Konstantinos Georgios Makiev; Ioannis Spyridon Vasios; Anthimos Keskinis; Reichan Molla Moustafa; Georgios Petkidis; Konstantinos Tilkeridis; Athanasios Ververidis; Efthymios Iliopoulos
Volume 13, Issue 1 , January 2025, , Pages 20-24
Abstract
Objectives: Ankle joint injuries are among the most common orthopedic injuries and are associated with significant healthcare costs. To reduce unnecessary radiographic screening, diagnostic tools such as the widely accepted Ottawa Ankle Rules (OARs) have been developed. However, the accuracy of OARs ...
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Objectives: Ankle joint injuries are among the most common orthopedic injuries and are associated with significant healthcare costs. To reduce unnecessary radiographic screening, diagnostic tools such as the widely accepted Ottawa Ankle Rules (OARs) have been developed. However, the accuracy of OARs in excluding fractures remains uncertain. Recently, a new diagnostic test, the Shetty Test (ST), has been introduced. This prospective comparative study aimed to evaluate the diagnostic accuracy of the “ST” in comparison to the “OARs” for detecting ankle and foot fractures.Methods: A total of 112 consecutive adult patients (>18 years old) were included in the study. They were presented to the Emergency Department of a University Hospital in Alexandroupolis due to an ankle or foot injury. Data were collected over 6 months, from November 2022 to May 2023.Results: The sensitivity of the ST was 68.4%, specificity was 76.3%, positive predictive value (PPV) was 37.1%, and negative predictive value (NPV) was 92.2%. For the OARs, sensitivity was 94.7%, specificity was 15%, PPV was 18.5%, and NPV was 93.3%. When at least one of the tests was positive, the sensitivity and NPV increased to 100%.Conclusion: The ST was found to be reliable; however, it did not outperform the OARs in this study. Nevertheless, when used in conjunction, the two tests significantly improved sensitivity and the NPV. Due to its simplicity and reproducibility, the ST could be a valuable tool in daily clinical practice, particularly for non-orthopedic emergency department personnel.
Elaheh Mianehsaz; Fateme Aghaei; Seyed Mohammadreza Tabatabaee; Babak Haghpanah; Mohammad Javad Azadchehr; khadijeh kalanfarmanfarma
Volume 13, Issue 1 , January 2025, , Pages 25-31
Abstract
Objectives: Intertrochanteric femur fractures are prevalent injuries among the elderly, significantly affecting their quality of life (QOL) and functional status. This study aimed to evaluate functional outcomes and QOL in elderly patients one year after sustaining an intertrochanteric femur fracture.Methods: ...
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Objectives: Intertrochanteric femur fractures are prevalent injuries among the elderly, significantly affecting their quality of life (QOL) and functional status. This study aimed to evaluate functional outcomes and QOL in elderly patients one year after sustaining an intertrochanteric femur fracture.Methods: This retrospective observational study was conducted at Shahid Beheshti Hospital in Kashan, Iran. The functional status and QOL of 79 elderly patients with intertrochanteric femur fractures, who were at least one year post-injury were assessed between February 2020 to February 2021.Data were collected from patient’s records, which included sociodemographic and clinical information at the time of admission. Functional status was evaluated using the Barthel Index, and QOL was assessed using the shortened form of the SF-36 questionnaire.Results: The study population comprised 60.8% women, with a mean age of 79.81±7.07 years. The mean of the Barthel index score was 11.49±2.22, indicating that participants achieved approximately 60% of the maximum functional score. The mean overall QOL score was 50.59±9.54, suggesting that patients attained approximately 51% of the maximum QOL score. A final linear regression model indicated that increased age was significantly associated with declines in both functional abilities (R²=0.53, p<0.001) and QOL (R²=0.39, p<0.001). Additionally, patients who received physiotherapy demonstrated significantly better functional outcomes than those who did not.Conclusion: This study highlighted the significant impact of intertrochanteric femur fractures on the functional status and QOL of older adults. The findings emphasized the critical role of rehabilitation services, such as physiotherapy, in improving patient outcomes. Further research is warranted to explore the influence of comorbidities and optimize interventions for this vulnerable population.
Johannes Gossner
Volume 9, Issue 1 , January 2021, , Pages 48-49
Abstract
Ankylosing spinal disease (ASD) is a common clinical entity [1]. The main etiologies of ASD are diffuse idiopathic skeletal hyperostosis (DISH), ankylosing spondylitis and postoperative spinal fusion after removal of instrumentation. Because of the rigidity of the spine patients with ASD are prone to ...
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Ankylosing spinal disease (ASD) is a common clinical entity [1]. The main etiologies of ASD are diffuse idiopathic skeletal hyperostosis (DISH), ankylosing spondylitis and postoperative spinal fusion after removal of instrumentation. Because of the rigidity of the spine patients with ASD are prone to fractures even with minor trauma and unstable fracture patterns (distraction fractures and involvement of the posterior column) are common [1].
Zenon Pogorelic; Tonći Vodopić; Miro Jukić; Dubravko Furlan
Volume 7, Issue 2 , April 2019, , Pages 169-175
Abstract
Objective: To analyze outcomes of treatment and complications in children treated with elastic stable intramedullary nailing (ESIN) due to femoral fracture.Methods: From May 2002 until May 2018 case records of 103 patients (76 male and 27 female), with median age of 9 (range, 3-17) and follow-up of 92 ...
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Objective: To analyze outcomes of treatment and complications in children treated with elastic stable intramedullary nailing (ESIN) due to femoral fracture.Methods: From May 2002 until May 2018 case records of 103 patients (76 male and 27 female), with median age of 9 (range, 3-17) and follow-up of 92 months, who underwent ESIN because of displaced femoral fracture were retrospectively reviewed. The patient’s information including age, sex, side involved, trauma mechanism, type of fracture, associated injuries, neurovascular status, complications, operation time, duration of hospital stay, time to implant removal were analyzed. The surgical procedure implied a reposition of bone fragments and osteosynthesis with titanium elastic nails introduced through an incision over the lateral and medial border of the distal femoral metaphysis.Results: All patients achieved complete radiographic healing at a mean of 8.5 (range, 5-15) weeks. Nine (8.49%) postoperative complications were recorded: three entry site skin irritation, two cases of valgus angulation and one case of nail protrusion, re-fracture, Varus angulation and delayed union. All complications, except case of re-fracture and one valgus angulation, were treated conservatively, with no long term consequences for the patients. Two patients were re-operated. After removal of nails all patients recovered complete function of the extremity, without long term consequences.Conclusion: The ESIN for treatment of femoral fractures shows very good functional and cosmetic results. It allows an early functional and cast-free follow-up with a quick pain reduction. Because of the excellent objective and subjective results, the operative stabilization of femoral fractures with ESIN should be recommended to all pediatrics patients.
Nadeem Ali; Naseer Ahamd Mir; Tahir Ahmad Dar; Mohmad Nawaz Rather; Wajahat Ahmad Mir; Senin Shah; Saheel Maajid
Volume 6, Issue 4 , October 2018, , Pages 306-312
Abstract
Objective: To determine the time to radiological union and final functional outcome of fixation of extra-articular distal humeral fractures with extra-artricular distal humerus locking plate.Methods: This prospective study was conducted from March 2014 to February 2018 and included extra-articular distal ...
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Objective: To determine the time to radiological union and final functional outcome of fixation of extra-articular distal humeral fractures with extra-artricular distal humerus locking plate.Methods: This prospective study was conducted from March 2014 to February 2018 and included extra-articular distal humeral fractures managed by operative fixation using extra-articular distal humerus locking plate. All the fractures were approached using lateral para-tricepetal approach of Gervin, and stabilized with extra-articular distal humerus locking plate with or without lag screws. Time to radiological union was assessed in the follow up and at the final follow up functional outcome was evaluated using Mayo Performance Elbow Score (MEPS). Complications and need for any additional procedures was also recorded.Results: A total of 20 patients with mean age of 36.5 years and an average follow up of 17 months were included. The mean time to radiological union was 17.4 weeks (12 to 36 weeks) which included one delayed union that required bone grafting. The mean flexion at elbow was 127o with only one patient having flexion extension arc movement of less than 100o at the final follow up. The average MEPS at final follow up was 94.7±8 with 19 patients having excellent and good results.Conclusion: Use of extra-articular distal humeral locking plate using lateral para-tricepetal approach in extra-articular distal humeral fractures allows stable fixation of the fracture to allow early return to function with minimal soft tissue dissection and excellent final functional results and minimum complications.
Marjan Jeddi; Mohammad Hossein Dabbaghmanesh; Alireza Kharmandar; Gholamhossein Ranjbar Omrani; Marzieh Bakhshayeshkaram
Volume 5, Issue 1 , January 2017, , Pages 29-35
Abstract
Objective: To determine the prevalence of fractures and associated risk factors in healthy Iranian children and adolescents.Methods: In this cross sectional population based study, 478 healthy Iranian children and adolescents aged 9–18 years old participated. Baseline data and bone mineral content ...
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Objective: To determine the prevalence of fractures and associated risk factors in healthy Iranian children and adolescents.Methods: In this cross sectional population based study, 478 healthy Iranian children and adolescents aged 9–18 years old participated. Baseline data and bone mineral content and density have been determined. One questionnaire was completed for all individuals including previous history of fracture, its location, and level of trauma. Albumin, calcium, phosphorus, alkaline phosphatase, and vitamin D levels were measured.Results: We found a prevalence of 12.9% for fracture. (34.5% for girls and 65.5% for boys); about 71% suffered long bone fracture with distal forearm as the most common site. Totally 58% of the boys and 54% of the girls had fracture with low-energy trauma. The fracture group had lower bone mineral apparent density in the lumbar spine (0.19±0.04 vs. 0.20±0.03, p=0.04), lower serum albumin (4.6±0.5 vs 4.8±0.4, p=0.02), and higher serum alkaline phosphatase level (446±174 vs. 361±188, p=0.02) compared with non-fracture subjects. By logistic regression analysis, we found a significant association for sex, and bone mineral content of the lumbar spine with fracture (p=0.003, p=0.039).Conclusion: Compared to other studies, our subjects had lower rate of fracture. We found an association between low bone density and fracture in children and adolescents. This finding has important implications for public health. Further research may contribute to recognition of preventive measures.
