A review of acetabular fracture patterns, etiologies, and management in Jordan.

OBJECTIVES: To review the epidemiology of acetabular fractures in Jordan and to provide a base to advance high-level clinical research in the future. METHODS: A total of 141 acetabular fractures admitted to King Hussein Medical City, Amman, Jordan, from July 2018 to December 2022 were reviewed retrospectively. Fractures were classified according to Judet and Letournel and were analyzed regarding age, gender, the cause of injury, fracture classification, mode of treatment, and associated nerve and other body part injuries. RESULTS: Males represented 84.4% of patients. The mean age was 42.52 (±17.655) years, and the age group from 20 to 39 represented 54.6% of patients. Road traffic accidents caused 56.7% of injuries, and 53.9% had other accompanying injuries. Posterior wall fractures were the most common (37.6%) patterns, and femoral head dislocation was reported in 28.4%. Posttraumatic and iatrogenic sciatic nerve injuries were reported in 7% of patients. The mean time from admission to surgery was 7.62 (±7.915) days; 66% of patients received surgical treatment, and 83.9% had a satisfactory reduction. CONCLUSION: Acetabular fractures are uncommon injuries, with road traffic accidents being the most common cause of injury. Posterior wall fracture was the most frequent pattern; most patients were males. Our results are comparable to the literature. However, we recommend future studies to measure the outcome of acetabular fracture management.

Impact of Social Distancing on Geriatric Hip Fractures Among Jordanian Population During COVID-19 Pandemic.

Background: There were serious concerns about delivering the care and support to the elderly population in Jordan during the full lockdown period. In turn, this raised concerns about how this group of population will care for themselves and if this change in the situation will increase the risk of falls and related geriatric hip fractures. Hip fractures are a significant cause of morbidity and mortality in the geriatric population. Jordan has been affected by the coronavirus disease, COVID-19; pandemic like other parts of the world. The Jordanian authorities acted early to prevent the infection from spread, and lockdown along with social distancing measures were implemented early and enforced. Even though these measures successfully slowed the spread of the virus, some concerns were raised about the delivery of care by the family and caregivers to Jordanian geriatric population. Objective: We studied the effect of lockdown and social distancing in Jordan on hip fracture incidence among the geriatric population during the lockdown period. Methods: This retrospective observational study was conducted at two Jordanian Royal Medical Services (JRMS) hospitals, King Hussein Medical Center and Prince Rashid Hospital. Patients who were treated surgically for traumatic hip dislocation during lockdown (15th March to 30th April 2020) were compared with patients during the corresponding period in 2019 regarding the incidence of geriatric hip fractures. Results: The lockdown group included 102 trauma patients, 68 patients (66.7%) had geriatric hip fractures. On the other hand, the non-lockdown group included 144 patients, 45 (31.3%) had hip fractures. Thus, the proportion of patients with geriatric hip fractures in the lockdown group was significantly higher than the non-lockdown group (P=0.034). However, the geriatric hip fractures male to female ratio were the same in lockdown and non-lockdown groups (1:1.5). Conclusion: During the complete lockdown and social distancing due to COVID-19, the epidemiology of surgically treated fractures changed; there is a decrease in the total number of trauma patients and an increase in the proportion of geriatric hip fractures.

Hereditary Tyrosinemia Type 1 in Jordan: A Retrospective Study.

BACKGROUND: Hereditary tyrosinemia type 1 (HT1) is a recessively inherited inborn error of metabolism affecting the final step of tyrosine catabolism. The accumulation of tyrosine toxic metabolites leads to progressive hepatic, renal, and neurological manifestations. Treatment of HT1 consists of tyrosine-restricted diets and nitisinone. The untreated disease progresses into life-threatening liver failure with an increased risk of hepatocellular carcinoma. METHODS: From April 2010 to March 2021, eighteen patients were diagnosed with HT1 in the metabolic department at Queen Rania Al Abdullah Hospital for Children in Jordan. Patients were reviewed retrospectively regarding their clinical features, laboratory data, and sociodemographic history. RESULTS: The mean age of nine boys and nine girls was 6.03 years (SD ± 3.85). The mean age for symptom onset was 5.61 months (SD ± 6.02). However, the diagnosis was belated from the onset by 10.50 months (±10.42). Nitisinone treatment was delayed from diagnosis around 12.28 months (SD ± 25.36). Most of the patients (66.7%) had acute onset of the disease. Two children (11.1%) died due to hepatic complications. Positive family history was identified in 61.1% of patients, and a similar percentage were born to parents with consanguineous marriage. The most common presentation was abdominal pain, vomiting, and fever. Hepatomegaly and abdominal distention were the most common findings. Six patients' (42.9%) first presentation was rickets. CONCLUSION: HT1 diagnosis is usually delayed because it is not part of newborn screening and nonfamiliarity with the clinical features of the disease. Therefore, nationwide newborn screening should be expanded to include HT1.