Background: Decreased bone mass, often measured using bone mineral density (BMD) is frequently seen in patients with end-stage renal disease (ESRD) undergoing hemodialysis. It may cause serious bone health problems such as fractures. Several risk factors of low bone mass in the patients on hemodialysis have been proposed including age and body mass index (BMI). Our current study explored the relationship between BMI, age, sociodemographic status, and BMD among postmenopausal women on hemodialysis.
Methods: This study enrolled postmenopausal women on hemodialysis whose bone densitometry was checked and assessed with the age, BMI, and social status. Statistical analysis was performed in SPSS software.
Results: Sixty participants with a mean ± standard deviation (SD) of age of 57.00 ± 10.63 years were enrolled. After adjustment of sex and age, normal-weight women had 2 times the prevalence of low bone density compared to the obese women [prevalence ratio (PR) = 2, 95% confidence interval (CI): 1.4–2.8]. For osteoporosis,  the PR was also twice higher for the women with normal BMI (PR = 2, 95% CI: 1.3-2.8) and 1.6 times higher for the overweight group than the women in the obese group (PR = 1.6, 95% CI: 1.3-2.4).
Conclusion: Among the women on hemodialysis, obese women have lower prevalence of osteoporosis than normal-weight cases

Polytrauma describes the condition of a child subjected to multiple traumatic injuries and can be a life-threatening condition. Approximately 30% of children with severe trauma die because of inadequate initial assessment. To reduce the rate of mortality and morbidity, it is essential to know the primary and then the secondary survey of the patient. The first hour (the “golden hour”) after injury is the most critical in influencing the rates of survival from the injuries. Initial resuscitation follows the Advanced Trauma Life Support (ATLS) or Pediatric Advanced Life Support (PALS) protocols (ABCDE), Airway, Breathing, Circulation, Disability (neurologic), Exposure (Extremities). Urine catheter is mandatory too.After the management of the patient in the first survey and stability of the vital signs, the team and the physician can start their second survey. It includes a complete history and a complete and serial examination from head to toe. With Ecchymosis on the abdominal wall, abdominal injury is suspected. Taking radiographs and other imaging according to physical exam are included in the second survey too. Taking a pelvic and chest and bed side lateral neck radiograph is mandatory.

Scapholunate instability is the most common cause of carpal instability. The entity is  often missed in practise. If diagnosed early, it may be repairable. However, the later it is diagnosed, the more complicated and difficult the management would be. In this paper we aimed at reviewing the main concepts of the carpal instability and delineating the wide management options of scapholunate interosseous ligament injury discussed in the literature.

Femoral neck fracture is a global public health problem with 1.5 million hip fractures per year worldwide. However, there is no current consensus on the choice of ideal treatment. In this study, we aimed to answer the questions of when to choose internal fixation and arthroplasty, whether to do total hip arthroplasty or hemiarthroplasty, whether to use cemented or uncemented prosthesis, and whether to use a bipolar or unipolar design for hemiarthroplasty. We also discussed the complications associated with each method. We attempted to discuss these issues based on the latest literature and also presented the protocol of our institute in each subject. 

Background: Asymmetric bilateral hip dislocation is a rare condition and the association with bilateral femoral head fracture makes it even more rare. We report a patient with asymmetric bilateral hip fracture – dislocation and our management and therapeutic approach.
Case Report: A 28-year-old male sustained motor vehicle accident and presented asymmetric bilateral hip fracture-dislocation. In the initial step close reduction was performed and in the following step the patient underwent bilateral open reduction and fixation of femoral head fragment by screws. The results were satisfactory after 5 year follow-up.
Conclusion: Although rare, paradoxical femoral head fracture should be considered in patients with hip dislocation. Our management and therapeutic approach seems to be appropriate for this case and is suggested in similar cases.