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
It is clear to everyone how important it is to implement transactions electronically, as it facilitates the provision of services to beneficiaries, whether individuals or institutions, to achieve many benefits that are not exclusive to the beneficiary or the applicant, but extends to the governmental and international bodies. And the number of users has reached millions since its emergence in 1995, because the concepts of electronic transactions have great advantages for the economy in general and the banking sector in particular, so cooperation in various fields with the aim of becoming an information society has become paramount, It allows customers to pay money to any company they want t
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The current research aims to identify the effect of the program to develop the skill of friendship among kindergarten children, as well as the scope of the impact of the program on the sample. To achieve the objectives of the research, the researcher hypothesizes there is no significant difference between the average scores of the sample members on the friendship skill scale for the dimensional scale according to the experimental and control group. The research sample consisted of (60) girl and boy with age ranges (4-6) who were randomly selected from the Kindergarten Unity at Baghdad city/ Rusafa 1. The children were distributed into an experimental and control group, each group consists of (30) girl and boy. The two groups were chosen
... Show MoreThis study aims at identifying the reality of alternative assessment for teachers of the first cycle of the basic education in the Sultanate of Oman with respect to the degree of teachers' use of alternative assessment strategies, level of self-efficacy for alternative assessment strategies, and attitude towards alternative assessment, and their relationship with other variables. To achieve the aims of the study, a descriptive research approach was utilized. A 5-point self-rated questionnaire was developed. It consists of three sections: Actual use of alternative assessment strategies (21 items), self-efficacy for alternative assessment strategies (21 items), and attitude towards alternative assessment (27 items). The psychometric proper
... Show MoreThis study was carried out to determine the heavy metal accumulation of Juncus rigidus Desfontaines, 1798 from three different regions of the Basrah Province in Southern of Iraq. Specifically, the concentrations of lead, nickel, and cadmium were determined in the roots, culms and leaves of the plant. The results indicated that the highest accumulation of the heavy metal was recorded in lead (Pb) 12.50± 3.58 mg kg-1and then in nickel (< 0.30). The lowest value was recorded for cadmium (< 0.05). As well, lead concentrations in J. rigidus varied in different locations and parts of the plant from undetectable in control to 12.66, 19.33, and 9.80 mg kg-1 in leaves, culm, and roots respective
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The research aims at evaluating the illustrations images and determining the availability of good image standards in the illustrations images of the content of the second intermediate stage computer's book for the academic year (2019-2020) as seen by computer teachers. The sample was randomly selected, (30) teachers who are actually teaching the subject in schools within the geographical area of the province of Baghdad (Karkh III). To achieve this goal, ten standards were identified: scientific accuracy, suitability for the level of students, image clarity, image freshness, quality of coloring, suitability of its location of the subject, Matching their content glimpsed, The subject matter is appropriate in terms of area, matching its tit
... Show MoreWhereas conventional methods of teaching history do not meet the sometimes purpose has suggested some educators strategies modern help to improve the level of students in the education process through activating prior knowledge and employed in positions of current learning, and focus attention on the points and the outstanding elements of the content and practice techniques Calendar criticof ideas and meanings and mental and linguistic activities used to verify the extent of reaching understanding. &n
... Show MoreThe research aims to identify the role of the dimensions of financial inclusion in achieving the competitive advantage by An exploratory research of the views of a sample of customers of the 20 Algerian commercial banks, And the relationship between its dimensions (Access dimension, Usage dimension, Quality) And competitive advantage. This research is based on the analytical descriptive approach. The questionnaire was adopted as a main tool in collecting data and information on the sample of 377.
The The research showed several results, the most important of which is a strong correlation between the dimensions of the three financial inclusion combined and the competitive advantage of the Algerian commercial banks, and explained t
... Show MoreThe current research aims to investigate the effect of a specimen of Daniel in the acquisition of concepts for the Arabic language curricula material to the students of the third phase of the Faculty of Basic Education Department of Arabic Language. The sample consists of (93) applications and a student of (47) students in the Division (A), which represents the experimental group which studied the use of a specimen of Daniel, and (46) students in the Division (B), which represents the control group, which studied the traditional way. The subject of unified two groups, which subjects the Arabic language curricula which includes six chapters.
The duration of the experiment is a full semester. The researchers also prepared a tool for mea
The auditor has a role in allocating joint costs in the gas industry, and the auditor's procedures are considered as systematic critical examination, analysis and evaluation of everything related to costs in general and joint costs in the gas industry in particular, with the aim of controlling the joint costs of gas industry products, and knowing the share of the cost of each product from the total industry costs Gas products reflect the reality of the company's performance by discovering weaknesses, defects and any errors, to ensure increased effectiveness and efficiency of the parties concerned with auditing them and imposing control and control over the company's resources, as well as
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