bluuebunny/crossref_metadata_2025_split huggingface dataset:
Reconstruction of Anterior Cruciate Ligament Using Peroneus Longus Autograft. Systematic Review
Authors: Mohamed Abdel Rahman Haitham Abdel Azeem , Hafez Sallam Haitham Emad Eldin , Badr Ashraf Magdy Abdel Aziz 
Published: November 2024

Abstract

Background
ACLR provides surgical restoration of the injured ACL using the placement of graft material. The choice of graft is principal in providing optimal knee stability after surgery. Peroneus longus tendon PLT is an autograft modality that offers unique benefits for ACL reconstruction cases.

Aim of the Work
Our study was conducted to evaluate. PLT as an autograft modality benefits in ACL reconstruction and asses if this modality has any complications. Post-operative biomechanical outcomes were evaluated using the International Knee Documentation Committee (IKDC) and the American Orthopedic Foot and Ankle Score (AOFAS) score.

Materials and Methods
In our metaanalysis, 11 studies were included evaluating the outcome of the Anterior Cruciate Ligament Reconstruction with the Peroneus Longus Tendon. The total number of patients was 600 patients. The mean age was 29 years.

Results
The mean follow up time was 24 month our results revealed that: functional outcomes using PLT autograft were satisfactory. There was a significant difference between the mean pre-operative and postoperative IKDC scores with a mean difference 30.50, statistically significant decrease in AOFAS after PLT harvest was identified, PLT harvest does not appear to affect foot and ankle function to any clinically significant degree. In our meta-analysis there was non significant decrease in FADI score. The use of peroneus longus tendon graft in ACL reconstruction did not cause significant changes or major complications at the donor ankle site. Complications in the form of infection were detected only in three studies. Re-rupture was detected only in one study.

Conclusion
ACL reconstruction with peroneus longus autograft has an excellent functional score. Excellent results were achieved in both the knee and the donor site according to the Modified Cincinnati, International Knee Documentation Committee (IKDC) and Lysholm scores, American Orthopedic Foot and Ankle Score (AOFAS). Foot and Ankle Disability Index (FADI) showed insignificant change between pre-operative and post-operative scores. PLT autograft is a suitable alternative graft choice from outside the knee for patients undergoing ACL reconstruction.
Treatment of Fracture Neck Femur with Biplane Double Screws Fixation Method in Elderly Patients
Authors: Fekry Shady Samir , Kotb Mohamed Ismail , Elmezayen Eslam Yosri Gamal 
Published: November 2024

Abstract

Background
In active elderly patients with displaced femoral neck fractures, the total hip replacement is a golden standard. However, there are also patients with high operative risk for a large surgical intervention, defined by the presence of comorbidities and the arthroplasty procedure with these patients is contraindicated.

Objective
To assess the efficacy of Biplane double support screws in fixation of fracture neck of femur in elderly patients.

Patients and Methods
This was prospective study that was conducted in operative rooms of Ain Shams University Hospital, twenty one elderly patients with fracture neck of femur was treated using biplane double support screws fixation.

Results
Regarding garden classification of femur neck fracture, 47.6% of the patients were type 4. Regarding outcome, 10 patients were excellent, 6 patients were good, 3 patients were fair and 2 patients were poor. Mean ± SD of Union duration is 10.59 ± 1.46 weeks and only 2 cases (9.5%) complicated by Femoral head resorption.

Conclusion
In elderly and in those patients who cannot afford arthroplasty or in those patients where arthroplasty is contraindicated, BDSF method is an alternate method for fixing fracture neck of femur.
Management of Fracture Neck Femur in Elderly Patients Using Dual Mobility Cup Arthroplasty versus Bipolar Hemiarthroplasty
Authors: Heshmat Hany , Samir Wael , Abdel-Moneim Mohamed , Zakaria Zeiad M 
Published: November 2024

Abstract

Purpose
Femoral neck fractures represent a major public health problem worldwide. The purpose of this study is to evaluate the clinical, functional outcome and rate of complications of dual mobility cup total hip arthroplasty versus bipolar hemiarthroplasty in the management of displaced fracture neck femur in elderly patients.

Methods
A prospective Randomized control study was done in a university specialized unit between January 2018 till January 2021 on forty elderly patients had a mean age of 70.5 years (range 60-91) with displaced Fracture neck of femur. Twenty patients were managed by Dual Mobility Cup Total Hip Arthroplasty (DM group) and 20 patients underwent Bipolar Hemiarthroplasty (BHA group) for the treatment of their femoral neck fractures with a minimum 24 months folow up (range 24- 35). Functional outcome (Haris Hip Score) and rate of dislocation postoperatively were the primary outcomes while intraoperative blood loss, blood transfusion rate, length of operation, postoperative infection and mortality rate were the secondary outcomes.

Results
The Harris hip score (HHS) was higher in the DM group and was most significant after 6 and 12 months with p-value (p &lt; 0.05). The dislocation rate was less in the DM group. The BHA group demonstrated less intra-operative blood loss (p &lt; 0.001). and a shorter length of operation (p &lt; 0.001). However, there was no significant difference in two-year mortality with p-value (P &gt; 0.05), blood transfusion rate with p-value (p = 0.471) and infection rate with p-value (p = 1.000).

Conclusion
The use of THA DMC did not seem to increase mortality, morbidity, or complications rate like infection or bleeding but it decreases dislocation rate and increase functional outcome (especially in active healthy patients) when compared to BHA. Also, THA DMC is not affected by pelvic morphological factors and dysplasia which may lead to dislocation with BHA.
Proximal Femoral Nail vs Arthroplasty for Unstable Intertrochanteric Fracture in Elderly (Systematic Review & Meta Analysis)
Authors: Abou El Hasan Kareem Mohamed , Kamal Asal Mohamed , El Din Hafez Sallam Haitham Emad 
Published: November 2024

Abstract

Background
Hip fractures impose a considerable economic burden on healthcare, with intertrochanteric fractures contributing to increasing morbidity. The global incidence of hip fractures is expected to rise to 4.5 million by 2050, primarily due to aging and osteoporosis. Osteoporosis weakens bones, making them susceptible to fractures even from minor traumas, with femoral intertrochanteric fractures being prone to comminution.

Aim of the Work
To compare between proximal femoral nail and arthroplasty for Unstable intertrochanteric fracture in elderly. The objective is to perform a systematic review to better management procedure.

Patients and Methods
This systematic review and meta-analysis aimed to compare arthroplasty and proximal femoral nail (PFN) fixation for unstable intertrochanteric fractures in elderly patients. The study included 24 studies with 2699 patients, analyzing factors such as surgery duration, peri-operative blood loss, blood transfusion, complications, Harris hip score (HHS), and mortality.

Results
PFN had a significantly shorter surgery duration compared to arthroplasty, with the latter exhibiting higher blood loss. Arthroplasty also required more blood transfusion, attributed to its invasive nature. While complications did not significantly differ between groups, arthroplasty showed a higher rate of thromboembolic complications. Mortality rates were significantly higher in the arthroplasty group, emphasizing the importance of early mobilization for patient outcomes.

Conclusion
Underscores the significant superiority of PFN over hemiarthroplasty in treating elderly patients with intertrochanteric fractures. The PFN group had a statistically shorter operative time, less blood loss, lower mortality compared to the arthroplasty group. However, no significant differences in functional outcomes using HHS were observed between the two compared groups. In addition, no significant differences were found concerning complications between the PFN and arthroplasty groups.
Arthroscopic Capsular Release Versus Subscapularis Recession for Internal Shoulder Contracture in Obstetric Brachial Plexus Palsy: A Systematic Review and Meta-Analysis
Authors: Abdelaziz Tarek Hassan , Mohammed Amr Moustafa , Beshay Kirollos Samir Saad 
Published: November 2024

Abstract

Background
Shoulder internal rotation contracture, active abduction and external rotation deficits are frequent secondary complications observed in children with obstetric brachial plexus palsy (OBPP). Soft tissue shoulder operations are often done for treatment as arthroscopic capsular release and open subscapularis recession. There is a lack of studies regarding the subscapularis recession and also regarding the comparison between the two techniques.

Aim of the Work
to review systematically and meta-analyze the currently available literature regarding arthroscopic capsular release (ACR) and open subscapularis recession (OSR) in internal shoulder contracture in OBPP regarding the clinical efficacy and complications.

Methods
A literature search pooled the studies pertaining to the children with OBPP in early age treated with ACR and OSR. A systematic review and meta-analysis was conducted to assess the success rates of the two techniques using the Mallet score. We excluded the studies or the patients with history of any concomitant surgical interventions eg: humeral osteotomy, tendon transfer.

Results
Data from eight studies (152 patients) were compiled for our meta-analysis. The mean follow-up duration was 23.87 months with average age 2.4 years. The standardized difference in means (SMD) for the active abduction (ABD. score was 0.59 for the ACR in comparison to the OSR (SMD= 0.427). The Std. diff. regarding the ACR was 1.22 in passive abduction, 1.68 in passive external rotation (ER) in ABD., 2.31 in passive ER in adduction, 2.38 in hand to mouth, 2.67 in hand to neck, -0.49 in hand to spine, 2.84 in total Mallet score, 3.18 in the active ER (in comparison to the OSR the SMD was 0.427) and -2.06 in active internal rotation (in comparison to the OSR the SMD was 0.128). Recurrence of internal shoulder contracture was documented in 8 of 93 children after ACR and regional pain syndrome with shoulder stiffness was reported in only on case out of 28 cases after ACR.

Conclusion
In this study, we found that the ACR is highly effective than the OSR technique regarding the functional outcome of the shoulder in all the Mallet score items except in hand to spine and internal rotation. The ACR shows more advantages than OSR intra-operatively regarding soft tissue identification and post-operatively regarding scarring and infection, but with higher risk of recurrence and axillary nerve injury.
Are Outcomes of Dynamic Locking Plates Better Than Cannulated Screws Augmented with Anteromedial Buttress Plate in Treating Fracture Neck Femur in Adults Less Than 60 Years Old? A systematic Review
Authors: Attia Mina Aymen , Rahman Amr Ahmed Abdel , Kamel Mohamed Elsayed 
Published: November 2024

Abstract

Background
A displaced femoral neck fracture (FNF) in a young adult is still an unsolved problem with considerable debate and represents a great challenge for orthopedic surgeons. Literature shows that when using DHS or cannulated screws, the most commonly used implants, there is a high chance of post-operative complications such as avascular necrosis, non-union, and fixation failure leading to unacceptable high rate of 2ry reoperation. A 2015 meta-analysis of 41 studies regarding young femoral neck fractures found a reoperation rate of 20% after internal fixation of isolated femoral neck fractures, with AVN (14.35%) and nonunion (9.3%) being the most common complications leading to repeat surgeries.

Aim of the Work
To compare the clinical outcomes, radiological outcomes and complications of dynamic locking plates and cannulated screws augmented with anteromedial buttress plates in treating fracture neck femur in adults less than 60 years old.

Materials and Methods
This systematic review was conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines. Literature was searched till 31 December 2022 using Web of Science, PubMed, and Cochrane databases. A search was performed for all published articles in English using the following keywords “femoral neck system”, “FNS”, “femoral neck fracture” and “femoral neck system”, “femoral neck fracture” and “medial plate”, “femoral neck fracture” and“ buttress plate”.

Results
According to this review, the reporting FNS studies had mean age 51.4 years with male percentage 58%, displaced fracture was 81%. The weighted mean Operation time 62 min mean and blood loss was 73ml. The weighted mean postoperative HHS was 89. Nonunion occurred in 2.6%, AVN occurred in 1.3%, Femoral neck shortening in 9.5% and Cut out or implant failure 2.6% The reporting CS augmented with anteromedial femoral neck plate studies had mean age of 40.5 years with male percentage 70%, displaced fracture was 100%. The weighted mean Operation time 82 min and mean blood loss was 196 ml. The weighted mean postoperative HHS was 90. Nonunion occurred in 6.5%, AVN occurred in 3.2%, femoral neck shortening in 6.3% and Cut out or implant failure 4%. There was statistically significant difference in blood loss and operation time, but there was no statistically significant difference in postoperative HHS, Nonunion, AVN, Femoral neck shortening and Cut out or implant failure.

Conclusion
Femoral neck system (FNS) and cannulated screws combined with antero- medial femoral neck plates have no significant difference in nonunion rate, AVN rate and femoral neck shortening rate with almost similar Harris Hip score. However, Femoral neck system (FNS) has significantly less blood loss and operation time compared to cannulated screws combined with medial plates.
Femoral Neck System versus Cannulated Screws in Management of Fracture Neck Femur in Adults
Authors: Sallam Mohamed Ihab Shawky , Salem Ahmed , Koriem Islam 
Published: November 2024

Abstract

Background
Femoral Neck Fractures (FNF) accounts for about 3.6% of adult fractures, which is one of the more common fractures in the body. FNF is more common in elderly patients, generally refers to the fracture in the part of the femoral head down to the base of the femoral neck. Garden classification is often adopted for FNF in the elderly, type I and type II, because no displacement or displacement of fracture end to a lesser degree, damage degree of fracture is lesser, belongs to the stable fractures.

Aim of the Work
To review systematically studies about the use of Femoral Neck System versus Cannulated screws in management of non displaced femoral neck fracture in elderly.

Materials and Methods
We prepared this systematic review with a careful following of the Cochrane Handbook for Systematic Reviews of Interventions. We also adhered to The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines during the design of our study.

Results
This meta-analysis compared the clinical outcomes of FNS and CS fixation for femoral neck fracture in young adults. The study found that FNS is superior to CS in terms of intraoperative fluoroscopies, weight-bearing time, Harris Hip Score, total complications, femoral neck shortening, and nail retreat. However, the two fixation methods were similar in terms of the operation time, length of hospital stay, healing time, intraoperative blood loss, non-union, femoral head necrosis, and internal fixation cut-out. From the perspective of surgical outcomes, intraoperative fluoroscopies were used less in FNS fixation than in CS fixation.

Conclusion
Femoral neck system fixation shows improved outcomes compared to the cannulated screw fixation for neck femur fractures regarding intra operative surgery, prognosis and reduced complication rates, more Studies and RCTs for this new fixation method are needed to obtain more conclusive results.
Modified Broström Repair versus Internal Ankle Bracing Augmentation with Modified Broström procedure in Chronic Lateral Ankle Instability: A Systematic Review and Meta-Analysis
Authors: Barsoum Samuel Maher Naguib , Diab Hossam Saeed , Haroun Yahia Mohammed 
Published: November 2024

Abstract

Background
Lateral ankle instability can be treated conservatively, but surgery may be necessary if conservative treatment fails. Approximately 20-40% of patients will require surgical intervention due to recurrent sprains.

Objective
To compare complications in treating chronic lateral ankle instability, a systematic review and meta-analysis were conducted using former studies of the Modified Broström procedure versus Internal ankle bracing augmentation.

Patients and Methods
This study was conducted following the preferred items for systematic reviews meta-analysis (PRISMA) 6 guided items and a checklist to answer the question of which result in less complications either modified Broström procedure or Internal ankle bracing augmentation between 1/1/2010 -1/6/2022.

Results
The metanalysis showed that there is no significant statistical difference in both groups as regards Recurrence of instability rates, Irritation of peroneal nerve, Revision surgery rates and Overall complications.

Conclusion
We conducted this systematic review and meta-analysis study to compare the complications of two surgical procedures used to treat lateral ankle instability after conservative measures have failed. Both surgical techniques showed no significant statistical difference in terms of complications.
E-Cadherin and Snail Immunohistochemical Expression in Multiple Ipsilateral Breast Carcinoma Disease
Authors: El-Maraghy Maissa N , Salman Manal I , Osman Wesam M , Shash Lobna S , Al Gammal Eman A N 
Published: November 2024

Abstract

Background
As compared to invasive breast cancer- no special type (IBC-NST), Invasive lobular cancer (ILC) traditionally shows loss of function of the E-cadherin- catenin membrane complex, frequent downregulation of E-cad expression and is significantly more associated with Multiple Ipsilateral Breast Carcinoma (MIBC). Nevertheless, E cadherin downregulation was also described in MIBC with IBC-NST phenotype. MIBC was suggested to have a more aggressive biologic nature than unifocal disease, Epithelial mesenchymal transition (EMT) has been suggested as an attribute to such poorer prognosis. The transcription factor Snail commonly acts as one of the earliest switches of the EMT process and E-cadherin downregulation is one of its major downstream effects. Causation and association links between EMT and MIBC in different types of breast cancer needs further elucidation.

Objective
to investigate whether the association betweenE-cadherin downregulation and MIBC is attributed to EMT and whether such association and expression of EMT markers is differentially presented in ILC and IBC-NST.

Methods
This study was conducted retrospectively on 77 breast cancer cases diagnosed at Ain Shams University Hospitals (2012-2022). We included all ILC cases meeting study criteria (20 unifocal, 14 MIBC) and randomly selected sets of IBC- NST cases (13 unifocal, 16 MIBC) and mixed ductolobular IBC (7 unifocal, 7 MIBC). Immunohistochemical expression of E-cadherin and Snail was evaluated and compared in different study groups with subsequent statistical analysis.

Results
E- cadherin expression showed 15/40 (37.5%) negative expression, 15/40 (37.5%) with low expression, and 10/40 (25%) with high expression in the unifocal group, compared to 14/37 (37.8%) negative result, 13/37 (35.1%) low E-cadherin expression, and 10/37 (27%) with high E-cadherin expression in the MIBC group. There was no significant difference in E-cadherin expression regarding focality neither in all cases (p-value: 0.97) nor in each of the histological subgroups (p-values: 0.34 for IBC- NST, 1.00 for mixed, 0.2 for ILC). On the other hand, Snail expression was extensive in 24/37 MIBC cases (64.86%) as compared to 17/40 unifocal cases (42.5%), this was statistically significant (p-value: 0.038).

Conclusions
E-cadherin downregulation doesn’t seem to contribute to MIBC whether ILC, mixed or IBC-NST, however snail overexpression is significantly associated with MIBC. This suggests that EMT may have a role in multiplicity of IBC.
Speckle Tracking Echocardiography and Cardiac Biomarkers in Multi-System Inflammatory Syndrome in Children
Authors: Hassan Abdelwahab Ahmed , Kotby Alyaa Amal , El-Ganzoury Mona Mostafa , Habeeb Nevin Mohamed , Hashem Azza Elsayed , Hady Marwa Waheed Abdel 
Published: November 2024

Abstract

Background
Cardiac affection in multisystem inflammatory syndrome in children (MIS-C) occurs in ∼80% of patients. Left ventricular (LV) systolic dysfunction is the most frequent finding.

Methods
In this prospective cohort study, we assessed LV function and cardiac injury in 22 patients with MIS-C using Cardiac biomarkers (Troponin I and CK-MB) and Speckle Tracking Echocardiography. We compare those patients at initial presentation and at 3 months follow up.

Results
Among the 22 patients with MIS-C cardiac biomarkers (cardiac troponin and CK-MB) showed statistically significant regression on comparing their values at initial presentation and after 10 days follow up (P value &lt;0.01). Ejection fraction was impaired in 43.7%, with a mean value of 52.3% (Range: 32% to 69%). Patients with abnormal strain had a lower EF, more organ system involvement and were more likely to require inotropic support. Lower peak longitudinal strain rates were detected in 59% of MIS-C patients at initial presentation in comparison to follow up assessment 3 months later. Patients with initially depressed function, EF normalized in 21 of 22 patients (95.4%) (P value 0.000), but 5 of 22 (18.1%) of patients had persistently abnormal systolic strain at 3 months follow up (P value 0.817).

Conclusion
LV systolic dysfunction is common in the acute phase of MIS-C, and detection may be improved with global longitudinal strain assessment. Longitudinal cardiac follow-up is imperative, as patients may be at risk for persistent LV dysfunction.