ABSTRACT
BACKGROUND: Knowledge of skin complications and contributing factors in orthopedic patients is important for design and development of preventive approaches. Therefore, this study was designed to assess skin complications in orthopedic patients. METHODS: In this case-series study, 126 orthopedic patients referred to Rasoul-e-Akram and Bahman hospitals from 2012 to 2016 with skin complications were analyzed. The adverse effects were assessed with respect to type and contributing factors. Fisher's exact test, Chi-square, and independent sample t-test were performed to assess the associations between skin complications and other variables. RESULTS: Skin complications in orthopedic patients included infections in 33 (26.1%) cases and hypersensitivity reactions in 88 (40%) cases. In total, 66 (55%) cases of fracture and 35 (29.2%) cases of cellulitis were detected, while the remaining cases involved complications such as disc herniation, nerve involvement, and osteoarthritis-related arthroplasty. Severe reactions presenting as toxic epidermal necrolysis were observed in 3 patients, 2 of whom died eventually. Age and gender were not related to the type of skin complications (P>0.05). CONCLUSION: Complications due to orthopedic treatments were not common. However, since the disease may become fatal on certain occasions, patients should receive more attention from physicians and nurses.
ABSTRACT
BACKGROUND: The purpose of this study was to compare the outcomes of anterior cruciate ligament (ACL) reconstruction using the patellar versus hamstring tendon (HT) autograft. MATERIALS AND METHODS: In this randomized clinical trial, fifty patients undergoing arthroscopic ACL reconstruction were randomized into two equal groups: Those treated with either autogenous patellar tendon grafts (PT group) or HT group grafts. All patients were reviewed immediately after surgery, at 6 and 12 weeks after surgery, and then at 6 months using the International Knee Documentation Committee evaluation form. Infection, severity of pain (visual analog scale), duration of rehabilitation, and clinical and magnetic resonance imaging (MRI) findings were assessed at the 6-month follow-up. Positive pivot shift and Lachman test were considered clinical signs and symptoms of treatment failure. In addition, the absence of the ACL or transverse ACL rather than the posterior oblique ligament is an MRI finding that indicates treatment failure. RESULTS: Comparing changes in pain and range of motion (ROM) in patients first and 6 months after therapy show that pain had been relief significantly (P < 0.001) and ROM dramatically changes (P < 0.001). The average rehabilitation period in the PT group was 13.2 ± 2.08 weeks whereas in the HT group, it was 9.28 ± 2.26 weeks. A significant difference was seen between the two groups in terms of the rehabilitation period (P < 0.001). No significant difference was found in the normal ROM between the groups (P = 0.32). When the pain severity was considered, a significant difference was found between the PT group and the HT group (P < 0.001). The HT group patients had less knee pain than did the PT group patients. No significant difference in infection rates was seen between two groups (P = 0.66). CONCLUSION: Considering the better outcomes of HT reconstructions for the two parameters of pain severity and rehabilitation period, we consider HTs to be the ideal graft choice for ACL reconstructions.
ABSTRACT
Pachydermodactyly is a rare and benign disease that may be idiopathic, genetic, acquired as a response to repetitive trauma, or associated with several other acquired conditions often pushing the health caregiver to do a bunch of costly lab tests and diagnostic workups to rule out other entities. All health care givers must be aware about this disease for reassure the patients and cut unnecessary costs. Moreover, there seems to be an issue of association with certain occupations. A good example might be computer keyboards causing special damages to certain organs like eyes and musculoskeletal system. We have observed deleterious effects of excess work with computer keyboards on fingers in the form of Pachydermodactyly in our case. A 27-yr-old man presented with wider hand span and longer fingers to Dermatology Clinic of Rasoul-E-Akram Hospital in June 2015, especially the ring finger in our case, considered a big symptom who depressed due to their fingers appearance as a rare disease. We gave him an emollient to make his hand smoother. The patient improved both clinically and psychologically on a simple emollient. This disease with its deleterious psychological effects and a simple way of management should be appreciated more by the health care system.
ABSTRACT
We present a case of neutrophilic dermatosis of dorsal hands (NDDH), with lesions on the dorsal part of the hands with pustular features and histologic picture of vasculitis.This case highlights the notion that low dose oral steroid can offer a useful first therapeutic option for NDDH. Interstingly, in this case, a few additional lesions were located on the legs, making it different from some previously described cases of NDDH. As with other authors, we believe that this recently described neutrophilic dermatosis is a localized and acral variant of SS. To our knowledge, this is the first case report of NDDH from Iran.
