Serum level of vitamin D in patients with kidney transplantation in Gorgan (South East of Caspian Sea), Iran

Patients who received kidney transplantation, vitamin D deficiency is probable due to deficient sun exposure and the lag between transplant and normal kidney function. In this study, serum level of vitamin D was assessed in patients with kidney transplantation and normal population. All transplant patients in 5 Azar hospital and clinics of Gorgan were recruited. The results show that among kidney transplant receivers and control subjects, 55.1% and 2% had significantly 25-hydroxyvitamin D deficiency, 42.9% and 63.3% significantly 25-hydroxyvitamin D insufficiency, respectively. In kidney transplant receivers, there was one person with normal 25-hydroxyvitamin D level. The time passed from the transplantation had no significant effects on serum level of vitamin D and was lower in those with higher time passed. It could be concluded that there is high prevalence of 25-hydroxyvitamin D insufficiency and deficiency after kidney transplantation (98% of our patients), without considering of transplantation time. In accord with recent informs, we suggest it very necessary that status of vitamin D deficiency/insufficiency are corrected in kidney transplant patients. Hence, supplementing of vitamin D appeared to be the only possible ways of making better and correcting vitamin D status in kidney transplant receivers. © IDOSI Publications, 2012

Non-operative treatment of common finger injuries

Finger fractures are common injuries with a wide spectrum of presentation. Although a vast majority of these injuries may be treated non-operatively with gentle reduction, appropriate splinting, and careful follow-up, health care providers must recognize injury patterns that require more specialized care. Injuries involving unstable fracture patterns, intra-articular extension, or tendon function tend to have suboptimal outcomes with non-operative treatment. Other injuries including terminal extensor tendon injuries (mallet finger), stable non-articular fractures, and distal phalanx tuft fractures are readily treated by conservative means, and in general do quite well. Appropriate understanding of finger fracture patterns, treatment modalities, and injuries requiring referral is critical for optimal patient outcomes

Pathologies inguino-scrotales

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Traitement d'une instabilité post-traumatique en hyperextension de l'articulation métacarpophalangienne du pouce par greffe tendineuse libre et fixation par ancres

The authors are reporting on a patient with chronic posttraumatic instability of the thumb metacarpophalangeal joint in extension. Conservative treatment had failed. Upon surgical exploration, it was found that no capsular or ligamentous structures were available for adequate repair. A volar carpi radialis ligamentoplasty stabilized with bone anchors was performed. Stability and good functional result were obtained. © 2007 Elsevier Masson SAS. All rights reserved.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Unusual upward closed tibiotalar dislocation without fracture: A case report

Pure tibiotalar dislocations without associated fracture are rare. The authors report a case of an unusual closed tibiotalar dislocation without fracture, involving proximal ascension of the talus. Despite immediate closed reduction, a tibiofibular diastasis remained, therefore two syndesmosis screws were inserted, followed by six weeks of plaster casting. After 5 years of follow-up, functional results were excellent, MRI showed slight arthritic degenerative changes. © 2009 European Foot and Ankle Society.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Intérêt des radiographies ostéo-articulaires comparatives en traumatologie de l'enfant

Purpose of the study: There is a controversy over whether or not routine comparative x-rays should be prescribed for young children with bone and joint trauma. We conducted a retrospective analysis to assess the contribution of such x-rays. Material and methods: The series included 203 children aged less than fifteen years who had experienced bone and joint trauma. Two junior orthopedic surgeons, two senior orthopedic surgeons and two pediatric radiologists reread the x-rays to establish the diagnosis, using comparative x-rays to make any necessary correction of the diagnosis. The surgeons were asked to propose a therapeutic strategy for each diagnosis and the radiologists were asked to judge the value of the comparative x-rays. Results: The comparative x-rays were found to be reliable in only 87.5% of the cases, and were useful for diagnosis in only 8.8%. There were statistically significant differences depending on the localization, the patient's age, and the physician's experience. Discussion: Systematic use of comparative x-rays should be discouraged. Only trauma affecting the elbow in older children can, in particular cases, warrant prescription of comparative x-rays.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Lateral femoral condyle osteochondral fracture combined to patellar dislocation: A case report

The authors report the case of an osteochondral fracture involving the weight-bearing portion of the lateral femoral condyle in a 23-year-old sportsman. The defect was concomitant to a lateral patellar dislocation involving a rare injury mechanism. Fixation of the osteochondral fragment was performed with bioabsorbable pins and healing was achieved within an acceptable time. Clinical and radiographic outcome at one year is highly satisfactory and bioabsorbable implant fixation reveals to be a worthwhile option in such a case. This rare lesion is diagnostically challenging and requires an adapted and prompt treatment. © 2009 Elsevier Masson SAS. All rights reserved.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Fracture ostéochondrale du condyle fémoral latéral en zone portante associée à une luxation de patella. Fixation par un matériel résorbable. À propos d'un cas

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Les lésions ligamentaires intracarpiennes associées aux fractures du poignet: Étude prospective radio-clinique sur 40 cas

Purpose of the study We performed a prospective study to search for arthrographic signs in favor of intracarpal ligament lesions occurring concomitantly with wrist fractures. We looked for a relationship between type of fracture and displacement and examined their impact on early functional outcome. Material and methods The series included 40 patients treated over a 1-year period. All 40 patients had a displaced wrist fracture requiring surgical treatment. A three-phase arthrography was performed during the initial operation in order to search for injuries involving the scapho-lunate, luno-pyramidal or triangular complex ligaments. A second arthrography was performed at the time the osteosynthesis material was removed. All patients were followed one year postperatively. Functional outcome was recorded at one year. Results Abnormal images were found in 57% of the patients at the first arthrography. Injury to the triangular complex predominated, followed by combined injuries. There was no statistical correlation between type of fracture, degree of displacement, and presence of ligament lesions (p > 0.05). Lesions of the triangular fibrocartilaginous complex (TFCC) were significantly increased (p = 0.04) in the event of intra-articular fracture. Age and gender did not influence ligament injury. At one year, the functional outcome was statistically comparable between patients with and without ligament injury. At the second arthrography, we observed only five cases where cure of the luno-pyramidal ligament had been achieved. Discussion Intracarpal ligament injuries associated with wrist fractures are frequent. Age had no effect on occurrence of ligament injury in our series, similar to findings reported by others. Likewise, the type of fracture had no effect. Data in the literature show that intra-articular fractures and highly-displaced fractures aggravate ligament injury. Our functional results at one year did riot demonstrate any significant difference in patients with and without ligament injury. A 3 or 5-year follow-up might provide further insight. Nevertheless, neglected scapho-lunate lesions still have a bad reputation in the literature, leading us to search for such lesions and to provide adapted treatment in all patients aged less than 50 years presenting a displaced fracture of the wrist.SCOPUS: ar.jinfo:eu-repo/semantics/publishe