Publications by authors named "Mehrdad Sadighi"

8 Publications

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Epidemiologic trend of mobile spine and sacrum chordoma: A National population-based study.

J Craniovertebr Junction Spine 2020 Jul-Sep;11(3):226-231. Epub 2020 Aug 14.

Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Introduction: Chordoma is a rare sarcoma of the axial skeleton. The incidence of this tumor is different between races. To understand the epidemiologic characteristic and due to rarity of this pathology, large number of cases should be evaluated through national data registries.

Materials And Methods: All pathologically confirmed cases of chordoma were derived from the Iran National Cancer Registry. Descriptive analysis was performed to extract age-standardized and age-specific incidence rates. Data regarding tumor location and chordoma subtypes were derived and analyzed.

Results: One hundred twenty-two cases of chordoma including 80 male and 42 female were identified. One hundred seven cases of nonotherwise specified chordoma, 14 chondroid chordoma, and one dedifferentiated chordoma were detected. The age-standardized incidence rate (ASIR) of chordoma was 0.28. Chordoma of the sacrum composed 67.2% of cases. The mean survival time was 4.5 years.

Conclusion: Epidemiology characteristic of chordoma in Iran is similar to other studies; however, the total ASIR was lower and the incidence in sacrum is nearly twice respect to the mobile spine. While men affected by sacral chordoma in relatively older age, the female patients had higher mean age in case of mobile spine involvement. The survival rate of chordoma is significantly lower in comparison with other studies.
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http://dx.doi.org/10.4103/jcvjs.JCVJS_109_20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7546048PMC
August 2020

Reliability of Postoperative Radiographies in Ankle Fractures.

Arch Bone Jt Surg 2020 Sep;8(5):598-604

Department of Orthopedic Surgery, Shohada Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Background: The accuracy of reduction of ankle fractures using postoperative plain radiographies (x-ray) remains widely controversial. Some authors have demonstrated that postoperative computed tomography (CT) scan can be useful for these patients. In current study, the efficacy of x-rays after fixation of ankle fractures was investigated based on the CT scan findings.

Methods: A total of 73 patients with ankle fractures who were subjected to open reduction internal fixation (ORIF) were enrolled. After surgery, if the reduction was acceptable based on the x-rays according to standard measurements, the patient was referred for CT scanning. Forty four patients were included in the study. Undesirable CT scan findings including malreduction of fragments or articular surfaces, device malpositioning, missed fractures, and undetected intra-articular fragments were documented.

Results: Undesirable CT findings were seen in 25 patients (56.8%). CT scan showed acceptable reduction without device malpositioning in 19 patients. The most prevalent findings in CT images were malreduction and device malpositioning in 17 and 16 patients, respectively. There was no abnormal finding in CT imaging of lateral malleolar fractures. In two thirds of the injured syndesmosis, device malpositioning, and malreduction were detected in CT scan.

Conclusion: Despite acceptable postoperative x-rays, a considerable number of patients with ankle fractures had inappropriate reduction or undesirable findings in their postoperative CT scan. It seems necessary to use CT scan after ORIF of ankle fractures in order to examine the accuracy of reduction. Further validation of postoperative CT scan in ankle fracture surgery should be investigated.
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http://dx.doi.org/10.22038/abjs.2020.43134.2173DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7547165PMC
September 2020

The Survival and Incidence Rate of Ewing Sarcoma; a National Population-based Study in Iran (2008-2015).

Arch Bone Jt Surg 2020 May;8(3):391-399

Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Background: The effect of race and ethnicity on some kind of malignant bone tumors including Ewing sarcoma has been proven in different studies. In order to evaluate the latter, national cancer registries may help to increase understanding about potential cancer causes, prevention and control strategies, and apply these findings to control health problems among populations with similar characteristics.

Methods: A national population-based cancer registry study based on all patients affected by Ewing Sarcoma was registered in the Iran National Cancer Registry (INCR) between 2008 and 2015 was designed. Demographic data of microscopically confirmed cases of bone Ewing sarcoma were registered. Patients with Ewing sarcoma were divided in groups to describe the primary site of the tumor (including axial or appendicular bones) and analyzed. In order to analyze the survival rate, randomized selection of the patient through the INCR data-base was performed.

Results: A total of 678 cases of malignant Ewing sarcoma of the bone were identified through the INCR. The mean age of Ewing sarcoma in Iran was 21.53 years. Nearly half of patients were observed at the age group of 15-24. The total crude incidence rate of Ewing sarcoma was 1.29 in 1 million. The mean 5 year survival rate was 47%. The Mean survival rate for study population was 5.53.

Conclusion: The crude incidence rate of Ewing sarcoma in Iran is relatively lower with respect to other registries. The majority of patients are in 15-25 years group and shows affection by Ewing sarcoma in an older age. Socioeconomic factors had direct influence on survival rate.
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http://dx.doi.org/10.22038/abjs.2020.44095.2206DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7358229PMC
May 2020

Fracture Surgery in Known COVID-19 Infected Patients: What Are the Challenges?

Arch Bone Jt Surg 2020 May;8(3):378-382

Department of Orthopedic Surgery, Shohada Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Background: Surgery in the time of COVID-19 pandemic is a challenging issue while treatment of affected fracture patients is inevitable. The present study summarizes the challenges that an orthopedic surgeon is confronting during the surgical treatment of fracture patients with concomitant COVID-19 infection.

Methods: Demographic and fracture related data of 13 fracture patients with concomitant COVID-19 infection who were treated with surgery was collected from three trauma centers in Tehran and Kermanshah cities from 21, February 2020 to April 3, 2020.

Results: All patients were male with mean age of 38.6±19.5 years. Eight patients had high energy fracture and seven patients had multiple fractures and trauma. Wrist and hand were the common sites of fracture following hip and pelvis. The mean interval time period between the diagnosis of COVID-19 infection and surgery was 2.3±1.5 days. Before surgery, all patients except one had been admitted to the corona dedicated wards, while two patients were admitted to the intensive care unit (ICU). One of the ICU admitted patients died. All the 12 alive patients remained in home isolation after discharge.

Conclusion: Fracture surgery in COVID-19 patients has many challenges such as lack of medical resources, delay of surgery, medial staff fear, and patient isolation. However, a multidisciplinary approach using all potential hospital resources would lead to successful operation and acceptable outcome.
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http://dx.doi.org/10.22038/abjs.2020.47899.2372DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7358239PMC
May 2020

Management of Spine Trauma in COVID-19 Pandemic: A Preliminary Report.

Arch Bone Jt Surg 2020 Apr;8(Suppl 1):270-276

Functional Neurosurgery Research Center, Shohadaye Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Background: COVID-19 was first identified in Iran in February 2020 and since then it spread rapidly through all over the country and soon after that it was reported as a pandemic. The current study presents a preliminary report of spine trauma management during COVID-19 pandemic.

Methods: A cross sectional study was designed to evaluate patients admitted for vertebral fractures with diagnosis of COVID-19 infection on February and March 2020. Analysis was made based on clinical and laboratory data along with the imaging findings from chest HRCT.

Results: Seven patients with spine trauma including five males and two females ranging from 14 to 59 years were diagnosed for COVID-19 infection through CT-scan findings. Except one, all other patients were asymptomatic for COVID-19 at the time of admission. In three cases the COVID diagnosis was made the day after arrival and in others after 10, 14 and 35 days. Five patients were treated surgically among whom four were admitted to ICU soon after the surgery. The mean ICU stay for operated patients were eight days and the mean hospital stay was 22.6 days.

Conclusion: Proper diagnosis of COVID-19 is the keystone to protect both patients and health care providers. During the pandemic all admitted patients should be screened for COVID-19 infection. Unnecessary procedures for spine trauma patients should be avoided in order to reduce complications related to surgery and to preserve ICU beds.
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http://dx.doi.org/10.22038/abjs.2020.47882.2368DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7296594PMC
April 2020

Minimally Invasive Repair of Acute Achilles Tendon Rupture Using Gift Box Technique.

Arch Bone Jt Surg 2019 Sep;7(5):429-434

Department of Orthopedic Surgery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Background: This study aimed to introduce a modified technique for minimally invasive Achilles tendon (AT) rupture repair using gift box sutures. The preliminary clinical and functional outcomes were investigated among a number of patients.

Methods: In a consecutive case series study, 24 patients with acute AT rupture underwent modified minimally invasive AT repair using two mini-incisions and gift box sutures. The patients were followed up for 24 months. The AT rupture score (ATRS) and the American Orthopedic Foot and Ankle Society (AOFAS) measure score were obtained from all patients. The other measured variables included pain intensity and satisfaction using a visual analog scale (VAS), calf atrophy, the range of sagittal ankle motion, development of wound complications, sural nerve injury, and re-rupture.

Results: After two years, the mean scores of AOFAS and ATRS were obtained at 83±4 and 81.9±6.3, respectively. Approximately 87.5 % of the patients regained their previous level of activity. The mean VAS score was 7.7±0.9 regarding the satisfaction with the outcomes. Moreover, isokinetic testing of plantar flexion and dorsiflexion strength were 82.7±5.8 and 87.7±4.1%, respectively, compared to those of the normal side. The calf atrophy was not statistically significant. In total, five patients reported pain during their activities. The range of operated ankle motion decreased significantly, compared to that of the other side; however, the differences were not significant functionally. There was no patient with wound complications, nerve injury, or complaint about problem with footwear.

Conclusion: Minimally invasive repair of acute AT rupture using two mini-incisions and gift box sutures offers good functional and clinical outcomes without wound complications which can be usually observed following open repair of AT ruptures.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6802554PMC
September 2019

The Relationship between Plasma Levels of Interleukin-6, Multiple Organ Dysfunction and Mortality in Orthopedic Patients.

Iran J Immunol 2018 Jun;15(2):156-164

Taleghani Hospital, Research Development Committee, School of Medicine, Shahid Beheshti University of Medical Science, Tehran, Iran.

Background: Interleukin 6 (IL-6) functions as both a pro-inflammatory cytokine and an anti-inflammatory cytokine.

Objective: To evaluate the levels of IL-6 in patients with multiple organ dysfunction syndrome (MODS).

Methods: Level of IL-6 was assessed and recorded for 14 days subsequent to the injury in 161 multiple trauma patients. MODS were diagnosed using Marshal Score. Injury Severity Scoring (ISS) was measured for all patients.

Results: The results of this study indicated that there was a significant relationship between the level of IL-6 and ISS on the first and second days post trauma (P=0.0001). The high level of IL-6 on the second day post trauma was associated with high mortality rate.

Conclusion: Our study suggests the second day as the golden time for measuring the serum levels of IL-6. These findings warn us to take more health care actions in patients with higher serum levels of IL-6 on the second day.
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http://dx.doi.org/IJIv15i2A8DOI Listing
June 2018

Comparative investigation of percutaneous plating and intramedullary nailing effects on IL-6 production in patients with tibia shaft fracture.

Acta Orthop Traumatol Turc 2017 Dec 6;51(6):478-481. Epub 2017 Nov 6.

Department of Orthopaedic Surgery, Taleghani Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Electronic address:

Objective: The aim of this study was to analyze the effect of intramedullary nailing (IMN), open plating and percutaneous plating on the induction of IL-6 in patients with tibia fractures.

Methods: A total of 30 patients with tibia shaft fracture underwent either intramedullary nailing (IMN, n = 15; 14 males and 1 female; mean age: 32.1 ± 15.6), ORIF plating (n = 8; 5 males and 3 females; mean age: 60.0 ± 17.8), or percutaneous plating (n = 7; 6 males and 1 female; mean age: 43.1 ± 21.4). Serum IL-6 cytokine levels were measured prior to, and 6 and 24 h after the surgery, using a special ELISA kit.

Results: The IL-6 concentration increased to peak levels at 6 h in both IMN and percutaneous plating groups, and at 24 h in ORIF plating group (p < 0.001). The mean IL-6 concentration of percutaneous plating group was significantly lower than that of the IMN group at 6 h following the surgery (p = 0.022). In addition, the mean IL-6 concentration of ORIF plating group was significantly higher than that of the percutaneous plating group at 24 h post operation (p = 0.009).

Conclusion: Our results suggest that percutaneous plating compared to the IMN has lower effects on IL-6 production in patients with tibia fracture.

Level Of Evidence: Level III, therapeutic study.
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http://dx.doi.org/10.1016/j.aott.2017.09.006DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6197449PMC
December 2017