Seyed Mohammad Javad Mortazavi, MD.
Vol 5, No 3 (2019)
The Formation of Joint Orthopedic Congress of Medical Universities in Tehran City, Iran: Hopes and Worries
The modern human society is continuously becoming more and more complex and interconnected, thanks to advanced sources of communication, social mobility and international relations. Huge amount of science and data is one of the products of this complex human system, which stress the quality of information transfer and education for all and also derives socio-cultural evolution. Scientific societies is one of the crucial parts of socio-cultural evolution by their creative role (Klüver, 2008). Scientists’ role as the members of professional society is becoming more sub-specialized and at the same time, more relied on other sub-specialized members of the system, to keep the system running together.
Electron Microscopy and Microanalysis of Ovis Aries Knee Joint Meniscus: Does It Have Any Similarity with Human Meniscus?
Background: Meniscus plays a pivotal role in normal function of knee joint and is exposed to heavy load of pressure and trauma. The aim in this study is to investigate ultrastructure of medial and lateral meniscus of Ovis aries, in addition to comparing the findings with human meniscal structure.
Methods: 14 samples of freshly-excised meniscus of ovis aries were provided. After conventional preparation, the samples were studied via electron microscopy (EM) and its elements were microanalyzed.
Results: In the macroscopic evaluation, the meniscus surface was completely smooth, but in the microscopic observation, longitudinal ridges and grooves were observed. In addition, several types of cells that were different morphologically and bundles of collagen fibers were observed. The major direction of collagen fibers was circumferentially, but there were radial fibers as well. In the microanalysis of the ovis aris meniscus, the following elements were present: sodium, carbon, and oxygen, with sodium having the highest percentage among the elements. In medial meniscus of the samples, a small amount of calcium was detected.
Conclusion: By comparing the present findings with those of other studies, many similarities were observed between ultrastructure of ovis aries and human knee meniscus. The compatibility in the ultrastructures will imply the possibility of application of this specimen for xenograft meniscal transplant procedure.
Comparison of Patient-Reported Outcomes between Two Different Techniques of Carpal Tunnel Release: Classical Incision versus Minimal Incision
Background: Carpal tunnel syndrome (CTS) is the most common compression neuropathy in the upper limb which needs surgery in many cases. Two common surgical incisions for carpal tunnel release (CTR) are classical incision and minimal incision. In this survey, the aim is to compare patient-reported outcomes of these two types of incisions.
Methods: In this retrospective study, patients with CTS who underwent two different approaches for CTR (classical or minimal) during one year were included. The diagnosis was confirmed clinically and by electrodiagnostic studies. The patients were categorized into two groups regarding the type of surgery. At the 12-month visit, the patients were assessed for functional outcome, level of the pain, and satisfaction with Quick Disability of Arm, Hand and Shoulder score (QuickDASH), the visual analogue score (VAS) scale, and the scar appearance and symptom relief, respectively.
Results: 39 patients were entered in this study, 3 of who had bilateral symptoms. The 42 operated hands were divided into two groups: classical incision group (n = 21) and minimal incision group (n = 21). No significant difference was discovered between the two groups considering age and sex. In addition, no significant difference was found in the variables evaluated between the two groups, except for the higher patient satisfaction with the scar appearance in minimal incision group after 12 months.
Conclusion: After a one-year period, the minimal incision procedure had no priority to classical incision procedure, except for higher patient satisfaction considering the scar appearance.
Femoral neck fractures are challenging injuries to treat, as they commonly involve high-energy trauma mechanisms and displaced fracture patterns. Despite the effective treatment techniques and devices available to fix these fractures, the cases of fixation failure following femoral neck fractures are not uncommon. The most important underlying causes of fixation failure include nonunion, avascular necrosis, reoperation, infection, and implant failure. The management of this condition depends mainly on the features of the patient and fracture. In this educational corner, we are aimed to present a review of and stepwise approach to the management of fixation failure following femoral neck fracture.
Proximal humerus fracture-dislocation is a rare condition that occurs mostly in young adults due to high energy trauma and about 60-79% of misdiagnosis occurred in the first diagnosis. In this article, we present two patients with proximal Humerus fracture-posterior dislocation whom their fractures have been diagnosed but even though after radiographic studies including x-ray and CT scan the posterior dislocation has been misdiagnosed. Also, complications, management, and avoidance of this misdiagnosis have been discussed.
Background: Laryngeal fractures are one of the complications of direct damage to the neck, which can lead to airway obstruction and life-threatening conditions. Other causes of laryngeal fractures include injuries during fights, sports injuries, hangings, and iatrogenic causes. In this study, we introduce a child with a laryngeal fracture following an accidental hanging.
Case Report: A 9-year-old girl was presented to the emergency department with respiratory distress and inability to speak after being hanged by her scarf. We secured the cervical spine with a hard collar and provided two intravenous (IV) lines. Then, the patient was transferred to the radiology department to perform cervical and thoracic computerized tomography (CT) scans. In the cervical CT scan, the fracture of laryngeal cartilage was detected. We repaired the fracture by prolene sutures. Then the patient was transferred to the intensive care unit (ICU) ward. After 2 days, she was transferred to ward and discharged without any complications.
Conclusion: The cervical trauma is a critical condition that must be managed carefully and urgently. For the rapid diagnosis of possible damage, imaging is necessary. Among all modalities, CT scan is the best choice for detection of the vertebral injuri es and airway competence in emergent conditions.