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Hadavi D, Shahbazi P, Gholami N, Hajialigol A, Azarsina S. External iliac artery thrombosis as a result of acetabular fixation through the ilioinguinal approach: a case report. Ann Med Surg (Lond) 2023; 85:6211-6214. [PMID: 38098579 PMCID: PMC10718346 DOI: 10.1097/ms9.0000000000001408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 10/09/2023] [Indexed: 12/17/2023] Open
Abstract
Introduction and importance Acetabular fractures mostly occur in young people who are involved in high-energy trauma and they are treated by orthopedic trauma surgeons. Patients with acetabular fractures are at high risk for different kinds of complications. We report a case of postoperative thrombosis of the external iliac artery following fixation surgery performed by an ilioinguinal approach while receiving thromboprophylaxis during admission to the hospital. Case presentation A 57-year-old healthy woman presented with a left both-column acetabular fracture and underwent acetabular fixation through the ilioinguinal approach. The patient was receiving antithrombotic prophylaxis medications in the course of treatment. Clinical discussion During her convalescence, while at the hospital, she was diagnosed with left external iliac artery thrombosis, needing surgical thrombectomy. These severe and rare complications will lead to uncertainty about a commonly used ilioinguinal approach. Postoperative arterial thrombosis may be rare in patients undergoing acetabular fixation surgery but searching for signs and symptoms of this condition is always necessary. Conclusion It is possible to prevent severe complications by performing a routine measurement of the distal arterial pressure after similar surgeries.
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Affiliation(s)
- Dorsa Hadavi
- Radiology Department, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Parmida Shahbazi
- Orthopaedic Department, Orthopaedic Subspecialty Research Center (OSRC), Sina University Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Niloofar Gholami
- Cardiovascular Research Center, Alborz University of Medical Sciences, Alborz, Iran
| | - Amirhossein Hajialigol
- Alborz Office of Universal Scientific Education and Research Network (USERN), Alborz University of Medical Sciences, Karaj, Iran
| | - Salman Azarsina
- Department of Orthopedic Surgery, Shahid Madani Hospital, Alborz University of Medical Sciences, Karaj, Iran
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Taabbodi A, Shahbazi P, Mohammad Hosseini Azar P, Gholami N, Hadavi D, Najafi A. A shotgun-induced nonunion humeral fracture treated by Masquelet technique and arthrodesis: a case report. Ann Med Surg (Lond) 2023; 85:4561-4565. [PMID: 37663745 PMCID: PMC10473378 DOI: 10.1097/ms9.0000000000000457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 03/16/2023] [Indexed: 09/05/2023] Open
Abstract
Introduction and importance The Masquelet technique remains one of the procedures with low rates of failure and infection. The use of this technique in humeral defects is still rare. Case presentation A 38-year-old male patient with an open humeral comminuted fracture induced by shotgun injury was referred to our hospital. The Masquelet technique was chosen as the best option with a lower risk of infection and the lower expenses at this stage due to the second time of open reduction and internal fixation and bone graft failure, low patient compliance, and the increasing size of the defect due to bone absorption. An arthrodesis procedure was performed 5 days after the second Masquelet stage as restoring the elbow joint's range of motion was impossible. Clinical discussion The Masquelet technique, is a two-step surgical procedure to manage pseudoarthroses and bone defects. Various surgical options are available for performing this procedure. There are several reasons behind the rising popularity of this technique during recent years. Some of these reasons include the reproducibility of this technique, as well as requiring less time, not being technically challenging, and having fewer neurovascular complications. Conclusion This case was one of the limited examples of successful implementation of the Masquelete procedure on severe traumatic injuries of the upper limb with bone defects providing more evidence on the safety and efficacy of this technique in similar conditions.
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Affiliation(s)
- Alireza Taabbodi
- Orthopedic Surgery Ward, Shahid Madani Hospital, Alborz University of Medical Sciences, Karaj
| | - Parmida Shahbazi
- Orthopedic Surgery Ward, Shahid Madani Hospital, Alborz University of Medical Sciences, Karaj
| | | | - Niloofar Gholami
- Cardiovascular Research Center, Alborz University of Medical Sciences, Alborz, Iran
| | - Dorsa Hadavi
- Department of Radiology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Arvin Najafi
- Orthopedic Surgery Ward, Shahid Madani Hospital, Alborz University of Medical Sciences, Karaj
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Najafi A, Shahbazi P, Zargar D, Gholami N, Hadavi D, Mirhoseini MS. Two case reports of adult traumatic inferior hip dislocations following road traffic accidents without complications. Ann Med Surg (Lond) 2023; 85:3004-3007. [PMID: 37363597 PMCID: PMC10289605 DOI: 10.1097/ms9.0000000000000639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 04/02/2023] [Indexed: 06/28/2023] Open
Abstract
Inferior dislocation of the hip is the rarest type of hip dislocation, mainly occurring from high-energy incidents, mostly from road traffic accidents or sports. It is generally an injury among adults. Case presentation A 17-year-old male sustained injuries as a pedestrian, and a 30-year-old male sustained a traffic accident as a motorcycle rider. Both patients complained of severe pain in the hip, decreasing range of motion, and the inability to weight bearing. In both, the affected hip joint was fixed in 90° flexion, abduction, and external rotation, and the leg was slightly shorter than the other limb. An X-ray showed the inferior dislocation of the right hip and left hip, respectively, without any sign of fracture. We reduced both dislocations closely after sedation without any complications during follow-ups. Conclusion This injury should be treated as an emergency, and reduction performed as soon as possible, within 6 h. It can be managed usually with closed reduction under general anesthesia. Close follow-up is necessary to prevent its complications, including avascular necrosis, associated fractures, neurovascular compromise, and articular cartilage injuries.
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Affiliation(s)
- Arvin Najafi
- Orthopedic Surgery Ward, Shahid Madani Hospital, Alborz University of Medical Sciences, Karaj
| | - Parmida Shahbazi
- Orthopedic Surgery Ward, Shahid Madani Hospital, Alborz University of Medical Sciences, Karaj
| | - Danoosh Zargar
- Orthopedic Surgery Ward, Shahid Madani Hospital, Alborz University of Medical Sciences, Karaj
| | - Niloofar Gholami
- Cardiovascular research center, Alborz University of Medical Sciences, Alborz, Iran
| | - Dorsa Hadavi
- Radiology Department, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad S. Mirhoseini
- Orthopedic Surgery Ward, Shahid Madani Hospital, Alborz University of Medical Sciences, Karaj
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Najafi A, Shahbazi P, Azarsina S, Zargar D, Kahrizi MS, Hadavi D, Minaei-Noshahr R. Cortical bridging a union predictor: A prospective study after intramedullary nailing of the femoral shaft fractures. Eur J Transl Myol 2022; 32:10835. [PMID: 36305702 PMCID: PMC9830402 DOI: 10.4081/ejtm.2022.10835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Accepted: 10/12/2022] [Indexed: 01/13/2023] Open
Abstract
Early prediction of the union helps for timely intervention, reduction of hospitalization, treatment costs, and disability in cases of nonunion. With this in mind, we tried to find how long any cortical bridging predicts the union in femoral shaft fractures. A prospective study of 113 femoral shaft fractures treated with reamed, locked intramedullary nailing was performed. Radiographs were taken during months 2 to 4, 6, 9, and one-year follow-up. The cortical bridging (presence and number) was assessed by anterior-posterior and lateral views. The ROC curve provides the prediction of the union. The overall nonunion rate was 10.6% (12 of 113 fractures). Age and diabetes mellitus were statistically significant with nonunion (p value < 0.001). The final analysis demonstrated that any cortical bridging at four months postoperatively was the most accurate and earlier indicator (105 of 113, 92.9% accuracy), while it was 84.9% at six months in bicortical and 80.5% accuracy at nine months in tricortical bridging. Low-cost and simple radiographic imaging presents cortical bridging in any form 4 months after surgery that precisely predicts a union in femoral shaft fractures.
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Affiliation(s)
- Arvin Najafi
- Department of Orthopedic Surgery, Shahid Madani Hospital, Alborz University of Medical Sciences, Karaj, Iran
| | - Parmida Shahbazi
- Department of Orthopedic Surgery, Shahid Madani Hospital, Alborz University of Medical Sciences, Karaj, Iran
| | - Salman Azarsina
- Department of Orthopedic Surgery, Shahid Madani Hospital, Alborz University of Medical Sciences, Karaj, Iran
| | - Danoosh Zargar
- Department of Orthopedic Surgery, Shahid Madani Hospital, Alborz University of Medical Sciences, Karaj, Iran
| | - Mohammad Saeed Kahrizi
- Department of Orthopedic Surgery, Shahid Madani Hospital, Alborz University of Medical Sciences, Karaj, Iran
| | - Dorsa Hadavi
- Department of Orthopedic Surgery, Shahid Madani Hospital, Alborz University of Medical Sciences, Karaj, Iran
| | - Reza Minaei-Noshahr
- Bone, Joint and Related Tissues Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran,Assistant Professor of orthopedic surgery, Bone, Joint and Related Tissues Research Center, Shahid Beheshti University of Medical Sciences, Velenjak St., Shahid Chamran Highway Tehran, Iran. Phone: +98912 857 6268. ORCID iD: 0000-0002-7851-842X
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Najafi A, Hadavi D, Jalalpour P. Pelvic Osteochondroma as a Differential Diagnosis for Abdominal Mass: A Case Report. jost 2022. [DOI: 10.18502/jost.v7i4.8865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background: Osteochondroma is the most common benign tumor of the bone.
Case Report: In this case, we present a young patient complaining of sensation of a mass in her abdomen since a few weeks ago and abdominal pain, which caused her visit to the clinic. Imaging studies revealed a well-defined lobulated lesion, and pathological examination was correlated with osteochondroma of the iliac bone
Conclusion: This site for osteochondroma is very rare, and this case was the solitary type.
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Najafi A, Tavakoli M, Zargar D, Hadavi D, Seif E, Azarsina S. Valgus Impacted Femoral Neck Fractures: Surgery or Non-Operative Approach? jost 2021. [DOI: 10.18502/jost.v7i2.6998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background: Non-operative management of valgus impacted femoral neck fracture leads to prolonged bed rest which may lead to deep vein thrombosis. The preferred method is the internal fixation because of pain control, enhanced mobilization, and better fracture healing but fails in older patients and individuals with medical comorbidities. The present study aims to assess the functional outcomes after the internal fixation or the non-operative management.
Methods: A retrospective cohort study was conducted at a Level I trauma center from January 2013 to December 2019 on all patients with valgus-impacted femoral neck fractures [Arbeitsgemeinschaft für Osteosynthesefragen/Orthopedic Trauma Association Classification (AO/OTA 31-B1)]. Overall, 81 patients were managed operatively with three partially threaded, cannulated screws in a parallel configuration and 21 patients were managed non operatively with instant mobilization, physical therapy, and partial weight-bearing protocol.
Results: 6 (28.0%) patients in the non-operative group and 3 (4.0%) cases in the operative group experienced fracture displacement (P < 0.001). 48 (59.2%) patients of the operative treatment group returned to baseline ambulatory function at 3 months, while this figure was 43.0% in the non-operative treatment group, not significantly different (P = 0.100). There was no significant difference in the mortality rates at one month and three months between the two groups (2 patients in each group, P = 0.140).
Conclusion: The ideal treatment of valgus-impacted femoral neck fractures is still controversial. The main purpose in the treatment of hip fractures is to return the patient to functional level equal to the level he or she was before the fracture. Surgically treated patients had lower failure rates in comparison with the other group.
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