ABSTRACT
Periodic evaluation and monitoring the health and economic outcome of joint replacement surgery is a common and popular process under the territory of joint registries in many countries. In this article we introduce the methodology used for the foundation of the National Iranian Joint Registry (IJR) with a joint collaboration of the Social Security Organization (SSO) and academic research departments considering the requirements of the Iran's Ministry of Health and Education.
ABSTRACT
INTRODUCTION: For decades, acetabular fractures were treated conservatively. Judet et al. in 1960s established the operative treatment of these fractures by continuous improvement of pre-operative evaluation and classification of fractures. Several studies demonstrated that accurate fracture reduction decreases the incidence of post-traumatic arthritis and improves functional outcome. CASE SERIES: We report 67 consecutive patients who underwent surgical treatment for acetabular fracture; 44 patients were available for follow-up. In 35 (79.5%) cases, congruent reductions were achieved. The final mean Harris hip score was 81.8 (53-95). Functional outcomes according to Harris score were excellent and good in 31 patients (70.5%). CONCLUSIONS: The results of internal fixation of displaced acetabular fractures in our series were satisfactory.
ABSTRACT
BACKGROUND: Osteoid osteomas account for approximately 2- 3% of all primary bone neoplasm's sampled for biopsy. 50% of all of them occur in the long bones of the lower extremities, but osteoid osteoma of the coracoid process is rare. We have found only nine previously reported cases of coracoid osteoid osteoma in the international literature. We report a child with coracoid base osteoid osteoma. CASE PRESENTATION: A twelve-years-old boy with a persistent pain at the right shoulder since 9 months ago, were evaluated. His pain relatively responds to non-steroidal anti-inflammatory drugs (NSAIDs). Imaging studies showed foci of sclerosis at right coracoid base with increased uptake on the Technetium-99m study. Because proximity to the neurovascular bundle we couldn't use radiofrequency ablation technique, so the patient underwent open surgery with a mini- deltopectoral approach and two level osteotomies ; one proximal to coracoid tip and the other at the base of coracoid just distal to subcoracoidphyseal line. Then a segment of coracoid resected. Tip of coracoid securely reattached with a screw. CONCLUSIONS: To our knowledge in the literature up to now there are only nine reports of coracoid osteoid osteoma. These cases were treated with different approaches and different techniques. We used en-bloc resection via mini-anterior approach. Our patient 30 months after surgery (October 2012) have full range of motion and became pain free since wound healing with normal control imaging.Definite diagnosis of osteoid osteoma in the uncommon sites may be delayed. En bloc resection of tumor with two osteotomies by an anterior approach has been limited soft tissue injury and is a reliable method of treatment.
ABSTRACT
Osteoid osteoma is a benign bone tumor of undetermined etiology, composed of a central zone named nidus which is an atypical bone completely enclosed within a wellvascularized stroma and a peripheral sclerotic reaction zone. There are three types of radiographic features: cortical, medullary and subperiosteal. Forty-four patients with osteoid osteoma were studied retrospectively. In plain films, 35 patients presented as the cortical type, six cases were located in the medullary zone and three had subperiosteal osteoid osteoma. In all the cases, the nidus was visualized on computed tomography (CT) scan. The nidus was visible in four out of five patients who had also undergone magnetic resonance imaging (MRI). Double-density sign, seen on radionuclide bone scans was positive in all patients. MRI is more sensitive in the diagnosis of bone marrow and soft tissue abnormalities adjacent to the lesion, and in the nidus that is located closer to the medullary zone. On the other hand, CT is more specific when it comes to detecting the lesion's nidus.
