Tehran University of Medical Sciences Journal of Orthopedic and Spine Trauma 2538-2330 7 2 2021 09 18 39 43 Arvin Najafi Department of Orthopedic, Shahid Madani Hospital, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran Mohsen Tavakoli Department of Orthopedic, Shahid Madani Hospital, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran Danoosh Zargar Research Committee, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran Dorsa Hadavi Department of Orthopedic, Shahid Madani Hospital, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran Ehsan Seif Research Committee, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran Salman Azarsina Department of Orthopedic, Shahid Madani Hospital, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran 2021 03 25 2021 09 18   Background: Non-operative management of valgus impacted femoral neck fracture leads to prolonged bed rest which may lead to deep vein thrombosis. The preferred method is the internal fixation because of pain control, enhanced mobilization, and better fracture healing but fails in older patients and individuals with medical comorbidities. The present study aims to assess the functional outcomes after the internal fixation or the non-operative management.   Methods: A retrospective cohort study was conducted at a Level I trauma center from January 2013 to December 2019 on all patients with valgus-impacted femoral neck fractures [Arbeitsgemeinschaft für Osteosynthesefragen/Orthopedic Trauma Association Classification (AO/OTA 31-B1)]. Overall, 81 patients were managed operatively with three partially threaded, cannulated screws in a parallel configuration and 21 patients were managed non operatively with instant mobilization, physical therapy, and partial weight-bearing protocol.   Results: 6 (28.0%) patients in the non-operative group and 3 (4.0%) cases in the operative group experienced fracture displacement (P < 0.001). 48 (59.2%) patients of the operative treatment group returned to baseline ambulatory function at 3 months, while this figure was 43.0% in the non-operative treatment group, not significantly different (P = 0.100). There was no significant difference in the mortality rates at one month and three months between the two groups (2 patients in each group, P = 0.140).   Conclusion: The ideal treatment of valgus-impacted femoral neck fractures is still controversial. The main purpose in the treatment of hip fractures is to return the patient to functional level equal to the level he or she was before the fracture. Surgically treated patients had lower failure rates in comparison with the other group. https://jost.tums.ac.ir/index.php/jost/article/view/263 https://jost.tums.ac.ir/index.php/jost/article/download/263/218

Tehran University of Medical Sciences Journal of Orthopedic and Spine Trauma 2538-2330 7 2 2021 09 18 44 7 EN Faezeh Eskandari Amirkabir University of Technology (Tehran Polytechnic), Tehran, Iran Shima Bahramizadeh Sajadi Amirkabir University of Technology (Tehran Polytechnic), Tehran, Iran Hamid Reza Katoozian Amirkabir University of Technology (Tehran Polytechnic), Tehran, Iran 2021 04 01 2021 08 31 Background: Center of pressure (CoP) trajectory is one of the gait parameters that is widely used for clinical assessments. Moreover, the CoP trajectory could be adversely affected by anatomic and mechanical factors that involve foot function, which was shown to be correlated with musculoskeletal diseases. The aim of this study is to compare angle-associated parameters of gait in patients with different lumbar spinal disorders.   Methods: The subjects suffered from the same levels of spine impairment, including patients with lumbar spinal stenosis (LSS) and lumbar intervertebral disc degeneration (LIDD) were recruited in this study. The spatio-temporal angular parameters associated with the CoP of the subjects during their gait were collected and examined. The measurements were used to calculate the CoP angle and symmetry angle (SA). Then the butterfly diagram (BD) intersection angle was introduced as a new potential parameter in gait assessment.   Results: The results of the current study showed that CoPs and SAs did not vary between the two groups (P > 0.05). The BD intersection angle, however, indicated some variations between patients with LSS and LIDD (P < 0.05).   Conclusion: While the results showed that CoP angles and SAs did not differ between the LSS and LIDD groups, it is hypothesized that such disorders that affect the gait could be reflected in the BD intersection angle. Therefore, the BD intersection angle is suggested as a clinical indicator in clarifying patients with lumbar spinal disorders.   https://jost.tums.ac.ir/index.php/jost/article/view/264 https://jost.tums.ac.ir/index.php/jost/article/download/264/219

Tehran University of Medical Sciences Journal of Orthopedic and Spine Trauma 2538-2330 7 2 2021 09 18 48 52 Mohammad Reza Guity Joint Reconstruction Research Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran Arvin Najafi Shahid Madani Hospital, Alborz University of Medical Sciences, Karaj, Iran Pejman Mansouri Shahid Madani Hospital, Alborz University of Medical Sciences, Karaj, Iran Nima Bagheri Joint Reconstruction Research Center, Imam Hospital, Tehran University of Medical Sciences, Karaj, Iran 2021 04 12 2021 09 18 Background: This study was aimed to evaluate the final results of surgical treatment (Latarjet procedure) in the recurrent anterior shoulder instability following episodes of tramadol-induced seizure.   Methods: From January 2005 to March 2013, 47 patients with recurrent anterior shoulder dislocation after suffering a seizure episode following tramadol use underwent surgical procedure. There were 53 shoulders in 47 male patients (six had bilateral recurrent dislocations). The mean age of the patients at the time of operation was 24.7 years (ranging from 20 to 44 years). The average number of episodes of anterior shoulder dislocation before surgery was 16.   Results: External rotation with the elbow at the side improved from 45.8 ± 9.3° (30°-60°) pre-operatively to 61.5 ± 7.8° (45°-90°) post-operatively (P < 0.001). Forward elevation also increased significantly post-operatively (P = 0.002). Mean pre-operative Rowe score was 28.41 ± 4.30 (30-85) which increased to 73.57 ± 8.40 post-operatively. The Western Ontario Shoulder Instability Index (WOSI) score decreased from 1352 ± 74 to 618 ± 46 (P < 0.0001).   Conclusion: Correcting glenoid bone loss by Latarjet procedure combined, if necessary, with humeral head defect reconstruction could be a proper treatment method in patients experiencing recurrent anterior shoulder dislocation after idiosyncratic seizure reaction of tramadol. https://jost.tums.ac.ir/index.php/jost/article/view/268 https://jost.tums.ac.ir/index.php/jost/article/download/268/220

Tehran University of Medical Sciences Journal of Orthopedic and Spine Trauma 2538-2330 7 2 2021 09 18 53 6 Mohammad Moshirifar Joint Reconstruction Research Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran Alireza Moharrami Joint Reconstruction Research Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran Mir Mansour Moazen Jamshidi Joint Reconstruction Research Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran SM Javad Mortazavi Joint Reconstruction Research Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran 2021 02 04 2021 04 20 no abstract is available. https://jost.tums.ac.ir/index.php/jost/article/view/257 https://jost.tums.ac.ir/index.php/jost/article/download/257/221

Tehran University of Medical Sciences Journal of Orthopedic and Spine Trauma 2538-2330 7 2 2021 09 18 57 60 Hassan Taheri Department of Orthopedic Surgery, Kashani Hospital, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran Mohammad Ali Tahririan Department of Orthopedic Surgery, Kashani Hospital, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran 2021 04 15 2021 09 18 No abstract is available.   https://jost.tums.ac.ir/index.php/jost/article/view/269 https://jost.tums.ac.ir/index.php/jost/article/download/269/222

Tehran University of Medical Sciences Journal of Orthopedic and Spine Trauma 2538-2330 7 2 2021 09 18 61 3 Mohammad Zarei Joint Reconstruction Research Center, Department of Orthopedic Surgery, Tehran University of Medical Sciences, Tehran, Iran Mohsen Rostami Department of Neurosurgery, Neuroscience and Sports Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran Furqan Khan Joint Reconstruction Research Center, Department of Orthopedic Surgery, Tehran University of Medical Sciences, Tehran, Iran 2021 03 24 2021 07 28 Background: Revision surgery of spine can be a complex procedure and has known complications. It involves hardware revision, removal of scar/callus tissue, realignment of sagittal balance, and anterior augmentation. However, through this report, we aim to demonstrate that a stand-alone rod augmentation at the failure site without removal of scar/callus tissue and/or anterior fixation can achieve excellent results in select cases.   Case Report: A 66-year-old woman underwent L2 pedicle subtraction osteotomy (PSO) + T9-iliac fixation for fixed sagittal imbalance and osteoporotic collapse of L3. One year later, she developed progressive axial lumbar pain and difficulty in mobilization. The patient was diagnosed with pseudoarthrosis and instrumentation failure and underwent revision spine surgery with stand-alone rod augmentation. She had an uneventful rehabilitation and showed complete radiographic union and excellent clinical outcome in the 2-year follow-up.   Conclusion: Stand-alone rod augmentation can provide stable posterior construct to prevent future pseudoarthrosis and/or instrumentation failure after revision spine surgery in selected cases. Anterior augmentation or resection dural scar tissue or dissection through callus tissue is not always necessary.   https://jost.tums.ac.ir/index.php/jost/article/view/262 https://jost.tums.ac.ir/index.php/jost/article/download/262/225

Tehran University of Medical Sciences Journal of Orthopedic and Spine Trauma 2538-2330 7 2 2021 09 18 64 6 Shahin Talebi Department of Orthopedic Surgery, Orthopedic Research Center, Mazandaran University of Medical Sciences, Sari, Iran Alireza Teimourey Student Research Committee, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran Abolfazl Ghadiri Department of Orthopedic Surgery, Orthopedic Research Center, Mazandaran University of Medical Sciences, Sari, Iran 2021 04 08 2021 09 18 Background: Among all joint dislocations, dislocations of the shoulder are the most common. Although posterior shoulder dislocation is infrequent, it is more common following seizures. Trauma, electrocution, and seizures can cause bilateral shoulder dislocation. Anterior shoulder dislocations can be accompaniment by greater tuberosity (GT) fractures, Bankart fractures, and other complications such as rotator cuff tears and neuro-vascular injuries.   Case Report: This article describes a 19-year-old boy who suffered from bilateral anterior shoulder dislocation due to an episode of generalized seizure, which happened after taking tramadol.   Conclusion: Any sign of shoulder pain in a patient who has experienced a generalized tonic-clonic seizure should warrant full radiographic evaluation to prevent the complications. https://jost.tums.ac.ir/index.php/jost/article/view/267 https://jost.tums.ac.ir/index.php/jost/article/download/267/226

Tehran University of Medical Sciences Journal of Orthopedic and Spine Trauma 2538-2330 7 2 2021 09 18 67 70 Mohamadsajad Mirhoseini Department of Orthopedics, Shahid Madani Hospital, Alborz University of Medical Sciences, Karaj, Iran Salman Azarsina Department of Orthopedics, Shahid Madani Hospital, Alborz University of Medical Sciences, Karaj, Iran Mohsen Tavakoli Department of Orthopedics, Shahid Madani Hospital, Alborz University of Medical Sciences, Karaj, Iran Omid Kohandel Gargari Alborz Artificial Intelligence Association, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran 2021 04 26 2021 09 18 Background: Retained surgical items (RSIs) are not very common in the orthopedic surgery. Here, we are reporting a case of a sponge pad left in the femoral canal for 22 years. We could not find any other reported case of retained surgical sponge in the femoral canal and that is what makes this case report unique.   Case Report: The patient was a 42 year-old man who underwent surgery for the fixation of a fractured femur 22 years ago. In August 2020, this patient was seen complaining about pain at the surgical site. The assessments revealed a sponge pad retained in the femoral canal, which was removed by Department of Orthopedic Surgery, Shahid Beheshti University of Medical Sciences, Shohada Tajrish Hospital, Tehran, Iran Meisam Jafari Kafiabadi Department of Orthopedic Surgery, Shahid Beheshti University of Medical Sciences, Shohada Tajrish Hospital, Tehran, Iran Farsad Biglari Department of Orthopedic Surgery, Shahid Beheshti University of Medical Sciences, Shohada Tajrish Hospital, Tehran, Iran Mohammadreza Chehrassan Department of Orthopedic Surgery, Shahid Beheshti University of Medical Sciences, Shohada Tajrish Hospital, Tehran, Iran Amin Karami Department of Orthopedic Surgery, Shahid Beheshti University of Medical Sciences, Shohada Tajrish Hospital, Tehran, Iran Adel Ebrahimpour Department of Orthopedic Surgery, Shahid Beheshti University of Medical Sciences, Shohada Tajrish Hospital, Tehran, Iran 2020 11 22 2021 03 29 Background: The application of a cannulated device is a widely used fixation method for hip fractures. Although the breakage of the guide wire during this procedure is an uncommon complication, migration of the broken fragment might be catastrophic.   Case Report: We presented a case of intertrochanteric fracture with breakage of the lag screw guide wire in the acetabulum during fixation with cephalomedullary nail. The broken fragment was located with computed tomography (CT) scan and removed through Stoppa approach.   Conclusion: We found the Stoppa approach a safe and useful method for extracting the intra-pelvic broken guide wire. https://jost.tums.ac.ir/index.php/jost/article/view/243 https://jost.tums.ac.ir/index.php/jost/article/download/243/215

Tehran University of Medical Sciences Journal of Orthopedic and Spine Trauma 2538-2330 7 1 2021 04 20 34 6 Marjan Zeinali Department of Neurology, Firoozgar Hospital, Iran University of Medical Sciences, Teheran, Iran Bahram Haghi Ashtiani Department of Neurology, Firoozgar Hospital, Iran University of Medical Sciences, Teheran, Iran Mohammad Hossein Nabian Department of Orthopedic Surgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran Hamid Rabie Department of Orthopedic Surgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran 2020 12 12 2021 03 29 Background: Post traumatic lumbosacral plexopathy (LSP) is a well-known condition following pelvic fracture or abdominal trauma and surgery. A rare condition of LSP has been reported in the literature following femoral shaft fractures.   Case Report: Two cases of LSP after bilateral femoral shaft fracture presented to our center. In both cases, the mechanism of injury was a high energy trauma without any signs or symptoms of pelvic or spinal injury. Electrodiagnostic studies confirmed acute plexopathy and spontaneous recovery occurred in both.   Conclusion: LSP can be seen in association with fractures or traumas far from anatomical location of the plexus. Multidisciplinary approach and complete accurate examination are mandatory for diagnosis management of the condition. https://jost.tums.ac.ir/index.php/jost/article/view/249 https://jost.tums.ac.ir/index.php/jost/article/download/249/216

Tehran University of Medical Sciences Journal of Orthopedic and Spine Trauma 2538-2330 7 1 2021 04 20 37 8 Mohammadreza Piri Ardakani Department of Orthopedic Surgery, Ayatollah Kashani Hospital, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran Mehdi <