[Midterm results of hip bipolar hemiarthroplsty in elderly patients with traumatic femoral neck fractures]

Background and Objectives: hemiarthroplasty [HA] is generally considered to be the treatment of choice in the most elderly patients with a displaced fracture of the femoral neck. Hip fractures especially in the elderly imposed many problems to health care system. In these patients with proper treatment and rapid ambulation complications is reduced. The purpose of this study was to evaluate the results of bipolar hemiarthroplasty treatment in the traumatic femoral neck fractures

Materials and Methods: in this descriptive analytical study, 50 patients candidate to hip arthroplasty were studied. Short-term complications and functional abilities were assessed with the Harris Hip Score questionnaire

Results: in this study, 40 patients with a mean age of 76.3 +/- 8.2 years, including 12 men [30%] and 28 women [70%] were studied. The mean functional hip score was 78/02 +/- 20.8. Between men and women was significant statistical difference according to hip function scores which men had earned a better score than women. The main complications were a dislocation and infection. In three cases there was a need for further surgery. At follow-up 35 patients [87.5%] had no pain, and 30 [75%] walked with a cane

Conclusion: according to our results bipolar hip arthroplasty for hip fractures has good functional outcome. As regards to possible suitable placement for each patient is more stable and is not associated with significant complications

[Comparison the results of Salter Osteotomy versus Femoral Osteotomy after open reduction in treatment of developmental Dysplasia of Hip]

Background and Objectives: Congenital dislocation of the hip [DDH] is a common cause of morbidity in different communities. Therapeutic implications include reduction and surgical stabilization of the hip joint. The purpose of this study was to compare the results of femoral osteotomy with Salter osteotomy

Materials and Methods: In a descriptive analytical study on 40 children 23 were treated with salter osteotomy and 17 cases underwent femoral osteotomy therapeutic outcome and complications were compared between two groups. Results were analyzed using Mc.Kay classification

Results: Studied group were 40 children [age 4.3 +/- 1.5 years M/F 17/23]. All patients in both groups had stable hip joint after treatment, and all patients achieved full range of joint motion. Trendelenburg gait was improved in all patients in both groups. Excellent results was achieved in 65% after Salter osteotomy and in 47% of cases femoral osteotomy, the difference was not statistically significant. The most important complication in Salter osteotomy was avascular necrosis of femoral head in 13% of the treated patients. It was not detected in femoral osteotomy method. On the contrary in femoral osteotomy, limb length discrepancy was the most important complication observed in 5 patients [29.1%]

Conclusion: Femoral osteotomy and Salter both methods are successful in stabilizing the hip joint. Both femoral and salter osteotomy methods could successfully stabilize the hip joint

Comparison of the Combined Anterior-Posterior Approach versus Posterior-Only Approach in Scoliosis Treatment

STUDY DESIGN: This is descriptive analytical study. PURPOSE: The present study aims at comparing treatment results found between the two groups comprising of patients who underwent posterior spinal fusion using thoracic pedicle screws and the ones who underwent combined anterior-posterior method, respectively. OVERVIEW OF LITERATURE: There was controversy about surgical techniques including anterior, posterior, or a combined anterior-posterior approaches are applied to treat non-congenital scoliosis with surgical indications. METHODS: Medical records of 50 patients suffering from thoracic non-congenital scoliosis with curves exceeding 70degrees were reviewed. In this study, 25 patients who underwent posterior spinal fusion using thoracic pedicle screws were compared with 25 patients who underwent combined anterior-posterior method. RESULTS: Patients treated through posterior-only and combined approaches were respectively hospitalized for 11.84+/-5.18 and 26.5+/-5.2 days (p=0.001). There was a significant difference between these two groups considering intensive care unit admission duration (p=0.001), correction in sagittal view of X-ray (p=0.01), and number of days the patients underwent traction (0.001). Finally, coronal view was corrected without any significant difference (p=0.2). CONCLUSIONS: According to our findings, it is hypothesized that posterior-only method is associated with some significant advantages and is an advisable method in patients with severe scoliosis over than 70degrees.

Clinical Findings and Results of Surgical Resection of Thoracolumbar Osteoid Osteoma

STUDY DESIGN: Descriptive, cases series study. PURPOSE: To evaluate clinical findings and results of treatment of patients with spinal osteoid osteoma who underwent surgery. OVERVIEW OF LITERATURE: Osteoid osteoma is a benign tumor with spinal involvement rate of about 10%. It is manifested during adolescence with symptoms such as painful scoliosis. To treat the problem, operation on the patients and excising the nidus are suggested. METHODS: This descriptive study was conducted on 11 patients with spinal osteoid osteoma at our orthopedic educational center. All patients were treated through open surgery and nidus curettage. All samples were pathologically confirmed. Imaging methods (spiral computed tomography-scan) was used in preoperative planning. Scoliosis and other clinical findings were studied. RESULTS: The study was conducted on 11 patients comprising 6 females (54.5%) and 5 males (45.5%) with the mean age of 14.6 years. Mean deviation of scoliosis resulting from spinal osteoid osteoma was 22.8 degrees. There was more scoliosis in the involvement of the lumbar vertebra. In comparison with adults, scoliosis was more severe in youths. There was one case of vertebra body involvement with manifestation of painful scoliosis. Due to lack of careful preoperative examination, the surgery was repeated for this case. No sign of recurrence was observed in patients who underwent open surgery and all scoliosis in the follow-up had improved. CONCLUSIONS: Based on our findings, surgical excision of spinal ostoeid osteoma was successful and complete recovery was achieved in spinal deformity in the course of follow-up. Scoliosis is often seen during adolescence and lumbar involvement is more severe.

Adolescence spinal epidural abscess with neurological symptoms: case report, a lesson to be re-Iearnt

Epidural abscess of the spinal column is a rare condition that can be fatal if left untreated. It promptly progresses and can cause neurologic paralysis, urinary retention or cauda equina syndrome. Compromised immune system that occurs in patients with diabetes mellitus, AIDS, chronic renal failure, alcoholism, or cancer is a predisposing factor. It mostly occurs in adults. Here we would like to report a case of spontaneous pyogenic lumbar epidural abscess with neurological deficit diagnosed in a 15 year old boy. We treated this case successfully with surgical microscopic decompression and drainage

Osteoid osteoma of a scapula: a case report in a 34 years old woman

Osteoid osteoma is a benign bone tumor and accounts for 10% of benign tumors. Almost any bones can be involved but half of cases involving femur or tibia. Osteoid osteoma is a rare tumor of the scapula with only 18 reported cases in the literature. We presented a case of osteoid osteoma of the scapula in right shoulder in angle of coracoid and geloneid in a 34- year old woman. She had right radicular shoulder pain increased at night for 4 years. An important point about this case is that, patient was treated in long-term with miss diagnosis of cervicospinal discopathy. The key of diagnosis in this patient was paying attention to the nature of night increasing pain and performing bone scan. After the operative curettage of the tumor, the pain dramatically stopped and a few weeks of physical therapy led to full range of motion in her shoulder