1.Posterior First and Second Cervical Vertebrae Fusion by Screw Fixation Technique using the Modern Pre-fabricated Template Method on Cadaver Samples
Athari M ; Golbakhsh MR ; Mirbolook A ; Athari M ; Ahmadi A ; Komlakh K ; Azarhomayoun A ; Paydarniya P
Malaysian Orthopaedic Journal 2021;15(No.3):58-64
Introduction: C1 lateral mass and C2 pedicular screws
insertion are used for C1-C2 posterior fusion. Fluoroscopy
Guided technique is routinely used for screw placement but
it is associated with risk of injury to spinal cord and vertebral
artery. 3D printing has developed rapidly in the fields of
medicine. It is helpful in improving precise treatment and
used for instrumentation in spine. We want to evaluate the
accuracy of C1 lateral mass screws and C2 pedicle screws
insertion by Pre-Fabricated Template made by threedimensional (3D) printing.
Materials and methods: Five cervical samples were
obtained from cadavers. Based on fine-cut CT scan 3Dimages reconstructed and the path of the screws designed by
special software. A template produced by 3D-printer from
3D images. After printing the templates, they were fixed on
the relevant vertebra in the operation room and based on the
template path, C1 lateral mass screw and C2 pedicular
screws were inserted. Placement of the screws was evaluated
using CT scans post-operatively.
Results: A total of 14 screws were inserted by abovementioned method. After evaluation with CT scans none of
the screws were entered in the spinal canal. Two screws had
vertebral artery canal perforation with less than 50% breach.
Violation was judged as noncritical and would probably not
have resulted in injury to vertebral artery.
Conclusions: The accuracy of C1 lateral mass screw and C2
pedicle screw insertion is acceptable with pre-fabricated
template and can provide a useful aid for screw placement.
2.Clubfoot Deformity Treatment with Ilizarov Apparatus in the Paediatric Population without Corrective Osteotomies and Soft Tissue Release: A Cross-Sectional Study
Aslani HS ; Athari MB ; Tavakoli-Darestani R ; Pourmojarab A ; Baroutkoub M ; Zamani M
Malaysian Orthopaedic Journal 2023;17(No.3):42-47
Introduction: Neglected Club Foot deformity is not an
uncommon limb anomaly encountered by orthopaedic
surgeons. Many treatment methods have been proposed.
Ilizarov apparatus is one of the techniques used to correct
this deformity.
Materials and methods: In this cross-sectional study 47
patients (56 feet) between the ages of 5 and 10 years with
clubfoot deformity were treated using the Ilizarov external
fixator. Age, sex, type of deformity, and radiographic
parameters were measured on foot radiographs. Also, the
American Orthopaedic Foot and Ankle Society (AOFAS)
score and the Dimeglio classification were recorded for each
patient before and after treatment.
Results: The treatment was unilateral in 38 patients and
bilateral in 9 patients. 39 patients (69.6%) were male, and 17
patients (30.4%) were female with a mean age of 7.86 ± 1.4
years. Plantar angles of ankle flexion and ankle flexion curve
increased from 20.12±6.52 and -16.51±8.36 to 25.89±6.44
and 6.19±6.42, respectively. There was also an improvement
in the talocalcaneal and tibiocalcaneal angles. Also, the angle
between the first metatarsus and the talus in the front and
side views improved (P<0.00). Additionally, the mean
AOFAS score and Dimeglio classification significantly
improved. Three cases were complicated with distal tibial
physeal separation that were treated with additional open
surgeries.
Conclusion: Ilizarov technique without osteotomies and soft
tissue release could be considered a less invasive and
successful method of treatment for neglected clubfoot
deformity in patient five to ten years old that are not good
candidate for Ponseti method.