Papers by Mohamed Mansour Elzohairy
Archives of Orthopedics and Rheumatology
Zagazig university medical journal, Aug 28, 2023
Orthopaedics & traumatology: surgery & research, Apr 1, 2017
Background: Surgical stabilization of posterior pelvic ring fractures can be achieved by either o... more Background: Surgical stabilization of posterior pelvic ring fractures can be achieved by either open or closed methods. They all provide a comparable biomechanical stability. The aim of the present study is to compare the clinical results of both techniques for treating posterior pelvic ring injuries. Material and methods: Seventy patients operated for unstable posterior pelvic ring disruptions were retrospectively reviewed. We compared 35 patients treated by open reduction internal fixation (ORIF group) versus 35 patients stabilized by using closed reduction and percutaneous iliosacral screw fixation (CRIF group) under fluoroscopic guidance. Results: According to pelvic outcome scoring system of Pohlemann et al., 28 patients out of the ORIF group obtained good or excellent results (20 excellent and 8 good), five fair and two poor. In the CRIF group, 30 patients obtained good or excellent results (25 excellent and 5 good), four fair and one poor (P = 0.64). The average intraoperative blood loss in the ORIF group was 500 cc with average blood transfusion of 2 units (1000 cc) compared to blood loss 150 cc in the CRIF group, with average blood transfusion of 1 unit (500 cc) (P = 0.002). No intraoperative complications were reported in the ORIF group while operative guide wires were broken in two cases in the CRIF group (P = 0.16). There were no neurological complications observed in the ORIF group, but one radiculopathy (L5 root palsy) occurred in the CRIF group (P = 0.317). In the ORIF group, three patients had superficial wound infection and one patient had deep infection while in the CRIF group, we noted only one case of deep infection (P = 0.083). Conclusion: No difference was noticed between ORIF and CRIF. The technical decision is variable according to time of surgery, fracture types, patient general condition, skin condition, presence of ipsilateral fractures of the acetabulum and feasibility of the closed reduction. More studies are needed to identify prognostic factors related to quality of the reduction. We need for creation of decisional algorithm for ORIF versus CRIF.
Revue de Chirurgie Orthopédique et Traumatologique, Apr 1, 2017
Trauma & Treatment, 2012
Purpose: The purpose of this prospective study was to assess the results of immediate radial nerv... more Purpose: The purpose of this prospective study was to assess the results of immediate radial nerve palsy associated with closed humeral shaft fractures treated by the closed interlocking intramedullary nail without radial nerve exploration. Methods: Eighteen patients suffered from immediate radial nerve palsy associated with closed humeral shaft fractures treated by closed interlocking intramedullary nail, without exploration of the radial nerve. Results: Patients were followed up for a mean of 18 months (range from 12 to 24 months). All the cases had united in a good alignment within 12 weeks. Full clinical and electrodiagnostic radial nerve recovery as regarding the range of shoulder, elbow, wrist and hand movements occurred at 6 months examination. Conclusion: Closed interlocking nailing for immediate radial nerve palsy associated with closed humeral shaft fractures, provides immediate stability and can be done with a closed technique, brief operative time and minimum violation to the radial nerve, with early return of optimal extremity function.
Journal of Vascular Surgery, 2014
and 37.5% were women. The preintervention and postintervention patient risk factor profile is pre... more and 37.5% were women. The preintervention and postintervention patient risk factor profile is presented in the Table. Medication usage and risk factor control improved at follow-up, except for diabetic glycemic control. Conclusions: The strategy of providing PAD patients and their physicians with a one-time, individualized plan for risk factor modification improves risk factor control. Other studies have reported minimal improvement in risk factor control with usual medical care or another intervention, although the literature is limited and based on short-term followup. The impact on cardiovascular events and limb outcomes remains to be determined.
The Egyptian Journal of Hospital Medicine
Background: Distal radius and ulna fractures are the most common fracture in adults representing ... more Background: Distal radius and ulna fractures are the most common fracture in adults representing 44% of all fractures. Fragment-specific fixation can be a useful tool in treating distal radius fractures. Objective: The aim of the present study was to evaluate the results of treating intra-articular distal radius fractures with fragment-specific fixation to provide good functional outcome. Patients and methods: This prospective study included 36 patients with distal radial fractures. They were admitted and operated in the Casualty Unit of the Orthopedic Department, Zagazig University Hospitals. The average time of follow up period of the cases was 9 months. Results: Age was distributed as 39.5 ± 9.17 years, male were 61.1% and dominant right were in 88.9%. Mayo score distribution at different time among studied group was significant increase from 6 weeks to 3 months and to 6 months. There was significant increase in range of motion distribution from 6 weeks & 3 months to 6 months. There was significant increase in grip strength distribution from 6 weeks & 3 months to 6 months. Overall complicated cases were 6 cases. Complicated cases were significantly associated with longer union time and significant delayed return to work. Conclusion: Fragment-specific fixation is a valuable technique for intra articular distal radius fractures in well planned and selected patients. As it achieves a high rate of union and good functional outcome on follow up and it allows excellent grip strength and range of motion of wrist joint.
Zagazig University Medical Journal, 2013
Acromioclavicular injury is considered as a common athletic shoulder injury. Many of these injuri... more Acromioclavicular injury is considered as a common athletic shoulder injury. Many of these injuries can be treated nonoperatively but high-grade injuries can result in pain and loss of shoulder function. A numerous operative techniques have been proposed with recent renewed focus on the anatomy of the coracoclavicular ligaments which has led to anatomic reconstructive techniques that show promised results in biomechanical comparisons. These techniques involve reconstruction of the conoid and trapezoid ligaments through anatomically-based tunnels in the clavicle, with preservation of the distal clavicle that improves the biomechanical stability of this construct. The purpose of this study was to evaluate the results of anatomic reconstruction of unstable acromioclavicular joint by using an autogenous semitendinosus graft. All the patients gave the informed consent prior to being included into this study; the study was authorized by the local ethical committee and was performed in accordance with the Ethical standards of the 1964 Declaration of Helsinki as revised in 2000.
The Egyptian Journal of Hospital Medicine, 2020
Background: Total hip arthroplasty is the most common surgery performed for complications of hip ... more Background: Total hip arthroplasty is the most common surgery performed for complications of hip hemiarthroplasty. Hemiarthroplasty has been a good method of treating displaced fracture neck of femur. With the increased demands placed on the prosthesis by highly active patients, the failure rate increased following hemiarthroplasty. Pain is the most reliable complaint that indicates failure. Pain may be due to many complications related to hemiarthroplasty as loosening, sepsis, protrusio, dislocation, and periprosthetic and prosthetic fractures. Conversion to total hip replacement is a good method for treating patients with painful hemiarthroplasties. Objective: This study aimed to evaluate the result of revision total hip replacement after failed hemiarthroplasty. Patients and Methods: This is a retrospective study included 62 patients with ages ranged from 38 years to 75 years with a mean (62.7±11.38), with the conversion of failed hip hemiarthroplasty to total hip arthroplasty be...
Background: No agreement between the orthopedic surgeons regarding the best treatment for the dia... more Background: No agreement between the orthopedic surgeons regarding the best treatment for the diaphyseal tibial fracture in children. Hypothesis: The flexible intramedullary nailing technique is a valuable procedure with the lower reported incidence of complications for pediatric patients suffering from diaphyseal tibial fractures in the age group that ranges from 6 to 12 years old. Materials and Methods: This study was performed prospectively on 16 pediatric patients who underwent flexible intramedullary nailing for the management of the diaphyseal tibial fractures. Results: The final results in 12 patients (75%) were excellent and satisfactory in four patients (25%). The average time of clinical union was 6.75 ± 1.12 weeks, while the average time of radiological union was 9.31 ± 0.79. Discussion: The results of the present study were according to other authors raising our hypothesis that flexible intramedullary nailing procedure has many advantages for children suffering from diap...
The Egyptian Journal of Hospital Medicine, 2020
Background: There are different indications for total hip arthroplasty (THA) after failed interna... more Background: There are different indications for total hip arthroplasty (THA) after failed internal fixation of neck femur fracture. This led us to carry out a prospective study of the clinical outcomes, radiological outcomes, technical issues and complications of this procedure. Objective: To evaluate the clinical and radiological outcome of total hip arthroplasty after failed internal fixation of neck femur fracture, along with the technical difficulties and complications encountered. Patients and methods: This was a prospective, single-center study of 12 THA cases performed after internal fixation of neck femur fracture. These procedures were performed between 2017 and 2019 in 12 patients (5 men, 7 women). The initial fracture fixation involved a screw-plate (n = 1), intramedullary nail (n = 2) or screws (n = 9). The mean patient age at the time of THA was 50 years [38–72]. The THA was performed an average of 2.8 years [0.2–28] after the fracture. The lateral (Modified Hardinge) h...
Clinics in Orthopedic Surgery, 2020
Background: The most common causes of re-dislocation after open reduction are inadequate exposure... more Background: The most common causes of re-dislocation after open reduction are inadequate exposure and failure to release the obstructing soft tissues inside and around the hip. Methods: This clinical study included 33 consecutive children (34 hips) who underwent a revision surgery after failed open reduction of developmental dysplasia of the hip (DDH). Results: According to the McKay clinical criteria, the results were good in 28 cases (82.4%), fair in 4 cases (11.8%), and poor in 2 cases with re-dislocation (5.9%). Radiological results according to the modified Severin criteria were as follows: 28 hips (82.4%) were identified as category 2 (good), 4 hips (11.8%) category 4 (fair), and 2 hips (5.9%) category 5 (poor). Conclusions: Revision surgery for DDH is demanding and the long-term consequences are usually serious, but stable, concentric reduction should be obtained either at the first or second open reduction by addressing the causes of failure. Failed acetabulum remodeling and technical errors with inadequate soft-tissue release were the most common causes of failure in the primary operation. Based on the results, the outcome of revision surgery after failed open reduction for DDH was good.
European Journal of Orthopaedic Surgery & Traumatology, 2020
The complexity of interactions in socio-ecological systems makes it very difficult to plan and im... more The complexity of interactions in socio-ecological systems makes it very difficult to plan and implement policies successfully. Traditional environmental management and assessment techniques produce unsatisfactory results because they often ignore facets of system structure that underlie complexity: delays, feedbacks, and non-linearities. Assuming that causes are linked in a linear chain, they concentrate on technological developments ("hard path") as the only solutions to environmental problems. Adaptive Management is recognized as a promising alternative approach directly addressing links between social and ecological systems and involving stakeholders in the analysis and decision process. This "soft path" requires special tools to facilitate collaboration between "experts" and stakeholders in analyzing complex situations and prioritizing policies and actions. We have applied conceptual modeling to increase communication, understanding and commitment in the project of seven NGOs "Sustainable Regional Development in the Odra Catchment". The main goal was to help our NGO partners to facilitate their efforts related to developing sustainable policies and practices to respond to large-scale challenges (EU accession, global changes in climate and economy) to their natural, economic and socio-cultural heritages. Among the variety of sustainability issues explored by these NGOs, two (extensive agricultural practices and "green" local products) were examined by using Adaptive Management (AM) as a framework that would link analysis, discussion, research, actions and monitoring. Within the AM framework the project coordinators used tools of systems analysis (Mental Model Mapping) to facilitate discussions in which NGO professionals and local stakeholders could graphically diagram and study their understanding of what factors interacted and how they affect the region's sustainability. These discussions produced larger-scale Regional Sustainability Models as well as more detailed sub-models of particular factors, processes, and feedback loops that appear critical to a sustainable future. The Regional Sustainability Model was used to identify a subset of key interacting factors (variables). For each variable, several sustainability indicators were suggested. The growing understanding and acceptance of the AM framework and systems analysis created a momentum both locally and within the region, which makes continued successful use of these indicators quite likely. In contrast to expert-driven projects that inject outside knowledge into a local context, this project established a broad basis for stakeholder-driven discussion that is articulated into goals, objectives, conceptual models, and indicators. The ability to learn and adapt in the AM framework increases the capacity to innovate and find policies and practices that enhance resilience and sustainability in a world in transition.
Orthopedics and Rheumatology Open Access Journal, 2017
Zagazig University Medical Journal, 2014
Symptomatic nonunion after fracture clavicle, ……….
Indian Journal of Public Health Research & Development, 2019
European Journal of Orthopaedic Surgery & Traumatology, 2018
Background Pigmented villonodular synovitis or PVNS is a benign proliferating disease of the syno... more Background Pigmented villonodular synovitis or PVNS is a benign proliferating disease of the synovium; it behaves much as a neoplastic process does. Methods This retrospective clinical study included 11 consecutive cases who underwent for total synovectomy combined with cementless total hip arthroplasty of PVNS of the hip joint. Results The mean patient preoperative hip score of Harris was 46.1 points (range 30-70 points) improved to 94.3 points (range 90-100 points) at the last follow-up visits. No clinical or radiological evidence of recurrent PVNS or osteolysis or loosening had been detected in our patients. Conclusion Total synovectomy combined with total arthroplasty (THA) could be considered as the ideal treatment in the case of pigmented villonodular synovitis with major osteoarticular destruction and provided good results, as reported in the current series. Level of evidence IV, case series.
European journal of orthopaedic surgery & traumatology : orthopedie traumatologie, Jan 13, 2018
Sprengel's shoulder deformity is a rare condition that happens because of the abnormal termin... more Sprengel's shoulder deformity is a rare condition that happens because of the abnormal termination of the caudal migration of the scapula during the embryonic period. This retrospective clinical study included 10 consecutive children who underwent a Woodward operation to correct the Sprengel's shoulder deformity. The average preoperative Cavendish grade for cosmetic evaluation was 3.5 (range 3-4), which decreased to 1.4 (range 1-2) at the final review (statistically significant, p > 0.002, Wilcoxon signed-rank test). Cavendish grade improvement and increase in abduction had a strong positive association (r = 0.681, Spearman correlation coefficient. The results showed that both functional and cosmetic outcome had a positive correlation with Woodward procedure. More cosmetic and functional improvement was seen at the last follow-up visit especially in cases where the operation was done in the younger years. IV.
Trauma, 2016
BackgroundNeglected fractures in young adults can be amongst the most difficult to treat in the s... more BackgroundNeglected fractures in young adults can be amongst the most difficult to treat in the spectrum of fractures of the femoral neck. Because of its complex anatomy and blood supply, timely fixation is paramount. When this does not occur, non-union and avascular necrosis are common complications. Here, we present a meta-analysis of three common options available to the surgeon treating such complications.MethodsWe identified 97 relevant papers by the keywords ‘femoral neck fractures’; ‘neglected’; ‘joint preserving’ and ‘young adults’; 23 met the inclusion criteria and reported on an overall population of 725 patients.ResultsOsteotomy with internal fixation had a union rate of 91.33% (95% CI 84.91–92.87). Fractures fixed by internal fixation with pedicled muscle graft proceeded to union in 86.25% (95% CI 78.92%–88.54%) of cases and those managed with free fibular graft in 88% (95% CI 78.35%–90.84%), respectively. Internal fixation alone, in this study, used as an illustrative c...
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Papers by Mohamed Mansour Elzohairy