Journal of Research in Orthopedic Science
Year:2018 | Volume:5 | Issue:2|Papers Count:6

Background: Fanconi anemia is the most common hereditary aplastic anemia characterized by progressive bone marrow deficiency, congenital anomalies, and an increased risk for leukemia. Skeletal deformity is one of the primary manifestations beforediagnosis and hematological disorder. Methods: This study presents a perspective of Fanconi anemia at its concomitant skeletal anomalies at a sub-national level innorthwestern Iran. Between 2000 and 2017, all records were collected in 3 provinces of northwest Iran. Results: Overall, 64patients (38 female (59. 4%)and26male(40. 6%)) with Fanconianemiain 3 provinces of northwestern of Iran wereidentified. The mean age at the time of diagnosis was 6. 6 4. 8 years. Thirty-seven (57. 8%) patients had skeletal deformity in theirupper or lower limbs. The 3 most common anomalies, included microcephaly in 29 (45. 3%), short stature in 27 (42. 2%), and thumbanomalies in 22 (34. 2%) patients. The association of the thumb anomalies with microcephaly and short stature was a significantassociation between them (Chi-square test, p value 0. 03; Odds Ratio 3. 1 in 95% confidence interval 1. 07 to 9. 2). Fourteen (21. 9%)patients among the 37 patients with skeletal deformities sustained surgeries before the diagnosis of the disease. Conclusions: A combination of the thumb anomalies and microcephaly should alert the physician to investigate further for a probableexistence of Fanconi anemia.

Background: While there is consensus about the treatment of acutely presented displaced lateral condyle fracture (LCF) of distalhumerus in children by open reduction and internal fixation, treatment for lately presented LCF remained challenging due tocontradictory results of treatments and paucity of studies in this field. Objectives: The aim of this study was to report the clinical and radiological results of open reduction and internal fixation for thetreatment of lately presented LCF of distal humerus in children. Methods: Prospectivelywestudied the clinical and radiographical results of open reduction and internal fixation of 8 patients from12 cases. These cases had a delayed presentation of more than 3 weeks from injuryamongthosewhowere referred to our center from2011 to 2017. We evaluated the range of motion, alterations in carrying angle, presence of prominent deformity, presence of arthriticor neurological symptoms, andfinally nonunion or avascular necrosis of the lateral condyle. For assessment of the treatment resultswe used the Hardacre criteria. Results: A total of 8 patients, including 7 males and 1 female with mean age of 5. 2 years (2. 5-8) bearing time delay from injury tothe surgery of 32. 4 days (22-48), underwent surgical treatment. The mean follow up was 21 months (8-54). The main reason forreferring to the clinic consisted of palpable mass followed by decreased range of motion. All patients achieved satisfactory union. Of the patients, 2 suffered from complications; 1 patient experienced avascular necrosis of the lateral condyle and the other wascomplicated by carrying angle abnormality. According to the Hardacre criteria, 6 patients achieved excellent results and 2 patients, with mentioned major complications, obtained fair results. Conclusions: Open reduction and internal fixation of lately presented lateral condyle fracture of distal humerus can result in excellentfunctional and radiological results in most of the patients.

Introduction: Coronal plane Fractures of the femoral condyle are known as Hoffa fractures. Although isolated posterior Hoffafractures of medial femoral condyle have been rarely reported, no reports are available regarding the anterior fracture of this type. Here, we report a large isolated anterior osteoarticular fracture of the medial femoral condyle. Case Presentation: A 16-year-old girl with a traumatic open joint injury of the right knee caused by a car-to-pedestrian accidentwas referred to our emergency department for further evaluation. A physical examination of the knee revealed effusion and limitedknee range of motion. While no obvious fracture was detectable on plain radiographs of the knee, a large anterior osteoarticularfracture of the medial femoral condyle was observed in computed tomography (CT), which was detached from the medial condyle. The fracture was managed with open reduction and internal fixation. Eight weeks after the surgery, the patient retrieved the fullknee motions and the complete union of the fracture was observed. No complication was reported by the patient at a follow-upperiod of 12 months. Conclusions: In cases with knee tenderness and/or effusion and normal plain radiographs, whenever there is a discrepancy betweenplain radiographsandclinicalsymptomsof the patient, a further evaluation of the knee with a CT scan and/orMRIis necessaryto avoid missing a Hoffa fracture, which could be successfully treated if timely diagnosed.

Introduction: Skeletal involvements are less reported in tuberculosis and even less likely observed in fingers. Fingers are rarelyinvolved in adults and it often has been reported in children under 5 years old. Most likely, a recent condition in adult patients isrequired to provoke reactivation of bacilli lodged in the bone during the original mycobacteremia of primary infection. Case Presentation: In this report, a 31-year-old female patient, suffered from detached extensor tendon due to the fourth fingertrauma, was diagnosed as a Mallet finger and treated by closed percutaneous pining is introduced. The patient had chronic swellingand progressive pain in the same finger for six months after treatment. Thecommonanti-inflammatory and antibiotic therapy wasnot successful. Radiographic images of the ring finger demonstrated erosion and irregularity of the articular surfaces around thedistal interphalangeal join (DIP). She expressed a history of untreated cough and exposure to people with tuberculosis. A positivetuberculosis (TB) skin testwasdetermined withmorethan10mminduration. Treatment with anti-tuberculosis medication regimenwas successful and continued for 12 months. Conclusions: Skeletal tuberculosis should always be considered by physicians in endemic areas. Aslow progression of the disease inskeletal involvement and lack of clinical suspicion can lead to misdiagnosis. Using anti-tuberclusis medications for an appropriateperiod is effective in the disease control and treatment of patients.

Background: The degree of patient’ s suffering in association with radiological evidence of osteoarthritis (OA) determines the timepoint of surgery. Thus, amoreclear understanding of the association between clinical and radiological symptoms of OAis necessary. Objectives: Here we aim to evaluate how clinical and radiographic symptoms of patients are associated with each other in an IranianKnee OA population. Methods: In a cross-sectional study, patients with knee OA were recruited. The diagnosis of OA was made using the criteria ofAmerican College of Rheumatology (ACR) Classification. Western Ontario & McMaster Universities Osteoarthritis Index (WOMAC)was used as an indicator of self-reported disability. The Kellgren-Lawrence index was used for OA grading. Results: A total of 96 OA patients, including 77 females and 19 males, with a mean age of 53. 27 10 years, were included. The OA wasgraded as I, II, III, and IV in 28, 35, 19, and 14 patients, respectively. The mean WOMAC score was 55. 2 20. 5, ranging from 6. 3 to 100. TheWOMACscore was not significantly correlated with the grade of OA (p = 0. 1, r =-0. 188). When we stratified the patients based ontheir gender, a strong correlation was observed between WOMAC scores and OA grade in male patients (p < 0. 001, r =-0. 882), whileit was still non-significant in female patients (p = 0. 9, r = 0. 002). Conclusions: Self-reported disability is associated with radiographic symptoms in male patients with knee OA, but not in females. Hence, the orthopedic surgeons should consider this discrepancy in their decision-making process to decide appropriately aboutthe choice of therapy.

Introduction: Consumption of anabolic-androgenic steroids (AAS) is described as a major factor in tendon weakening process. The reports of bilateral quadriceps tendon rupture (QTR) following the AAS consumption are very rare. The current study describeda case of simultaneous bilateral QTR following a low-energy trauma in a body builder with the history of ASS consumption. Case Presentation: A 32-year-old male body builder was referred to under study center with a history of falling down from thestairs nearly 2 weeks earlier. Magnetic resonance imaging (MRI) showed QTR in both knees from superior pole of patella. He deniedany major trauma to explain the recent problem. Thus, the QTR was attributed to a low-energy trauma. While ruling out the tendonweakening conditions promptly, the history of oral and intramuscular consumption of AAS was noted. The patient was operatedto repair QTR. At the last follow-up session, he was able to actively straighten his legs. The consumption of AAS was discontinuedafterward. Conclusions: Consumption of AAS by athletes has considerably increased during the last few decades. An appropriate warningof orthopedic surgeons regarding AAS side effects is necessary in order to recognize the predisposing factor of tendon rupture insimilar circumstances and address the case properly.