Pradeep Kumar Meena; Sahil Gaba; Sandesh Bobade; Rajendra Verma; Amrut Borade; Jayesh Sonaje; Ankit Chouhan
Volume 5, Issue 4 , October 2017, , Pages 266-272
Abstract
Objective: To compare the short-term functional outcome between resection and reconstruction in Mason Type II and Type III radial head fractures using Broberg and Morrey score.Methods: A prospective cohort study was conducted in the Department of Orthopedic Surgery of SMS Medical College and attached ...
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Objective: To compare the short-term functional outcome between resection and reconstruction in Mason Type II and Type III radial head fractures using Broberg and Morrey score.Methods: A prospective cohort study was conducted in the Department of Orthopedic Surgery of SMS Medical College and attached Hospitals. A total of 29 patients (15 in resection group, 14 in reconstruction group) between the age group of 20-60 years with Mason Type II and Type III fresh closed radial head fractures were included in the study. The functional outcome including the range of motion, extension lag and Broberg Morrey score were determined and compared between two group.Results: The mean age of resection group was 44.5 ± 6.6 years and mean age of reconstruction group was 37.1 ± 6.2 years. The baseline characteristics . At 12-months follow-up, in Mason type II fracture, radial head reconstruction group with mean extension lag of 9.4 ± 4.1 and mean Broberg Morrey score of 94.9 ± 5.1 showed better results compared to radial head resection with mean extension lag of 15.7 ± 4.1 (p=0.022) mean Broberg Morrey score 88.3 ± 5.1 (p=0.045) respectively. In Mason type III fractures, radial head resection with mean supination of 79.4 ± 4.7, mean pronation of 74.4 ± 4.1 and mean Broberg Morrey score 89.8 ± 6 showed better results when compared with radial head reconstruction group with mean supination of 64.2 ± 4 (p<0.001), mean pronation of 59.2 ± 8.4 (p=0.003) and mean Broberg Morrey score 81.9 ± 5 (p=0.031).Conclusion: The procedure suggested in Mason type II, is reconstruction of radial head. In Mason type III due to difficulty in achieving anatomical reduction results were not good with reconstruction when compared with resection. We recommend radial head excision in Mason type III fractures where anatomical and stable fixation is not possible.
EhsanAli Alibai; Fahim Baghban; Majid Reza Farrokhi; Navideh Mohebali; Mohammad Hossein Ashraf
Volume 3, Issue 3 , July 2015, , Pages 79-85
Abstract
Objective: To determine the effects of recombinant human erythropoietin (rhEPO) on functional outcome and disability of patients with traumatic cervical spinal cord injury (SCI). Methods: This was a randomized, double blind, placebo controlled clinical trial being performed in Nemazee and Shahid Rajaei ...
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Objective: To determine the effects of recombinant human erythropoietin (rhEPO) on functional outcome and disability of patients with traumatic cervical spinal cord injury (SCI). Methods: This was a randomized, double blind, placebo controlled clinical trial being performed in Nemazee and Shahid Rajaei hospitals of Shiraz during a 3-year period from 2011 to 2014. A total number of 20 patients with acute traumatic cervical SCI less than 8 hours after injury were included. We excluded those with anatomic cord dissection, penetrating cord injury and significant concomitant injury. Patients were randomly assigned to receive rhEPO in 500IU/mL dosage immediately and 24-hour later (n=11) or placebo (n=9). All the patient received standard regimen of methylprednisolone. Neurological function was assessed on admission, 1, 6 and 12 months after the injury according to the American Spinal Cord Injury Association (ASIA).Results: Overall we include a total number of 20 patients. The mean age of the patients was found to be 40.1 ± 9.5 (ranging from 19 to 59) years. There were 18 (90.0%) men and 2 (10.0%) women among the patients. There was no significant difference between two study groups regarding the baseline characteristics. The baseline ASIA score was comparable between two study groups. The motor and sensory ASIA scores were comparable between two study groups after 1, 6 and 12 months follow-ups. We also found that there was no significant difference between two study groups regarding the motor and sensory outcome in complete cord injury and incomplete cord injury subgroups. Conclusion: Administration of rhEPO does not improve the functional outcome of patients with traumatic cervical SCI.Clinical trial registration: The study has been registered with Iranian Registry for Clinical Trials (www.irct.ir; IRCT2014122920471N1)
Abdolkarim Rahmanian; Ali Haghnegahdar; Abdolvahab Rahmanian; Fariborz Ghaffarpasand
Volume 2, Issue 4 , October 2014, , Pages 151-155
Abstract
Objective: To investigate the effects of intracranial pressure (ICP) monitoring on mortality rate and functional outcome of patients with severe traumatic brain injury (TBI).Methods: This was historical cohort study being performed in Nemazee hospital of Shiraz during a 4-year period (from 2006 to 2010) ...
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Objective: To investigate the effects of intracranial pressure (ICP) monitoring on mortality rate and functional outcome of patients with severe traumatic brain injury (TBI).Methods: This was historical cohort study being performed in Nemazee hospital of Shiraz during a 4-year period (from 2006 to 2010) including those patients with severe TBI who had undergone care based on ICP monitoring (case group) or clinical evaluation (control group).Patients and controls were matched regarding the age, sex, initial GCS, initial pupils, and CT findings. The functional outcome, complications and mortality rate were recorded and compared between those who underwent ICP monitoring and those who did not.Results: There was no significant difference between two study groups regarding the baseline characteristics. The rate of meningitis was significantly higher in those who underwent Ventriculostomy and ICP monitoring when compared to those who were managed without ICP monitoring. [14 (23.3%) vs. 7 (11.6%); p=0.041]. We found that the mortality rate (28.3% vs. 11.6%; p=0.172) as well as the frequency of persistent vegetative state (5.0% vs. 5.0%; p=0.998) were comparable between two study groups. However the frequency of severe disability was higher in control group compared to case group (26.7% vs. 15.0; p=0.046). In the same way, the frequency of good recovery (26.7% vs. 15.0; p=0.046) and favorable outcome (51.7% vs. 33.3%; p=0.021) was significantly higher in case group.Conclusion: Care based on ICP monitoring in patients with severe TBI was associated with increased frequency of good recovery and favorable outcome and decreased frequency of moderate disability. However higher meningitis rate was associated with Ventriculostomy and ICP monitoring.
