ali andalib

Nowadays, surgical procedures are assessed based on the state of an individual. This study aimed to investigate the effect of lumbar spinal stenosis surgery on the patient’s quality of life and motor functions in Kashani and Alzahra Hospital in Esfahan.

In the present cross-sectional study, 40 patients aged between 50-70 were respectively evaluated who underwent lumbar spine stenosis surgery in Al Zahra and Kashani Hospitals in Esfahan University of Medical Sciences, Esfahan, Iran, during 2020-2021. The SF-36 questionnaire was used as a research tool. The visual analog scale (VAS), and spine functional index (SFI), were measured initially before surgery and 6 months and 9 months after surgery.

The mean scores of the SF-36, SFI, and VAS scores questionnaire were 87.95±4.94, 21.38±1.24, 6.07±0.69 (p<0.001) before surgery, 89.77±5.25, 19.73±1.40, 5.37±1.56 (p<0.001) six months after surgery, and 94.70±5.34, 18.63±1.56, 4.57±0.81 (p<0.001) nine months after surgery, and all were significant. Improvement in the domains of general health, role-physical, role disorder due to impaired physical health, social function, emotional role, and bodily pain was evident. Also, the overall quality of life was enhanced but energy levels and role disorder due to impaired mental health showed no improveme.

Not only does lumbar spinal stenosis surgery significantly improve the general health, role-physical, and the social function of the patients but also enhances their quality of life.

Irony is a tool for authors developed in linguistic terms using charming, integrated, and technical methods. An ironic expression has different purposes to make the words understood for recipients without expressing the words directly. This is because the author tends to avoid possible negative feedbacks. In this way, he can prevent the recipients from accurate comprehension. Thus, the recipients guess these mental images and think them possible. Since the irony is required to be comprehended in any situation, the recipient uses the mechanism of interpretation. The present analytical study aimed to investigate the ironic aspects of the poem Nazaf Al-Habib'O shaqaeq Al-Nomaan written by the contemporary poet Mahmoud Darwish. The results of the present study showed that, in this poem, the use of irony along with practical skills, linguistic and rhetorical awareness, and multiple reading strategies keep the recipient away from comprehending the author’s point of view. It can be concluded that interpretations arise from the use of irony in poems make a word more beautiful and clearer so that the recipient could get the content of it.

Hip dysplasia is one of the most widespread hip disorders. Total hip arthroplasty (THA) is the preferred treatment in patients with cup placement choices in true or false acetabulum. The objective of this research was to compare the effectiveness of the two mentioned procedures.

This study was a randomized, open?label, parallel?group clinical trial, in which 46 patients/51 hips with Crowe type 3 dysplastic hip having THA were assigned to two groups:  roup 1 – patients who had cup placement in the true acetabulum and Group 2 – patients who underwent cup placement in the false acetabulum. The variables that were evaluated and analyzed included severity of pain using the visual analog scale (VAS), range of motion (ROM), gait ability, the need for repeated joint replacement, and the Harris Hip Score (HHS).

Forty?six patients/51 hips were included in the present study. The patients who were evaluated included 30 (65.2%) males and 16 (34.8%) females. The mean age in the population under study was 71.0 ± 10.22, and the mean body mass index of participants was 26.34 ± 2.22 kg/m2. The basic parameters in the two research groups were similar (P > 0.05). There were no significant differences between the two groups in terms of the mean values of VAS and ROM (P > 0.05); however, the mean HHS was significantly higher in the true acetabulum group, 57.90 ± 18.47 versus 48.29 ± 13.80 (P = 0.04).

The effectiveness of cup placements both in the true and false acetabula was similar in all of the evaluated variables in terms of clinical outcomes except for HHS which was higher in the true acetabulum group. To further support the results of this research, it is recommended that more research be done on a greater population.

Sacroiliac pain is one of the causes of low back pain, representing with discomfort and tenderness in the sacroiliac joint. Interventional procedures might be beneficial in cases unresponsive to medical treatments. Here, we aimed to investigate the effects of intra‑articular corticosteroid injections in patients with sacroiliac pain.

This is a clinical trial performed in 2017–2018 in Kashani Hospital, Isfahan, on patients with low back pain and formerly diagnosed with sacroiliac pain. Patients were recruited based on inclusion and exclusion criteria. Corticosteroid injections were performed for patients. Patients were visited within 2 weeks, 4 weeks, and 6 months after interventions, and pain and disabilities of patients were assessed using the numerical rating scale (NRS) and Oswestry Disability Questionnaire.

A total number of 27 patients entered our clinical trial. We showed that the mean NRS score among patients before interventions was 8.01 ± 0.96. Assessments of disability score also indicated that the mean disability scores was 41.48 ± 7.48. Our data also indicated that there was a significant reducing trend in both NRS and disability score after interventions (P < 0.001 for both items).

Intra‑articular steroid injection is associated with significantly reduced pain and disability in patients with sacroiliac pain. Previous studies evaluated variable methods and reported that this method has high values and significant advantages compared with other techniques which were in line with our results.

This research deals with the irony as a social mediator, a mechanism aimed at communicating the social reform messages. This mechanism has been considered by many contemporary Arab researchers. This theoretical research, has explored Irony from a perspective of reception theory and analyzed the components of this theory and its concepts, and their compatibility with Irony's elements. It also focuses on verbal communication to understand irony and its types and analyze the elements of perception. This study considers the criterion of ironic perception as the recipient's mastery of the general subject of the message; Because until the recipient manages to understand the general subject or ironic situation, he will not be able to understand the original meaning and concept of irony, so he will simply fall victim to irony.Finally, the receiving process benefits from certain types of irony, because this process requires the presence of the written text and its reading, and this is something that does not exist in all types of irony. This study considers Irony as a tool to convey the author's reformist goals, which is achieved through the interaction between the recipient and the text. We recognize the author's priority in making and promoting Irony, because the author must consider himself a hypothetical reader in order to succeed in Irony. The creator of Irony provides the reader with the opportunity to achieve the best and most obvious results by creating textures and tools as well as a purposeful technical structure.

Studying communication functions in the chapters of the Qur'an could be a good way to achieve the esoteric meanings of this eternal miracle. The more researchers try to study the structure of Qur’anic verses, the more they understand its basic concepts and main purposes. One of the tools for studying the Qur’anic discourse is to find communication functions based on Jacobson's theory. The present study intends to study this chapter from different angles by adapting Jacobson's theory of communication theory and combining it with the ironic technique. Using a descriptive-analytical method, in this study, an attempt is made to explore the communication structure of the sura with the addressee or the recipient to find what communication method could be more effective and what kinds of meanings are emphasized by it. What is certain is that the main orientation in the communication model of the verses of this sura is more towards the subject of worshiping God. However, the persuasive role of the verses in Sura Zumr cannot be ignored because the sender of the message (God) has provided the dimensions of the referential and persuasive role by using literary, metalanguage, and empathy tools.

Conceptual metaphor is a modern method of expressing thoughts, and hidden and inner mental concepts whose appearance in literature is not possible except with a considerable effort. This method was first developed by two European authors named Laykov and Johnson. Conceptual metaphor emerges among peoplechr('39')s common speech mechanism. War, being driven and displacement are among complex and hidden concepts which can only be observed through epic poetry in literature. The modern epic phenomenon in the current era is noticed among Palestinian Resistance poets especially Mahmud Darwish. Although the words resonate with past Arab poets such as Antarah, Tarafa and others allowed them to portray battlefields and their events, Mahmud Darwish placed concept of war and fighting in the form of durable sonnets which we wonchr('39')t face with any difficulties in comprehending them and creating rhetoric frameworks. Mahmud Darwish, known as the Poet of Resistance and one of the romantic symbolist ones, has widely utilized conceptual metaphor besides rhetoric techniques and symbols in his poems. In this study, we tried to analyze conceptual metaphors reflecting poetchr('39')s inner thoughts and expressing events such as war, plundering and displacement in his country by using analytical-descriptive method. We found that concepts like movement, life and humanity are the most mental concepts in the poetchr('39')s works and can be consider as the criteria for evaluating conceptual metaphor. We concluded that the poet has made use of conceptual metaphors to depict the Palestinian Resistance and this method is a simple way to express the amount of his grief and painful memories.

Trauma and traumatic injuries are the most common causes of disabilities among the young population in developing countries. Besides morbidity and mortality, traumatic injuries can significantly decrease the quality of life and life expectancy of the victims.

Traumatic Spinal Cord Injury (TSCI) is an acute, traumatic lesion of the spinal cord. It usually produces economic problems that can emotionally and psychologically affect the patients. This study aims to evaluate spinal column fractures and TSCI in Iran.

In this study, we evaluated all of the cases diagnosed with TSCIs between 2012 and 2018. A total of 1014 patients were included in our study. Prevalence of spinal column fractures was evaluated and the percentage of each type of fractures was extracted. The need for surgery and the percentage of TSCI were also evaluated.

The most common cause of trauma was vehicle and road accidents (83.4%) followed by falling (12.7%). A total of 21 patients (2.1%) died due to injuries. The incidence of TSCI among patients with traumatic spinal column fractures were 62 cases (6.1%). Also, 67.7% of patients with TSCI underwent surgery. Furthermore, we found that the lumbar area received the highest incidence of TSCI (38.3% of all TSCIs) followed by thoracic spine fractures (27.4% of all TSCIs). Also thoracic and cervical spine fractures were mostly associated with mortality compared with other sites of spine fractures (47.6% and 38.1% of all mortalities, respectively).

In our study, most cases (83.4%) were injured by road accidents which indicates the low safety of vehicles and roads in Iran. Epidemiological features of spinal column injuries and TSCI vary among different societies due to different causes. So far, this study is the first one to evaluate different spine fractures and TSCI and other associated factors in the Iranian population.The results indicate a high incidence of thoracic and lumbar fractures and a higher mortality rate in thoracic and cervical fractures.

The best method for repairing intertrochanteric fractures is still controversial. The fixation methods includeextramedullary (EM) and intramedullary (IM). Studies that compare IM and EM fixations for unstable hip fractures arerare. In this study, our goal was to compare the efficacy of EM and IM fixation in treatment of unstable intertrochantericfractures. A total of 113 patients with unstable intertrochanteric were randomized in this cohort study between March2016 and June 2018 in trauma center of Kashani and Alzahra Hospitals, Isfahan, Iran. The patients were followed for aperiod of 12 months with sequential clinical and imaging evaluations. Baseline data were recorded at the time of injury.Radiographs were evaluated immediately post-operatively and at the scheduled follow-up intervals. A total of 20 of patients were excluded during the study and finally 93 patients (43 males and 50 females)with mean age of 62.74±16.4 completed the follow-up sessions. Mann-Whitney test indicated a significant difference intip-apex distance between the two groups. While the two groups were homogeneous in the baseline LEM score, it wasnot significantly different between two groups after 1 and 3 months of surgery as well. However, the LEM score wassignificantly higher in IM group after 6 and 12 months of surgery. According to our findings, IM nails (such as the cephalomedullary nail) afforded more advantages overEM devices (such as the DHS and DCS) in the treatment of unstable intertrochanteric fractures. Our results indicatedthat the final LEM scores as well as the time to union were better in IM fixation group.Level of evidence: I

The origin of irony is not only from Greek philosophy but also, it is a modern literary approach. Irony has enterd and expanded in Arabic literature. Irony includes many meanings and in science of rhetoric similar to verbal sharing and in cultural and social communication near to literary critisim. We have found the role of semantic in this discourse is noticable, and it emerges as a semantic method in rhetoric and literary criticism. So, we tried to uncover the semantic dimension of the concept of irony, and to reveal the contradiction of meaning and verbal sharing. However, it seems that irony is the same as common arts in rhetoric such as meaning, eloquence and exquisite. There are many difrences between irony and rhetorical methods. The authors, using new ideas by an analytical method, interpreted examples of irony. The conclusion of this research is that the term irony -from a semantic point of view- is a verbal sharing that cinsists of sarcasim and paradox. In orther to use verbal or situational sarcasim, speakers redicule the person and say the meaning different to what speakers say.

Elbow fracture, especially supracondylar fracture, is one of the most common fractures in children. The aim of this study was to evaluate the distribution of elbow fractures in children aged 2 to 18 years. In this study, 340 patients with elbow fracture aged 2 to 18 years who referred to emergency departments of Kashani and Alzahra hospitals in Isfahan City, Iran, during the period from 2014 to 2017 were evaluated. Age, sex, type of fracture, season of injury, mechanism of injury, and vascular and neurological damages were studied. Findings: 340 patients with an average age of 7.88 ± 4.94 years participated in the study. Most of the patients aged under 4 years (31.8%), or 4 to 8 years (31.5%), while 75.6% of the patients were boys. The most common type of fracture was supracondylar (65%), the most common season of injury was spring (38.5%), and the most common injury mechanism was falling (87.6%). Among the injuries followed fractures, 10% were vascular and 16.5% were neuronal damages. Considering that the elbow fracture, especially supracondylar type, is more common in boys, and in the age group of 4 to 8 years, it usually occurs with falling, and accompanies by vascular and neurological damages. Its proper control and treatment can prevent subsequent damages

The purpose of this study is to report outcomes of total hip arthroplasty (THA) in patients under the age of 35 years regarding pain and joint function.

This preliminary analytic‑descriptive study was performed in prospective consecutive series of forty‑three patients younger than 35 years old who had undergone unilateral THA during a 36‑month period. As the primary outcome, the severity of pain using visual analog scale (VAS) of 1–10, and as the secondary outcomes, joint range of motion (ROM) and the Harris Hip Score (HHS) were assessed in the preoperative visit, 1, 6, and 18 months after operation for each patient. Complications were recorded at 6 months and 18 months after surgery.

The data of VAS showed the mean severity of pain was significant between preoperation measurements and postoperative assessments (P < 0.001). The means of HHS and hip ROM were also statistically significant before the operation in comparison with postoperative assessments (P < 0.001 for both means). A total of 19 patients had postoperative complications including periprosthetic fracture in two patients, infection in two patients, cup loosening in three patients, limb length discrepancy in 10 patients, and heterotopic ossification in two patients. Seven patients had been readmitted.

We believe THA using uncemented prosthesis has a high survivorship with low rate osteolysis in young patients with good bone stock. It is necessary to have longer follow‑up to have a better evaluation on outcomes.

Scoliosis is lateral curvature of the spine and postoperative complications are common in these patients. This study aimed to evaluate these complications in adult patients with idiopathic scoliosis.
In this cross-sectional study, postoperative complications of posterior fusion with instrumentation were evaluated in the 93 adult patients. Convenience sampling method was used and patients were allocated into 4 groups of scoliosis deformity types (Long c, thoracic, thoracolumbar/lumbar, and double curve). Complications were compared between the 4 groups.
Findings: There was a significant difference between the 4 groups regarding postoperative respiratory complications (P = 0.009). There were 35 cases with postoperative complications of them, 20 cases had respiratory complications.
Postoperative complications are common in the adult patients with idiopathic scoliosis undergoing posterior fusion with instrumentation. Postoperative respiratory complications are the most common one in these patients.

Comminuted fractures happen frequently due to traumas. Fixation without opening the fracture site, known as minimally invasive plate osteosynthesis (MIPO), has recently become prevalent. This study has been designed to assess the outcomes of this treatment for tibial and femoral comminuted fractures.
A total of 60 patients with comminuted femoral or tibial fractures were operated with MIPO method in this cross-sectional study at Alzahra university hospital in 2015. Eleven patients were excluded due to lack of adequate follow-ups. Patients’data including union time; infection in the fractured site; hip and knee range of motion; and any malunion or deformities like limb length discrepancy were collected after the surgery in every session.
Among 32 femoral and 17 tibial fractures, union was completed in48 patients, while only one patient with femoral fracture had nonunion. The mean union time was 18.57±2.42 weeks. Femur fractures healed faster than tibia (17.76±2.36 compared to 19±2.37 weeks, respectively, P=0.09). None of the patients suffered from infections or fistula. The range of motion in hip and knee remained intact in approximately all patients. Malunion happened in 3 patients; 100 internal rotation in 1 patient; and 1cm limb shortening in 2 patients.
According to the result of this study, MIPO is a simple and effective method of fixation with a high rate of union as well as minimal complications for comminuted fractures of long bones. Infection is rare, and malunion or any deformity is infrequent. MIPO appears to be a promising and safe treatment alternative for comminuted fractures.

Ihram is one of the obligatory rites of Hajj pilgrimage and lesser pilgrimage. It has obligatory and recommended acts. Even though most famous jurists, since the era of Sayyid Murtada, have considered the Ihram ritual bathing as one of the recommended aspects of Ihram, but with accurate research on the saying of the jurists on this topic, it becomes obvious that Ihram ritual bathing is obligatory based on the sayings of the earlier jurists. Likewise, by studying the proof of the two parties, it is also established that Ihram ritual bathing is compulsory. Of course, objecting the tremendous stand of the recent scholars which says that Ihram ritual bathing is a recommended act difficult, but it is very obvious that objecting the text and the view of many earlier jurists shall be more problematic. Therefore the only way out is to observe precaution.

Elbow dislocation is one of the most prevalent dislocations among adults, following shoulder dislocation. The present study aimed to evaluate the effects of Kirschner wire (K-wire) on fixation of comminuted radial head fracture when radial head prosthesis is inaccessible in terrible triad of elbow (TTE) dislocation.
In this retrospective study, a total of 21 adult patients with TTE dislocation, who were scheduled for fixation of radial head using K-wire, were enrolled according to the inclusion criteria. Variables, such as supination, pronation, range of flexion-extension motion, forearm rotation, and Mayo elbow performance score (MEPS) index, were measured, and the patients were followed-up for 1 postoperative year.
After surgery, the mean forearm rotation and elbow joint flexion-extension range of motion were 121.42 ± 29.71 and 115.23 ± 32.34 in patients with TTE dislocation, respectively. Regarding the MEPS results, the mean MEPS score was above 70, and the majority of patients showed good performance in the follow-up.
Considering the limitations and side effects of prosthesis in TTE dislocation, K-wire can be used as an effective approach for fixing comminuted radial head fractures, such as TTE dislocation.

Distal radius fracture is one of the most common fractures with different treatment options. This study compared closed reduction and percutaneous pinning with cast immobilization to open reduction and locked volar plating in the treatment of adult patients aged 60 years or younger with isolated, unstable, closed extra-articular, distal radius fractures.
In a single-blind controlled study, eighty eight patients were randomly divided into two groups; namely, the plating and pinning groups. Primary outcome was the severity of pain in the wrist joint which was measured via visual analog scale (VAS). The wrist range of movement, radiologic parameters, and ability in daily activities were also recorded as secondary outcomes and evaluated 3 and 12 months after the surgery.
Findings: The severity of pain was significantly lower in plating group after 3 (P = 0.001) and 12 (P = 0.040) months. The range of movements was significantly better in the plating group after 3 (P = 0.001) and 12 (P = 0.001) months. No significant difference was observed in the ability to perform daily activities between the two groups 3 months after the treatment. Twelve months after the surgery, limitations in daily activities were significantly higher in the pinning group.
Bone fixation, using locked volar plating, can be a better modality with regard to postsurgical pain and also the wrist range of motion than percutaneous pinning with cast immobilization in patients younger than 60 years sustaining unstable, closed extra-articular, distal radius fractures.

In intertrochanteric fractures, dynamic hip screw (DHS) is the most frequently used tool, but several studies did not give good results for this device in reverse-oblique and transverse fractures. Current study aimed to compare fixation results of reverse-oblique intertrochanteric and short-segment subtrochanteric fractures using dynamic condylar screw (DCS) and DHS in patients referred to Alzahra and Kashani Hospitals in Isfahan, Iran.
In a cross-sectional study, medical files of the patients referred to emergency units of the two hospitals who were diagnosed with intertrochanteric or subtrochanteric fractures and underwent DHS or DCS surgery more than 6 months before were assessed; they were invited for follow-up visit and examination. Written consent forms were taken from all the patients upon their entry; and they were examined in terms of complications including nonunion and failure of device and level of fracture improvement. These cases were evaluated by simple radiography, too. Results obtained from examination of patients in addition to demographic information were recorded in the data collection form for each patient.
Findings: Perfect union was observed in 14 (of 25) patients in DHS group and 21 (of 25) patients in DCS group (56% vs. 84%) six months after the surgery. Bone union was significantly better in DCS group (P = 0.031). In addition, six months after the surgery, the devices used in 14 people in DHS group and 24 people in DCS group were fixed and the difference between the two groups was significant (P = 0.001). 14 and 24 patients had total recovery in DHS and DCS groups, respectively (20% vs. 44%) with a significant difference (P = 0.020).
Considering obtained results, it can be concluded that using DCS is recommended over DHS due to severity of pain, bone union and fixation of the device.

Os odontoideum (OO) is a form of odontoid anomaly presented by a separate ossicle with a smooth, sclerotic border not fused with C2 body. The current paper reports a boy with irreducible displaced os odontoideum with severe neurologic deficit after a minor trauma.
A 16-year-old boy admitted in the center due to neck pain and torticollis with neurologic deficit. He had a history of multiple minor traumas. Advanced imaging assessment demonstrated displaced os odontoideum with minimal space available for cord (SAC) and myelomalacia. After unsuccessful closed reduction a 2-stage operation was planned: first, the anterior transoral release and odontoid resection with subsequent halo-traction and second, the posterior atlanto-axial instrumented fusion with bilateral C1 hook and C2 pedicular screws.
Congenital anomalies of the odontoid are associated with C1-C2 instability that can be subluxated or dislocated with minor trauma and cause permanent neurologic deficit or even death. When acute cervical spine trauma is imaged, os odontoideum should be distinguished from an acute dens fracture with a multimodality imaging approach including computed tomography (CT), magnetic resonance imaging (MRI) and radiography. Here is the report of a rare case with irreducible displaced os odontiodeum treated him with anterior release, odontoid resection and posterior C1-C2 instrumented fusion.

Thoracolumbar fractures are the most common fractures of the spinal column. There is no consensus about treatment method of choice among authors. The purpose of this study was to compare radiographic and functional outcomes of conservative management with that of surgical treatment in thoracolumbar spine fractures. Patients and Forty-nine patients with single level acute thoracolumbar fractures and normal neurological examination were evaluated, of those 21 patients underwent surgery and 28 treated with orthosis. Radiographic outcomes were evaluated by measuring sagittal kyphotic angle, anterior vertebral body collapse and functional outcomes were assessed using SF36 health survey questionnaire and the Denis work and pain scales. Among the surgically treated patients, sagittal kyphotic angle was significantly corrected immediately after operation and in the last follow-up compared to preoperative measurements (P < 0.001), functional results of SF36 score and pain scale were satisfactory. Among those received conservative management, sagittal kyphotic angle and anterior vertebral collapse were not significantly different before and after bracing (P = 0.4 and P = 0.8, respectively); functional outcome of SF36 scores were satisfactory and functional and radiographic results had no correlation. Functional outcome in both groups with surgical and non-surgical treatment was satisfactory. Radiographic indices were improved with surgical treatment and no correlation was found between functional and radiographic outcome.

Granular cell tumor is a rare benign neoplasm most commonly appears in the head and neck region, especially in the tongue, cheek mucosa, and palate. Occurrence in limbs is even rarer. These tumors account for approximately 0.5% of all soft tissue tumors. Granular cell tumor can also affect other organs including skin, breast, and lungs. Local recurrence and metastasis is potentially higher in malignant forms with poor prognosis in respect to the benign counterparts. The average diameter of the tumor is usually about 2-3 cm. We report a granular cell tumor in the leg with an unusual size.

Femoral shaft fractures are among the most common fractures following high trauma injuries. Different kinds of treatment have been suggested for these injuries.

The aim of this study was to compare the results femoral fractures treated by mini open and close intramedullary nailing (IMN) technique.

A total of 48 adult patients were operated due to fracture of the femur with close or open IMN technique between September 2010 and September 2011. 23 patients operated with close. IMN technique was included in Group I while 24 patients operated with mini open IMN technique constituted Group II. In Group I, all patients. Were operated on the fracture table in the supine position while in Group II, all patients underwent surgery on standard tables in the lateral position.

The mean age of patients was 27.3 years, ranging between 16 and 62. The mean age of the close nailing and open nailing groups was 30.5 and 24.5 respectively (P = 0.052). Only one patient from the open nailing group failed to unite. The mean time for union in close and open nailing groups was 13 + 2.4 and 17.7 + 2.3 weeks respectively (P = 0.001). No infection or limb length discrepancies were observed in the two groups.

Although close nailing is the preferred methods in most cases, but in poly‑traumatized patients or in centers where there are no fracture tables or C‑arm, open nailing is a good option.

Osteoid osteomata are rarely found in the distal phalanges of the hand. The usual presenting features are chronic pain, nail enlargement and increase in size of the terminal part of the digit. Diagnosis is difficult but surgical excision is effective for treating the patients’pain. We reported this tumor in distal phalanx of the middle finger.

Classic open incision is used usually in surgical release of carpal tunnel syndrome, but its complications are painful scar and delayed rehabilitation. The other method used, short palmar incision seems to have fewer complication and easier rehabilitation. Therefore, the aim of this study was to compare the efficacy and complications of these two surgical methods. In this clinical trial, the patients candidate for surgery were randomly divided in two groups of 51. One group was operated with classic incision and the other was operated with short palmar incision. The rate of Infection, surgical scar, tenderness and pain in incision, paresthesia and numbness, Tinnel test, Phallen test and recovery of sensory symptom postoperatively in the two groups in 3 weeks and 3 months after the operation were registrated and compared using Fisher, X2 and t-student tests. In the case of wound infection and damage to median nerve and its palmar branch no difference was seen in the two groups. Tenderness at the incision site in the case and control groups was 7.8% and 58.8% at the third week and was 2% and 47.1% in the third month, respectively (P<0.05). The mean of pain intensity in the case and control groups was 1.64±0.22% and 2.04±0.23% at the third week (P<0.001) and was 1.28±0.14% and 1.39±0.18% in the third month, respectively (P>0.05). There were no significant differences between the two groups in the cases of the amount of paresthesia, numbness and recovery of sensory symptoms. Regarding the similar effectiveness in both classic and short palmar incision and less post-operation complication of the later method, this method is recommended for surgical release of median nerve of wrist.

The treatment of comminuted fractures in long bones has continued to be a problem in orthopedic surgery. Recently, fixation without exploration of the fracture site, known as "biologic fixation”, has been introduced. This study was performed to assess the results and complications of this method for the treatment of comminuted fractures of the tibia and femur. The study included 41 patients with comminuted fractures of the tibia and femur treated with biologic plating from 2003 to 2006 (25 femur fractures and 16 tibial fractures). After biological fixation joint motion was started but weight bearing was avoided until radiographic evidence of union was shown. The mean time of union in the tibial fractures was 19 ± 2 weeks and 17 ± 2 weeks for the femur fractures. All patients had fracture union without any infection, non-union or implant failure. In one patient with a femur fracture there was a 10° internal rotation deformity. Two of the femoral fractures had shortening of 1 cm, and one patient had shortening of about 2 cm. Compared to similar studies, all results were statistically significant (P<0.05). The biologic plating method is a safe, simple and effective method of fixation for comminuted fractures of long bones. It has a high rate of union with minimal complications.