Journal of Neurological and Orthopaedic Medicine and Surgery

Online ISSN: 0890-6599
Publications
Article
Three thousand patients with painful diskal and other spinal disorders have been treated by the author for the past nearly 30 years. The overall success rate for this type of atraumatic and harmless treatment method (for disk disease) is 92 percent! Colchicine is effective in relieving the patients' neck, back and limb pain and also allows the patient to return to his former employment without complications. Besides being extremely effective, Colchicine is an exceedingly safe medication. Over the many years of my use of Colchicine, I have found it to be infinitely more effective and safer to use than aspirin.17 Complications from Colchicine use are not hematologic (particularly when used in the dosage recommended in this report). The only real complication from Colchicine usage is the Colchicine 'burn' from extravasation of the intravenous form. This is easily treated as outlined in the body of this monography. Herniated (or damaged) intervertebral disk is a relatively benign non-surgical disorder, and is a self-limiting disease (or injury) process for the most part. In patients with resistant disk disease (resistant to home or Neurological-Orthopaedic conservative remedies), the use of Colchicine rapidly returns the patient to a painfree, functional state.
 
Article
How much angulation of midshaft fractures of the forearm in children can be accepted before one should attempt closed reduction? How long after the angulated fracture of the forearm is discovered should one attempt to correct angulation? Finally, how much angulation of a middle shaft forearm fracture is acceptable in a 3-year-old child compared with one who is 12-years-old? Two case reports are submitted to exemplify these problems.
 
Article
Fifty patients who sustained only battlefield head injury by low velocity missile were the subject of this study. All of these patients received endotracheal tubes at some stage in their intensive care. The significant aspect of our study is that aspiration of gastric contents has been identified as a predominant single factor in 11 of 13 (76 percent) patients who developed ARDS. Gastric aspiration is probably the single most important factor for development of ARDS. Every effort should be made to prevent direct injury to lung parenchyma by early intubation and by keeping the patient in lateral decubitus positions.
 
Article
Seventeen cases of back pain combined with pain referred down the lateral thigh on one side, specifically into the tensor fascia lata and iliotibial band. These cases were treated with physical therapy and when necessary, injection of corticosteroid and xylocaine into the length of the iliotibial band. Four patients required transection of the iliotibial band and one patient had a unilateral laminectomy. The referral of this pain into the thigh is not the same as the more common radicular type of pain.
 
Article
Thirty-eight patients with definite resistant disk disorders are presented in a Colchicine F.D.A.-Approved Double-Blind study. Fourteen (of 17) of these disk-damaged patients took Colchicine according to the Protocol and responded initially and permanently to its use. Only 3 patients who took Colchicine did not respond. On the other hand, seven patients who took placebo had a clinical response, while 14 had none whatsoever. Chi-square analyses of these results indicate that with the significance at 99.9 percent confidence level (risk of error at 0.1 percent), Colchicine is demonstrated to be a highly effective and safe medication in the treatment of those who suffer diskogenic back pain.
 
Article
Analysis was done of results of electromyography and nerve conduction velocity (EMG-NCV) tests performed in 571 patients (991 upper extremities) with different neck or upper extremities traumas. Entrapment syndromes were found in 489 extremities: carpal tunnel syndrome (CTS) in 71.1%, cubital tunnel syndrome (CuTS) in 37.8%, and Guyon canal syndrome (GCS) in 6.1%, with occasional overlap of syndromes. Cervical radiculopathy was found in 91.8% of cases of entrapment syndromes. Incidence of entrapment syndromes and severity of motor fiber impairment increased with increased severity of radiculopathy, while impairment of sensory fibers remained the same. While overlap of CTS and CuTS was close to random, a significant increase of overlap of CuTS and GCS was observed. These findings suggest that damage of the proximal stretch of nerve fibers can provoke or facilitate development of peripheral entrapment syndromes. Consequently, thorough evaluation and aggressive treatment of neck problems may be indicated in cases of double crush syndrome.
 
Article
Previous studies have demonstrated that pediatric patients have a proclivity for developing depressive and emotional disorders. In this study, the assessment of depression levels in a group of 10 pediatric patients (aged 8 to 16 years) with neurological pathologies and 19 hospitalized for orthopedic procedures using DUSS Stories, Raven Progressive Matrices, and the Child Depression Scale revealed that (1) pediatric patients demonstrate lower levels of depression and have a more favorable attitude about the surgical correction of their handicap if the necessity for its correction is explained and stressed by their parents, and (2) it is very important to test and assess the levels of depression in pediatric patients undergoing surgery for the correction of orthopedic pathologies.
 
Article
Despite the pervasive problem of obesity and the ex-penditUre of billions of dollars devising methods of losing weight. no studies have been published on the role of the ol-factory sense in determining weight. To assess the effect of inhalation of certain aromas upon weight control. we studied 3193 overweight volunteers. Their average age was 43 years, average height 65 inches. and average weight 217pounds. Each was given <:'01 inhale. containing a blend of odorants and in-structed to inhale three times in each nostril whenever feeling hungry. New inhalers containing a new blend of odorants were supplied each month over a period of 6 months. Those subjects whose test scores showed they had good olfactory abilities and who use their inhalers frequently. ate 2 to 4 meals a day, felt bad about overeating, but did not feel bad about themselves lost nearly 5 .pounds, or 2% of body weight per month. It appears possible that inhalation of certain aromas can induce sustained weight loss over a 6-month period.
 
Article
The question of muscle injury has not been discussed well in the medical literature. Muscles which are not strong, or are unused to specific, externally imposed demands, may be overloaded in their function as either a prime mover or by acting as a brake. The present study was based upon an objective study of the range of motion (ROM), manual muscle test (MMT), and the muscle 'trigger' location with its referred pain and paresthesia pattern, in one hundred consecutive victims of motor vehicular accidents. The purpose of this study was to determine if a correlation existed between the external forces of injury, and the muscles responding to those forces looking for evidence of weakness, shortening or trigger tenderness. The muscle 'trigger' appears to be a reliable, consistent, and useful marker to validate past muscle overload injury. The consistent finding of breakaway weakness on manual muscle testing (MMT) suggests the need for a new classification for overload of muscle. The term 5(b)/5 is suggested for breakaway muslce weakness.
 
Article
Background: Acquired talipes equinovarus is usually seen in conditions such as post-polio syndrome, cerebral palsy, meningitis and sciatic nerve damage. However, it may be possible in any condition favouring contracture development. Aim: The aim of this article is to report a case of a 7 year old child who developed acquired talipes equinovarus following tetanus infection. Method: The talipes equinovarus was managed initially for 2 days using manual stretching, and later on using serial casting and wedging. Result: The serial casting and wedging for 18 days resulted in plantigrade foot position. Conclusion: Tetanus infection is characterized by generalized body spasms and rigidity. In the presence of spasms and rigidity contracture may develop, and if this affects the foot, talipes equinovarus may develop. However, early mobilization of the foot can help prevent contracture and subsequently talipes equinovarus.
 
Article
This report describes the case of a 59-year-old female patient in the chronic phase after stroke who underwent a total knee arthroplasty (TKA) of her non-hemiparetic knee. Evaluation of spatio-temporal gait parameters and functional mobility assessments (Performance oriented mobility assessment, dynamic gait index and timed up and go) were carried out initially, after 24 months of physical therapy (PT) and 8 months after TKA replacement. Comfortable walking speed after the TKA decreased by 23.4% compared to after 24 months of PT. Measurement comparisons indicated an increased risk of falling after TKA. In addition, the patient reported an increase in pain frequency and intensity of the knee and a reduction of activities and participation. These results might be useful in identifying potential consequences following the replacement of the non-hemiparetic knee in chronic stroke, which may warrant more intense consideration before a TKA of the non-hemiparetic knee is carried out.
 
Injury to Repair Time Interval vs. Limb Outcome 
Mechanism vs. Site of Injury 
Skeletal and Arterial Injuries in Upper Extremity 
Details of Patients with Secondary Amputation 
Article
Background Vascular injuries combined with fractures and/or dislocations are associated with a high rate of limb amputation. The aim of this prospective study conducted in Ghazi Al-Hariri Surgical Hospital, Baghdad, Iraq was to assess the surgical management of these injuries in this tertiary center.
 
Article
General discussion about "Tarasoff v. Regents of the University of California," dangerousness, and duty to act.
 
Article
Muscle tone was measured by tissue compliance (TC) method in six selected sites in order to establish normal values and assess the reliability of the method. Compliance (softness) of the tissue is expressed by the depth of penetration of the rubber disc in relation to the force employed. TC is a simple clinical method which can be used as part of the physical examination. The TC meter is a handheld mechanical instrument, 20 x 3 x 3 cm in size, consisting of a force gauge attached to a rubber disc with a surface of 1 cm2. When the rubber tip of the force gauge is pressed into the examined soft tissue, a ringplatform is sliding up on the shaft of the force gauge, and indicates the depth of penetration. The usual force used for single measurement is 1-4 kg. Penetration at this force was measured in 20 normal males (2 left handed) and 10 females in the following sites, which are frequently affected by muscle spasm: masseter (TMJ joint), cervical(C6) and lumbar-(L3) paraspinals, hamstrings, upper trapezius, gluteus medius. There were no statistically significant differences between dominant and non dominant side in any of the measured sites in either group. Pearson's correlation coefficient between measurements on both sides was high (.81-1.0) also corroborating the validity and reproducibility of the method. Male-female contrast was significant only in gluteus medius (males softer). The presented lower cutoff values of TC can be used for diagnosis of mucle spasm.
 
Article
Cryogenic surgery is an experimental alternative to conventional surgery. In cryogenic surgery, viable tissue is subjected to ultralow temperatures to cause certain physiological effects upon both disease and living cells in vivo. The cytological effects, produced by ultralow temperature physics, generally creates cryogenic freezing and therapeutic cryonecrosis. The cryonecrotic effects may be procured through various physiochemical mechanisms generated by the freezing and thawing of the biologic medium.
 
Article
Cryogenic surgery is an experimental alternative to conventional surgery. In cryogenic surgery, viable tissue is subjected to ultralow temperatures to cause certain physiological effects upon both disease and living cells in vivo. The cytological effects, produced by ultralow temperature physics, generally creates cryogenic freezing and therapeutic cryonecrosis. The cryonecrotic effects may be procured through various physiochemical mechanisms generated by the freezing and thawing of the biologic medium.
 
Article
Pellagrini-Stieda Disease manifests itself as a post-traumatic para-articular calcification of the medial collateral ligament of the knee. It must be considered as a residual complication whenever a patient complains of recent severe trauma to the inner aspect of the knee joint. After clinical identification of the disease is confirmed through radiographic examination, surgical intervention is discouraged because surgery may stimulate the formation of new calcareous deposits. Instead, pharmacologic and physiotherapy are indicated to arrest the disease. Once the pathologic process is completely stabilized, surgical excision of the heterotopic bone may be indicated.
 
Article
Pellegrini-Stieda Disease (also called Stieda disease and Köhler–Pellegrine–Stieda disease) manifests itself as a post-traumatic para-articular calcification of the medial collateral ligament of the knee. It must be considered as a residual complication whenever a patient complains of recent severe trauma to the inner aspect of the knee joint. After clinical identification of the disease is confirmed through radiographic examination, surgical intervention is discouraged because surgery may stimulate the formation of new calcareous deposits. Instead, pharmacology and physiotherapy are indicated to arrest the disease. Once the pathologic process is completely stabilized, surgical excision of the heterotopic bone may be indicated.
 
Top-cited authors
Thamer Hamdan
  • University of Basrah
Abdulsalam Taha
  • University of Sulaimani