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

Assessment results of patellar fracture treatment after tension band wiring

To assess the results of patellar fracture treatment by tension band wiring. This retrospective study was performed to evaluate clinical and radiological results of patellar fracture during past 6 years. Twenty four patients were participated in follow-up. Union was occurred in the mean time of 2.67 +/- 0.61 months. Falling down and direct trauma were the most common cause of fracture. Most common complications were thigh muscle atrophy and pin irritation. Excellent and good results in 87.5% and fair results in 12.5% of the patients were seen. Fixation of patellar fractures with tension band wiring was associated with a high rate of union

Assessment of prophylactic bone grafting effect on union of open tibial fracture

The fracture of the tibial shaft is the most common fracture of long bone in human. Considerable proportion of this fractures are open fractures. Treatment of open fractures is one of the orthopedic problems. In the developing country with economic problem, early mobilization and returning to work may be important for people. We compared result of treatment with addition of autogenus bone graft in two different time periods in two groups. In this study, 144 patients with open tibial fracture were randomly divided in two groups and were treated with autogenus bone graft at two different time intervals, the first group in the end of third week and second group in the end of sixth week. All Patients were followed up periodically in first two month every month and then every two weeks. T-test was used for comparison. SPSS ver. 13.0 [SPSS Inc, Chicago, IL, USA] was used for analysis. The mean fracture healing time in the first group [with bone graft in 3rd week] was 14.24 +/- 4.4 week and in the second group [with bone graft in 6th week] was 16.4 +/- 5.4 week and the difference was statistically meaningful. Differences in the rate of delayed union and none union in two groups were statistically insignificant. In addition to time of bone graft, the age, gender, injury mechanism, fixation method, cigarette smoking and drug abuse were studied in two groups. The difference as regards these factors in two groups was statically insignificant. Achievement of autogenus bone graft in open tibial fracture at the end of third week causes reduction of union time from 16.4 week to 14.4 week without increment of deep infection

Short term outcome of congenital clubfoot treated by Ponseti method

To assess the effectiveness of the Ponseti technique in the treatment of congenital clubfoot in children in Ahvaz, Iran. The data of 42 patients [60 feet], who presented with clubfoot were treated with the Ponseti casting technique between October 2008 and November 2010 at Emam Khomeini Hospital, Ahvaz, south of Iran, were collected and studied retrospectively. The outcome was evaluated using the Pirani score for clubfoot. All the patients were followed up for 12 months. The mean age of patients was 3.7 days [ranged 1-24 days]. The average time to achieve acceptable correction was 7.6 weeks [range: 6-10 weeks]. Eight patients [10 feet] [16.7%] were not corrected with initial casting and required early surgery. Full correction was obtained in 34 patients [50 feet, 83.3%]. Subcutaneous tenotomy of the Achilles tendon was performed in 36 feet [72%] and in 14 other feet it was not performed [28%]. Tenotomy was performed more in children with higher Pirani score [P < 0.0001], and those with sever clubfoot had more chance for surgery [p < 0.0001]. The Ponseti casting technique is a safe and effective conservative treatment for clubfoot that decreases the need for surgical interventions. It is an easy method to be applied by most orthopaedic surgeons

[Evaluation of validity and reliability of the questionnaire of student evaluation of teaching]

In any research work, the tools used to approach the designed project goals should be evaluated. The purpose of the present study was to obtain validity and reliability of the questionnaire of student ratings of teaching in Ahvaz JundiShapur University of Medical Sciences. The questionnaire of student ratings of teaching was evaluated in a descriptive study. In this study the views of 70 expert faculty members and 5420 completed questionnaire by students were used. To investigate the reliability, two methods of split-half and internal consistency [Cronbach's Alpha] were applied, and the validity was determined by three aspects of construct validity [factor analysis], concurrent validity and content validity. The Data were analyzed by SPSS-15 software. The factor analysis revealed 2 factors as tutor capability and expert teaching, which could explain 67.69% of the total variance. The concurrent validity coefficiency was determined as 0.538 for the first 14 questions in comparison to question number 15. Within content validity the coefficient of all items was determined as 0.920. The internal consistency of questions showed a high correlation of all 15 questionnaire items. The Cronbach's alpha was 0.947% and split-half reliability was 0.884%. It is concluded that student ratings questionnaire with a reasonable degree of validity and reliability could be accounted as a suitable tool to evaluate the University teaching conditions

Study of acetabular index before and after salter innominate osteotomy

To evaluate pre and post acetabular index in patients with Developmental Dysplasia of Hip whom underwent Salter innominate osteotomy. This cross sectional study was carried out on patients with CDH that underwent Salter innominate osteotomy. All cases with CDH admitted in Imam Khomeini and Razi Hospitals from November 2007 to August 2009 were included. Age, sex, number of involved limb, and affected side were recorded. Antero-posterior [AP] roentgenogram were done and acetabular index were calculated before and after surgery. Five months later after surgery, AP Roentgenogram were obtained from cases and acetabular index were calculated again. Before and after surgery acetabular index were compared for each cases. Dislocation of hip and avascular necrosis occurrence and grading were assessed for each case. Dislocation rate were assessed based on proposed criteria by author from 0 to 4. This criteria was based on percentage of head of femur, which was not covered by acetabulum. Our classification is as follows: Grade 0: No dislocation; grade I: 30% subluxation; grade II: 30-60% subluxation grade III: 60-90% subluxation; grade IV: Complete dislocation. During two year period of the study, fourteen CDH patients were operated. From these cases, four hips were excluded because the patients did not come for follow up. Pre operative acetabular index was 34.40 +/- 1.22 and post operative acetabular index was 19.20 +/- 1.22. There was significant difference among pre- and post- acetabular index. This study showed that there was significant difference among pre and post operative acetabular index. Our limitations in this study were low sample size and short duration of follow-up. Another prospective study with more sample and long duration is recommended

study on the healing effect of honey on infected open fracture wounds

Failure of antibiotic therapy in the treatment of open wounds that result from acute complicated traumatic orthopedic injuries is a clinical problem. In this study, honey was used in the control of infections. One hundred two patients who suffered traumatic open fractures with grade II or III on Castillo scale and despite treatment with classical antibiotics, the wounds did not heal were included. The wounds were initially washed with normal saline and a layer of honey, obtained commercially, was applied and covered with sterile gauze. The patients were instructed to follow the same dressing pressure on discharge. Follow up was on weekly basis, until complete wound healing. Almost in all, except two, discharge from wounds stopped within two weeks, with a production of healthy granulation tissue in the wound beds. The duration for complete wound closure was between 2 to 5 months, which was related to the initial wound size. Two cases, both had large wounds, required re-deridement, suturing and grafting and took 11 and 13 months for complete wound closure. The findings suggest that honey is useful in the control and treatment of infected wounds that follow complicated traumatic orthopedic injuries

Prolonged retention of an intra medullary wooden foreign body

Cases of accidental penetrating injury by foreign bodies are not rare, especially in children. In this report, a case of an intra osseous wooden foreign body retained over an 8-month period causing various complications and suspected of metacarpal tumor is presented. Various previous treatment protocols including curettage, debridement and antibiotic therapy proved unsuccessful. This case was successfully diagnosed by fistulogram using radio-opaque agents and treated accordingly