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Background: Carpal tunnel syndrome is a common condition in which the median nerve passes through the carpal tunnel is compressed. Then, gradual paralysis occurs. This study aimed to compare patient outcomes after surgery for carpal tunnel syndrome in both groups with and without splint.. Methods: This study was conducted in Isfahan University of Medical Sciences, Iran, in Kashani hospital during 2011. 64 patients underwent surgery for carpal tunnel syndrome were selected and randomly divided into two groups of 32. For the first group, splints were considered after the surgery and for the second group, as the control group, splint was not given. Patients within 3, 6 and 12 weeks after surgery were followed and healing in the sense of motion and pain based on the visual analogue scale (VAS) measures were examined. Findings: Sensory conflict scores at the 3rd and 6th weeks in the group with splint were higher than the group without it; but, 12 weeks after the treatment, the results were identical. In any cases, motor involvement was not seen. At the 3rd week after the treatment, the mean pain score in the group without splint was higher than with splint group. The results of the 6th week after the treatment in both groups were almost identical; but, at the 12th week after the treatment, changes in pain intensity was not significantly different between the two groups (P = 0.97). Conclusion: Splinting after the surgical release of the median nerve probably causes a delay in the recovery of sensory, motor and pain; but due to the effect of material of used splint, the result is still uncertain and further broader interventions needs to be done in this regard. [ABSTRACT FROM AUTHOR]

Background: The best treatment for mild to moderate carpal tunnel syndrome (CTS) is still controversial. The main aim of our study was to determine whether corticosteroid injection would result in a better outcome. Methods: In this randomized clinical trial, 88 individuals with mild to moderate CTS were selected from patients who referred to Kashani Hospital in Isfahan, Iran. The patients were randomly assigned into two groups. Splinting in neutral position of wrist was the only therapeutic method utilized in first group. However, splinting accompanied with corticosteroid injection was performed in the second group. Then the patients were evaluated in terms of pain intensity, and the relative prevalence of Phalen's and Tinel tests. Findings: Pain intensity and prevalence of Phalen's and Tinel tests were significantly lower in patients treated with splinting accompanied with corticosteroid injection. Conclusion: It seemed that splinting accompanied with corticosteroid injection is a more effective method in treatment of mild to moderate CTS. [ABSTRACT FROM AUTHOR]

Background: A glass injury to the wrist and forearm is a common condition in adults and children that may cause significant discomfort and disability. This study was conducted to evaluate the accuracy of preoperative examination of this injury. Methods: In this prospective study, among patients referred to Kashani hospital in Isfahan, Iran from August 2006 to March 2008, 150 patients with glass injury to the wrist and forearm were enrolled. In this case, the first, careful clinical examination and routine exploration without expansion of wound was done by an orthopedic specialist and then surgical exploration in the operative room was done for the same patient by the same physician. The evaluated information was obtained and compared before and after treatment. Findings: Despite the enough accuracy of preoperative examination in glass injury of dorsal side of wrist and forearm, the preoperative examination significantly underestimated the amount of damage to tendons, nerves and arteries on the volar side of forearm and wrist. The most frequent injury pattern was the flexor digitorum superficialis (60%), median nerve (18%), and Flexor carpi ulnaris (16%). The most injured structure on dorsal side of forearm was Extensor digitorum tendons. Conclusion: It seemed that the preoperative examination, even when specifically evaluating for deficiencies is done, significantly underestimates the extent of glass injury to the volar side of wrist and forearm. If glass is implicated as a causative agent, careful orthopedic evaluation and surgical management should be considered even in sight of a normal preoperative examination. [ABSTRACT FROM AUTHOR]

Background: The scaphoid fractures are of the most prevalent fractures of the wrist and there are different ways for the treatment of these fractures. The aim of this study was to compare results and complications of three of these methods. Methods: In this randomized clinical-trial study, among patients referred to Kashani hospital in Isfahan, Iran, from September 2006 to September 2008, 39 with scaphoid fracture, with more than 1 mm displacement, were enrolled. They were randomly assigned into three groups (13 patients in each). In the first group, close reduction and immobilization (cast) was used. In the second group, percutaneous fixation with pin and in the third group, one percutaneous screw was used. The patients were evaluated monthly with X-Ray, and by Mayo Wrist Scoring. The evaluated information was obtained and compared. Findings: The mean time of union was significantly shorter in the third group and there was no malunion, nonunion or any other complication in this group. Results of Mayo Wrist Scoring was better in third group, too. Conclusion: The percutaneous screw fixation in scaphoid fractures causes better fixation and results in shortening of union period and, if technically possible, can be suggested as a good method of treatment for these types of fractures. [ABSTRACT FROM AUTHOR]

Background: Despite the advances in techniques and the improvements in surgical implants, treatment of distal femoral fractures remains a challenge in many situations. Long-term disability can still occur if inappropriate treatment is done. This study was conducted to evaluate the results of distal femoral nailing in treatment of the distal femur fractures. Methods: In this cohort study, among patients referred to Kashani hospital in Isfahan, Iran from December 2005 to December 2007, 36 patients with distal femoral fracture were enrolled in our study. Patients were treated with retrograde femoral nailing. The patients' demographic information, Anterior Cruciate Ligament (ACL) tearing, duration of surgery, volume of hemorrhage, and after-surgery complications such as stiffness, infection and rate of union was obtained and reported. Findings: The mean of time of surgery was 97.4 ± 11.6 minutes. There were not any ACL tearing in studied patients. In first two weeks, infection was seen in 4 patients that recovered. The rate of union was 100% after 6 month. Regard to results, retrograde nailling has very good results in treatment of distal femoral fractures. [ABSTRACT FROM AUTHOR]

Background: Prediction of ventricular tachycardia (VT) inducibility through clinical and paraclinical predictors and ability of ventriculoatrial (VA) conduction can help to identify high risk patients easier. Methods: Fifty four patients suspicious for ventricular tachyarrhythmia underwent electrophysiologic study for basic measurements and programmed stimulation for ventricular tachycardia induction, electrocardiography and echocardiography during October 2007-October 2009. Finding: The mean age of participants was 59.4 ± 13.9 years. Forty three patients (79.6%) were male and 39 patients (72.2%) had history of ischemic heart disease (IHD). Ventricular tachycardia was induced in 30 patients (55.6%). Ventriculoatrial conduction was recorded in 38.9% of patients (21/54). Ventricular tachycardia was induced in 52.4% of patients (11/21) with ventriculoatrial conduction versus 57.6% (19/33) in ventriculoatrial dissociate patients (P = 0.3). Mean of ventriculoatrial Wenchebach point (VAWP) was 400 ± 96.6 and 393 ± 103.6 ms in ventricular tachycardia inducible and non inducible patients respectively (P = 0.4). Presence of ischemic heart disease and lower left ventricular ejection fraction (LVEF) were associated with increased probability of ventricular tachycardia induction (P = 0.008 and 0.04 respectively). Presence of ischemic heart disease predicts ventricular tachycardia inducibility independently. Patients with inducible ventricular tachycardia had slightly shorter atrial-His (AH) interval (97.33 ± 30.4 and 112.1 ± 42.6 ms, P = 0.07). Conclusion: Ventricular tachycardia induction was very slightly more common in ventriculoatrial dissociate patients but we could not prove it. Presence of ischemic heart disease independently and lower left ventricular ejection fraction dependently could predict ventricular tachycardia inducibility. [ABSTRACT FROM AUTHOR]