IRANIAN JOURNAL OF ORTHOPAEDIC SURGERY
Year:2017 | Volume:14-15 | Issue:4-1 (56) |Papers Count:8

Backgrounds: Several tests are used to assess the presence of palmaris longus tendon. In the present study we attempted to assess the interobserver and intraobserver reliability of five of the most famous ones and also the examination of fifth superficial flexor function.Methods: Two observers, who had been trained about the tests and had practiced on them, examined 105 volunteers on two separate occasions and in one-month interval and the results were recorded. The reliability of each method was assessed with Kappa measurement.Results: Kappa ranged from 0.541 (moderate reliability) to 0.813 (almost complete agreement) for Palmaris. The highest interobserver and intraobserver reliability and also the best agreement with other tests was the Shaeffer test. The lowest Kappa was for Thompson and the others had good to excellent reliability. Kappa for interobserver and intraobserver reliability for fifth flexor was respectively 0.415 and 0.500 (moderate reliability). Conclusion: The tests that were assessed have good reliability except for Thompson that has a moderate one. It seems that the standard test (Schaeffer) is the best method for assessment of palmaris Longus absence or presence. The method assessed for evaluation of fifth superficial flexor variations assessment has a moderate interobserver and intraobserver reliability.

Background: Osteoarthritis is a response to the repeated and long term forces applied to the joint resulting in increased energy consumption and changes in the rate of displacement of the center of pressure in effected patients. The purpose of the present study was to investigate the effect of an 8-degree lateral heel wedge in medial compartment knee osteoarthritis in change in energy consumption and displacement of the center of pressure in frontal plane.Methods: A quasi-experimental study with pretest and posttest evaluation was designed on 26 patients with medial compartment knee osteoarthritis. The cases that were selected through available sampling had 40-60 years old age range. The energy consumption was measured by “Polar-Electro” system, and center of pressure displacement by force plate apparatus. The cases were tested with and without the heel wedge during walking.Results: The mean energy consumption and the displacement in center of pressure showed decline after using lateral heel wedge. The energy consumption was 0.381 before, and 0.318 after heel wedge use. The displacement of center of pressure was 26.99 before and 17.23 after heel wedge use.Conclusions: The use of 8-degree lateral heel wedge in a shoe can reduce energy consumption, as well as center of pressure in cases of medial compartment osteoarthritis of knee.

Botulinum toxin is produced by clostridium botulinum bacteria, and has seven serotypes, some of which are pharmacologically active in human.An inactive protein is bound to this toxin, as toxin contains two distinct chains, each one with a specific characteristic. The mechanism of action is acetyl choline inhibition at the synapses.The general pharmacological and practical points for the use of this toxin will be discussed in this article without emphasis on its use in any specific field.

Introduction: Hip dysplasia can be associated with early degenerative changes. Different values have been reported for incidence of hip dysplasia in different countries. In the current study, we are reporting on the incidence of hip dysplasia in a group of normal Iranians evaluated by measuring the morphologic parameters of acetabulum on radiographs.Materials and Method: 586 hips (293 person) were enrolled in this study. On anteroposterior hip radiographs, the following 5 parameters were measured: Central edge angle (CEA), acetabular angle (AA), acetabular depth (AD), acetabular roof obliquity (ARO) and roof angle (RA). The normal and abnormal values were obtained in different sexes and compared with the known normal values in orthopaedic literature. Furthermore, the correlation between the above measurements was investigated.Results: Based on CEA, 15 (2.6%) of hips were dysplastic:-0.7% definite and 1.9% mild. 19 hips (3.2%) were dysplastic when using AA values. AD and RA were significantly higher in males. Except for lack of correlation between AA and AD, the other parameters -in particular, CEA and AA- were closely correlated. CEA, AA, ARO and RA were significantly different between dysplastic and non-dysplastic hips.Conclusion: Definite or mild dysplasia was recognized in 0.7% and 1.9% of the “normal” population that was studied. Since CEA was the same between males and females and was correlated with all other morphologic parameters, it seems that CEA is a useful measurement to evaluate presence of hip dysplasia.

Background: Knee is one of the important joints of the body, and osteoarthritis is the most common disease of this joint. It causes pain, swelling, limited mobility and other functional disabilities. Several therapeutic approaches, including drug therapy, physiotherapy, and surgical treatments such as arthroscopic debridement and knee replacement have been used for this disease. Knee replacement is one of the most effective treatments for this disease. Method: In a clinical prospective study, 57 patients who had undergone knee replacement in one year period in a teaching hospital were evaluated before and after surgery with a mean follow-up of 7.3 months. VAS, WOMAC, KSS, and SF-36 questionnaires were completed for all. The postoperative radiographs were analyzed using KSRE form. Results: From the 57 patients that were studied, 51 were female and 6 male. The mean age at surgery was 62.5 years (45-82 years) evaluated, on average, 7.31 months after the operation. Based on the KSS form, the mean" Function score" increased from 15.27±24.03 before surgery to 69.96±8.93 after surgery; and the mean "Knee score" from 7.58±40.43 to 82.38±7.03. The mean WOMAC score decreased from 69.02±11.02 to 25.73±5.92 and the pain score decreased from 8.89±0.77 before surgery to 1.54±1.00 after surgery. The mean SF-36 score increased from 45.75±18.85 before surgery to 65.26±17.86 after surgery. The postoperative radiographic imaging showed a mean alpha angle of 97.8±0.98, beta angle of 89.7±1.11, gamma angle of 2.57±1.62, and the mean delta angle of 86.38±0.81.Conclusion: Due to the significant improvement in pain, WOMAC score, knee score, range of motion and quality of life in this short term study, the knee replacement surgery is considered an effective treatment for osteoarthritis of the knee in the group we studied.

Background: Hand function is considered as one of major indicators of health. In some of the medical specialities the power of the grip and pinch is important. In this study we wanted to see if grip and pinch power in orthopedic residents and surgeons is higher than other similar specialities.Method and materials: 164 medical school doctors, both faculty staff and residents of different specialities voluntarily participated in this study. The “grip power” was measured with mechanical Dynamometer and “pinch” with standard mechanical pinch gauge.Result: Grip power of the orthopedic surgeons, with average age 44.8 and standard deviation of 10.27 in both hands were significantly higher than orthopedic and non-orthopedic residents. The grip power of right hand and left hand of orthopedic group was significantly higher than non-orthopedic group 48.8519 kg (SD: 2.36320) versus 41.8675 kg (SD: 10.94105) and p<0.001. For the pinch power there was no significant difference 9.4814 kg (SD: 0.70858) versus 9.4815 kg (SD: 1.86404), (P<0.799). The finding of this study showed that grip power of the right and left hands of orthopedic residents and surgeons was more than the others but “pinch power” in this study 87.2% were right and 12.8 were left handed.Conclusion: This study has shown that the grip power of the orthopedic surgeons and residents in both right and left hand are higher than the other measured group, with no difference in pinch power.