bluuebunny/crossref_metadata_2025_split huggingface dataset:
Consequences of sagittal malalignment following reconstruction of complex tibial plateau fractures
Authors: Sharaby Mohamed M F , Abuheif Mohamed 
Published: September 2023

Abstract

Purpose
Changes of posterior tibial slope following complex tibial plateau fractures have not been fully evaluated in the literature. Some studies indicated that arthritic changes that occur following tibial plateau fracture were more correlated to deformity and instability rather than articular surface step-off.
The aim of this study was to evaluate the midterm clinical effects following changes in the posterior slope that might be associated with reconstruction of complex tibial plateau fractures.

Patients and methods
This retrospective cohort study was carried out on 112 patients operated by internal fixation following complex tibial plateau fracture within 4 weeks of the incident of injury. Modified Rasmussen score was used for both clinical and radiological evaluations in addition to final evaluation of the slope by computed tomography scan. The Knee Injury and Osteoarthritis Outcome Score was used for subjective evaluation of the clinical results, and Kellgren–Lawrence radiological grading was used for osteoarthritis grading.

Results
The mean flexion was 118.8 ± 13.0° (range, 90–140) in GI and 119.7 ± 13.5° (range, 70–140) in GII, and the mean extension deficit was 1.6 ± 2.7° (range, 0–10) in GI compared with 1.9 ± 2.9° (range, 0–10) in GII. The mean clinical Rasmussen score was 26.3 ± 2.9 (18–30) in GI and 26.1 ± 3.2 (16–30) in GII. The mean Knee Injury and Osteoarthritis Outcome Score in GI was 79.3 ± 5.1 compared with 77.7 ± 5.6 in GII. According to Kellgren–Lawrence grading system for osteoarthritis, there were 23 patients with grades 2 and 3 osteoarthritis in GI compared with 32 cases in GII. The study showed a statistically significant correlation between decreased tibial slope and limitation of extension. Otherwise, there were no statistically significances between changes of tibial slope and stability, pain, or the overall postoperative knee score.

Conclusion
Changes in posterior slope angle of the tibial plateau during fracture fixation is an important factor that can significantly affect range of motion, particularly extension. Osteoarthritis is higher in patients with disturbed posterior slope; however, a larger sample is needed for possible significance.
Level of evidence: therapeutic level IV.
Treatment of intra articular fracture calcaneus using sinus tarsi approach, bone block substitute, and screws
Authors: Samy Mohamed 
Published: September 2023

Abstract

Objective
To evaluate the results of fixation of intra articular calcaneus fracture using Sinus Tarsi Approach, bone block substitute, and screws fixation.

Background
Minimal invasive techniques for treatment calcaneus fractures have developed to overcome soft tissue complications associated with the traditional lateral approach. Sinus Tarsi approach has the advantage of visualization of posterior part of subtalar joint.

Methods
All patients underwent preoperative calcaneal lateral and axial radiographs and CT scan of the injured foot. The injured type was graded according to the Sanders classification on the basis of the CT scan findings.
Bohler and Gissane angles were measured as anatomical parameters before surgery. Sinus Tarsi Approach was done for all patients, in addition to use of percutaneous screws fixation and bone block graft substitute.

Results
A total of 17 patients were included in our study. The mean age was 37.8 years. At the end of follow-up, radiological evaluation was done by measuring the Bohler angle and the angle of Gissan. The American Orthopaedic Foot and Ankle Society (AOFAS) ankle/hindfoot score was calculated at the end of the follow-up for all cases. Excellent results were found in7 patients, good results in 8 patients and fair results in only 2 patients. There was a statistically significant improvement of Bohler angle at the end of the follow-up.

Conclusion
Treatment of intra articular calcaneal fractures using Sinus Tarsi Approach with a bone block substitute and screws can provide satisfactory clinical outcomes.
The effects of arthroscopic rotator cuff repair on human sexual activity
Authors: Amr Ibrahim , Mohamed Ghandour Tarek 
Published: September 2023

Abstract

Purpose
To assess the effect of arthroscopic rotator cuff repair on sexual function, desire, and satisfaction, in addition to the shoulder function.

Methods
We did arthroscopic rotator cuff repair for 55 sexually active married individuals with rotator cuff tears. Shoulder and sexual function were assessed using: 1- the Constant-Murley score (CMS), 2- two visual analog scales (VAS) questionnaires, one to evaluate pain level during daily activities and the second to assess the pain level only during sexual activity, 3- Change in Sexual Functioning Questionnaire (CSFQ), 4- Sexual Desire Inventory (SDI) Questionnaire, 5- the Index of Sexual Satisfaction (ISS) Questionnaire, and 6- the study-specific short questionnaires. Assessment parameters were done before surgery and at 1 month (1M), 3 months (3M), 6 months (6M), 12 months (12M), 18 months (18M), and 24 months (24M) after surgery.

Results
Only 49 subjects were included in the final analysis (6 were excluded from the last follow-up). 77% of the study subjects found that their sexual life was affected by their shoulder condition, with 65% reporting that this was due to increased pain.75% needed to adjust their sexual position to accommodate their shoulder problem. 55% found that below the partner position is the most comfortable position during the sexual act. Additionally, we found a significant improvement over time in the CMS score, two VAS questionnaires, CSFQ, and ISS.

Conclusion
Arthroscopic rotator cuff repair improved shoulder function, pain level, sexual function, satisfaction, and mobility during sexual engagements. it did not affect the level of sexual desire.
Management of the 4th of August explosion in an orthopedics department
Authors: Daher Mohammad , Ghoul Ali , Salameh Bendy-Lemon , Youssef Bryan , Sabbagh Joanna , Zalaquett Ziad , Roukoz Sami 
Published: September 2023

Abstract
Mass casualty incidents (MCI) are rare, large-scale events that result in heavy damage to people and infrastructure. These types of incidents result in a high influx of patients in local hospitals. In Beirut, this was witnessed on the 4th of August. A massive explosion took place in Lebanon’s capital city Beirut. Although Hotel-Dieu de France Hospital was damaged, it played a crucial role in the management of numerous injured, especially in the orthopedics department. Six months later, the hospital contacted all patients that had been hospitalized during that night and the following 2 days for musculoskeletal injuries. The contact was done for feedback purposes as the event was considered one of the largest non-nuclear explosions in international history. Accordingly, most of the patients that were contacted gave a credible and positive rating. There were few who had suggestions for management improvement. MCIs are rare, but it is crucial to be prepared to face any edging situation. Having effective communication and an organized plan in any risk management process are essential tools to foster for the well of the community and to scale down the losses of the locals in the area.
Metacarpals and phalanges malunion: a narrative review
Authors: Daher Mohammad , Ghoul Ali , Salameh Bendy-Lemon , Ghanimeh Joe , Sabbagh Joanna , Zalaquett Ziad , Roukoz Sami 
Published: September 2023

Abstract
Malunions are fractures that have healed with a deformity. Multiple abnormalities can coexist, but only one usually takes the lead causing symptoms, such as bone shortening, finger scissoring, etc. It is mainly caused by insufficient reduction. Malunions of the metacarpals are usually apex dorsal, while malunions of the phalanx tend to angulate volarly. Each patient with malunion should be assessed individually and treated conservatively if there is little to no functional impairment. Surgeries can be used to treat individuals with angular and rotational deformity.
Augmentation plates and bone grafting for treatment of nonunited long bones fractures fixed by intramedullary nails
Authors: Metwally Osam Mohamed , Elkady Reda Hussein , Shehata Ehab Mohamed 
Published: September 2023

Abstract

Background
A delayed union was defined as when the fracture fails to unite within the expected time. Delayed union becomes nonunion when the fracture healing stops (at least 6 months). Intramedullary nailing has proven to be a good treatment option in the management of long bones fracture. The aim of this study is to obtain union in nonunited long bones fractures fixed previously by intramedullary nails by using of augmentation plating and bone grafting to obtain the best outcome.

Patients and methods
The study included 18 patients of nonunited long bones fractures fixed previously by intramedullary nails treated with augmentation plating and bone grafting with maintaining the nail in situ. Full history, clinical and radiological examination were performed. All subjects gave their informed consent prior to their inclusion in the study. Eight cases with femoral fracture nonunion were performed through the lateral approach of the femur. Seven cases of tibial fracture nonunion were performed through the anterior approach of the tibia, Three cases of humeral nonunion was performed using the posterior approach of the humerus. In the postoperatively follow-up, function was assessed using Dash score and Lower extremity functional score.

Results
There was an excellent improvement for bone union occurred to 94.4% of studied patients. Furthermore lower extremities function percent ranged between 92.5-100 with mean±SD 98.1 ± 2.56, and humerus Dash score ranged between 4.16-6.66 with mean±SD 5.41 ± 1.77. There was statistically insignificant difference between the period of nonunion bone per months and fracture bone criteria of studied patients P>0.05. Also, there is statistically insignificant difference between lower extremities function score percent after implant procedure and fracture bone criteria of studied patients P > 0.05.

Conclusion
Augmentation plating is an excellent solution for the management of nonunited nailed long bones fractures with maintaining the nail in situ, especially with instability at nonunion site and comminution or gap nonunion.
Assessment of tissue level of interleukin-9 in psoriasis and vitiligo
Authors: Mahmoud Sara B. , Salem Nesma A.M. , Shaker Olfat G. , Fahim Aya M. 
Published: September 2023

Background
Psoriasis is a chronic, inflammatory, T-cell-mediated autoimmune disease. Vitiligo is an acquired depigmentary disease that occurs due to the loss of functional melanocytes from the epidermis. Interleukin (IL)-9 is a T cell-derived cytokine that was initially designated as a T helper2 cytokine. There is a link between the expression and action of IL-9 and pro-inflammatory cytokines tumor necrosis factor, IL-1, IL-17, and interferon-γ, suggesting that IL-9 is associated with the pathogenesis of autoimmune diseases.

Objective
To evaluate the tissue levels of IL-9 in patients with psoriasis and vitiligo in comparison with controls, to assess the possible role of IL-9 in the pathogenesis of these diseases.

Patients and methods
This case–control study included 30 patients with psoriasis, 30 patients with vitiligo, and 30 age-matched and sex-matched healthy controls. A skin biopsy was taken from all participants for evaluation of tissue IL-9 levels by enzyme-linked immunosorbent assay.

Results
Tissue IL-9 was significantly higher in patients with psoriasis (28.65±18.456) and patients with vitiligo (51.056±41.536) than controls (P=0.013 and P<0.001, respectively). In addition, it was significantly higher in patients with vitiligo than in patients with psoriasis (P=0.004).

Conclusion
This study suggests a possible role for IL-9 in the pathogenesis of psoriasis and vitiligo by documenting significantly higher tissue levels in patients than in controls.
Alopecia areata: trichoscopic markers in determining disease activity
Authors: Fathi Haitham B. , Al Mallah Mohammed N. , Al Chalabi Qasim S. 
Published: September 2023

Background
Trichoscopy is an important tool in detecting alopecia areata activity.

Objective
To determine the relation of the trichoscopic markers with alopecia areata activity. To demonstrate its discriminative capabilities in classifying alopecia areata activity.

Patients and methods
One hundred and thirty-seven patients (86 males and 51 females) with alopecia areata underwent dermoscopic assessment of bald patches. Hair-pulling test was used to assess disease activity. A 2×2 table of alopecia areata activity and trichoscopic marker was used to estimate sensitivity, specificity, accuracy, predictive value, and likelihood ratio.

Results
Trichoscopic markers commonly seen in alopecia areata were short vellus hairs (65.7%), broken hairs (56.9%), exclamation mark hairs (46.7%), and black dots (42.3%). According to disease activity, exclamation mark hairs (91.9%) and broken hairs (87.1%) were the most common markers in active disease while yellow dots (72.3%) and short vellus hairs (69.3%) were in stable disease. Exclamation mark hairs (91.9% vs. 9.3%), broken hairs (87.1% vs. 38.7%), black dots (53.2% vs. 33.3%), and triangular hairs (21.0% vs. 8.0%) were significantly higher in active compared with stable alopecia areata. The discriminative capability index reveals that exclamation mark hairs (91.9%) and broken hairs (87.1%) were the most sensitive signs. Triangular hairs (92.0%), and exclamation mark hairs (90.7%) were the most specific markers. Exclamation mark hairs and broken hairs were the most reliable markers (91.2% and 72.9%, respectively). The presence of exclamation mark hairs, triangular hairs, and broken hairs in bald patches raises the likelihood ratio of activity by 9.88, 2.65, and 2.45 times.

Conclusion
Exclamation mark hairs are the most important reliable marker of disease activity. Broken hairs, triangular hairs, and black dots found in bald patches increase the chance of disease activity. Other trichoscopic markers(yellow dots, pigtail hairs, short vellus hairs, and upright regrowing hairs) were useless signs in determining disease activity.
Skin reactions to COVID-19 vaccination among Egyptians in three governorates
Authors: Alkady Osama H. , Abdelhameed Sara Y. , Rezk Shymaa M. 
Published: September 2023

Background
In the first 6 months of the pandemic, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) caused more than a million deaths. Vaccines from several manufacturers, such as Pfizer-BioNTeck, AstraZeneca’s Vaxzevria, and Sinopharm, have been used in an effort to contain the pandemic.

Objective
To evaluate the skin reactions that occurred after receiving multiple types of coronavirus disease-19 (COVID-19) vaccinations among Egyptians in three governorates.

Patients and methods
This clinical cohort study was conducted on 1000 individuals receiving COVID vaccines. The registry’s vaccination module gathered data on vaccine dosage dates, cutaneous reaction(s), reaction timing, and duration. There were four categories of adverse responses to vaccines: systemic, local acute site reactions, delayed local skin reactions, and generalized cutaneous side effects.

Results
Of all individuals, 53.1% had previously contracted Covid-19. 76.3% of the study patients experienced systemic side effects. 91.4% of patients had an ‘injection site’ acute local cutaneous side effect. The Johnson and Johnson vaccination was associated with the highest systemic and local cutaneous side effects incidence, whereas the Sinopharm vaccine was linked to the lowest incidence. 10.2% of individuals experienced delayed cutaneous reactions, with the AstraZeneca vaccine having the greatest incidence and the Pfizer vaccine having the lowest.

Conclusion
Acute cutaneous side effect differs from one vaccine to another. Johnson and Johnson was associated more with bruising and redness, AstraZeneca was more associated with itching, and Pfizer was linked to increased discomfort and tenderness at the injection site. The AstraZeneca vaccination showed the highest prevalence of delayed cutaneous side effects.
Pharyngeal airway dimensions in Iranian female young adults with different skeletal patterns using cone-beam computed tomography
Authors: Golshah Amin , Jalilian Tanaz Hosseini , Nikkerdar Nafiseh 
Published: September 2023

OBJECTIVES:
To assess the oropharyngeal airway in Iranian female young adults with different skeletal patterns using cone-beam computed tomography (CBCT).

MATERIALS AND METHODS:
This descriptive, cross-sectional study evaluated 105 CBCT scans of female patients between 18 and 35 years retrieved from the archives of a radiology clinic. The images were evaluated in axial, sagittal, and frontal sections. In the axial plane, the maximum and minimum cross-sectional area (CSA) of the airways at the oropharynx, minimum width (anteroposteriorly), and minimum depth (laterally) were measured using Mimics Medical software. The oropharyngeal volume was measured by NemoFAB software. The values were compared among the groups with different sagittal, vertical, and transverse patterns. The correlation of indices with airway measurements was analyzed using Monte Carlo Chi-square and Pearson's correlation coefficient.

RESULTS:
No significant difference was noted in oropharyngeal airway dimensions and volume among cases with different skeletal sagittal, vertical, and transverse patterns (P > 0.05) except for class III patients with normal transverse pattern in whom maximum CSA in low-angle group was larger than that in normal-angle group (P < 0.05) and class I normal-angle patients in whom maximum CSA in transverse normal group was smaller than that in constriction group (P < 0.05).

CONCLUSIONS:
Oropharyngeal dimensions were not significantly different in Iranian female young adults with different skeletal patterns.
Evaluation of bond strength of orthodontic brackets using light- and chemical-cure adhesive systems over time: An in vitro study
Authors: Omidkhoda Maryam , Eslami Neda , Mazloum Maryam , Entezari Mostafa 
Published: September 2023

AIMS:
This study aimed to evaluate the bond strength of light- and chemical-cure adhesive systems over six months.

MATERIALS AND METHODS:
A total of 144 sound human maxillary first and second premolars were randomly divided into six groups according to the adhesive type (i.e., Transbond XT and Unite) and evaluation time. The groups were T0 (24-h group without thermocycling), T1 (24-h group with thermocycling), T2 (1-month group), T3 (2-month group), T4 (4-month group), and T5 (6-month group). The bond strength was then measured and the data were analyzed by SPSS software (version 23) through the independent t-test and one-way ANOVA. A P value less than 0.05 was considered statistically significant.

RESULTS:
The results of this study showed that shear bond strength of chemical-cure orthodontic adhesive (Unite, 15.37 MPa) at all-time points was significantly 1.37 times higher than that of the Transbond XT light-cure adhesive (11.15 MPa). Moreover, shear bond strength of self-cure adhesive (Unite) 1 month after debonding showed a significant difference with the 24-h group without thermocycling (P = 0.002), 24-h group with thermocycling (P = 0.008), and 6-month group (P = 0.016). The highest shear bond strength in both adhesives was observed at one month. Furthermore, the shear bond strength of Transbond XT light-cure adhesive one month after debonding showed a significant difference with the 24-h group without thermocycling (P = 0.000) and 24-h group with thermocycling (P = 0.000), as well as with the 2-month (P = 0.008), 4-month (P = 0.000), and 6-month groups (P = 0.016).

CONCLUSION:
Unite self-cure adhesive compared to Transbond XT light-cure adhesive has higher bond strength and is recommended for rebonding brackets in patients with multiple rebonds.
The prevalence of Brodie bite in untreated orthodontic patients in Nigeria
Authors: Ize-Iyamu Idia N. , Otaren Joseph N. 
Published: September 2023

OBJECTIVE:
The Brodie bite (BRB) is a rare posterior crossbite affecting the transverse occlusal relationship with the palatal cusps of the upper molars, biting into the vestibule and outside the buccal cusps of the lower molar teeth. The BRB is a highly challenging orthodontic problem and is an extreme form of scissors bite. Patients with this problem present with facial deformity and inability to chew on the affected side. The problem is usually not identified until it becomes severe. This study aimed to identify the prevalence of BRB among untreated orthodontic patients in two geo-political zones in Nigeria.

METHODS:
A total of 1,041 untreated orthodontic patients who presented to two different orthodontic centres located in two geo-political zones (South/South-Benin City and North Central-Abuja, Nigeria) over a 3-year period were evaluated for the presence of BRB. The transverse dimension of the occlusion was examined for the presence of a crossbite or scissors bite. The molar teeth were used as the reference point for occlusion with Angle's classification of malocclusion. Four groups were identified, namely, teeth in occlusion (TIO) (Angle's Classes I, II or III malocclusion served as the control group), scissors or lingual crossbite (LCB), buccal crossbite (BCB) and BRB. A posterior crossbite was confirmed when the upper molar teeth were biting outside the buccal groove of the lower molar teeth either lingually or buccally. A BRB was identified when the palatal cusps of the upper molars were biting into the buccal vestibule of the lower jaw, with the deviation of the face to that side. Statistical analyses were performed using SPSS version 21; frequencies were determined for the variables, and cross-tabulations between the variables were established. P values < 0.05 were considered significant.

RESULTS:
The overall prevalence of BRB in this study was 0.6% (six patients). The values in the South/South (Benin City) were 997 untreated orthodontic patients, with a prevalence of 0.5% (five patients). The North Central (Abuja) zone had a total of 44 untreated orthodontic patients, with a prevalence of 2.3% (one patient). Unilateral BRB was seen in five patients (80%), and bilateral BRB was seen in one patient (20%). The condition was more prevalent among women (four patients, 80%) and on the right side (three patients, 60%). Angle's relationship in Classes I, II and III (TIO or control group) was seen in 911 patients (87.5%). The LCB and BCB groups comprised 39 (3.8%) and 85 patients (8.1%), respectively. Posterior crossbite was seen in 130 patients (12.5%).

CONCLUSION:
The prevalence of BRB in this study was found to be 0.6%, with the condition being more prevalent in women and on the right side.