Seyed Mohammad Javad Mortazavi, MD.
Vol 5, No 4 (2019)
The Post-Operative Outcome of Stoppa Approach in the Treatment of Anterior Column Acetabular Fractures
Background: Choosing the proper approach to surgical treatment of various types of acetabular fractures can play an important role in minimizing adverse outcomes during and after surgery. In the present study, we described our experience on the outcome of Stoppa approach in anterior column acetabular fractures.
Methods: This was a retrospective analysis of 40 patients with acetabular anterior column fractures that had undergone surgery with Stoppa approach. The study information, Harris Hip Score (HHS), and pre- and post-operative radiographic findings were collected by reviewing the hospital recorded files.
Results: HHSs of 80 to 100 were achieved in 75.0% of patients. Completed (anatomic reduction less than 2 mm) displacement reduction was found in 97.5%. 2 mg/dl decreased serum level of hemoglobin (Hb) was found in 75.0%, leading to blood transfusion in 60% of subjects. Regarding post-procedural complications, the common event was infection in 15.0%, followed by degenerative joint disease (DJD) in 15.0%. The post-operative complications were similar in men and women, but were significantly higher in patients older than 50 years than the younger patients.
Conclusion: Stoppa approach is associated with high success rate and the occurrence of rare and tolerable major complications.
A Simple Test for the Most Common Cause or Aggravating Factor of the Neck, Shoulder, or Upper Extremity Pain
Background: Shoulder pain and neck pain affect respectively 25% and 43% of the population. The aim of this clinical study is to assess the proportion, correct diagnosis, and treatment of hypertension (HTN) in patients with pain in the neck, shoulder, and upper extremity.
Methods: 300 patients with complaints of neck, shoulder, or upper extremity pain without trauma or infection were studied from January 2015 to December 2017. After taking the history and examination, the blood pressure of these patients was recorded. Laboratory tests, x-ray, and magnetic resonance imaging (MRI) of the neck and affected shoulder joint were requested. Antihypertensive and symptomatic treatments were prescribed for patients with HTN. In the next visits, new history and examination, including the range of motion (ROM) of neck, shoulder, and upper extremity, blood pressure, and the results of laboratory tests, and images were checked. The final data were analyzed using chi-square test in SPSS software.
Results: The Prevalence of HTN in patients in the age groups of 20-30, 31-60, and above 60 years were 21%, 44%, and 56 %, respectively. Neck, shoulder, and upper extremity pain and motion improved significantly after antihypertensive and symptomatic treatment in patients with HTN.
Conclusion: HTN is the most common cause of neck, shoulder, and upper extremity pain in the adults and older patients referring to a physician. Thus, checking blood pressure by a physician or specialist is recommended for adults or older patients with neck, shoulder, or upper extremity pain. Antihypertensive and symptomatic treatments must be prescribed for nonsteroidal anti-inflammatory drugs (NSAIDs), and acetaminophen-codeine and corticosteroids should be prohibited for the patients with HTN.
Huge Post-Traumatic Cystic Hygroma, Combination of Surgical and Non-Surgical Treatment Methods: A Case Report
Background: Cystic hygroma (cystic lymphangioma) is a malformation of the lymphatic system. It is rare in adults and trauma may be the cause in some cases. Surgical and non-surgical treatment methods have been described in the management of cystic hygroma.
Case Report: A 38-year-old woman, known case of systemic lupus erythematosus (SLE), presented a huge cystic formation in the posterior aspect of her thigh following trauma. We treated the patient using a combination of three treatment methods including surgical excision, intra-cavity bleomycin injection, and post-operative use of compression pants.
Conclusion: Huge post-traumatic cystic hygroma in adults is rare. By the combination of the above three therapeutic regimens, there was no cystic lesion recurrence after eight months.
Background: Intraosseous stab wounds are extremely rare. Only a few cases have been reported in the upper extremity.
Case Report: In this report, we presented a case of stab wound to the right shoulder with penetration to the scapula. The patient was successfully managed in a team-based approach. During a 12-month follow-up, he showed no abnormality in passive and active movements or physical examination.
Conclusion: Relying on the physical examinations and paraclinical studies may be an appropriate substitution for exploration surgery when possible iatrogenic injuries may affect the patient's quality of life.