for Journals by Title or ISSN
for Articles by Keywords
Followed Journals
Journal you Follow: 0
Sign Up to follow journals, search in your chosen journals and, optionally, receive Email Alerts when new issues of your Followed Jurnals are published.
Already have an account? Sign In to see the journals you follow.
Journal Cover Archives of Bone and Joint Surgery
  This is an Open Access Journal Open Access journal
     ISSN (Print) 2345-4644 - ISSN (Online) 2345-461X
     Published by Mashhad University of Medical Sciences Homepage  [11 journals]
  • Tranexamic acid in total joint arthroplasty: efficacy and safety

    • Abstract: Various blood conservation strategies have developed to reduce need for allogenic blood transfusion in patients undergoing total joint arthroplasty (TJA). Undoubtedly, one of the most effective blood conservative strategies that have been introduced is administration of Tranexamic acid (TA). TA is a synthetic lysine derivative drug that binds to plasminogen and prevents interaction of plasminogen with fibrin that eventually leads to dissolution of fibrin clot.There is level I evidence about efficacy of TA in reducing blood loss and need for allogenic transfusion in primary total hip and total knee arthroplasties. Despite proven efficacy of TA in TJA, there are still little concerns about predisposition of TJA patients to venous thromboembolism following use of TA and is advised that patients with cardiac stents and previous thromboembolic events including ischemic stroke not be administered TA. In conclusion, administration of TA in TJA patient is a cost-effective blood conservation strategy and there are strong evidences about efficacy and safety of the drug in reducing blood loss and transfusion in TJA patients. Given adverse effects of allogenic blood transfusion on outcome of TJA patient, administration of TA should be considered in patients with no contraindication of use of TA undergoing TJA.
      PubDate: Tue, 09 Dec 2014 20:30:00 +010
  • Doctor Shoja-ad-Din Sheikholeslamzadeh and his Achievements

    • Abstract: Doctor Shoja-ad-Din Sheikholeslamzadeh (Dr. Sheikh) (1931- 2014) was an outstanding orthopedic surgeon. He is credited for the establishment of the Association of Rehabilitation, Shafa Yahyaian Hospital as an Orthopedic and Rehabilitation Center, Social Welfare Organization , Iran’s whole country emergency service (115) and many other fundamental projects for upgrading the health care services. He served as the Minister of Social Welfare and Minister of Health and Welfare before Islamic revolution. The history of modern health care management and modern orthopedic surgery in Iran are indebted to great leadership and executive abilities of Dr. Sheikh. Doctor Shoja-ad-Din Sheikholeslamzadeh (Dr. Sheikh) (1931- 2014) was an outstanding orthopedic surgeon. He is credited for the establishment of the Association of Rehabilitation, Shafa Yahyaian Hospital as an Orthopedic and Rehabilitation Center, Social Welfare Organization , Iran’s whole country emergency service (115) and many other fundamental projects for upgrading the health care services. He served as the Minister of Social Welfare and Minister of Health and Welfare before Islamic revolution. The history of modern health care management and modern orthopedic surgery in Iran are indebted to great leadership and executive abilities of Dr. Sheikh.
      PubDate: Tue, 09 Dec 2014 20:30:00 +010
  • Bilateral Neck Femur Fracture following a Generalized Seizure- A rare case

    • Abstract: Hip fractures are one of the most common injuries which present to an orthopaedic surgeon. Most of these cases are unilateral .Bilateral simultaneous femur neck fracture is a rare occurrence. We report a case of a bilateral neck femur fracture in a 30 year male following a generalized tonic clonic seizure in view of its rarity and also to increase the awareness of such rare injuries. The patient was operated within 3 hours. At 5 months, the patient had good radiological and functional outcome. During a convulsion, there is a powerful and forceful contraction of muscles which may lead to fracture or dislocation. The incidence of fractures following a convulsion is 1.1%. A delay in diagnosis can lead to complications like avascular necrosis, osteoarthritis, non union, functional disability and legal consequences. All orthopaedic surgeons and emergency physicians should be aware of such uncommon injuries to ensure early diagnosis and treatment.
      PubDate: Tue, 09 Dec 2014 20:30:00 +010
  • Small finger metacarpal shaft wedged between ring and small metacarpal
           bases: a report of 2 cases

    • Abstract: We present two patients with a displaced fracture of the small finger metacarpal base, where the shaft of the small finger metacarpal was wedged between the bases of the ring and small finger metacarpals. The striking appearance on radiographs led to initial recommendations for surgery, but both patients preferred non-operative treatment and did well in the short term without surgery. DiscussionWe thought these two fractures were interesting because their striking appearance on radiographs led to recommendations for surgery, but both patients preferred non-operative treatment and did very well in the short term. In 1970, Hunter et al. (3) reviewed 45 fifth metacarpal base fractures and reported that those without articular involvement tend to heal rapidly with an average period of disability of less than a month. While we have no long-term follow-up, no form of deterioration is anticipated with a healed extra-articular fracture.The typical deformity of small finger metacarpal fractures is apex dorsal, creating a “sunken knuckle” or “lump in palm” deformity (6). With small finger metacarpal base fractures, the usual concern relates to articular involvement (1). In our two patients, the small finger metacarpal shaft was in a stable position between the bases of the ring and small finger metacarpals, resulting in no rotation, and minimal shortening or angular deformity of the distal metacarpal fragment. As long as the fracture is stable, splinting of the hand in a functional position followed by mobilization and early use of the hand has been shown to lead to early return to active duty with a fully functional hand (3-5).For other patients and surgeons making management decisions, we felt it would be helpful to have similar fractures to read about with the lesson that as striking as the radiographs may appear, non-operative treatment is an option.
      PubDate: Tue, 09 Dec 2014 20:30:00 +010
  • Primary Osteosarcoma of the Sternum: A case Report and Review of the

    • Abstract: Osteosarcoma (osteogenic sarcoma: OS) is the most common primary malignant bone tumor in long bones , but Primary osteosarcoma of chest wall especially in sternum is extremely rare. We report a 57-year-old man with an immobile slow growing mass in middle part of sternum. He had no significant pain or tenderness and his past medical history was negative. CT scan showed a large densely sclerotic sternal mass and MRI showed extensive central signal loss within tumor due to new bone formation. CT guided needle biopsy performed but it was inconclusive. A high-grade osteosarcoma of the sternum was diagnosed by incisinal biopsy. He underwent subtotal sternal resection and reconstruction with the use of synthetic mesh and bone cement with a good post operative course and followed by chemotherapy and external beam radiotherapy. Now, after one year, he normally lives and performs her usual tasks. No evidence of focal recurrence or metastatic disease is seen.
      PubDate: Tue, 09 Dec 2014 20:30:00 +010
  • Comparison of internal fixation with blade plate with casting in distal
           femoral osteotomy

    • Abstract: Objection: To compare the results of two different ways for distal femoral osteotomy stabilization, internal fixation with plate and casting in patients suffering from genovalgum. Methods: In a non-randomized prospective study, after distal femoral osteotomy with zigzag method, patient divided into two groups: long leg casting, and internal fixation with blade plate. For all patients, questionnaires were filled to obtain data. Information such as range of motion, Tibiofemoral anatomical angle and complications were recorded. Results: 38 knees with valgus deformity underwent distal femoral supracondylar osteotomy. (8 with plaster cast and 30 internal fixation with a blade plate). Preoperative range of motion was 129±6 and six months later it was 120±14. Preoperative Tibiofemoral angle was 32±6; postoperative Tibiofemoral angles were 3±3, 6±2, and 7±3 just after operation, six months and two years later respectively. Although this angle had higher levels among group stabilized with cast but this difference wasn't significant. In postoperative complication, over correction was found in 5, recorvatom deformity in 1, knee Stiffness in 3 and superficial wound infection was recorded in 3 knees. Conclusion: Supracondylar osteotomy is an effective with low complication procedure for correction of knee deformities specially genuvalgum. There is no prominent difference in final range of motion and alignment whether fixation done with casting or internal fixation. However, complication rate seems more in the casting method.
      PubDate: Tue, 09 Dec 2014 20:30:00 +010
  • Granular cell tumor presenting as a large leg mass

    • Abstract: AbstractGranular cell tumor is a rare benign neoplasm that is more frequently found in the head and neck region . Clinically, these tumours are rare and account for approximately 0.5% of all soft tissue tumours. Most granular cell tumors occur in the head and neck region, especially in the tongue, cheek mucosa, and Palate. [3] Granular cell tumor is a rare tumor that can affect various organs of the body, such as the skin, soft tissues, breast, and lungs. They have a higher potential for local recurrence and metastasis with poor prognosis than their benign counterparts .In literature the common site of this tumor is tongue.This tumor is very rare in limbs and also the common size of tumor is 2-3 cm.We report it in the leg where this tumor is much more uncommon for this location and many of orthopedic surgeons have not hear these term and was presented in very uncommon size.
      PubDate: Tue, 09 Dec 2014 20:30:00 +010
  • Heterotopic ossification around the knee after internal fixation of a
           complex tibial plateau ...

    • Abstract: Demineralized bone matrix has been successfully commercialized as an alternative bone graft material that not only can function as filler but also as an osteoinductive graft. Numerous studies have confirmed its beneficial use in clinical practice. Heterotopic ossification after internal fixation combined with the use of demineralized bone matrix has not been widely reported. In this paper we describe a 39 year old male who sustained a complex articular fracture that developed clinically significant heterotopic ossification after internal fixation with added demineralized bone matrix. Although we cannot be sure that there is a cause-and-effect relation between demineralized bone matrix and the excessive heterotopic ossification seen in our patient, it seems that some caution in using demineralised bone matrix in similar cases is warranted. Also, given the known inter- and intraproduct variability, the risks and benefits of these products should be carefully weighed. Demineralized bone matrix has been successfully commercialized as an alternative bone graft material that not only can function as filler but also as an osteoinductive graft. Numerous studies have confirmed its beneficial use in clinical practice. Heterotopic ossification after internal fixation combined with the use of demineralized bone matrix has not been widely reported. In this paper we describe a 39 year old male who sustained a complex articular fracture that developed clinically significant heterotopic ossification after internal fixation with added demineralized bone matrix. Although we cannot be sure that there is a cause-and-effect relation between demineralized bone matrix and the excessive heterotopic ossification seen in our patient, it seems that some caution in using demineralised bone matrix in similar cases is warranted. Also, given the known inter- and intraproduct variability, the risks and benefits of these products should be carefully weighed.
      PubDate: Tue, 09 Dec 2014 20:30:00 +010
  • Epidemiology of Hand Injuries in Children Presenting to an Orthopedic
           Trauma Center in ...

    • Abstract: Background:  Hand injuries are among the most common childhood injuries. No study has been performed regarding the epidemiology of hand injuries in the pediatric population of Iran. This study aimed to examine the epidemiology of hand injuries among children in southeast of Iran.   Methods:  This cross-sectional study was performed via census sampling on patients, aged 16 years or less, with a final diagnosis of hand injury. Patients presenting to the orthopedic department of Khatam-al-Anbia General Hospitalof Zahedan, Iran, were selected from March 2012 to December 2013. Data were analyzed  trospectively, using a chart review. Results:  Two-hundred patients (136 males and 64 females with the mean age of 13±2.8 years) with 205 hand injuries were included in this study. As the results indicated, door-related injuries were the most common type (25%), accounting for 24% and 28% of injuries in male and female patients, respectively (P=0.016). Most injuries occurred at home (64%) and the lowest number was reported at school(22%) (P=0.012). Compared to boys, girls were more likely to be injured at home (78% vs. 57%) (P=0.13). In addition, the dominant hand was mostly injured by doors (28%). The most common type of injury was laceration(81%) and the least common type was finger amputation (7%); also, children with finger amputation were significantly younger than those with other types of hand injuries (P<0.001).Thumb alone (20%) and index and middle fingers together with anequal percentage (3.5%) were the most commonly injured digits. Also, the mean hospitalization cost was 297± 38 dollars. Conclusions:  Most hand injuries occurred at home and were door-related; they were also more frequentamong younger children. Prospective studies in order to identify specific protective door devices could potentially decrease the frequency of these injures.
      PubDate: Fri, 19 Sep 2014 19:30:00 +010
  • Soluble Mediators in Posttraumatic Wrist and Primary Knee Osteoarthritis

    • Abstract: Background:  New discoveries about the pathophysiology changed the concept that all forms of osteoarthritis are alike; this lead to the delineation of different phenotypes such as age, trauma or obese related forms. We aim to compare soluble mediator profiles in primary knee and posttraumatic wrist osteoarthritis. Based on the general faster progression rate of wrist osteoarthritis, we hypothesize a more inflammatory profile. Methods: We collected synovial fluid from 20 primary osteoarthritic knee and 20 posttraumatic osteoarthritic wrist joints. 17 mediators were measured by multiplex enzyme-linked immunosorbent assay: chemokine ligand 5, interferon-γ, leukemia inhibitory factor, oncostatin-M, osteoprotegerin, tumor necrosis factor-α, vascular endothelial growth factor, interleukin (IL)-1α, IL-1β, IL-1 receptor antagonist, IL-4, IL-6, IL-7, IL-8, IL-10, IL-13 and IL-17. Results:  Ten mediators were higher in posttraumatic osteoarthritic synovial fluid: tumor necrosis factor-α (TNFα), IL-1α, IL-1RA, IL-6, IL-10, IL-17, oncostatin-M, interferon-γ, chemokine ligand 5 and leukemia inhibitory factor(P<0.001). IL-1ß, IL-4, IL-7 were not detected, TNFα was not detected in knee osteoarthritic synovial fluid. IL-8, IL-13, osteoprotegerin and vascular endothelial growth factor levels did not differ between the synovial fluid types.  Conclusions:  In general wrist osteoarthritis seems characterized by a stronger inflammatory response than primary knee osteoarthritis. More pronounced inflammatory mediators might offer a paradigm for the faster progression of posttraumatic osteoarthritis. Increase of specific mediators could form a possible target for future mediator modulating therapy in wrist osteoarthritis.
      PubDate: Thu, 11 Sep 2014 19:30:00 +010
  • Multiple Rib Exostoses in a Boy: A Rare CaseResulting in Surgery Secondary
           to Cosmetic Concerns

    • Abstract: A seven year-old boy with several painless masses on the ribs and shoulder was referred to our hospital. The masses were so prominent that they prevented the child’s sleep. Since the patient had been ridiculed by his friends due to the rib prominences, he had refused to attend school. After clinical and radiological evaluations, the masses were diagnosed as hereditary multiple exostoses of the shoulder and ribs. He underwent surgery for cosmetic reasons resulting in the patient’s return to a normal life.
      PubDate: Fri, 05 Sep 2014 19:30:00 +010
  • Greetings from the Editor

    • PubDate: Sun, 31 Aug 2014 19:30:00 +010
  • Biopsy in Musculoskeletal Tumors

    • PubDate: Sun, 31 Aug 2014 19:30:00 +010
  • Reconstruction of the Acetabulum in Developmental Dysplasia of the Hip in
           Total Hip Replacement

    • Abstract: Developmental dysplasia of the hip (DDH) or congenital hip dysplasia (CDH) is the most prevalent developmental childhood hip disorder. It includes a wide spectrum of hip abnormalities ranging from dysplasia to subluxation and complete dislocation of the hip joint. The natural history of neglected DDH in adults is highly variable. The mean age of onset of symptoms is 34.5 years for dysplastic DDH, 32.5 years for low dislocation, 31.2 years for high dislocation with a false acetabulum, and 46.4 years for high dislocation without a false acetabulum. Thorough understanding of the bony and soft tissue deformities induced by dysplasia is crucial for the success of total hip arthroplasty. It is important to evaluate the existing acetabular deformity three-dimensionally, and customize the correction in accordance with the quantity and location of ace tabular deficiencies. Acetabular reconstruction in patients with DDH is hallenging. Interpretation of published data is difficult and should be done with caution because most series include patients with different types of hip disease. In general, the complication rate associated with THA is higher in patients with hip dysplasia than it is in patients with osteoarthritis. Overall, clinical and functional outcomes following THA in patients hip dysplasia (DDH) differ from those treated for primary hip osteoarthritis, possibly due to the lower age and level of activity. Although function scores decline with age, the scores for pain and range of motion presented with a statistically significant improvement in the long-term.
      PubDate: Sun, 31 Aug 2014 19:30:00 +010
  • Medial Unicompartmental Osteoarthritis (MUO) of the Knee: Unicompartmental
           Knee Replacement ...

    • Abstract: The aim of this review article is to analyze the clinical effectiveness of total knee replacement (TKR) compared to unicompartmental knee replacement (UKR) in patients with medial unicompartmental osteoarthritis (MUO) in terms of survival rates, revision rates and postoperative complications. The search engine was MedLine. The keywords used were: medial knee osteoarthritis. Three thousand and ninety-six articles were found on 28 April 2014. Of those, only twenty-eight were selected and reviewed because they were strictly focused on the topic of this article. Compared with those who have TKR, patients who undergo UKR have higher revision rates and lower survival rates at 5, 10 and 15 years. The reported overall risk of postoperative complications for patients undergoing TKR is 11%, compared with 4.3% for patients undergoing UKR. In conclusion, UKR have higher revision rates and lower survival rates than TKR. There is, however, an increased risk of postoperative complications after TKR.
      PubDate: Sun, 31 Aug 2014 19:30:00 +010
  • Intraarticular Administration of Tranexamic Acid Following Total Knee
           Arthroplasty: A ...

    • Abstract: Background:  Tranexamic acid (TXA) has received extensive attention in management of blood loss in orthopedic surgeries. However, the ideal method of TXA administration is still controversial. This study aims to determine whether intraarticular injection of TXA reduces blood loss after total knee arthroplasty (TKA).   Methods:  Through a retrospective case-control study consecutive TKA patients receiving intraarticular TXA (Case group) were compared with similar patients undergoing TKA using traditional blood management strategy (Control group). Hemoglobin levels (Hb) before and after the surgery, need for transfusion, and reoperation due to massive blood loss were compared between the two groups.   Results:  Fifty TXA patients were compared with 50 patients of the control group. There was no significant difference between the two groups in terms of age, gender, and preoperative Hb. Postoperative blood loss and transfusion rate were significantly reducedin TXA patients compared to the control group (P<0.05). Conclusions:  Our study revealed that intraarticular administration of TXA reduces postoperative blood loss as well as need for blood transfusion in patients undergoing TKA.    
      PubDate: Sun, 31 Aug 2014 19:30:00 +010
  • In-Hospital Outcomes after Hemiarthroplasty versus Total Hip Arthroplasty
           for Isolated Femoral ...

    • Abstract:   Background:    Previous studies suggest total hip arthroplasty may have some benefits compared to hemi-arthroplasty for displaced intracapsular femoral neck fractures in patients more than 60 years of age. The primary research question of our study was whether in-hospital adverse events, post-operative length of stay (LOS) and mortality in patients 60 year of age or older differed between total hip and hemi-arthroplasty for femoral neck fracture.    Methods:    We obtained data on 82951 patients more than 60 years of age with an isolated femoral neck fracture treated with either hemi-arthroplasty or total hip arthroplasty in 2009 or 2010 from the National Hospital Discharge Survey (NHDS) database. The International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9, CM) was used to code diagnoses, comorbidities, complications, and procedures.    Results:    Controlling for demographics and comorbidities, patients treated with hemi-arthroplasty had a 40% (95% CI 1.4-1.5) higher risk of adverse events compared to patients treated with a total hip arthroplasty. Length of stay and in-hospital mortality did not differ between these groups.  Conclusions:   The observed advantage for total hip arthroplasty might reflect greater infirmity in hemi-arthroplasty patients that was not accounted for by ICD-9 codes alone.
      PubDate: Sun, 31 Aug 2014 19:30:00 +010
  • Long Term Outcomes of Total Hip Arthroplasty in Young Patients under 30

    • Abstract: Background:  We aimed to report outcomes of total hip arthroplasty (THA) in very young patients under the year of 30.   Methods:  Thirty patients (45 hips) with various indications for THA were retrospectively reviewed radiologically and clinically and analyzed regarding survival, reasons of failure, factors associated with outcomes and postoperative complications.   Results:  Within a mean follow-up time of 116 months the 10-year survival rate was 90.3%. All hips were revised due to aseptic loosening. No association was found among the tested parameters with increased revision rates.Three complications associated with the THA were recorded and managed conservatively. All patients had statistically significant improved clinical scores compared to the pre-operative period, despite the underlying disorder that compromised the condition in the majority of the patients. Conclusions:  Our study showed excellent long term outcomes of THA in patients younger than 30 years of age, comparable with those in older patients.
      PubDate: Sun, 31 Aug 2014 19:30:00 +010
  • Hemodynamic and Arterial Blood Gas Parameters during Cemented Hip
           Hemiarthroplasty in Elderly ...

    • Abstract: Background:  Patients undergoing cemented hip hemiarthroplasty may develop bone cement implantation syndrome (BCIS) which is a leading cause of intraoperative complications. The purpose of this study was to evaluate cardiovascular changes during cemented hip hemiarthroplasty in elderly patients.   Methods:  Cemented hip hemiarthroplasty was performed on 72 patients with femoral neck fracture. All patients were catheterized with a radial artery catheter to assess mean arterial pressure (MAP) and arterial blood gas (ABG) in these time points: just before cementation, just after cementation (0th), 5 min (5th) and 10 min (10th ) after cementation, and at the end of surgery (END). Also, systolic and diastolic blood pressure (SBP & DBP), heart rate and any arrhythmia or cardiac arrest was evaluated.  Results:  Seventy-two patients (33 females, 39 males; mean age: 66.8±7 years) were evaluated. All parameters changed during cementation with a significant drop in MAP, SBP, and DBP immediately after cementation and pH and base excess decreased significantly (P<0.001) with no changes in O2 saturation. Mean heart rate rose until the 5th and then decreased dramatically with no bradycardia presentation. During cementation, 12 patients showed arrhythmia, but no cardiac-arrest was observed.   Conclusions:  Under strict observation of a anesthesiology care team, hemiarthroplasty can be a safe method for femoral neck fracture in elderly osteoporotic patients without severe cardiopulmonary compromise. 
      PubDate: Sun, 31 Aug 2014 19:30:00 +010
  • Management of Hip Fractures in Lateral Position without a Fracture Table

    • Abstract: Background:  Hip fracture Management in supine position on a fracture table with biplane fluoroscopic views has some difficulties which leads to prolongation of surgery and increasing x- rays’ dosage. The purpose of this study was to report the results and complications of hip fracture management in lateral position on a conventional operating table with just anteroposterior fluoroscopic view.  Methods:  40 hip fractures (31 trochanteric and 9 femoral neck fractures) were operated in lateral position between Feb 2006 and Oct 2012. Age, gender, fracture classification, operation time, intra-operation blood loss, reduction quality, and complications were extracted from patients’ medical records. The mean follow-up time was 30.78±22.73 months (range 4-83). Results: The mean operation time was 76.50 ± 16.88 min (range 50 – 120 min).The mean intra-operative blood loss was 628.75 ± 275.00 ml (range 250-1300ml). Anatomic and acceptable reduction was observed in 95%of cases. The most important complications were malunion (one case in trochanteric group), avascular necrosis of oral head and nonunion (each one case in femoral neck group).  Conclusions:  It sounds that reduction and fixation of hip fractures in lateral position with fluoroscopy in just anteroposterior view for small rural hospitals may be executable and probably safe.
      PubDate: Sun, 31 Aug 2014 19:30:00 +010
  • How to Treat the Complex Unstable Intertrochanteric Fractures in Elderly
           Patients' DHS or ...

    • Abstract: Background:  Due to difficulty in obtaining anatomical reduction, management of the unstable intertrochanteric fractures in elderly osteoporotic patients is challenging. The purpose of this study is to compare the results of hip arthroplasty (total, hemi, or bipolar) with DHS in the elderly patients with unstable intertrochanteric fractures.   Methods:  We prospectively studied and followed-up 80 old patients with complex unstable intertrochanteric fracture from January 2007 to December 2010. Depending on the time of the patients’ admission, we alternatively treated them by DHS and arthroplasty, and placed them in Groups A and B, respectively. We followed them up radiologically and also clinically by Harris Hip Score for more than 24 months. Statistical analysis was performed using SPSS version 11.5 for Windows.  Results: The mean length of follow-up and age were 34.3±4.1 months (ranged; 24-59) and the 75.2±5.2 years (ranged; 58-96), respectively. Comparing Group A with B, demographic data, mean blood loss, duration of operation, time to walking and duration of hospital stay had no significant difference but overall device related complications were significantly higher in Group A. Functional scores were also higher in Group B, but this difference was not significant statistically. In both groups, the patients with Type A3 compared with Type A2, had more duration of surgery and blood loss.  Conclusions:  Arthroplasty is an alternative treatment in elderly patients with unstable intertrochanteric fractures and can provide good and satisfactory clinical outcomes associated with low complication and mortality rates. 
      PubDate: Sun, 31 Aug 2014 19:30:00 +010
  • Outcome Assessment after Aptis Distal Radioulnar Joint (DRUJ) Implant

    • Abstract: Background:  Conventional treatments after complicated injuries of the distal radioulnar joint (DRUJ) such as Darrach and Kapandji-Sauvé procedures have many drawbacks, which may eventually lead to a painful unstable distal ulna.  The development of DRUJ prosthesis has significantly evolved over the past years. In this study, we assessed the outcome results of patients after DRUJ implant arthroplasty using the Aptis (Scheker) prosthesis. Methods: We identified 13 patients with 14 prosthesis during the past 10 years. Patients underwent DRUJ arthroplasty due to persistent symptoms of instability, chronic pain, and stiffness. Records and follow-up visits were reviewed to find the final post-operative symptoms, pain, range of motion, and grip strength with a mean follow-up of 12 months (range: 2-25 months). Also, patients were contacted prospectively by phone in order to  minister the disabilities of the armshoulder and hand (DASH), patient rated wrist evaluation (PRWE), and visual analogue scale (VAS), and to interview regarding satisfaction and progress in daily activities. Eleven patients out of 13 could be reached with a median followup time of 60 months (range: 2 to 102 months).  Results: No patient required removal of the prosthesis. Only two patients underwent secondary surgeries in which both required debridement of the screw tip over the radius. The median DASH score, PRWE score, VAS, and satisfaction were 1.3, 2.5, 0, and 10, respectively. The mean range of flexion, extension, supination, and pronation was 62, 54, 51, and 64, respectively. Conclusions: Distal radioulnar joint injuries are disabling and patients usually undergo one or more salvage surgeries prior to receiving an arthroplasty. The Scheker prosthesis has shown satisfactory results with 100% survival rate in all reports. The constrained design of this prosthesis gives enough stability to prevent painful subluxation.
      PubDate: Sun, 31 Aug 2014 19:30:00 +010
  • Progression of Carpal Tunnel Syndrome According to Electrodiagnostic
           Testing in Nonoperatively ...

    • Abstract: Background:  This study tested the null hypothesis that nonoperatively treated patients would not show disease progression of carpal tunnel syndrome (CTS) over time according to median nerve distal motor latency (DML) on two electrodiagnostic tests.   Methods:  This retrospective study analyzed sixty-two adult nonoperatively treated patients who were diagnosed with CTS confirmed by a minimum of two electrodiagnostic tests at our institution between December 2006 and  tober 2012. A Wilcoxon signed-rank test was conducted to test the difference between electrodiagnostic measurements between the first and last test. Results: The mean time between the first and last electrodiagnostic test was 26±12 months (range, 12 to 55 months). The only electrodiagnostic measurement that increased significantly was the difference between median and ulnar DML on the same side (r=0.19, P =0.038). The time between the electrodiagnostic tests was significantly longer for patients with at least 10% worsening of the DML at the second test compared to cases of which the DML did not worsen or improve a minimum of 10% (P =0.015).  Conclusions: There is evidence that—on average—idiopathic median neuropathy at the carpal tunnel slowly progresses over time, and this can be measured with electrodiagnostics, but studies with a much longer interval between lectrodiagnostic tests may be needed to determine if it always progresses.
      PubDate: Sun, 31 Aug 2014 19:30:00 +010
  • Predictors of Missed Research Appointments in a Randomized
           Placebo-Controlled Trial

    • Abstract: Background:  The primary aim of this study was to determine predictors of missed research appointments in a prospective  andomized placebo injection-controlled trial with evaluations 1 to 3 and 5 to 8 months after enrollment.   Methods:  This study represents a secondary use of data from 104 patients that were enrolled in a prospective randomized  ontrolled trial of dexamethasone versus lidocaine (placebo) injection for various diagnoses. Patients were enrolled between June 2003 and February 2008. Sixty-three patients (61%) had lateral epicondylosis, 17 patients (16%) had trapeziometacarpal arthrosis, and 24 patients (23%) had de Quervain syndrome. Each patient completed a set of questionnaires at time of enrollment. Bivariable and multivariable analyses were used to determine factors associated with missed research appointments.  Results:  Fourteen patients (13%) did not return for the first follow-up and 33 patients (32%) did not return for the second follow-up. The best multivariable logistic regression model for missing the first research visit explained 35% of the variability and included younger age, belief that health can be controlled, and no college education. The best model for missing the second research visit explained 17% of the variability and included greater pain intensity, less personal responsibility for health, and diagnosis (trapeziometacarpal arthrosis and de Quervain syndrome). Conclusions:  Younger patients with no college education, who believe their health can be controlled, are more likely to miss a research appointment when enrolled in a randomized placebo injection-controlled trial. 
      PubDate: Sun, 31 Aug 2014 19:30:00 +010
  • Current Rates of Publication for Podium and Poster Presentations at the
           American Society for ...

    • Abstract: Background:  Research projects are presented at the Annual Meetings of the American Society for Surgery of the Hand (ASSH). It is unknown how many achieve publication in peer-reviewed journals. We sought to determine current rates of publication of podium and poster presentations.   Methods:  All ASSH podium and poster presentations from 2000 to 2005 were reviewed, and an Internet-based search using PubMed and Google was conducted to determine whether the presented studies had been published. Times to publication and journal names were recorded. Data were analyzed with descriptive statistics. Fisher’s exact test was conducted to compare current trends with previous trends. Results:  Of 1127 podium and poster presentations reviewed, 46% were published in peer-reviewed journals. Forty-seven percent of published presentations (242 presentations) were in Journal of Hand Surgery , and 11% (59 entations) were in Journal of Bone and Joint Surgery . Forty-five percent of presentations were published within 2 years and 66% within 3 years. The publication rate for podium presentations was significantly higher than that previously reported for Journal of Hand Surgery, at 54% compared with 44% (P=0.004).  Conclusions:  Currently, fewer than half of the studies presented at Annual Meetings of the ASSH achieve publication in peer-eviewed journals. Presentations are most likely to be published within 3 years, and almost half are published in Journal of Hand Surgery . 
      PubDate: Sun, 31 Aug 2014 19:30:00 +010
  • Anterior Ankle Arthrodesis with Molded Plate: Technique and Outcomes

    • Abstract: Background:  There is still controversy regarding the best technique for ankle arthrodesis to acheive stable rigid fixation along with reconstructing a functional plantigrade foot. Moreover, existing techniques have complictions related to stability, soft tissue covering, fusion rate, and exposure. Methods: With the anterior approach exactly on the tibialis anterior sheath, the joint was exposed and previous hardware, if any, was removed and with the safe direct approach, the ankle, hindfoot, and indirectly the subtalar joints were accessed. Then fresh cancellous bone was obtained and complete denudation was preformed. Lastly, a narrow 4.5 millimeter plate was carefully placed on what was determined to be the best final position.In this prospective study, 12 patients with severe ankle pain and arthritis enrolled from February 2010 to January 2012. Eight of them had posttraumatic arthritis and deformity with hardware, two had rheumatoid arthritis, one had poliomyelitis with severe deformity of the foot and knee, and another had chronic ulcerative ynovitis of the ankle joint. The patients were assessed clinically and radiographically for an average of two years (range: 13 months to 4 years) for functional recovery, range of motion, stability of the ankle, and imaging evidence of union.  Results:  Ankle deformities and pain in all 12 cases were corrected. With a short healing time and rapid recovery period, after six weeks all of the patients could walk independently. Also, scores of the Manchester–Oxford Foot Questionnaire (MOXFQ) improved significantly from 69 preoperatively to 33 postoperatively). Conclusions:  Anterior ankle arthrodesis with molded plating can be an easy and safe way to manage deformities and it has excellent fusion rate and sufficient rigid fixation.
      PubDate: Sun, 31 Aug 2014 19:30:00 +010
  • The Comparison of Results of Treatment of Midshaft Clavicle Fracture
           between Operative ...

    • Abstract: Background:  Clavicle fractures are common and usually heal without complications. In this study, we evaluated the outcomes of non-operative versus operative management of displaced fractures.   Methods:  In a prospective clinical trial study, sixty-five patients with displaced clavicle mid-shaft fractures were nonrandomly divided in two treatment groups. The first group underwent non-operative treatment with figure of 8 bandage (30 patients), and the other underwent operative treatment with plate fixation (35 patients). Figure of 8 bandage and 3.5 millimeter DCP plate with at least six cortical screws were used in non-operative and operative groups respectively. We followed up all patients at weeks 2, 6 and 12, and at month sixth. In addition to clinical examination and x-ray evaluation, we assessed satisfaction, DASH and Constant Shoulder Score for each individual. Results:  The average durations of union were 19.3 and 24.4 weeks in operative and non-operative groups respectively (P=0.006). Satisfaction with operative treatment was 74.3% and with non-operative treatment was 66.7%, showing no significant difference (P=0.500). The non-union rate was 5.7% in the operative group and 13.3% in the non-operative group (P=0.518). A significant difference between the two groups in terms of DASH and Constant Shoulder Scores after the six-month follow-up was not found (P=0.352). Conclusions:  According to our results, we recommend operative treatment in mid-shaft clavicle fractures only when there is a definitive indication. 
      PubDate: Sun, 31 Aug 2014 19:30:00 +010
  • A Comparison of Glenohumeral Internal and External Range of Motion and
           Rotation Strength in ...

    • Abstract: Background:  The glenohumeral joint becomes dislocated more than any other major joint because it maintains a wide range of motion and its stability is inherently weak. The most common complication following acute initial shoulder dislocation is recurrent dislocation or chronic instability. Imbalance of strength and range of motion in individuals with anterior dislocation can be a contributing factor in recurrent dislocation as well.  Methods:  This case-control study consisted of 24 individuals with a mean age of 24.29±4.33 years, and a mean dislocation rate of 5.37±3.62 times. Isometric cuff strength was measured using a handheld dynamometer and for range of motion, the Leighton flexometer was used in internal and external rotational motions of both upper extremities. Independent t-test was used for data analysis. Results:  The internal and external range of motion of the injured glenohumeral joint was lower than the uninjured joint (P<0.001). Similarly, the internal and external rotation strength of the injured joint was lower than the uninjured joint (P<0.001).  Conclusions:  According to previous data, imbalance of strength and range of motion in individuals with anterior shoulder dislocation can be a contributing factor in long-term disability and increased recurrent dislocation and our finding confirm decreased range of motion and strength in our patients. Hence, proper exercise and rehabilitation plans need to be developed for those suffering from this complication.
      PubDate: Sun, 31 Aug 2014 19:30:00 +010
  • Clinical Outcomes after Arthroscopic Release for Recalcitrant Frozen

    • PubDate: Sun, 31 Aug 2014 19:30:00 +010
  • Intra-articular Ganglion Cyst of the Long Head of the Biceps Tendon
           Originating from the ...

    • Abstract: Ganglion cysts commonly occur around the shoulder, mostly in the spinoglenoid and suprascapular notches. We report a very rare case of intra articular Ganglion cyst of the long head of the biceps tendon that originated from the bicipital groove as a rare cause of shoulder pain.
      PubDate: Sun, 31 Aug 2014 19:30:00 +010
  • Osteoid Osteoma in the Neck of the Scapula; A Misleading Case

    • Abstract: Osteoid osteoma is a benign bone tumor that when located on the base of the coracoids process of the scapula is very rare and diagnosis and treatment is often delayed because of its rarity. Almost any bone can be involved, but half of cases involve the femur or tibia. The radiologic features of osteoid osteoma are well known, but these tumors may present with unusual features and be easily misdiagnosed. In this report, we present a case of osteoid osteoma of the neck of the left scapula that took almost 27 months to be diagnosed accurately.
      PubDate: Sun, 31 Aug 2014 19:30:00 +010
  • Bilateral Intraosseous Tumor of the Calcaneus with Imaging-Pathologic
           Discordance A Case Report ...

    • Abstract: A case of bilateral intraosseous tumor of the calcaneus with different MRI imaging is presented. On the left, radiological findings suggest intraosseous lipoma, but on the right-sided lesion, imaging studies were not convincing. The microscopic report showed foreign body granulomatous reaction, a rare clinical pathological discordant.
      PubDate: Sun, 31 Aug 2014 19:30:00 +010
School of Mathematical and Computer Sciences
Heriot-Watt University
Edinburgh, EH14 4AS, UK
Tel: +00 44 (0)131 4513762
Fax: +00 44 (0)131 4513327
About JournalTOCs
News (blog, publications)
JournalTOCs on Twitter   JournalTOCs on Facebook

JournalTOCs © 2009-2014