Primary subacute osteomyelitis is difficult to diagnose, because of its insidious onset, mild symptoms, lack of a systemic reaction, and similarity with tumoral conditions. This condition is seen mostly in the epiphysis or metaphysis of tibia. Although it has been reported at various bones, its occurrence in the Greater trochanter is rare. We describe two patients, 4 and 14 years old, with mild pain of the hip joint and limping without history of acute bone infection. Radiography showed a lytic lesion in the Greater trochanter resembling Brodie abscess. Both patients were treated completely with antibiotics.

Introduction: Traumati c anterior dislocation of the hip is not common and open perineal variant of the inferior type of anterior dislocation is an even rare event. Case Presentation: We report a case of open perineal variant of the inferior type of anterior hip dislocation, with concomitant fracture of the femoral head and Greater trochanter, in a 17-year-old male patient. Closed reduction of dislocation and later open reduction and fixation of the Greater trochanter were performed. Eighteen months after the injury, the femoral head resorption, due to infection and avascular necrosis, led to a poor functional outcome. Conclusions: Open perineal variant of anterior hip dislocation can lead to very poor outcome when performed with closed reduction.

Background: Femoral bone fractures are one of the most important bone fractures particulary following trauma. Femur length measurements and insertion of properly sized intramedullary nail is among the major concerns of orthopedic surgeons. Nowadays the length of the femoral nail is calculated by measuring the trochanteric length of the femur to the upper patellar pole or lateral epicondyle. The aim of this study was to evaluate the relationship between the length of the Greater trochanter to the lateral femoral epicondyle and the distance between the olecranon tip and the 5 th fingertip. Methods: This cross-sectional study was performed on 380 outpatients (17 to 65 years old) in Kashani and Alzahra hospitals in Isfahan. The length of the olecranon tip to 5 th fingertip and the length of the Greater trochanter to the lateral femoral epicondyle were measured while overall the groups were gonna evaluated in terms of age, gender and body mass. T-test was used to analyze the research data for any statistical significance. Findings: Examination of the data showed that there was no significant difference between the mean length of the Greater trochanter to the lateral epicondyle of the femur and the length of the olecranon to 5 th fingertip. When the mean difference between the two lengths was examined separately in terms of sex and age and body mass index, similar results were obtained and no significant difference was observed. Conclusion: There was no significant difference between the mean length of the Greater trochanter to the lateral epicondyle of the femur and the length of the olecranon to 5 th fingertip. There was no significant difference between the two measured lengths in different age, sex and weight groups.

Background: Intertrochanteric fractures, commonly caused by falls in older people, are a significant issue. This study evaluated a new fixation technique for Greater trochanter fractures in elderly hip arthroplasty patients. Unstable intertrochanteric fractures present challenges in orthopedic surgery, and this article assessed a new method for fixing these fractures during hip arthroplasty. Objectives: We assessed the efficacy and clinical outcomes of a new fixation technique for managing Greater trochanter fractures in elderly patients during hip arthroplasty. Methods: This retrospective study, conducted from 2019 to 2022 at Poorsina and Pars hospitals in Rasht, included patients with unstable intertrochanteric fractures. It assessed the efficacy and outcomes of a new fixation technique for the Greater trochanter following hip arthroplasty. Statistical analyses were conducted using SPSS software, version 24, employing the Shapiro-Wilk test, Levene’s test, generalized estimation equations, and the chi-square and Fisher’s exact tests. Results: The new fixation technique significantly improved patient outcomes, leading to high rates of complete union, reduced pain levels, improved mobility, and lower complication rates. Conclusion: The novel fixation technique for Greater trochanter fractures shows significant promise in improving healing rates and reducing complications in elderly patients undergoing hip arthroplasty. This study provides a foundation for future research and clinical practice enhancements in orthopedic surgery.

Background: Quality of the bone before surgery determines the choice of the appropriate prosthesis and the surgical approach as well as the result of total hip arthroplasty (THA). The proximal femur morphology determines the decision of cemented or uncemented THA, and the Dorr classification is often employed for this purpose. Methods: 100 patients over the age of 40 who had been referred to the emergency department of Shohada Hospital, Tabriz, Iran, for any reason and had an accurate pelvic anteroposterior (AP) X-ray with proximal femur were included in this study, and Dorr classification and mean cortical thickness index (CTI) just below the lesser trochanter and 10 cm below it were measured. Results: In this study, the Dorr classification differed significantly in men and women, and type C was higher in women. Classification is strongly subjected to the surgeon's clinical experience, and training class significantly affects it. There was a significant relationship (P < 0. 001) between the CTI 10 cm below the trochanter and just below it. Conclusion: The proximal femur morphology covers a wide range. Therefore, it is difficult to determine the exact morphology, especially for groups B and C. There was also a significant correlation between the mean CTI below the lesser trochanter and 10 cm below it. Therefore, we think this is a practical and most straightforward method for classifying proximal femur morphology with cortical index (CI) just below the lesser trochanter and 10 cm below it, especially for inexperienced training residents.

Objectives This study aimed to assess the anatomical variations of the Greater palatine canal (GPC) and Greater palatine foramen (GPF) in an Iranian subpopulation using cone-beam computed tomography (CBCT). Methods This cross-sectional study was conducted on 193 CBCT scans of adults (94 males, 99 females) taken between 2017-2021 that were retrieved from a radiology clinic in Urmia, Iran. Axial sections were used to assess the position, diameter, and shape of GPF, and sagittal sections were used to assess the length and path of GPC. Data were analyzed by paired and independent t-test, Wilcoxon test, Mann-Whitney test, and Chi-square test (alpha=0. 05). Results In most cases (97. 34% of males and 98. 49% of females), GPF was located distal to the maxillary first molar. The mean distance between the GPF and midpalatal suture was significantly Greater in males than females (15. 2±, 1. 8 vs. 14. 3±, 1. 5 mm,P=0. 002). The mean diameter of GFP was significantly larger in males than females in both mesiodistal (2. 34±, 0. 64 vs. 1. 96±, 0. 63 mm, P<0. 05) and anteroposterior (4. 69±, 1. 17 vs. 4. 07±, 1. 20 mm, P=0. 001) dimensions. The mean length of GPC in males was significantly higher than that in females (28. 55±, 2. 62 vs. 26. 90±, 3. 31 mm, P<0. 05). The most common form of GPF and GPC (on sagittal sections) was oval, and sigmoid, and curve, respectively. The most common GPC path was anterior-inferior (65. 96% of males and 64. 65% of females). Conclusion The present results provided valuable information regarding the anatomical variations of GPF and GPC in Iranian population. CBCT was proven to be a valuable tool for assessment of maxillofacial anatomical landmarks.