Archives of Trauma Research Archives of Trauma Research Arch Trauma Res http://www.archtrauma.com 2251-953X 2251-9599 10.5812/atr. en jalali 2018 1 23 gregorian 2018 1 23 3 3
en 10.5812/atr.11443 Analgesic Effects of Gabapentin and Diclofenac on Post-Operative Pain in Patients Undergoing Tonsillectomy Analgesic Effects of Gabapentin and Diclofenac on Post-Operative Pain in Patients Undergoing Tonsillectomy letter letter Pain;Gabapentin;Diclofenac;Tonsillectomy Pain;Gabapentin;Diclofenac;Tonsillectomy http://www.archtrauma.com/index.php?page=article&article_id=11443 Sermin Oztekin Sermin Oztekin Department of Anesthesiology and Reanimation, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey Department of Anesthesiology and Reanimation, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey Seden Duru Seden Duru Department of Anesthesiology and Reanimation, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey; Department of Anesthesiology and Reanimation, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey, Tel: +90-5072341930 Department of Anesthesiology and Reanimation, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey; Department of Anesthesiology and Reanimation, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey, Tel: +90-5072341930
en 10.5812/atr.18325 Plate on Plate Technique of Minimally Invasive Percutaneous Plate Osteosynthesis in Distal Tibial Fractures, an Easy and Inexpensive Method of Fracture Fixation Plate on Plate Technique of Minimally Invasive Percutaneous Plate Osteosynthesis in Distal Tibial Fractures, an Easy and Inexpensive Method of Fracture Fixation research-article research-article Background

Plate on plate technique can lessen operative time and patient morbidity.

Objectives

This study aimed to evaluate the outcomes of minimally invasive percutaneous plate osteosynthesis (MIPPO) using plate on plate technique of locking plate fixation for closed fractures of distal tibia in a prospective study.

Patients and Methods

Twenty-five patients with distal tibial fractures were treated by MIPPO using locking plate by plate on plate technique. Preoperative variables including age of patient, mode of trauma, type of fracture and soft tissue status were recorded for each patient. Perioperative variables included surgical time and radiation exposure. Postoperative variables included wound status, time to union, return to activity and the American orthopaedic foot and ankle score (AOFAS).

Results

All the fractures had united at one year. The average time to union was 16.8 weeks. There were two cases of superficial infection and two cases of deep infection, which required removal of hardware after the fracture was united. The average AO foot and ankle score was 83.6 in our study population.

Conclusions

MIPPO using locking plate by plate on plate technique was a safe, effective, inexpensive and easily reproducible method for the treatment of distal tibial fractures in properly selected patients, which minimized operative time and soft tissue morbidity.

Background

Plate on plate technique can lessen operative time and patient morbidity.

Objectives

This study aimed to evaluate the outcomes of minimally invasive percutaneous plate osteosynthesis (MIPPO) using plate on plate technique of locking plate fixation for closed fractures of distal tibia in a prospective study.

Patients and Methods

Twenty-five patients with distal tibial fractures were treated by MIPPO using locking plate by plate on plate technique. Preoperative variables including age of patient, mode of trauma, type of fracture and soft tissue status were recorded for each patient. Perioperative variables included surgical time and radiation exposure. Postoperative variables included wound status, time to union, return to activity and the American orthopaedic foot and ankle score (AOFAS).

Results

All the fractures had united at one year. The average time to union was 16.8 weeks. There were two cases of superficial infection and two cases of deep infection, which required removal of hardware after the fracture was united. The average AO foot and ankle score was 83.6 in our study population.

Conclusions

MIPPO using locking plate by plate on plate technique was a safe, effective, inexpensive and easily reproducible method for the treatment of distal tibial fractures in properly selected patients, which minimized operative time and soft tissue morbidity.

Percutaneous;Plate on Plate;Tibia;Bone Fractures Percutaneous;Plate on Plate;Tibia;Bone Fractures http://www.archtrauma.com/index.php?page=article&article_id=18325 Nasir Muzaffar Nasir Muzaffar Bone and Joint Surgery Hospital, Barzalla, Srinagar, Kashmir, India; Bone and Joint Surgery Hospital, Barzalla, Srinagar, Kashmir, India. Tel: +91-01942430155; +91-01942430149, Fax: +91-01942433730 Bone and Joint Surgery Hospital, Barzalla, Srinagar, Kashmir, India; Bone and Joint Surgery Hospital, Barzalla, Srinagar, Kashmir, India. Tel: +91-01942430155; +91-01942430149, Fax: +91-01942433730 Rafiq Bhat Rafiq Bhat Bone and Joint Surgery Hospital, Barzalla, Srinagar, Kashmir, India Bone and Joint Surgery Hospital, Barzalla, Srinagar, Kashmir, India Mohammad Yasin Mohammad Yasin Bone and Joint Surgery Hospital, Barzalla, Srinagar, Kashmir, India Bone and Joint Surgery Hospital, Barzalla, Srinagar, Kashmir, India
en 10.5812/atr.20957 Peritoneal Potassium and pH Measurement in Early Diagnosis of Acute Mesenteric Ischemia in Rats Peritoneal Potassium and pH Measurement in Early Diagnosis of Acute Mesenteric Ischemia in Rats research-article research-article Background

In contemporary practice, acute mesenteric ischemia (AMI) remains a serious cause of morbidity and mortality in abdominal emergencies.

Objectives

We report the measurement of peritoneal fluid potassium and pH on a small series of rats that developed extensive AMI following the surgical ligation of superior mesenteric vessels and compare the results with control groups.

Materials and Methods

A total of 32 rats were used in our study. They were divided into four groups with eight rats in each one and received following treatments: group I (G-I), 60-minute controls; group II (G-II), 120-minute controls; group III (G-III), 60-minute cases; and group IV (G-IV), 120-minute cases. In case groups, the small bowel mesenteric root was double-ligated and an arrow single-lumen central venous catheter was passed through the skin to the peritoneum. In control groups, the catheter was placed without any intervention. Postoperatively, peritoneal lavage was performed at 60 (G-I, G-III) and 120 minutes (G-II, G-IV).

Results

The mean peritoneal potassium values were 1.3 ± 0.3, 1.97 ± 1.06, 2.14 ± 0.89, and 3.28 ± 0.66 mmol/L in G-I, G-II, G-III, and G-IV, respectively. There were significant differences between G-III and G-IV (P = 0.002), between G-I and G-III (P = 0.024), and between G-II and G-IV (P = 0.001). The mean values of peritoneal fluid pH were 7.1 ± 0.26, 6.82 ± 0.22, 6.66 ± 0.16, and 6.78 ± 0.04 in G-I, G-II, G-III, and G-IV, respectively, which indicated significant differences between G-I and G-III (P = 0.001) and between G-II and G-IV (P = 0.018). There was a significant correlation between peritoneal fluid potassium and intestine ischemic grade (F = 4.77, P = 0.048)

Conclusions

Our findings show that for early detection of bowel ischemia, an evaluation of intraperitoneal potassium and pH was useful and with prolongation of ischemia, potassium changes were more significant.

Background

In contemporary practice, acute mesenteric ischemia (AMI) remains a serious cause of morbidity and mortality in abdominal emergencies.

Objectives

We report the measurement of peritoneal fluid potassium and pH on a small series of rats that developed extensive AMI following the surgical ligation of superior mesenteric vessels and compare the results with control groups.

Materials and Methods

A total of 32 rats were used in our study. They were divided into four groups with eight rats in each one and received following treatments: group I (G-I), 60-minute controls; group II (G-II), 120-minute controls; group III (G-III), 60-minute cases; and group IV (G-IV), 120-minute cases. In case groups, the small bowel mesenteric root was double-ligated and an arrow single-lumen central venous catheter was passed through the skin to the peritoneum. In control groups, the catheter was placed without any intervention. Postoperatively, peritoneal lavage was performed at 60 (G-I, G-III) and 120 minutes (G-II, G-IV).

Results

The mean peritoneal potassium values were 1.3 ± 0.3, 1.97 ± 1.06, 2.14 ± 0.89, and 3.28 ± 0.66 mmol/L in G-I, G-II, G-III, and G-IV, respectively. There were significant differences between G-III and G-IV (P = 0.002), between G-I and G-III (P = 0.024), and between G-II and G-IV (P = 0.001). The mean values of peritoneal fluid pH were 7.1 ± 0.26, 6.82 ± 0.22, 6.66 ± 0.16, and 6.78 ± 0.04 in G-I, G-II, G-III, and G-IV, respectively, which indicated significant differences between G-I and G-III (P = 0.001) and between G-II and G-IV (P = 0.018). There was a significant correlation between peritoneal fluid potassium and intestine ischemic grade (F = 4.77, P = 0.048)

Conclusions

Our findings show that for early detection of bowel ischemia, an evaluation of intraperitoneal potassium and pH was useful and with prolongation of ischemia, potassium changes were more significant.

Ischemia;Potassium;Acute Ischemia;Potassium;Acute http://www.archtrauma.com/index.php?page=article&article_id=20957 Mehrdad Hosseinpour Mehrdad Hosseinpour Trauma Research Center, Kashan University of Medical Sciences, Kashan, IR Iran; Trauma Research center, Kashan University of Medical Sciences, Kashan, IR Iran. Tel: +98-3116255368, Fax: +98-3116255368 Trauma Research Center, Kashan University of Medical Sciences, Kashan, IR Iran; Trauma Research center, Kashan University of Medical Sciences, Kashan, IR Iran. Tel: +98-3116255368, Fax: +98-3116255368 Tahere Khamechian Tahere Khamechian Trauma Research Center, Kashan University of Medical Sciences, Kashan, IR Iran Trauma Research Center, Kashan University of Medical Sciences, Kashan, IR Iran Soraya Shahrokh Soraya Shahrokh Trauma Research Center, Kashan University of Medical Sciences, Kashan, IR Iran Trauma Research Center, Kashan University of Medical Sciences, Kashan, IR Iran
en 10.5812/atr.20556 Split Fracture: A Complication of Cerclage Wiring of Acute Patellar Fracture Split Fracture: A Complication of Cerclage Wiring of Acute Patellar Fracture case-report case-report Introduction

Iatrogenic patellar fracture is reported as a complication of patella procedures, such as medial patellofemoral ligament reconstruction, reconstruction of the anterior cruciate ligament of the knee using bone-patellar tendon-bone technique, and resurfacing the patella in total knee arthroplasty.

Case Presentation

A 65-year-old lady with right patella fracture was treated with open reduction and cerclage wiring. An iatrogenic split fracture was noted during tension of the cerclage wire and was successfully managed by screw fixation of the split fracture.

Conclusions

Split fracture is a rare complication of circumferential cerclage wiring of patellar fracture. The surgeon should be aware of the contributing factors in order to avoid this complication.

Introduction

Iatrogenic patellar fracture is reported as a complication of patella procedures, such as medial patellofemoral ligament reconstruction, reconstruction of the anterior cruciate ligament of the knee using bone-patellar tendon-bone technique, and resurfacing the patella in total knee arthroplasty.

Case Presentation

A 65-year-old lady with right patella fracture was treated with open reduction and cerclage wiring. An iatrogenic split fracture was noted during tension of the cerclage wire and was successfully managed by screw fixation of the split fracture.

Conclusions

Split fracture is a rare complication of circumferential cerclage wiring of patellar fracture. The surgeon should be aware of the contributing factors in order to avoid this complication.

Patella;Fracture;Cerclage Wire;Split Patella;Fracture;Cerclage Wire;Split http://www.archtrauma.com/index.php?page=article&article_id=20556 Cho Yau Lo Cho Yau Lo Department of Orthopedics and Traumatology, North District Hospital, Hong Kong, China Department of Orthopedics and Traumatology, North District Hospital, Hong Kong, China Tun Hing Lui Tun Hing Lui Department of Orthopedics and Traumatology, North District Hospital, Hong Kong, China; Department of Orthopedics and Traumatology, North District Hospital, 9 Po Kin Road Sheung Shui, Hong Kong, China. Tel: +852-26838023, Fax: +852-26838028 Department of Orthopedics and Traumatology, North District Hospital, Hong Kong, China; Department of Orthopedics and Traumatology, North District Hospital, 9 Po Kin Road Sheung Shui, Hong Kong, China. Tel: +852-26838023, Fax: +852-26838028 Yan Kit Sit Yan Kit Sit Department of Orthopedics and Traumatology, North District Hospital, Hong Kong, China Department of Orthopedics and Traumatology, North District Hospital, Hong Kong, China
en 10.5812/atr.20608 Dependency in Activities of Daily Living Following Limb Trauma in Elderly Referred to Shahid Beheshti Hospital, Kashan-Iran in 2013 Dependency in Activities of Daily Living Following Limb Trauma in Elderly Referred to Shahid Beheshti Hospital, Kashan-Iran in 2013 research-article research-article Background

Activities of daily living (ADL) are an important indicator of health and independence in elderly. It provides useful information for proper planning in the field of elderly care. Trauma in elderly population is frequent and can negatively affect the independence in ADL.

Objectives

The purpose of the present study was to evaluate elderly independence in activities of daily living (ADL) following limb trauma and its related factors in patients referred to trauma emergency ward of Shahid Beheshti Hospital, Kashan, Iran, in 2013.

Patients and Methods

This descriptive study was conducted on 200 traumatic patients admitted to trauma emergency ward of Shahid Beheshti Hospital in 2013. The questionnaire used in this study had three parts as demographic data, information related to trauma and ISADL (independency scale of activities of daily living). ISADL was completed in emergency ward to declare pretraumatic status; it was also completed 1 and 3 months after trauma. Statistical analysis was conducted by Chi-square test, One-way and two-factor ANOVA, and Multiple regression analysis. Data analysis was conducted using SPSS software, version 16.

Results

The average age of participants was 70.57 ± 9.05 years. In total, 80.5% of the elderly were completely independent in ISADL before trauma; this decreased to 13.5% one month after trauma. Besides, 32% of the elderly were completely or relatively dependent three months after trauma. Two-factor ANOVA showed a significant association between the scores of ISADL, the time interval and the type and location of an injured organ, and having the surgery as a treatment.

Conclusions

More than three-quarters of the elderly were independent in ISADL before the trauma, but trauma in elderly patients had a substantial negative effect on patients' ability and ADL function.

Background

Activities of daily living (ADL) are an important indicator of health and independence in elderly. It provides useful information for proper planning in the field of elderly care. Trauma in elderly population is frequent and can negatively affect the independence in ADL.

Objectives

The purpose of the present study was to evaluate elderly independence in activities of daily living (ADL) following limb trauma and its related factors in patients referred to trauma emergency ward of Shahid Beheshti Hospital, Kashan, Iran, in 2013.

Patients and Methods

This descriptive study was conducted on 200 traumatic patients admitted to trauma emergency ward of Shahid Beheshti Hospital in 2013. The questionnaire used in this study had three parts as demographic data, information related to trauma and ISADL (independency scale of activities of daily living). ISADL was completed in emergency ward to declare pretraumatic status; it was also completed 1 and 3 months after trauma. Statistical analysis was conducted by Chi-square test, One-way and two-factor ANOVA, and Multiple regression analysis. Data analysis was conducted using SPSS software, version 16.

Results

The average age of participants was 70.57 ± 9.05 years. In total, 80.5% of the elderly were completely independent in ISADL before trauma; this decreased to 13.5% one month after trauma. Besides, 32% of the elderly were completely or relatively dependent three months after trauma. Two-factor ANOVA showed a significant association between the scores of ISADL, the time interval and the type and location of an injured organ, and having the surgery as a treatment.

Conclusions

More than three-quarters of the elderly were independent in ISADL before the trauma, but trauma in elderly patients had a substantial negative effect on patients' ability and ADL function.

Activities of Daily Living;Limb;Trauma;Elderly Activities of Daily Living;Limb;Trauma;Elderly http://www.archtrauma.com/index.php?page=article&article_id=20608 Negin Masoudi Alavi Negin Masoudi Alavi Trauma Nursing Research Center, Kashan University of Medical Sciences, Kashan, IR Iran Trauma Nursing Research Center, Kashan University of Medical Sciences, Kashan, IR Iran Azade Safa Azade Safa Department of Medical Surgical Nursing, School of Nursing and Midwifery, Kashan, IR Iran; Department of Medical Surgical Nursing, School of Nursing and Midwifery, Kashan, IR Iran. Tel: +98-3615550021, Fax: +98-3615556633 Department of Medical Surgical Nursing, School of Nursing and Midwifery, Kashan, IR Iran; Department of Medical Surgical Nursing, School of Nursing and Midwifery, Kashan, IR Iran. Tel: +98-3615550021, Fax: +98-3615556633 Masoumeh Abedzadeh-Kalahroudi Masoumeh Abedzadeh-Kalahroudi Trauma Research Center, Kashan University of Medical Sciences, Kashan, IR Iran Trauma Research Center, Kashan University of Medical Sciences, Kashan, IR Iran
en 10.5812/atr.19122 Evaluation of the Use and Reasons for Not Using a Helmet by Motorcyclists Admitted to the Emergency Ward of Shahid Bahonar Hospital in Kerman Evaluation of the Use and Reasons for Not Using a Helmet by Motorcyclists Admitted to the Emergency Ward of Shahid Bahonar Hospital in Kerman research-article research-article Background

Motorcycle crashes are the cause of severe morbidity and mortality especially because of head injuries. It seems that wearing a helmet has an effective role in protection against head injuries. Nevertheless, motorcyclists usually have no tendency to wear a helmet when driving in cities and have several reasons for this behavior.

Objectives

This study aimed to evaluate the use and reasons for not using a helmet by motorcyclists admitted to an emergency ward of a trauma hospital due to accident in Kerman, Iran.

Patients and Methods

This study was carried out by recoding the opinions of motorcyclists who had been transferred to the emergency ward of Shahid Bahonar Hospital (Kerman/Iran). Since no data was available on the frequency of the use of helmets, a pilot study was carried out and a sample size of 377 was determined for the main study. Then a researcher-made questionnaire was used to investigate the motorcyclists’ reasons for not using a helmet.

Results

Only 21.5% of the motorcyclists had been wearing helmets at the time of the accident. The most frequent reasons for not using a helmet were the heavy weight of the helmet (77%), feeling of heat (71.4%), pain in the neck (69.4%), feeling of suffocation (67.7%), limitation of head and neck movements (59.6%) and all together, physical discomfort was the main cause of not wearing a helmet during motorcycle rides.

Conclusions

In general, it appears that it is possible to increase the use of helmets by eliminating its physical problems, and increasing the knowledge of community members in relation to the advantages of helmet use, which will result in a significant decrease in traumas resulting from motorcycle accidents.

Background

Motorcycle crashes are the cause of severe morbidity and mortality especially because of head injuries. It seems that wearing a helmet has an effective role in protection against head injuries. Nevertheless, motorcyclists usually have no tendency to wear a helmet when driving in cities and have several reasons for this behavior.

Objectives

This study aimed to evaluate the use and reasons for not using a helmet by motorcyclists admitted to an emergency ward of a trauma hospital due to accident in Kerman, Iran.

Patients and Methods

This study was carried out by recoding the opinions of motorcyclists who had been transferred to the emergency ward of Shahid Bahonar Hospital (Kerman/Iran). Since no data was available on the frequency of the use of helmets, a pilot study was carried out and a sample size of 377 was determined for the main study. Then a researcher-made questionnaire was used to investigate the motorcyclists’ reasons for not using a helmet.

Results

Only 21.5% of the motorcyclists had been wearing helmets at the time of the accident. The most frequent reasons for not using a helmet were the heavy weight of the helmet (77%), feeling of heat (71.4%), pain in the neck (69.4%), feeling of suffocation (67.7%), limitation of head and neck movements (59.6%) and all together, physical discomfort was the main cause of not wearing a helmet during motorcycle rides.

Conclusions

In general, it appears that it is possible to increase the use of helmets by eliminating its physical problems, and increasing the knowledge of community members in relation to the advantages of helmet use, which will result in a significant decrease in traumas resulting from motorcycle accidents.

Motorcyclists;Helmet;Use;Reasons Motorcyclists;Helmet;Use;Reasons http://www.archtrauma.com/index.php?page=article&article_id=19122 Javad Faryabi Javad Faryabi Department of Oral and Maxillofacial Surgery, Oral and Dental Diseases Research Center, Kerman University of Medical Sciences, Kerman, IR Iran Department of Oral and Maxillofacial Surgery, Oral and Dental Diseases Research Center, Kerman University of Medical Sciences, Kerman, IR Iran Mahboobeh Rajabi Mahboobeh Rajabi Research Center for Health Services Management, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, IR Iran; Research Center for Health Services Management, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, IR Iran. Tel: +98-3432111511, Fax: +98-3432111613 Research Center for Health Services Management, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, IR Iran; Research Center for Health Services Management, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, IR Iran. Tel: +98-3432111511, Fax: +98-3432111613 Shahin Alirezaee Shahin Alirezaee Shahid Bahonar Hospital, Kerman, IR Iran Shahid Bahonar Hospital, Kerman, IR Iran
en 10.5812/atr.15840 Impact of Psychological Problems and Marital Adjustment of Iranian Veterans on Their Children's Quality of Life and Happiness Impact of Psychological Problems and Marital Adjustment of Iranian Veterans on Their Children's Quality of Life and Happiness research-article research-article Conclusions

In veterans' family, psychological health of the veterans and marital adjustment of the parents have a significant relationship with their children's quality of life and happiness.

Results

Global Severity Index (GSI) scores of veterans and veteran's age were inversely correlated with the scores of children's quality of life, while marital adjustment of parents and number of rooms in house were positively correlated. Mother's age was inversely correlated with the scores of children's happiness, while marital adjustment of the parents, the number of rooms in their house and the number of children were positively correlated.

Patients and Methods

The sample was all children of veterans in Isfahan city that registered by Veterans and Martyrs Affair Foundation (VMAF). One hundred sixty-three veterans were selected by systematic randomized sampling and the symptom checklist-90-revised (SCL-90-R) and dyadic adjustment scale (DAS) were administered for them. Their wives filled out the DAS and their children answered to World Health Organization Quality of Life-Brief version (WHOQOL-BREF) and Oxford Happiness Inventory (OHI). The data from questionnaires completed by 149 families were analyzed using the multiple regressions analysis.

Background

The Iran-Iraq war during the 1980-1988 has left many consequences on veterans and their families that persist long after the war ended.

Objectives

The aim of this study was to evaluate the impact of psychological problems and marital adjustment of Iranian veterans on their children's quality of life and happiness 24 years after the war ended.

Conclusions

In veterans' family, psychological health of the veterans and marital adjustment of the parents have a significant relationship with their children's quality of life and happiness.

Results

Global Severity Index (GSI) scores of veterans and veteran's age were inversely correlated with the scores of children's quality of life, while marital adjustment of parents and number of rooms in house were positively correlated. Mother's age was inversely correlated with the scores of children's happiness, while marital adjustment of the parents, the number of rooms in their house and the number of children were positively correlated.

Patients and Methods

The sample was all children of veterans in Isfahan city that registered by Veterans and Martyrs Affair Foundation (VMAF). One hundred sixty-three veterans were selected by systematic randomized sampling and the symptom checklist-90-revised (SCL-90-R) and dyadic adjustment scale (DAS) were administered for them. Their wives filled out the DAS and their children answered to World Health Organization Quality of Life-Brief version (WHOQOL-BREF) and Oxford Happiness Inventory (OHI). The data from questionnaires completed by 149 families were analyzed using the multiple regressions analysis.

Background

The Iran-Iraq war during the 1980-1988 has left many consequences on veterans and their families that persist long after the war ended.

Objectives

The aim of this study was to evaluate the impact of psychological problems and marital adjustment of Iranian veterans on their children's quality of life and happiness 24 years after the war ended.

Marital Status;Adjustment;Veterans;Quality of Life;Happiness Marital Status;Adjustment;Veterans;Quality of Life;Happiness http://www.archtrauma.com/index.php?page=article&article_id=15840 Fatemeh Zargar Fatemeh Zargar Trauma Research Center, Kashan University of Medical Sciences, Kashan, IR Iran; Department of Clinical Psychology, Kashan University of Medical Sciences, Kashan, IR Iran. Tel: +98-3615550021 Trauma Research Center, Kashan University of Medical Sciences, Kashan, IR Iran; Department of Clinical Psychology, Kashan University of Medical Sciences, Kashan, IR Iran. Tel: +98-3615550021
en 10.5812/atr.23364 The Transforming Face of Fracture Epidemiology The Transforming Face of Fracture Epidemiology editorial editorial Epidemiology; Trauma Epidemiology; Trauma http://www.archtrauma.com/index.php?page=article&article_id=23364 Babak Haghpanah Babak Haghpanah Trauma Research Center, Kashan University of Medical Sciences, Kashan, IR Iran; Trauma Research Center, Kashan University of Medical Sciences, Kashan, IR Iran. Tel: +98-3615550026 Trauma Research Center, Kashan University of Medical Sciences, Kashan, IR Iran; Trauma Research Center, Kashan University of Medical Sciences, Kashan, IR Iran. Tel: +98-3615550026
en 10.5812/atr.21742 Clinical Outcomes After Posterior Open Elbow Arthrolysis for Posttraumatic Elbow Stiffness Clinical Outcomes After Posterior Open Elbow Arthrolysis for Posttraumatic Elbow Stiffness research-article research-article Background

Loss of motion is a well-known complication after elbow trauma and in severe cases, arthrolysis of elbow is the procedure of choice. The posterior approach might have some advantages especially in post-traumatic patients who have undergone the same surgical approach in the past.

Objectives

The aim of this study was to evaluate the short-term outcomes of elbow arthrolysis through posterior approach. Moreover, we assessed the effect of operation on the patients’ quality of life.

Patients and Methods

During a retrospective-cohort study, the medical records of 14 patients (12 men, two women) whose range of movement had been limited post-traumatically and had undergone elbow arthrolysis with posterior approach were reviewed. Before intervention, the patients had a flexion less than 100 degrees or an extension lag of 30 degrees or more. For evaluation of the final outcomes, they were invited to participate in our study and the final range of motion, visual analogue score (VAS), disability of arm, shoulder and hand (DASH), Mayo elbow score (MES) and short form health survey (SF-36) scores were measured in the patients.

Results

Mean age of the participants was 28.7 years. The interval from initial injury and arthrolysis was 16 months and the patients were followed for 14 months. The mean range of motion in patients before surgery was 35.8 degrees, which was increased to a mean of 108.9 after the surgery, indicating a 73.1 degrees improvement. The means of VAS, DASH, Mayo elbow and SF-36 scores in the patients were 1.6, 34, 68 and 43, respectively. A significant inverse correlation was found between the preoperative range of motion and final range of motion.

Conclusions

According to our results, elbow arthrolysis through posterior approach could be an effective technique with low complications. Since the final range of motion improved significantly, it might be a valuable method in promoting the patients’ quality of life.

Background

Loss of motion is a well-known complication after elbow trauma and in severe cases, arthrolysis of elbow is the procedure of choice. The posterior approach might have some advantages especially in post-traumatic patients who have undergone the same surgical approach in the past.

Objectives

The aim of this study was to evaluate the short-term outcomes of elbow arthrolysis through posterior approach. Moreover, we assessed the effect of operation on the patients’ quality of life.

Patients and Methods

During a retrospective-cohort study, the medical records of 14 patients (12 men, two women) whose range of movement had been limited post-traumatically and had undergone elbow arthrolysis with posterior approach were reviewed. Before intervention, the patients had a flexion less than 100 degrees or an extension lag of 30 degrees or more. For evaluation of the final outcomes, they were invited to participate in our study and the final range of motion, visual analogue score (VAS), disability of arm, shoulder and hand (DASH), Mayo elbow score (MES) and short form health survey (SF-36) scores were measured in the patients.

Results

Mean age of the participants was 28.7 years. The interval from initial injury and arthrolysis was 16 months and the patients were followed for 14 months. The mean range of motion in patients before surgery was 35.8 degrees, which was increased to a mean of 108.9 after the surgery, indicating a 73.1 degrees improvement. The means of VAS, DASH, Mayo elbow and SF-36 scores in the patients were 1.6, 34, 68 and 43, respectively. A significant inverse correlation was found between the preoperative range of motion and final range of motion.

Conclusions

According to our results, elbow arthrolysis through posterior approach could be an effective technique with low complications. Since the final range of motion improved significantly, it might be a valuable method in promoting the patients’ quality of life.

Elbow;Stiffness;Release;DASH Elbow;Stiffness;Release;DASH http://www.archtrauma.com/index.php?page=article&article_id=21742 Ali Birjandi Nejad Ali Birjandi Nejad Orthopedic Research Center, Shahid Kamyab Hospital, Mashhad University of Medical Sciences, Mashhad, IR Iran Orthopedic Research Center, Shahid Kamyab Hospital, Mashhad University of Medical Sciences, Mashhad, IR Iran Mohammad Hosein Ebrahimzadeh Mohammad Hosein Ebrahimzadeh Orthopedic Research Center, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, IR Iran; Orthopedic Research Center, Ghaem Hospital, Mashhad University of Medical Sciences, P. O. Box: 91799-99199, Mashhad, IR Iran. Tel/Fax: +98-5118417453 Orthopedic Research Center, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, IR Iran; Orthopedic Research Center, Ghaem Hospital, Mashhad University of Medical Sciences, P. O. Box: 91799-99199, Mashhad, IR Iran. Tel/Fax: +98-5118417453 Ali Moradi Ali Moradi Department of Orthopedic Surgery, Mashhad University of Medical Sciences, Mashhad, IR Iran; Mass General Hospital, Harvard Medical School, Boston, US Department of Orthopedic Surgery, Mashhad University of Medical Sciences, Mashhad, IR Iran; Mass General Hospital, Harvard Medical School, Boston, US
en 10.5812/atr.19036 Spinal Cord Injury Without Radiological Abnormality in Adult Thoracic Spinal Trauma Spinal Cord Injury Without Radiological Abnormality in Adult Thoracic Spinal Trauma case-report case-report Introduction

Spinal cord injury without radiological abnormality (SCIWORA) is a rare entity and usually involves the cervical spine. Thoracic spine involvement is very rare due to the stability provided by the rib cage. The mechanisms of injury and pathophysiology are still debatable.

Case Presentation

We present a case of an adult male who had road traffic accident and presented with paraplegia. The initial radiological investigations carried out in the emergency department were reported to be normal, however, subsequent magnetic resonance imaging revealed spinal cord contusion without vertebral column disruption. The patient recovered partially with conservative treatment measures including bed rest and methylprednisolone.

Conclusions

Spinal trauma patients presenting with neurological deficit but no radiological abnormality should be treated as a case of SCIWORA.

Introduction

Spinal cord injury without radiological abnormality (SCIWORA) is a rare entity and usually involves the cervical spine. Thoracic spine involvement is very rare due to the stability provided by the rib cage. The mechanisms of injury and pathophysiology are still debatable.

Case Presentation

We present a case of an adult male who had road traffic accident and presented with paraplegia. The initial radiological investigations carried out in the emergency department were reported to be normal, however, subsequent magnetic resonance imaging revealed spinal cord contusion without vertebral column disruption. The patient recovered partially with conservative treatment measures including bed rest and methylprednisolone.

Conclusions

Spinal trauma patients presenting with neurological deficit but no radiological abnormality should be treated as a case of SCIWORA.

Spinal Cord Injuries;Trauma;Spine Spinal Cord Injuries;Trauma;Spine http://www.archtrauma.com/index.php?page=article&article_id=19036 Kavin Khatri Kavin Khatri Department of Orthopaedics, Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, Safdarjung Enclave, New Delhi, Delhi, India; Department of Orthopaedics, Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, Safdarjung Enclave, New Delhi, Delhi, India. Tel: +91-8743878077 Department of Orthopaedics, Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, Safdarjung Enclave, New Delhi, Delhi, India; Department of Orthopaedics, Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, Safdarjung Enclave, New Delhi, Delhi, India. Tel: +91-8743878077 Kamran Farooque Kamran Farooque Department of Orthopaedics, Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, Safdarjung Enclave, New Delhi, Delhi, India Department of Orthopaedics, Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, Safdarjung Enclave, New Delhi, Delhi, India Ankit Gupta Ankit Gupta Department of Orthopaedics, Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, Safdarjung Enclave, New Delhi, Delhi, India Department of Orthopaedics, Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, Safdarjung Enclave, New Delhi, Delhi, India Vijay Sharma Vijay Sharma Department of Orthopaedics, Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, Safdarjung Enclave, New Delhi, Delhi, India Department of Orthopaedics, Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, Safdarjung Enclave, New Delhi, Delhi, India