The Comparison Between 3.5- and 4.5-mm T-plates for Management of the Patients with Schatzker Type II Tibial Plateau Fractures that Referred to our Emergency Department: A Clinical Trial.

Background: Tibial plateau fractures have become more frequent in recent years. The most prevalent Schatzker classification is type II, which is a lateral tibial plateau fracture with depression. Our null hypothesis was that the 3.5 T-plate and the 4.5 T-plate have no difference in the management of patients with Schatzker type II tibial plateau fractures. Materials and Methods: The current study is a clinical trial that was conducted on patients with tibial plateau fractures. The Knee Society Score (KSS) was this study's main outcome. Tourniquet time (TT) and patient quality of life using the 36-item Short Form Survey Instrument (SF-36) were secondary goals of the outcomes measurement study. VAS measured pain. Among 176 patients, 89 and 87 of cases underwent surgical treatment with 3.5-mm (group A) and 4.5-mm (group B) T-plate, respectively. The data were entered into SPSS software (version 25, IBM Corporation, Armonk, NY) and analyzed. Results: In our study, we evaluated 176 patients with a mean age of 34.8 ± 15.2 years. Functional and clinical KSS scores were similar between the two groups throughout follow-up (P > 0.05). Regarding the other variables of VAS, TT, SF-36 physical function, and SF-36 mental health, no significant difference was observed between the two groups, and the two groups had similar averages in terms of these indicators (P > 0.05). Conclusion: According to the results, both plates had the appropriate functional outcomes in patients with split depression tibial plateau fracture.

Evaluating the Effectiveness of Conventional Prostheses Against Dual-Mobility Prostheses in the Treatment of Femoral Neck Fractures in Two Separate Groups of Patients: A Clinical Trial Study.

Background: Femoral neck fracture is a common posttraumatic injury in the elderly. Currently, orthopedic surgeons conducting total hip arthroplasty (THA) for hip fractures have various prosthetic alternatives. Dual-mobility cup THA is recommended for hip fracture patients to reduce prosthesis dislocation. Therefore, the goal of this research is to evaluate the effectiveness of conventional prostheses against dual-mobility prostheses in treating femoral neck fractures in two groups of patients. Materials and Methods: The current clinical investigation involved patients with femoral neck fractures. Among approved 84 patients, 44 and 40 were undergoing conventional THA (group A) and dual-mobility THA (group B), respectively. Patients were observed regularly after surgeries, and the same measurements were performed. The data were assembled and entered into SPSS software (version 25, IBM Corporation, Armonk, NY, USA) and analyzed. In all analyses, a P value of less than 0.05 was considered significant. Results: Eighty-four cases with an average age of 63.97 years were evaluated. In postoperative follow-up, there were no statistically significant differences between the groups in terms of Harris hip score, SF-36, and infection (P > 0.05). However, patients who received conventional implants had more dislocation postoperatively (P = 0.045). Regarding the rehabilitation costs, there were no statistically significant differences between the groups, so the group using the conventional implants incurred a higher cost (P = 0.041). Conclusion: According to the results, both dual mobility and conventional implants had optimal functional outcomes in patients with femoral neck fractures.

Comparison of the effects of preoperative celecoxib and gabapentin on pain, functional recovery, and quality of life after total knee arthroplasty: A randomized controlled clinical trial.

Background: Acute pain is one of the main complaints of patients after total knee arthroplasty (TKA), which causes delayed mobility, increased morphine consumption, and subsequently increased costs. Therefore, the present study was performed to evaluate the preventive effect of preoperative celecoxib and gabapentin on reducing patient pain as a primary outcome after TKA surgery. Materials and Methods: This randomized, double-blind controlled clinical trial was performed on 270 patients with osteoarthritis that were candidates for TKA surgery allocated into three groups. In the first group, 900 mg of gabapentin was administered orally on a daily basis for 3 days before surgery. In the second group, 200 mg of oral celecoxib was administered twice daily for 3 days before surgery. In the third group, oral placebo was administered twice daily for 3 days before the surgery. The patients' pain score and knee and its functional score were recoded. Results: The mean of reduction pain in gabapentin and celecoxib groups was significantly lower than that of the control group at 12, 24, and 48 h after surgery (P < 0.001); however, two groups were not significantly different from each other (P > 0.05). Furthermore, the two medication groups were not significantly different in this regard (P > 0.05). In addition, the knee score in the gabapentin group with the means of 85.40 ± 5.47 and the celecoxib group with the means of 87.03 ± 3.97 were significantly higher than those of the control group with the means of 78.90 ± 4.39 in the 1st month after the surgery (P < 0.001). Conclusion: According to the results of the present study, the preventive administration of gabapentin and celecoxib showed a significant and similar effectiveness on reducing patient pain after TKA surgery and on improving the KSS and quality of life scores.

Management of orthopedic patients during COVID-19 outbreak.

Coronavirus Disease 2019 (COVID-19) pandemic was declared on March 11, 2020, which led to the massive economic and social crisis in the world. Hospitals and healthcare systems faced the most changes during this time. As for any other medical departments, orthopedic departments were affected by this situation. Trauma and musculoskeletal injuries require emergency action or even operation which would not stop due to COVID-19 crisis. Special protocols and guidelines were used to minimize infection risks in Kashani educational trauma center. Here we explain the changes and protocols in the following sections: Outpatient-Clinic, emergency department, Operation room and Orthopedic Ward. These strategies included: reducing the number of admitted patients in clinics, changing the decoration of waiting rooms, screening the patients at the entrance and personal protection equipment for staff. We also dedicated special emergency rooms for patients suspicious to COVID-19 infection and also special operation rooms and corridor for patients with COVID-19 infection. Changes in discharging protocols and continuous consultations with infectious diseases specialists brought us the ability to manage these patients. Here in the present paper, we described different strategies of the management of patients in Kashani hospital during COVID-19 outbreak. We hope that our experience of patient's management could help other physicians and hospitals.