Tehran University of Medical Sciences Journal of Orthopedic and Spine Trauma 2538-2330 8 3 2022 11 27 74 8 Mir Mansour Moazen Jamshidi Department of Orthopedic Surgery, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran Behzad Nezhad Tabrizi Joint Reconstruction Research Center, Tehran University of Medical Sciences, Tehran, Iran Ehsan Fallah Joint Reconstruction Research Center, Tehran University of Medical Sciences, Tehran, Iran Mazaher Ebrahimian Department of Orthopedics, Sina Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran Ali Salehi Department of Radiology, Imam Hossein Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran Alireza Moharrami Joint Reconstruction Research Center, 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 2022 01 09 2022 05 14 During an open fracture, the barrier of skin that protects the bones is breached, and the unprotected bones are exposed to the environment, resulting in contamination that leads to hematoma formation. It is often found that open fractures are associated with a high rate of morbidity and infection. In spite of the lack of evidence supporting negative pressure wound therapy (NPWT), open fractures may benefit from it. An increasing number of studies have demonstrated that it can be used to treat open fractures and open complex wounds after failure of arthroplasty or spinal surgery. Based on the recent studies and evidence, we reviewed the role of the NPWT in the open fracture in the present study.   https://jost.tums.ac.ir/index.php/jost/article/view/357 https://jost.tums.ac.ir/index.php/jost/article/download/357/274

Tehran University of Medical Sciences Journal of Orthopedic and Spine Trauma 2538-2330 8 3 2022 11 28 79 82 Alireza Sadeghpour Department of Orthopedics, School of Medicine Shohada Educational Hospital, Tabriz University of Medical Sciences Seyed Hamed Ghaffari Department of Orthopedic Surgery, Shohada Educational Hospital, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran Jafar Ganjpour Sales Department of Orthopedic Surgery, Shohada Educational Hospital, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran Hossein Aslani Department of Orthopedic Surgery, Shohada Educational Hospital, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran Ali Hossein Zeinalzadeh Department of Community and Family Medicine Specialist, Social Determinants of Health Research Center, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran 2021 11 20 2022 08 19 Background: Quality of the bone before surgery determines the choice of the appropriate prosthesis and the surgical approach as well as the result of total hip arthroplasty (THA). The proximal femur morphology determines the decision of cemented or uncemented THA, and the Dorr classification is often employed for this purpose. Methods: 100 patients over the age of 40 who had been referred to the emergency department of Shohada Hospital, Tabriz, Iran, for any reason and had an accurate pelvic anteroposterior (AP) X-ray with proximal femur were included in this study, and Dorr classification and mean cortical thickness index (CTI) just below the lesser trochanter and 10 cm below it were measured. Results: In this study, the Dorr classification differed significantly in men and women, and type C was higher in women. Classification is strongly subjected to the surgeon's clinical experience, and training class significantly affects it. There was a significant relationship (P < 0.001) between the CTI 10 cm below the trochanter and just below it. Conclusion: The proximal femur morphology covers a wide range. Therefore, it is difficult to determine the exact morphology, especially for groups B and C. There was also a significant correlation between the mean CTI below the lesser trochanter and 10 cm below it. Therefore, we think this is a practical and most straightforward method for classifying proximal femur morphology with cortical index (CI) just below the lesser trochanter and 10 cm below it, especially for inexperienced training residents. https://jost.tums.ac.ir/index.php/jost/article/view/348 https://jost.tums.ac.ir/index.php/jost/article/download/348/275

Tehran University of Medical Sciences Journal of Orthopedic and Spine Trauma 2538-2330 8 3 2022 11 28 83 6 Nasrin Navaeifar Department of Orthopedics, Imam Khomeini Hospital Complex, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran Ali Tabriz Department of Orthopedics, Imam Khomeini Hospital Complex, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran   Mehrdad Motalebizadeh School of Medicine, Urmia University of Medical Sciences, Urmia, Iran 2021 12 16 2022 08 19 Background: Vitamin B12 is a micronutrient essential for deoxyribonucleic acid (DNA) synthesis, which can affect osteogenesis. Based on in-vivo investigations, vitamin B12 is associated with osteogenesis, and low levels of this vital vitamin in the human body can be related to an increased risk of osteoporosis. Methods: In this descriptive-analytical study, 60 women over 65 years who visited an orthopedic clinic were included. They were divided into three groups based on bone density in the hip and lumbar areas using dual-energy X-ray absorptiometry (DEXA) scans, including normal bone density, osteopenia, and osteoporosis. The average serum level of vitamin B12 in the experimental subjects was then determined and compared. Results: 6 (10%) showed normal bone density, 25 (41.7%) osteopenia, and 29 (48.3%) were considered to have osteoporosis. Measured vitamin B12 levels showed no statistically significant difference between the two groups of normal bone density (601.3 ± 194.8) and osteopenia (560.4 ± 131.5). However, there was a significant statistical difference between vitamin B12 levels in people with osteoporosis (400.7 ± 162.4) and the two groups of normal and osteopenic individuals. There was also a negative statistical relationship between vitamin B12 levels and bone density (P = 0.004, r = -0.8). Conclusion: A low serum level of vitamin B12 is associated with a severe decline in bone density in elderly Iranian women.   https://jost.tums.ac.ir/index.php/jost/article/view/353 https://jost.tums.ac.ir/index.php/jost/article/download/353/276

Tehran University of Medical Sciences Journal of Orthopedic and Spine Trauma 2538-2330 8 3 2022 11 28 87 9 Koduru Kumar Department of Orthopaedics, NRI Medical College, Chinakakani, India Balakrishna Bathina Department of Orthopaedics, NRI Medical College, Chinakakani, India Tankala Jayadev Department of Orthopaedics, NRI Medical College, Chinakakani, India Manidhar Sane Department of Orthopaedics, NRI Medical College, Chinakakani, India 2022 02 02 2022 08 19 Background: Ankle ligament injuries in the sports like basketball, volleyball, and cricket are the most common reasons for missed participation in athletics, accounting for 14% of all sports injuries. These injuries may often require splinting and rest for a longer duration, leading to a permanently reduced level of sports performance. The autologous conditioned cytokine-rich serum (ACRS) is becoming a reliable treatment option in acute ankle injuries as it enhances biological healing. The objective of this study is to evaluate the role of ACRS in acute ankle injuries and report the efficacy of ACRS injections on time to return to physical activities. Methods: 42 patients with clinical and radiological signs of ankle ligamentous injuries (grades 1 and 2) secondary to sporting or gaming activity were recruited for this study. Each patient received one injection of ACRS at the injury site and was put on a soft cast for one week. Clinical and functional evaluation was performed using the Visual Analogue Scale (VAS), American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Scale, and the Foot and Ankle Disability Index (FADI) scores before the injection, at one week, i.e., after removing the soft cast, three weeks, six weeks, and three months. Results: Our study showed gradual improvement of all the evaluation scales at all the follow-ups. Few patients showed minor side effects like aseptic effusion. The least common complaint was a pain in the subsequent days after the injection. Conclusion: Our results, in conjunction with pre-existing studies in the literature regarding the biological effects of ACRS, demonstrate the viability of this therapy for the treatment of acute ankle injuries, showing the positive influence on pain and healing capacity and returning to gaming activities immediately in about two weeks without significant adverse effects. https://jost.tums.ac.ir/index.php/jost/article/view/358 https://jost.tums.ac.ir/index.php/jost/article/download/358/277

Tehran University of Medical Sciences Journal of Orthopedic and Spine Trauma 2538-2330 8 3 2022 11 28 90 4 Farsad Biglari Department of Orthopedic Surgery, Shahid Beheshti University of Medical Sciences, Shohada Tajrish Hospital, Tehran, Iran Mehrdad Sadighi Department of Orthopedic Surgery, Shohada-e Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Seyyed Saeed Khabiri Department of Orthopedic Surgery, Shohada-e Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Meisam Jafari Kafiabadi Department of Orthopedic Surgery, Shohada-e Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Amir Sabaghzadeh Department of Orthopedic Surgery, Shohada-e Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Azadeh Hakakzadeh Department of Sports and Exercise Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran Pedram Khalighinejad Department of Orthopedic Surgery, Shohada Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Amir Human Hoveidaei Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran. Adel Ebrahimpour epartment of Orthopedic Surgery, Clinical Research Development Unit, Shohada Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran 2022 02 02 2022 05 14 Background: Trauma is a leading cause of death and morbidity in developing countries. Previous research has revealed that epidemiological features of fractures may change from one study to the next. National Trauma Registry of Iran (NTRI) was launched in 2015, but it did not include any centers in northern Tehran, Iran. This study aimed to evaluate the epidemiology of fractures in the only Level 1 Trauma Center in that area. Methods: This retrospective cross-sectional study was performed on all patients with the primary diagnosis of orthopedic injury, from July to October 2019, who referred to the emergency department of Shohada Tajrish Hospital, Tehran. The patients’ files and operation notes were reviewed for demographics, medical history, physical examination, referral time, mechanism of injury, hospital stay, level of education, and intensive care unit (ICU) hospitalization. Results: 398 patients with orthopedic trauma were referred to the hospital with a mean age of 40.85 ± 21.03 years. 317 patients (79.65%) were men. The peak referral time was between 12 AM and 12 PM. A road traffic accident was the main cause of orthopedic trauma (39.4%). The mean days of hospital stay were 6.29 ± 5.36 days. The waiting time for surgery and days of hospital stay were related to the fracture site (high in lower extremity fractures) and older age. Conclusion: Trauma in northern Tehran is primarily caused by motor vehicle accidents and falls, respectively. Patients with older age and lower extremity fractures need more time of hospitalization. https://jost.tums.ac.ir/index.php/jost/article/view/359 https://jost.tums.ac.ir/index.php/jost/article/download/359/278

Tehran University of Medical Sciences Journal of Orthopedic and Spine Trauma 2538-2330 8 3 2022 11 28 95 6 Mir Mansour Moazen Jamshidi Department of Orthopedic Surgery, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran Sciences Alireza Moharrami Joint Reconstruction Research Center, Tehran University of Medical Sciences, Tehran, Iran Behzad Nezhad Tabrizi Joint Reconstruction Research Center, Tehran University of Medical Sciences, Tehran, Iran 2021 12 04 2022 11 21 No abstract is available. https://jost.tums.ac.ir/index.php/jost/article/view/352 https://jost.tums.ac.ir/index.php/jost/article/download/352/279

Tehran University of Medical Sciences Journal of Orthopedic and Spine Trauma 2538-2330 8 3 2022 11 28 97 100 Seyed Peyman Mirghaderi Joint Reconstruction Research Center, Tehran University of Medical Sciences, Tehran, Iran Sadula Sharifpour Joint Reconstruction Research Center, Tehran University of Medical Sciences, Tehran, Iran Amirhossein Ghaseminejad Raeini Joint Reconstruction Research Center (JRRC), Tehran University of Medical Sciences, Tehran, Iran Maryam Salimi Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran Alireza Moharrami Joint Reconstruction Research Center, Tehran University of Medical Sciences, Tehran, Iran Seyed Hadi Kalantar Joint Reconstruction Research Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran 2021 11 16 2022 11 21 Background: Transolecranon fracture is an unstable intra-articular injury in the elbow caused by high-energy trauma. Here, we introduce a medial humerus plate for severely comminuted transolecranon fracture. Case Report: This article presents the case of a 29-year-old man who had a severely comminuted transolecranon fracture due to a motorcycle accident. A dorsal longitudinal approach was used in order to reach the fracture site. An olecranon anatomical plate and a medial humerus plate were applied for fixation, a new treatment method. The range of motion (ROM) was complete at a two-month follow-up, and the Mayo Elbow Performance Score (MEPS) was obtained 100 with no signs of complications. Conclusion: Despite the several methods available for fixing transolecranon fractures, using the medial humerus plate, especially in severe comminution, can yield acceptable results. It should be considered in future studies to prove its efficacy in this type of fracture. https://jost.tums.ac.ir/index.php/jost/article/view/344 https://jost.tums.ac.ir/index.php/jost/article/download/344/280

Tehran University of Medical Sciences Journal of Orthopedic and Spine Trauma 2538-2330 8 3 2022 11 28 101 3 EN Mojtaba Ahmadinejad Shahid Madani Hospital, Alborz university of medical sciences, Karaj, Alborz, Iran Samaneh Rashidi Shahid Madani Hospital, Alborz university of medical sciences, Karaj, Alborz, Iran Mohammad Saeed Kahrizi Shahid Madani Hospital, Alborz university of medical sciences, Karaj, Alborz, Iran Fatemeh Moghadasi Shahid Madani Hospital, Alborz university of medical sciences, Karaj, Alborz, Iran Izadmehr Ahmadinejad Student Research Committee, Tehran University of Medical Sciences, Tehran, Iran Arvin Najafi Shahid Madani Hospital, Alborz university of medical sciences, Karaj, Alborz, Iran. 2021 11 21 2022 05 14 Background: Neurilemmomas also called schwannomas are benign tumors originating from the Schwann cells participating in the peripheral nerve sheath and the pathophysiology of the formation of these tumors is not completely understood. Schwannomas are mostly benign with equal incidence rate in men and women. These tumors have been mainly found in the head and neck, upper extremities, and the trunk. Lower extremity schwannomas are extremely rare, specifically in the dorsum of the foot. Case Report: In this report, we present an 18-year-old man referred to surgery clinic with a painful mass on the anterolateral dorsal aspect of his left ankle with radicular pain and paresthesia to the distal dorsum of the forefoot. After completing all the assessments including ultrasonography and magnetic resonance imaging (MRI), he underwent the surgical resection procedure. The pathology laboratory reported an encapsulated 35 * 20 * 15 mm solitary benign schwannoma. Conclusion: The dorsal aspect of the foot is an extremely rare site for schwannoma formation, but practitioners should always be aware of rare underlying diseases for neurologic deficits or just a simple pain in the lower extremities. https://jost.tums.ac.ir/index.php/jost/article/view/349 https://jost.tums.ac.ir/index.php/jost/article/download/349/281

Tehran University of Medical Sciences Journal of Orthopedic and Spine Trauma 2538-2330 8 3 2022 11 28 104 6 Reza Shahriar Kamrani Department of Orthopedic and Trauma Surgery, Shariati Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran Kian Zohrabi Department of Orthopedic Surgery, Shariati Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran 2022 02 23 2022 08 19 Background: Proximal humerus shortening and varus can occur secondary to neonatal shoulder septic arthritis and focal fibrocartilage dysplasia. Valgus osteotomy of the proximal humerus compensates for a little bite of shortening, and improves the shoulder joint's range of motion. Case Report: In this study, we present two patients with severe proximal humerus deformity following glenohumeral septic arthritis. Both of them underwent valgus osteotomy, and had a satisfactory result in terms of range of motions and cosmesis at five years follow-up. Conclusion: Treatment of varus deformity of proximal humerus is challenging issue. There are few reports of surgical treatment. Sever varus deformity of proximal humerus impacts the motion of shoulder. We reported a novel method of valgus osteotomy of proximal humerus in patients with severe varus deformity secondary to neonatal septic arthritis and long-term clinical follow-up. https://jost.tums.ac.ir/index.php/jost/article/view/368 https://jost.tums.ac.ir/index.php/jost/article/download/368/282

Tehran University of Medical Sciences Journal of Orthopedic and Spine Trauma 2538-2330 8 3 2022 11 28 107 8 Adel Ebrahimpour Department of Orthopedic Surgery, Shohadaye Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran Ahmadreza Afshar Department of Orthopedic Surgery, Imam Khomeini Hospital Complex, Urmia University of Medical Sciences, Urmia, Iran Ali Tabriz Department of Orthopedic Surgery, Panzdahe Khordad Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran 2021 12 16 2022 08 19 No abstract is available. https://jost.tums.ac.ir/index.php/jost/article/view/354 https://jost.tums.ac.ir/index.php/jost/article/download/354/283