Pub Date : 2023-06-25DOI: 10.18502/jost.v9i3.13036
Hamidreza Aslani, Seyyed Mehdi Hosseini, E. Kouhestani, Amir Bisadi
Background: Anterior cruciate ligament (ACL) reconstruction surgery is a common orthopedic procedure. Minimally invasive surgeries and arthroscopy are becoming more common, and tourniquets are utilized in these procedures to reduce bleeding and allow for improved tissue visualization. Case Report: In this paper, we report a 32-year-old man who underwent the right knee ACL reconstruction using a tourniquet following trauma. He developed thigh swelling at the tourniquet site after surgery. Right thigh ultrasound and magnetic resonance imaging (MRI) indicated extensive interstitial edema in all compartments without collection, hematoma, or hemorrhage. The patient was treated with dexamethasone and Lasix for four days. Rehabilitation activities included exercises to improve range of motion (ROM), strength exercises, and a home workout routine. Two weeks after discharge, the swelling decreased by about 80%. Conclusion: We believe that using a tourniquet during the reconstruction surgery may be responsible for the extensive edema in the limb. However, despite several diagnostic methods, we could not explain the reason for the edema in the limb following surgery.
{"title":"Abnormal Thigh Swelling after Anterior Cruciate Ligament Reconstruction with Tourniquet","authors":"Hamidreza Aslani, Seyyed Mehdi Hosseini, E. Kouhestani, Amir Bisadi","doi":"10.18502/jost.v9i3.13036","DOIUrl":"https://doi.org/10.18502/jost.v9i3.13036","url":null,"abstract":"Background: Anterior cruciate ligament (ACL) reconstruction surgery is a common orthopedic procedure. Minimally invasive surgeries and arthroscopy are becoming more common, and tourniquets are utilized in these procedures to reduce bleeding and allow for improved tissue visualization. \u0000Case Report: In this paper, we report a 32-year-old man who underwent the right knee ACL reconstruction using a tourniquet following trauma. He developed thigh swelling at the tourniquet site after surgery. Right thigh ultrasound and magnetic resonance imaging (MRI) indicated extensive interstitial edema in all compartments without collection, hematoma, or hemorrhage. The patient was treated with dexamethasone and Lasix for four days. Rehabilitation activities included exercises to improve range of motion (ROM), strength exercises, and a home workout routine. Two weeks after discharge, the swelling decreased by about 80%. \u0000Conclusion: We believe that using a tourniquet during the reconstruction surgery may be responsible for the extensive edema in the limb. However, despite several diagnostic methods, we could not explain the reason for the edema in the limb following surgery.","PeriodicalId":34870,"journal":{"name":"Journal of Orthopedic and Spine Trauma","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49136004","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 : 2023-06-25DOI: 10.18502/jost.v9i3.13039
S. Talebi, Shirin Sheibani, Pedram Hassani, M. Dehghan
Background: The talus bone is the second-largest bone in the tarsal region. Talar fractures are rare injuries that occur due to highenergy traumas. Open reduction and internal fixation (ORIF) is the treatment of choice in the talar body fracture-dislocation. Avascular necrosis (AVN), osteoarthritis (OA), malunion, non-union, skin infections, and ankylosis of the subtalar joint are complications that can happen following the talar body fracture. Case Report: We reported a rare open fracture-dislocation of the talar body concomitant with the anterior talofibular ligament (ATFL) rupture in a 24-year-old motorcyclist man. ORIF with two 4.5 mm cancellous screws and ATFL repair were performed. After 6 months of follow-up, the radiographic bone union was achieved, and the patient had no complaints of pain, disability, and discomfort. Conclusion: According to the blood supply of the talus bone, appropriate management and follow-up should be considered to prevent severe consequences. Due to the lack of literature on this lesion, in this report, we tried to provide more comprehensive information regarding the diagnosis, treatment, and follow-up of this group of patients. To the best of our knowledge, our case will probably be the second case of the talar body fracture concomitant with rupture of the ATFL.
{"title":"Open Fracture-Dislocation of the Talar Body Concomitant with the Anterior Talofibular Ligament Rupture: A Case Report and Literature Review","authors":"S. Talebi, Shirin Sheibani, Pedram Hassani, M. Dehghan","doi":"10.18502/jost.v9i3.13039","DOIUrl":"https://doi.org/10.18502/jost.v9i3.13039","url":null,"abstract":"Background: The talus bone is the second-largest bone in the tarsal region. Talar fractures are rare injuries that occur due to highenergy traumas. Open reduction and internal fixation (ORIF) is the treatment of choice in the talar body fracture-dislocation. Avascular necrosis (AVN), osteoarthritis (OA), malunion, non-union, skin infections, and ankylosis of the subtalar joint are complications that can happen following the talar body fracture. \u0000Case Report: We reported a rare open fracture-dislocation of the talar body concomitant with the anterior talofibular ligament (ATFL) rupture in a 24-year-old motorcyclist man. ORIF with two 4.5 mm cancellous screws and ATFL repair were performed. After 6 months of follow-up, the radiographic bone union was achieved, and the patient had no complaints of pain, disability, and discomfort. \u0000Conclusion: According to the blood supply of the talus bone, appropriate management and follow-up should be considered to prevent severe consequences. Due to the lack of literature on this lesion, in this report, we tried to provide more comprehensive information regarding the diagnosis, treatment, and follow-up of this group of patients. To the best of our knowledge, our case will probably be the second case of the talar body fracture concomitant with rupture of the ATFL.","PeriodicalId":34870,"journal":{"name":"Journal of Orthopedic and Spine Trauma","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49312024","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 : 2023-06-25DOI: 10.18502/jost.v9i3.13038
Ramin Shayan-Moghadam, M. Sharafi, E. Mahmoudi, M. Nabian
Background: Familial synovial hypertrophy is a rare condition presenting as the flexion contracture of the small joints of the hands and feet, in addition to the large joint effusion and range of motion (ROM) restriction. Case Report: Herein, we introduce a 14-year-old boy with a long history of deformities in the hand and foot joints. Painless swelling and limited motion of big joints were present since birth. There were no similar diseases in paternal or maternal relatives, while his 9-year-old brother also had a lifelong history of same deformities. Conclusion: Involvement of the hands and feet can severely restrict young patients’ function in daily tasks, raising the importance of early diagnosis and treatment in familial synovial hypertrophy.
{"title":"Familial Synovial Hypertrophy: A Case Report","authors":"Ramin Shayan-Moghadam, M. Sharafi, E. Mahmoudi, M. Nabian","doi":"10.18502/jost.v9i3.13038","DOIUrl":"https://doi.org/10.18502/jost.v9i3.13038","url":null,"abstract":"Background: Familial synovial hypertrophy is a rare condition presenting as the flexion contracture of the small joints of the hands and feet, in addition to the large joint effusion and range of motion (ROM) restriction. \u0000Case Report: Herein, we introduce a 14-year-old boy with a long history of deformities in the hand and foot joints. Painless swelling and limited motion of big joints were present since birth. There were no similar diseases in paternal or maternal relatives, while his 9-year-old brother also had a lifelong history of same deformities. \u0000Conclusion: Involvement of the hands and feet can severely restrict young patients’ function in daily tasks, raising the importance of early diagnosis and treatment in familial synovial hypertrophy.","PeriodicalId":34870,"journal":{"name":"Journal of Orthopedic and Spine Trauma","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45310407","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 : 2023-06-24DOI: 10.18502/jost.v9i3.13021
Dixit Savajiyani, Nishant Chauhan, Shailesh D. Ramavat
Background: Forearm shaft fractures are common in developing countries. Anatomical reduction of these fractures using plates and screws is considered an accepted treatment mode. Like other shaft fractures, this can be treated with intramedullary nails like square nails, Rush nails, and interlocking nails. This study evaluates radiological and functional treatment results using square nailing. Methods: A prospective study was conducted on 100 adult patients with diaphyseal forearm fractures over 3 years. Out of 100 patients, 68 were men, and 32 were women. Patients were followed up at 2 weeks, 6 weeks, 8 weeks, and then every 3 months till 1 to 1.5 years. We have used criteria described by Anderson et al. and the shortened version of the Disabilities of the Arm, Shoulder, and Hand (QuickDASH) score for functional evaluation of the patients. Results: Out of 100 patients, the union was achieved in 88 patients, while the rest 12 patients required re-surgery. 4 patients had delayed union, 4 patients developed an infection at the ulnar entry site, and 3 patients developed bursitis of olecranon bursa. Conclusion: Intramedullary nailing of both bone forearm shaft fractures using square nails can give satisfactory results in most cases, comparable with treatment by plates and screws, and provides an alternative, cost-effective treatment of both bone forearm shafts fractures with good cosmesis owing to small incisions.
{"title":"Outcomes of Intra-Medullary Square Nail for Adult Both Bone Forearm Shaft Fractures","authors":"Dixit Savajiyani, Nishant Chauhan, Shailesh D. Ramavat","doi":"10.18502/jost.v9i3.13021","DOIUrl":"https://doi.org/10.18502/jost.v9i3.13021","url":null,"abstract":"Background: Forearm shaft fractures are common in developing countries. Anatomical reduction of these fractures using plates and screws is considered an accepted treatment mode. Like other shaft fractures, this can be treated with intramedullary nails like square nails, Rush nails, and interlocking nails. This study evaluates radiological and functional treatment results using square nailing. \u0000Methods: A prospective study was conducted on 100 adult patients with diaphyseal forearm fractures over 3 years. Out of 100 patients, 68 were men, and 32 were women. Patients were followed up at 2 weeks, 6 weeks, 8 weeks, and then every 3 months till 1 to 1.5 years. We have used criteria described by Anderson et al. and the shortened version of the Disabilities of the Arm, Shoulder, and Hand (QuickDASH) score for functional evaluation of the patients. \u0000Results: Out of 100 patients, the union was achieved in 88 patients, while the rest 12 patients required re-surgery. 4 patients had delayed union, 4 patients developed an infection at the ulnar entry site, and 3 patients developed bursitis of olecranon bursa. \u0000Conclusion: Intramedullary nailing of both bone forearm shaft fractures using square nails can give satisfactory results in most cases, comparable with treatment by plates and screws, and provides an alternative, cost-effective treatment of both bone forearm shafts fractures with good cosmesis owing to small incisions.","PeriodicalId":34870,"journal":{"name":"Journal of Orthopedic and Spine Trauma","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41703221","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 : 2023-06-24DOI: 10.18502/jost.v9i3.13020
S. Kar, Anantharamakrishnan Ganesh, Anurag Singh
Background: Pediatric femoral shaft fractures are one of the common fractures that we encounter in the orthopedics outpatient department. These fractures have various treatment options ranging from traction and early hip spica casting to elastic titanium intramedullary nails [titanium elastic nailing system (TENS)] and reamed intramedullary nails. In this study, we are evaluating the functional outcome and results following the use of flexible intramedullary nails and conservative management for femoral shaft fractures in children. Methods: This was a prospective observational study which was carried out in a tertiary care hospital from October 2015 to May 2017 for two groups of children who sustained traumatic femoral shaft fractures. A total of 40 patients were taken into consideration with 20 patients each in two groups. Results: The male-to-female ratio was 2.6:1 in our study population. The overall post-operative complication rate was more in the TENS group. Besides, we found that the TENS group of patients had a less limb length discrepancy (LLD) (P = 0.004) and a lower degree of angular deformity (P = 0.36). Conclusion: TENS demonstrated advantages including sufficient axial stability, early mobilization, and more rapid return to function than spica cast treatment; however, it had the drawback of possible infection and pin site irritation. Overall, TENS offers a minimally invasive method for treatment of the femoral shaft fractures in children which stands superior to traditional spica casting.
{"title":"TENS in Femoral Shaft Fractures of Children","authors":"S. Kar, Anantharamakrishnan Ganesh, Anurag Singh","doi":"10.18502/jost.v9i3.13020","DOIUrl":"https://doi.org/10.18502/jost.v9i3.13020","url":null,"abstract":"Background: Pediatric femoral shaft fractures are one of the common fractures that we encounter in the orthopedics outpatient department. These fractures have various treatment options ranging from traction and early hip spica casting to elastic titanium intramedullary nails [titanium elastic nailing system (TENS)] and reamed intramedullary nails. In this study, we are evaluating the functional outcome and results following the use of flexible intramedullary nails and conservative management for femoral shaft fractures in children. \u0000Methods: This was a prospective observational study which was carried out in a tertiary care hospital from October 2015 to May 2017 for two groups of children who sustained traumatic femoral shaft fractures. A total of 40 patients were taken into consideration with 20 patients each in two groups. \u0000Results: The male-to-female ratio was 2.6:1 in our study population. The overall post-operative complication rate was more in the TENS group. Besides, we found that the TENS group of patients had a less limb length discrepancy (LLD) (P = 0.004) and a lower degree of angular deformity (P = 0.36). \u0000Conclusion: TENS demonstrated advantages including sufficient axial stability, early mobilization, and more rapid return to function than spica cast treatment; however, it had the drawback of possible infection and pin site irritation. Overall, TENS offers a minimally invasive method for treatment of the femoral shaft fractures in children which stands superior to traditional spica casting. \u0000 ","PeriodicalId":34870,"journal":{"name":"Journal of Orthopedic and Spine Trauma","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42852816","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 : 2023-06-24DOI: 10.18502/jost.v9i3.13019
M. Javdani, Pegah Khosravian, A. Barzegar, M. Hashemnia
Full Title: Evaluation of Changes in Antioxidant Factors and Albumin Level Following the Administration of a Controlled-Releasing Drug Delivery System of Chitosan Hydrogel Loaded with Buprenorphine and Ketorolac in an Experimental Bone Defect in the Tibia of the Rat Model Background: In the present study, the effectiveness of a controlled-release drug delivery system of chitosan hydrogel loaded with ketorolac and buprenorphine on oxidative stress indices and albumin changes in the experimental bone defect model was considered. Methods: After creating an experimental defect in the right tibia of each rat, 5 groups, including (A) the control group that did not receive any pharmacological intervention, (B) the chitosan hydrogel receiving group, (C) the group receiving chitosan hydrogel loaded with buprenorphine, (D) the group receiving chitosan hydrogel loaded with ketorolac, and (E) the group receiving chitosan hydrogel loaded with ketorolac and buprenorphine, were considered. Serum concentrations of antioxidant factors and albumin levels were then measured on days 0, 3, 7, and 21 after surgery. Results: In the control group, the maximum amount of oxidative stress and the maximum activity of antioxidant enzymes on the third and seventh days were compared between the 4 treatment groups. Moreover, the maximum amount of albumin on the third day was recorded and compared between the 4 other treatment groups. In 4 treatment groups, a significant decrease was observed in the mean of parameters related to oxidative stress compared to the control group, which was more noticeable in the group receiving ketorolac. Conclusion: In the present study, the highest rate of control of oxidative stress conditions was observed in the group treated with the ketorolac-loaded chitosan hydrogel system, possibly due to its antioxidant properties and better control of inflammatory conditions caused by the use of chitosan and ketorolac in this treatment group.
{"title":"Evaluation of Changes in Antioxidant Factors and Albumin Level Following the Administration of a Controlled-Releasing Drug Delivery System of Chitosan Hydrogel Loaded with Buprenorphine and Ketorolac in an Experimental Bone Defect in the Tibia of the Rat","authors":"M. Javdani, Pegah Khosravian, A. Barzegar, M. Hashemnia","doi":"10.18502/jost.v9i3.13019","DOIUrl":"https://doi.org/10.18502/jost.v9i3.13019","url":null,"abstract":"Full Title: Evaluation of Changes in Antioxidant Factors and Albumin Level Following the Administration of a Controlled-Releasing Drug Delivery System of Chitosan Hydrogel Loaded with Buprenorphine and Ketorolac in an Experimental Bone Defect in the Tibia of the Rat Model \u0000Background: In the present study, the effectiveness of a controlled-release drug delivery system of chitosan hydrogel loaded with ketorolac and buprenorphine on oxidative stress indices and albumin changes in the experimental bone defect model was considered. \u0000Methods: After creating an experimental defect in the right tibia of each rat, 5 groups, including (A) the control group that did not receive any pharmacological intervention, (B) the chitosan hydrogel receiving group, (C) the group receiving chitosan hydrogel loaded with buprenorphine, (D) the group receiving chitosan hydrogel loaded with ketorolac, and (E) the group receiving chitosan hydrogel loaded with ketorolac and buprenorphine, were considered. Serum concentrations of antioxidant factors and albumin levels were then measured on days 0, 3, 7, and 21 after surgery. \u0000Results: In the control group, the maximum amount of oxidative stress and the maximum activity of antioxidant enzymes on the third and seventh days were compared between the 4 treatment groups. Moreover, the maximum amount of albumin on the third day was recorded and compared between the 4 other treatment groups. In 4 treatment groups, a significant decrease was observed in the mean of parameters related to oxidative stress compared to the control group, which was more noticeable in the group receiving ketorolac. \u0000Conclusion: In the present study, the highest rate of control of oxidative stress conditions was observed in the group treated with the ketorolac-loaded chitosan hydrogel system, possibly due to its antioxidant properties and better control of inflammatory conditions caused by the use of chitosan and ketorolac in this treatment group.","PeriodicalId":34870,"journal":{"name":"Journal of Orthopedic and Spine Trauma","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43385143","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 : 2023-06-24DOI: 10.18502/jost.v9i3.13018
M. Salehi, L. Seddigh, Sahar Shafagh, Behshad Pazooki, M. Hajmiri, Banafsheh Moradmand-Badie, Nasim Khajavi Rad, S. D. Manshadi, Nima Bagheri, M. Rasolinejad, Seyed Mahmoud Sajadi Jazi
Background: The diabetic foot is a chronic complication of diabetes. There is a strong relationship between glucose levels, the severity of diabetic foot ulcers (DFUs), and the need for amputation. This study aimed to evaluate the blood sugar (BS) trends before and after surgery in patients with DFU who had been amputated. Methods: The adult patients who had undergone DFU-related amputation surgery between 2017 and 2020 in Imam Khomeini Hospital Complex, Tehran, Iran, were evaluated. The cases whose BS levels were charted at least three days before and after amputation were recruited. The main data, including hypoglycemia (defined as a blood glucose level < 70 mg/dl) and mean BS and fasting BS (FBS) levels, were recorded. The data were then analyzed and compared before and after amputation. Results: Of 267 patients reviewed for inclusion criteria, 55 patients were included in the study. Twenty-eight patients (50.9%) were men, and the mean age was 60 years. The mean FBS before and after amputation was 229.5 and 181.3 mg/dl, respectively, and the mean BS before and after amputation was 227.3 and 197.8 mg/dl, respectively. The differences were significant (P < 0.001). Twelve patients (21.8%) before and 21 patients (36.4%) after amputation suffered from hypoglycemia (P = 0.057). Conclusion: DFU-related amputation is associated with a significant decrease in blood glucose levels and inflammatory indexes. However, it can increase the risk of hypoglycemia during the first three days after the surgery.
{"title":"Blood Sugar Trends in Patients with Diabetic Foot Ulcers: A Comparative Study before and after Amputation Surgery","authors":"M. Salehi, L. Seddigh, Sahar Shafagh, Behshad Pazooki, M. Hajmiri, Banafsheh Moradmand-Badie, Nasim Khajavi Rad, S. D. Manshadi, Nima Bagheri, M. Rasolinejad, Seyed Mahmoud Sajadi Jazi","doi":"10.18502/jost.v9i3.13018","DOIUrl":"https://doi.org/10.18502/jost.v9i3.13018","url":null,"abstract":"Background: The diabetic foot is a chronic complication of diabetes. There is a strong relationship between glucose levels, the severity of diabetic foot ulcers (DFUs), and the need for amputation. This study aimed to evaluate the blood sugar (BS) trends before and after surgery in patients with DFU who had been amputated. \u0000Methods: The adult patients who had undergone DFU-related amputation surgery between 2017 and 2020 in Imam Khomeini Hospital Complex, Tehran, Iran, were evaluated. The cases whose BS levels were charted at least three days before and after amputation were recruited. The main data, including hypoglycemia (defined as a blood glucose level < 70 mg/dl) and mean BS and fasting BS (FBS) levels, were recorded. The data were then analyzed and compared before and after amputation. \u0000Results: Of 267 patients reviewed for inclusion criteria, 55 patients were included in the study. Twenty-eight patients (50.9%) were men, and the mean age was 60 years. The mean FBS before and after amputation was 229.5 and 181.3 mg/dl, respectively, and the mean BS before and after amputation was 227.3 and 197.8 mg/dl, respectively. The differences were significant (P < 0.001). Twelve patients (21.8%) before and 21 patients (36.4%) after amputation suffered from hypoglycemia (P = 0.057). \u0000Conclusion: DFU-related amputation is associated with a significant decrease in blood glucose levels and inflammatory indexes. However, it can increase the risk of hypoglycemia during the first three days after the surgery.","PeriodicalId":34870,"journal":{"name":"Journal of Orthopedic and Spine Trauma","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47408087","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 : 2023-06-03DOI: 10.18502/jost.v9i2.12826
M. Soleymani, M. Nabian, Asma Mafhoumi, B. Panjavi, Leila Oriadi Zanjani, S. Mehrpour
Background: Despite the high prevalence of proximal humeral fracture, one of the most prevalent osteoporotic fractures, its treatment has always been challenging. Here we are going to determine the factors that affect the outcomes of such fractures. Methods: The present retrograde cohort study was conducted in a tertiary trauma center during 2015-2020. The Neer classification was used to classify fracture severity. Patients’ functional status was measured using the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire and Constant-Murley Score (CMS). Patients were selected thorough purposive sampling method. Results: The study participants included 70 patients with a mean age of 50.47 ± 16.73 years. The 3 treatment options of open reduction and internal fixation (ORIF) (39 cases; 52%), hemiarthroplasty (3 cases; 4%), and conservative treatment (33 patients; 44%) were considered. Malunion was the most prevalent complication in the study population (9 cases; 12%). The mean DASH score of the participants was 29.91 ± 20.43. The mean DASH score in patients of over 65 years of age was higher than in those under 65 years (36.97 vs. 28.14; P = 0.136). The score in patients underwent surgery (ORIF and hemiarthroplasty) showed a significant difference compared to the patients who were treated non-surgically (P = 0.050). The mean CMS of participants was 64.09 ± 22.71. The mean age of patients classified as “poor” was significantly higher than the “excellent” group (P = 0.041). The mean visual analogue scale (VAS) score of the participants was 2.80 ± 2.49. The VAS score was significantly higher in patients with more severe fracture based on the Neer classification (P = 0.050). Conclusion: The present study results showed the significant effect of age, fracture severity, and underlying disease on the proximal humeral fracture outcome. A longer follow-up period was observed in patients who had better functional outcomes. However, more studies with larger sample size are required to evaluate proximal humeral fracture outcomes in order to help us to improve outcomes and reduce complications.
{"title":"Proximal Humeral Fracture; Predictors of Functional and Radiologic Outcome","authors":"M. Soleymani, M. Nabian, Asma Mafhoumi, B. Panjavi, Leila Oriadi Zanjani, S. Mehrpour","doi":"10.18502/jost.v9i2.12826","DOIUrl":"https://doi.org/10.18502/jost.v9i2.12826","url":null,"abstract":"Background: Despite the high prevalence of proximal humeral fracture, one of the most prevalent osteoporotic fractures, its treatment has always been challenging. Here we are going to determine the factors that affect the outcomes of such fractures. \u0000Methods: The present retrograde cohort study was conducted in a tertiary trauma center during 2015-2020. The Neer classification was used to classify fracture severity. Patients’ functional status was measured using the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire and Constant-Murley Score (CMS). Patients were selected thorough purposive sampling method. \u0000Results: The study participants included 70 patients with a mean age of 50.47 ± 16.73 years. The 3 treatment options of open reduction and internal fixation (ORIF) (39 cases; 52%), hemiarthroplasty (3 cases; 4%), and conservative treatment (33 patients; 44%) were considered. Malunion was the most prevalent complication in the study population (9 cases; 12%). The mean DASH score of the participants was 29.91 ± 20.43. The mean DASH score in patients of over 65 years of age was higher than in those under 65 years (36.97 vs. 28.14; P = 0.136). The score in patients underwent surgery (ORIF and hemiarthroplasty) showed a significant difference compared to the patients who were treated non-surgically (P = 0.050). The mean CMS of participants was 64.09 ± 22.71. The mean age of patients classified as “poor” was significantly higher than the “excellent” group (P = 0.041). The mean visual analogue scale (VAS) score of the participants was 2.80 ± 2.49. The VAS score was significantly higher in patients with more severe fracture based on the Neer classification (P = 0.050). \u0000Conclusion: The present study results showed the significant effect of age, fracture severity, and underlying disease on the proximal humeral fracture outcome. A longer follow-up period was observed in patients who had better functional outcomes. However, more studies with larger sample size are required to evaluate proximal humeral fracture outcomes in order to help us to improve outcomes and reduce complications.","PeriodicalId":34870,"journal":{"name":"Journal of Orthopedic and Spine Trauma","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68133268","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 : 2023-05-03DOI: 10.18502/jost.v9i2.12623
Yousef Fallah, M. Rezaei, Ramin Shayan-Moghadam, Salar Baghbani, Sahar Zafarmandi, E. Mahmoudi
Background: Complex regional pain syndrome (CRPS) is an important common complication after surgical treatment for distal radius fracture. Recognition of the related factors is important to reduce the burden of the problem. Herein, the contributing factors for CRPS after distal radius fracture surgery are studied. Methods: In this cross-sectional comparative study, 250 patients admitted to the orthopedics ward in Sina Hospital in Tehran, Iran, from 2017 to 2020, were enrolled. The contributing factors for CRPS after distal radius fracture surgery were determined in them. Results: The CRPS was seen in 17 cases (6.8%). 9 percent of male and 1.9 percent of female patients were diagnosed with CRPS. This showed a significant difference in the Fisher test (P = 0.028). The mean pain severity by Visual Analogue Scale (VAS) was higher in CRPS cases, that showed a significant difference by the Mann-Whitney test (P = 0.001). Conclusion: According to the obtained results, it may be concluded that CRPS was seen in seven percent of patients under surgery for distal radius fracture and was related to the male gender and higher pain severity.
{"title":"Factors Associated with Complex Regional Pain Syndrome in Patients with Surgically Treated Distal Radius Fracture","authors":"Yousef Fallah, M. Rezaei, Ramin Shayan-Moghadam, Salar Baghbani, Sahar Zafarmandi, E. Mahmoudi","doi":"10.18502/jost.v9i2.12623","DOIUrl":"https://doi.org/10.18502/jost.v9i2.12623","url":null,"abstract":"Background: Complex regional pain syndrome (CRPS) is an important common complication after surgical treatment for distal radius fracture. Recognition of the related factors is important to reduce the burden of the problem. Herein, the contributing factors for CRPS after distal radius fracture surgery are studied. \u0000Methods: In this cross-sectional comparative study, 250 patients admitted to the orthopedics ward in Sina Hospital in Tehran, Iran, from 2017 to 2020, were enrolled. The contributing factors for CRPS after distal radius fracture surgery were determined in them. \u0000Results: The CRPS was seen in 17 cases (6.8%). 9 percent of male and 1.9 percent of female patients were diagnosed with CRPS. This showed a significant difference in the Fisher test (P = 0.028). The mean pain severity by Visual Analogue Scale (VAS) was higher in CRPS cases, that showed a significant difference by the Mann-Whitney test (P = 0.001). \u0000Conclusion: According to the obtained results, it may be concluded that CRPS was seen in seven percent of patients under surgery for distal radius fracture and was related to the male gender and higher pain severity.","PeriodicalId":34870,"journal":{"name":"Journal of Orthopedic and Spine Trauma","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45451217","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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