bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical Efficacy of Medial and Lateral Plating in Distal Femur Fractures: Thesis Study
Authors: Zaher El Zaher Hassan El , Nagy Amr Mohammed , Ali Ahmed Ezzat Mahmoud 
Published: November 2024

Abstract

Background
The problem of treating distal femoral fractures is complicated. The principles of the surgical management of supracondylar femur fractures have changed. Up until 1970, conservative management of these fractures was the recommended course of care. This was mostly caused by a lack of adequate implants and procedures. In modern times, locking compression plates offer the benefits of locking head screws, offering better fixation and absolute stability. This is significant in the treatment of fractures in osteoporotic bone because it enables the use of monocortical screws in the diaphyseal region, preserving the periosteum's blood supply and preventing structural bone loss to the opposite cortex. Varus collapse was the main complication, especially in osteoporotic bone. Therefore, anatomical reduction and rigid, stable fixation provided by double plating was considered the best option for treating this type of fracture.

Patients and Methods
This is a retrospective cohort study done in El Demerdash Hospital, Ain Shams University specialised hospitals, Air Force specialised hospital, and El Helmia military hospital through 20 cases of distal femur fractures of types 33-A3 to 33-C3, all of which were managed by dual plating and followed up for 6 months. People with open fractures, fracture type 33-A1, periprosthetic, and pathological fractures were excluded.

Results
In our study, through 20 cases with distal femur fractures between types 33-A3 and 33-C3, all managed by double plating, the mean age was 51.50, 6 of our patients had comorbidities (DM, HTN, or Both), the rest were medically free, the average operation time was 150 minutes, 2 of our patients needed a bone graft, the range of full union was from 3 to 6 months, the average AKSS among the 20 patients was 81.05, 14 of our cases achieved uneventful union, 2 cases had superficial wound infection, and 1 case had implant failure (screw cut out) and needed revision, so double plating is one of the better options to achieve bony union and a better functional outcome in severely comminuted distal femur fractures

Conclusion
Even though there were problems such as a lengthy operation and longer recovery period in our study, double plating is one of the best options for achieving bone union and a better functional outcome in severely comminuted distal femur fractures. Functional outcomes were excellent in 75% of cases and fair in 25% of cases, and the union rate was 100% with no Varus deformity or malunion.
Outcome of Short Segment Fixation for Degenerative Scoliosis in Osteoporotic Patients Using Augmented Pedicle Screws; Prospective Case Series Study
Authors: Rahman Mohamed Farrage Ahmed Mohamed Abdel , Saoud Abdelfattah Mohamed Fathy , Abdel Kader Yousef Magdy Gamal , Elbadrawy Ahmed Mohamed , Mohamed Ahmed ElSayed Mohamed Nabil , Morsi Ahmed Mohamed Ahmed 
Published: November 2024

Abstract

Background
When a patient’s general condition is taken into account, long-segment fusion may not necessarily be the best approach for degenerative scoliosis management. Often, a patient’s symptoms may be alleviated by short segment decompression and fusion surgery that is limited to the upper and lower vertebral boundaries of the scoliotic region. In osteoporotic patients studies reported good functional outcomes and very low revision rates with polymethylmethacrylate augmented screws.

Aim of the Work
This study aims to evaluate the clinical and radiological outcomes of short segment fixation for degenerative scoliosis in osteoporotic patients using augmented screws.

Patients and Methods
This is a prospective Case series study carried out at Ain Shams University hospitals which included 23 patients resistant back pain and lower limb claudication pain not relieved by medical treatment or physical therapy for at least 6 months. All cases managed with Posterior decompression and short segment fixation using pedicle screws augmented with cement (PMMA).

Results
As regards the VAS for leg pain, it showed improvement from 7.18 (± 0.07) to 1.91 (± 0.14). The VAS for back pain also improved from preoperatively 8.17 (± 0.11) to postoperatively 2.52 (± 0.24). As regards the ODI score, there was a significant decrease in the ODI scores from pre-surgery 68.09 (± 1.13) to 12 months post-surgery 25.57 (± 2.02). The Cobb angle decreased dramatically from pre-operative 15.9 (± 0.57) to post- operative, and then increased slightly but remained stable at 6 and 12 months with mean value at last follow up 4.85 (± 0.45). We did not have nonunion cases but only 3 delayed union cases at 6 months and was full united at 12 months that assessed by continuity of osseous bridging between transverse processes in plain X rays and CT scan. compared to similar published literatures This study technique has average blood loss, operation time and hospital stay and decrease the need for revision surgery but with increased hazards of high intraoperative radiation exposure.

Conclusion
Short segment fixation using augmented screws showed a very good clinical outcome in management of degenerative scoliosis with osteoporosis as regards VAS for back pain, VAS for leg pain and ODI score. According to radiological parameters it showed a good result in cobb angle correction, fusion rate, screws and construct stability after 1 year follow up, less pedicle screw loosening and less rate of revision surgery.
Minimally Invasive Sacroiliac Joint Fusion versus Non Surgical Management in Chronic Sacroiliitis: A Systematic Review and Meta-Analysis
Authors: Soliman Ahmed Mohamed Ahmed , El-Sayed Mohamed Nabil , Ibrahim Mohammed Ali 
Published: November 2024

Abstract

Background
Sacroiliac joint fusion for low back pain attributed to sacroiliac joint is beneficial in a subset of patients. However, varied conservative treatments were measured in previous studies. Moreover, there are lack of well design and long-term follow-up studies.

Aim of the Work
The primary objective of this study was to determine whether sacroiliac joint fusion was superior to conservative treatment for patients with low back pain in pain and function.

Materials and Methods
In the current metaanalysis, the 18 studies included 1457 patients with chronic sacroiliitis, from which 841 patients underwent Non-surgical management & 616 patients underwent minimally invasive SI fusion. The mean age of pooled sample is 50 years. The follow up period ranged from 2 weeks to 72 months.

Results
In our meta-analysis, there was significant decrease in pain scores in patient treated with minimally invasive sacroiliac joint fusion. The decrease reported in the included studies of VAS and ODI after MISJF is clinically relevant statistically significant. In terms of pain reduction: all conservative treatment modalities showed statistically significant reduction of pain at the end of follow up except in local anesthetic injection. In terms of disability score (ODI): all conservative treatment modalities showed statistically significant reduction of ODI score at the end of follow up. There was a dramatic relief of pain in cases treated with joint fusion than those treated with conservative treatment. Using EQ-5D time trade-off scale, there was improvement in patient quality of life on patient treated with joint fusion higher than in cases of conservative management, but was statistically insignificant. We found that proportion of patients who were able to walk for distance more than one kilometer were higher in case treated with joint fusion, but it was statistically insignificant. By month 24, we observed 39 severe adverse events after sacroiliac joint arthrodesis, including sacroiliac joint pain, postoperative gluteal hematoma, and postoperative nerve impingement. With conservative treatment there were no reported complications except in one study. In fusion group few complication reported mostly were : hematoma formation, piriformis syndrome, cellulitis, deep-soft tissue infection, Implant penetration, non-displaced fracture and persistent joint pain.

Conclusion
In cases of low back pain related to chronic sacroiliitis, improvements in pain, and disability, observed following minimally invasive SIJF surgery was statistically significant compared to non-surgical management.
Management of Pediatric Distal Humerus Metaphyseal Diaphyseal Junction Fracture; A Systematic Review and Meta-analysis
Authors: Al-Kersh Mohamed Ahmed , Aly Ahmad Saeed , Mohamed Ahmed Mohsen 
Published: November 2024

Abstract

Background
Fracture at the distal humerus metaphyseal diaphyseal junction (MDJ) in children is less frequently found in literature. Until this moment, there is no gold standard technique regarding its management and most surgeons treat it as a regular supracondylar humerus fracture by conventional pinning. This systematic review explores the relevant literature to assess the efficacy of different techniques.

Methods
Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used for this review. We searched online databases including PUBMED/MEDLINE, Scopus, Web of Science Core Collection, and Google Scholar. Data from papers that met our general inclusion criteria were extracted and categorized into treatment method groupings. Functional and cosmetic outcomes, demographic characteristics, and complications were the main parameters used to analyze the data.

Results
Ten (10) retrospective studies met our inclusion criteria with a total of 178 participants of unilateral pediatric distal humerus metaphyseal diaphyseal junction fractures. Most literature chose closed reduction and percutaneous pinning (CRPP) in 7 papers, followed by Elastic Stable Intra-medullary Nails (ESIN) used in 3 papers, then conservative treatment was chosen in 2 papers, while only one paper used lateral miniplate and assisted K-wire and another paper used combined CRPP and Intra- medullary (IM) K-wire. As regards the operation time; ESIN had the lowest time with a mean of 39.7 min (range: 37.5 – 41.9 min), while CRPP had the most prolonged time with a mean of 75.47 min (range: 55.9 – 92.1 min). The lowest healing time was observed in ESIN with a mean of 7.9 weeks (range: 6.8 – 9 weeks) while the most prolonged was in conservative management with a mean of 12 weeks and CRPP lies in between with a mean of 10 weeks. Regarding Flynn’s criteria, all participants received excellent and good except in CRPP; 13 cases were fair and 2 cases were poor. Regarding complications the most commonly observed complication after MDJ fracture was cubitus varus, the highest incidence was in conservative management 33% of cases, followed by CRPP 10.9% of cases, the least incidence was observed in ESIN 3.77% of cases, and none of the cases treated with mini plate developed this complication. Other complications were observed only with CRPP; 8.5% of cases developed fixation loss, 6.2% of cases had significantly reduced range of motion and one case refractured.

Conclusion
Pediatric distal humerus MDJ fracture should be differentiated from supracondylar fracture regarding management, as conventional pinning techniques are associated with a higher incidence of complications and increased both operative and healing times.
Bengin Tuomrs of the Spine: A Systematic Review
Authors: Elsaadany Ahmed Saeed , Mazyed Mohamed Ahmed , Ashour Mahmoud 
Published: November 2024

Abstract

Background
Spine tumors are classified as primary tumors which originate from the spine itself and its adjacent structures and secondary (metastatic) tumors of distant organs which spread hematogenously and lymphatically and are located in the spine and its surrounding tissues. As the spine is well vascularized and has close relationship with regional lymphatic and venous drainage systems (especially Batson’s venous plexus), it is generally susceptible to metastasis. Metastatic tumors are the most common (97%) tumors of the spine.

Aim of the Work
to give an overview of the most important benign tumors of the spine, their clinical pictures and the typical features in imaging.

Patients and Methods
Search results will be conducted to systematic review management software and manually screened for eligibility to be included. PRISMA flowchart will be produced based on the search results and the inclusion/exclusion criteria. We will search the MED-LINE database, PubMed, Cochrane Bone and Muscle Trauma Group Specialized Register, Cochrane Register of Controlled Trails (The Cochrane Library) using the following keywords related to: Bengin tumors, spine.

Results
Giant cell tumors in the spine, particularly lumbar region, are rare but can present with pain and neurologic deficits. Osteoid osteomas and osteoblastomas, more common in the thoracolumbar spine, exhibit distinct radiological features. Osteoblastomas, locally aggressive, cause persistent pain, stiffness, and neurological deficits, often diagnosed in later stages. Spinal osteoblastoma diagnosis relies on CT scans, superior to plain radiography, and may necessitate biopsy for confirmation. Vertebral hemangiomas, usually asymptomatic, can cause compression-related symptoms and are identified through characteristic radiographic and CT appearances.

Conclusion
Searching the literature, Comparison between clinical picture in various types of begnin tumors we found that all begnin tumors have similar symptoms such as localized pain, neurological symptoms. Hence different methods of investigation should be used such as plain x-ray, CT scan and MRI.
Internal Fixation of Geriatric Native Distal Femur Fractures: A Systematic Review
Authors: Ahmed Yousry H , Mohamed Kamel S , Ahmed Emam T 
Published: November 2024

Abstract

Background
Distal femur fractures account for 4-6% of osteoporosis related fractures of the femur in the elderly population. As life expectancy continues to increase, the population worldwide is ageing, and the number of individuals over 65 years of age is increasing and hence the incidence of distal femur fractures in elderly.

Objectives
management of geriatric distal femur fractures by surgical fixation whether locked plate or Retrograde intra medullary nail.

Data Sources
Data Sources: PubMed, Embase, and Cochrane databases were searched for English language articles up to April 24, 2022, identifying 2500 papers

Study Selection
studies discussing the outcomes and complications of post op fixation of distal femur either by locked plated, double plating, NP or RIMN

Data Extraction
one study provided Level III evidence, whereas the remaining 16 studies provided Level IV evidence. Studies were formally evaluated for methodological quality using established criteria. Treatment failure between groups was compared using an Odds rate ratio.

Data Synthesis
Treatment failure was defined for locked plating, double plating and RIMN for reasons such as mechanical failure, nonunion, deep and superficial infection, ROM and extensor mechanism disruption, revision surgeries. There were no significant differences in most of the outcomes and complication rates with some advantageous ROM in plates and lower infection in nails.

Conclusions
biological fixation overall provides lower complication rates with no significance between RIMN and locked plates in Extra articular fractures. no strong conclusions can be effectively made between the methods of fixations with both offering very good results overall, more prospective research with unified items for data resemblance across different studies should be made.
A Comparative Study Assessing the Efficacy and Outcomes of Sub-Muscular Plating and Elastic Stable Intramedullary Nailing in Paediatric Diaphyseal Femoral Fractures: A Systematic Review
Authors: El Sheikh Andrew Mina Samaan , Ghali Nabil Abdel Moneim , Elshabrawy Waleed Elsayed 
Published: November 2024

Abstract

Background
Femoral shaft fractures are among the most common fractures of long bones. Paediatric diaphyseal femur fractures account for 1.4% to 1.7% of all paediatric fractures; the annual rate of children who present with femoral shaft fractures is estimated at 19 per 100,000. The management of paediatric diaphyseal femoral fractures depends primarily on the age of the child although the bone age and size of a child may determine the choice of treatment. The choice of management may also be determined by surgical experience and local trends in practice. Non- operative management plays a role in some cases still though current practice has veered towards operative fixation as it allows early mobilization and shorter hospital stays.

Aim of the Work
to evaluate efficacy and outcomes of submuscular plating and elastic stable intramedullary nailing in paediatric diaphyseal femoral fractures.

Patients and Methods
Search results will be conducted to systematic review management software and manually screened for eligibility to be included. PRISMA flowchart will be produced based on the search results and the inclusion/exclusion criteria. A total of 303 cases were included with mean age 8.3 years. The majority of them were males.

Results
The current study showed that regarding Outcome; Mean operative time was 74.35 min in nail group vs 111.19 min in plate group. Mean intraoperative blood loss also was 58.1 ml in nail group vs 112.5 ml in plate group. As regarding hospital stay mean period was 4.4 days in nail group vs 5.5 days in plate group. As regarding time to full weight bearing was 10 wk in nail group vs 8.25 wk in plate group. Time to heal of fracture was 2.28 mn in nail group vs 2.35 in plate group. Total number of union in nail group was 161 cases vs 118 in plate. Our results showed that as regards complications; a total of 60 complications were found among included cases in form of infection in 3 with nail vs 4 with plate, malunion in 14 in nail vs 6 in plate group. Heterotopic ossification in 2 cases with plate fixation. Limb length discrepancy in 6 cases with nail vs 5 cases with plate fixation, refracture in 2 cases with plate fixation, pain in 7 cases with nail fixation. External rotation and antecurvatum in 4 cases with nail fixation vs 3 with plate fixation.

Conclusion
this review provides evidence that both ESIN and SMP are safe, effective, and minimally invasive surgical methods for the treatment of paediatric diaphyseal femoral fractures, under the conditions that the surgical techniques required have been mastered and the indications for surgery are observed carefully.
Fresh Femoral Head Allograft in Distal Femur Cartilage Lesions. A Case Series
Authors: Soubih Hesham Ossama , Mohammed Ahmed AI-Saed , AI-Ghazali Sherif Ahmed Farghali , Sobhy Mohammed Hassan , Haroun Haitham Kamel Omar , Al-Sayyed Kamel Mohammed 
Published: November 2024

Abstract

Background
Fresh osteochondral allograft transplantation is a good treatment option of cartilage defects. However, this treatment option is not available in all countries due to limited graft availability and tissue banks limitations. The purpose of this study is to assess the short term functional and imaging outcomes of fresh osteochondral allograft transplantation in the knee using the femoral head of living donors.

Hypothesis
Fresh osteochondral allografts from the femoral heads of living donors is a valid graft source for management of distal Femur cartilage defects. This technique can improve functional knee scores with good radiological outcomes.

Study Design
Prospective case series.

Methods
Ten patients with full thickness cartilage defects of the distal femur underwent osteochondral allograft transplantation from the femoral heads of living donors. Grafts were transplanted by both shell and multiple dowels techniques. The average follow up duration was 9.4 months (range, 6-13 months). Patients were evaluated by Lysholm and International Knee Documentation Committee (IKDC) scores, radiography and MR imaging using Osteochondral Allograft MRI Scoring System (OCAMRISS).

Results
There was a statistically significant improvement (P &lt; 0.001) in both Lysholm (52 to 83) and IKDC (40 to 80) average scores at 6 months postoperative. Postoperative MRI was done at an average 6.8 months (range, 5-11 months) postoperative. The mean total OCAMRISS score was 3.4 (range, 1-7). A second look arthroscopy was done in three patients and showed intact articular cartilage in all three patients.

Conclusion
Femoral head of living donors is a valid new source for fresh osteochondral allograft transplantation of knee osteochondral lesions. Short term results showed improvement in clinical assessment scores. Follow up imaging showed graft incorporation and good MRI scores.
Evaluation of the potential therapeutic efficacy of Lactobacillus rhamnosus in ratsexperimentally infected with Blastocystis hominis
Authors: Alkady Sara F , Abou-Seri Hanan M , El Naggar Heba M , Thabet Hala S , El-Sayed Hoda S , Fathalaa Iman F 
Published: November 2024

Abstract
Blastocystis hominis (Blastocystis) is a common intestinal protist found in humans and various animals globally. Although its implications for health and diseases remains controversial, it has been suggested to be associated with gastrointestinal disorders, including abdominal pain and diarrhea, as well as cutaneous lesions such as urticaria. While metronidazole (MTZ) remains the primary treatment for blastocystosis, it is accompanied by several adverse effects. This underscores the pressing need for a safe therapeutic alternative, and probiotics emerge as a promising candidate. Probiotics exhibit the ability to treat gastrointestinal infections by modifying the composition of the gut microbiota and influencing the host’s immune response. Lactobacillus rhamnosus (L. rhamnosus) has demonstrated efficacy against several parasitic diseases such as giardiasis and toxocariasis. The present study aims to evaluate the in vivo anti- Blastocystis activity of L. rhamnosus in comparison to MTZ. Twenty-eight Sprague- Dawley rats were divided into four groups (seven rats per group), all infected with Blastocystis, except for the non-infected group 1 (G1). The treatment duration was 7 days for MTZ and 10 days for L. rhamnosus. The therapeutic efficacy was assessed through parasitological follow-up of fecal and intestinal fluid parasitic counts on the 3rd, 6th, 9th, and 12th days post-treatment, along with histopathological evaluation of selected segments of the ileum and colon. L. rhamnosus induced a statistically significant reduction in fecal and intestinal fluid parasitic counts compared to MTZ, accompanied by normalized villous architecture and restoration of the villous to crypt ratio. Hence, this study highlights the potential therapeutic effectiveness of L. rhamnosus as a safe alternative against blastocystosis.