Seyed Mokhtar Esmaeilnejad-Ganji

Background. Distal radius fracture has been reported as the most common type of extremity fractures in adults. No treatment method has been introduced definitely for this type of fracture, especially for maintaining hand function in the best state. The aim of this study — to assess the functional and radiological outcomes following three surgical methods, including external fixation, K-wire and external fixation with pinning. Methods. This parallel-designed randomized controlled trial was conducted on adult patients with intra-articular fracture of distal radius. The participants were allocated in three research groups with block random sampling, and were matched for their age and gender. Primary outcome was radiographic parameters, including radial inclination, radial height, ulnar variance and dorsal/palmar tilt. Secondary outcome was the patient’s performance examined with DASH and PRWE questionnaires. All participants were followed 6, 12 and 24 weeks after the surgery for evaluation of these outcomes. Results. Totally, 78 patients, including 42 male and 36 female with mean age of 46.94±11.05 years completed the research protocol. Although the four radiologic primary endpoints were in the normal clinical range after the intervention, a significant statistical difference was observed between the three groups (р0.001). Also, both DASH and PRWE score showed a significant decrease after the therapeutic interventions (р0.001). Conclusion. The statistically significant difference in the research outcomes of the external fixation with pinning can show that this treatment method theoretically preserves the anatomical condition better than the other two methods, and probably has better functional effects on short-term and intermediate-term results following the surgery.

Background: Intertrochanteric fracture is a common injury among the elderly population causing fundamental lifestyle derangements, which influences the patients’ social and psychological functioning. We aimed to study the quality of life (QoL) and its different parameters in patients with this type of injury. Materials and methods: In this cohort study, all patients hospitalized with intertrochanteric fracture and aged above 50 from 2020 to the 2022 at the Shahid Beheshti Hospital in Babol, Iran, were included. Patients were managed mostly surgically and in exceptional cases non-surgically, were followed up for at least 12 months after receiving treatment. During the follow-up period, patients were dialed and completed a questionnaire to assess the patients' QoL by the 36-item Short Form Health Survey (SF-36). QoL parameters were analyzed based on patients’ sex, age, type of treatment, and height of fall causing fracture. Result: A total number of 200 patients including 101 (50.5%) males and 99 (49.5%) females with mean age of patients was 74.76 ± 11.36 years (range: 50-99) were included. Regarding the received treatment, 192 (96.0%) patients underwent surgery, and 8 (4.0%) underwent non-surgical treatment. In the study of SF-36 scores, the mean score of male patients was 42.31±14.58 and females scored 37.83±15.35, and the difference was statistically significant (P=0.04). The mean score of QoL and its subscales among the patients of the 50-75 group was significantly higher than the 76-99 group (PConclusion: This study revealed that patients with an intertrochanteric femoral fracture had a poor QoL in all aspects. The overall QoL was significantly higher among male patients, younger patients, those who underwent surgical treatment, and the falls from higher heights. These findings highlight the necessity of long-term follow-up and support in patients with intertrochanteric fractures.

Implantation metastasis occurs when tumor seeds into a wound or tissue by a significant amount of viable tumor cells. Here we describe the case of a 30-year-old man suffering from pain and swelling of the foot, which was misdiagnosed as a bone cyst. Surgery was performed involving curettage followed by bone grafting. After surgical pathology, the exact diagnosis was revealed as the synovial sarcoma (SS) of the foot. Implantation metastasis of SS in the iliac region, the grafting site, occurred 9 months post-surgery. Although there are a few reports on implantation metastasis of other types of tumoral lesions, to the best of our knowledge, we describe seeding of this type of tumor for the first time. Similar to other studies, we recommend that tumor surgeries should be carried out in a special setting to prevent any spread to or contamination of other sites by the tumor.

Single- and double-dose of platelet-rich plasma versus hyaluronic acid for treatment of knee osteoarthritis: A randomized controlled trial

A 51-year-old man shepherd presented with mild pain and swelling of the right posterior aspect of his right elbow. In ultrasonography, the affected bursal space had swelling and effusion. Moreover, the aspiration of the affected bursa revealed an inflammatory profile. Brucella melitensis was detected in aspirated fluid and blood cultures. The serum agglutination test (SAT) and 2-mercaptoethanol test for brucellosis were also positive. Therefore, the diagnosis of brucellar olecranon was confirmed. Treatment was initiated using gentamicin for the first 7 days and doxycycline plus rifampicin for 2 months. After treatment, all clinical signs and symptoms were resolved. No relapse was seen after 1 year of the completion of treatment. Clinicians should pay attention to the symptoms of olecranon brucellar bursitis that is similar to that of pyogenic bursitis.

Osteoarticular manifestations of human brucellosis: A review

Journal of Clinical and Diagnostic Research aims to publish findings of doctors at grass root level and post graduate students, so that all unique medical experiences are recorded in literature.

A systematic review and meta-analysis was conducted on the prevalence of osteoporosis in the Eastern Mediterranean Region. The overall pooled prevalence of osteoporosis was 24.4%. The prevalence has increased significantly over the recent years. The highest pooled prevalence was in Saudi Arabia (32.7%), and the lowest was in Kuwait (15.1%).

Background: Every year, millions of people die or are injured due to road traffic accidents worldwide. Investigating the epidemiology of these accidents could help reduce their frequency. Objectives: This study aimed to evaluate the epidemiological characteristics of non-fatal traffic accidents in Babol, northern Iran, over a seven-year period. Methods: Between 2010 and 2016, all of the orthopedic patients with road traffic accidents hospitalized at Shahid Beheshti hospital of Babol were enrolled in this cross-sectional study. The patients’ information, including details of the accidents and demographic characteristics, was collected using predesigned checklists. Results: The majority of 3649 subjects (2748, 75.3%) were male. The age range was from 1 to 86 years old, with an average of 30.5 ± 15.4 years. Traffic accidents were mostly seen in the age group of 19 - 40 years (58.7%) and in those who were drivers (52.7%). The accidents were highest in 2016 (19.9%), and on interurban roads (32.9%), in sunny days (73.4%), asphalt roads (74.3%), and in the morning (42.8%). November (12.7%) was associated with the highest monthly rate, followed by August (11.9%) and March (11.2%). Fractures were observed mostly in the leg (n = 960), followed by the forearm (n = 773). Conclusions: The results showed that road traffic accidents have increased in recent years. It is recommended to improve the traffic safety with the improvement of the geometric design of the roads, especially in roads with a high probability of accident risk. Keywords: Traffic; Accidents; Epidemiology

Introduction: Total Hip Arthroplasty (THA) is one of the most frequent major surgical procedures in orthopedics. Aim: To audit the results of THA in Babol, Northern Iran. Materials and Methods: From 2014 to 2015, all patients with indication for THA referred to Shahid Beheshti and Rohani teaching hospitals in Babol were recruited in this prospective study. Patients with severe osteoarthritis of the knee, a psychiatric disorder, history of previous arthroplasty, bilateral osteoarthritis, contraindications to a major surgery, or failure to attend followup were excluded. The Harris Hip Score (HHS) was used to measure physical hip performance, ranging from 0 (poor) to 100 (excellent) points. All patients were followed for six months. Data were collected and analysed using SPSS with t-test analysis. Results: A total of 58 patients were finally assessed, of whom 24 (41.4%) were male and others were female. The mean age was 56.8 +/- 16.56 years. The postoperative complications included infection (one case), posterior hip dislocation (two cases) and peroneal nerve paresis (one case). The mean HHS was 49.69 +/- 5 before the surgery, but it improved significantly to 88.02 +/- 4.04 at sixth months after THA (p<0.001). Conclusion: According to this audit, THA is associated with a significant improvement and satisfactory outcome in the patients and the rate of complications was low.