According to the Hueter-Volkmann law, there is asymmetry in the loads applied to the spinal structure on the convex and concave sides, which can increase the severity of scoliosis and its progression. The purpose of this review was to examine the asymmetry of vertebrae in subjects with scoliosis and explore how this theory can be utilized to enhance the effectiveness of braces in controlling and reducing scoliosis curves. A search was conducted in databases such as Google Scholar, PubMed, and ISI Web of Knowledge using keywords like Hueter-Volkmann law and asymmetry in relation to scoliosis.

While there were limited studies on the asymmetry of vertebrae in individuals with scoliosis, the findings indicated significant differences in the height of vertebrae and discs between the concave and convex sides. Additionally, the degree of asymmetry was found to be correlated with the severity of scoliosis. It appears that the design of scoliotic braces is influenced by the Hueter-Volkmann law. It is recommended that new brace designs be developed based on the principles of this law to minimize the impact of gravity on the spine.

Abstract

Purpose: Occipitocervical fusion is a rare and often challenging surgical procedure. Several methods have been introduced to obtain the best measures for occipitocervical alignment. The mandible-C2 angle was first introduced in 2020. In this study we aimed to evaluate the out-of-sample validity of this measures.

Methods: To compare our results, we followed the same methodology as the root article. We retrospectively studied 274 lateral cervical radiographs of patients aging 1 to 87 years who had no cervical pathology evident on X-ray. A board-certified radiologist and a second-year radiology resident, performed the measurements pertaining to five specific angles as suggested by Bellabarba. The five angles measured consisted of (1) anterior C2 body/anterior mandible angle, (2) anterior C2 body/posterior mandible angle, (3) posterior C2 body/anterior mandible angle, (4) posterior C2 body/posterior mandible angle, and (5) Occiput-C2 Angle.

Results: Inter-rater correlation data was calculated for single and average measures. The Inter-rater agreement for individual angle measures of O-C2A, AB/AM, AB/PM, PB/AM, and PB/ PM were 0.49, 0.11, 0.25, 0.33, and 0.49 respectively. The Intraclass correlation coefficient for average measures of O-C2A, AB/AM, AB/PM, PB/AM, and PB/PM were 0.66, 0.20, 0.40, 0.50, and 0.66 respectively.

Conclusion: Our study did not show satisfying results to confirm using these angles as a reliable marker for occipitocervical alignment, except for one of them, showing outcomes relatively compatible with our standard angle

Purpose: To evaluate the impact of a very low dose of naloxone added to a remifentanil infusion on postoperative pain in patients undergoing hip replacement surgery in the lateral position.

Methods: This randomized clinical trial included 80 patients candidates undergoing hip replacement surgery under general anesthesia were randomly divided into two groups of 40 using block randomization: group 1 received remifentanil at a dose of 0.3 μg/kg/min, while group 2 received remifentanil at a dose of 0.3 μg/kg/min with a very low dose of naloxone administered at 0.05 μg/kg/h following injection. Postoperative pain (measured using VAS pain assessment criteria), drowsiness caused by narcotics and analgesics in recovery, and the duration of getting out of bed were all monitored and recorded in the ward.

Results: The mean time to administration of the first sedative drug was 1.30 ± 1.89 hours in the control group and 3.20 ± 2.55 hours in the intervention group. The difference between the groups in this regard was statistically significant (P <0.0001). The frequency of pain after surgery at 0, 4 and 8 hours was significantly different between the control and intervention groups (P = 0.003, P <0.0001, and P=0.021, respectively).

Conclusions: Based on the results, we recommend using a very low dose of naloxone along with remifentanil infusion in patients undergoing complete hip replacement surgery to reduce their pain and the need for painkillers.

Acetabular fractures are among the most common fractures in pelvic injuries. These types of fractures are mostly caused by high energy impact. Considering that there are many challenges in using the type of treatment method in acetabular fractures and the incorrect treatment of these fractures can have many complications for the patient. In this regard, we decided to conduct a study to examine the treatment results of patients who underwent surgery with a posterior approach.
method
To do this, the files of patients admitted to the orthopedic department of the hospital were examined. After contacting the patients and obtaining consent to participate in the study and explaining the work steps, for measurement Performance outcomes in the examination 6 months after the treatment results and final follow-up, the hip score index (Harris hip score) was used, which includes the four main parts of pain, the patient's performance during activities, different degrees of deformity, and range of motion of the hip joint. The scores were graded in four categories: excellent (100-90), good (89-80), average (79-70) and poor less than (70). It was entered into SPSS software and analyzed.
Conclusion
In this study, the total number of patients was 25, of which 80% were men and 20% were women. Our patients were generally in the age group of 10-60 years, respectively, 12% in the age group of 10-20 years, 32% in the age group of 21-30 years, 36%, in the age group of 31-40 years, 12% were in the age group of 41-50 years and 8% were in the age group of 51-60 years. Treatment results were evaluated as good or excellent in 15 (60%) patients.
Treatment results had no statistically significant relationship with age and sex. 48% have no pain and lameness and the others show different degrees of pain. 96% of the people were able to climb the stairs, but 4% were unable to climb the stairs. 76% of the people had the ability to use public transportation and the rest of the people did not. 40% of the people did not need to use crutches and the rest of the people depended on crutches to varying degrees. According to the therapeutic results obtained from the surgery, it can be concluded that this surgery has acceptable results finds out.

post-operative pain plays a key role in patients’ satisfaction. Since opioids may cause dependence and have a high abuse rate, non-opioid drugs such as Duloxetine are being investigated for their effect in this matter. Duloxetine is a dual serotonin and norepinephrine reuptake inhibitor (SNRI) which causes a synergism effect and can help manage post operative pain. For this cause, it’s prescribed as 60mg per day. There have been studies in the recent years proving its effectiveness both in total arthroplasty and elective surgeries. The collective data shows that duloxetine can be used for post-operative pain management, and with minimal side effect, it can lower the opioid usage and dependence.  

Low back pain (LBP) is a significant issue in both clinical and public health settings, resulting in high healthcare and social costs.
While knee joint pain is more prevalent than hip joint pain, standing posture is influenced not only by spinal alignment but also by
hip and knee joint alignment. The knee and spine are interconnected anatomically, and degenerative changes in one area could
often cause discomfort in the entire axis, leading to what is known as "knee-spine syndrome". LBP is a common condition associated
with knee pain and can significantly affect the results of total knee arthroplasty (TKA). Surgeons need to consider knee-spine
syndrome before any surgical intervention in patients with knee or back pain and explain it to the patients before the surgery.
Keywords: Low Back Pain; Knee; Spine; Syndrome; Patellofemoral Pain Syndrome

Abstract:

Introduction:

Freeman Sheldon syndrome is a rare genetic disease of varying severity with craniocarpotarsal manifestations, which has many difficulties in orthopedic management also anaesthetic concerns about intubation difficulties and malignant hyperthermia and mutch tendency of deformities for recurrence.

Objective:

Describe clinically manifestations of a patient with Freeman-Sheldon syndrome.

Presentation of the case:

An Iranian girl presents mask-like face, deep sunken eyes,ptosis, wide nasal bridge, small mouth with the facial typical appearance of a whistler, dental crowding and high narrow palate, skin dimple on the chin in the shape of an  H-shape and abnormally long philtrum. defect in the hands of typical windmill vane hand and clasped thumb deformity ,Resistant contracture of the fingers with ulnar deviation and bilateral  rigid clubfoot,  and failure to thrive.

Conclusions:

Freeman-Sheldon syndrome is a rare syndrome that mainly affects the face and upper and lower limbs of patients, whose clinical diagnosis is possible after a thorough physical examination. and

it is best to start treatment without delay regarding future prognosis at least with nonoperative modalities.

In 1893 chronic sclerosing osteomyelitis was explained by carle Garre, that characterized by sclerosing and thickening of cortices of bone and obliteration of medullary canal. [01]

It has periosteal reactions, that induces bone neo-formation but there is no abscess formation or sequestra or drainage. [02]

in our resistant case ,we accomplished  masquelet tecknique after shortcomings in several procedures .