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Article
Scaphoid Fracture Non Union Treated by Bone

Author: *Ghadeer H. Majeed, F.I.C.M.S. *; Mohammed S. Al- Iedani, F.I.C.M.S.
Journal: Al-Kindy College Medical Journal مجلة كلية الطب الكندي ISSN: 18109543 Year: 2012 Volume: 8 Issue: 1 Pages: 36-40
Publisher: Baghdad University جامعة بغداد

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Abstract

Objective: to evaluate the results of (Modification of Russe method) in treatment of nonunion fracture scaphoid bone by bone graft with external splintage (plaster of paris cast (pop ).Methods:Prospective study done on 26 patients (24 male, 2 female), age range between 25-42 years (mean age 34 years), fracture site at middle 1/3 with minimal displacements with no carpal bone or radial bone injury, technique of Matte- Russe method (explore the bone through volar approach using bone graft from iliac crest (cortico-cancellous peg plus cancellus bone) with thumb spica for 90 days with period of follow up 12-18 months.Results: out of 26 patients treated by this method , 23 patients (88.5%) union was achieved radiologically by the end of 3rd month &progressed over the next 3 months, range of motion of the wrist & power of grip increased gradually became almost comparable to the normal side by the end of sixth month , 5-7 degrees loss of dorsiflexion was residual in 6 patients . Three patients (11.5%) did not show union radiolgically after sixth postoperative month, their local symptoms were better than before surgery ,they were not keen to have another operation .No complications were noticed, wound healed well ,patient tolerance was goodConclusion: the use of cancellous bone graft with plaster of paris (p.o.p.) splint is less demanding surgically& less coasty and resulted in good results(88.5% healed well ).we recommend this treatment as a method for treating nonunion of carpal scaphoid bone .Key wards: nonunion, scaphoid , bone graft , plaster of paris


Article
Histopathological evaluation of aragonitic calcium carbonate as a bone graft substitute in rabbit's mandible (An experimental study)

Authors: Samir W. Abrahem سامر ابراهيم --- Kadhim A. Al-Soudani كاظم السوداني
Journal: Journal of baghdad college of dentistry مجلة كلية طب الاسنان بغداد ISSN: 16800087 Year: 2012 Volume: 24 Issue: 4 Pages: 58-61
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: Augmentation of the craniomaxillofacial region is required for many aesthetic and reconstructiveprocedures. Many bone grafts substitutes have been developed .These products differ in their osteoconductive andosteoinductive properties .The use of bone graft substitutes offers the ability to lessen the possible morbidity of theharvest site inautograft. Aragonitic calcium carbonate has proved to have biocompatible properties as bone graftsubstitute. This study aimed to evaluate the histopathological effects of aragonitic calcium carbonate inexperimentally induced bone defect in rabbit's mandible.Material & method: Twenty five adult male healthy rabbits were used in current study. Two holes were prepared inthe rabbit's mandible, first hole remain empty as control, the second filled with aragonitic calcium carbonate.Samples were taken after 2, 6,8,12 and 24 weeks. Histopathological evaluation include; examination of new boneformation and inflammatory response, in both control and experimental groups.Results: At 2 weeks, there was no new bone formation in both defects with moderate amount of inflammation .At6,12 and 24 weeks the amount of new bone formation in implant group was more than that formed in control group( statistically highly significant correlation, p<0.01). At 8 weeks, less bone amount in implant group .There weremarked degradation of implant particles at 6 weeks.Conclusions: ACC is suitable bone graft substitute and induce new bone formation by acting as bioactive,osteoconductive bone graft when come in contact with bone.


Article
Bone graft from iliac bone for maxillofacial reconstruction: An operative approach with decrease morbidity

Authors: Bassem T. Merry بسيم ميري --- Balsam S. Abdulhamed بلسم عبد الحميد
Journal: Journal of baghdad college of dentistry مجلة كلية طب الاسنان بغداد ISSN: 16800087 Year: 2012 Volume: 24 Issue: 4 Pages: 77-82
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: In Maxillofacial surgeries, iliac bone graft has traditionally been harvested to provide osteoconductive,osteoinductive and osteogenic components to initiate bony formation. There are multiple types of procedures forharvesting iliac bone graft, either by surgical exposure procedure for procurement bone graft bicortical, unicortical,tricortical or by using Fritsch bone harvesting (trephine) system or by Spine-Tech grinding harvester technique. Thisstudy compares procedures for harvesting iliac bone graft by using sub-crestal window technique procedure andtrap-door iliac crest bone graft procedure for different purposes like alveolar cleft, bone resection due to tumor,reconstruction of avulsed facial bone due to trauma by bullet injury or RTA, confirming that donor site morbidity ofthe sub-crestal window technique is more significant than trap-door technique.Patients and methods: In this study (40 patients / 22♂:18♀) underwent harvesting of iliac bone graft with age range(3.5-65 years) in Al-Kadhmyea Teaching Hospital (2009-2012) for different purposes like alveolar cleft, reconstructionof mandible after tumor resection and reconstruction of maxillofacial defects due to massive blast or bullet injury.Results and Conclusions: The results indicate that major complications from ICBG harvest are uncommon, but minorcomplications are common. The findings suggest that donor site morbidity of the sub-crestal window technique issignificantly less than trapdoor technique. Making the sub-crestal window technique is the method of choice forharvesting large amounts of bone graft


Article
ILIAC CREST BONE GRAFT IN MAXILLOFACIAL BONY DEFECTS

Authors: Ayad A. Hasan اياد عبدالخالق حسن --- Ammar Y. Khudhir عمار ياس خضر
Journal: IRAQI JOURNAL OF MEDICAL SCIENCES المجلة العراقية للعلوم الطبية ISSN: P16816579,E22244719 Year: 2013 Volume: 11 Issue: 3 Pages: 216-224
Publisher: Al-Nahrain University جامعة النهرين

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Abstract

Background:The reconstruction of facial deformity has been of paramount clinical concern for many years and one of the most difficult and challenging tasks facing the maxillofacial surgeon. The ultimate goal in the treatment is the relief of suffering, restoration of function of jaw, restoration of speech, regain of the normal looking contour and improvement in the quality of life.Objective:To obtain more knowledge on autogenous on lay bone graft behavior in different facial defects and to evaluate the lateral and medial surgical approaches to the iliac crest.Methods:A prospective study was conducted during the period from January 2009 to January 2012 on 20 patients with facial defects, in the orbit, zygoma, maxilla and mandible. The causes of defects were trauma, odontogenic tumors and alveolar cleft. Types of bone graft used were either block cortico-cancellous or chips cancellous bone, the block was either monocortical or bicortical bone graft.Results:Complications associated with donor site harvesting procedure included pain 5% and gait disturbance 5%. Failure of bone graft was observed in 3 patients (15%) while the rest, 17 patients, (85%) ended with functional and esthetic successful graft. Causes of failure were due to sequestration (5%), inflammation due to osteomesh (5%) and soft tissue breakdown (5%).Conclusion:Iliac crest graft has evolved as a safe, well accepted procedure, with relatively low morbidity that can be used for a wide variety of maxillofacial procedures.Keywords:Iliac crest, bone graft, facial defects


Article
Non Union of Diaphysial Humeral Fractures

Authors: Mohammed Ali F. Al Bayati --- Naji Kareem Hasaan --- Lauy Assad Mahmood
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2013 Volume: 12 Issue: supplement Pages: 716-720
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT: BACKGROUND: Humeral shaft fractures represent 3-5% 0f all fractures mostly heal by conservative methods ,frequently few fractures fail to unite , several fixation modalities have been used with types of bone graft .OBJECTIVE: To analyze the local and environmental factors of 44 patients having non union of diaphysial humeral fractures and the result of treatments by open reduction and fixation with plate and screws and autogenous bone graft application .METHODS: Retrospective and prospective study of forty four patients had non union of the daiphysis of the humerus, 34 males ,10 females, age ranged from 18-61, 29 had open injuries , 15 had closed injuries . All patients treated by rigid fixation with plate and screws and ample amount of autogenous bone graft. Follow up from 6-24 months .RESULTS: 40 patients had good results in clinical and radiological union of their humeri , in four patients the bone fail to unite ,graft resorbed with or without plate failure.CONCLUSION : Sever injuries with soft tissue damage is a major cause of nonunion and rigid fixation by plate and screws with autogenous bone graft is a good optional method of treatment when other modalities are not available ..


Article
Anterior cervical decompression and fusion using cage and autogenously graft

Author: MUSAED AL-DAHHAN مساعد حكمت الدهان
Journal: Al-Qadisiyah Medical Journal مجلة القادسية الطبية ISSN: 18170153 Year: 2010 Volume: 6 Issue: 9 Pages: 159-166
Publisher: Al-Qadisiyah University جامعة القادسية

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Abstract


Aim
Use of cage and bone graft for decompression and fixation cervical spine

Methods
Fourty patients between june2004 _ june 2006 , evaluated by physical and neurological examination with radiograby by x
Ray and MRI . the treated by anterior disectomy and replaced by cage and bone graft.

Result
Regarding the site of disc prolapsed (10%) between C4 -5(65%) between C5 -6 and (25%) between C6-7 .
37 patients treated disectomy by and bone graft while two
Patient treated by corpectopmy of C5,6 body
The complete recovery presented in 80% , incomplete recovery in 7,5% while no any improvement in 2,5%

Conclusion
Immediate stability with good clinical improvement and no graft morbidity are the advantage of this implant compared to
conventional interbody grafting techniques .

تم اجراء عملية رفع الانزلاق الغضروفي العنقي من الناحية الامامية علاجا للانزلاق الغضروفي العنقي وتم استبدال الغضروف المرفوع بغضروف صناعي مع استعمال عظم طبيعي اخذ من عظم الورك لنفس الشخصتم اعتماد الأعراض التي يشكوا منها المريض مع طرق التشخيص المساعدة مثل أشعة x مع الرنين المغناطيسي للفقرات العنقية تم معالجة أربعون شخصاً (10%) منهم كانوا يعاني من الانزلاق الغضروفي بين الفقرات العنقية الرابعة والخامسة (65%) الانزلاق بين الفقرة الخامسة والسادسة و(25%) الانزلاق بين الفقرة السادسة والسابعة تم رفع الانزلاق الغضروفي من الناحية الامامية لـ(38) مريض بينما أجريت عملية رفع الفقرة الخامسة والسادسة لمريض واحد فقط كانت نتيجة تحسن الأعراض لدى المرضى (80%) بينما كان تحسن في الأعراض ولكن بصورة جزئية (17,5%) وعدم وجود أي تغير أو تحسن في الحالة الصحية في (2,5%) فقط.توصلت الدراسات بضرورة تثبيت العمود الفقري للفقرات العنقية بأستعمال الفقرات الصناعية مع العظم للوصول إلى أحسن النتائج


Article
THE TREATMENT OF OPEN & CLOSED TIBIAL ‎FRACTURES BY PRIMARY EXTERNAL FIXATION & ‎BONE GRAFT

Authors: Mohammad S Al-Edany --- Thamer A Hamdan
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2005 Volume: 11 Issue: 2 Pages: 38-44
Publisher: Basrah University جامعة البصرة

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Abstract

‎ We prospectively studied 64 patients with fracture shaft tibia, 23 patients with closed tibial fracture and ‎‎41 patients with open type. All fractures were stabilized by external fixation device AO/ASIF type after ‎failed manipulation under anesthesia (MUA) to restore the osseous alignment. In 28 patients cancellous ‎bone graft were used after the upper part of the tibia to enhance healing process, all these patients were ‎followed for an average of 8-12 months.‎‎ Our findings showed that stabilization of the fracture shaft tibia by external fixation with cancellous bone ‎graft had significantly better results, than external fixation alone.‎‎ The use of external fixation device with bone graft, is safe, effective, cheap and available in almost all ‎orthopaedic units n Iraq. ‎


Article
Anatomical Cervical Cage Versus Autologous Bone Graft for Anterior Cervical Discectomy and Interbody Fusion In Patients with Cervical Disc Degeneration

Authors: Dawood Sadik Alobidi --- Firas Abdalhadi AL Obidi
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2014 Volume: 13 Issue: 3 Pages: 398-406
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND:Anterior cervical discectomy and interbody fusion (ACDF) is a surgical technique used to treat a variety of cervical spine disorders, such as nerve root or spinal cord compression, cervical spondylosis, and cervical spinal stenosis (1,2).OBJECTIVE:To evaluate the clinical outcome of ACDF with an autologous iliac crest graft (AICG) versus ACDF with an artificial anatomical cervical cage made of polyethereterketone (PEEK) filled with artificial bone substitute for patients with cervical spondylosis.METHODS:This was a nonrandomized prospective study of 68 patients ( 28 females,41.2%), and (40 males,58.8%) with mean age of 59.4 years, who had symptomatic cervical disc degeneration (CCD) and underwent ACDF from 1st February 2010 till 1st of September 2013.We divided the patients into two groups, group A made of 25 patients underwent ACDF by using AICG and group B made of 43 patients underwent ACDF by using anatomical cervical cage (PEEK) filled with bone substitute.All patients were evaluated preoperatively and six months postoperatively by using Neck disability index (NDI), and Visual analogue scale (VAS) for radicular pain, neck pain and headache.RESULTS :For group A, the postoperative improvement in NDI was statistically significant, and for VAS the postoperative improvement was statistically significant for radicular pain, neck pain and headache. For group B, the postoperative improvement in NDI was statistically significant, and for VAS the postoperative improvement was statistically significant for radicular pain, neck pain and headache.The difference in postoperative improvement between group A and B was statistically not significant for NDI, and VAS (radicular pain, neck pain and headache).CONCLUSION:Both methods are effective in treating cervical spondylosis in selected patients.No method is statistically superior to another in 6 months postoperative clinical outcomes by using NDI and VAS for radicular pain, neck pain and headache.


Article
OPEN REDUCTION AND INTERNAL FIXATION WITH CORTICOCANCELLOUS BONE GRAFT FOR TREATMENT OF VOLARY MALUNITED FRACTURE OF DISTAL RADIUS

Author: Falih Waheed Hashim
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2018 Volume: 24 Issue: 1 Pages: 31-38
Publisher: Basrah University جامعة البصرة

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Abstract

OPEN REDUCTION AND INTERNAL FIXATION WITH CORTICOCANCELLOUS BONE GRAFT FOR TREATMENT OF VOLARY MALUNITED FRACTURE OF DISTAL RADIUS Falih Waheed Hashim MB,ChB, FICMS Orthopedics, Lecturer, Department of Surgery, College of Medicine, University of Basrah, IRAQ. Abstract Malunion of the distal radius is actually a late complication, not salvageable by re-manipulation or a change of immobilization, it requires different management technique. The aim of this study is to choose a technique that corrects the deformity as much as possible, with less complications. An assessment was done for 24 patients with unilateral malunited fractures of the distal radius. The mean age was 42 years (range 25-61 years). They were treated by open-wedge volar osteotomy with corticocancellous graft from upper tibia. Both osteotomy and graft were fixed by volarly applied plate and screws. Preoperative antero-posterior and lateral wrist radiographs were obtained and fracture pattern and radio-carpal alignment were assessed. Radial length and palmar tilt were also measured. The clinical outcome was assessed depending on the modified Gartland and Werley score. Radiological assessment of the parameters was done postoperatively to detect how much these parameters were corrected. This study shows that volar open-wedge osteotomy with corticoocancellous bone graft and internal fixation is a method for correction of malunited distal radial fractures with encouraging results. About 90% of the patients were satisfied with their results regarding the correction of the deformity and improvement of wrist and hand function, as well as limited complications when it is done carefully with appropriate facilities. In conclusion, the corrective osteotomy should be considered only when there is a clear-cut indication. It is actually a method to correct the deformity, rather than treatment of symptoms, specially pain.

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