Cemented versus uncemented hemiarthroplasty in patients with displaced femoral neck fractures

Objective: This study compared functional outcomes and preoperative between cemented and uncemented bipolar hemiarthroplasty in patients older than 65 years with subcapital displaced femoral neck fracture

Methods: Fifty one patients with displaced femoral neck fracture were enrolled in this study. Twenty nine patients underwent uncemented bipolar hemiarthroplasty and 22 underwent cemented bipolar hemiarthroplasty. Physical examination and radiographs were performed at the first and sixth months after operation and results were recorded. The patients' pain and function were measured with Visual analogue Scale and with Harris Hip Score [HHS], respectively and then compared with each other

Results: The mean duration of follow up was 18.9 and 19.5 months in the cemented and uncemented groups, respectively. All patients were followed up for at least 6 months. Mean operation and bleeding times were longer in the cemented group compared to the uncemented group [P>0.05]. The mean pain score was significantly less in the cemented group compared to the uncemented group [P=0.001]. Hip functional outcome based on HHS was more in the cemented group [P= 0.001]. The intraoperative and postoperative complication rate was higher in the uncemented group [P<0.05]

Conclusion: Although higher rates of intraoperative bleeding and surgery time were seen with cemented bipolar hemiarthroplasty in older patients with femoral neck fracture compared to uncemented bipolar hemiarthroplasty, cemented bipolar hemiarthroplasty can cause less complications and improve patients' function in less time

Comparison of negative pressure wound therapy [NPWT] and conventional wound dressings in the open fracture wounds

Objective: Successful closure is a primary step of treatment in open fracture wounds. Delayed healing or complications can lead to increased treatment duration, costs and disability rates. The aim of this study was to compare Negative Pressure Wound Therapy [NPWT] and conventional wound dressings in patients with open fracture wounds

Methods: In a prospective randomized clinical trial study, 90 patients with open fractures that were referred for treatment were enrolled between February 2013 to March 2015. Patients were divided into two groups. Group I underwent NPWT and group II underwent conventional wound dressing. Then patients were followed up for one month. Within the one month, the number of dressing change varied based on the extent of the wound. Duration of wound healing, presence of infection and the number of hospitalization days in these patients were recorded and compared at the end of the study between the two groups. Questionnaires and check lists were used to collect data. Analysis was done with SPSS 20, paired sample T-test, and chi-square tests. P<0.05 was considered significant

Results: There was a significant difference between the rate of wound healing in the group one or NPWT group and group II [conventional wound dressings] P<0.05. There was no significant difference between two groups in incidence of infection [P=0.6]

Conclusion: Using NPWT expedites the healing process of extremity wounds. It is more economical and can be considered as a substitute for the treatment of extremity wounds

Comparison of clinical outcomes of scarf and chevron osteotomies and the mcbride procedure in the treatment of hallux valgus deformity

Hallux valgus deformity is a common chronic problem with a reported prevalence of 28.4% and its chief complaint is pain. Thus far, different surgical procedures with their proposed indications have been introduced. This study compared three current procedures, namely the chevron and scarf osteotomies and the McBride procedure. This retrospective cohort was conducted at the Ahvaz University of Medical Sciences on 44 patients with moderate hallux valgus deformity from 2010 and 2013. All of the patients underwent one of the three procedures [chevron, scarf or McBride]. Preoperative and follow up radiographies were evaluated in terms of hallux valgus and intermetatarsal angle correction. The Foot and Ankle Disability Index was filled out to assess the functional outcome and the Visual Analogue Scale was used to evaluate pain. Also, satisfaction, aesthetics and the rate of recurrence was evaluated. Hallux valgus angle and intermetatarsal angle correction were significantly higher in scarf, but not in chevron and McBride. However, from amongst the three procedures, there was no significant difference in terms of the Foot and Ankle Disability Index score, aesthetics, satisfaction level, pain score and recurrence rate. Considering that scarf osteotomy had better results in this study, we think that scarf osteotomy can be considered as a first choice for the treatment of moderate hallux valgus deformity

Efficacy of methylprednisolone acetate injection for the treatment of plantar heel pain

To assess the short term results of local methyl prednisolone acetate injection for the treatment of heel pain syndrome. This prospective study was carried out on 109 patients with plantar heel pain who were treated by local methyl prednisolone acetate injection. Reduction of pain and tenderness were the primary measurement outcome. Rest pain, walking pain and tenderness at 3 weeks was relived in 70 and 67 and 74 patients, and after 3 months in 72, 68 and 81 patients respectively. Mean patient's pain score was 8.2 +/- 2.2 before injection, 4.1 +/- 1.5 at 3 weeks, and 3.9 +/- 1.4 at 3 months after injection. Local injection of methyl prednisolone acetate was associated with a fairly high satisfactory short term results in the treatment of heel pain