Demographic pattern of carpal tunnel syndrome in western Saudi Arabia.

OBJECTIVE: To study the demographic characteristics of patients with carpal tunnel syndrome (CTS) in Saudi Arabia. METHODS: A retrospective collection of 135 cases with CTS, diagnosed clinically and electrophysiologically. The studied cases presented to the Orthopedic Clinic of King Abdulaziz University Hospital in Jeddah, Saudi Arabia, between January 1999, and December 2009. The demographic data (age, gender, and site of involvement) were collected from the medical records. RESULTS: The 135 cases comprised 112 females, and 23 males, with a male:female ratio of 1:4.9. The mean age was 45.5 years in women (range 17-74 years) and 48.5 years in males (range 20-77). The age related gender distribution of the subjects were the highest among the age group 45-54 years in both males (34.8%) and females (33.9%). The CTS occurred bilaterally in 74 cases (55%), and unilaterally in 61 cases (45%), with 41 cases affected on the right side and 20 the left side. CONCLUSION: The demographic pattern of CTS patients in the different provinces of Saudi Arabia is almost similar, and comparative to that reported in the western countries, with slightly higher male to female ratio among the Saudi patients.

Tuberculous arthritis revisited as a forgotten cause of monoarticular arthritis.

BACKGROUND AND OBJECTIVES: Tuberculosis (TB) continues to be a major concern for health care workers. The number of reported cases of extrapulmonary tuberculosis, particularly osteoarticular tuberculosis, is increasing. This fact is attributed to different factors such as underestimating the disease and difficulty in diagnosis, which requires tissue sampling and can lead to a delay in the diagnosis, and can result in significant morbidity and mortality. The aim of this study was to highlight the difficulties and delay in diagnosis of articular tuberculosis, raising the need to create awareness about the importance of early diagnosis to avoid major complications of joint destruction. DESIGN AND SETTING: Retrospective review of patients presenting to a tertiary care center between 2003 and 2009. PATIENTS AND METHODS: We reviewed cases who presented with monoarticular joint pain and swelling that failed to respond to treatment elsewhere and were eventually diagnosed as having articular tuberculosis. We collected the demographic data, history, data on clinical examination and the relevant laboratory investigations, in addition to the data on radiological studies. All patients were treated medically with antituberculosis chemotherapy and surgically according to the severity of joint destruction. RESULTS: Thirteen patients had a mean age was 40 years (range, 17-70 years). The average delay in diagnosis was 2 years. Only 1 patient had pulmonary TB. The hip, knee and elbow were the most common joints involved. Bacteriology was positive in 69% of the cases; and histopathology, in 92%. Fifteen percent of the patients had arthrodesis. None showed recurrence after follow-up of 4 years. CONCLUSION: A high level of clinical suspicion is essential for early diagnosis and treatment of osteoarticular TB to reduce its significant morbidity.

Evaluation of the calori et Al nonunion scoring system in a retrospective case series.

Nonunion is one of the most challenging orthopedic complications. Although current definitions are accepted, they fail to provide a satisfactory definition of nonunion. Different classifications for nonunion have been described, but these systems did not take all required factors and requirements of nonunion treatment into account for fracture healing. Calori et al recently developed a new comprehensive nonunion scoring system, which takes into account the whole fracture personality that influences non-union. The aim of this study is to evaluate the validity of the Calori et al system in the treatment of nonunions. We retrospectively reviewed our database for lower extremity nonunion from 2002 to 2009. The demographic and clinical data, laboratory, and radiological investigations were collected from medical records and phone interviews. Forty cases were identified: 32 men and 8 women. Mean patient age was 39.75 years (range, 6-102 years). Seventeen were femoral and 23 were tibial. Our patients were divided into 3 groups according to the database treatment: group 1 standard treatment (3 patients), group 2 specialized care and treatment (33 patients), group 3 amputations (4 patients). If we apply the recommended management by Calori et al to our patients, they will be divided into groups similar to the database treatments. Statistical analysis showed significant correlation between our actual treatment and those recommended by the Calori system where the P value was <.01. We concluded that the Calori et al scoring system could be valid as a guideline for lower extremity nonunion treatment.