IRANIAN JOURNAL OF ORTHOPAEDIC SURGERY
Year:2015 | Volume:13 | Issue:3 (52) |Papers Count:6

Background: Rupture of tendons is a common injury. The outcome of surgical repair of injured tendon is often unsatisfactory. At best, the restored tendon is about half of its initial mechanical properties. In this study the effect of zenologous and autologous platelet gel were compared in rabbit model.Methods: 45 rabbits in the age range of 7 months to 1 year old were divided into autologous, zenologous and control groups. Superficial digital flexor tendon was cut transversely and then sutured with Mayer stitch pattern. Then 5cc of either aotologous or zenologous platelet gel was injected to the incision area. The control group had no material injection. On 7th, 14th, and 28th post-operative days, five rabbits of each group were euthanized and tendons were harvested for histopathological and biomechanical evaluations. The results were analyzed statistically.Results: Biomechanical factors were significantly superior in the autologous and zenologous groups than the control group. In histopathological examination the autologous groups showed a significant difference in fibroblast maturation in all the tested weeks. The collagen fiber alignment at 7th postoperative day and collagen accumulation on 7th and 28th postoperative days were superior in autologous compared with zenologous and control groups.Conclusions: Utilization of zenologous platelet gel has a positive effect on tendon healing, but not as good as autologous platelet gel.

Background: Hallux valgus is one of the most prevalent deformities which causes changes in the center of pressure (COP) and standing balance. This paper looks at the mechanical changes of spacer pads used for such a deformity.Methods: In this quasi experimental study, 24 people suffering from hallux valgus were reffered to a trainig hospital in Tehran, Iran. A Bertec force plate was used to collect data related to COP parameters. The balance tests of TUG and FR were used to evaluate the changes in balance. The tests were done without and with toe spacers in a 15 second period of time and the COP displacement in anteroposterior and mediolateral directions and also the path length of COP displacement, velocity of COP displacement and confidence ellipse of the COP were measured. The data were analyzed using statistical tests.Results: Using the toe spacers did not cause a significant change in displacement of COP in anteroposterior and mediolateral directions, confidence ellipse, velocity of COP displacement and the path length of COP displacement (p≥.05). But the change in the results of FR and TUG tests was significant (p<.05).Conclusions: Using the toe spacers in hallux valgus causes no significant changes in COP displacement, path length, velocity and confidence ellipse, but shows improvement in results of balance tests in elderly suffering from hallux valgus deformity.

Background: There have been investigations on the effect of absence or presence of Palmaris longus tendon on pinch and grip strength of the hand. In the same way the effect of presence of fifth superficial flexor digitorum on grip strength of the hand has been investigated. The aim of the present study was to assess the combined effect of these anatomical variations on pinch and grip strength.Methods: In a cross sectional study, 1046 hands in 523 volunteers were enrolled. Each hand was assessed for the presence or absence of palmaris longus tendon and also variations of fifth superficial flexor digitorum function. Then the grip and pinch power of the hands were measured with Jammar Dynamometer. Results: Presence or absence of Palmaris longus had no effect on grip strength of the individuals. In the same way, variations of fifth superficial flexor digitorum function had no effect on the grip and pinch strengths. But the positive and statistically significant effect of presence of palmaris longus on pinch strength (25.38 in hands with palmaris present v/s 24.43 in hands without it) was evident (p=.03). Grip and pinch powers were higher in men compared to women (p<.0001) and in right compared to left hands (p=.013).Conclusions: Based upon the findings of the present study, it seems that absence of palmaris longus tendon is associated with a reduction in pinch strength, but has no effect on grip strength and the variations of fifth superficial flexor digitorum have no effect on pinch and grip strengths.

Background: Total knee arthroplasty is an accepted method for treatment of osteoarthritis of the knee. Measuring the distal femoral rotation is one of the most important problems in such operations. In the conventional 2D method, measuring the angle is based on CT scan images but these methods usually contain errors. In this study, the three-dimensional measurement of the aforementioned angle was investigated.Methods: In this research, using CT scans and 3D modeling, 3D lower extremity models of 40 patients were extracted. The rotation of distal femur was measured for plane perpendicular to the anatomical and the plane of mechanical axis of femur. Four axes were drawn on these planes using anatomical landmarks: posterior condylar line (PCL), anatomical and surgical transepicondylar line (ATEA+STEA), and the Whiteside line (WL).Results: The mean difference of these measurements on the plane perpendicular to the mechanical axis of the femur, between PCL and WL, STEA, ATEA was 3.41, -1.31, 5.53; and angles on the plane perpendicular to the anatomical axis of femur were -0.74, -1.26, and 5.67, respectively. In addition, Bland-Altman diagram was plotted between every two measurements and no relationship found, except for STEA and ATEA.Conclusions: The measurements between PCL, ATE, and STEA are not affected by the plane on which these measurements are carried out on, except for the 4 degrees difference present in WL axis. With a greater sample size and proper grouping, some relationship might be found between the aforementioned axes.

Background: Bone bruise is a signal change in MRI and could be the result of bleeding or edema with microfractures in trabecular bone system. Analysis of the location of bone bruise could be a clue for mechanism of trauma. Awareness of pattern, severity and location of bone bruise and pain gives a better understanding of its nature and the related concomitant injuries. In this research the relation between pain and its severity with bone bruise is investigated.Methods: In a prospective study, 22 patients (20 males, 2 female) with mean age of 34 years old and with isolated bone bruise after a knee trauma was studied in a trauma center in Urmia, Iran. Patients scored their pain using Visual Analogue Scale (VAS). For volumetric calculation of bone bruise we used A*B*C vectors multiplication and for severity of bone bruise we used software that measures the resotution of pictures. The locations of bone bruise were also determined and recorded. Finally, the relationship between these parameters and patients’ pain were statistically analyzed. Results: The mean pain score were 4.40±1.56 in males and 7±2.82 in females. Mean bone bruise intensity was 176.4±42.47. There was no relationship between patient's age and pain severity. There was also no significant correlation between volume or location of bone bruise and severity of pain score (p≥.05). The mean bone bruise volume was 8.77±8.12 and the mean pain sc ore was 4.63±1.78.Conclusions: Among the multiple characteristics of bone bruise, the intensity has the most direct correlation with severity of pain.