Prevalence and severity of preoperative disabilities in iranian patients with lumbar disc herniation

Literature recommends that refractory cases with lumbar disc herniation and appropriate indications are better to be treated surgically, but do all the patients throughout the world consent to the surgery with a same disability and pain threshold? We aim to elucidate the prevalence and severity of disabilities and pain in Iranian patients with lumbar disc herniation who have consented to the surgery. In this case series study, we clinically evaluated 194 [81 female and 113 male] admitted patients with primary, simple, and stable L4-L5 or L5-S1 lumbar disc herniation who were undergoing surgical discectomy. The mean age of the pa-tients was 38.3+/-11.2 [range: 18-76 years old]. Disabilities were evaluated by the items of the Oswestry Disability Index [ODI] questionnaire and severity of pain by the Visual Analogue Scale [VAS]. Chi-square test was used to compare the qualitative variables. Severe disability [39.2%] and crippled [29.9%] were the two most common types of disabilities. Mean ODI score was 56.7 +/- 21.1 [range: 16-92]. Total mean VAS in all patients was 6.1 +/- 1.9 [range: 0-10]. Sex and level of disc herniation had no statistical effect on preoperative ODI and VAS. The scale of six was the most frequent scale of preoperative VAS in our patients. Iranian patients with lumbar disc herniation who consented to surgery have relatively severe pain or disability. These severities in pain or disabilities have no correlation with sex or level of disc herniation and are not equal with developed countries

Clinical Outcome of Femoral Osteotomy in Patients with Legg-Calve'-Perthes Disease

Legg-Calve'-Perthes disease is a juvenile idiopathic osteonecrosis in which the blood supply of femoral head is not sufficient and the bone dies provisionally. The aim of this study is to evaluate outcome of Femoral osteotomy in children with LCPD in our University Hospital. In a descriptive analytic study, between 2008 and 2013, patients with the diagnosis of Legg-Calve'-Perthes confirmed with lateral pillar calcification of B and B/C border were entered and patients were encouraged to come to an outpatient clinic for follow-up. Descriptive analysis of the demographics was performed and relation between variables was tested using a two-sided Student's t test with statistical significance set at [p=0.05]. Mean age of patients was 9 +/- 1.3 years, with the range of 4 to 12 years old. 25 patients [86.2%] were male and 4 patients [13.4%] female. There was no positive family history in patients. 17 patients [58.6%] had history of trauma. Duration of symptom presentation was 7 +/- 6.3 months, with the range of 3 to 36 months. In 20 of patients [69%] left hip and in 12 [41.4%] right hip was involved. There was significant relation between femoral head asymmetry, trochanter enlargement [P=0.04], acetabolum changes [P<0.000], femoral neck shortening [P<0.000]. There was no relation between age [P=0.28] and duration of disease [P=0.8] with femoral neck shortening. Intrtrochantric Osteotomy led to improvement in pain, limping and increase range of motion. Subluxation before surgery is one of the criteria, which could influence further prognosis. Acetabulom changes and femoral neck shortening are two factor seriously effect hip ROM

Accuracy of lachman and anterior drawer tests for anterior cruciate ligament injuries

The knee joint is prone to injury because of its complexity and weight-bearing function. Anterior cruciate ligament [ACL] ruptures happen in young and physically active population and can result in instability, meniscal tears, and articular cartilage damage. The aim of this study is to evaluate the accuracy of Lachman and anterior drawer tests in ACL injury in compare with arthroscopy. In a descriptive, analytical study from 2009 to 2013, 653 patients who were suspected to have ACL rapture were entered the study. Statistical analysis was performed by the usage of SPSS 16. Multiple comparison procedures were performed for comparing data between clinical examination and arthroscopic findings and their relation with age and sex. Mean age of patients was 28.3 +/- 7.58 years [range from 16 to 68 years]. From 428 patients, 41.2% [175 patients] were between 26 and 35, 38.8% [165 ones] between 15 and 25 and 20% [85 patients] out of 36 years. 414 patients were male [97.2%] and 12 were female [2.8%]. Sensitivity of anterior drawer test was 94.4% and sensitivity of Lachman test was 93.5%. The diagnosis of the ACL injury and the decision to reconstruct ACL could be reliably made with regards to the anterior drawer and Lachman tests result. The tests did not have privilege to each other. The test accuracy increased considerably under anesthesia especially in women