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.
ABSTRACT
The purpose of the research is to identify the role of drinking water quality in achieving customer satisfaction in one of the formations of the Ministry of Construction, Housing and Public Municipalities (Diwaniyah Water Directorate), as they are important service organizations that have a fundamental role in serving the community. Faced many administrative challenges, as a result of the continuous and accelerating environmental changes, environmental pollution and immaturity of social awareness and social responsibility, as these contributed to and affected the quality of drinking water, Therefore, it is necessary to know the role of quality, specifically "drinking water and its effect o
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In order to have an idea about what happens in Iraqi food establishments in relation to implement quality management system ISO 9001, this study was performed to show the actual situation of Iraqi food establishments concerning quality management system (ISO 9001:2015), reasons of implementing, factors that hinder implementing and problems faced high administration for getting establishments certification ISO 9001:2015. The study demonstrated from the questionnaire some difficulties to implement ISO 9001 for both of establishments that implemented the quality system or which in implementing of this international standard. The most important problems during implementing were business culture and costs and the most important proble
... Show MoreThe research deals with the problems of improvisation in two basic subjects and applied a samples and conclusion. The first topic focuses on the concept of improvisation and spontaneity and clarifies the confusion between them. The second topic deals with the foundations and principles on which the actor is based in his artistic preparation for the purpose of developing his improvisational abilities.
The research focuses on clarifying the dimensions of improvisational techniques and its multiplicity in the modern theater. It analyzes the method of improvisation and its use in the construction and composition of the theatrical performance. It deals with two important experiments, such as the experience of the Russian directo
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In this study, gamma-ray spectrometry with an HPGe detector was used to measure the specific activity concentrations of 226Ra, 232Th, and 40K in soil samples collected from IT1 oil reservoirs in Kirkuk city, northeast Iraq. The “spectral line Gp” gamma analysis software package was used to analyze the spectral data. 226Ra specific activity varies from 9 0.34 Bq.kg-1 to 17 0.47 Bq.kg-1. 232Th specific activity varies from 6.2 0.08 Bq.kg-1 to 18 0.2 Bq.kg-1. 40K specific activity varies from 25 0.19 Bq.kg-1 to 118 0.41 Bq.kg-1. The radiological hazard due to the radiation emitted from natural r
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The study aimed to explore the school principals’ servant leadership practices for primary teachers’ perspectives in the Sultanate of Oman, furthermore to investigate the differences in those practices attributable to variables (gender, qualification, educational stage, years of experience, governorate). The study relied on the descriptive approach, by employing the survey research design using the questionnaire as a main tool for data collection, which included five dimensions of servant leadership (altruism, humility, enhancing teacher development, emotional healing, commitment to community development), Data collected from (1094) teachers in basic education schools, and they were chosen randomly. The results of the study indicated
... Show MoreThe purpose of the study is to investigate the effect of the constructivist model of yager in acquiring the geographical concepts among first intermediate students in geography. The study was carried on based on the null hypothesis, which states, there is no significant difference at the level of (0.05) between the experimental group that follows yager model in learning the principles of geography, and the control group that studies the same subject considering the traditional methods of learning, the. To do so, a sample of (70) first-intermediate student were chosen purposefully from two random class for the academic year (2016-2017) divided into two groups. The selected schools located at Al-rusafa side in the city of Baghdad, as well
... Show MoreThe study focuses on Kamez model and the Claus Meyer model of instructional design, which are models that provide the learner with educational experiences to suit the logical information of the learner and the variety of instructional models. Research Objective: The present research aims to identify Limitations of the study. The current research is determined by ((fourth grade preparatory students, the book of the date of the fourth preparatory course)) Chapter II includes Arabic and foreign studies on the model of Kemp and Claus Mayer in the acquisition of concepts and direction towards the material. Chapter III Experimental Design: The researcher adopted an experimental design with two experimental groups and a control group. The resea
... Show Moreبسبب محدودية الموارد الطبيعية، فأن سكان الخليج ومنذ القدم وجهوا جلّ نشاطاتهم توجهاً بحرياً: صيد الاسماك وصناعة اللؤلؤ العنصر الرئيس في حجم التشغيل، وتكوين الفائض الاقتصادي في المنطقة آنذاك.
لقد تزايدت أهمية هذا النشاط بخاصة بعد النصف الثاني من القرن التاسع عشر، لرواج تجارة اللؤلؤ عالمياً، وأنفتاح الخليج على الدول الاوروبية التي شهدت نهضة صناعية متسارعة، وحيث وصلت الخليج العديد من بضائع
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The present study aims at knowing the effect of instrumental enrichment in the acquisition of geographical concepts for first grade student in intermediate school. The study is restricted in the students of first grade student in intermediate school\ The EducationalDirectorate of Rusafa for academic (2013/2014),for the purpose of achieving the objective, the following hypotheses:
There is no statistical significant different at the level of (0.5) between the scores of the experimental group who study geography according to the instrumental enrichment and the scores of the control group who learned geographical according to the traditional methods.
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