Tehran University of Medical Sciences Journal of Orthopedic and Spine Trauma 2538-2330 9 1 2023 06 16 1 5 Osama Farouk Department of Orthopedics, Assiut University Hospital, Assiut, Egypt Ahmed Khalifa Department of Orthopaedic, Qena Faculty Of Medicine, South Valley University, Qena, Egypt & Assiut University Hospital, Assiut, Egypt 2022 03 22 2022 05 14 Segmental tibial bone defects (STBD) represent a dilemma for the trauma surgeon; these defects could result from trauma, after debridement for infection, or after tumor resection. We aimed in this review to shed some light on the various reconstruction options without the need to use a circular fixator. Reconstruction options rely on various factors related to the patient, the surgeon, and the nature of the defect (location and size). Various reconstruction techniques include simple bone grafting (autograft or allografts), bone transport [distraction osteogenesis (DO)], induced membrane technique, and vascularized fibular graft. Fixation could be performed using either internal or external fixators; the latter could be a circular or a unilateral frame. Although circular frames (Ilizarov) fixators reported good results, they are still considered cumbersome, need special attention, carry pin tract infection risk, and could not be tolerated by patients. Hence, various other options were introduced, such as bone transport over an intramedullary nail (IMN), rail monolateral external fixator, and tibialisation of the ipsilateral fibula. https://jost.tums.ac.ir/index.php/jost/article/view/381 https://jost.tums.ac.ir/index.php/jost/article/download/381/295

Tehran University of Medical Sciences Journal of Orthopedic and Spine Trauma 2538-2330 9 1 2023 07 28 6 9 Midhat Patel Department of Orthopedic Surgery, College of Medicine Phoenix, Phoenix, University of Arizona Arizona, USA Michael McKee Department of Orthopedic Surgery, College of Medicine Phoenix, Phoenix, University of Arizona Arizona, USA 2023 07 28 2023 07 28 Dislocations around the elbow joint can be isolated (termed a simple elbow dislocation), or occur with concurrent ligamentous and/or bony injuries. In cases of a simple elbow dislocation, surgery is rarely required. Patients should be evaluated radiographically for a concentric reduction, immobilized for 7-10 days, and begin early range of motion activities. In patients who return for follow-up with no bony injuries but a loss of concentric reduction, surgical treatment is recommended. This may consist of static or dynamic external/internal fixation or direct repair of the damaged ligamentous structures. Fractures associated with elbow dislocations may be difficult to identify and require CT scans to characterize. A terrible triad injury consists a radial head fracture, coronoid fracture, and ulnohumeral dislocation. This may be associated with lateral and/or medial collateral ligament injures. These injuries require operative treatent with open reduction and internal fixation of the coronoid, fixation or replacement of the radial head, and repair of damaged ligamentous structures, depending on the specific injuries.   https://jost.tums.ac.ir/index.php/jost/article/view/520 https://jost.tums.ac.ir/index.php/jost/article/download/520/296

Tehran University of Medical Sciences Journal of Orthopedic and Spine Trauma 2538-2330 9 1 2023 07 29 9 13 Sie-Hiong Tan Division of Neurosurgery, Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan ; Division of Neurosurgery, Department of Surgery, National Taiwan University Hospital, Yun-Lin Branch, Yun-Lin, Taiwan Ming-Chi Kuo Division of Neurosurgery, Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan ; Division of Neurosurgery, Department of Surgery, National Taiwan University Hospital, Yun-Lin Branch, Yun-Lin, Taiwan Yu‑Cheng Yeh Spine Division, Department of Orthopedic Surgery, College of Medicine, Bone and Joint Research Center, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan Meng-Yin Ho Division of Neurosurgery, Department of Surgery, National Taiwan University Hospital, Hsin-Chu Branch, Hsin-Chu, Taiwan Fon-Yih Tsuang Division of Neurosurgery, Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan ; Spinal Tumor Center, National Taiwan University Hospital, Taipei, Taiwan 2023 01 17 2023 07 29 There are several surgical strategies which have been proposed to treat the osteoporotic patient with vertebral fracture, ranging from vertebral body cement augmentation, percutaneous/mini-open short segment pedicle screw fixation, and cortical bone trajectory screw to kyphotic deformity correction surgery. Minimally invasive spine surgery has the potential benefits of faster recovery, reduced blood loss, less postoperative wound pain, lower infection risk, and shorter length of hospital stay. Novel surgical techniques such as percutaneous instrumentation fixation, cortical bone trajectory technique, screw cement augmentation, and vertebral body augmentation are developed. However, various complications have been reported, including pedicle fracture, instrumentation loosening, adjacent-level disc degeneration with herniation, and progressive junctional kyphosis. The purpose of this review was to outline various advancements in minimally invasive spinal surgery for patients with osteoporosis. Minimally invasive surgical techniques for fixation including percutaneous instrumentation, cortical bone trajectory technique, screw cement augmentation, and vertebral body augmentation have benefited patient with osteoporosis. Studies and discussions about short-segment pedicle screw fixation (one level above and below the fracture level) have shown that it provides enough stability for thoracolumbar burst fractures. There are also complications, including cement embolism, adjacent vertebral fracture, neuraxial anesthesia, and infection, which have been observed with the above technique. With the advancement of instrument and technique, the complication rate decreased in recent studies. Minimally invasive fixation still has many advantages for patients with osteoporosis. Many of these studies and strategies only have evidence from biomechanical and cadaveric studies and require further clinical trials to establish their clinical efficacy. https://jost.tums.ac.ir/index.php/jost/article/view/473 https://jost.tums.ac.ir/index.php/jost/article/download/473/297

Tehran University of Medical Sciences Journal of Orthopedic and Spine Trauma 2538-2330 9 1 2023 07 29 14 9 EN Theerachai Apivatthakakul Department of Orthopedics, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand 2023 06 21 2023 07 29 Displaced femoral neck fractures in the young are difficult to treat. The complexity of the fractures for closed or open reduction requires careful surgical planning and experience. Acceptable reduction criteria in this fracture is crucial and should be followed strictly in order to get the favorable outcomes. Various reduction techniques have been described ranging from closed reduction by traction table or closed reduction with minimal direct manipulation with instruments to direct open reduction. This manuscript describes the mini open reduction, Watson-Jones and Smith-Petersen approaches, and some modifications in terms of indications, advantages, and disadvantages of each approach for the decision-making in these complex fractures. https://jost.tums.ac.ir/index.php/jost/article/view/509 https://jost.tums.ac.ir/index.php/jost/article/download/509/298

Tehran University of Medical Sciences Journal of Orthopedic and Spine Trauma 2538-2330 9 1 2023 07 29 20 2 Cordula Netzer Deputy Head Spine Center, University Hospital Basel, Spitalstrasse 21, CH-4031 Basel, Switzerland Christian Ulrich Spine Surgery; Lindenhof Hospital, Bremgartenstrasse 119, CH- 3012 Bern, Switzerland Sven Hoppe Spine Surgery, Salem Hospital Bern, Schänzlistrasse 39, CH-3013 Bern, Switzerland David Bellut Spine Center, University Hospital Zürich, Rämistrasse 100, CH-8091 Zürich Switzerland 2023 01 12 2023 07 29 No abstract. https://jost.tums.ac.ir/index.php/jost/article/view/470 https://jost.tums.ac.ir/index.php/jost/article/download/470/299

Tehran University of Medical Sciences Journal of Orthopedic and Spine Trauma 2538-2330 9 1 2023 07 29 23 5 Niloofar Dehghan University of Arizona College of Medicine Phoenix; Chief of Orthopaedic Trauma, The CORE Institute – Phoenix, USA 2023 01 11 2023 07 29 No abstract is available. https://jost.tums.ac.ir/index.php/jost/article/view/467 https://jost.tums.ac.ir/index.php/jost/article/download/467/300

Tehran University of Medical Sciences Journal of Orthopedic and Spine Trauma 2538-2330 9 1 2023 07 29 26 30 Seyyed Saeed Khabiri 0000-0002-8906-7660 Farsad Biglari Department of Orthopedic Surgery, Clinical Research Development Unit of Shohada Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran Meisan Jafari Kafi Aabadi Department of Orthopedic Surgery, Clinical Research Development Unit of Shohada Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran Mehrdad Sadighi Assistant Professor, Department of Orthopedic Surgery, Clinical Research Development Unit of Shohada Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran Adel Ebrahimpour Department of Orthopedic Surgery, Physiotherapy Research Center, Shohada Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran Amir Sabaghzadeh Department of Orthopedic Surgery, Clinical Research Development Unit of Akhtar Hospital, Clinical Research Development Unit of Shohada Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran 2022 09 01 2022 10 25 Background: This study aimed to assess and follow up on patients who had peritrochantric hip fractures during the first wave of the coronavirus disease-2019 (COVID-19) outbreak in Iran. These patients were compared to patients from the previous year during the same period. Their prognosis and one-year mortality rates were also compared. Methods: In this two-center, retrospective cohort study, patients aged over 60 years with a proximal femoral fracture admitted to the hospital between March 2019 and April 2020 were included. The primary outcome was one-year mortality.  Results: The patients counted 146, and we had access to all of them. Seventy-four were from the year 2019, and 72 were from the year 2020. There was no significant difference between the two groups regarding age, sex, type of fracture, or the American Society of Anesthesiology (ASA) score in the analytical investigation. Regarding patient mortality at this time, our one-year mortality rate in patients hospitalized before the COVID-19 era was 29.7%, compared to 51.5% in the COVID-19 period. Conclusion: The one-year mortality rate for patients with hip fracture increased considerably during the COVID-19 pandemic. Comorbidity and ASA score were related to mortality in this patient population. This increase in mortality may be attributable to postoperative complications, including coagulopathy and proper health care limitation. https://jost.tums.ac.ir/index.php/jost/article/view/430 https://jost.tums.ac.ir/index.php/jost/article/download/430/301

Tehran University of Medical Sciences Journal of Orthopedic and Spine Trauma 2538-2330 9 1 2023 07 29 35 7 Aidin Arabzadeh Department of Orthopedics and Trauma Surgery, Imam Khomeini Hospital Complex, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran Hosein Hamdilahzadeh Department of Orthopedics and Trauma Surgery, Imam Khomeini Hospital Complex, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran Kian Zohrabi Department of Orthopedics and Trauma Surgery, Imam Khomeini Hospital Complex, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran Mahmoud Farzan Department of Orthopedics and Trauma Surgery, Joint Reconstruction Research Center, Imam Khomeini HospitalComplex, Tehran University of Medical Sciences, Tehran, Iran Omid Salkhori Department of Orthopedic Surgery, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran 2022 06 08 2023 07 29 Background: Rice bodies can be found in rheumatic diseases, infectious diseases, and osteoarthritic joints. Rice bodies' most common locations include the subacromial bursa of the shoulder and the knee, while rice body synovitis of the wrist extensor tendons is uncommon. We have presented the case of tuberculous tenosynovitis with rice body formation in the extensor tendon sheaths of the hand and wrist. Case Report: A 51-year-old man presented with swelling and mild pain in the dorsal side of left wrist, hand, and proximal phalanx of the second finger. He stated a history of traumatic injury to the proximal phalanx of the index finger. Radiographs showed a soft-tissue mass shadow, and magnetic resonance imaging (MRI) showed edema and soft tissue swelling around extensor tendons extending into the distal forearm and ulnar side of the second finger in favor of tenosynovitis. Laboratory test results were normal. The patient had a negative Mantoux test result and no history of mycobacterial exposure. Surgical exploration of the lesion revealed rice bodies in the synovial sheath of extensor tendons in the wrist, extending distally to the dorsal aspect of the hand, especially the radial side. Removal of the rice bodies and complete excision of the sheath and tenosynovectomy was performed. Conclusion: As in our case, even in the absence of past tuberculosis (TB) infection or exposure, Mycobacterium TB (MTB) should be considered in the differential diagnosis of long-standing extensor tenosynovitis in the hand and wrist https://jost.tums.ac.ir/index.php/jost/article/view/401 https://jost.tums.ac.ir/index.php/jost/article/download/401/303

Tehran University of Medical Sciences Journal of Orthopedic and Spine Trauma 2538-2330 9 1 2023 07 29 38 40 EN Abbas Abdoli Tafti Trauma Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Ali Salmani School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran 2022 05 15 2023 07 29 Background: Trochlea fracture usually happens with other fractures such as capitellum fracture or medial or lateral condyle fracture and isolated trochlea fracture is very rare because of its location and there are only a few cases of isolated trochlea fracture that have been reported. Case Report: We present here a 40-year-old man who suffered from an isolated trochlea fracture due to falling from three meters height on his flexed left elbow. After examination, imaging, and setting up a plan for surgery, the patient's fragment was fixed with two Herbert screws through anterior approach and after five years of follow-up which was the longest follow-up that had been reported, the patient’s elbow range of motion was 5° to full flexion with Mayo Elbow Performance Index (MEPI) of 85/100 and Disabilities of Arm, Shoulder, and Hand (DASH) score of 13.6/100. Conclusion: Isolated trochlea fracture is very rare, and it is best treated with open reduction and secure internal fixation using anterior or medial approaches. https://jost.tums.ac.ir/index.php/jost/article/view/394 https://jost.tums.ac.ir/index.php/jost/article/download/394/304

Tehran University of Medical Sciences Journal of Orthopedic and Spine Trauma 2538-2330 9 1 2023 07 29 31 4 Mohammad Sadeghian Orthopedic Surgery Research Center (OSRC), Sina University Hospital, Tehran University of Medical Sciences, Tehran, Iran Mohammadreza Golbakhsh Orthopedic Surgery Research Centre(OSRC), Sina University Hospital, Tehran University of Medical Sciences, Tehran, Iran Abbas Rahimiam Orthopedic Surgery Research Centre(OSRC), Sina University Hospital, Tehran University of Medical Sciences, Tehran, Iran Parham Talebiyan Orthopedic Surgery Research Center (OSRC), Sina University Hospital, Tehran University of Medical Sciences, Tehran, Iran Mohammad Javad Dehghani firoozabadi Orthopedic Surgery Research Center (OSRC), Sina University Hospital, Tehran University of Medical Sciences, Tehran, Iran 2022 04 08 2022 05 09 “Sagittal balance” is defined by the anatomic relationship between the pelvis and the spine in the sagittal plane to keep the center of gravity over the feet. It is important to calculate the anatomical parameters of cervical, thoracic, lumbar, and spinopelvic regions and how any static and dynamic changes could affect the sagittal balance to understand the conditions necessary for such a balance. One of the effective changes in sagittal balance is aging, which leads to changes in spine parameters and further activation of compensatory mechanisms. Understanding the relationships between these parameters, especially in pathological cases, helps correct spine sagittal imbalance. https://jost.tums.ac.ir/index.php/jost/article/view/385 https://jost.tums.ac.ir/index.php/jost/article/download/385/302

Tehran University of Medical Sciences Journal of Orthopedic and Spine Trauma 2538-2330 9 1 2023 07 29 41 3 Niloofar Dehghan University of Arizona College of Medicine, The CORE Institute, Phoenix, AZ, USA 2023 01 11 2023 07 29 No abstract is available. https://jost.tums.ac.ir/index.php/jost/article/view/466 https://jost.tums.ac.ir/index.php/jost/article/download/466/306

Tehran University of Medical Sciences Journal of Orthopedic and Spine Trauma 2538-2330 9 1 2023 07 29 44 5 AmirHossein Tavallaei Center of Orthopedic Trans-Disciplinary Applied Research (COTAR), Tehran University of Medical Sciences, Tehran, Iran Audrey Angelliaume Saint-Leonard Private Clinic, Angers, France MohammadHossein Nabian Center of Orthopedic Trans-Disciplinary Applied Research (COTAR), Tehran University of Medical Sciences, Tehran, Iran 2022 04 25 2022 07 15 No abstract is available.   https://jost.tums.ac.ir/index.php/jost/article/view/389 https://jost.tums.ac.ir/index.php/jost/article/download/389/307