1
|
Keyhani S, Movahedinia M, Sherafat Vaziri A, Soleymanha M, Vosoughi F, Tahami M, LaPrade RF. Is posterior knee arthroscopy using posterior portals necessary for orthopedic surgeons? The latest evidence on applications and techniques. EFORT Open Rev 2023; 8:189-198. [PMID: 37097043 PMCID: PMC10155121 DOI: 10.1530/eor-22-0133] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/26/2023] Open
Abstract
Various uses of posterior knee arthroscopy have been shown, including all-inside repair of posterior meniscal lesions, posterior cruciate ligament (PCL) reconstruction or PCL avulsion fixation, extensile posterior knee synovectomy for pigmented villonodular synovitis or synovial chondromatosis, posterior capsular release in the setting of knee flexion contractures, and loose bodies removal. Posterior arthroscopy provides direct access to the posterior meniscal borders for adequate abrasion and fibrous tissue removal. This direct view of the knee posterior structures enables the surgeon to create a stronger biomechanical repair using vertical mattress sutures. During PCL reconstruction, posterior arthroscopy gives the surgeon proper double access to the tibial insertion site, which can result in less acute curve angles and the creation of a more anatomic tibial tunnel. Moreover, it gives the best opportunity to preserve the PCL remnant. Arthroscopic PCL avulsion fixation is more time-consuming with a larger cost burden compared to open approaches, but in the case of other concomitant intra-articular injuries, it may lead to a better chance of a return to pre-injury activities. The high learning curve and overcaution of neuromuscular injury have discouraged surgeons from practicing posterior knee arthroscopy using posterior portals. Evidence for using posterior portals by experienced surgeons suggests fewer complications. The evidence suggests toward learning posterior knee arthroscopy, and this technique must be part of the education about arthroscopy. In today's professional sports world, where the quick and complete return of athletes to their professional activities is irreplaceable, the use of posterior knee arthroscopy is necessary.
Collapse
Affiliation(s)
- Sohrab Keyhani
- Akhtar Orthopedic Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Movahedinia
- Akhtar Orthopedic Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Arash Sherafat Vaziri
- Center of Orthopedic Trans-Disciplinary Applied Research, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehran Soleymanha
- Orthopedic Surgery, Poursina Hospital Orthopaedic Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Fardis Vosoughi
- Department of Orthopaedic and Trauma Surgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Tahami
- Bone and Joint Disease Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Robert F LaPrade
- Department of Orthopedic Surgery, University of Minnesota, Minneapolis, Minnesota, USA
| |
Collapse
|
2
|
Keyhani S, Qoreishi M, Mousavi M, Ronaghi H, Soleymanha M. Peroneus Longus Tendon Autograft versus Hamstring Tendon Autograft in Anterior Cruciate Ligament Reconstruction: A Comparative Study with a Mean Follow-up of Two Years. Arch Bone Jt Surg 2022; 10:695-701. [PMID: 36258748 PMCID: PMC9569136 DOI: 10.22038/abjs.2022.59568.2938] [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] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 02/02/2022] [Indexed: 01/24/2023]
Abstract
BACKGROUND Peroneus longus tendon can be a suitable alternative autograft for anterior cruciate ligament reconstruction (ACLR). The present study aimed to compare the clinical outcome and donor site morbidity in ACLR using peroneus longus tendon autograft versus hamstring tendon autograft. METHODS In a comparative cross-sectional study, ACLR was performed with quadrupled hamstring tendon autograft in 65 patients between 2017 and 2018, and in another group, peroneus longus tendon autograft was used for ACLR in 65 patients between 2018 and 2019. The same surgical technique, fixation method, and postoperative protocol were used in both groups. The knee functional outcomes were assessed according to the Lysholm score and the International Knee Documentation Committee scale at preoperative and at the end of at least 2 years after the procedure. Moreover, graft diameter was measured intraoperatively. Thigh circumference, the American Orthopedic Foot and Ankle Score (AOFAS), The Foot & Ankle Disability Index (FADI), and ankle range of motion (ROM) were used to evaluate ankle donor site morbidities. RESULTS A total of 130 patients (65 patients in each group) were evaluated with a minimum follow-up of 2 years (range 24-31 months). Both groups showed no significant differences in clinical outcomes and knee stability. The peroneus longus graft diameter was significantly larger than the hamstring diameter (P<0.001). Assessment of AOFAS, FADI, and ankle ROM showed no apparent ankle joint dysfunction in the peroneus longus tendon group. CONCLUSION Faster knee extensions, less anteromedial knee pain, and thigh hypotrophy were observed in peroneus longus tendon patients. Peroneus longus tendon autograft can be an appropriate autograft for ACLR due to its strength, larger graft diameter, and avoiding potential complications of hamstring autograft obtained from the knee region.
Collapse
Affiliation(s)
- Sohrab Keyhani
- Bone, Joint and Related Tissues Research Center, Akhtar Orthopedic Training and Research Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohamad Qoreishi
- Bone, Joint and Related Tissues Research Center, Akhtar Orthopedic Training and Research Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Hossein Ronaghi
- Poursina Hospital Orthopaedic Research center, Guilan University of medical sciences, Rasht, Iran
| | - Mehran Soleymanha
- Poursina Hospital Orthopaedic Research center, Guilan University of medical sciences, Rasht, Iran
| |
Collapse
|
3
|
Abstract
The optimal operative technique for the treatment of the tibial-side avulsion injuries of the posterior cruciate ligament (PCL) is debatable. This study was aimed to evaluate the postoperative outcomes and complications if any after an open direct, posterolateral approach using cannulated cancellous screw fixation of a PCL tibial avulsion. From January 2016 to June 2018, 17 patients (14 males and 3 females) with PCL avulsion fraction treatment-who underwent open reduction and internal fixation using cannulated cancellous screws-were included in this prospective study. A direct posterolateral approach in the prone position was used in all cases. The Lysholm's knee score and International Knee Documentation Committee (IKDC) score were assessed preoperatively and during regular follow-up examinations for at least 1 year (12-20 months) postoperatively. All patients had fracture union and all of their knees were stable upon physical examination. No nerve or blood vessel injuries occurred. The mean Lysholm's scores and mean IKDC scores were improved significantly at the last follow-up. This study provides evidence that open direct posterolateral approach may be reliable for the treatment of tibial-sided bony PCL avulsion fractures. This approach can provide direct visualization of the posterior capsule and PCL avulsion site associated with good reduction and stable fixation, easy application of the screws directly from posterior to anteriorly without extensive soft tissue damage. Nevertheless, long-term follow-up is recommended.
Collapse
Affiliation(s)
- Sohrab Keyhani
- Department of Knee Surgery and Sports Medicine, Akhtar Orthopedic Training and Research Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mehran Soleymanha
- Department of Orthopedic Surgery, Poursina Hospital Orthopaedic Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Amir Salari
- Department of Orthopedic Surgery, Poursina Hospital Orthopaedic Research Center, Guilan University of Medical Sciences, Rasht, Iran
| |
Collapse
|
4
|
Keyhani S, Soleymanha M, Verdonk R, Amouzadeh F, Movahedinia M, Kazemi SM. Posterior knee arthroscopy facilitates the safe and effective all-inside repair of locked bucket-handle medial meniscal tear using a suture hook technique. Knee Surg Sports Traumatol Arthrosc 2022; 30:1311-1315. [PMID: 33871661 DOI: 10.1007/s00167-021-06576-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 04/09/2021] [Indexed: 12/27/2022]
Abstract
PURPOSE This study reported the outcomes of locked bucket-handle medial meniscal tear (BHMMT) repairs using an arthroscopic posterior approach during anterior cruciate ligament (ACL) reconstruction. METHODS Between 2011 and 2014, 48 patients with BHMMTs and ACL tears who met the eligibility criteria were enrolled in the present study. BHMMTs were assessed using a posterolateral transseptal portal and repaired using a posteromedial portal. Transportal ACL reconstruction was performed using hamstrings autograft. Patients were assessed based on their IKDC and Lysholm scores and Tegner activity level. Meniscal healing was clinically evaluated based on the absence of swelling, joint line tenderness, locking, and catching; McMurray test results; and the need for meniscectomy. RESULTS According to follow-up assessments, the average IKDC and Lysholm scores improved significantly after 3-5 years (P < 0.001) CONCLUSION: Excellent clinical outcomes were obtained when locked BHMMTs were repaired using an all-inside suture technique that employed posteromedial and posterolateral transseptal portals. LEVEL OF EVIDENCE IV.
Collapse
Affiliation(s)
- Sohrab Keyhani
- Bone Joint and Related Tissues Research Center, Akhtar Orthopedic Hospital, Shahid Beheshti University of Medical Sciences, Sharifi Manesh Street, Shariati Street, Tehran, Iran.
| | | | - Rene Verdonk
- Department of Orthopedics and Traumatology, Gent University, Ghent, Belgium
| | - Farzad Amouzadeh
- Bone Joint and Related Tissues Research Center, Akhtar Orthopedic Hospital, Shahid Beheshti University of Medical Sciences, Sharifi Manesh Street, Shariati Street, Tehran, Iran
| | - Mohammad Movahedinia
- Bone Joint and Related Tissues Research Center, Akhtar Orthopedic Hospital, Shahid Beheshti University of Medical Sciences, Sharifi Manesh Street, Shariati Street, Tehran, Iran
| | - Seyyed Morteza Kazemi
- Bone Joint and Related Tissues Research Center, Akhtar Orthopedic Hospital, Shahid Beheshti University of Medical Sciences, Sharifi Manesh Street, Shariati Street, Tehran, Iran
| |
Collapse
|
5
|
Keyhani S, Movahedinia M, Soleymanha M, Verdonk R, Kazemi M, Qoreishy M. Repair of popliteomeniscal fascicles tear using a posterior transseptal portal fixes hypermobile lateral meniscus. J Exp Orthop 2021; 8:93. [PMID: 34676494 PMCID: PMC8531177 DOI: 10.1186/s40634-021-00412-4] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 10/01/2021] [Indexed: 11/10/2022] Open
Abstract
PURPOSE This study investigates the effects of the all-inside repair of posterosuperior popliteomeniscal fascicle (PMF) on lateral meniscus stabilization using a posterior arthroscopic approach. METHODS Between 2015 and 2018, 17 patients with hypermobile lateral meniscus (HLM) underwent posterior knee arthroscopy for PMF repair. The all-inside repair was performed through posteromedial transseptal and posterolateral portals using a suture hook technique. Patients were clinically assessed based on IKDC and Lysholm scores. RESULTS Both IKDC and Lysholm scores improved significantly after an average follow-up of 3.5 years (P < 0.001). No patients underwent reoperation, and no complications associated with posterior knee arthroscopy were reported. CONCLUSION The all-inside suture hook technique using posterolateral and posteromedial transseptal portals fixes HLM with excellent IKDC and Lysholm scores. LEVEL OF EVIDENCE Level IV.
Collapse
Affiliation(s)
- Sohrab Keyhani
- Bone Joint and Related Tissues Research Center, Akhtar Orthopedic Hospital, Shahid Beheshti University of Medical Sciences, Sharifi manesh street, Shariati street, Tehran, Iran.
| | - Mohammad Movahedinia
- Bone Joint and Related Tissues Research Center, Akhtar Orthopedic Hospital, Shahid Beheshti University of Medical Sciences, Sharifi manesh street, Shariati street, Tehran, Iran
| | | | - Rene Verdonk
- Department of Orthopedics and Traumatology, Gent University, Ghent, Belgium
| | - Morteza Kazemi
- Bone Joint and Related Tissues Research Center, Akhtar Orthopedic Hospital, Shahid Beheshti University of Medical Sciences, Sharifi manesh street, Shariati street, Tehran, Iran
| | - Mohamad Qoreishy
- Bone Joint and Related Tissues Research Center, Akhtar Orthopedic Hospital, Shahid Beheshti University of Medical Sciences, Sharifi manesh street, Shariati street, Tehran, Iran
| |
Collapse
|
6
|
Keyhani S, Hanafizadeh B, Verdonk R, Sajjadi MM, Soleymanha M. Revision Single-Stage Anterior Cruciate Ligament Reconstruction Using an Anterolateral Tibial Tunnel. J Knee Surg 2020; 33:410-416. [PMID: 30727016 DOI: 10.1055/s-0039-1677812] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Revision anterior cruciate ligament (ACL) reconstruction is a technically demanding enterprise. Management of widened or previously malpositioned tunnels is challenging and often requires innovative approaches. The purpose of this study was to evaluate the function and clinical results of revision single-stage ACL surgery using an anterolateral tibial tunnel (ALTT). A consecutive series of knees with arthroscopic ACL revision surgery were analyzed prospectively between April 2012 and September 2015. Among the 93 patients presented with revision ACL reconstruction, 25 patients met the study inclusion criteria for the ALTT technique and were followed up for a minimum of 2 years (range: 24-51 months). The clinical results were evaluated by means of the Lysholm score, International Knee Documentation Committee (IKDC) score, and Tegner activity level scale, and the knee stability was assessed by the Lachman test, pivot shift test, and anterior drawer test. Magnetic resonance imaging (MRI) of the index knee before the surgery and 2 years after revision surgery was assessed. The mean IKDC subjective score, mean Tegner activity level scale, and mean Lysholm score significantly improved in all study participants. This study showed that ACL revision surgery with ALTT can reliably restore stability and provide fair functional outcomes in patients with ACL retear. One could expect acceptable lateral tibial tunnel length compared with medial tibial tunnel in classic ACL revision, intact bony surround, and good graft fixation. This technique is clinically relevant in that making an anterolateral tunnel in one-stage ACL revision surgery had a good subjective result with low complication rate in midterm follow-up.
Collapse
Affiliation(s)
- Sohrab Keyhani
- Department of Knee Surgery and Sports Medicine, Akhtar Orthopedic Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Behzad Hanafizadeh
- Department of Orthopaedic Surgery, Akhtar Orthopedic Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - René Verdonk
- Department of Orthopedics and Traumatology, Ghent University, Ghent, Belgium
| | - Mohammadreza Minator Sajjadi
- Research Development Unit, Department of Orthopaedic Surgery, Taleghani Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mehran Soleymanha
- Department of Orthopedic Surgery, Orthopaedic Research Center, Poursina Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| |
Collapse
|
7
|
Keyhani S, Kazemi SM, Ahn JH, Verdonk R, Soleymanha M. Arthroscopic Treatment of Diffuse Pigmented Villonodular Synovitis of the Knee: Complete Synovectomy and Septum Removal-Midterm Results. J Knee Surg 2019; 32:427-433. [PMID: 29727868 DOI: 10.1055/s-0038-1646929] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The purpose of this study was to evaluate and describe the clinical results of complete arthroscopic synovectomy through the four arthroscopic portals in the knees affected by diffuse pigmented villonodular synovitis (DPVNS). Between 2009 and 2012, 21 patients (15 men and 6 women) with the diffuse form of PVNS of the knee were enrolled in the study after qualification. The clinical diagnosis was confirmed by magnetic resonance imaging and postsurgical pathologic examination. All patients underwent complete synovectomy through posteromedial, posterolateral, anteromedial, and anterolateral portals. Each patient was evaluated before treatment and followed up for a minimum of 5 years (range: 60-79 months) using the Lysholm score and International Knee Documentation Committee (IKDC) score. Both Lysholm score and IKDC scores were significantly improved in all study participants. No cases of clinical recurrence, infection, joint stiffness, or neurovascular lesions were observed. This study showed that an attentive arthroscopic synovectomy is a safer alternative with better clinical outcomes, with no clinical recurrences.
Collapse
Affiliation(s)
- Sohrab Keyhani
- Department of Orthopedic Surgery, Akhtar Orthopedic Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seyyed Morteza Kazemi
- Bone Joint and Related Tissues Research Center, Akhtar Orthopedic Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Jin Hwan Ahn
- Department of Orthopedic Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - René Verdonk
- Department of Orthopedics and Traumatology, Ghent University, Ghent, Belgium
| | - Mehran Soleymanha
- Department of Orthopaedics, Orthopaedic Research Center, Poursina Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| |
Collapse
|
8
|
Keyhani S, Ahn JH, Verdonk R, Soleymanha M, Abbasian M. Arthroscopic all-inside ramp lesion repair using the posterolateral transseptal portal view. Knee Surg Sports Traumatol Arthrosc 2017; 25:454-458. [PMID: 28028568 DOI: 10.1007/s00167-016-4410-9] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Accepted: 12/09/2016] [Indexed: 10/20/2022]
Abstract
PURPOSE The purpose of this study was to evaluate and describe the clinical results and outcomes of a novel method for all-inside suture repair of medial meniscus ramp lesions through posteromedial and posterolateral transseptal portals during anterior cruciate ligament (ACL) reconstruction. Further, this investigation compared the posterolateral view to the notch view for diagnosis and repair. METHODS Between 2011 and 2014, 166 patients had ramp lesions concomitantly with ACL injury; 128 patients (107 men and 21 women) were enrolled in the study after qualification. All patients underwent repair of the posterior horn ramp lesion of the medial meniscus, using a suture hook device with PDS No. 1 through a posteromedial portal while viewing from the posterolateral transseptal portal during ACL reconstruction, with a minimum of a 2-year follow-up. RESULTS Patients were followed up for a minimum of 2 years (range 24-47 months). Their average Lysholm score increased from 61.7 ± 3.2 preoperatively to 87.8 ± 3.9 at last follow-up (p < 0.001). Moreover, their average IKDC scores also improved from 53.6 ± 2.1 (pre-op) to 82.1 ± 3.5 (at last follow-up) (p < 0.001). The peroneal nerve and the popliteal neurovascular bundle were not damaged in any of the patients. CONCLUSION This study provides evidence that the posterolateral transseptal technique protects neurovascular structures. This technique may be used safely and easily for repair of the posterior horn ramp lesion of the medial meniscus during ACL reconstruction. LEVEL OF EVIDENCE IV.
Collapse
Affiliation(s)
- Sohrab Keyhani
- Orthopedic Department Chair, Akhtar Orthopedic Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Jin Hwan Ahn
- Department of Orthopedic Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - René Verdonk
- Department of Orthopedics and Traumatology, Ghent University, Ghent, Belgium
| | | | - Mohammadreza Abbasian
- Akhtar Orthopedic Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| |
Collapse
|
9
|
Kivi MM, Soleymanha M, Haghparast-Ghadim-Limudahi Z. Treatment Outcome of Intramedullary Fixation with a Locked Rigid Nail in Humeral Shaft Fractures. Arch Bone Jt Surg 2016; 4:47-51. [PMID: 26894218 PMCID: PMC4733235] [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] [Subscribe] [Scholar Register] [Received: 10/29/2015] [Accepted: 05/28/2015] [Indexed: 06/05/2023]
Abstract
BACKGROUND The aim of this study was to determine the treatment outcome of humeral shaft fractures with a locked rigid intramedullary nail in patients indicated for surgical treatment. METHODS In this descriptive-cross sectional study, all patients were followed up for one, six, and 18 months post operatively. The Short Form Questionnaire (SF-36) and Constant Shoulder Score were applied. RESULTS Of 78 included patients (mean age: 35), one patient had a soft tissue infection, one had secondary radial nerve palsy, eight had non-union, one had elbow limited range of motion in extension, and three patients had decreased shoulder range of motion. The Constant Shoulder Score and Short Form Questionnaire Score (SF-36) increased in all patients, although aged women showed lower improvement. CONCLUSION Intramedullary nail fixation in the humeral shaft fracture may be associated with high rates of non-union.
Collapse
Affiliation(s)
- Mohsen Mardani Kivi
- Department of Orthopedic Surgery, Pursina Hospital, Guilan University of Medical Sciences, Rasht, Iran
| | - Mehran Soleymanha
- Department of Orthopedic Surgery, Pursina Hospital, Guilan University of Medical Sciences, Rasht, Iran
| | | |
Collapse
|
10
|
Soleymanha M, Karimi A, Mehrdad SM. A Case of Slipped Capital Femoral Epiphysis in Association With Craniopharyngioma. Trauma Mon 2015; 20:e25633. [PMID: 26543843 PMCID: PMC4630600 DOI: 10.5812/traumamon.25633] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [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: 11/29/2014] [Revised: 03/10/2015] [Accepted: 04/05/2015] [Indexed: 01/18/2023] Open
Abstract
Introduction: Slipped capital femoral epiphysis is characterized by the slippage of the proximal femoral epiphysis on the metaphysis, which is sometimes associated with an underlying endocrine disorder. Panhypopituitarism due to craniopharyngioma has been reported several times. We report a case of craniopharyngioma recurrence leading to slipped capital femoral epiphysis. Case Presentation: A 28-year-old man diagnosed with recurrent craniopharyngioma presented with slipped capital femoral epiphysis. He was treated with gentle manipulation, capsulotomy, and placement of one screw as fixation per side. No complications showed up in a follow-up duration of 4 months. Conclusions: We underscored the importance of endocrinologic disorders in craniopharyngioma cases. Such disorders should be taken into consideration and be followed up.
Collapse
Affiliation(s)
- Mehran Soleymanha
- Department of Orthopedics, Guilan University of Medical Sciences, Rasht, IR Iran
- Corresponding author: Mehran Soleymanha, Department of Orthopedics, Guilan University of Medical Sciences, Rasht, IR Iran. Tel: +98-9122142629, Fax: +98-1333113311, E-mail:
| | - Ali Karimi
- Department of Orthopedics, Guilan University of Medical Sciences, Rasht, IR Iran
| | | |
Collapse
|
11
|
Haghighi M, Soleymanha M, Sedighinejad A, Mirbolook A, Naderi Nabi B, Rahmati M, Ashoori Saheli N. The effect of magnesium sulfate on motor and sensory axillary plexus blockade. Anesth Pain Med 2015; 5:e21943. [PMID: 25830117 PMCID: PMC4363737 DOI: 10.5812/aapm.21943] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [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: 07/11/2014] [Revised: 10/21/2014] [Accepted: 11/26/2014] [Indexed: 11/29/2022] Open
Abstract
Background: Magnesium is a physiologic cation that blocks neuromuscular transmission and does not allow the nerve to be stimulated. Objectives: This study investigates the effect of adding magnesium sulfate to lidocaine to extend the duration of sensory and motor blocks of the axillary plexus in orthopedic surgeries of the upper extremities. Patients and Methods: This controlled randomized double-blind study was performed on patients who were candidates for orthopedic surgery of the upper extremities. A total of 60 patients between 18–60 years with ASA Class 1 or 2 participated in the study. One group received lidocaine (5 mg/kg) with magnesium sulfate 20% (3 mL) as the case group, while the second group received lidocaine (5 mg/kg) with normal saline (3 mL) as a placebo to block the axillary plexus using the trans-arterial technique. The duration of the sensory and motor block of the axillary plexus was monitored and evaluated using the pinprick and modified Bromage scale. Results: A total of 60 patients were included in the study with 30 patients having received lidocaine plus magnesium and the other 30 patients having received lidocaine plus normal saline. The mean sensory block duration in the case group was 248.83 ± 18.36 and in control group was 204.67 ± 22.62. The mean motor block duration in the case group was 207.0 ± 16.64 and in control group was 147.33 ± 21.52 (both P < 0.0001). The mean onset of sensory block in case group was 15.5 ± 3.79 and the onset block in control group was 10.33 ± 4.13 (P < 0.0001). The mean onset of motor block in case group was 20.66 ± 4.09 and the onset block in control group was 19.73 ± 26.18 (P < 0.848). Conclusions: The addition of magnesium sulfate to lidocaine increased the duration of motor and sensory axillary block in the upper extremities during surgeries when compared to the use of lidocaine alone.
Collapse
Affiliation(s)
- Mohammad Haghighi
- Anesthesiology Research Centre, Guilan University of Medical Sciences, Rasht, Iran
| | - Mehran Soleymanha
- Orthopedic Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Abbas Sedighinejad
- Anesthesiology Research Centre, Guilan University of Medical Sciences, Rasht, Iran
| | - Ahmadreza Mirbolook
- Orthopedic Research Center, Guilan University of Medical Sciences, Rasht, Iran
- Corresponding author: Ahmadreza Mirbolook, Orthopedic Research Center, Guilan University of Medical Sciences, Rasht, Iran. Tel: +98-1313223970, +98-1313228842, E-mail:
| | - Bahram Naderi Nabi
- Anesthesiology Research Centre, Guilan University of Medical Sciences, Rasht, Iran
| | - Mehdi Rahmati
- Anesthesiology Department, Intensive Care Unit Ward , Erfan Private Hospital, Rasht, Iran
| | - Nasim Ashoori Saheli
- Anesthesiology Research Centre, Guilan University of Medical Sciences, Rasht, Iran
| |
Collapse
|
12
|
Soleymanha M, Mobayen M, Asadi K, Adeli A, Haghparast-Ghadim-Limudahi Z. Survey of 2582 cases of acute orthopedic trauma. Trauma Mon 2014; 19:e16215. [PMID: 25717444 PMCID: PMC4310155 DOI: 10.5812/traumamon.16215] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [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: 11/16/2013] [Revised: 11/21/2013] [Accepted: 01/22/2014] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Orthopedic injuries are among the most common causes of mortality, morbidity, hospitalization, and economic burden in societies. OBJECTIVES In this research, we study the prevalence of different types of trauma requiring orthopedic surgery. PATIENTS AND METHODS We conducted a cross-sectional study on 2582 patients with acute orthopedic injuries admitted to the orthopedic emergency ward at the Poursina Hospital (a referral center in Guilan province (northern Iran), during December 2010 through September 2011. Patients were examined and the data collection form was filled for each patient. Data were analyzed by SPSS software version 19 and were listed in tables. RESULTS Of 2582 included cases, 1940 were male and 642 were female, with a mean age of 34.5 years. Most injuries were seen in the 25 to 44 year age group from rural areas. The highest frequency of trauma related to falls. On the other hand, bicycling and shooting had the lowest frequencies. There were 18 cases with limb amputation. Overall, 66.5% of patients had fractures, 5% had soft tissue lacerations, and 10% had dislocations. CONCLUSIONS Identification of risk factors and methods of prevention is one of the most important duties of healthcare systems. Devising plans to minimize these risk factors and familiarizing people with them is prudent.
Collapse
Affiliation(s)
- Mehran Soleymanha
- Department of Orthopedics, Guilan University of Medical Sciences, Rasht, IR Iran
| | - Mohammadreza Mobayen
- Department of Surgery and Burn, Guilan University of Medical Sciences, Rasht, IR Iran
- Corresponding author: Mohammadreza Mobayen, Department of Surgery and Burn, Guilan University of Medical Sciences, Velayat Hospital, Parastar St., Rasht, IR Iran. Tel.: +98-9125139506, Fax: +98-1313210506, E-mail:
| | - Kamran Asadi
- Department of Orthopedics, Guilan University of Medical Sciences, Rasht, IR Iran
| | - Alborz Adeli
- Department of Orthopedics, Poursina Hospital, Guilan University of Medical Sciences, Rasht, IR Iran
| | | |
Collapse
|