Search

Background: Percutaneous pedicle screw fixation [PPSF], where screws are inserted through small holes in the skin, has become a popular approach for treating thoracolumbar and lumbar fractures. It has been shown to produce satisfactory outcomes.Aim of the work: The aim was to examine the procedure and assess the practicality, safety and results of using PPSF to treat thoracolumbar fractures.Patients and Methods: A prospective cohort study included 20 patients with thoracic or lumbar spine fracture, without neurological deficit, whom were operated upon by percutaneous screw fixation, and were assessed clinically [for improvement and development of complications] and radiologically [for healing and correction of deformity] by follow up over 6 months after surgery.Results: All cases achieved full radiological union by 3 months. The mean union time in our cohort was 2.1±0.5 months. Postoperatively, a statistically significant improvement in the vertebral kyphotic angle to a mean value of 4.7 ± 2.3 was observed [Bonferroni post-hoc test, P = 0.001]. The correction was maintained till last follow-up. Two patients [10%] developed incomplete paraplegia [Frankel grade D]. Misplacement of the pedicle screws was recorded in 6 of 90 screws in six patients.Conclusion: The PPSF is a valuable surgical procedure for patients with thoracic and lumbar vertebral fracture.

Background: Transcervical neck fracture is common in daily orthopedic practice. Internal fixation is the curative option. However, there is controversy exists regarding the ideal fixation device. The aim of the work: This study aims to compare the clinical, functional and radiological results of cannulated screws versus dynamic locking plate in fixations of femoral neck fractures.Patients and Methods: Thirty patients with transcervical fracture neck femur were included. They were divided into two groups; the first for dynamic locked plate, and the second for cannulated screws. All were assessed preoperatively by radiological and clinical methods. Postoperative care consisted of routine vital data recording, intravenous antibiotics and appropriate analgesia. X-rays were done in the first postoperative to check fixation and after 12 weeks to check for union. The follow-up evaluation included questioning the patient about pain during activity and rest and about ability to walk and stand determining the range of motion of the hip joint using modified Harris Hip Scoring System.Results: The mean operative time in screws group was 38 minute compared to 72 minutes in plate group with significant difference between both groups. Both groups showed high successful union rate with no significant difference. In the screw group, 3 cases fail to union while in plate group only one case failed. The mean union time in screws group was 19.7 weeks while in plate group was 18.3 weeks. Screws group showed 8 cases of complication, compared to 5 cases in the plate group. There was a significant blood loss [more than 500ml] in plate group.Conclusion: Although both groups were comparable regarding union rate, the screw group was associated with significantly shorter operative time, and lower blood loss. The anatomical reduction is the main determining factor of success regardless the type of device used in fixation.

Background: With the advancement of hip surgery and increased life span in many nations, the need for acetabular revision surgery is expected to grow. Many options are available for such surgery, including the use of impacted bone graft. The Aim of The Work: This work aimed to assess the clinical results of impacted bone graft in reconstructing the acetabular bone defect after a failed hip surgery.Patients and Methods: Between 2013 and 2019, we performed reconstructions of the acetabulum for 20 patients, who had at least one acetabular operation before revision. Surgical reconstruction was conducted using an impacted cancellous bone graft. Each patient was directed to long-term clinical [primary outcome] and radiological evaluations. The direct postoperative clinical and radiographic outcomes were evaluated and the patient continued regular follow up visits for at least 12 months after surgery.Results: According to the modified Harris-Hip [MHH] score, the results rated as excellent [35%], good [25%], fair [25%] and poor [15%]. No pain was recorded for 40%, slight pain for 30%. Thirteen patients [65%] were able to walk alone without support, while the remaining 7 used a support in the form of a cane [25%] or crutches [10%]. Leg-length discrepancy [>2.5 cm] was reported in two patients.Conclusion: Successful results were obtained using the impaction technique for acetabular reconstruction, with restoration of near normal mechanics. The union rate is satisfactory. Augmentation of the grafting technique by mesh or rings added more stability to the cup component.

Hepatocellular carcinomas will emerge as a major form of malignancy in the coming decades. When these tumors are in advanced stages, few therapeutic options are available. Therefore, it is eßential to search for new treatment modalities to fight this disease. Aim Evaluate the poßible protective and therapeutic effects of Cannabis extract on dimethylnitrosamine (DMNA)-induced hepatocarcinogenicity in mice. Methods Seventy-five male mice were divided into five groups of 15 each: group I mice received corn oil only as the control group; group II mice were injected intraperitoneally with DMNA (10μg/kg body weight) weekly for 12weeks; group III mice were pretreated orally with cannabis extract (0.5ml/kg body weight) every other day for two weeks before the injection of DMNA, and continued until the end of the experiment (12weeks); group IV mice were treated orally with cannabis extract every other day simultaneously with DMNA injection and continued until the end of the experiment; group V mice were treated orally with cannabis extract every other day after receiving the last intraperitoneal injection of DMNA. A real time PCR was used to quantify telomerase reverse transcriptase and caspase-8 m-RNA expreßion level. Results As compared to the control group, mTERT mRNA expreßion level was significantly increased in group II. The gene in groups (III, IV, and V) was insignificantly higher than the control group but it was significantly decreased as compared to group II. The caspase-8 mRNA expreßion level was significantly decreased in all groups as compared to the control group. As compared to group II, caspase-8 mRNA level was significantly increased in group III. Conclusion The protective effect of cannabis extract is more pronounced in group taking cannabis before DMNA. Cannabinoids might exert their anti-tumor effects by the direct induction of apoptosis and can decrease telomerase activity by inhibiting the expreßion of the TERT gene. Coordination between inhibition of telomerase activity and induction of apoptosis might be a potential therapeutic agent for cancer treatment. [ABSTRACT FROM AUTHOR]

Background: Flexible Flat Foot [FFF] in children is a frequent abnormality. Although its benign nature, sometimes a significant pain and discomfort is sufficient enough to consider surgery for alleviating symptoms. Subtalar arthroereisis is becoming more popular as a treatment for FFF symptoms.Aim of the work: To assess the feasibility of subtalar joint screw arthroereisis procedure in the treatment of FFF in children and assess its related outcomes.Patients and methods: This prospective interventional study, where a total of 10 patients [20 feet] presented with bilateral flexible flatfeet were enrolled in our study. Patients were treated with Subtalar joint Screw Arthroereisis. The American Orthopedic Foot & Ankle Society [AOFAS] score was employed to assess preoperative status and postoperative healing of ankle and hindfoot function. The three main components are pain, function, and alignment.Results: The mean preoperative AOFAS score was 52.5 ± 13.5 [range, 23 – 75]. At 3-month and 6-month follow-up, the average AOFAS score was 85 ± 11.3 [range, 65 – 95], and 87 ± 7.8 [range, 70 – 96], respectively. Fourteen [70%] feet had good functional scores, and six [30%] feet had excellent scores.Conclusion: Subtalar joint screw arthroereisis technique was safe and effective in the treatment of flexible flatfoot in children. It was minimally invasive procedure associated with low operative time, good clinical and radiologic outcome and low complication rate.

Hepatocellular carcinomas will emerge as a major form of malignancy in the coming decades. When these tumors are in advanced stages, few therapeutic options are available. Therefore, it is essential to search for new treatment modalities to fight this disease. Aim: Evaluate the possible protective and therapeutic effects of Cannabis extract on dimethylnitrosamine (DMNA)-induced hepatocarcinogenicity in mice. Methods: Seventy-five male mice were divided into five groups of 15 each: group I mice received corn oil only as the control group; group II mice were injected intraperitoneally with DMNA (10 μg/kg body weight) weekly for 12 weeks; group III mice were pretreated orally with cannabis extract (0.5 ml/kg body weight) every other day for two weeks before the injection of DMNA, and continued until the end of the experiment (12 weeks); group IV mice were treated orally with cannabis extract every other day simultaneously with DMNA injection and continued until the end of the experiment; group V mice were treated orally with cannabis extract every other day after receiving the last intraperitoneal injection of DMNA. A real time PCR was used to quantify telomerase reverse transcriptase and caspase-8 m-RNA expression level. Results: As compared to the control group, mTERT mRNA expression level was significantly increased in group II. The gene in groups (III, IV, and V) was insignificantly higher than the control group but it was significantly decreased as compared to group II. The caspase-8 mRNA expression level was significantly decreased in all groups as compared to the control group. As compared to group II, caspase-8 mRNA level was significantly increased in group III. Conclusion: The protective effect of cannabis extract is more pronounced in group taking cannabis before DMNA. Cannabinoids might exert their anti-tumor effects by the direct induction of apoptosis and can decrease telomerase activity by inhibiting the expression of the TERT gene. Coordination between inhibition of telomerase activity and induction of apoptosis might be a potential therapeutic agent for cancer treatment.