A vascular necrosis (AVN) is defined as cellular death of bone components due to interruption of the blood supply; the bone structures then collapse, resulting in bone destruction, pain, and loss of joint function. AVN is associated with numerous conditions and usually involves the epiphysis of long bones, such as the femoral head. In clinical practice, AVN is most commonly encountered in the hip. Early diagnosis and appropriate intervention can delay the need for joint replacement. However, most patients present late in the disease course. Without treatment, the process is almost always progressive, leading to joint destruction within 5 years. Treatment of a vascular necrosis depends mainly on early diagnosis which mainly based on clinical findings, x-ray finding & MRI.A variety of non-vascularized bone grafting techniques have been proposed with varying degrees of success as treatment alternatives for osteonecrosis of the femoral head. The success of these procedures may be enhanced using ancillary growth and differentiation factors. Patients & Methods: We retrospectively reviewed 37 patients (44 hips) with osteonecrosis of the femoral head between May 2007, and March 2011, divided into two groups. Group A include 17 patients (22 hips) with osteonecrosis of the femoral head who had non vascularized bone grafting procedures done for them. Minimum follow-up was 12 months. We compared the outcomes in this cohort to similar hip number (22 hips) in 20 patients treated with core decompression only (group B). We used Phemister technique to make a window at the posterior aspect of greater trochanter to remove necrotic bone and packed the excavated area with autogenous cancellous bone graft taken from ipsilateral iliac crest or leave it without bone graft (decompression only). Results: We report the result of treatment for femoral head avascular necrosis depending on Ficat classification stage I, II, & III. The minimum follow up was 12 months (12m-36m).The success percentage of hips in our cohort of patients with non-vascularized bone grafting group A are 86% (19 of 22 hips), which is higher than group B 63% (14 of 22 hips) with core decompression alone. Conclusion: These procedures (core decompression and autogenous cancellous bone graft) effectively reduce donor site morbidity and may defer joint arthroplasty in selected patients & it is more effective than core decompression alone in treating early stages of femoral head osteonecrosis.
Background: Avascular necrosis (AVN) is defined as cellular death of bone components due to interruption of the blood supply; the bone structures then collapse, resulting in bone destruction, pain, and loss of joint function. AVN is associated with numerous conditions and usually involves the epiphysis of long bones, such as the femoral head. In clinical practice, AVN is most commonly encountered in the hip. Early diagnosis and appropriate intervention can delay the need for joint replacement. However, most patients present late in the disease course. Without treatment, the process is almost always progressive, leading to joint destruction within 5 years.Treatment of a vascular necrosis depends mainly on early diagnosis which mainly base
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Core decompression is one of the commonest used techniques in the handling of osteonecrosis of the pre-collapsed head of the femur. Core decompression had succeeded in preserving the hip joint and delaying the requisite for total hip replacement, but it had failed in the induction of osteogenesis in the necrotic area, thus augmenting core decompression with biological agents to induce osteogenic activity. To assess the effects of platelet-rich plasma in non-traumatic avascular necrosis of the hip joint (early stage) after core decompression. Interventional comparative study for twenty-four patients (32 hip joints) with AVN of the head of the femur was involved in this prospective study, and they were separated into two groups of 16
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Avascular necrosis have always presented great challenges to orthopedic surgeons and patients, remain in many ways today the unsolved dilemma. Varieties of non-vascularized bone grafting techniques preceded by core decompression have been proposed with varying degrees of success. O bb j ee cc t i vv ee ss : The aim of this study is to review the the value of core decompression and non-vascularized tibial bone strip graft treatment for early stages of non-traumatic osteonecrosis stage II & III according to stein burg staging . M ee t hh oo dd ss : prospectively reviewed 26 patients (32 hips) with osteonecrosis of the femoral head between June 2006 and December 2013 at Imam Ali hospital in Sader city & Al-Wasity teaching hosp
... Show MoreObjective: to evaluate the results of (Modification of Russe method) in treatment of nonunion fracture scaphoid bone by bone graft with external splintage (plaster of paris cast (pop ). Methods:Prospective study done on 26 patients (24 male, 2 female), age range between 25-42 years (mean age 34 years), fracture site at middle 1/3 with minimal displacements with no carpal bone or radial bone injury, technique of Matte- Russe method (explore the bone through volar approach using bone graft from iliac crest (cortico-cancellous peg plus cancellus bone) with thumb spica for 90 days with period of follow up 12-18 months. Results: out of 26 patients treated by this method , 23 patients (88.5%) union was achieved radiologically by the end of 3rd mo
... Show MoreObjective: to evaluate the results of (Modification of Russe method) in treatment of nonunion fracture scaphoid bone by bone graft with external splintage (plaster of paris cast (pop ).
Methods:Prospective study done on 26 patients (24 male, 2 female), age range between 25-42 years (mean age 34 years), fracture site at middle 1/3 with minimal displacements with no carpal bone or radial bone injury, technique of Matte- Russe method (explore the bone through volar approach using bone graft from iliac crest (cortico-cancellous peg plus cancellus bone) with thumb spica for 90 days with period of follow up 12-18 months.
Results: out of 26 patients treated by this method , 23 patients (88.5%) union was achieved radiologically by the end
Background: spontaneous subarachnoid hemorrhage (SAH) is subtype of hemorrhagic stroke with extremely poor prognosis. It’s a medical emergency and can lead to death or severe disability even when recognized and treated at an early stage. Computed tomographic angiography (CTA) is frequently become the initial step in detecting intracranial aneurysms and planning therapeutic interventions.
Objectives: to analyze the findings of non traumatic SAH in cerebral CTA and characterization of the underlying causes, emphasizing the importance of CTA as a new advent investigation in Iraq.
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J Fac Med Baghdad 2014; Vol.56, No .2 |
BACKGROUND: The humeral shaft fractures have a good rate of union, despite this fact, still there is a significant rate of nonunion after nonoperative treatment and more often after operative treatment. AIM: The aim of the study is to evaluate the autogenous onlay graft with compression plate for treatment of persistent humeral shaft non-union with failed previous surgery both radiological and functional outcome. MATERIALS AND METHODS: A prospective study on twenty patients having persistent aseptic non-union age between 20 and 60 years old, after failed surgical treatment of fractures humeral shaft in Al-Zahra teaching and Al-Kindy teaching hospitals, while infected nonunion, diabetes mellitus, secondary metastasis, smoking, a
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Background : The aim of this work is to study the clinical features and causative fungi of tinea pedis in diabetic and non-diabetic patients. Result : Tinea pedis was estimated to be the second most common skin disease in the United States, after acne. Up to 15% of the U.S., population may have tinea pedis. Across Europe and East Asia, prevalence rates reach 20 %. Methods: The Complete history taking regarding: age, sex, occupation, residency, history of diabetes and diabetic profile (fasting blood sugar and post prandial).and Clinical examination of the feet Aim of the study : The aim of this work was to study the clinical features and causative fungi of tinea pedis in diabetic and non-diabetic patients Conclusion : Tinea pedis is more
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Background: Abdominal symptoms are possibly the most frequent of all symptoms encountered in surgical practice. Pain is the most common of all abdominal symptoms. Causes of acute abdominal pain include both medical and surgical. Most symptoms arise from intra-abdominal organs or systems while some may originate extra abdominally and are then referred to the abdomen. Medical causes of abdominal pain are encountered more frequently.
Objective: To study the causes of acute abdominal pain in patients attending emergency department in Al- Imamain Al- Kadhimain Medical City.
Type of the study: A prospective cross sectional study
Meth
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Background: Techniques of Inguinal hernia repair have seen an evolution from the pure tissue repair to the prosthetic repair and in the recent years past to laparoscopic repair. High recurrence rates using fascia for the hernia repair or the use of sutures under tension prompted the development of polypropylene mesh to reinforce the posterior wall of the inguinal canal.The aim of this study is to compare the post operative results of Lichtenstein mesh technique with Dar ning repair.<br />Patients and methods:-A prospective study of "100" patients with inguinal hernia were conducted to evaluate two methods, of open repair of inguinal hernia Lichtenstein mesh technique with Traditional non-mesh technique (modified Bassini or Darning)
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