Journal of Surgery and Trauma
Volume:8 Issue: 1, Spring 2020

Ceramic surfaces are commonly used in total hip arthroplasty (THA) in young patients due to their good tribological properties. Nonetheless, the fracture of ceramic components is among the most demanding complications of total hip arthroplasty.Ceramic failure is a matter of emergency and needs urgent revision arthroplasty. In this regard, the present study aimed to better understand how to diagnose a ceramic component fracture, identify the major risk factors for the fracture of ceramic components, and analyze the different techniques used in revision arthroplasty for ceramic bearing failure.The literature search was performed on PubMed, MEDLINE-Ovid, and Cochrane Reviews. The search keywords included ceramic fracture, ceramic failure, and ceramic arthroplasty revision surgery. A number of 47 articles were selected out of 126 articles found in the initial research. X-ray and computed tomography (CT) scan must be utilized on suspicion of ceramic component fracture. The most relevant risk factor for head fracture is short neck and 28-mm head combination. Moreover, acetabular cup malpositioning and liner misalignment during insertion are the two major risk factors for liner fracture. There is no consensus on the best revision treatment strategy. Nonetheless, it is necessary to perform a complete synovectomy and an accurate cleaning of the hip joint before the implant of the new components. Stability, integrity, and positioning of both femoral and acetabular components must be evaluated during surgery. If damaged, even well-fixed components should be removed. New ceramic bearing surface is the best option, whereas metal is not recommended for revision surgery.

The ever-increasing and common occurrence of head traumas highlight the importance of adopting therapeutic measures for the reduction of the associated morbidity and mortality. Citicoline, as a safe medicine with positive effects on improving traumatic injuries, has been proven to be useful in various studies. However, there are still no data on the specific standard method and dosage of citicoline for the treatment of patients with traumatic head injuries. Regarding this, the present study was performed to determine the effective therapeutic dosage of citicoline and its impact on patients with traumatic head injuries.

This double-blind clinical trial was performed on 30 patients with traumatic concussion (a Glasgow coma scale [GCS] of ≤8) admitted to the intensive care unit and neurosurgery department. The patients were randomly divided into three groups of A (control), B (citicoline with a dosage of 0.5 g/twice a day), and C (citicoline with a dosage of 1.5 g/twice a day). The GCS, degree of muscle strength, Glasgow outcome score (GOS), contusion volume, and cerebral edema (based on brain CT scans) were calculated at specific times and intervals. In addition, the patients' dependency on a ventilator and their length of ICU stay were registered.

Mean GCS on the first day of stay, GCS changes on the third and fourth days of stay, first and seventh days of stay, seventh and fourteenth days of stay, and first and fourteenth days of stay in the three study groups showed the significant statistical difference (P<0.05). Significant statistical differences were seen between the GOS of the 30th day of stay in the three study groups (P<0.05). The contusion volume difference was only significant between the first and seventh days of stay in groups A and C (P<0.05). No significant difference was observed in the mean length of stay in ICU and duration of dependency on a ventilator in the three study groups (P<0.05). The mean degree of muscle strength was only significantly different on the first day of stay between groups B and C (P=0.008).

In contrary to similar studies, the results of the current study revealed that citicoline had no positive effect on patient healing. This result may be due to the small sample size and the inconsistent first-day GCSs of the patients in all three groups. Therefore, given the confirmation of the effectiveness of citicoline even at higher dosages in other studies in future studies, it is recommended to use populations with a larger number of patients.

Erythropoietin (EPO) is a glycoprotein hormone that is secreted for biological responses and is regulated by the interaction between EPO and specific cytokine receptors. The EPO is a mediator of angiogenesis and erythropoiesis and can increase several growth factors. The current research aimed to compare the effects of systemic and subcutaneous injection of recombinant human EPO on the tissue-healing process.

For the purposes of the study, 30 male BALB/c mice were selected and divided into three groups. The first one received EPO treatment with systemic injection (n=10) while the second one received EPO treatment with subcutaneous injection (n=10). The third group was the control or placebo group without any treatment (n=10). The biopsies were studied on days 4, 7, 10, and 14 through staining by hematoxylin-eosin and Mallory's trichrome. In each group, 3 mice were sacrificed due to exposure to high doses of anesthetic on days 4 and 7. Moreover, 2 other mice were sacrificed after 10 and 14 days. The collected data and images were analyzed in SPSS (version 18.0) and ImageJ software, respectively. Furthermore, they were analyzed using Wilcoxon signed-rank and analysis of variance tests in. During all the analytical processes, a p-value of <0.05 was considered statistically significant

According to the results, the density of inflammatory cells significantly decreased in EPO-treated groups, compared to the control group. Moreover, the EPO-treated groups underwent an increase regarding the number of fibroblast cells, new capillary formation, and epithelial thickness in the margins of the wound, unlike the control group.

Findings of the present study indicated that the systemic injection of EPO resulted in a better physiological response regarding the acceleration of tissue-healing in comparison with the subcutaneous injection. Furthermore, the systemic injection of EPO improved the parameters related to skin wound repair.

nowadays, one of the most important risks threatening the community health promotion and development is increasing the number of accidents. The aim of this study was to evaluate the demographic characteristics of people injured by driving accidents and admitted to Imam Khomeini Hospital of Urmia in 2016.

This cross-sectional and retrospective study was conducted using the census method. It was conducted on all road accident patients hospitalized in Imam Khomeini Hospital of Urmia in 2016. A total of 2050 records were reviewed and 2015 of them were included in the study. Data were collected using a checklist in which demographic and accidental data of the injured people were recorded. Data were analyzed using descriptive statistics (frequency distribution tables, central indicators, and dispersion).

The mean age of the subjects was 33.63± 18.53 years. Most of the injured people were male (73.2%) and self-employed (46.8%). The majority of females were housewives (70.8%). In two gender groups, most accidents occurred on the streets and within the city. Moreover, 48.1% of injured people were male and 48.1% of females were transferred to the hospital by emergency department and 56 (0.20%) of injured people died before discharge from the hospital.

Most accidents occurred on the streets and within the city and among males, low education, and self-employed people. Hence, this group of people should be in priority in designing and implementing a variety of educational interventions.

Carbon dioxide (CO2) laser is an available technological tool for laryngeal surgeons. Given the importance of laser outcomesand complications, this research was conducted to identify the complications associated with laser surgery in the patients referring to the5th Azar Medical-Educational Center in Gorgan, Iran, from 2013 to 2017.

This descriptive cross-sectional study was conducted on 85 patients with laryngeal lesions who underwent microscopic surgerywith CO2 laser at the 5th Azar Medical Educational Center in Gorgan, Iran, from 2013 to 2017. The patients were examined for the associated short-term complications 1, 7, and 21 days after the operation. They were also examined after 3 months to determine the long-term complications and patient satisfaction with sound quality. The data were analyzed in SPSS software (version 16). A p-value less than 0.05 was considered statistically signifificant.

Out of the 85 patients undergoing laser surgery, 60 (70.6%) cases were male. None of the patients experienced short-term complications. In terms of long-term complications, 2 (2.35%) cases, who had failed to perform the follow-up, had recurrent lesions after 3 months of surgery. In addition, 18 (21.8%) subjects had recurrent hoarseness, 18.8% (n=16) and 2.35% (n=2) of whom were detected with laryngeal carcinoma and recurrence, respectively. However, a total of 67 (78.91%) cases did not suffer from long-term complications. In this study, out of 85 patients undergoing larynx surgery, 69 (81.2%) cases had benign pathology, while the rest (n=16, 18.8%) had malignant pathology.

It seems that a CO2 lasersurgery that follows scientific principles can produce good outcomes.

Lipomas are the most common benign tumors of connective tissue which can be found in different parts of the human body. In rare cases, their size may be so giant which could be an indication for surgery. Here, we present a case of congenital multiple asymmetrical giant lipomas of the back in a young female. She presented with a chief complaint of physical discomfort due to the giant size and weight of the lipomas. Apart from that, she was in total health. She was born with 5 small lipomas in the back and flank region which had become giant lipomas with estimated weigh around 16 kg in total by the age of 24. The patient underwent seven operations to remove or debulk the mass over a 24-year period since the recurrence of the growths was inevitable.Considering the size of the mass and differential diagnosis, such as liposarcoma, and since no risk factor or underlying etiology was detected for the patient`s condition, surgical excision was the preferred technique for this case.

Coronary artery anomalies are reported to have a higher incidence in young victims of sudden cardiac arrest (4-15%), as compared to adults (1%). Among coronary anomalies, anomalous coronary artery arising from the opposite sinus of Valsalva (ACAOS) remains a major clinical problem which poses daunting challenges. The current paper reports on the first case with main left coronary anomalies with aortic failure due to the web sub-aortic. A 29-year-old woman with orthopnea referred to a doctor. Echocardiography and electrocardiogram (ECG) confirmed sub aortic web with severe aortic insufficiency. Subsequently, the patient was subjected to aortic valve replacement surgery and the subvalvular resection was performed. During the surgery, the aorta was initially opened and the left coronary hole was not found in the coronary sinus. Therefore, only a cardioplegia from the right coronary (artery) hole was administered to the patient. The cusps of the valve and subvalvular web were removed. During the release, the left main artery which apparently originated from the right coronary artery(RCA) was found to be damaged. Therefore, the damaged part of the left main coronary artery was repaired, the valve was placed, and the aorta was repaired. Following deaeration, cross-clamp was removed, and the right heart started to work; nonetheless, the left heart was not engaged in any activity. Therefore, the cross-clump was attached again to the aorta, and a vein graft on the left anterior descending (LAD) artery was placed on the aorta. After the removal of the cross-clamp, the heart recovered its normal function, and the patient was removed from the pump with low inotropic. Thereafter, she was transferred to the Intensive Care Unit (ICU) of open-heart surgery. The present report aimed to express the incidence of multiple complications, such as recurrence of illness, the optimal time for surgery, the best way of surgery, getting cardiologists' attention (colleagues) during angiography, and knowing the characteristics of these abnormalities.

Intrusive luxation often results in severe damage to the tooth, periodontium, and pulp tissue. Furthermore, treatment outcome is often unpredictable due to the presence of numerous injury-related variables affecting the treatment option and prognosis. The current report presents the case of a 14-year-old boy with a 9.0 mm intruded permanent right maxillary central incisor with a closed apex which was treated by orthodontic repositioning and root canal treatment with a favorable prognosis. At the last follow-up visit (30 months after the first treatment session), the tooth was asymptomatic, and radiographic examination showed normal periapical and periodontal appearance.