ABSTRACT
Legg-Calve-Perthes disease is one of the most common disabling diseases of childhood and if not managed appropriately is truly disabling. Severity of disease and duration of disease onset are main determinants of choosing treatment strategy of either conservative management or surgical treatment. This study was designed to determine Legg-Calve-Perthes treatments and relation between type of treatment and duration of the disease. This descriptive study was carried out on 50 patients with Legg-Calve-Perthes disease admitted in Ghaem Hospital in Mashhad, North East of Iran from 1995-2005. According to age of patients and severity of disease, the subjects allocated to conservative [11 patients] and surgical treatment [39 patients]. Clinical improvement signs include pain reduction, range of joints motion, which were evaluate by physical examination and taking medical history of patients. In conservative group, only 4 patients assumed to be successfully treated with mean age of 7.25 years and the mean interval between disease onset and beginning of treatment was 2.25 months. Surgical group had mean age of 10.85 years and mean interval between onset of disease and initiation of treatment was 18 months. Conservative group showed less sever form of disease [lateral pillar group A and group B with age less than 8 years], but patients treated surgically were more severely involved [lateral pillar group B with age more than 8 years and group C]. This study showed that age and severity of disease [lateral pillar classification] are main elements in treatment strategy [choosing conservative VS surgical treatment]. The interval between onset of disease and onset of treatment strongly affects treatment success
Subject(s)
Humans , Age Factors , Severity of Illness Index , Age of OnsetABSTRACT
Background and Purpose: Osteosarcoma is among primary bone tumors, seen mostly in long bones among young adults
Therapeutic approach to this disease consists of surgery and chemotherapy. Unfortunately, there is no access to information on its early symptoms and the high risk group. Therefore, in this study we have assessed the epidemiologic, clinical and paraclinical characteristics of osteosarcomaMethods and Materials: This cross sectional descriptive study involved 100 cases of osteosarcoma with various ages admitted to academic hospitals in Mashad, Iran. The obtained data were analyzed statistically in SPSS 11.5
Results: There were 69 male and 29 female patients, with a mean age of 17.6 +/- 7.04 years. The most common tumor sites were femur [46%] and tibia [41%]. Bone pain [56 cases], swelling [18 cases] and pathologic fractures [11 cases] were the most common complaints
Conclusion: Osteosarcoma can be recognized as a malignancy in young male adults, which is characterized mainly with pain
ABSTRACT
Indirect reduction and posterior instrumentation with short -segment pedicle screw is the method of choice for treatment of unstable burst thoraco-lumbar fractures. The literature regarding the time of surgery and its effect on outcome of thoraco-lumbar unstable burst fractures is sparse. The aim of this study is to evaluate the efficacy of early and late surgery on the outcome of thoraco - lumber unstable burst fractures. Patients with unstable burst thoraco-lumbar fractures were included in this prospective review of patients treated with indirect reduction and short - segment pedicle screw fixation between 2000-2004.The mean follow up period was 42 months [range from 16 to 66 months]. Radiographic analysis was evaluated pre and post-operatively and clinical evaluation was performed postoperatively and at follow - up review. The mean time of surgery was 11 days after injury [form 2 to 33 days]. 35 patients underwent early surgery [2-15 days after injury] [Group A] and 15 patients had late surgery [15-33 days after injury] [Group B] .In group A the anterior vertebral height [A.V.H] was improved from a median preoperative of 20.5 mm to 39.5 mm [37% correction], and sagittal alignment [S.A] was improved from a mean preoperative kyphosis of 20.4 degrees to 1/5 degrees. In group B the anterior vertebral height [A.V.H] was improved from a mean preoperative of 20.3mm to 28/2 mm [24.5% correction] and sagittal alignment [S.A] was improved from a mean preoperative Kyphosis of 20.5 degrees to 8.4 degrees. At final follow - up observation a mean kyphosis of 4 degrees was increased in group B. Early indirect reduction and posterior stabilization [with short - segment pedicle screw] of unstable burst thoraco - lumbar fractures allows a satisfactory reduction and correction of deformity