Purpose: This study aimed to correlate the severity of carpal tunnel syndrome (CTS) in terms of the clinical picture with electrophysiological studies to determine whether the severity could be predicted through one measure based on correlations with another.Methods: This cross-sectional correlational study enrolled 96 patients (139 hands) whose nerve conduction studies (NCS) confirmed the diagnosis of CTS, and to whom the Boston Carpal Tunnel Questionnaire (BCTQ) was administered to determine the subjective and clinical CTS severity. The severity of both measures was correlated. Results: The patients’ mean age was 49.84±12.23 years. Most (67.7%) were female. The NCS severity grades were as follows: mild, 46%; moderate, 32.4; severe, 9.4%; and very severe, 12.2%. The sensory and motor NCS parameters were significantly correlated with the BCTQ severity. The patients’ overall mean scores for symptom severity had substantive predictive accuracy for the patients’ CTS severity measured with the NCS. Similarly, most of the functional severity score items had significant predictive accuracy for the patients’ NCS-based carpal tunnel severity score.Conclusion: The clinical severity of CTS was strongly correlated with the severity based on nerve conduction. This correlation was more notable for symptom severity scores than for functional status scores. Night pain and numbness demonstrated the strongest associations of all BCTQ items with the NCS. Although clinical severity (based on the BCTQ) predicts the nerve conduction severity, we still recommend performing NCS for patients with a clinical diagnosis of CTS as a confirmatory objective measure and for medico-legal reasons.
Objectives: The objectives of this study were to evaluate the accuracy of the diagnosis based on the phone forwarded pelvic radiographs for developmental dysplasia of the hip (DDH) and whether to accept decisions based on phone images. Methods: Two hundred and eight pelvic radiographs (416 hips) performed for DDH screening were evaluated by three orthopedic surgeons on picture archiving and communication system (PACS) and re-evaluated by the same surgeons after receiving them blindly on their phones through the WhatsApp application. Phone pictures were evaluated on both portrait and landscape viewing interfaces. Results: Nine ossification centers (2.9%) were detected on PACS but were not noticed when evaluated on the phone due to the lower phone image quality. All dislocated and dysplastic hips were correctly diagnosed by the phone. The phone overestimated the acetabular index by about two degrees, which explains why 4.8% and 7.5% of normal hips on PACS viewers were labeled dysplastic once evaluated on phone portrait and landscape viewers, respectively. However, landscape phone viewing and smaller phone screens were associated with a higher overestimation of the acetabular index. Conclusion: The phone is a valuable and safe tool for diagnosing DDH from pelvic radiographs. However, a precaution should be taken in borderline cases as the phone overestimated hip angles resulting in a misdiagnosis of normal hips as dysplastic. However, we do not recommend or encourage this practice because clinical evaluation is essential in any clinical decision-making.
<p class="abstract"><strong>Background: </strong>Femoral fractures are the most common pediatric orthopedic fractures that require hospitalization. The non-accidental injury should be suspected in early infancy and non-ambulatory children. Treatment of pediatric femoral fractures is widely variable and depends on intrinsic and extrinsic factors. This study presents pediatric femoral fracture epidemiology and outcomes and reviews the literature regarding best practices in pediatric femoral fractures.</p><p class="abstract"><strong>Methods:</strong> This retrospective study reviewed the clinical and radiological records of forty-sevens femur fractures in the pediatric age group from September 2020 until June 2021 in Prince Rashid bin AL Hassan Military Hospital in Jordan.</p><p class="abstract"><strong>Results:</strong> Males form 80.9% of patients. The mean age for the patients was equal to 6.70 years (±3.91). Falling is responsible for the majority of the injury. The middle femur shaft was fractured in 46.8%, and the pathological fracture was found in 17% of patients. Non-operative treatment by cast represents 42.6%. All fractures were healed at 7.90 weeks (±2.37).</p><p class="abstract"><strong>Conclusions: </strong>Pediatric femur fracture lacks standardized treatment. Nevertheless, most fractures healed with satisfactory results. Younger age groups are more likely to be treated non-operatively. Non-surgical treatment is more prone to shortening, angulation, and later return to weight-bearing and activity. Children older than eight years treated by plating demonstrated faster healing, return to full weight-bearing, and lower complication rate. </p>
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