Showing 15 results for Fracture
Alami Harandi B, Navab I, Noroozi M,
Volume 58, Issue 3 (6-2000)
Abstract
Tahmasbi Mt, Sajjadi Saravi M, Alami Harandi B,
Volume 59, Issue 5 (9-2001)
Abstract
Cut out or extrusion of the lag screw from the superior aspect of head and neck of the femur is one of the most common and devastating complications of the surgery of the intertrochanteric fractures with DHS. The exact cause of this complications is unknown, but it seems to be related to osteopenia, inappropriate position of lag screw inside head of the femur and inability of DHS to slide inside the barrel, which is the most ignored risk factor. We used short barrel Dynamic Hip Screw (DHS) for fixation of the intertrochanteric fractures in Dimon and Hughston procedure in 16 patients with unstable fracture, from may to August 2000. The only patient suffered from cut out is the one with static position of DHS in the center of the head. The other complications were delayed ::::union:::: in one, disingagement of the lag screw and side plate despite using compression screw, and one case of significant limb length discrepancy 6 months after surgery, mild limbing was the rule and the average of harris scores was 76. We think that, it is possible to reduce the rate of cut out with choosing short barrel DHS instead of the standard one, while using short length lag screw.
Shahriar Kamrani R, Shirani Sh, Tahmasbi M T,
Volume 61, Issue 2 (5-2003)
Abstract
Ilio-sacral screw is a technique for posterior pelvic fixation. In spite of its benefits, it had not performed commonly in Iran because of its difficulties. We changed this technique to insert the screw under CT-Scan guide with lical anesthesia to increase image quality and decrease neurological complications and performed it in two patients. In both cases the screws were inserted in correct position without any complication.
Karbakhshe M, Zargar M, Ershadi Z, Khaji A,
Volume 64, Issue 7 (8-2006)
Abstract
Background: We aimed to demonstrate the mechanism of fracture and functional outcome of patients with hip injury in our clinical setting.
Methods: In a historical cohort, all women 50 years of age and older admitted to three university hospitals of Tehran University of Medical Sciences (Shariati, Imam Khomeini and Sina) with the diagnosis of hip fracture from 21 March 2003 to 21 March 2004 were included in this study (n=115). Follow up was conducted via telephone post and even home visit to record the functional status of the patients at the time of study (5 Jan 2005) measured with Barthel index in addition to the exact mechanism of injuries.
Results: The mean and standard deviation of age were 76.3 ± 10.6 years. About 88.7% of injuries had occurred at home (65.2% on the carpet), the remaining happening in the streets. Mean length of hospitalization was 11 ± 7.9 days. Among our patients, 71% could mobilize spontaneously without aids before injuries. This had reduced to 20% at the time of follow-up. The mean Barthel index was 97.2 ± 8.2 before fracture and 75 ± 21.1 at the present. Among our patients, five cases died during hospitalization and 29 of them died afterwards (total: 34 or 29.6%).
Conclusion: The most common external cause of injuries in our cases was stumbling at home especially on carpeted surfaces. This necessitates preventive measures aimed at physical standards of houses and education of elderly on healthy locomotion, indoors.
Kaseb M.h, Moharrami M.r, Mortazavi S M.j,
Volume 65, Issue 1 (3-2008)
Abstract
Background: Tibial and femoral fractures, commonly seen in emergency departments, may be associated with various knee ligament injuries. The aim of this study was to determine the prevalence of such fracture-associated knee ligament problems, with especial attention to rapid diagnosis.
Methods: This study was carried out in patients with femoral or tibial fractures who were operated on in Imam Khomeini Medical Center from March 2003 to March 2005. All patients underwent surgical repair immediately after acute fracture, followed by a thorough knee examination. Patients with positive clinical findings were further evaluated using the stress view and arthroscopy.
Results: We enrolled 470 cases in this study, of which 266 were tibial and 204 were femoral fractures. There were 404 men and 67 women, with an average age of tibial fracture patients was 34.5 and 44.6 years for those with femoral fractures. Of all fractures, 66% were due to car accidents, 16% to industrial accidents and 8% due to falling. The overall prevalence of ligament injuries in tibial fractures was as follows: 6.58% ACL tearing, 2.5% PCL, 21.95% MCL and 14.63% LCL. The overall prevalence of ligament injuries in femoral fractures was as follows: 6% ACL tearing, 3% PCL, 14% MCL and 8% LCL.
Conclusion: The prevalence of ligament injuries of the knee was highest in distal femoral and tibial plateau fractures. It is prudent to perform a thorough knee examination once the fracture is stabilized in the operating room for the early detection of ligament injuries and prevention of further complications.
Moghtadaei M, Malekpoor S, Farahini H, Khosravi A,
Volume 66, Issue 10 (1-2009)
Abstract
Background: Pin loosening and infection in skeletal traction are important problems in orthopedic surgery and methods which are usually used to manage these problems, are costly and sometimes complicated. In this study, the efficacy of using cast support in infection and loosening of proximal tibial pin was investigated.
Methods: In a randomized clinical trial, 60 patients referring to Rasul-e- Akram hospital from 1383 to 1384, who needed to have proximal tibial pin for at least one month, were studied. All patients were treated with oral antibiotic until 24 hours after pin insertion. Depending on using cast support or not, they were randomly categorized into two groups (30, 30). The rate of pin loosening and infection between these two groups were compared.
Results: In the group without cast support infection rate was about %26.7 while this rate was %13.3 in the group with cast support, which means no significant difference (.33). In addition, although the rate of loosening in the group without cast support was more than the other group, it had no statistical meaning. (%20 compared with %10, p= 0.47)
Conclusions: Cast support doesn't affect the rate of pin loosening and pin site infection. However, considering correct technique for pin insertion including prevention of thermal injury and local hematoma is very important. Therefore, the use of cast support is an optional choice up to surgeons' preference.
Farahvash Mr, Yegane Ra, Farahvash B, Sheidaeian M, Masoomi M,
Volume 67, Issue 3 (6-2009)
Abstract
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Background: Trauma is the 2nd cause of mortality in Iran, after cardiovascular
diseases. In traumatic patients, head and neck and face skeletal fracture is
common. The most common facial fracture is mandible fracture and the least
common is frontal fracture. Complications due to orbital fracture are more
devasting than the other fractures in face.
Methods: These descriptive cross sectional studies are designed on 92 patients with
orbital fractures in a referral educational trauma center, Imam Khomeini
hospital, Tehran, Iran. Sample size was the patients
who referred to this hospital with orbital fracture during the ten years period
(1986-2000).
Results: In this study 74 patients were male and 18 patients were female. Mean age
of patients was 30 years. The most common cause of orbital fracture was motor
vehicle accident which was seen in 38 patients.46 patients had fracture in left
orbit and 44 patients in right. Isolated orbital fracture was seen in 38
patients and 54 patients had concomitant trauma and fracture in the other
organs. Management of orbital fracture was reduction of displaced bone fragment
and fixation for osteosynthesis. The most common methods for osteosynthesis was
fixation with miniplate which used in 53 patients and then reconstruction of
orbital floor and roof with autologus bone graft. The most common complications
due to orbital fracture was related to eyes that were seen in 20 patients.
Conclusion: Face
fractures are a piece of all problems in multiple trauma patients as the tip of
iceberg. Concomitant injuries are the concealed part of this iceberg. Early
detection of orbital fracture and immediate treatment that prevent the future
complications and deformities due to orbital fractures.
Farahvash Mr, Yegane Ra, Farahvash Y, Khodaei M,
Volume 67, Issue 4 (7-2009)
Abstract
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Background: The aim of this study was to describe the prevalence of different types of
maxillary fractures, concurrent fractures and accompanying signs and symptoms. Trauma
is the second cause of mortality in Iran, after cardiovascular diseases.
In traumatic patients, head, neck and facial bones fractures are common. The
maxillary fractures are seen much less commonly than the fractures of the
mandible, zygoma, or nose. Maxillary fractures include: (Le
fort I, II, III fractures- alveolar process fracture
and Sagittal fracture). The most common cause of maxillary fracture is motor
vehicle accidents.
Methods: This descriptive cross sectional study designed on 56
patients with maxillary fractures in a referral educational trauma
center of Tehran.
Sample size was the patients who referred to this hospital with maxillary
fracture during past seven years.
Results: Forty eight (86%) patients were male
and 8(14%) were female. Male to female ratio was 6/1.
Mean age of patients was 30 years. The most common
type of maxillary fracture was infra orbital rim and floor fracture. Among Le
fort fracture Le fort type II was the most common.
Paresthesia of infra orbital nerve and malocclusion were more common than the
other especial signs of maxillary fracture. Concomitant fracture with maxilla
include: zygomatic fracture in 62%, mandibular fracture
in 25%, nasoethmoidal fracture in 9%
and skull base fracture in 4%. Management of
maxillary fracture was reduction of displaced bone fragment and fixation for
osteosynthesis. The most common way for osteosynthesis was fixation with
miniplate and screw.
Conclusions: Face fractures are a piece of all problems in multiple trauma patients as the
tip of iceberg. Early diagnosis of maxillary fractures and immediate treatment
will prevent the future deformities and complications.
Mohammad Javad Zehtab , Ahmad Reza Mirbolook , Babak Syavashi , Mostafa Shahrezayi , Mostafa Mirmostafa ,
Volume 67, Issue 10 (1-2010)
Abstract
Background : Open fractures are associated with an increased risk of infection and healing complications. Management of open fractures is based on the following principles: assessment of the patient, classification of the injury, antibiotic therapy, debridement and wound management, Fracture stabilization, early bonegrafting, and supplemental procedures to achieve healing.
Methods : In a case- control retrospective study we evaluated 33 patients with open tibial fracture (type two gustillo) who were admitted in sina General hospital in Tehran, Iran during years 1999-2009 and were treated uniformly with external fixation as primary treatment in our center as case group and the other 33 patients with the same method and another 33 patients who had not been infected as control group. W e compared the folders of case and control groups retrospectively.
Results : There was no statisticant difference between two groups in mean age, gender, the mechanism of trauma and body mass index (p >0.05 ), while statistically significant difference between them in smoking habitus, blood transfusion, first debridment time, diabet mellitus, femoral shaft fracture (p <0.05 ).
Conclusions: Accompanying femoral fracture is the sign of high energy trauma and it is logical that it is an important risk factor for infection. In our study the time of the first debridment stablished as a significant factor influencing the infection rate in tibial open fracture. In some studies smoking had been recognized as a significant factor influencing in tibial bone open fracture our study reveals the same.
Fallah E, Siyavashi B, Ebadi S, Zehtab Mj, Golbakhsh Mr,
Volume 69, Issue 2 (5-2011)
Abstract
Background: Trauma to the hand is very common and consequently, metacarpal fractures are not rare entities. Some of these fractures need surgery. Considering the diversity of surgical methods available for these kinds of fractures and also the importance of achieving full function and speedy return to work for patients that are mainly young workers or athletes, this study was undertaken to investigate the outcome of treating these fractures by mini-plates.
Methods: Eighteen patients with open or comminuted fractures of metacarpal bones who were admitted to the emergency department of Sina Hospital between the years 2007 and 2010 underwent fixation surgery using mini-plates. Fourteen patients with 17 metacarpal fractures completed the study.
Results: Thirteen out of 14 patients had complete fracture ::::union::::. The patient with non- ::::union:::: underwent revision surgery and bone graft. Four individuals developed an extensor lag of 15 degrees without functional impairment. Two patients had joint stiffness that was relieved after a period of physiotherapy and one developed wound dehiscence and discharge that improved with debridement and use of antibiotics without plate removal. Six patients had complaints regarding their hardware prominence and were satisfied after its removal. Overall, there was a 79% satisfaction rate upon the treatment.
Conclusion: Despite the afore-mentioned complications, use of mini-plates seems to be a suitable treatment option for patients with comminuted metacarpal fractures. However, more studies with larger sample sizes are suggested to reach a firm conclusion.
Mortazavi Mj, Motamedi M, Niknam A, Mazoochy H, Espandar R,
Volume 69, Issue 10 (1-2012)
Abstract
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Background: One
of the difficulties in acetabulum surgery is appropriate exposure of the site
of surgery. Trochanteric flip osteotomy is one of the surgical methods for
superoposterior and posterior acetabulum exposure. However, due to possible
complications some surgeons prefer to avoid this procedure. This study was
undertaken to determine the outcome of surgical treatment of acetabular
fracture using trochanteric flip osteotomy.
Methods : In this prospective cohort study, 14
patients with acetabular fracture who had
been admitted in Imam Khomeini Hospital in Tehran, Iran, during 2003-2006 underwent trochanteric
flip osteotomy. The patients were followed for at least one year post-surgically.
Demographics, radiologic findings, intensity of pain using visual analogue scale
(VAS),
Harris hip score (HHS), force of hip abductors and complications were noted. Data analysis
was performed using SPSS ver. 13.
Results : The mean HHS was 82.5 (55-95). Heterotopic ossification was observed in three patients. There were
no cases of postoperative infection or non::::union::::. Only two patients showed
displacement of osteotomized fragments. Reduction was anatomic in 10 patients. In one patient, the
force of hip abductors was three-fifth. The mean hip pain was 3.4 based on VAS. There were no cases of
femoral head osteonecrosis. With respect to HHS, the final hip status was
excellent and good in four and six patients, respectively. Three patients had
fair and only one patient had poor condition.
Conclusion: It seems that trochanteric
flip osteotomy has much fewer complications in comparison to other methods justifying
its use in such cases.
Mehrpour Sr, Tavvafi Mr, Sorbi R, Aghamirsalim Mr,
Volume 70, Issue 2 (5-2012)
Abstract
Background: Comminuted subtrochanteric fractures have been a challenge for orthopedic surgeons in terms of appropriate reduction and stable fixation. Numerous methods have been used for the fixation of comminuted subtrochanteric fractures among which some are accompanied with technical difficulties and complications of their own. Regarding the results of previous studies, we decided to evaluate the biological fixation method in comminuted subtrochanteric fractures.
Methods: In this prospective study, we evaluated 20 men with comminuted subtrochanteric femoral fractures. The patients underwent indirect reduction with dynamic hip screw (DHS) or dynamic condylar screw (DCS) fixation within one week of injury. The patients were evaluated clinically for pain, hip and knee range of motion, leg-length discrepancy and angular and rotational deformities, in addition the radiographic assessment of the ::::union::::.
Results: According to Seinsheimer's classification of subtrochanteric fractures, four patients had type III, nine had type IV and seven had type V fractures. Fracture fixation was performed by DCS in eight and by DHS in 12 cases. The average time of the operations was 79.4 (ranging from 60-125) minutes. Mean blood loss was 634 (ranging from 340-1160) milliliters. Uneventfully, ::::union:::: occurred in all patients with no clinical pain or dysfunction.
Conclusion: Submuscular plating with either DCS or DHS is a viable option to treat comminuted subtrochanteric fractures. The results of this study highly suggest use of submuscular plating in the treatment of comminuted subtrochanteric fractures, especially in the third world countries.
Sadegh Saberi Saberi , Amir Sobhani Eraghi , Mahmood Farzan , Hossein Safar-Ali Farkhani , Shirin Mardookhpour , Mahmood Mirzaaghapour ,
Volume 71, Issue 11 (2-2014)
Abstract
Background: Rotational deformity after intramedullary nailing is a well-known complication. Femoral malrotation is the most common form of mal::::union:::: but it is underrecognized in part because of the difficulty in accurately assessing rotation as well as the variation that exists in normal anatomy. The aim of this study was to evaluate femoral malrotation following intramedullary nailing of the femur.
Methods: We studied 70 patients who had referred to Imam Khomeini Hospital and had undergone antegrade intramedullary fixation for isolated femoral shaft fracture during 3-year period from 2008 to 2011. Inclusion criteria including isolated femoral shaft fracture that had undergone antegrade intramedullary nailing. Exclusion criteria including spontaneous ipsilateral tibial fracture or pelvic fracture, contralateral femoral fracture, femoral fracture that had fixed using plate or external fixator or retrograde intramedullary nailing. During operation, the patients were assessed clinically for rotational deformity and then in the postoperative follow-up period, degree of rotation was identified with CT scan. Postoperative computed tomography measurements of rotation were compared with the opposite side.
Results: There were 70 patients, 56 men and 14 women. The average age of the patients was 28.21±14.39 patients (55/7%) had external rotation and 31 patients (44/3%) had internal rotation. The mean of malrotation degree in physical examination was 4/67 and The mean of malrotation degree in CT scan was 7. Degree of malrotation deformity, less of 5º, 5 to 10º and 10 to 15º was less of 8.6%, 75.7% and 15.7% respectively. Degree of malrotation didn’t relate to age, sex, fracture location and activity of the patients (P> 0.05).
Conclusion: Rotational deformity in 28% of the patients was equal to more 15º. This complication didn’t relate to fracture location. The patients with external rotation deformity had more symptoms than the patients with internal rotational deformity but there isn’t significant relation in this study.
Kamran Aghakhani , Ebrahim Ameri , Maryam Ameri , Seyed Ali Mohtarami ,
Volume 73, Issue 1 (4-2015)
Abstract
Background: Orthopedic trauma is a common type of injury in children and may cause deep and permanent psychological and physical damage both for the patient and the parents. This study aimed to analyze the epidemiology age, gender distribution and the mechanism of injury in patients presenting to a level I trauma center in urban population of Tehran. Methods: In this prospective descriptive study, the patients under 19 years old with orthopedic trauma who were hospitalized in Tehran Shafa University Hospital were entered. This hospital is the main orthopedic referral center in Iran. The patients were prospectively evaluated from April 2013 to March 2014. The data were collected and analyzed. Results: The study included 1081 patients under 19 years old. There was a male predominance (76.8% n= 830). The boys had a higher mean age 11.04±5.06 year, versus girls with mean age 8.67±4.63 year (P< 0.05). The peak age of boys was 18 and the girls had two peaks at three and nine. The fractures occurred in upper limb in 70.8% (n= 621) and 29.2% (n= 256) in lower limb of patients. There were 27 cases with joint dislocation, 5 cases with knee ligamentous injuries, 128 cases with soft tissue injuries and 44 cases with spine injuries. The most frequent mechanism in both gender were falls from standing position (48.5%). The most common fractures were foreman both bone fractures (n: 146 16.7%), elbow supracondylar fractures (n: 134, 15.3%) and distal radius fractures (n: 84, 9.6%). The most fractures occurred in summer (30.1%) and the least in winter (18.1%). Conclusion: Evaluation of epidemiologic factors can lead to the best prediction and treatment planning of trauma. Early recognition of injury, even minor, and expected care using specialized teams will help to improve outcomes for these patients. This study determines the most at risk children for trauma and fractures and may help the parents to prevent damage.
Seyed Mostafa Seyedmardani , Pooya Sedighiany, Yousef Roosta ,
Volume 80, Issue 5 (8-2022)
Abstract
Background: Non-traumatic bone fractures are considered a pathologic condition with various etiologies, including cancer metastases, osteoporosis, and long-term corticosteroid consumption, which can affect people's quality of life. The main aim of this study was to investigate the etiology of pathological bone fractures in patients who were referred to the Hospital.
Methods: In this cross-sectional study, all patients with non-traumatic pathological fractures were included from March 2015 to February 2019 at Imam Khomeini hospital in Urmia city. Data analysis was calculated by chi-square test using SPSS.ver.17.
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Results: A total of 168 patients participated in this study, of which 108 patients (64.3%) were female, and 60 patients (35.7%) were male with a mean age of 58.6±21.1 with a minimum and maximum age of 7 and 90 years old, respectively. According to the results, the most common etiologies consist of osteoporosis (33.3%), metastatic carcinoma (28.6%), and primary tumor (11.3%), respectively. Regarding the anatomical site involved, vertebrae (57.1%) and the neck of the proximal femur (27.4%) were detected as the most frequent sites with fractures, respectively. Moreover, a significant relationship was found between the fracture etiologies and demographics data (age and gender) (p<0.001). In this regard, osteoporosis and metastatic carcinoma were reported as the most common fracture etiologies in females and males. In addition, intertrochanteric-subtrochanteric (7.7%), distal femur (4.8%), intertrochanteric (1.2%), and acetabulum (1.2%) were considered other sites of fracture with less frequency. It is worth noting that for patients with ages less than fifty years old (<50 years old), commonly reported fracture etiology was the primary osteosarcoma, while in patients with ages more than fifty (>50 years old), osteoporosis was defined as the main fracture etiology.
Conclusion: Together, the present study results showed that osteoporosis and metastatic carcinoma were the most critical etiology of fractures, and there was a statistical correlation between demographic characteristics (such as gender and age) and pathological fracture etiologies. According to the statistical results, the most common sites exposed for fractures were also the vertebral and proximal femur.
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