complications. Further research is needed to validate these findings and explore underlying patterns in this rare clinical scenario.
{"title":"Bilateral Asymmetrical Hip Dislocations after Falling from Height: A Case Report and Literature Review","authors":"Omid Kohandel, Mohammad Sajjad Mirhoseini, Seyede Sanaz Mirrahimi","doi":"10.18502/jost.v10i2.15519","DOIUrl":"https://doi.org/10.18502/jost.v10i2.15519","url":null,"abstract":"Background: Hip dislocations, constituting 2-5 percent of all joint dislocations, predominantly present as posterior dislocations. Bilateral hip dislocations are rare, accounting for 1.25% of cases. Associated fractures often involve the proximal femur and acetabulum. \u0000Case Report: A 60-year-old man with no prior hip trauma history sustained bilateral hip dislocations after a 6-meter fall. Initial assessments and a hip computed tomography (CT) scan confirmed posterior dislocation of the right hip and anterior dislocation of the left hip. The patient underwent a successful closed pelvic reduction operation four hours post-injury, as confirmed by a post-reduction CT scan. \u0000Conclusion: The study, encompassing 11 relevant studies and 208 patients, predominantly men (81%), revealed that asymmetrical bilateral hip dislocations were exceptionally rare (0.01-0.02 percent). Contrary to expectations, this study challenges the presumed stronger association of traffic accidents with bilateral dislocations, presenting a statistically significant association between the type of dislocation and trauma mechanism. Associated fractures, such as acetabulum fractures in unilateral cases and posterior edge fractures in bilateral cases, varied. Avascular necrosis (AVN), a common complication, was not observed in the current case, where reduction occurred within the critical 6-hour timeframe. This report contributes valuable insights into the characteristics and associations of asymmetric bilateral hip dislocations, emphasizing the importance of prompt intervention to mitigate complications. Further research is needed to validate these findings and explore underlying patterns in this rare clinical scenario.","PeriodicalId":34870,"journal":{"name":"Journal of Orthopedic and Spine Trauma","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141113534","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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