Objective: To compare the radiological and functional outcomes of patients of Comminuted intraarticular distal radius fractures treated with or without bone marrow injection along with external fixator ligamentotaxis. Methodology: This prospective comparative study on 41 patients with comminuted intra-articular lower end radius fractures distributed patients randomly into two groups depending on whether an aspirate of bone marrow was injected at the fracture site two weeks after fracture management with external fixation ligamentotaxis. Results: The mean age was 35.8 years, with male predominance. The radiological parameters (radial height, radial inclination, and volar tilt) at the 6th month follow up were lower in the group who did not re

BACKGROUND: Keratoconus is a progressive non inflammatory bilateral (usually asymmetric) ectatic corneal disease characterized by paraxial stromal thinning ,weakening that lead to corneal surface distortion ,vision loss primarily from irregular astigmatism and myopia and secondly from corneal scar. OBJECTIVE: To evaluate visual and refractive outcomes after intracorneal continuous ring (ICCR) implantation combined with intrapocket corneal collagen cross linking in patient with keratoconus. Setting: Eye Specialty Private Hospital, Baghdad, Iraq. METHODS: This study assessed the results of implantation of Myoring ICCR combined with CXL in 40 eyes with KC. Outcome measures include UDVA,CDVA(spectacle correction),refraction, complications and s

BACKGROUND: Clavicle fractures are common injuries in young active individuals, the mid third of the clavicle is most commonly fractured part(80% of clavicle fracture) OBJECTIVE: To compare the outcomes of operative and non operative management of displaced and or comminuted closed fracture of the mid third of clavicle in young adults PATIENTS AND METHODS: This prospective observational study of 24 patients of fracture of the mid third of the clavicle was conducted in Alkindy teaching hospital from July 2015 to January 2017 and divided into two groups; one managed by operative treatment with plate and screws and the other by non operative sling immobilization after taking the consent and the patients were seen at 2, 4, 6 weeks,3, 6, and 9 m

Background : Xanthomatosis is a disease in which large tendon tumors can occur, especially in the Achilles tendon. This disease is a rare interesting orthopaedic condition. Case Report:A case of a twenty eight year old girl patient with giant bilateral Achilles tendon xanthomas in which both tumors were resected. There was no ulceration on the both sides. The patient was treated by total resection of the lesion and reconstruction using tendon transfer of the Peroneus brevis and Flexor hallusis longus. Postoperative treatment consisted of six weeks lower leg cast immobilization followed by partial weight bearing. After 4 months the patient was able to walk pain free without any difficulties. It has been suggested that total resection with au

Clavicle fractures are common injuries in young, active individuals. The majority of the fractures (80% to 85%) occur in the mid-shaft of the bone and account for approximately 2.6% of all fractures. For many years the standard treatment of fracture clavicle was the "figure-of-eight" bandage but several indications for operative fixation, the position of plate fixation for clavicle fracture remains controversial. The aim of this study is to compare between anterio—inferior and anterior-superior plating of mid-shaft displaced clavicle fracture in complications, plate prominence, nonunion, malunion and range of motion. This study is a prospective study conducted in Al-Kindy teaching hospital .A total of 30 patients with fracture mid –sh

Background: Plantar heel pain is a clinical syndrome characterized by pain and tenderness beneath the heel which is typically worse in the morning and improves after the first few steps in the day. It is a common and frequently disabling clinical complaint that may be caused by a broad spectrum of osseous or soft tissue disorders. Objective: To evaluate the effectiveness of an operation of multiple drilling of calcaneum for resistant plantar heel pain syndrome. Methods: During the period from November 2012 to August 2016, 17 patients (17heels) were enrolled in a cohort clinical study at the orthopedic unit in AL-Sheikh Zayed and AlWassity Hospitals. Result: Drilling of the calcaneum is a simple procedure achieving 70.6% cure in resistant as

Traumatic radial nerve injury in humeral shaft fracture is the most common traumatic nerve injury in long-bone fracture, with overall prevalence 2-18%, ranging from traction to complete transection. Spontaneous recovery may reach 88%. The aim of the study is to assess the sensitivity & specificity of the ultrasound to detect the radial nerve injury and to see if this can be used as a diagnostic test. This is a prospective study on 17 adult patients with a closed fracture of the humeral shaft, dividing into two groups, the first group of 7 patients had signs and symptoms of radial nerve palsy at presentation and the second group of 10 patients had intact radial nerve function was considered as a control group. All these patients had at leas

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

Background : Shoulder pain is a common problem that can pose difficult diagnostic and therapeutic challenges for the family physician It is the third most common musculoskeletal complaint in the general population, and account for 5% of all general practitioners musculoskeletal consults Objective: To determine the diagnostic performance of ultrasonography compared with the physical examination for detection of rotator cuff tears in painful shoulder syndrome. Method: Prospective study was done on seventy patients (48 male, 22 female), age ranged between 30-70 years (mean age 50 years), From February 2007 to July 2011, were subjected to comparative study in Al-Kindy teaching hospital with rotator cuff tears, including physical and ultrasonogr

Background : Shoulder pain is a common problem that can pose difficult diagnostic and therapeutic challenges for the family physician It is the third most common musculoskeletal complaint in the general population, and account for 5% of all general practitioners musculoskeletal consults Objective: To determine the diagnostic performance of ultrasonography compared with the physical examination for detection of rotator cuff tears in painful shoulder syndrome. Method: Prospective study was done on seventy patients (48 male, 22 female), age ranged between 30-70 years (mean age 50 years), From February 2007 to July 2011, were subjected to comparative study in Al-Kindy teaching hospital with rotator cuff tears, including physical and ultrasonogr

Background : Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy of upper extremities and Open carpal tunnel release is the most frequent surgical procedure and the gold standard for cases that do not respond to conservative treatment. Aims :This study is used to evaluate the functional outcome of limited palmar mini-incision of carpal tunnel release. This study aims to determine the safety and symptomatic and functional efficacy of median nerve decompression with limited incision in carpal tunnel syndrome surgery. Patients and methods:Carpal tunnel release with a 1.5-2 cm limited palmar incision was performed on 20 patients. Patients were evaluated initially at one month after treatment according to symptom severity

Background:Fractures of patella constitute 1% of all fractures. Various techniques have been described for internal fixation of patella fractures. Superiority of one technique over the other has long been debated. Objective:We reviewed a series of seventy patients with transverse or comminuted fractures of patella treated with cerclage and tension band wiring technique to assess if it had any advantages over k. wires and tension band wiring technique. Type of the study:Retrospective study.Methods; Seventy patients with displaced patella fracture, with a mean age of 47 years (range 13-75) were divided into two groups :group A 36 patients were treated with cerclageand tensi

Background: Cartilage forms most of the temporary skeleton of the embryo and provides a model in which most bones develop Objective: Using laser therapy to enhance autologous cartilage grafts expansibility and to analyze whether this "enhancement" results in reduced rates of cartilage resorption and greater preservation of normal architectural features compared with "unenhanced" grafts. Type of the study: Cross sectional study. Methods: 24 New Zealand rabbits were divided into two groups (control and treated with 904nm, 10mW diode laser). Auricular cartilage segments measuring 1 cm2 were harvested from both ears of each rabbit, and were implanted in to the subcutaneous region of the left flank. 3 rabbits from each group were anaesthetized a

Background: Carpal tunnel syndrome is the most common entrapment neuropathy in humans today. For patients in whom conservative treatment fails, surgical decompression is indicated. Various surgical techniques are becoming increasingly popular. Due to the rapid postoperative recovery shown after endoscopic operations, proximal palmar mini-incision for carpal tunnel release is a comparative alternative. Methods: Ninety four patients [113 hands] with a carpal tunnel syndrome underwent carpal tunnel release through a 1-cm longitudinal incision made just over the distal flexor crease. The self- administered Boston Questionnaire was used to assess the severity of patients’ symptoms and their functional status, both before and after the surgical

Background: A review of articles of method in treating compound phalangeal fractures by using mini-external fixator, elaborating the anatomy, mechanics, modalities of treatment, and complications of these types of fractures. Also, it compares between different studies regarding the functional results and final outcome. External fixation of phalangeal fractures is a good method for osteo synthesis in certain situations. The simplicity of the surgical procedure and the minimal disruption of the normal bone architecture also make it appealing. Objectives: Evaluating the functional results of the use of mini-external fixator for the treatment of compound fractures of phalangeal bones of the hand. Method: Our study consists of 15 patients, 12 we

Background: Osteoid osteoma(OO) is a relatively common benign skeletal neoplasm of unknown etiology that is composed of osteoid and woven bone, usually seen in adolescent and young males Although, the clinical, radiological and scintigraphic features of OO have been well described, these features may be misleading or altered in the cases of lesser trochanter of the femur which is relatively uncommon location for OO with a few number of cases reported up to date. Case Presentation: We report a case of a 20-year-old man who presented with painful limpThe pain had begun six months earlier and was made worse by walking and by exercise., with normal initial X-rays .The diagnosis was made after six months when typical Computed tomography, magneti

Introduction: An aneurysmal bone cyst are enigmatic lesion of unknown cause and presentation and are difficult to distinguish from other lesions, it is a benign, but expansible tumor like lesion that generally occurs in the long bones. An aneurysmal bone cyst arising from the flat bone like clavicle is rare . Case presentation: We report a 12-year-old girl child with an aneurysmal bone cyst of the lateral third of left clavicle treated with enblock resection. The pathologic findings confirmed the diagnosis of aneurysmal bone cyst. The patient has been followed up for one year with no evidence of recurrence . Conclusion: En bloc resection can be curative and provide good results for this rare type of clavicle tumour.

Background: Prolapsed intervertebral disc is an important and common cause of low backache. MRI has now become universally accepted investigation for prolapsed intervertebral disc. We, however, regularly come across situations, when MRI shows diffuse disc bulges, even at multiple levels, which cannot be correlated clinically and when such cases are operated, no significant disc prolapse is found resulting in negative exploration. Objective: To evaluate the role of M.R.I. finding not only for diagnosis of disc herniation at lumbar region but also for localization the level of herniation Methods: A prospective study on seventy five symptomatic low backache and MRI confirmed prolapsed intervertebral disc patients at lumbo-sacral region were op

Background: Fractures of the humeral shaft accounting for approximately 3% of all fractures. There is a wide array of good options for their treatment and controversy over the best methods. Although good techniques of osteosynthesis are available, the aim of this article is toemphasize on the benefit and good outcome of conservative treatment for properly selected cases to decrease the cost and avoid the complications of surgery. Method : During the period from February 2011 to June 2012 fifty-five fractures of humeral shaft were treated at orthopedicdepartment in the ALKindyteaching hospital. 22 fractures considered suitable for the study. The patients treatedconservatively by using the‘U’ shaped coaptation slab. Then we shift to POP c

Backgr ound: The transfer of the tibialis posterior tendon to the anterior aspect of the ankle not only replaces the function of the paralyzed muscles, but also removes the deforming force on the medial aspect of the foot. Objecti ves: In this study, we evaluated patients who underwent tibialis posterior tendon transfer for the treatment of foot drop, and comparison through interosseous membrane route versus anterior to lower tibia route of tibialis posterior tendon transfer, with evaluation of the results according to carayon criteria Methods: Nine patients with foot drop secondary to different causes treated with tibialis posterior tendon transfer from January 2011 to January 2012 were followed up for a mean of 12 months in Al Kindy Teach

Objective: To evaluate the functional outcomes after extended curettage and reconstruction using a combination of bone graft and bone cement (sandwich). Methodology: In this prospective case series 16 skeletally mature patients with primary giant cell tumor around the knee were included. Patients with previous surgically treated, malignant transformation, degenerative knee changes and those presenting with pathological fracture were excluded. The tumor was excised with bone graft filling space beneath the articular cartilage and a block of gel foam was placed over the cortical surface of picked bone graft. Remaining cavity was filled with polymethylmethacrylate cement (sandwich) with or without internal fixation. The func tional evaluation

Objective: To evaluate the functional outcome of percutaneous cross two K wires fixation for Gartland types II and III fractures of humerus. Methodology: This prospective study included80 patients with supracondylar humeral fracture, who underwent closed reduction and fixation by two crossed Kirschner wires. We included children with age < 15 years with closed fractures with Gartland types II and III, while the patient with vascular injury, open, irreducible fractures were excluded. The patients were following up for 6 months and assessed functionally by Flynn’s criteria. Results: The mean age of patients was 8.1 years. Trauma while child playing was the main mechanism of injury in 43 (59.8%) children and 46 (57.5%) fractures were of the

Background: Currently there are four general approaches to correct refractive errors: refractive corneal surgery, crystalline lens surgery and implantation of an intraocular lens in anterior or posterior chamber. Aim: To evaluate the predictability, safety and stability of toric phakic implantable collamer lens implantation to correct moderate to high myopic astigmatism. Methods: Sixty eyes of 40 patients underwent implantation of a toric implantable collamer lens (V4c design) in the Eye Specialty Private Hospital, Baghdad, Iraq were studied. The mean spherical refraction was -11.32±3.17 diopter (D) with a range of -6.00 to -18.00 D and a mean cylinder of -2.61±1.16 with range of -1.00 to -5.50 D. The outcome measures that evaluat

Objective: To compare distal tibia nonunion plating and grafting with and without platelet-rich plasma (PRP) regarding union rate, union time and complications Conclusion: Combining PRP with autologous bone graft results in a higher union rate, less healing duration, less post-operative pain, and more callus formation. (Rawal Med J 202;45:629- 632). Methodology: In this prospective comparative study, 32 patients with nonunion tibia from July 2017 January 2019 were divided into two groups: group A (16 cases) were treated by plating and grafting with PRP and group B (16 cases) were treated by plating and grafting only. Keywords: Tibial nonunion, bone graft, plateletrich plasma. Results: There was higher union rate in group A related to group