Tehran University Medical Journal

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Estimating fetal weight in utero, for better management of pregnancy and appropriate timing of delivery especially in high-risk pregnancies is necessary. Our purpose to evaluate a simple method in estimating fetal weight in Iranian pregnant patients and also to compare was with a previous western study. This study was carried out in Arash hospital, Tehran university of medical sciences in 1996-99. In a descriptive-analytic study that was done prospectively on 464 pregnant patients, ultrasonic measurement of biparietal diameter (BPD), mean abdominal diameter (MAD), and femur length (FL) performed close to delivery was conducted. Birth weight also was identified. Statistical analysis was done using multiple linear regression on the data and also student's T-test for comparison. Mean birth weight was 2320 gr. The outcome of linear regression analysis was the following model: Weight (gr)=95.8×FL (cm)+25×MAD (cm)-15.6×BPD (cm)-4632.1. The effect of all parameters were statistically significant (P<0.02). A fetal weight estimating table was also developed. T-test analysis showed a significant difference (P<0.05) in some final ranks of table (Weight estimations>4000 gr) in comparison with the Rose and Mc callum study. Our study showed that ultrasound using the sum of BPD, MAD and FL is a precise method in fetal weight estimation. Application of other biometric measurements may be needed for better elucidation especially in small and large for gestational age fetuses.

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Background: Genu valgum deformity is exaggerated valgus alignment of lower extremity mechanical axis in knee with a joint line that slopes superolaterally and is corrected by distal femoral osteotomy. In this study the results of treatment and satisfaction in patients with genu valgum were evaluated according to knee society score (KSS) and changes in pre-operation and post-operation lower extremity mechanical axis were compared to each other. Methods: The present study is a cross-sectional study that was performed on 27 patients (30 knees) who have had distal femoral varus osteotomies between 2005 to 2011. Patient’s data were collected from hospital documents, pre-operation and post-operation alignment views and physical exams of operated patients. Radiographs were from the lower extremities and including three joints of hip, knee and ankle (alignment view). Mechanical axis of femur and tibia were drown and they were compared to each other. For measuring patient satisfaction, KSS score was used. All data was collected and evaluated by SPSS 16 software. Results: In this study, 30 knees (in 27 patients) by mean of 30.7±3.36 months follow- up, (range, 5-76 months) were evaluated. The mean of ages in patients was 19.66±4.35, (range 10-34 years). Ten cases (37%) of valgus were on the right side and 14 cases (52%) on the left side and three (11%) cases were reported on both sides. Based on Student’s t-test, there was a significant difference in post- operation lower extremity mechanical axis. The mean of KSS score was 82.52 and the score was defined as 60.7% excellent, 25.1% good, 7.1% fair, and 7.1% poor in patients. According to the results of study, in five patients were non-::::union:::: and re-operated. Conclusion: Distal femoral varus osteotomy is a reliable procedure in knees with valgus correction. This procedure with precise selection of patients, have acceptable end results.

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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.