bluuebunny/crossref_metadata_2025_split huggingface dataset:
Eight Plate & Single Screw for Temporary Epiphysiodesis for Genu Varum and Genu Valgum Systematic Review and Meta-Analysis
Authors: Ragheb David G , Fayyad Tamer A , Nageeb Ahmed M 
Published: November 2024

Abstract
Angular deformities of lower limbs are a common finding in children. Although most of these correspond to physiological conditions that resolve spontaneously without intervention, some deformities persist through preadolescence and will not correct spontaneously. This review providing the best evidence for correction of genu varum and genu valgum by hemiepiphysiodesis. The literature extraction process yielded 38 articles for inclusion in this review.
Purpose: Aim of this review to compare, through the available literature and comparing between 8 plate & single screw for temporary epiphysiodesis for genu varum and genu valgum. Various techniques for epiphysiodesis involving screws, staples and wires have been trialled and described. However, good success rates, complications such as material fractures and implant loosening as well as damage to growth plates have frequently been reported.
Outcomes of Figure of Eight Graft Reconstruction of Anterior Sternoclavicular Joint Dislocation: A Systematic Review and Meta-Analysis
Authors: Abdullah Islam Abdullah Ahmed , Atiyya Ahmed Naeem , Ghazaly Sherif Ahmed El 
Published: November 2024

Abstract

Background
A sternoclavicular (SC) joint dislocation is a rare injury, accounting for 1% of all traumatic joint dislocations. Dislocation of the SCJ is a rare injury and typically requires high- energy forces applied directly or indirectly to the joint. Although anterior sternoclavicular dislocations are more common because of the strength of the posterior joint capsule, posterior sternoclavicular dislocations tend to be more morbid because of the risk of tracheal, esophageal, or neurovascular compression. Even after appropriate treatment of the initial dislocation, patients can occasionally have persistent SCJ instability that may present as pain and scapular dyskinesia.

Objective
To perform a systematic review on results of reconstruction of anterior sternoclavicular joint dislocation via figure of eight graft, aiming at highlighting clinical and functional outcomes of this technique.

Patients and Methods
This is a systematic review study and meta-analysis on human subjects studied in different literatures collected from different medical websites up to December 2022 that dealing with the reconstruction of anterior sternoclavicular joint dislocation via figure of eight graft, aiming at highlighting clinical and functional outcomes of this technique. The study was performed in the Orthopedic Surgery Department, Faculty of Medicine, Ain Shams University along the period from August 2022 to January 2023.

Results
The meta-analysis for postoperative complications showed non-significant difference (P = 0.068). This indicated that this technique had low risk of complications. Forest plot and pooling of data using random-effects method (REM) with 95% CI found minor heterogeneity (I2 = 38.4%) non- significant difference (p &gt; 0.05) in complications of this operative technique. The funnel plot for postoperative complications found no evidence of publication bias with symmetrical funnel plot. Rank correlation test and regression analysis for funnel plot asymmetry was insignificant (r = 0.0852, p = 0.068) for postoperative complication of anterior sternoclavicular joint dislocation operated by 8-shaped autologous graft.

Data Sources
Medline databases (PubMed, Medscape, ScienceDirect. EMF-Portal) and all materials available in the Internet till 2020.

Conclusion
SC joint reconstruction, using a gracilis graft, results in a prolonged improvement in shoulder function in most patients with symptomatic chronic anterior SC instability. The technique aims at reducing the risk of serious vascular and functional complications, but extreme care is still needed during the procedure.
Functional Outcomes after Total Hip Arthroplasty versus Hemiarthroplasty for the Treatment of Displaced Femoral Neck Fracture in Active Elderly Patients
Authors: Ramzy Awad Kirollos Hany , Zaher El Zaher Hassan El , Nagy Amr Mohammed 
Published: November 2024

Abstract

Background
Fracture neck of femur has always been a great challenge to orthopedic surgeons, the aim of the management is early ambulation and good functional outcome also avoiding complications and reoperation as the elderly patients often have several comorbidities.

Aim of the Work
To analyse Functional hip outcome as the primary end-point, after a displaced fracture of the femoral neck in a relatively healthy, active elderly patient who receive either a bipolar hemiarthroplasty or a Total Hip Arthroplasty.

Patients and Methods
Retrospective Cohort study was conducted at Ain Shams university hospitals recruiting 20 active patients aged from 60 to 80 years old with fracture neck of femur starting from January 2021 till January 2022. We excluded patients with grade 3 hip osteoarthritis (Tonnis classification), acetabular dysplasia and with previous ipsilateral hip surgeries. Patients were in 2 groups each 10 patients one for THA and the other for BHA. The follow up period was 1 year.

Results
In this study, we found that the duration of surgery, blood loss, and amount of blood transfusion were considerably less in the BHA group. These findings corroborate with the results of multiple studies and reviews on the topic conducted in the past both in the western and Indian populations. In elderly patients, the treatment outcome is significantly affected by the duration of surgery and the amount of blood loss.

Conclusion
For the healthy elderly with displaced FNFs. None of these treatment options (THA, BHA) appeared to be superior with respect to mHHs as indicator to Functional outcomes. BHA led to better outcomes regarding dislocation rate, while THA was more favorable regarding reoperation rate.
Open versus Percutaneous Repair of Acute Achilles Tendon Rupture A Systematic Review
Authors: Ahmed Mahmoud Gamal , Saeed Diab Hossam , Haroun Yahia Mohamed 
Published: November 2024

Abstract

Background
The optimal treatment of acute Achilles tendon ruptures (AATR) is still under debate. It is most frequently ruptured in the 3rd and 4th decade of age.

Objective
The aim of this study was to compare open repair and minimally invasive repair in acute Achilles tendon rupture in adults regarding operative techniques, functional outcome and complications.

Patients and Methods
This systematic review included 6 articles with 329 patients. There were 165 patients had open repair and 164 patients by percutaneous repair with a mean follow-up of 23 months (range 20–24 months). Variables of each article were recorded and analyzed with respect to age, sex, follow-up, complications, and final outcomes.

Results
Percutaneous technique was much faster than open repair but regarding time to return to work, open repair patients had fewer weeks than the percutaneous. Complications were less in percutaneous repair except sural nerve injury.

Conclusion
The review has showed out that minimally invasive techniques clinically and biomechanically suitable alternatives to open repair based on both clinical outcomes and complication.
Comparison of Clinical Outcomes of Arthroscopic Versus Mini-Open Rotator Cuff Repair
Authors: AbdElhady Amr Mohamed , Ebied Wessam Eldin Fakhry , Farag Makarious Mousa 
Published: November 2024

Abstract

Background
The treatment of rotator cuff pathology has evolved with an improved understanding of rotator cuff anatomy, more sophisticated instrumentation, and advances in surgical technique. The most effective method of surgical repair is controversial given that both arthroscopic and mini-open rotator cuff repairs have been shown to produce satisfactory clinical results.

Aim of the Work
Compare between the outcomes of two techniques arthroscopic versus mini-open rotator cuff repair regarding functional outcome, postoperative complications.

Patients and Methods
This study is a Randomized control trials (RCT), and studies with level evidence 1 and Duration of follow up equal or more than 6 months. The systematic literature review was performed following the preferred items for systematic reviews meta-analysis (PRISMA) guided items and check list.

Results
Studies was pooled and reported ASES score showed insignificant difference between the two groups. We revealed that the pooled results showed statistically significant difference regarding clinical outcomes ROM (External Rotation) between groups. The pooled results showed no statistically significant difference regarding clinical outcomes forward flexion and pain score between groups and studies were pooled to compare complication between arthroscopic repair with mini open repair. Results showed insignificant difference between the two groups.

Conclusion
The effects of arthroscopic compared to mini-open rotator cuff repair, on function, pain and range of motion are too small to be clinically important at 3-, 6- and 12-month follow up, So the surgical choice should depend on the surgeon experience, and how much the aesthetic factor means to the patient.
Clinical and Radiographic Outcome of Anatomical Locked Plates in the Management of Proximal Tibial Fractures (A Case Series Study)
Authors: Morsi Ahmed Mohamed , Mohseb Ahmed Mohamed , Rezk Michael Refaat Shafik 
Published: November 2024

Abstract

Background
Intra-articular proximal tibial fractures account approximately for 1 % of all fractures in the general population and about 8 % of fractures in the elderly. Extra-articular proximal tibial fractures are estimated to be 5-10 % of all tibial fractures. Several fracture classifications exist, and the most widely used is the Anatomical AO/OTA classification. The goal of treatment for intra-articular fractures is to restore joint mobility, joint stability, articular surface congruence, and axial alignment, and to avoid posttraumatic osteoarthritis.

Objective
To assess the Clinical and Radiographic Outcome of Anatomical Locked Plates in the Management of Proximal Tibial Fractures.

Methods
This case series study was done at Orthopedic Surgery department of Ain Shams University Hospital from January 2023 and ended in January 2024 on 20 Patients who are skeletally mature, aged 18 and above of either sex, suffering from closed proximal tibial fracture.

Results
The radiological and functional results are promising. The functional results were all good or excellent according to (KSS). The KSS ranges from 70 to100 the mean was 90.25 points. 90% of cases were excellent and 10% were good. The Total Flexion range was between 115 and 132 degrees. The Total Flexion range mean was 123.1 degrees. There was no significant loss of knee ROM at the last follow-up.

Conclusion
Anatomical reduction is the most important factor in fixation of proximal tibial fractures. Fixation using an Anatomical Locked plate for proximal tibial fractures without using bone graft or bone substitutes is a viable option, helps surgeons achieve and preserve the anatomic joint line and normal mechanical axis, with superior functional results in the short term.
External Fixation versus Internal Fixation in the Treatment of Severe Grade of Blount’s Disease. A Systemic Review & Meta Analysis
Authors: Someel Mina Saad , Thakeb Moaatz Fouaad , Ahmed Ahmed Rayan 
Published: November 2024

Abstract

Background
Blount disease is a developmental condition characterized by a failure of endochondral ossification localized at the medial aspect of the proximal tibial physeal plate with consequent angular and rotational deformities of the lower limb.

Objective
To review systemically studies about External fixation versus internal fixation in the treatment of severe grade of blount’s disease.

Patients and Methods
This is a systematic review study and meta-analysis on human subjects studied in different literatures collected from different medical websites from 2011 till 2021 that dealing with external and internal fixation in Severe Blount’s disease, aiming at highlighting clinical and functional outcomes of both techniques.

Data Sources
Medline databases (PubMed, Medscape, ScienceDirect. EMF-Portal) and all materials available in the Internet till 2021.

Data Extraction
If the studies did not fulfill the inclusion criteria, they were excluded. Study quality assessment included whether ethical approval was gained, eligibility criteria specified, appropriate controls, and adequate information and defined assessment measures.

Conclusion
Comparison of both preoperative and postoperative results of both internal and external fixation methods showed statistically non-significant difference.
A Systematic Review and Meta-Analysis Study in Functional Outcome between Olecranon Osteotomy and Triceps Anconeous Pedicle Elevation in Intercondylar and Supracondylar Humerus Fracture
Authors: Atiyya Ahmed Naeem , Soliman Ramy Ahmed Aly , Abdel-Nabi Seif Mohamed Abdel-Aal 
Published: November 2024

Abstract

Background
Approximately, 7% of all adult fractures involve the elbow, of these one third (2%) are distal humeral fractures. Articular fractures of elbow are the most difficult one to treat. Because of their complex anatomy, proximity to vital structures, injury patterns, associated osteoporosis in elderly patients and limited space for instrumentation. As far as we know, no previous meta-analysis study has investigated the privilege between olecranon osteotomy and triceps-reflacting anconeous pedicle (TRAP) regarding functional outcome and complications in the treatment of suprachondylar and interchondylar humerus fractures. Therefore, we performed this systematic review and meta-analysis study of this issue.

Methods
This meta-analysis study included all studies which comparing between TRAP and OO in the treatment of suprachondylar and interchondylar humerus fractures. The literature search was in the Web of Science, PubMed, Scopus, and Cochrane databases using advanced search strategy. The search results was screened using titles and abstracts then full paper. The following data were extracted: country, study design, sample size, baseline characters of included patients, intervention, outcomes, parameters measuring functional outcome as incidence of excellent and good elbow performance, Mayo elbow performance score, duration of operation, blood loss and, complications. The quality assessment was operated by ROBINS-I tool for assessment of risk of bias for non-randomized studies, cohort studies and the Cochrane RoB tool for randomized trials.

Results
This meta-analysis study included 10 studies. The result of meta-analysis study may be summarized as follow no statistically significant difference between operative time and blood loss during both approaches. No statistically significant difference between both approaches regarding MEPS score, DASH Score, incidence of excellent/good elbow function, supination and pronation. A significant increase in union time, extension deficit (degrees) and incidence of complications after OO approach comparing with TRAP approach. A significant decrease in ROM after OO approach comparing with TRAP approach.

Conclusion
TRAP approach is a better alternative to olecranon osteotomy approach in the treatment of inter-condylar and supracondylar humeral fracture. TRAP approach has privileges over olecranon osteotomy approach regarding post-operative union time, extension deficit, range of motion and incidence of complications.
Morbidity and Mortality of Surgical Management of Proximal Femur Fracture in COVID Positive Patients A Systematic Review and Meta-Analysis
Authors: EL-redi Mohamed Arafat Ahmed , Kamel Mohamed El-Sayed , El Hawi Ezzat Mohamed 
Published: November 2024

Abstract

Background
Corona virus disease 2019 (covid-19) which is caused by the novel severe acute respiratory inflammatory syndrome corona virus (SARS-CoV-2) lead to 21st century first pandemic crisis. First emerged in December, 2019 in China, and has since rapidly spread to become a world-wide pandemic. It affects healthcare system and patient’s morbidity and mortality rate. Orthopaedic surgery suffered a significant decline in the volume of surgical cases, while Emergency operations for proximal femur fractures (PFF) in the elderly population assumed levels comparable to before the pandemic, with the 1-year mortality rate ranging from 14% to 36%.

Objectives
To determine whether patients with proximal femur fractures and concomitant COVID-19 infection have a higher risk of postoperative mortality through a systematic review and meta-analysis.

Patients and Methods
The present systematic review will be performed in accordance with the preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A comprehensive search for all evidence published articles using the online databases MEDLINE, PubMed and Cochrane will be performed. The purpose of this search is to identify all eligible studies featuring co-morbidities and mortality in PFFS patient treated surgically.

Results
among 159 articles that came from the search query and hand-search, 24 studies included, 24 articles were eligible after applying inclusion and exclusion criteria. 15 comparative studies reported mortality for both covid +ve and non covid +ve pts underwent surgical management with total number of 78,486 patients, 569 /2744 covid +ve compared to 3567/75742 non covid +ve pts managed surgically had died. The overall mortality among covid +ve was 20.7% compared to 4.7% non covid +ve. Covid +ve pts had a significant higher mortality rate than non covid +ve pts. (Odds ratio 5.22, 95% CI (3.88-4.9), P value &lt; .00001), and I2 = 27%. Sensitivity test was done without Egol et al., 2020 and show decreased heterogeneity I2 from 27% to 14%. 8 case series studies reported 27.9% mortality for covid +ve pts. The weighted mean of hospital length stay for covid +ve pts was 15.9 compared to 9.2 days for non covid +ve with Total WMD 5.99 days.

Conclusion
there is significant increase In 30 day mortality in covid +ve patients 4 Folds compared to non-covid patients. covid +ve patients underwent hip fracture surgery had a significant longer hospital length stay compared to non-covid patients with a weighted mean difference of 6 days, IMN usage show tendency to increased usage In studies with a higher mortality rates. ORIF associated with increased mortality rate than Arthroplasty.
Use of Cemented Standard Stem Arthroplasty for Unstable Inter Trochanteric Fractures in Elderly Patients
Authors: Elrahman Mohamed Abd , Bassiony Ayman Abdelaziz , Elmasry Ayman , Eshak Sherif , Elashmawy Mohamed Ibrahim Ibrahim 
Published: November 2024

Abstract

Background
The treatment of unstable intertrochanteric fracture in the elderly patient is still controversial. Traditionally, internal fixation using a dynamic hip screw was of choice. Recently, some authors advocated the use of cemented arthroplasty which results in better functional outcome.

Aim and Objectives
to assess use cemented standard stem arthroplasty for treatment of unstable intertrochnteric fractures in elderly patients to detect functional outcomes and complications.

Subjects and Methods
This was single arm clinical trial, was conducted in Ain Shams University Hospitals and Dar El-shefa hospital on 20 patients with unstable inter-trochanteric fractures in12 months.

Result
There was high statistically significant difference between Harris hip score at different periods.

Conclusion
Primary cemented arthroplasty is an effective treatment option for the unstable intertrochanteric femur fractures in the elderly when compared to open reduction and internal fixation. Cemented fixation is recommended in the elderly patients with osteopenic bone. Results of cemented arthroplasty in the treatment of unstable intertrochanteric femur fractures are affected by the age and sex of the patients, and medical comorbidities. Long term evaluation of the results of cemented arthroplasty in the treatment of unstable intertrochanteric fractures in elderly is recommended to assess the survivorship of the prosthesis and to evaluate the patient response to the cemented arthroplasty.
Efficacy of Peri-Operative Intra-Articular Compared with Intravenous Tranexamic Acid in Reducing Blood Loss after Primary Total Knee Arthroplasty
Authors: Aly Mohammad Ashraf Farouk , El-Beltagy Atef Mohamed Fathy , Zakaria Zeiad M 
Published: November 2024

Abstract

Background
Total knee arthroplasty (TKA) is an established and reliable surgical procedure but it is associated with substantial perioperative blood loss. Tranexamic acid (TXA) reduces blood loss in this type of surgery.

Aim of the Work
The main primary outcome of this study is to investigate and compare the clinical effectiveness of intra-articular (IA) topical TXA with intravenous (IV) TXA in patients undergoing primary TKA regarding the efficacy in reducing blood loss. The other secondary targets for this study is to compare and discuss the efficacy of both regimens regarding the level of hemoglobin drop, reducing the need of blood transfusion, checking the safety of both interventions regarding the patient population and possible accompanying comorbidities, and the reduction of length of hospital stay and costs.

Materials and Method
The electronic search strategy included the following databases: PubMed, and Cochrane Library from January 2010 to January 2020. Published accessible completed studies on the use of tranexamic acid TXA via the intra-articular IA route or the intravenous IV route in patients undergoing primary total knee arthroplasty TKA were identified through searching PubMed, and Cochrane Library using this specific set of keywords: (((((total knee arthroplasty) AND (tranexamic acid)) AND (intravenous)) OR (intraarticular)) AND (primary)) AND (tourniquet).

Results
This meta-analysis demonstrates the statistically significant favoring of IA-TXA over IV-TXA in reducing blood loss and it demonstrates the statistically significant favoring of IV-TXA over IA-TXA in postoperative hemoglobin level drop.

Conclusion
Both IV-TXA and IA-TXA are equivalent effectively in reducing the need for postoperative blood transfusion and consequently helps reduce the possible accompanying complications of blood transfusion.
Functional Outcomes of Arthroscopic Frozen Shoulder Release in Diabetic and Non-Diabetic Patients: A Comparative Study
Authors: Hany Ezzat Mohammed Ahmed , AbdelHady Amr Mohamed , Haroun Yahia Mohammed , AbdelAziz El Dessokey Haitham Adel Ahmed 
Published: November 2024

Abstract

Background
Adhesive capsulitis (frozen shoulder) is a disorder that has been poorly understood in terms of pathology and optimal treatment. It is well established that frozen shoulder is a common condition among diabetic patients, with diabetes being a significant risk factor. However, literature has shown that finding an optimal intervention for this condition has been quite challenging.

Aim of the Work
To compare functional outcomes of arthroscopic capsular release (ACR) in diabetic versus non-diabetic patients with idiopathic frozen shoulder.

Patients and Methods
A prospective Cohort study was conducted at Ain Shams University Hospitals starting from September 2022 to September 2023. The study recruited 20 Patients with idiopathic frozen shoulder, who were categorized into two groups: diabetics and non-diabetics. All patients underwent arthroscopic 360° capsular release (ACR) and biceps tenotomy. Patients who had pre-existing glenohumeral pathology other than adhesive capsulitis (AC) were excluded. The follow-up period was 6 months.

Results
This study showed that both diabetics and non-diabetics with adhesive capsulitis showed significant improvement in pain, range of motion and functional outcomes after the index procedure. However, there is no statistically significant difference after ACR between both groups.

Conclusion
Arthroscopic 360° capsular release and biceps tenotomy significantly improved outcomes in both diabetics and non-diabetics with no significant difference between the two groups.