Mini-open reconstruction of rotator cuff of the shoulder

Background: shoulder pain is one of the most common musculoskeletal [MSK] disorder affecting a large portion of the population. It is estimated that one in three persons will have at least only one episode of shoulder pain within their lifetime. Rotator cuff tears are very common in the general population. Radiographic studies have shown the prevalence of rotator cuff tears to be 4-13% in the population aged between 40-60 years and 20% in population whom age between 60-70 years and 30-50% in population above 70 years. Rotator cuff tears are a common pathology associated with degenerative changes in the shoulder joint. They cause significant disability, pain, dysfunction and poor health status and their prevalence is currently increasing within an aging population

Aim of the Work: the aim of this work was to study the results of mini open rotator cuff repair of the shoulder joint

Patients and Methods: this study was conducted on ten patients presented to Al-Azhar University Hospital with rotator cuff tear of the shoulder. They are treated with mini-open repair technique. All our patients completed a period of at least one year of follow up

Results: a clinical success rate was found in ten patients treated by mini open technique, 70% had excellent and good results according to Constant and Murly score after one year of follow up

Conclusion: repair of rotator cuff tears by mini-open technique is one of the good viable options providing improvement in pain and function of the shoulder joint. Also it is more economic than arthroscopic repair and it does not need high learning curve as arthroscopic repair

Effect of melatonin and zinc on the lipid profile in typel diabetic patients poorly controlled with insulin

Many in vitro and experimental animal studies indicated that melatonin has an important role in regulation of blood glucose level. No clinical data on the pharmacological use of this supplement in the management of diabetic complications, like dyslipidemia, were available to support its therapeutic role in diabetes mellitus. This study was designed to evaluate the effect of adjuvant use of melatonin and zinc acetate to improve the impaired lipid profile in type 1 diabetes mellitus patients poorly controlled with exogenous insulin. This study was carried on 50 type 1 diabetes mellitus patients with mild response to insulin treatment, and randomized into 3 groups. Group A treated with a combination of lOmg melatonin and 50mg zinc acetate; group B treated with 50mg zinc acetate only and group C treated with placebo. All treatment formulas were administered orally for 90 days. Plasma levels of total cholesterol, triglycerides, low-density lipoprotein cholesterol [LDL-C] and high-density lipoprotein cholesterol [HDL-C] were evaluated before starting treatment and after each 30 days for 3 months. Treatment of DM patients with melatonin and zinc decreases the elevated levels of total cholesterol, triglycerides and LDL-C after 30 days, while HDL-C levels were significantly elevated after 90 days of treatment. Adjuvant use of a combination of melatonin and zinc improves the impaired lipid profile in type 1 diabetic patients poorly controlled with insulin treatment

Femoral condylar buttress plate

Nineteen cases with intercondylar femoral fractures treated surgically using the condylar buttress plate are presented in this study. Fifteen patients were males, four were females. The average age was 48 years and the follow up period was 6 to 9 months after surgery. Although the condylar buttress plate is not commonly in use nowadays, this plate proved to be very suitable to fix comminuted intercondylar fractures where its lower cloverleaf shaped end can be mounted to the lateral aspect of the lateral femoral condyle, with its anterior and posterior tongue-like extensions fitting to the anterolateral and posterolateral curvatures of the condyle allowing easy orientation of cancellous screws in all possible planes and this versatility permits fixation of different fragments easily and safely. Fracture reduction and stability of fixation achieved were satisfactory in all cases. Healing was manifested radiographically at an average of eleven weeks [range 9 to 17 weeks]. The knee joint range of flexion at the end of follow up was more than 95 degrees in all cases. We recommend the use of this implant especially in comminuted intercondylar femoral fractures

Oblique proximal femoral osteotomy for hip containment and correction of femoral torsion

We present twenty-seven cases [thirty two hips] where proximal femoral osteotomy was needed either to contain the femoral head concentrically within the acetabulum or to correct femoral torsion. The different indications included ten cases with Perthes' disease; eight cases with developmental dysplasia of the hip [DDH]; and nine patients [fourteen hips] with intoeing due to medial femoral torsion. In this procedure the degree of obliquity of the osteotomy was determined from special graphic curves designed for this purpose. The obliquity of the osteotomy was found to fulfill certain advantages including simultaneous correction of deformities in different planes, having wide surface of bone contact at osteotomy site, avoiding excessive shortening, achieving better stability, and better control on the bony fragments. This was reflected on the results achieved where we did not have any case of nonunion, implant failure, under- or over-correction