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Background : Avascular necrosis (AVN) of femoral head is one of the multifactorial pathologies, which can disturb hip joint and its range of motion. There have been several therapeutic methods for this pathology, but the results are controversial. Some studies show that core compression prevents the progress of the disease and its symptoms. This study aims to explore this issue. Materials and Methods : This clinical trial was conducted on patients who were diagnosed with AVN of femoral head stage I, II A, at educational hospitals of Isfahan in 2010. The patients who met the inclusion criteria and suffered from AVN of femoral head stage I, II A for any reason (primary or secondary), entered the study. Six and 12 months after surgery, final assessment in terms of range of motion, return to work, and severity of pain based on vancouver associated score (VAS) was made and recorded. The duration of hospitalization and rate of infection were also recorded. The data were entered into and analyzed by the SPSS software. Results: Mean and standard deviation of pain severity before surgery was 6.82 ± 1.74 in the participants. After 6 months, pain severity reduced to 4.05 ± 1.29, and after 12 months, it reached 2.41 ± 1.82. On the basis of analysis of variance with repeated observation, the severity of pain was significantly reduced in 1 year (P

Background: Scoliosis is a three-dimensional deformity of the spine with lateral curvature in addition to the rotation of vertebral bodies. The aim of the present study was to determine the prevalence of adolescent idiopathic scoliosis (AIS) in our society and its demographic-related factors. Materials and Methods: This was a cross-sectional study that took place from November 2014 to March 2015 in Isfahan, Iran. During the period of study, 24 schools were randomly chosen from six zones by a simple random sampling method. In each school, about 120 students were randomly selected and evaluated. Anterior forward bending test and scoliometry were done in all students and suspicious ones referred to Alzahra spine clinic for further evaluation. The diagnosis of AIS was based on radiographic finding and Cobb angle more than 10°. Data about age, sex, height, body mass index, hand dominancy, and type of schoolbag were recorded. Results: A total number of 3018 children were evaluated and 19 were diagnosed with AIS that showed the prevalence of 0.62%. None of the study variables had a significant relation with the presence of AIS. The cutoff point for the detection of AIS with scoliometry was calculated as 3.5, with a sensitivity of 73.7% and specificity of 86.7%. Conclusion: The prevalence of AIS in our area was 0.62%, which was lower than previous reports and did not have a relation with demographic factors; however, screening surveys identify a significant number of children with AIS who could benefit from preventive treatment. [ABSTRACT FROM AUTHOR]

Background: Patients who suffer from traumatic peripheral nerve injuries receive temporary treatment after referring to hospital. Peripheral nerve repair surgery in some patients is done immediatly after damage but many of them get secondary nerve repair after longer periods of time. In this study we have compared the clinical and electrodiagnostic outcome among primary and secondary nerve repair. Methods: Patients with primary or secondary repair of median and ulnar nerves were enrolled in a non-randomized clinical trial prospective study. Information used in this study was collected from patients that passed a surgery to repair the peripheral nerve betwen years 2003 to 2010 in Alzahra and Ayatollah Kashani hospitals of Isfahan, Iran. Patients were followed by clinical and electrodiagnostic examination in the third, sixth, twelfth and eighteenth month after surgery and the outcome of recovery in their hand function (sensory and motor) were evaluated. Findings: 122 patients (64 men and 58 female) were enrolled in this study. 56 patients (45.9%) had a primary repair surgery and 66 patients (54.1%) had a secondary repair surgery. The age range were between 7 to 55 years (mean: 24.9 ± 8.9), with the mean of 25.6 ± 7.1 for primary group and 24.4 ± 9.8 for secondary group (P = 0.59). By using the Maan-Whitney test, primary group had better clinical sensory and motor recovery and also improvement in sensory NCV (Nerve conduction velocity) and EMG (Electromyogram) findings compared with secondary group (P < 0.05), but no significant difference was seen in motor NCV between 2 groups (P = 0.1). Conclusion: In this research we studied the result of primary and secondary repair in both median and ulnar nerve injuries. We concluded that clinical and electrodiagnostic outcome in primary nerve repair were better than secondary nerve repair, thus we suggest immediate repair after peripheral nerve injuries, when possible. [ABSTRACT FROM AUTHOR]

Background: Anterior knee pain is a major problem in total knee arthroplasty (TKA). It is accepted that anterior knee pain (AKP) often contributes to a patellofemoral etiology; however, its etiology or treatment is not understood completely. Disabling pain receptors by electrocautery could theoretically lead to anterior knee area denervation. The present study aimed to evaluate the pain post-patellar denervation (PD) with electrocautery in TKA., Materials and Methods: Clinical results for 92 patients who underwent TKA (58 women, 34 men; mean age 67.5 years) were analyzed. In addition to removal of all osteophytes, PD by electrocautery was performed on patella of treatment group ( n = 46) and debridement alone including removing of all osteophytes was performed on the control group ( n = 46). Knee Society System (KSS) score, patella score (PS), and visual analog scale (VAS) were used to determine pre- and post-operative AKP., Results: The follow-up duration was 10 months. No revision or reoperations were performed. There were no patellar fractures. On all parameters (KSS score, PS, and VAS), there was a statistically significant pre- to post-operative difference in favor of the denervation group only 3 weeks after operation; however, there was no statistically difference postoperation on other follow-ups (3, 6, and 10 months)., Conclusions: PD with electrocautery could reduce AKP in TKA without patellar resurfacing only in a short-term period postoperation., Competing Interests: There are no conflicts of interest.

Background: High tibia osteotomy (HTO) is a common surgical operation for correction of genu varum deformity. In some patients, there are concurrent tibia vara and genu varum (bow leg). This study aimed to consider the possibility of better correction of bow leg deformity after double level tibial osteotomy (DLTO)., Materials and Methods: A case series of 10 patients of genu varum in addition to tibia vara (bow leg) deformity who were referred to orthopedic ward of an academic hospital of Isfahan- Iran during 2009-2011 were included in the study. The mean age was 17.3 ± 3.1 years and all of them underwent DLTO. The results of treatment have been assessed based on clinical and radiological parameters before and after surgery., Results: The mean pre- and post operative values for Tibia-Femoral Angle, Medial Proximal of Tibia Angle (MPTA), and Lateral Distal of Tibia Angle (LDTA) were 18.13 ± 3.05° vs. 3.93 ± 0.66°, 79.13 ± 3.4° vs. 89.7 ± 1.8° and 96.40 ± 1.8° vs. 88.73 ± 3.0° respectively (P < 0.05). Improvement of all radiological parameters was meaningful. Seventy three percent of patients had normal mechanical axis of limb after surgery. The remaining cases had varus deformity in distal femur that was corrected by valgus supracondylar osteotomy in an additional operation. Limited range of motion (ROM) near knee and ankle was not observed., Conclusion: DLTO correct bow leg deformity in the point of alignment of limb and paralleling of knee and ankle joint more effectively. This method can be used in metabolic and congenital bow leg which deformities are present in throughout of the lower limb. We described this technique for the first time.