Bander .Alrashedan - Academia.edu (original) (raw)

Papers by Bander .Alrashedan

Case reports in orthopedics, Feb 29, 2024

Acta Scientific Orthopaedics, Mar 1, 2024

Motor vehicle accidents are a common cause of spine trauma. They are specifically associated with... more Motor vehicle accidents are a common cause of spine trauma. They are specifically associated with cervical spine fractures. Subaxial facet fractures can present following the hyperextension mechanism and can also be associated with intervertebral disc injuries. Post-injury loss of lordosis is a feared complication following these injuries. The treatment algorithm available in the literature is unclear as to whether to treat these cases surgically. A retrospective case series was done on patients who presented to our institute with sub-axial extension Injuries of the cervical spine. The main reported outcome is post-operative sagittal alignment following the treatment modality used in our cases. Hyperextension mechanism fractures were found in 40.47% (n = 22) of all patients, 19 of whom were hyperextension compression injuries, and 3 were hyperextension distraction injuries. Anterior cervical discectomy and instrumented fusion were shown to maintain post-operative sagittal alignment in all cases with extension injuries. External orthosis showed a 50% prevalence of progressive junctional kyphosis on follow-up. Anterior cervical discectomy and instrumented fusion have been shown to provide excellent sagittal alignment restoration and maintenance on follow-up, while external orthosis showed a high rate of short-term post-operative junctional kyphosis.

Acta Scientific Orthopaedics, Mar 1, 2024

Subtrochanteric fractures are relatively rare and challenging for orthopedic surgeons. Failing to... more Subtrochanteric fractures are relatively rare and challenging for orthopedic surgeons. Failing to achieve proper alignment during surgery can result in devastating sequela and necessitate more complex reoperation. We present a case of a 50-year-old man with a history of diabetes and hypertension who suffered a right subtrochanteric fracture after a motor vehicle collision. He was treated with intramedullary fixation of the femur. Upon follow-up, the fracture was complicated by nonunion due to improper alignment and fixation method at the index procedure. Two attempts at revision with nailing and plating failed. Ultimately, we treated the patient with a revision nailing and autograft of the nonunion site which led to a desirable outcome and union of the fracture. This case highlights the complex and challenging nature of subtrochanteric fractures, which can require multiple interventions, consideration of underlying medical conditions, and perseverance in treatment before achieving successful outcomes.

Cureus, Jan 16, 2024

Background: Fractures of the humerus diaphysis are common and often result from motor vehicle acc... more Background: Fractures of the humerus diaphysis are common and often result from motor vehicle accidents (MVAs). Treatment methods range from nonoperative approaches to various operative techniques, including antegrade intramedullary nailing (AIMN) and dynamic compression plate (DCP) fixation. This study aimed to compare the cost effectiveness and outcomes of plating and nailing for humerus diaphyseal fractures. Methods: A retrospective cohort study involving 59 cases of humerus diaphyseal OTA/AO 12-A fractures was conducted at King Saud Medical City (KSMC), a level I trauma center located in the center region in Riyadh, Saudi Arabia. Patients treated with AIMN, anterolateral plating, or posterior plating were included. Data on demographics, clinical parameters, radiographic healing, and costs were collected and analyzed. Results: The average surgical duration was shorter in the AIMN group compared to the anterolateral and posterior plating groups but with no statistical significance (P > 0.05). The average length of stay (LOS) was shorter, and the change in hemoglobin levels was lower in the AIMN group when compared to other groups but without a statistically significant difference (P > 0.05). The average cost of AIMN was significantly higher than that of anterolateral and posterior plating groups (P < 0.0001). Conclusion: While both nailing and plating procedures are options for treating OTA/AO 12-A fractures, AIMN carries a higher overall procedural cost. The practice of drain placement in our study population is likely the cause of the increased LOS in the plating groups. Relative additional analgesic requirements were associated with AIMN. Surgeons should consider meticulous hemostasis to avoid drain placement, which can decrease LOS, thus possibly decreasing unnecessary treatment costs of humerus shaft fractures.

Journal of surgical case reports, Aug 31, 2023

International Journal of Research in Orthopaedics, Apr 28, 2023

Bilateral Simultaneous rotational ankle injuries are rare entities with little number of cases re... more Bilateral Simultaneous rotational ankle injuries are rare entities with little number of cases reported in literature. Unlike axial type ankle fractures, they tend to happen as a result of pivoting trauma on the supportive limb. We conducted a case series and literature review of patients who presented with simultaneous bilateral ankle injuries and discussed their presentation and imaging. A total of Four cases in our institute and 6 separate cases reported in literature were found who sustained bilateral simultaneous rotational ankle fractures. There were 10 cases, nine of which were simultaneous and symmetrical ankle injuries. Injuries found were; Maisonneuve fracture, Tillaux fracture, Syndesmotic injury, Lauge-Hansen's supination external rotation (SER), pronation external rotation (PER), supination adduction (SAD), and pronation abduction (PA). Four cases were presented in our institute over the last 10 years. A single case was asymmetrical in nature given the presence of an associated distal tibial metaphyseal fracture. Bilateral rotational ankle injuries are rare entity presenting simultaneously unlike axial type ankle fractures. When they present, they are likely caused by higher mechanism of injury than typical unilateral rotational ankle fractures. SER injuries are the most commonly found mechanism in both unilateral and bilateral ankle injuries.

Case reports in orthopedics, Nov 18, 2018

Avulsion fractures of the tibial tuberosity are commonly sustained in adolescent males during spo... more Avulsion fractures of the tibial tuberosity are commonly sustained in adolescent males during sport activities which involve jumping and tackling. Tibial tuberosity avulsions combined with lateral tibial plateau in an adolescent are rare injuries. We received an unusual case of left Ogden type IIIB avulsion fracture of the tibial tuberosity with an articular involvement of the lateral tibial plateau (Salter Harris type IV) in a 14-year-old boy. The injury was sustained after jumping from three stairs where the boy predominantly landed on his left lower limb. Unlike other cases reported, since they were athletes and injuries were sustained during sport activities, our case is an obese individual who jumped off few stairs. The results following surgical treatment are excellent since the fracture united, and the articular surface was restored without the need of arthrotomy with gaining full range of motion. Therefore, displaying this case in the literature will be helpful since it is rare and was successfully treated differently from the previously reported cases.

Journal of Taibah University Medical Sciences, Aug 1, 2018

Journal of Brachial Plexus and Peripheral Nerve Injury

Background Supracondylar fractures of the humerus (SCFHs) are the most common type of elbow fract... more Background Supracondylar fractures of the humerus (SCFHs) are the most common type of elbow fracture in children. Because of the influence on functional outcome, neuropraxia is one of the most common concerns at presentation. The impact of preoperative neuropraxia on surgery duration is not extensively probed. The clinical implications of several other risk factors associated with preoperative neuropraxia at presentation may contribute to longer surgical duration of SCFH. Hypothesis Preoperative neuropraxia is likely to increase surgery duration in patients who sustained SCFH. Patients and Methods This is a retrospective cohort analysis. Sixty-six patients who sustained surgical pediatric supracondylar humerus fracture were included in the study. Baseline characteristics including age, gender, the type of fracture according to Gartland classification, mechanism of injury, patient weight, side of injury, and associated nerve injury were included in the study. Logistic regression anal...

International Journal of Research in Orthopaedics

Bilateral Simultaneous rotational ankle injuries are rare entities with little number of cases re... more Bilateral Simultaneous rotational ankle injuries are rare entities with little number of cases reported in literature. Unlike axial type ankle fractures, they tend to happen as a result of pivoting trauma on the supportive limb. We conducted a case series and literature review of patients who presented with simultaneous bilateral ankle injuries and discussed their presentation and imaging. A total of Four cases in our institute and 6 separate cases reported in literature were found who sustained bilateral simultaneous rotational ankle fractures. There were 10 cases, nine of which were simultaneous and symmetrical ankle injuries. Injuries found were; Maisonneuve fracture, Tillaux fracture, Syndesmotic injury, Lauge-Hansen’s supination external rotation (SER), pronation external rotation (PER), supination adduction (SAD), and pronation abduction (PA). Four cases were presented in our institute over the last 10 years. A single case was asymmetrical in nature given the presence of an as...

Acta Scientific Orthopaedics

Background: Terrible triad injuries are devastating clinical entities with different approaches d... more Background: Terrible triad injuries are devastating clinical entities with different approaches described in the literature for fixation. Stability and an ideal range of motion are paramount for a favorable clinical outcome. The purpose of the study was to review the current protocols and surgical management of this complex injury and to assess the stability and range of motion of eight cases reported. Methods: Case series of patients involved in a non-salvageable radial head fracture. After surgery, the follow-up period was 27 months. The primary outcome measures were a range of motion and elbow stability intra-operatively and postoperatively. Secondary outcome measures were Mayo elbow performance scores. Results: Seven patients were included in the study, with a total of eight elbows presented with a terrible triad in our institute between February 2020 and May 2022. All cases reached the desired stability following coronoid repair, radial head replacement, and lateral ulnar collateral ligament repair (LUCL). Range of motion got 10 to 125 degrees on the twelfth week postoperatively. Mayo elbow performance and Disabilities of the Arm, Shoulder, and Hand Questionnaire scores were favorable at the final follow-up, with no chronic instability in all cases. Conclusion: Single incision using the Kocher approach, coronoid-first fixation using anchor suture is feasible following the removal of a comminuted radial head, followed by radial head replacement and LUCL repair resulting in desirable clinical outcomes. There is no superior current protocol for treating these injuries. Cases Case 1 A 36-year-old male, medically free, presented to Our emergency department after suffering a fall from a height (10 meters), complaining of right elbow pain and deformity. This patient was treated according to Advanced Trauma Life Support protocol and required

Cureus

Objective: The objective is to investigate one-year mortality rates following femur osteoporotic ... more Objective: The objective is to investigate one-year mortality rates following femur osteoporotic fractures, and to investigate factors that are associated with higher mortality rates. Design: A retrospective study was conducted from 2010 to 2021 (11 years) of all patients who presented to King Saud Medical City, Saudi Arabia, and had a fragility fracture of the proximal or distal femur. Patients: One hundred eight patients who sustained a proximal or distal femoral fracture, as a result of lowenergy trauma, were included. Results: The majority of our cohort (77.8%) had proximal femoral fractures, whereas only 22.2% had a distal femoral fracture. 55.6% were less than 75 years old, and 44.4% were 75 years or older. All patients had fallen from standing height. Hypertension and diabetes were the most common comorbidities among our cohort at 49.1% and 47.2%, respectively, but neither showed a statistically significant increase in the risk of mortality. When assessing the overall mortality, 21.3% of our patients had passed away. Although this finding was not statistically significant, mortality rates were found to be higher in patients with proximal femoral fractures compared to distal femoral fractures (25% vs. 8.3%, respectively, p=0.095). Patients with a normal bone mass density (BMD) had higher mortality rates as opposed to those with abnormal BMD (p=0.001). Conclusions: Mortality rates are higher in proximal femoral fractures compared to distal femoral fractures. In addition, within our study cohort, patients with normal BMD had higher mortality rates. We recommend prospective studies that compare mortality rates between proximal and distal femoral fractures in patients with osteoporosis, as these studies would provide more accurate data. We also recommend having BMD measured in those patients to avoid further fractures in this patient population.

International Journal of Health Sciences, 2018

Objectives: Pediatric diaphyseal forearm fractures are common injuries of childhood. Conservative... more Objectives: Pediatric diaphyseal forearm fractures are common injuries of childhood. Conservative modality of treatments is usually preferred when they are possible. We identified factors that may affect closed reduction success or lead to redisplacement in forearm diaphyseal fractures in children. Methods: This was a retrospective study from a level I trauma center on patients up to 18 years of age who presented with forearm diaphyseal fractures from January 1, 2007, to December 31, 2015. Cases were obtained from medical records. Data were collected and confirmed by plain films and medical files. Results: We included 145 patients in this study. The majority (86.2%) were boys. Around 29% of trials of closed reduction failed, and the patients were subsequently treated surgically. Following trials of closed reduction, 82.4% of both bone cases were successfully reduced compared to 42.9% of radius shaft cases (P = 0.006). Redisplacement following non-surgical treatment in the first foll...

Journal of Taibah University Medical Sciences, 2018

Journal of Musculoskeletal Surgery and Research, 2020

The neck of femur fractures are common in the aging population. Young people typically sustain ne... more The neck of femur fractures are common in the aging population. Young people typically sustain neck of femur fracture following a high-energy injury. Simultaneous bilateral neck of femur (BNOF) fractures in young patients are a rare entity. They might be sustained following a seizure episode. Timely diagnosis and treatment of these injuries are important and can affect the treatment modality and outcome. Internal fixation is desired in young, active, and healthy patients presenting with BNOF fractures. We report a case of a young adult presented with BNOF fractures following a single seizure episode. Bilateral open reduction and internal fixation using cannulated screws was chosen for this patient treatment. He was followed up for 2 years and showed a desirable outcome.

Journal of Musculoskeletal Surgery and Research, 2020

Distal humerus epiphyseal separation is a rare entity that can present as a birth-related injury.... more Distal humerus epiphyseal separation is a rare entity that can present as a birth-related injury. It commonly presents in children younger than 2 years of age and can be a result of a fall or forceful manipulation during delivery. It commonly presents with elbow swelling and decreased movement in newborns. It can be misinterpreted as elbow dislocations due to the lack of ossification in the distal part of the humerus on plain radiographs. Several treatment approaches have been reported in the literature including surgical and nonsurgical treatment modalities. We present a 2-day-old girl with a right distal humerus epiphyseal separation following spontaneous vaginal delivery. An anatomical and a stable reduction of the fracture was the aim in the management of this injury and was achieved using an arthrogram-assisted closed reduction and a single percutaneous Kirschner wire fixation. The patient was followed for 12 months and showed a satisfactory outcome.

Journal of Musculoskeletal Surgery and Research, 2019

Osteochondroma is the most common bone tumor. It mainly affects the proximal humerus, tibia, and ... more Osteochondroma is the most common bone tumor. It mainly affects the proximal humerus, tibia, and distal femur. It rarely affects the scapula, especially in the ventral aspect and when it does, winging of the scapula can occur, and can lead to a painful range of motion of the shoulder with a snapping sensation and secondary ribs erosion. Hereditary multiple exostoses (HME) is an autosomal dominant disorder causing multiple osteochondromas mainly in the metaphysis of long bones and it rarely affects the scapula. We present an uncommon presentation in a 7-year-old male with HME who presented with a superolateral ventral large osteochondroma measuring 8 cm × 5.5 cm that caused left scapular winging and left shoulder pain with a secondary ribs deformity. The patient was successfully treated surgically through a direct approach and was followed for 18 months and showed a satisfactory outcome with the regression of the ribs deformity.

Case Reports in Orthopedics, 2018

Avulsion fractures of the tibial tuberosity are commonly sustained in adolescent males during spo... more Avulsion fractures of the tibial tuberosity are commonly sustained in adolescent males during sport activities which involve jumping and tackling. Tibial tuberosity avulsions combined with lateral tibial plateau in an adolescent are rare injuries. We received an unusual case of left Ogden type IIIB avulsion fracture of the tibial tuberosity with an articular involvement of the lateral tibial plateau (Salter Harris type IV) in a 14-year-old boy. The injury was sustained after jumping from three stairs where the boy predominantly landed on his left lower limb. Unlike other cases reported, since they were athletes and injuries were sustained during sport activities, our case is an obese individual who jumped off few stairs. The results following surgical treatment are excellent since the fracture united, and the articular surface was restored without the need of arthrotomy with gaining full range of motion. Therefore, displaying this case in the literature will be helpful since it is r...

BMJ Open, 2020

ObjectivesTo describe the patterns and outcomes of traumatic spinal injuries (TSIs) in a tertiary... more ObjectivesTo describe the patterns and outcomes of traumatic spinal injuries (TSIs) in a tertiary care trauma centre in Riyadh, Saudi Arabia.DesignRetrospective medical record review.SettingLevel 1 trauma centre for all patients presented from 1 February 2016 to 31 December 2018.Participants and dataRecords of patients presenting with any spinal trauma were reviewed, and the data obtained included age, gender, nationality (as Saudi and non-Saudi), date of presentation, site of fracture/injury, associated injuries, mechanism of injury, presence of neurological involvement and hospital mortality.Main outcomesFrequencies of different types of TSI across various subgroups.ResultsWe identified 692 patients who presented with TSI throughout the study period. The mean age was 36.9 years. Males represented 83.2% (n=576) of the sample size, and the most common mechanism of injury was motor vehicle collision (MVC), accounting for 66.8% of cases (n=462), while fall-related injuries were seen i...

Case reports in orthopedics, Feb 29, 2024

Acta Scientific Orthopaedics, Mar 1, 2024

Motor vehicle accidents are a common cause of spine trauma. They are specifically associated with... more Motor vehicle accidents are a common cause of spine trauma. They are specifically associated with cervical spine fractures. Subaxial facet fractures can present following the hyperextension mechanism and can also be associated with intervertebral disc injuries. Post-injury loss of lordosis is a feared complication following these injuries. The treatment algorithm available in the literature is unclear as to whether to treat these cases surgically. A retrospective case series was done on patients who presented to our institute with sub-axial extension Injuries of the cervical spine. The main reported outcome is post-operative sagittal alignment following the treatment modality used in our cases. Hyperextension mechanism fractures were found in 40.47% (n = 22) of all patients, 19 of whom were hyperextension compression injuries, and 3 were hyperextension distraction injuries. Anterior cervical discectomy and instrumented fusion were shown to maintain post-operative sagittal alignment in all cases with extension injuries. External orthosis showed a 50% prevalence of progressive junctional kyphosis on follow-up. Anterior cervical discectomy and instrumented fusion have been shown to provide excellent sagittal alignment restoration and maintenance on follow-up, while external orthosis showed a high rate of short-term post-operative junctional kyphosis.

Acta Scientific Orthopaedics, Mar 1, 2024

Subtrochanteric fractures are relatively rare and challenging for orthopedic surgeons. Failing to... more Subtrochanteric fractures are relatively rare and challenging for orthopedic surgeons. Failing to achieve proper alignment during surgery can result in devastating sequela and necessitate more complex reoperation. We present a case of a 50-year-old man with a history of diabetes and hypertension who suffered a right subtrochanteric fracture after a motor vehicle collision. He was treated with intramedullary fixation of the femur. Upon follow-up, the fracture was complicated by nonunion due to improper alignment and fixation method at the index procedure. Two attempts at revision with nailing and plating failed. Ultimately, we treated the patient with a revision nailing and autograft of the nonunion site which led to a desirable outcome and union of the fracture. This case highlights the complex and challenging nature of subtrochanteric fractures, which can require multiple interventions, consideration of underlying medical conditions, and perseverance in treatment before achieving successful outcomes.

Cureus, Jan 16, 2024

Background: Fractures of the humerus diaphysis are common and often result from motor vehicle acc... more Background: Fractures of the humerus diaphysis are common and often result from motor vehicle accidents (MVAs). Treatment methods range from nonoperative approaches to various operative techniques, including antegrade intramedullary nailing (AIMN) and dynamic compression plate (DCP) fixation. This study aimed to compare the cost effectiveness and outcomes of plating and nailing for humerus diaphyseal fractures. Methods: A retrospective cohort study involving 59 cases of humerus diaphyseal OTA/AO 12-A fractures was conducted at King Saud Medical City (KSMC), a level I trauma center located in the center region in Riyadh, Saudi Arabia. Patients treated with AIMN, anterolateral plating, or posterior plating were included. Data on demographics, clinical parameters, radiographic healing, and costs were collected and analyzed. Results: The average surgical duration was shorter in the AIMN group compared to the anterolateral and posterior plating groups but with no statistical significance (P > 0.05). The average length of stay (LOS) was shorter, and the change in hemoglobin levels was lower in the AIMN group when compared to other groups but without a statistically significant difference (P > 0.05). The average cost of AIMN was significantly higher than that of anterolateral and posterior plating groups (P < 0.0001). Conclusion: While both nailing and plating procedures are options for treating OTA/AO 12-A fractures, AIMN carries a higher overall procedural cost. The practice of drain placement in our study population is likely the cause of the increased LOS in the plating groups. Relative additional analgesic requirements were associated with AIMN. Surgeons should consider meticulous hemostasis to avoid drain placement, which can decrease LOS, thus possibly decreasing unnecessary treatment costs of humerus shaft fractures.

Journal of surgical case reports, Aug 31, 2023

International Journal of Research in Orthopaedics, Apr 28, 2023

Bilateral Simultaneous rotational ankle injuries are rare entities with little number of cases re... more Bilateral Simultaneous rotational ankle injuries are rare entities with little number of cases reported in literature. Unlike axial type ankle fractures, they tend to happen as a result of pivoting trauma on the supportive limb. We conducted a case series and literature review of patients who presented with simultaneous bilateral ankle injuries and discussed their presentation and imaging. A total of Four cases in our institute and 6 separate cases reported in literature were found who sustained bilateral simultaneous rotational ankle fractures. There were 10 cases, nine of which were simultaneous and symmetrical ankle injuries. Injuries found were; Maisonneuve fracture, Tillaux fracture, Syndesmotic injury, Lauge-Hansen's supination external rotation (SER), pronation external rotation (PER), supination adduction (SAD), and pronation abduction (PA). Four cases were presented in our institute over the last 10 years. A single case was asymmetrical in nature given the presence of an associated distal tibial metaphyseal fracture. Bilateral rotational ankle injuries are rare entity presenting simultaneously unlike axial type ankle fractures. When they present, they are likely caused by higher mechanism of injury than typical unilateral rotational ankle fractures. SER injuries are the most commonly found mechanism in both unilateral and bilateral ankle injuries.

Case reports in orthopedics, Nov 18, 2018

Avulsion fractures of the tibial tuberosity are commonly sustained in adolescent males during spo... more Avulsion fractures of the tibial tuberosity are commonly sustained in adolescent males during sport activities which involve jumping and tackling. Tibial tuberosity avulsions combined with lateral tibial plateau in an adolescent are rare injuries. We received an unusual case of left Ogden type IIIB avulsion fracture of the tibial tuberosity with an articular involvement of the lateral tibial plateau (Salter Harris type IV) in a 14-year-old boy. The injury was sustained after jumping from three stairs where the boy predominantly landed on his left lower limb. Unlike other cases reported, since they were athletes and injuries were sustained during sport activities, our case is an obese individual who jumped off few stairs. The results following surgical treatment are excellent since the fracture united, and the articular surface was restored without the need of arthrotomy with gaining full range of motion. Therefore, displaying this case in the literature will be helpful since it is rare and was successfully treated differently from the previously reported cases.

Journal of Taibah University Medical Sciences, Aug 1, 2018

Journal of Brachial Plexus and Peripheral Nerve Injury

Background Supracondylar fractures of the humerus (SCFHs) are the most common type of elbow fract... more Background Supracondylar fractures of the humerus (SCFHs) are the most common type of elbow fracture in children. Because of the influence on functional outcome, neuropraxia is one of the most common concerns at presentation. The impact of preoperative neuropraxia on surgery duration is not extensively probed. The clinical implications of several other risk factors associated with preoperative neuropraxia at presentation may contribute to longer surgical duration of SCFH. Hypothesis Preoperative neuropraxia is likely to increase surgery duration in patients who sustained SCFH. Patients and Methods This is a retrospective cohort analysis. Sixty-six patients who sustained surgical pediatric supracondylar humerus fracture were included in the study. Baseline characteristics including age, gender, the type of fracture according to Gartland classification, mechanism of injury, patient weight, side of injury, and associated nerve injury were included in the study. Logistic regression anal...

International Journal of Research in Orthopaedics

Bilateral Simultaneous rotational ankle injuries are rare entities with little number of cases re... more Bilateral Simultaneous rotational ankle injuries are rare entities with little number of cases reported in literature. Unlike axial type ankle fractures, they tend to happen as a result of pivoting trauma on the supportive limb. We conducted a case series and literature review of patients who presented with simultaneous bilateral ankle injuries and discussed their presentation and imaging. A total of Four cases in our institute and 6 separate cases reported in literature were found who sustained bilateral simultaneous rotational ankle fractures. There were 10 cases, nine of which were simultaneous and symmetrical ankle injuries. Injuries found were; Maisonneuve fracture, Tillaux fracture, Syndesmotic injury, Lauge-Hansen’s supination external rotation (SER), pronation external rotation (PER), supination adduction (SAD), and pronation abduction (PA). Four cases were presented in our institute over the last 10 years. A single case was asymmetrical in nature given the presence of an as...

Acta Scientific Orthopaedics

Background: Terrible triad injuries are devastating clinical entities with different approaches d... more Background: Terrible triad injuries are devastating clinical entities with different approaches described in the literature for fixation. Stability and an ideal range of motion are paramount for a favorable clinical outcome. The purpose of the study was to review the current protocols and surgical management of this complex injury and to assess the stability and range of motion of eight cases reported. Methods: Case series of patients involved in a non-salvageable radial head fracture. After surgery, the follow-up period was 27 months. The primary outcome measures were a range of motion and elbow stability intra-operatively and postoperatively. Secondary outcome measures were Mayo elbow performance scores. Results: Seven patients were included in the study, with a total of eight elbows presented with a terrible triad in our institute between February 2020 and May 2022. All cases reached the desired stability following coronoid repair, radial head replacement, and lateral ulnar collateral ligament repair (LUCL). Range of motion got 10 to 125 degrees on the twelfth week postoperatively. Mayo elbow performance and Disabilities of the Arm, Shoulder, and Hand Questionnaire scores were favorable at the final follow-up, with no chronic instability in all cases. Conclusion: Single incision using the Kocher approach, coronoid-first fixation using anchor suture is feasible following the removal of a comminuted radial head, followed by radial head replacement and LUCL repair resulting in desirable clinical outcomes. There is no superior current protocol for treating these injuries. Cases Case 1 A 36-year-old male, medically free, presented to Our emergency department after suffering a fall from a height (10 meters), complaining of right elbow pain and deformity. This patient was treated according to Advanced Trauma Life Support protocol and required

Cureus

Objective: The objective is to investigate one-year mortality rates following femur osteoporotic ... more Objective: The objective is to investigate one-year mortality rates following femur osteoporotic fractures, and to investigate factors that are associated with higher mortality rates. Design: A retrospective study was conducted from 2010 to 2021 (11 years) of all patients who presented to King Saud Medical City, Saudi Arabia, and had a fragility fracture of the proximal or distal femur. Patients: One hundred eight patients who sustained a proximal or distal femoral fracture, as a result of lowenergy trauma, were included. Results: The majority of our cohort (77.8%) had proximal femoral fractures, whereas only 22.2% had a distal femoral fracture. 55.6% were less than 75 years old, and 44.4% were 75 years or older. All patients had fallen from standing height. Hypertension and diabetes were the most common comorbidities among our cohort at 49.1% and 47.2%, respectively, but neither showed a statistically significant increase in the risk of mortality. When assessing the overall mortality, 21.3% of our patients had passed away. Although this finding was not statistically significant, mortality rates were found to be higher in patients with proximal femoral fractures compared to distal femoral fractures (25% vs. 8.3%, respectively, p=0.095). Patients with a normal bone mass density (BMD) had higher mortality rates as opposed to those with abnormal BMD (p=0.001). Conclusions: Mortality rates are higher in proximal femoral fractures compared to distal femoral fractures. In addition, within our study cohort, patients with normal BMD had higher mortality rates. We recommend prospective studies that compare mortality rates between proximal and distal femoral fractures in patients with osteoporosis, as these studies would provide more accurate data. We also recommend having BMD measured in those patients to avoid further fractures in this patient population.

International Journal of Health Sciences, 2018

Objectives: Pediatric diaphyseal forearm fractures are common injuries of childhood. Conservative... more Objectives: Pediatric diaphyseal forearm fractures are common injuries of childhood. Conservative modality of treatments is usually preferred when they are possible. We identified factors that may affect closed reduction success or lead to redisplacement in forearm diaphyseal fractures in children. Methods: This was a retrospective study from a level I trauma center on patients up to 18 years of age who presented with forearm diaphyseal fractures from January 1, 2007, to December 31, 2015. Cases were obtained from medical records. Data were collected and confirmed by plain films and medical files. Results: We included 145 patients in this study. The majority (86.2%) were boys. Around 29% of trials of closed reduction failed, and the patients were subsequently treated surgically. Following trials of closed reduction, 82.4% of both bone cases were successfully reduced compared to 42.9% of radius shaft cases (P = 0.006). Redisplacement following non-surgical treatment in the first foll...

Journal of Taibah University Medical Sciences, 2018

Journal of Musculoskeletal Surgery and Research, 2020

The neck of femur fractures are common in the aging population. Young people typically sustain ne... more The neck of femur fractures are common in the aging population. Young people typically sustain neck of femur fracture following a high-energy injury. Simultaneous bilateral neck of femur (BNOF) fractures in young patients are a rare entity. They might be sustained following a seizure episode. Timely diagnosis and treatment of these injuries are important and can affect the treatment modality and outcome. Internal fixation is desired in young, active, and healthy patients presenting with BNOF fractures. We report a case of a young adult presented with BNOF fractures following a single seizure episode. Bilateral open reduction and internal fixation using cannulated screws was chosen for this patient treatment. He was followed up for 2 years and showed a desirable outcome.

Journal of Musculoskeletal Surgery and Research, 2020

Distal humerus epiphyseal separation is a rare entity that can present as a birth-related injury.... more Distal humerus epiphyseal separation is a rare entity that can present as a birth-related injury. It commonly presents in children younger than 2 years of age and can be a result of a fall or forceful manipulation during delivery. It commonly presents with elbow swelling and decreased movement in newborns. It can be misinterpreted as elbow dislocations due to the lack of ossification in the distal part of the humerus on plain radiographs. Several treatment approaches have been reported in the literature including surgical and nonsurgical treatment modalities. We present a 2-day-old girl with a right distal humerus epiphyseal separation following spontaneous vaginal delivery. An anatomical and a stable reduction of the fracture was the aim in the management of this injury and was achieved using an arthrogram-assisted closed reduction and a single percutaneous Kirschner wire fixation. The patient was followed for 12 months and showed a satisfactory outcome.

Journal of Musculoskeletal Surgery and Research, 2019

Osteochondroma is the most common bone tumor. It mainly affects the proximal humerus, tibia, and ... more Osteochondroma is the most common bone tumor. It mainly affects the proximal humerus, tibia, and distal femur. It rarely affects the scapula, especially in the ventral aspect and when it does, winging of the scapula can occur, and can lead to a painful range of motion of the shoulder with a snapping sensation and secondary ribs erosion. Hereditary multiple exostoses (HME) is an autosomal dominant disorder causing multiple osteochondromas mainly in the metaphysis of long bones and it rarely affects the scapula. We present an uncommon presentation in a 7-year-old male with HME who presented with a superolateral ventral large osteochondroma measuring 8 cm × 5.5 cm that caused left scapular winging and left shoulder pain with a secondary ribs deformity. The patient was successfully treated surgically through a direct approach and was followed for 18 months and showed a satisfactory outcome with the regression of the ribs deformity.

Case Reports in Orthopedics, 2018

Avulsion fractures of the tibial tuberosity are commonly sustained in adolescent males during spo... more Avulsion fractures of the tibial tuberosity are commonly sustained in adolescent males during sport activities which involve jumping and tackling. Tibial tuberosity avulsions combined with lateral tibial plateau in an adolescent are rare injuries. We received an unusual case of left Ogden type IIIB avulsion fracture of the tibial tuberosity with an articular involvement of the lateral tibial plateau (Salter Harris type IV) in a 14-year-old boy. The injury was sustained after jumping from three stairs where the boy predominantly landed on his left lower limb. Unlike other cases reported, since they were athletes and injuries were sustained during sport activities, our case is an obese individual who jumped off few stairs. The results following surgical treatment are excellent since the fracture united, and the articular surface was restored without the need of arthrotomy with gaining full range of motion. Therefore, displaying this case in the literature will be helpful since it is r...

BMJ Open, 2020

ObjectivesTo describe the patterns and outcomes of traumatic spinal injuries (TSIs) in a tertiary... more ObjectivesTo describe the patterns and outcomes of traumatic spinal injuries (TSIs) in a tertiary care trauma centre in Riyadh, Saudi Arabia.DesignRetrospective medical record review.SettingLevel 1 trauma centre for all patients presented from 1 February 2016 to 31 December 2018.Participants and dataRecords of patients presenting with any spinal trauma were reviewed, and the data obtained included age, gender, nationality (as Saudi and non-Saudi), date of presentation, site of fracture/injury, associated injuries, mechanism of injury, presence of neurological involvement and hospital mortality.Main outcomesFrequencies of different types of TSI across various subgroups.ResultsWe identified 692 patients who presented with TSI throughout the study period. The mean age was 36.9 years. Males represented 83.2% (n=576) of the sample size, and the most common mechanism of injury was motor vehicle collision (MVC), accounting for 66.8% of cases (n=462), while fall-related injuries were seen i...