Tehran University Medical Journal

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Cleft hand deformity is a rare congenital anomaly of the hand with an incidence rate about 1/90,000. It has two clinical types Typical and Atypical. In this paper we are representing ten cases of this anomaly admitted during seven years from 1992 in Emam Khomeini Hospital. Some of the patients especially those with typical cleft hand deformity achieved good functional results after surgical correction of the deformity. In the younger age group we observed better functional results.

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Maxillary sinus atelectasis is a rare and relatively unknown disease. Most patients present with non-sinonasel complaints. Negative intracavitary pressure due to ostial obstruction is suggested as the most probable etiology. Two patients with sinus atelectasis are presented in this paper: Case 1 presented with enophthalmus and maxillary sinus opacity and atelectasis in imaging. Endoscopic uncinectomy and midle antrostomy was done for this patient. Case 2 presented with mid-facial deformity and depression. Caldwel-Luc procedure with inferior meatal antrostomy was done. In 1 year follow up, they were asymptomatic and with no deterioration of facial deformity.

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Background: Infants and children present with a wide range of congenital chest wall deformities which have both physiologic psychologic consequences and are often associated with other abnormalities. Surgical intervention offers excellent cosmetic results with minimal morbidity and mortality. In order to investigation of chest wall deformities, and surgical results, this study was performed.

Materials and Methods: A descriptive study on existing data on 60 consecutive patients with chest wall deformity during 10 years carried out. Patient's characteristics such as age, gender, signs and symptoms type of operation, associated disorder, syndrome, and surgical complications were considered.

Results: Pectus excavatum 60% and pectus carinatum 30% Poland syn 6.7% 9 sternal cleft 3.2. Inpectus, M/F: Was 3/1 and others were 1:1. Age of admission 4 to 27 years 13.4±6.82) and association syndromes were, turner, Morgue and marfan, most patients were operated in delayed time (75) and hence, scoliosis was common than others.

Conclusion: Pectus excavatum was the most common deformity and if scoliosis was prominent and most operation was done in old age but surgical result was excellent no anyone expired and complication was a little. So we recommended that all of the chest deformities must be operated in anytime.

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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.

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Background: Application of Hybrid 6 degrees of freedom fixation could lead to space motion in each 3 anatomic plates together and decrease the time of complex deformities correction. This study is an investigation on the function of hybrid external fixation and the influence of it on decreasing the treatment time. About this case utilize of Ortho-SUV Frame (OSF) system is explained for the first time in Iran and report of its novel. These robotic systems are divided into two groups: active and passive, about active system all movements are done by actuators in joints and links. And in passive, the system needs an operator or patient to actuates Sturats by hand.

Methods: The femur bone has been investigated was non::::union:::: with deformity in sagittal, frontal and transversal planes. Ilizarov external fixation was applicate firstly, with this condition that the OSF systems jacks were replaced instead of simple rods in side of fracture. Software work was done on February of 2016 in Ayatollah Taleghani Hospital, Tehran, Iran. Fractures were happened in a car accident and some other operating were perforemed for this patient without any result.

Results: The correction of studied deformity needs 3 planar moving. Acting this movement by Ilizarov requirements 33 mm displacement in frontal plane, 12 mm horizontal distraction and 48 mm displacement in sagittal plane. Due to the rate of correction in Ilizarov which is 1 mm per day, this bone needs 93 days for general correction and three times changing in shape of rings connections. While, by using the hybrid external fixation, all displacements were corrected in 46 days and first connection had supported all planes.    Conclusion: According to that the decreasing of treatment time is one of the main goal, the hybrid external fixation systems could be an appointment choice in complex deformities and replaced with some common fixation. In addition to, using of updated software increases the accuracy of displacement.