Journal of Research in Orthopedic Science
Volume:8 Issue: 4, Nov 2021

Bone grafting is a surgical procedure, dating back to the Neolithic era. This paper to review the history of bone grafting surgery. The search was conducted in PubMed, Embase, Web of Science and Google scholar databases for any related article, as well as pearling of the references of these papers.

It is the goal of medicine discovery to help patients. It is therefore important to analyze studies published by Iranians in PubMed related to shoulder and elbow problems.

We conducted a bibliometric search to determine the number of papers published by Iranian scholars in PubMed related to shoulder and elbow.

A search in PubMed database was conducted using 129 keywords such as shoulder, cubitus, bankart, rotator cuff, olecranon, etc. Articles with at least one author from Iran published from 1995 to 2021 were selected. The selected papers were studied in terms of the institution name, study subject, total number of papers, study design, contribution rate of Iranian orthopedic surgeons each year, annual number of papers published by Iranians in five journals with the greatest impact factor, and in journals with an impact factor.

There were 463 eligible articles in the field of shoulder and elbow (17 per year); 89 (18%) were clinical trials, and 375 (82%) were retrospective studies. Fracture dislocations were the most common study subject (17%), 11 % related to shoulder and 6 % related to elbow. Among shoulder related articles, the most common study subjects were fracture dislocation (24%), brachial plexus (14%), rotator cuff (12%), and tumor (6%). In elbow related articles, the most common study subjects were fracture dislocations, tennis elbow, and cubital tunnel syndrome (23%, 21%, and 16%, respectively). 

Although the number of articles published by Iranians in the field of shoulder and elbow in PubMed has increased significantly in recent years, there is still a long way for Iran to become a science exporting country.

Proximal tibial fractures account for 1% of all fractures. Different treatments have been proposed for this fracture. 

The present study aims to evaluate the clinical and radiological results of single-locking and double-locking plate fixation methods in patients with proximal tibial fractures.

The present study was carried out on 40 patients with proximal tibial fractures referred to Imam Khomeini Hospital in Sari, Iran. They were divided into two groups of double-locking fixation with 3.5-mm Locking Compression Plate (LCP) and single-locking fixation with 4.5-mm LCP. They were followed up for at least 6 months after surgery. At the time of admission, they were assessed using Lysholm Knee Scoring Scale and Visual Analogue Scale. Radiographs were taken from all patients and the articular surface, and fracture healing,. 

Of 40 patients, 17 and 23 were treated with 3.5-mm and 4.5-mm LCPs, respectively. The mean Lysholm score in the groups with 3.5-mm and 4.5-mm LCPs was 84±8.2 and 78.3±16.2, respectively. There was no statistically significant difference between the two groups (P>0.5). 

The radiological and functional outcomes were almost the same for single-locking and double-locking plate fixation methods. Both methods can be used to treat the tibial plateau fracture. The treatment can be selected according to the surgeon and the patient’s request

There is no clear consensus on the best treatment option for scaphoid fractures. 

In this study, we aim to evaluate the short-term clinical and radiologic outcomes in patients with acute isolated scaphoid fractures treated with surgical or nonsurgical methods.

In a retrospective study, 31 patients with acute isolated scaphoid fracture (Mean±SD age: ‎28.9±9.9 ‎years) treated with open reduction and internal fixation (n=15) or cast immobilization (n=16) methods were included. The fractures were classified according to Herbert & Fishers’ classification system. Clinical outcome measures were the wrist range of motion, pinch strength, and grip strength. Radiographic outcome measures were the lunocapitate angle, scapholunate angle, and ulnar variance. The outcome were compared between the involved and uninvolved hands and between surgical or nonsurgical groups.

The majority of fractures were type B2 (n=14). In a Mean±SD follow-up of 15.1±3.2‎‏ months, the mean extension, flexion, pinch, and grip strength of the involved hand averaged 81.3%, 80.7%, 90%, and 87% of the uninvolved hand. Accordingly, clinical outcomes were significantly lower in the involved hand. The scapholunate angle was significantly higher in the involved hand (P=0.002). Clinical and radiographic outcomes were not significantly different between the surgical and nonsurgical groups. Radiographic malalignment was detected in 25 scaphoids. No significant correlation was found between the clinical and radiographic outcomes.

After scaphoid fracture union, the decrease in wrist range of motion (extension, flexion) and grip/pinch strength has no correlation with radiographic results.

Regarding the fact that lateral compression is usually not the underlying mechanism of fracture, Locked pubic symphysis is a very rare injury. At most times it can be managed with closed reduction method; however, open reduction with or without internal fixation may sometimes be required. In rare cases, osteotomy is the only choice. Urethral or bladder damage can occasionally be found. In this study, we presented a case of locked pubic symphysis with failed closed reduction who underwent successful open reduction with internal fixation.

Closed dislocation of thumb Interphalangeal (IP) joint is rare, due to the inherent stability of the thumb IP joint. The interposition of the volar plate, flexor pollicis longus, sesamoids, and digital nerves can treat the joint closed reduction. In this study, we report a case of three-week-old irreducible closed dislocation of thumb IP joint in a 33-year-old woman. We planned to perform open reduction surgery using a dorsal approach on the IP joint and the ulnar side opening. The volar plate was interposed in the joint. Seven months after surgery, the patient achieved 0-45 degrees of IP range of motion. No sign of degenerative joint changes on the x-ray images was observed in the final visit. This study suggests the high probability of open reduction for these injuries and recommends the use of dorsal approach, excluding the complications of volar approach.

Carpal tunnel syndrome (CTS) is a common disorder with several known risk factors. However, the role of radiographic characteristics of the distal radius and risk factors of CTS has been overlooked.

To identify radiographic characteristics of the distal radius as the risk factors of CTS.

In a case-control study, 60 patients with CTS who underwent surgical treatment (case group) and 60 people who underwent radiographic evaluation for reasons other than CTS (control group) were included. The case and control participants were matched for age and sex. Radiographic records of the patients were reviewed in the picture archiving and communication system, and the distal radius characteristics, including volar tilt, radius slope, radius height, and ulnar variance, were investigated.

The Mean±SD volar tilt was 10.49±6.42º in the case group and 16.65±5.31º in the control group (P <0.001). The Mean±SD radius inclination angle was 19.58±4.72º in the case group and 17.88±4.88º in the control group (P=0.049). The Mean±SD height of radius was 10.30±3.21 mm in the case group and 12.24±5.33 mm in the control group (P=0.017). The Mean±SD ulnar variance was 1.36±1.43 mm in the case group and 0.75±0.27 mm in the control groups (P=0.002).

Radiological characteristics of the distal radius are significantly different between the CTS and non-CTS patients and could be regarded as the inherent risk factors of CTS development.

Thoracic exostosis (osteochondroma) is rare. In this study, we report a rare case of thoracic exostosis in a 10-year-old boy arising in the T8 spinous process without expansion of mass to spinal canal. The patient’s parents noticed a mass in the dorsal aspect of the thorax for the past two years with gradual enlargement over six months. The patient had no clinical symptoms of spinal cord compression, such as pain and myelopathy. In the radiological evaluation, a calcified lesion was detected with the typical characteristics of exostosis. The lesion was removed with en bloc resection, and histologic examination confirmed the diagnosis of thoracic exostosis. The six-month follow-up of the patient showed the event-free survival. This study suggests the importance of early diagnosis and treatment of thoracic exostosis for preventing it from causing long-term neurological deficits and reducing its potential risk of malignant transformation.