[Comparison the method of wrist supination with elbow flexion as classical method with hyperpronation method in reduction of radial head subluxation in less than 7 years old children]

The radial head subluxation is a common cause in less than 7 years old children who refered to emergency center after pulling of their wrist by parents. Compare the method of wrist supination with elbow flexion as classical method with hyperpronation method in reduction of radial head subluxation [pulled elbow] in children less than 7 years old referig to poorsina hospital during 2004-2009. In this randomized clinical trial, children who had referred to Poursina orthopedic emergency center with clinical diagnosis of radial head subluxation were studied consequent. Patients were randomly treated as consequent male and female with one of two methods. The patients were checked in order to diagnosis extremity functions return every 5 minutes. If extremity function had not returned, the primary method was repeated after 15 minutes. Unsuccessful treatment led to treatment with another method 30 minutes after first try. That method repeated if replacing method was not successful after 15 minutes. If both methods were unsuccessful, elbow radiography to roll-out other injury was performed. After collecting data, analysis was performed using chi- square test and T- test with SPSS software version 16. Among 110 patients were included in this study with average age [4.05 +/- 1.51 years] 58 patients [3.91 +/- 1.41 years] with first method [SF] and 52 patients [4.21 +/- 1.62 years] with second method were treated. [P=0.31]%62.7 of patients were male and the remaining were female [%37.3]. In 47 patients [%90.4] of 52 patients who were treated by [HP] method. This was 46 patients [%79.3] from 58[P=0.11]. Five patients of [HP] group needed second attempt where as this number were 12 about [F] group. Treatment with [HP] method was successful in 100 percent patients, but successful rate was%87.9 for [SP] method. There was significant superiority of [HP] success in comparison to [SF] [P+0/006]. In reduction of radial head subluxation [HP] method was more successful upination method in reduction of radial head, it is more successful than supination, when supination was not successful than [SF] method

[Effect of smoking on healing time of tibia fracture]

Introduction: Smoking is proven to be a factor in development of osteoporosis and its related fractures and al so its role in delaying bone union in spinal fusion has been cited. In attention to popularity of smoking in patients with limb fracture in Guilan province, we studied the relation between smoking and bone healing time

Objectives: The aim was to study the effect of smoking on clinical and radiological union in closed and Type I Open fracture

Materials and Methods: From 195 consecutive tibia fractures in 190 patients, 146 patients of Poorsina hospital with closed or open type I fractures have been studied in a 4 years period. 76 of them were non-smoker and 70 patients were smoker. From these patients, 44 [58%] non-smokers and 59[84%] smokers were followed until complete union or up to one year. union has been confirmed clinically and radiologically

Results: Statistical differences in clinical and radiological healing rates between those who smoked and those who didn't smoke were observed in patients receiving intramedullary fixation or external fixation. Statistical differences were not seen in the clinical and radiographic healing of tibias treated with cast immobilization

Conclusion: This study revealed that smoking dramatically delay the tibia fracture union, especially when the surgical treatment has been used

[Does intercortical bone graft obtaining from iliac crest have any effect on pain and hematoma at donor site?]

Introduction: bone graft is one of the most common orthopedic operations. The most common donor site is iliac crest. Pain and hematoma of donor site has been reported in some patients

Objective: this research was carried out to evaluate a bone grafting procedure [intercortical] and its effect upon the rate of hematoma and pain in donor site in comparison with the usual method [the graft is obtained from outer iliac table with cancellous bone]

Materials and Methods: in a prospective [cohort] study, 60 patients were randomly divided into two groups [A, B]. In group A, the bone graft has been obtained from outer iliac table with cancellous bone, and in group B, the graft has been obtained from intercortical bone with preservation of outer and inner table. 48 patients were followed up for two years. [Group A 25 [%83] and group B 23[%77]

Results: two years after operation there was no significant difference between group A [20%]and group B [17%] for donor site pain [P>0.02]. For hematoma after operation, the results were the same. The mean weight of graft in group A was 36gr and in group B 25.7 gr. The average duration of operation in group B was 20.3minutes and 14 minutes in group A[P<0.05]

Conclusion: the intercortical graft obtaining from iliac crest has no significant effect upon decreasing pain and hematoma in donor site, but it makes the operation longer and weight of graft is less than usual method