Percutaneous vertebroplasty in iranian patients with osteoporotic vertebral fractures

Osteoporotic compression vertebral fractures are common clinical problems. In those with refractory fractures, percutaneous cement augmentation has been suggested. The aim of this study was to evaluate the functional outcome of percutaneous vertebroplasty in Iranian patients with refractory Osteoporotic fractures. We retrospectively studied 37 Osteoporotic fractures in 28 patients [6 men and 22 women], who had been treated with vertebroplasty from August 2009 to June 2012. The mean follow-up period was 12.1 +/- 3.6 [range: 6-42 months]. The patients' states were assessed by the visual analogue scale and short form-36 questionnaire. Student t test was used to analyze the pre- and postoperative data. The mean age of the patients was 71.6 +/- 6.1 [range: 50 to 91 years] and the most common fractured vertebrae were L1 and T12, There were five patients with two levels of vertebral fractures and two with three levels. Vertebroplasty could improve the scores for pain and quality of life from preoperative 7.6 +/- 1.4 and 44.8 +/- 7.6 to 1.8 +/- 0.4 and 74.1 +/- 5.3 at four weeks after surgery. At the last follow-up visit, this improvement continued with no significant decline. The most common complication was cement leakage [32.4% per vertebra], wherein all of of the patients were clinically asymptomatic. Adjacent vertebral fracture occurred in six cases. By understanding the risks, we propose vertebroplasty in Iranian patients with refractory Osteoporotic vertebral fracture. If correctly performed, this procedure can significantly improve the pain and quality of life in these elderly Osteoporotic patients

Carpal tunnel release in diabetic and non-diabetic patients

Carpal tunnel syndrome [CTS] is a compression neuropathy that causes paresthesia, pain or numbness in the territory of median nerve. The aim of this study is to compare the open surgery outcome and patients' satisfaction in carpal tunnel syndrome among diabetic and non-diabetic patients. In a retrospective cohort study from April 2011 to June 2012, patients suffered from carpal tunnel syndrome at least 6 months, without response to conservative treatment, who had the inclusion and exclusion criteria, were evaluated by the usage of MHQ and WHOQOL-BREEF tests, one month before surgery and three months after that. Carpal tunnel decompression surgery was performed by two surgeons, experienced in hand surgery, which used the same surgical method. Statistical analysis was performed by SPSS 19.0, 24 of patient [34,2%] were male and 46 [65.8%] were female and there was no significant difference between two groups [P>0.05]. MHQ total score before and after surgery was respectively 50.22 +/- 7.13 and 63.49 +/- 11.28 and this difference was significant [P<0.05]. In WHOQOF-BREEF parameters, physical parameters [36.81 +/- 19.8 vs. 55.30 +/- 24.36] and psychological parameters [41.64 +/- 14,77 vs. 61.24 +/- 19.9] improved significantly after surgery. The outcome of carpal tunnel syndrome open surgery is good in both men and women, but diabetes has a negative impact on surgery outcome in short term

modified triple pelvic osteotomy for the treatment of hip hypoplasia

The prevalence of hip dysplasia Is 1 in 1000. Several pelvic osteotomy methods have been developed to prevent early osteoarthritis, such as triple osteotomy. In this study we are going to introduce our new technique that was done on 4 patients with favorable short-term results. Four patients underwent triple osteotomy and fixation using a reconstruction plate and early weight bearing was started. The Harris Hip Score, limb length, center-edge angle, and acetabular inclination showed improvement. This modified technique is suggested for corrective surgery on adult dysplastic hips

Traumatic Hip dislocation in an infant

A 19 month-old child with pain and deformity in hip following a downfall was admitted to the Emergency Department of Emdadi Hospital. After clinical examination and plain X-ray, hip dislocation was diagnosed and the patient was transferred to the emergency operation theater. Under general anesthesia, the hip was simply reduced using closed method. In the following day, a hip spica-cast was applied for three weeks. Regarding the lowenergy trauma required in this kind of dislocation and long-term and hazardous complications due to the delayed diagnosis, it is important to consider the probability of hip dislocation in children