Balance problems after unilateral lateral ankle sprains

Ankle ligament injury is the most common injury in athletic activities. This study examined balance problems in athletes with acute lateral ankle sprains. Thirty male athletes aged 20 to 35 years with right dominant side and traumatic ankle sprain were recruited through simple nonprobability sampling. We measured the sway index and limits of stability with the Biodex Balance System under different conditions. Functional balance was evaluated with two clinical tests: the Functional Reach Test and the Star-Excursion Balance Test. The results showed that balance ability in patients with acute lateral ankle sprain was significantly weaker under closed- versus open-eye conditions. Symmetry of weight-bearing on involved and sound limb in bilateral standing was not significantly different, but weight-bearing on the nondominant limb was significantly higher than on the dominant limb. We can conclude that balance problems occur after acute ankle sprains because of proprioception deficits and that the unconscious (reflexive) aspect of proprioception is more severely affected than the conscious (voluntary) aspect

Morphology of proximal tibia in iranian population and its correlation with available prostheses

Background: Total knee arthroplasty is a complex procedure aiming to relieve pain and improve function. It is critical to select prosthesis that best cover the bone surfaces. Ethnicity may affect fitness of the components mainly designed for Caucasian populations. This study aimed to evaluate morphometric features of proximal tibia in Iranian population. Methods: During 2013, 150 consecutive patients (96 males and 54 females) form orthopedics department of Rasoul-Akram hospital with knee CT scan were randomly enrolled. We entered cases with apparent normal extremity alignment and bone maturity. Cases with history of fracture or conditions affecting knee profile were excluded. Standard cuts were simulated on CT scan. Anteroposterior (AP), mediolateral (ML) and aspect ratio (ML/AP) were measured for general morphology. Medial and lateral AP distance of tibia and their distance to tibial center were measured for checking symmetry. Results: Mean age was 43.0± 10.4 years (rang 11-80). Males showed significantly larger values in ML dimension and aspect ratio than females under a given AP value (p<0.001). However, the aspect ratio was suggestive of similar configuration of proximal tibia profiles among genders. Totally, close correlations were observed among simulated cuts and size-matched tibial components of the prostheses. However, better coverage was provided by some brands via designing interchangeable components for a given dimension. Medial and lateral condyles of tibia were almost symmetrical. Conclusion: Our findings indicated that some alterations in the shape of the components are needed to provide optimal coverage in Iranian population. We propose symmetrical configuration in designing tibial components as well

Short-term Outcomes of Induced Membrane Technique in Treatment of Long Bone Defects in Iran

INTRODUCTION: Severe defects in long bones can be caused by several factors such as trauma that lead to open wound and secondary infections after surgery. Induced membrane technique is one of the therapeutic strategies that can be used for these patients. Due to importance of this method and lack of information about this technique in Iran. AIM: this study was performed to investigate technical strengths and weakness of induced membrane technique. MATERIAL AND METHODS: This case series study conducted on 21 patients with bone defects in the femur and tibia and metatarsal bones referred to orthopedic clinic of Rasoul Akram Hospital, Tehran, Iran, for induced membrane surgery in 2012-2015. Demographic and clinical data were obtained using history, clinical examinations and observations for each patient. Union achievement was the main outcome of this study, which was confirmed by radiographic findings and physical examination. Obtained data was analyzed by SPSS ver. 16. RESULTS: All patients were male except one and their mean age was 30.52 years old. Bone defects were in tibia, femur and metatarsus in 9, 9 and 3 patients, respectively. Three patients received soft tissue reconstruction with flap before induced membrane surgery. Age, defects size, cigarette addiction and drug use and delay to start the treatment had no significant effect on union status. In total, 90 of patients had successful surgery. CONCLUSION: using induced membrane technique in patients with defects in their long bone such as tibia, femur and metatarsus would lead to high success for reconstruction

Evaluation of Judet view radiographs accuracy in classification of acetabular fractures compared with three-dimensional computerized tomographic scan: A retrospective study

Background: In the current diagnostic procedure, generally, both plain radiographs and 3D-CT scans are used for the diagnosis of acetabular fractures. There is no consensus regarding the value of a three-dimensional computerized tomographic (3D-CT) scan alone in the classification of acetabular fractures. In this study, we compared the accuracy of 3D-CT scan and plain radiography through the evaluation of their agreement with the intraoperative surgeon's classification. Method: In a retrospective study, patients who were referred to our center with an acetabular fracture and underwent surgical treatment were included. The classification of acetabular fractures was performed once using Judet view plain radiographs and once using a 3D-CT scan by the corresponding one Experienced musculoskeletal radiologist one independent trauma fellowship-trained orthopaedic who routinely treat acetabular fractures and based on Letournel and Judet classification (17 and 23 years of experience respectively). Cohen's kappa value was used for the assessment agreement between the two imaging modalities, as well as between the imaging modalities and intraoperative classification. Results: Medical files of 152 patients with acetabular fracture were retrospectively reviewed. A kappa value of 0.236 was obtained as the agreement level between radiographs and intraoperative findings (p < 0.001). A kappa value of 0.943 was obtained as the agreement level between 3D-CT and intraoperative classification (p < 0.001). An agreement level of 0.264 was found between the Judet radiographs and 3D-CT scans (p < 0.001). Conclusions: 3D-CT scans are reliable enough in the classification of acetabular fractures, and plain radiographs could be omitted to avoid radiation exposure as well as to reduce the cost for patients who sustain acetabular fractures. © 2020 The Author(s)

MicroRNAs signatures, bioinformatics analysis of miRNAs, miRNA mimics and antagonists, and miRNA therapeutics in osteosarcoma

MicroRNAs (miRNAs) involved in key signaling pathways and aggressive phenotypes of osteosarcoma (OS) was discussed, including PI3K/AKT/MTOR, MTOR AND RAF-1 signaling, tumor suppressor P53- linked miRNAs, NOTCH- related miRNAs, miRNA -15/16 cluster, apoptosis related miRNAs, invasion-metastasis-related miRNAs, and 14Q32-associated miRNAs cluster. Herrin, we discussed insights into the targeted therapies including miRNAs (i.e., tumor-suppressive miRNAs and oncomiRNAs). Using bioinformatics tools, the interaction network of all OS-associated miRNAs and their targets was also depicted. © 2020 The Author(s)

Iranian joint registry (iranian national hip and knee arthroplasty registry)

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. ©BY THE ARCHIVES OF BONE AND JOINT SURGERY

Iranian joint registry (iranian national hip and knee arthroplasty registry)

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. ©BY THE ARCHIVES OF BONE AND JOINT SURGERY

Result of Femoral Fracture Nonunion Surgery with Plating and Bone Graft

Introduction: Close reduction and intra medullary nailing has been established as the treatment for femoral shaft fractures with a nonunion rate of 0.9-1.1 %; though, it is still controversial. Currently, the most accepted method for treatment of non union is exchange nailing. Therefore, this study aimed to investigate treatment of femoral shaft fractures non union via 2 methods of exchange nailing with bone graft and nail removal, and plating with bone graft. Methods: In this case series study, we included all patients with aseptic nonunion femoral fracture who referred to Rasool-Akram hospital from 2007 to 2012 and were clinically indicated for reoperation for nonunion after primary intra medullary nailing. Patients were assessed clinically and radiologically. The patients were treated via either method according to the type of nonunion (atrophic, oligotrophic, hypertrophic). Collected data were recorded in check lists and analyzed with SPSS V.18 software. Results: Of 23 patients with mean age of 30.4±8.5 years, 13 (56%) were treated by exchange nailing with bone graft and 10 (44%) treated by plating and bone graft. Complete union was achieved in 85.7% of patients treated by exchange nailing and bone graft and in 90.9 % of patients treated with plating with bone graft. No leg length discrepancy, pain and infection were reported. Conclusion: This study suggests that treatment results of nonunion femoral fractures with plating bone graft method is as good as or even better than exchange nailing with bone graft. In addition, the prevalence of femoral fracture nonunion seems to be more than what was expected before

Surgical treatment of humeral shaft fractures by interlocking nailing

Background: Interlocking nailing is a surgical technique in the treatment of patients with humeral shaft fractures that can not be treated by non surgical procedures. There are controversies about benefits of this technique. So we evaluated this technique in patients with humeral shaft fracture during 2000-2004. Materials and Methods: This case series study was performed on 34 patients who operated by antigrade or retrograde nailing. They are followed up till :::union::: formation. Decreasing range of motion in the shoulder and elbow joints was classified as good (less than 10o), intermediate (10o-30o) and bad (more than 30o) scale. Data analysis was performed by sign test. Results: 34 patient (56% male, 44% female) aged between 17 and 68 years were studied. 71% and 29% of patients were operated by antigrade or retrograde nailing, respectively. In the 44.1% of patients, duration of :::union::: was less than 3 months. Good scale in the function of shoulder and elbow joints occurred in 88.2% and 85/3% of cases (P<0.01). The frequency of non :::union::: was 5.9%. Conclusion : It seems that Interlocking nailing is a safe and reliable technique in the treatment of patients with humeral shaft fracture

New method for fixation point of tibialis posterior tendon transfer

Background: The transfer of the tibialis posterior tendon to the dorsum of foot can restore the function of the paralyzed dorsiflexor muscles of the foot and ankle. In order to reduce the wound complication in the insertion site of tendon to bone by a plantar knop we used a new method of fixation by an absorbable screw inserted dorsally. Methods: we performed this operation on 15 patients in a 3 years period. All patients had drop foot deformity due to irreversible lesions of the peroneal nerve. The inclusion criteria was the peroneal nerve palsy that was not improved after 18 months even by using nerve releasing or nerve repairing. All patients were evaluated after 6 months for ankle function and wound complications. Result: Of 15 patients one was excluded from study. At 6 month ten patients got excellent score (66) and 4 good score (26) further ankle function. There was no wound complication at insertion site. Conclusion: This simple modification for insertion site fixation had good result in restoring ankle function whiles eliminated the possibility of plantar pressure sores caused by fixation knop