IRANIAN JOURNAL OF ORTHOPAEDIC SURGERY
Year:2019 | Volume:17 | Issue:3 (66)|Papers Count:6

Background: Previous studies suggest an existingassociation between massive rotator cuff tear (RCT) and peripheral neuropathy. However, the findings are often inconsistent. In the present prospective study we assessed the prevalence of peripheral neuropathy in patients with massive RCT. In addition, we evaluated the effect of surgical repair of this rupture on thetreatment outcomes of neuropathies. Methods: In this study, 58 patients were evaluated with a massive RCT. All patients underwent arthroscopic repair using suture anchor groups. Before surgery, electromyography (EMG)/nerve conduction velocity(NCV)were performed to check for neuropathy. In addition, before and after the surgery, Quick Disabilities of the Arm, Shoulder and Hand (DASH) score was calculated for all patients and the pain intensity was measured using visual analogue scale (VAS). Patients were followed up for 6 months. In the final visit, EMG/NCV was reperformed for those patients with neuropathy. Results: A total of 8 patients with neuropathy were observed (13. 5%), of which 5 cases were presented with suprascapular neuropathy, 2 cases of upper trunk neuropathy and 1 case of neuropathy. In the final visit examinations, all cases except one suprascapular neuropathy and an upper trunk neuropathy were recovered. In the final visit, the average Quick DASH score was significantly reduced from 72. 6 to 19. 7 (p <0. 001). Similarly, the severity of pain significantly decreased from 5. 3 to 1/1 (p <0. 001). In the final visit, the most important complaint of the patients was a limitation of motion in 11 patients (19%). Three patients also complained of pain, two of whom were those whose neuropathy had not improved. Conclusion: Precise screening for neurological damage is recommended in all patients with extensive RCT. Moreover, electromyographic studies can be of benefit in suspected cases of neuropathy before repair of rotator cuff.

Background: Tea consumption and exercise loading may have favorable effects on risk of osteoporosis. However, effects of tea plus exercise training on bone density are not clear. The aim of this study was to clarify the influence of combined treatment with tea extract and treadmill exercise on bone mineral density in middle-aged rats. Material and Method: Forty male Wistar rats (14 weeks old) were randomized into four groups: control, sham, exercise training and tea plus exercise training. Rats in the exercise groups were participated in a running exercise program (1 h/day, 5 times/ week for 8 weeks). Tea extract were intraperitoneally injected by 0. 3 mg/kg. Body composition and bone mineral density of the whole body were assessed by dual-energy X-ray absorptiometry at baseline and after intervention. Data were analyzed using SPSS software using ANOVA and post hoc Tukey test. Results: Running on treadmill significantly increased femur bone mineral density in rats compared to control group (P=0. 04). On the other hand, it was observed that exercise plus tea consumption increased bone mineral density in whole body (P=0. 01) and femur (P=0. 03) of middle aged rats. Conclusion: Tea enhanced the bone response to mechanical loading and a synergistic effect was observed in a rat model.

Background: Bone grafts have been used to stimulate the fracture healing in orthopaedic surgery. Allograft and xenograft are more used because of auto graft use problems. Royal jelly is the principal food source of the queen honey bee. Royal jelly has pharmacological activities such as anti-bacterial, antioxidant, antitumor and anti-inflammatory effects. This research was designed to evaluate the effects of royal jelly on bone healing and restoration in the rabbit model. Materials and Methods: In this study, we used 10 New Zealand white rabbits with an approximate weight of 2 kg. They were divided into two groups (N=5) midradius bone defect created and filled with royal jelly and in the second group (N=5) the defected filled with nothing. The radiological evaluation performed on days 14th, 28th and 42nd after the operation. Histopathological evaluation was done on 42 days after the operation. Results: Radiological result has not shown the significant difference in days 14th and 42nd (p>0. 05) and only on day 28, there was a meaningful division (p<0. 05). There was no significant difference between the two groups in histopathological evaluation. Conclusion: This study indicates using of royal jelly could accelerate bone healing process in rabbit and has the potential for use in medicine.

Background & Aim: Brachymetatarsia is a rare condition of the foot characterized by a shortening of the metatarsal bones. Brachymetatarsia may be congenital and idiopathic in etiology, or caused by trauma, and may be associated with systemic diseases. This deformity is recognized with a wide range of clinical patterns, from aesthetic dissatisfaction to severe pain. Various surgical methods have been proposed to treat the disease, which could be associated with different complications such as stiffness, lack of union, and deviation from the axis. The present study aimed to evaluate the result of chr('39')chr('39')over the pinchr('39')chr('39') surgical method for patients with brachymetatarsia. Methods: This case series research was performed in a training hospital on the patients referred to the orthopedic clinic, with congenital brachymetatarsia confirmed by foot radiographs. Data related to the demographic characteristics of patients, the obtaince length, and the duration between treatment onset and removal of the fixator were obtained using a checklist and the medical files of the participants. In this study, the exclusion criteria were non-metatarsal involvement, trauma, secondary foot surgeries, genetic syndromes, syndactyly, and polydactyly. Results: There were women and one male, with the mean age of 12. 3 years. Bilateral involvement was detected in two female subjects, and a total of 11 surgeries were assessed. According to the results, there was a total length increase of 16. 58 millimeters over a mean duration of 96. 5 days. In addition, metatarsal length increased by 48. 23% during treatment, and no malunion was observed in the patients. Conclusion: chr('39')chr('39')Lengthening over a pingchr('39')chr('39') for brachymetatarsia, of fourth ray is superior to other techniques, which avoids malunion, and higher length gain is possible. to the results of the study, malunion was reported in none of the participants after the surgery, which showed an apparent superiority of the method, compared to other techniques. However, a higher length increase was detected in the current research, compared to other studies.

Background: Osteoarthritis is a major public health consideration which leads to disability because of chronic pain, stiffness, sleeping disorder and depression. Among the herbal products Psidium Guajava L. fruit could be regarded as a potential natural remedy due to its anti-oxidant characteristics. The aim of this study was to evaluate the healing effect of Psidium Guajava L. fruit on osteoarthritis of the knee in rats. Methods: Forty male Sprague-Dawley rats with induced osteoarthritis by intra-articular injection of 500U of type 2 collagenase in the left knee were recruited in four treatment groups (n=10): (A) control, (B) Piascledine (10mg/kg) as positive control, (C) oral administration of hydro-alcoholic extract of Psidium Guajava L. fruit (500mg/kg), and (D) oral administration hydro-alcoholic extract of Psidium Guajava L. fruit (1000mg/kg). After 8 weeks of daily administration, the outcome was evaluated by histopathological and radiographic assessments. The data were analyzed using Kruskal-Wallis nonparametric in SPSS version 23. 00, and P<0. 05 was considered statistically significant. Results: Psidium Guajava extract exhibited good radical scavenging activities with IC50 of 0. 46 ± 0. 13 mg/mL (quercetin as a positive control). Histopathological assessments of the cartilage showed smooth and continuous articular surface with columnar cell distribution in the experimental group that received 1000mg/kg Psidium Guajava L. fruit hydro-alcoholic extract which healed better than others, especially in the control group (p-value =0. 02). The radiological assessments of the knee joints showed similar findings in histopathological assessment. Conclusion: Psidium Guajava L. fruit hydro-alcoholic extract might be regarded as an effective complementary and alternative treatment for osteoarthritis of the knee in rats.

Ulnar shaft fracture with DRUJ injury in children is rare. This pattern of injury does not adapt to the account for Monteggia or Galeazzi fractures-dislocation. We present the case of patient with ulnar shaft fracture and DRUJ dislocation in 10 years old man and discussed about mechanisms and treatment of this injury.