Journal of Academic Research

Proximal Humerus Fracture with Plating

Dr.Mustafa Elsagier, Dr. Mohamed Mahmoud, Dr. Mohamed Sosi — Sun, 10 Aug 2025 00:00:00 +0000

Background:
Displaced proximal humerus fractures, especially in young adults or osteoporotic elderly patients, may require surgical fixation. The PHILOS locking plate provides angular stability and facilitates early mobilization.

Methods:
Thirty patients (age 18–60) with Neer type II–IV fractures were treated using the PHILOS plate between May 2020 and June 2024. A deltopectoral approach was used in all cases. Clinical and radiological follow-up averaged 24 months. Functional outcomes were assessed using the UCLA Shoulder Score.

Results:
Excellent or good outcomes were seen in 72% of cases. Mean UCLA score was 29.5. Average elevation reached 127°, with external rotation of 42°. Complications occurred in 28%, most commonly inadequate reduction (16%) and adhesive capsulitis (6%).

Conclusion:
PHILOS plate fixation is effective for displaced proximal humerus fractures, particularly when anatomic reduction is achieved. Outcomes are favorable, with a low complication rate when technical precision is maintained.

Systematic meta-analysis on risk factors for Postoperative complica-tion in brain tumor surgery

Dr.Amina mohammed khdora, Dr.Eman mahmod kram mahammed, Dr. Ahmed Omar Abushahma — Sun, 10 Aug 2025 00:00:00 +0000

Background:
Brain tumor surgery represents a high-stakes and technically demanding area in neurosurgery. This study aims to systematically analyze the incidence and types of postoperative complications, using data from a tertiary care center, with emphasis on tumor type and surgical context.

Methods:
This meta-analysis is based on data collected between January 2022 and September 2023 from adult patients who underwent surgery for intracranial tumors. Adverse events (AEs) occurring within 30 days postoperatively were documented by attending neurosurgeons. Tumor histology, surgical approach, urgency, and complications were analyzed.

Results:
Among 1,173 patients (mean age 57.4 ± 15.3 years), 93.4% underwent elective surgery. The most common tumors were meningiomas (31.1%) and gliomas (28.2%). The rate of surgery-related AEs was 12.7%, with dural leaks observed in 1.5% of cases. Postoperative hemorrhage was a significant issue, especially among glioma patients; 10 experienced bleeding and 8 required reoperations. The 30-day mortality rate was 0.8%, with causes including postoperative bleeding (n=1), pulmonary embolism (n=2), and tumor progression (n=2).

Conclusions:
Despite the inherent risks associated with brain tumor surgery, the overall mortality in this cohort was low. Comprehensive documentation and early intervention strategies play a crucial role in improving patient outcomes following neurosurgical procedures.

The Effect of Calcar Screw Use in Fractures of the Proximal Humerus

Dr. Mustafa Elsagier, Dr. Mohamed Mahmoud — Sun, 10 Aug 2025 00:00:00 +0000

Background:
Proximal humerus fractures are common in elderly patients. Locking plates offer stable fixation, but loss of reduction and varus deformity still occur, especially with poor medial support.

Methods:
25 patients treated with PHILOS plates were studied. Calcar screws were used in some cases. Radiographs were assessed for neck-shaft angle and calcar screw position. Shoulder function was measured using the Oxford Shoulder Score.

Results:
91% of optimally placed calcar screws were associated with neck-shaft angles between 130°–150°. Malposition rate was 32%. Fixation failure occurred in 3 patients without calcar screws; none occurred in the calcar screw group.

Conclusion:
Use of calcar screws and achieving a neck-shaft angle between 130°–150° reduces fixation failure. Proper placement improves medial support and patient outcomes.

Clinical and Histopathological Correlation in Acute Appendicitis in the Pediatric Age Group

Esam Alsaghair, Salem Shnaishah, Ahmed Abugarsa, Walid kaibah — Sun, 10 Aug 2025 00:00:00 +0000

Background:- : Acute appendicitis is the most common surgical emergency in the pediatric population. Accurate diagnosis is crucial to reduce negative appendectomy rates. This study evaluates the clinical presentation, imaging findings, and histopathological outcomes in children who underwent appendectomy.

Methods:- : A retrospective analysis of 131 pediatric appendectomy cases ages (2–16 years) was conducted. Data on demographics, clinical signs, imaging, and histopathology were collected and correlated.

Results: The male-to-female ratio was 2.2:1. The most frequent symptoms were right iliac fossa pain (86.3%), nausea (70.2%), vomiting (54.2%), anorexia (59.5%), and fever (45%). Ultrasound was performed in 89 cases and was positive in 83 (93.3%). CT scans were used in only 2 cases. Histopathology confirmed in 131 patients with a negative appendectomy rate of 23.6%.
Conclusion: Strong clinical suspicion and imaging (ultrasound) showed high sensitivity. Histopathology remains the definitive diagnostic tool. Combining clinical and radiological findings can reduce unnecessary surgeries

Parathyroidectomy failures and causes evaluation

Mohamed Baayou, Mohamed Bashagha, Mostafa Sgheir, Eltaher Elshagmani — Sun, 10 Aug 2025 00:00:00 +0000

Background: Persistent primary hyperparathyroidism (PHPT) after surgery is often due to missed ectopic or supernumerary glands. Reoperation is challenging and requires precise imaging, anatomical understanding, and surgical expertise.

Methods: A 34-year-old woman with classic PHPT symptoms and biochemical evidence (Ca: 12.75 mg/dL, PTH: 891 pg/mL) underwent two failed parathyroidectomies. Imaging was inconclusive; histology showed nodular hyperplasia in the first and absence of parathyroid tissue in the second. A third surgery, guided by high-resolution ultrasound and intraoperative endoscopy, located an ectopic retroesophageal adenoma, which was excised.

Results: Immediate postoperative laboratory confirmed cure (Ca: 7.2 mg/dL, PTH: <1.2). The patient developed transient hungry bone syndrome. No complications were noted.

Conclusion: Persistent PHPT requires high suspicion for ectopic or supernumerary glands. Third-time parathyroidectomy, when planned with expert imaging and surgical collaboration, can be safe and curative.

Glomus tumer management outcomes of the hand

Dr.Mustafa Elsagier, Dr Mohamed Mahmoud, Dr Moftah engam — Sun, 10 Aug 2025 00:00:00 +0000

Background: Glomus tumors are rare, benign, and painful vascular tumors arising from the glomus body, most found in the subungual region of the fingers. Despite their typical clinical presentation, diagnosis is often delayed for years.

Methods: A retrospective case series was conducted on 7 patients treated at Misurata Medical Centre between June 2020 and October 2023. Clinical presentation, imaging, surgical technique, and postoperative outcomes were analyzed. Pain relief was measured using the Visual Analog Scale (VAS), and patients were followed up for 6 months to assess recurrence and nail deformity.

Results: All patients (100%) reported pain and localized tenderness; 66% had cold sensitivity. The average delay in diagnosis was 73 months. Surgical excision using the transungual approach led to complete symptom relief in all patients. VAS scores improved from 9.3 preoperatively to 0.59 at 6 weeks. Nail regrowth was complete in all cases; minor deformities occurred in 2 patients. No recurrence was observed during follow-up.

Conclusion: Glomus tumors of the fingers can be effectively diagnosed clinically and treated with surgical excision. Early recognition and precise surgical technique result in excellent functional and cosmetic outcomes with minimal recurrence.

Results of spica cast in treatment of developmental dysplasia of the hip in children between 6-18 Months

Sun, 10 Aug 2025 00:00:00 +0000

Background: Developmental dysplasia of the hip (DDH) includes a spectrum from mild dysplasia to complete dislocation. Early treatment improves outcomes and reduces complications.

Objective: To assess clinical and radiological outcomes of closed reduction and static long leg spica casting in children aged 6–18 months with DDH.

Methods: This retrospective study included 29 patients (38 hips) treated at Misurata Medical Center in 2018. All underwent adductor tenotomy, closed reduction, and hip spica casting. Outcomes were assessed using McKay’s criteria and Severin classification. AVN was evaluated by Salter’s criteria.

Results: 70% of hips had good radiological outcomes; 89% showed good clinical outcomes. AVN occurred in 7.89% of cases. Mean casting duration was 90 days.

Conclusion: Closed reduction and spica casting is effective and safe for managing DDH in children 6–18 months, with high success rates and low complication risk when properly applied.

Simultaneous removal of retained metal hardware during primary knee Arthroplasty

Dr.Mustafa Elsagier, Dr.Abd algafor alsadi — Sun, 10 Aug 2025 00:00:00 +0000

Background:
Retained hardware is usually removed during TKR only if no infection is present. We follow clinical and lab criteria to rule out infection and proceed in one session.

Methods:
In 39 cases, hardware was removed during primary TKR. Most staplers were taken out through the main incision; blade plates needed separate lateral incisions. One tibial nail was partially removed: one DCS plate through lateral dissection.

Results:
No infections at 6 months. Dropout rate 5%. Over 10 years, no late complications, skin necrosis, or fractures were noted. No metallosis observed.

Conclusion:
Simultaneous hardware removal during TKR is safe and effective when infection is excluded, and proper planning is followed.