ABSTRACT
BACKGROUND: There is controversy regarding routine prophylaxis for deep vein thrombosis (DVT) in patients treated via a short leg cast or splint following lower extremity trauma. OBJECTIVES: The main aim of this study is to evaluate the incidence of DVT and need for chemoprophylaxis in these patients. MATERIALS AND METHODS: Patients with ankle sprains or stable foot/ankle fractures were entered in this cross-sectional study. Serum D-dimer levels were measured 2 weeks following fixation. If the D-dimer levels were above 0.2 micrograms/ml the test was considered positive and the patient was referred for Doppler ultrasound examination (DUE) to confirm or rule out the diagnosis of DVT. Finally, the incidence of DVT was calculated and the role of predisposing factors was investigated. RESULTS: There were 95 patients with an average age of 38 ± 13.7 (77.9% males); 46 patients had at least one risk factor for DVT. The D-dimer test was positive in 21(22.1%) patients. DVT was confirmed by DUE in 3 patients (3.1%). The incidence of DVT significantly increased in the presence of 3 or more risk factors (P = 0.01). CONCLUSIONS: It seems that DVT is not a common complication of below knee fixation and chemoprophylaxis is not necessary when the patient has less than 3 predisposing factors. With 3 or more risk factors chemoprophylaxis and periodic follow-ups must be considered.
ABSTRACT
BACKGROUND: There is considerable variation in the treatment of distal forearm torus fractures (DFTF), from soft bandaging to cast immobilization. OBJECTIVES: The present study aimed to show the result of removable wrist splint (RWS) in the treatment of these fractures. MATERIALS AND METHODS: One hundred forty two children aged less than 17 years old with DFTF were studied prospectively. These patients were randomly treated either by a short arm cast (SAC) or a RWS for three weeks. Finally the treatment results of the two groups were compared. RESULTS: There were no significant differences regarding degree of pain, compliance or complications between RWS and SAC groups. Resource savings can be made with this approach also patients' and parents' satisfaction can be increased without compromising patients' care. CONCLUSIONS: RWS can be considered as an easy and acceptable treatment modality with very low costs and complications in the management of DFTF.
ABSTRACT
BACKGROUND: Tennis elbow (TE) is a common myotendinosis. It was first described by Runge in 1873; different modes of treatment are used in management of TE. OBJECTIVES: This study aimed to report the results of autologous blood injection (ABI) in the treatment of TE. MATERIALS AND METHODS: A prospective case study was performed to evaluate the results of ABI in the management of TE. The level of pain based on Nirschl phase scale (NPS) and a visual analogue scale (VAS) was calculated before and 1, 3 and 6 months after injection; then satisfaction was assessed. RESULTS: Twenty-nine patients with diagnosed TE were treated by ABI (24% males, 76 % female). The mean age of the patients was 44.1 ± 5.2 years. The level of pain on VAS decreased from 6.46 ± 2.08 to 0.54 ± 0.7 (P=0.001) and on NPS from 6.15 ± 1.48 to 0.54 ± 0.76 (P = 0.001) 6 months after treatment. At the end of the study, 84% of patients expressed a high level of satisfaction. CONCLUSIONS: Given the acceptable outcomes, autologous blood injection can be considered a good treatment option for TE when traditional treatment has fails.
