Predictors of Acute Compartment Syndrome in Patients With Forearm Fractures: A Systematic Review.

Acute compartment syndrome (ACS) is a critical orthopedic and traumatology emergency arising from elevated pressure within a confined osteofascial compartment, leading to compromised blood circulation and tissue ischemia. This systematic review aims to comprehensively identify and analyze the most predictable risk factors associated with ACS development in patients with forearm fractures. Published articles on ACS were meticulously searched and evaluated on reputable medical databases such as PubMed. The keywords "risk factors associated with the ACS in patients who have sustained forearm fractures"were used to create the search syntax on various databases. Data were gathered on raw prevalence, population under study, and methodology. A total of 10 articles that met the search criteria were identified and included in this review with a total of more than 300,000 patients across the studies. Fracture-related ACS was the most common, followed by soft tissue damage among patients with forearm fractures. This review underscores fractures as primary ACS catalysts, along with the role of soft tissue trauma. Meticulous consideration of these risk factors can enhance clinical decision-making, early detection, and intervention, improving patient outcomes and care quality.

Etiologies of Orthopedic Implant Removal Among Patients Who Underwent Orthopedic Fixation Surgeries in King Abdulaziz Medical City.

BACKGROUND: Hardware removal surgeries are considerably common. However, the justifications for these surgeries are debatable. The indications may vary from pain, surgical site infection, or failure of osteosynthesis. Additionally, the surgery can be performed without medical indication. Following these surgeries, many complications can occur. Therefore, surgeons and patients should be aware of the appropriate indications and have realistic expectations of the risks and benefits of implant removal. METHODS: This was a retrospective chart review study. We included all patients aged 17-86 years who underwent hardware removal surgery in the orthopedic surgery department of King Abdulaziz Medical City, Riyadh, Saudi Arabia, from 2010 to 2019. All relevant data, such as demographic characteristics, location and type of hardware, indication for hardware removal, duration between insertion and removal, and complications after removal were recorded and analyzed. RESULTS: A total of 244 medical records were reviewed with a mean patient age of 34 years. Out of the total, 190 patients (77.9%) were male. The femur was the most common location of hardware removal, in 50 cases (20.58%). Plates and screws were the most common type of implants (40.2%). Most patients underwent hardware implantation because of fractures (89.3%). In total, 119 patients (48.8%) had the hardware removed electively. Only 29 patients (12%) reported postoperative complications; 190 patients (77.9%) were advised by their surgeon against hardware removal. CONCLUSION: Hardware removal procedures are commonly performed worldwide for various reasons, including infection, pain, and loosening. In this study, we have outlined the reasons for implant removal, the locations, complications, and the rationale behind this surgery. We have provided a new decision-making assessment, aimed at the general population and surgeons alike, that will help patients better comprehend the complications and risks associated with this elective surgery.

A Decade's Perspective on the Orthopedic Workforce in Saudi Arabia.

Background The orthopedic surgery workforce constitutes a vital role in the healthcare system, with data being scarce. Therefore, through this study, we share an overview of the orthopedic workforce distribution, demographic trends, and changes over the past decade in Saudi Arabia. Methods All practicing orthopedic surgeons in Saudi Arabia from January 1, 2010, to December 31, 2021, were included in the study. Data regarding orthopedic surgeons' demographics and numbers were obtained from the Saudi Commission for Health Specialties (SCFHS), whereas the data related to the geographical distribution of orthopedic surgeons was obtained from the Ministry of Health Statistical Yearbook of 2020. Results The ratio of orthopedic surgeons per 100,000 people was 5.42 in 2010, which grew subsequently to 12.29 in 2021. The number of Saudi orthopedic surgeons has been noticeably rising through the years, while a slowly growing pattern can be seen among non-Saudi orthopedic surgeons. In addition, the highest ratios of orthopedic surgeons per 100,000 were in Makkah (1.72), Riyadh (1.26), and the Eastern Region (1.06). Conclusion In this study, we demonstrate the progress of the orthopedic workforce in Saudi Arabia over a period of 12 years. The number of orthopedic surgeons per 100,000 people showed a significant rise due to several factors, one of which is road traffic accidents. Also, although the number of female orthopedic surgeons has been rising lately, they are still much fewer than males in this field. In addition, Saudi Arabia has been developing a new healthcare system via the privatization of some of the governmental hospitals, which will lead to changes in the future workforce and its accommodations.

Plasmacytoid Variant Urothelial Cell Carcinoma: A Case of a Histological Variant of Urinary Bladder Cancer With Aggressive Behavior.

This paper presents a case report of plasmacytoid variant urothelial carcinoma (PVUC), a rare form of transitional cell carcinoma. PVUC is known for its unique clinical features, aggressive behavior, and poor survival rates. PVUC comprises less than 3% of all bladder tumors, and its diagnosis is often difficult due to its resemblance to other forms of bladder cancer. It requires a staging workup to rule out metastasis, relies heavily on immunostaining and histopathological analysis for diagnosis, and requires a multidisciplinary approach with early aggressive treatment, including cisplatin-based chemotherapy following surgery. This report highlights the importance of understanding rare variants of bladder cancer to ensure timely and accurate diagnosis and appropriate treatment planning. We report here a case of a 75-year-old male with multiple comorbidities who presented with hematuria and was diagnosed with urothelial carcinoma plasmacytoid type, which was initially treated with transurethral resection but later found to be unresectable and treated with palliative chemotherapy and radiation therapy. Eventually, the patient passed away three years after the diagnosis.