Tehran University of Medical Sciences Journal of Orthopedic and Spine Trauma 2538-2330 5 2 2020 08 08 29 31 Farzad Amoozadeh Omrani Department of Orthopedic Surgery, Imam Hossein Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran Mohsen Elahi Department of Orthopedic Surgery, Imam Hossein Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran Mohammad Mahdi Sarzaeem Department of Orthopedic Surgery, Imam Hossein Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran Shahram Sayadi Anesthesiology Research Center, Imam Hossein Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran Hamed Farzaneh Department of Infectious Diseases, Bu-Ali Hospital, School of Medicine, Qazvin University of Medical Sciences, Qazvin, Iran 2020 01 24 2020 05 11 Background: Intramedullary nailing (IM nailing) is the standard of care for the treatment of most diaphyseal lower extremity fractures. A few studies have assessed and compared the infection rate following reamed and unreamed IM nailing in open long bone fractures. In the present study, we attempted to compare the infection rate between two procedures in open fractures of tibia. Methods: In this prospective study, we included consecutive patients suffering from open fractures of tibia (Gustilo subtypes II or IIIA) who required IM nailing. Patients younger than 16 years old, other Gustilo types (I, IIIB, and IIIC), fractures reaching to the tibial plateau articular surface, and simultaneous fractures of other bones in the extremity were excluded. All patients were followed up for one year to assess the postoperative infection rate. Results: Of 59 patients, 37 underwent reamed IM nailing and 22 underwent unreamed IM nailing. In reamed group, 4 cases (10.8%) experienced an infection requiring reoperation and antibiotic therapy, while in the unreamed group, it was 5 cases (22.7%). The difference between the groups was not statistically significant. Conclusion: Reamed and unreamed IM nailing procedures for fractures of tibia have similar outcome regarding long-term postoperative infections that require reoperation and antibiotic therapy. https://jost.tums.ac.ir/index.php/jost/article/view/156 https://jost.tums.ac.ir/index.php/jost/article/download/156/148

Tehran University of Medical Sciences Journal of Orthopedic and Spine Trauma 2538-2330 5 2 2020 08 10 37 9 EN Mohamad Sajad Mirhoseini Department of Orthopedics, Alborz University of Medical Sciences, Karaj, Iran Mohsen Tavakoli Department of Orthopedics, Alborz University of Medical Sciences, Karaj, Iran Mina Bakhtiari Department of Orthopedics, Alborz University of Medical Sciences, Karaj, Iran Salman Azarsina Department of Orthopedics, Alborz University of Medical Sciences, Karaj, Iran Monir Pirasteh Department of Orthopedics, Alborz University of Medical Sciences, Karaj, Iran Farsad Biglari Department of Orthopedics, Alborz University of Medical Sciences, Karaj, Iran Arvin Najafi Department of Orthopedics, Alborz University of Medical Sciences, Karaj, Iran Nooshin Taherzadeh-Ghahfarokhi student research committee,alborz university of medical science,karaj,iran 2020 03 28 2020 04 29 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. https://jost.tums.ac.ir/index.php/jost/article/view/167 https://jost.tums.ac.ir/index.php/jost/article/download/167/150

Tehran University of Medical Sciences Journal of Orthopedic and Spine Trauma 2538-2330 5 2 2020 08 10 50 2 Soroush Baghdadi Joint Reconstruction Research Center, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran; Children's Hospital of Philadelphia (CHOP), Division of Orthopedics, Philadelphia, Pennsylvania, USA Taghi Baghdadi Department of Orthopedics, Joint Reconstruction Research Center, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran 2020 03 22 2020 04 11 Background: Congenital patellar dislocation (CPD) is a rare disorder which presents with hypoplastic and irreducible patellae. It is accompanied by flexion contracture of the knee joint, genu valgum, and external tibial rotation. Case Report: A seven-year-old girl with CPD who was misdiagnosed as having cerebral palsy (CP) crouch gait and underwent distalfemoral extension osteotomy (DFEO) without paying attention to the dislocated patellae, is presented. Recurrence ensued, and the patient was referred for further evaluation. After a second surgery to address the dislocated patellae, the flexion contracture andgait pattern improved significantly. Conclusion: The case underscores the importance of a systematic, thorough physical examination, without which uncommon diagnoses will be overlooked, exposing the patient to further morbidity and complications. https://jost.tums.ac.ir/index.php/jost/article/view/166 https://jost.tums.ac.ir/index.php/jost/article/download/166/153

Tehran University of Medical Sciences Journal of Orthopedic and Spine Trauma 2538-2330 5 2 2020 08 08 32 6 Seyyed-Mohsen Hosseininejad Bone, Joint and Related Tissue Research Center(BJRTrc), Shahid Beheshti University of Medical Sciences, Tehran, Iran Mehrdad Aghaei Assistant professor of Rheumatology, Golestan Rheumatology Research Center, Golestan University of Medical Sciences, Gorgan, Iran Hossein Mohebi Bone, Joint and Related Tissue Research Center (Bjrtrc), Shahid Beheshti University of Medical Sciences, Tehran, Iran Gholamreza Roshandel MD., Epidemiologist MPH, Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran Sahab-Sadat Tabatabaei Resident of Internal Medicine, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran Saeid Amirkhanlou Associate professor of Nephrology, Golestan Rheumatology Research Center, Golestan University of Medical Sciences, Gorgan, Iran 2020 03 09 2020 04 11 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 https://jost.tums.ac.ir/index.php/jost/article/view/165 https://jost.tums.ac.ir/index.php/jost/article/download/165/149

Tehran University of Medical Sciences Journal of Orthopedic and Spine Trauma 2538-2330 5 2 2020 08 10 40 4 Farzad Vosooghi Joint reconstruction research center, imam khomeini hospital, tehran university of medical sciences Rohollah Khajeh Department of Orthopedic Surgery, Hand, and Upper Extremity Service, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran SM Javad Mortazavi Department of Orthopedic Surgery, Joint Reconstruction Research Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran 2020 04 05 2020 04 29 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. https://jost.tums.ac.ir/index.php/jost/article/view/168 https://jost.tums.ac.ir/index.php/jost/article/download/168/151

Tehran University of Medical Sciences Journal of Orthopedic and Spine Trauma 2538-2330 5 2 2020 08 10 53 5 SM Javad Mortazavi Department of Orthopedic Surgery, Joint Reconstruction Research Center, Tehran University of Medical Sciences, Tehran, Iran Hamed Mazzochy Department of Orthopedic Surgery, Shahid Modares Hospital, Saveh University of Medical Sciences, Saveh, Iran Mohammed Ghasemi Department of Orthopedic Surgery, Joint Reconstruction Research Center, Tehran University of Medical Sciences, Tehran, Iran Furqan Khan Department of Orthopedic Surgery, Joint Reconstruction Research Center, Tehran University of Medical Sciences, Tehran, Iran 2020 03 01 2020 04 11 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. https://jost.tums.ac.ir/index.php/jost/article/view/164 https://jost.tums.ac.ir/index.php/jost/article/download/164/154

Tehran University of Medical Sciences Journal of Orthopedic and Spine Trauma 2538-2330 5 2 2020 08 10 45 9 EN Seyed Mir Mansoor Moazen Jamshidi Joint Reconstruction Research Center (JRRC), Tehran University of Medical Sciences, Tehran, Iran, Mohammadreza Razzaghof Department of Orthopedics, Joint Reconstruction Research Center, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran SM Javad Mortazavi Joint Reconstruction Research Center (JRRC), Tehran University of Medical Sciences, Tehran, Iran, 2020 04 14 2020 05 07 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.  https://jost.tums.ac.ir/index.php/jost/article/view/171 https://jost.tums.ac.ir/index.php/jost/article/download/171/152