Cam-type hip morphology in asymptomatic patients.

BACKGROUND: The alpha angle has been widely used in the assessment of cam-type of impingement, but recent studies have shown that this angle may also be high in asymptomatic patients. The aim of this study is to report the prevalence of cam-type morphology in asymptomatic volunteers and explore its correlation with hip clinical and radiological parameters. METHODS: This single-centre prospective study included 48 asymptomatic male volunteers (96 hips). All candidates fulfilled the inclusion and exclusion criteria. Physical examination and 1.5 -T MRI imaging were done for bilateral hips on the same day. Alpha angle measurements were obtained from 4 different positions and cam-type morphology was considered positive using 2 different cut points >55° and >60°. Descriptive statistics were analysed and correlations were performed where appropriate and p-value < 0.05 was considered to be significant. RESULTS: The prevalence of cam-type morphology using alpha angle >55° was 68.8%, 87.5%, 50% and 34.4% in the 12, 1, 2 and 3 o'clock positions respectively. While it was 38.5%, 69.8%, 26% and 12.5% in the 12, 1, 2 and 3 o'clock positions of the studied hips respectively using alpha angle >60°. The maximum alpha angle was more frequently prevalent at the 1 o'clock position in 71 (74%). Labral tear was detected in 26 (27.1%) hips and impingement test was positive in 12 (12.5%) hips. There was no correlation between the presence of cam-type morphology and range of motion of the hip, presence of positive impingement test nor labral tears. CONCLUSIONS: Cam-type morphology prevalence is high among asymptomatic males, and mostly pronounced at the 1 o'clock position. A correlation between high alpha angle and positive impingement test or labral tear was not found in our cohort. Future studies are required to determine the natural history of asymptomatic cam-type morphology and risk of hip derangement.

Time of surgery and surgeon level in supracondylar humerus fractures in pediatric patients: A retrospective study.

BACKGROUND: Supracondylar humerus fractures account for more than 60% of all elbow fractures and about 1/5 of all pediatric fractures. Unfortunately, these fractures can be associated with risk of complications including neurovascular injuries, malunions and limb deformities. Controversy exists regarding the effect of time of surgical intervention and/or level of surgeon performing the surgery on outcome of these fractures. AIM: To determine whether time of surgical intervention and/or surgeon level influence the outcomes of surgically managed pediatric supracondylar humerus fractures. METHODS: We retrospectively studied 155 pediatric patients presenting with a supracondylar humerus fracture in a level 1 trauma center from January 2006 to December 2019. The data extracted included demographic data, fracture characteristics, surgical data, and follow-up outcomes. The collected data was analyzed and P values of < 0.05 were considered statistically significant. RESULTS: Of the cohort, 11% of patients had documented post-operative complications, of which the majority occurred in surgeries performed after day time working hours and in fractures requiring open reduction. While the lowest complication rate was found in surgeries performed by pediatric orthopaedic surgeons, this did not reach statistical significance. CONCLUSION: In pediatric patients undergoing surgery for supracondylar fractures, we found a higher complication rate when surgeries were not performed during working hours. Surgeon level and training had no significant effect on the risk of post-operative complications.

Factors Affecting Utilization of the E-Health "Seha" Interactive Application for Online Medical Consultation in Saudi Arabia.

Purpose: Telehealth, Internet interventions, or digital apps provide healthcare to isolated regions and can span borders. The purpose of this research was to assess the use of the Seha application, public perceptions toward the application, and factors that affect its utilization. Methods: The cross-sectional method was used to analyze the quantitative data. Grounded Theory was used to analyze the qualitative data. This study was conducted from December 1, 2018, to January 31, 2019. A total of 419 participants were surveyed online, and semi-structured interviews were conducted for 20 participants. The participants were chosen based on convenience sampling techniques. The survey contained two sections. The first section consisted of demographic data and the second section included eight questions, each covering one main aspect. For the qualitative approach, participants were chosen using a theoretical sampling technique. Researchers acted as the primary data collection instrument. Results: Out of the total, 88.5% of the participants did not use "Seha" application. Among users, the main perceived benefit from the application was the ability to contact a general practitioner anytime. Among non-users, the greatest barrier to use was the lack of awareness about it, while the ability to contact a general practitioner any time (25%) and reducing visits to the doctor (23%) were the top motivations. A conceptual framework was developed to define the different aspects affecting the use of the online medical consultation application. These aspects included awareness and education, technical issues, access, and consultation information. Conclusion: Public awareness and education about the application, as well as the integration of its functions with other healthcare systems were the main recommendations suggested. Implementing these recommendations is encouraged to deliver value to e-health initiatives in Saudi Arabia.