Pub Date : 2022-08-31DOI: 10.18502/jost.v8i4.10449
Rajendra Rayal, Vishal Shekhawat, Rakesh Dukia, Narendra Joshi, S. Agarwal
Background: Tibial diaphyseal fracture is the most commonly encountered fracture in orthopedic practice. There are various methods to treat the same, ranging from conservative to operative treatment. The operative methods include internal fixation using nailing and plating and external fixation using fixator/ring fixator. This study aims to evaluate the results of primary treatment of segmental tibial fracture in patients with a compromised skin condition using the Ilizarov fixator and look for complications. Methods: This prospective study was conducted at a tertiary level health care center. It included a series of 40 patients with segmental tibial fractures. Classification of the segmental tibial fractures was done according to Melis et al. The fixator was designed with three fixation blocks and two working length sections. The patients were evaluated for the progression clinically and radiographically at 2-week intervals for the first 2 months and were then followed by 4-week intervals. Results were evaluated according to the Association for the Study and Application of the Methods of Ilizarov (ASAMI) classification. Results: We treated 40 patients with a segmental tibial fracture with compromised skin using the Ilizarov ring fixator. Patients were followed up after surgery with an average follow-up of 13.8 months. The average union time came out to be 27.6 weeks for the proximal segment and 33.31 weeks for the distal segment. Out of the total patients, 15 (37.5%) patients had pin tract infection, and one (2.7%) patient had nonunion, which later required bone grafting. Bone results of patients at final follow-up as evaluated by ASAMI score were 91.7% excellent, 5.6% good, and 2.7% poor. Functional results of patients at final follow-up as evaluated by ASAMI score were 80.5% excellent, 1.7% good, and 2.8% poor. Conclusion: In the existing literature, segmental tibial fractures have always been difficult to treat. They are associated with high complication rates due to the lack of surrounding soft tissues. The proximal and distal fragments may be more difficult to treat because of the serious direct injury to the soft tissues overlying the segment and the difficulty stabilizing this bone segment with implants. With the use of Ilizarov technique, there is a good mean time to union, a low rate of reoperations, and good functional and general health-status outcome.
{"title":"Outcomes of Primary Ilizarov Ring Fixator for Segmental Tibial Fracture with Compromised Skin: A Prospective Study","authors":"Rajendra Rayal, Vishal Shekhawat, Rakesh Dukia, Narendra Joshi, S. Agarwal","doi":"10.18502/jost.v8i4.10449","DOIUrl":"https://doi.org/10.18502/jost.v8i4.10449","url":null,"abstract":"Background: Tibial diaphyseal fracture is the most commonly encountered fracture in orthopedic practice. There are various methods to treat the same, ranging from conservative to operative treatment. The operative methods include internal fixation using nailing and plating and external fixation using fixator/ring fixator. This study aims to evaluate the results of primary treatment of segmental tibial fracture in patients with a compromised skin condition using the Ilizarov fixator and look for complications. \u0000Methods: This prospective study was conducted at a tertiary level health care center. It included a series of 40 patients with segmental tibial fractures. Classification of the segmental tibial fractures was done according to Melis et al. The fixator was designed with three fixation blocks and two working length sections. The patients were evaluated for the progression clinically and radiographically at 2-week intervals for the first 2 months and were then followed by 4-week intervals. Results were evaluated according to the Association for the Study and Application of the Methods of Ilizarov (ASAMI) classification. \u0000Results: We treated 40 patients with a segmental tibial fracture with compromised skin using the Ilizarov ring fixator. Patients were followed up after surgery with an average follow-up of 13.8 months. The average union time came out to be 27.6 weeks for the proximal segment and 33.31 weeks for the distal segment. Out of the total patients, 15 (37.5%) patients had pin tract infection, and one (2.7%) patient had nonunion, which later required bone grafting. Bone results of patients at final follow-up as evaluated by ASAMI score were 91.7% excellent, 5.6% good, and 2.7% poor. Functional results of patients at final follow-up as evaluated by ASAMI score were 80.5% excellent, 1.7% good, and 2.8% poor. \u0000Conclusion: In the existing literature, segmental tibial fractures have always been difficult to treat. They are associated with high complication rates due to the lack of surrounding soft tissues. The proximal and distal fragments may be more difficult to treat because of the serious direct injury to the soft tissues overlying the segment and the difficulty stabilizing this bone segment with implants. With the use of Ilizarov technique, there is a good mean time to union, a low rate of reoperations, and good functional and general health-status outcome.","PeriodicalId":34870,"journal":{"name":"Journal of Orthopedic and Spine Trauma","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46946340","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 : 2022-08-31DOI: 10.18502/jost.v8i4.10453
A. Maleki, Seyed Reza Aghapour, Abaalfadel Abbas Saleh
Background: Clubfoot is a multifactorial disease with the prevalence of one in 1000 live births. The presentations of clubfoot are forefoot adductus, hindfoot varus, cavus, and equinus. Ponseti method is an efficient nonoperative clubfoot treatment containing manipulation, serial casting, and Achilles tendon tenotomy if necessary. Our prospective observational study assessed the outcome and probability of recurrence in the treated clubfoot with the Ponseti method. Methods: This prospective observational study was performed in Akhtar Hospital in Tehran, Iran. 27 patients with 38 feet of idiopathic clubfoot in our study were treated with the Ponseti method. The patients were assessed before and after treatment and demographic characteristics, Dimeglio scores, number of recurrenes, and need for tenotomy were recorded. Results: All patients (38 feet) successfully achieved complete deformity correction, but 13 feet had a relapse. The mean age of cases with relapse was more than cases without relapse. Cases with a higher initial Dimeglio score had a higher recurrence rate after Ponseti method treatment. Eight feet (five patients) out of 38 feet did not use Denis Browne (DB) splint as our protocol; all of them had a relapse. On the other hand, only 5 of 30 feet (16.7%) that used splint had recurrence. Conclusion: The treatment should be started as soon as possible because it is more effective at a younger age. Severe cases at the initial visit had more recurrence rate. Besides, the recurrence rate in cases that used DB orthosis improperly, irregularly, and incorrectly was higher than others.
{"title":"Outcomes of the Clubfoot Treatment with the Ponseti Method: Recurrence and Prognostic Factors","authors":"A. Maleki, Seyed Reza Aghapour, Abaalfadel Abbas Saleh","doi":"10.18502/jost.v8i4.10453","DOIUrl":"https://doi.org/10.18502/jost.v8i4.10453","url":null,"abstract":"Background: Clubfoot is a multifactorial disease with the prevalence of one in 1000 live births. The presentations of clubfoot are forefoot adductus, hindfoot varus, cavus, and equinus. Ponseti method is an efficient nonoperative clubfoot treatment containing manipulation, serial casting, and Achilles tendon tenotomy if necessary. Our prospective observational study assessed the outcome and probability of recurrence in the treated clubfoot with the Ponseti method. \u0000Methods: This prospective observational study was performed in Akhtar Hospital in Tehran, Iran. 27 patients with 38 feet of idiopathic clubfoot in our study were treated with the Ponseti method. The patients were assessed before and after treatment and demographic characteristics, Dimeglio scores, number of recurrenes, and need for tenotomy were recorded. \u0000Results: All patients (38 feet) successfully achieved complete deformity correction, but 13 feet had a relapse. The mean age of cases with relapse was more than cases without relapse. Cases with a higher initial Dimeglio score had a higher recurrence rate after Ponseti method treatment. Eight feet (five patients) out of 38 feet did not use Denis Browne (DB) splint as our protocol; all of them had a relapse. On the other hand, only 5 of 30 feet (16.7%) that used splint had recurrence. \u0000Conclusion: The treatment should be started as soon as possible because it is more effective at a younger age. Severe cases at the initial visit had more recurrence rate. Besides, the recurrence rate in cases that used DB orthosis improperly, irregularly, and incorrectly was higher than others.","PeriodicalId":34870,"journal":{"name":"Journal of Orthopedic and Spine Trauma","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42731044","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 : 2022-08-31DOI: 10.18502/jost.v8i4.10457
Maysa Eslami, Farzad Pourghazi, B. Ilharreborde, M. Nabian
The Article Abstract is not available.
文章摘要不可用。
{"title":"Preoperative Radiographic Planning of Adolescent Idiopathic Scoliosis: Educational Corner","authors":"Maysa Eslami, Farzad Pourghazi, B. Ilharreborde, M. Nabian","doi":"10.18502/jost.v8i4.10457","DOIUrl":"https://doi.org/10.18502/jost.v8i4.10457","url":null,"abstract":"The Article Abstract is not available.","PeriodicalId":34870,"journal":{"name":"Journal of Orthopedic and Spine Trauma","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47985072","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}
Nasrin Navaeifa, A. Tabrizi, Mehrdad Motalebizadeh
Background: Vitamin B12 is a micronutrient essential for deoxyribonucleic acid (DNA) synthesis, which can affect osteogenesis. Based on in-vivo investigations, vitamin B12 is associated with osteogenesis, and low levels of this vital vitamin in the human body can be related to an increased risk of osteoporosis. Methods: In this descriptive-analytical study, 60 women over 65 years who visited an orthopedic clinic were included. They were divided into three groups based on bone density in the hip and lumbar areas using dual-energy X-ray absorptiometry (DEXA) scans, including normal bone density, osteopenia, and osteoporosis. The average serum level of vitamin B12 in the experimental subjects was then determined and compared. Results: 6 (10%) showed normal bone density, 25 (41.7%) osteopenia, and 29 (48.3%) were considered to have osteoporosis. Measured vitamin B12 levels showed no statistically significant difference between the two groups of normal bone density (601.3 ± 194.8) and osteopenia (560.4 ± 131.5). However, there was a significant statistical difference between vitamin B12 levels in people with osteoporosis (400.7 ± 162.4) and the two groups of normal and osteopenic individuals. There was also a negative statistical relationship between vitamin B12 levels and bone density (P = 0.004, r = -0.8). Conclusion: A low serum level of vitamin B12 is associated with a severe decline in bone density in elderly Iranian women.
{"title":"Association between Serum Vitamin B12 Level and Bone Mineral Density in Older Women","authors":"Nasrin Navaeifa, A. Tabrizi, Mehrdad Motalebizadeh","doi":"10.18502/jost.v8i3.9905","DOIUrl":"https://doi.org/10.18502/jost.v8i3.9905","url":null,"abstract":"Background: Vitamin B12 is a micronutrient essential for deoxyribonucleic acid (DNA) synthesis, which can affect osteogenesis. Based on in-vivo investigations, vitamin B12 is associated with osteogenesis, and low levels of this vital vitamin in the human body can be related to an increased risk of osteoporosis. \u0000Methods: In this descriptive-analytical study, 60 women over 65 years who visited an orthopedic clinic were included. They were divided into three groups based on bone density in the hip and lumbar areas using dual-energy X-ray absorptiometry (DEXA) scans, including normal bone density, osteopenia, and osteoporosis. The average serum level of vitamin B12 in the experimental subjects was then determined and compared. \u0000Results: 6 (10%) showed normal bone density, 25 (41.7%) osteopenia, and 29 (48.3%) were considered to have osteoporosis. Measured vitamin B12 levels showed no statistically significant difference between the two groups of normal bone density (601.3 ± 194.8) and osteopenia (560.4 ± 131.5). However, there was a significant statistical difference between vitamin B12 levels in people with osteoporosis (400.7 ± 162.4) and the two groups of normal and osteopenic individuals. There was also a negative statistical relationship between vitamin B12 levels and bone density (P = 0.004, r = -0.8). \u0000Conclusion: A low serum level of vitamin B12 is associated with a severe decline in bone density in elderly Iranian women.","PeriodicalId":34870,"journal":{"name":"Journal of Orthopedic and Spine Trauma","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48598670","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}
A. Sadeghpour, S. H. Ghaffari, Jafar Ganjpour Sales, Hossein Aslani, A. Zeinalzadeh
Background: Quality of the bone before surgery determines the choice of the appropriate prosthesis and the surgical approach as well as the result of total hip arthroplasty (THA). The proximal femur morphology determines the decision of cemented or uncemented THA, and the Dorr classification is often employed for this purpose. Methods: 100 patients over the age of 40 who had been referred to the emergency department of Shohada Hospital, Tabriz, Iran, for any reason and had an accurate pelvic anteroposterior (AP) X-ray with proximal femur were included in this study, and Dorr classification and mean cortical thickness index (CTI) just below the lesser trochanter and 10 cm below it were measured. Results: In this study, the Dorr classification differed significantly in men and women, and type C was higher in women. Classification is strongly subjected to the surgeon's clinical experience, and training class significantly affects it. There was a significant relationship (P < 0.001) between the CTI 10 cm below the trochanter and just below it. Conclusion: The proximal femur morphology covers a wide range. Therefore, it is difficult to determine the exact morphology, especially for groups B and C. There was also a significant correlation between the mean CTI below the lesser trochanter and 10 cm below it. Therefore, we think this is a practical and most straightforward method for classifying proximal femur morphology with cortical index (CI) just below the lesser trochanter and 10 cm below it, especially for inexperienced training residents.
{"title":"The Dorr Type and Cortical Thickness Index just Below the Lesser Trochanter and its Comparison with Cortical Thickness Index Ten Centimeters Below the Tip of the Lesser Trochanter: A Cross-Sectional Study","authors":"A. Sadeghpour, S. H. Ghaffari, Jafar Ganjpour Sales, Hossein Aslani, A. Zeinalzadeh","doi":"10.18502/jost.v8i3.9904","DOIUrl":"https://doi.org/10.18502/jost.v8i3.9904","url":null,"abstract":"Background: Quality of the bone before surgery determines the choice of the appropriate prosthesis and the surgical approach as well as the result of total hip arthroplasty (THA). The proximal femur morphology determines the decision of cemented or uncemented THA, and the Dorr classification is often employed for this purpose. \u0000Methods: 100 patients over the age of 40 who had been referred to the emergency department of Shohada Hospital, Tabriz, Iran, for any reason and had an accurate pelvic anteroposterior (AP) X-ray with proximal femur were included in this study, and Dorr classification and mean cortical thickness index (CTI) just below the lesser trochanter and 10 cm below it were measured. \u0000Results: In this study, the Dorr classification differed significantly in men and women, and type C was higher in women. Classification is strongly subjected to the surgeon's clinical experience, and training class significantly affects it. There was a significant relationship (P < 0.001) between the CTI 10 cm below the trochanter and just below it. \u0000Conclusion: The proximal femur morphology covers a wide range. Therefore, it is difficult to determine the exact morphology, especially for groups B and C. There was also a significant correlation between the mean CTI below the lesser trochanter and 10 cm below it. Therefore, we think this is a practical and most straightforward method for classifying proximal femur morphology with cortical index (CI) just below the lesser trochanter and 10 cm below it, especially for inexperienced training residents.","PeriodicalId":34870,"journal":{"name":"Journal of Orthopedic and Spine Trauma","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48602807","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: Proximal humerus shortening and varus can occur secondary to neonatal shoulder septic arthritis and focal fibrocartilage dysplasia. Valgus osteotomy of the proximal humerus compensates for a little bite of shortening, and improves the shoulder joint's range of motion. Case Report: In this study, we present two patients with severe proximal humerus deformity following glenohumeral septic arthritis. Both of them underwent valgus osteotomy, and had a satisfactory result in terms of range of motions and cosmesis at five years follow-up. Conclusion: Treatment of varus deformity of proximal humerus is challenging issue. There are few reports of surgical treatment. Sever varus deformity of proximal humerus impacts the motion of shoulder. We reported a novel method of valgus osteotomy of proximal humerus in patients with severe varus deformity secondary to neonatal septic arthritis and long-term clinical follow-up.
{"title":"Treatment of Proximal Humerus Varus Deformity Secondary to Neonatal Glenohumeral Septic Arthritis: A Case Report","authors":"R. Kamrani, Kian Zohrabi","doi":"10.18502/jost.v8i3.9912","DOIUrl":"https://doi.org/10.18502/jost.v8i3.9912","url":null,"abstract":"Background: Proximal humerus shortening and varus can occur secondary to neonatal shoulder septic arthritis and focal fibrocartilage dysplasia. Valgus osteotomy of the proximal humerus compensates for a little bite of shortening, and improves the shoulder joint's range of motion. \u0000Case Report: In this study, we present two patients with severe proximal humerus deformity following glenohumeral septic arthritis. Both of them underwent valgus osteotomy, and had a satisfactory result in terms of range of motions and cosmesis at five years follow-up. \u0000Conclusion: Treatment of varus deformity of proximal humerus is challenging issue. There are few reports of surgical treatment. Sever varus deformity of proximal humerus impacts the motion of shoulder. We reported a novel method of valgus osteotomy of proximal humerus in patients with severe varus deformity secondary to neonatal septic arthritis and long-term clinical follow-up.","PeriodicalId":34870,"journal":{"name":"Journal of Orthopedic and Spine Trauma","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46929379","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}
Mir Mansour Moazen Jamshidi, Behzad Nezhad Tabrizi, E. Fallah, Mazaher Ebrahimian, Ali Salehi, A. Moharram, S. M. J. Mortazavi
During an open fracture, the barrier of skin that protects the bones is breached, and the unprotected bones are exposed to the environment, resulting in contamination that leads to hematoma formation. It is often found that open fractures are associated with a high rate of morbidity and infection. In spite of the lack of evidence supporting negative pressure wound therapy (NPWT), open fractures may benefit from it. An increasing number of studies have demonstrated that it can be used to treat open fractures and open complex wounds after failure of arthroplasty or spinal surgery. Based on the recent studies and evidence, we reviewed the role of the NPWT in the open fracture in the present study.
{"title":"Negative Pressure Wound Therapy Uses in Orthopedic Open Fracture: A Current Concept Review","authors":"Mir Mansour Moazen Jamshidi, Behzad Nezhad Tabrizi, E. Fallah, Mazaher Ebrahimian, Ali Salehi, A. Moharram, S. M. J. Mortazavi","doi":"10.18502/jost.v8i3.9903","DOIUrl":"https://doi.org/10.18502/jost.v8i3.9903","url":null,"abstract":"During an open fracture, the barrier of skin that protects the bones is breached, and the unprotected bones are exposed to the environment, resulting in contamination that leads to hematoma formation. It is often found that open fractures are associated with a high rate of morbidity and infection. In spite of the lack of evidence supporting negative pressure wound therapy (NPWT), open fractures may benefit from it. An increasing number of studies have demonstrated that it can be used to treat open fractures and open complex wounds after failure of arthroplasty or spinal surgery. Based on the recent studies and evidence, we reviewed the role of the NPWT in the open fracture in the present study.","PeriodicalId":34870,"journal":{"name":"Journal of Orthopedic and Spine Trauma","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48607969","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}
{"title":"A Google Trends Analysis of Orthopedic Surgery Interests during the COVID-19 Pandemic","authors":"A. Ebrahimpour, A. Afshar, A. Tabrizi","doi":"10.18502/jost.v8i3.9913","DOIUrl":"https://doi.org/10.18502/jost.v8i3.9913","url":null,"abstract":"\u0000 \u0000 \u0000 \u0000 \u0000 \u0000 \u0000The Article Abstract is not available. \u0000 \u0000 \u0000 \u0000 \u0000 \u0000 \u0000 \u0000 \u0000 \u0000","PeriodicalId":34870,"journal":{"name":"Journal of Orthopedic and Spine Trauma","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48629327","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}
K. Kumar, Balakrishna Bathina, Tankala Jayadev, Manindhar Sane
Background: Ankle ligament injuries in the sports like basketball, volleyball, and cricket are the most common reasons for missed participation in athletics, accounting for 14% of all sports injuries. These injuries may often require splinting and rest for a longer duration, leading to a permanently reduced level of sports performance. The autologous conditioned cytokine-rich serum (ACRS) is becoming a reliable treatment option in acute ankle injuries as it enhances biological healing. The objective of this study is to evaluate the role of ACRS in acute ankle injuries and report the efficacy of ACRS injections on time to return to physical activities. Methods: 42 patients with clinical and radiological signs of ankle ligamentous injuries (grades 1 and 2) secondary to sporting or gaming activity were recruited for this study. Each patient received one injection of ACRS at the injury site and was put on a soft cast for one week. Clinical and functional evaluation was performed using the Visual Analogue Scale (VAS), American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Scale, and the Foot and Ankle Disability Index (FADI) scores before the injection, at one week, i.e., after removing the soft cast, three weeks, six weeks, and three months. Results: Our study showed gradual improvement of all the evaluation scales at all the follow-ups. Few patients showed minor side effects like aseptic effusion. The least common complaint was a pain in the subsequent days after the injection. Conclusion: Our results, in conjunction with pre-existing studies in the literature regarding the biological effects of ACRS, demonstrate the viability of this therapy for the treatment of acute ankle injuries, showing the positive influence on pain and healing capacity and returning to gaming activities immediately in about two weeks without significant adverse effects.
{"title":"Clinical and Functional Results Using Autologous Conditioned Serum in the Treatment of Acute Ankle Injuries in Sporting Activities","authors":"K. Kumar, Balakrishna Bathina, Tankala Jayadev, Manindhar Sane","doi":"10.18502/jost.v8i3.9906","DOIUrl":"https://doi.org/10.18502/jost.v8i3.9906","url":null,"abstract":"Background: Ankle ligament injuries in the sports like basketball, volleyball, and cricket are the most common reasons for missed participation in athletics, accounting for 14% of all sports injuries. These injuries may often require splinting and rest for a longer duration, leading to a permanently reduced level of sports performance. The autologous conditioned cytokine-rich serum (ACRS) is becoming a reliable treatment option in acute ankle injuries as it enhances biological healing. The objective of this study is to evaluate the role of ACRS in acute ankle injuries and report the efficacy of ACRS injections on time to return to physical activities. \u0000Methods: 42 patients with clinical and radiological signs of ankle ligamentous injuries (grades 1 and 2) secondary to sporting or gaming activity were recruited for this study. Each patient received one injection of ACRS at the injury site and was put on a soft cast for one week. Clinical and functional evaluation was performed using the Visual Analogue Scale (VAS), American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Scale, and the Foot and Ankle Disability Index (FADI) scores before the injection, at one week, i.e., after removing the soft cast, three weeks, six weeks, and three months. \u0000Results: Our study showed gradual improvement of all the evaluation scales at all the follow-ups. Few patients showed minor side effects like aseptic effusion. The least common complaint was a pain in the subsequent days after the injection. \u0000Conclusion: Our results, in conjunction with pre-existing studies in the literature regarding the biological effects of ACRS, demonstrate the viability of this therapy for the treatment of acute ankle injuries, showing the positive influence on pain and healing capacity and returning to gaming activities immediately in about two weeks without significant adverse effects.","PeriodicalId":34870,"journal":{"name":"Journal of Orthopedic and Spine Trauma","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42558860","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. Ahmadinejad, S. Rashidi, M. S. Kahrizi, F. Moghadasi, I. Ahmadinejad, A. Najafi
Background: Neurilemmomas also called schwannomas are benign tumors originating from the Schwann cells participating in the peripheral nerve sheath and the pathophysiology of the formation of these tumors is not completely understood. Schwannomas are mostly benign with equal incidence rate in men and women. These tumors have been mainly found in the head and neck, upper extremities, and the trunk. Lower extremity schwannomas are extremely rare, specifically in the dorsum of the foot. Case Report: In this report, we present an 18-year-old man referred to surgery clinic with a painful mass on the anterolateral dorsal aspect of his left ankle with radicular pain and paresthesia to the distal dorsum of the forefoot. After completing all the assessments including ultrasonography and magnetic resonance imaging (MRI), he underwent the surgical resection procedure. The pathology laboratory reported an encapsulated 35 * 20 * 15 mm solitary benign schwannoma. Conclusion: The dorsal aspect of the foot is an extremely rare site for schwannoma formation, but practitioners should always be aware of rare underlying diseases for neurologic deficits or just a simple pain in the lower extremities.
{"title":"A Rare Case of a Schwannoma in the Dorsal Aspect of the Foot: A Case Report of an 18-Year-Old Man with an Ankle Mass","authors":"M. Ahmadinejad, S. Rashidi, M. S. Kahrizi, F. Moghadasi, I. Ahmadinejad, A. Najafi","doi":"10.18502/jost.v8i3.9911","DOIUrl":"https://doi.org/10.18502/jost.v8i3.9911","url":null,"abstract":"Background: Neurilemmomas also called schwannomas are benign tumors originating from the Schwann cells participating in the peripheral nerve sheath and the pathophysiology of the formation of these tumors is not completely understood. Schwannomas are mostly benign with equal incidence rate in men and women. These tumors have been mainly found in the head and neck, upper extremities, and the trunk. Lower extremity schwannomas are extremely rare, specifically in the dorsum of the foot. \u0000Case Report: In this report, we present an 18-year-old man referred to surgery clinic with a painful mass on the anterolateral dorsal aspect of his left ankle with radicular pain and paresthesia to the distal dorsum of the forefoot. After completing all the assessments including ultrasonography and magnetic resonance imaging (MRI), he underwent the surgical resection procedure. The pathology laboratory reported an encapsulated 35 * 20 * 15 mm solitary benign schwannoma. \u0000Conclusion: The dorsal aspect of the foot is an extremely rare site for schwannoma formation, but practitioners should always be aware of rare underlying diseases for neurologic deficits or just a simple pain in the lower extremities.","PeriodicalId":34870,"journal":{"name":"Journal of Orthopedic and Spine Trauma","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46038232","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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