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Article: Acute osteoarticular infections in children are frequently forgotten multidiscipline emergencies: beyond the technical skills.

El-Sobky, Tamer / Mahmoud, Shady

2021 Volume 6, Issue 7, Page(s) 584–592

Abstract: Acute osteoarticular infections (AOI) should be treated as top emergencies. The first few days following the inception of infection are ultra-critical to long-term prognosis.A comprehensive road map for management of childhood AOI is still lacking ... ...

Abstract	Acute osteoarticular infections (AOI) should be treated as top emergencies. The first few days following the inception of infection are ultra-critical to long-term prognosis.A comprehensive road map for management of childhood AOI is still lacking despite recent advances in microbiology and imaging (magnetic resonance imaging). The many faces of childhood AOI warrant a multidiscipline approach to management.Laboratory and imaging findings of are still debatable and should not overshadow or delay a management plan based on the experienced physician's clinical judgment.Ample evidence-based practice supports the use of a few days of intravenous antibiotic administration followed by oral therapy until correlative clinical and basic laboratory (acute phase reactants) results improve.The growing body of evidence on 'high-risk' children/neonates of AOI warrants continual clinical extra-vigilance in identifying these patient subsets.Open drainage and debridement remain the mainstay of treatment of septic hips, whereas for other joints the use of alternative surgical techniques should be individualized or on case-by-case basis.Because the consequences of misdiagnosis of AOI are usually grave and permanent, proactive treatment/overtreatment is justified in the event of unconfirmed but suspicious diagnosis. Cite this article:
Language	English
Publishing date	2021-07-08
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	2844421-8
ISSN	2058-5241 ; 2058-5241 ; 2396-7544
ISSN (online)	2058-5241
ISSN	2058-5241 ; 2396-7544
DOI	10.1302/2058-5241.6.200155
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Article ; Online: Recurrent Instability after the Latarjet Procedure.

Alkhelaifi, Khalid / Alzobi, Osama Z / Mahmoud, Shady A / Zikria, Bashir A

Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews

2023 Volume 7, Issue 12

Abstract: The Latarjet procedure is a favored approach for managing chronic and recurrent dislocation, especially in the presence of bone loss. Although generally yielding excellent results, the procedure carries a 15 to 30% complication rate. Although recurrent ... ...

Abstract	The Latarjet procedure is a favored approach for managing chronic and recurrent dislocation, especially in the presence of bone loss. Although generally yielding excellent results, the procedure carries a 15 to 30% complication rate. Although recurrent instability is a major concern, various complications such as infection, nerve injuries, and hardware impingement can also necessitate revision after a Latarjet procedure. Strategies for addressing this issue include glenoid bone grafting, using autogenous bone grafts from the iliac crest or distal clavicle, and allografts, with fresh lateral distal tibial allografts offering advantages because of their osteochondral nature. In addition, soft-tissue procedures offer another solution for recurrent instability, suitable for patients lacking substantial bone loss or those experiencing multidirectional instability. This review aims to provide a comprehensive overview of the causes and management strategies for recurrent instability following a failed Latarjet procedure.
MeSH term(s)	Humans ; Shoulder Joint/surgery ; Arthroplasty ; Scapula/surgery ; Shoulder Dislocation/surgery ; Bone Transplantation
Language	English
Publishing date	2023-11-27
Publishing country	United States
Document type	Review ; Journal Article
ZDB-ID	2898328-2
ISSN	2474-7661 ; 1067-151X
ISSN (online)	2474-7661
ISSN	1067-151X
DOI	10.5435/JAAOSGlobal-D-23-00205
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Article ; Online: Naviculectomy With Limited Soft-Tissue Releases as a Third Way Beyond Manipulative Treatment and Extensive Soft-Tissue Releases for Ambulatory Children With Complex Congenital Vertical Talus: A Technical Note.

Aly, Ahmad S / Samir, Shady / Mahmoud, Shady / El-Sobky, Tamer A

Foot & ankle specialist

2022 , Page(s) 19386400211068265

Abstract: We investigated the radioclinical outcomes of naviculectomy and limited/tailored soft-tissue releases in a short series of ambulatory children with complex/intractable congenital vertical talus subsets namely neglected, multiple operated, and recurrent ... ...

Abstract	We investigated the radioclinical outcomes of naviculectomy and limited/tailored soft-tissue releases in a short series of ambulatory children with complex/intractable congenital vertical talus subsets namely neglected, multiple operated, and recurrent patients. We postulated that this technique will yield satisfactory radioclinical outcomes and minimal complications because it avoids extensive surgical release/trauma that is otherwise classically recommended for complex congenital vertical talus. The cohort consisted of 5—4 boys and 1 girl—complex congenital vertical talus children with neglected, multiple operated, and/or recurrent subsets. Patients were included if manipulative casting techniques were deemed unlikely to produce a plantigrade foot. Patients underwent naviculectomy with variable on-demand limited soft-tissue releases. Two patients had bilateral affection and 2 had a nonidiopathic cause. The mean age was 5.2 years (4-6.25) and mean follow-up was 2.3 years (1-3). We reported satisfactory outcomes as per foot posture, function, overall parent satisfaction including pain and radiography per lateral views of talar-axis-first metatarsal base angle on the short/intermediate term. Whereas manipulative casting is unlikely to yield lasting outcomes in ambulatory children with complex subsets of congenital vertical talus, extensive surgical soft-tissue releases have unfavorable long-term complications. As a substitute, naviculectomy as a form of resection arthroplasty created a practical and affordable third way between manipulative casting with or without minimally invasive surgery and the extensive surgical soft-tissue releases on the short-to-intermediate term. Level of evidence: Level IV case series.
Language	English
Publishing date	2022-01-19
Publishing country	United States
Document type	Journal Article
ZDB-ID	2488579-4
ISSN	1938-7636 ; 1938-6400
ISSN (online)	1938-7636
ISSN	1938-6400
DOI	10.1177/19386400211068265
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Article: Is the level of vitamin D deficiency correlated with the severity and bilaterality in slipped capital femoral epiphysis? A case series study.

Elbeshry, Shady / Abdelaziz, Tarek Hassan / Aly, Ahmad Saeed / Mahmoud, Shady

Acta orthopaedica Belgica

2022 Volume 88, Issue 2, Page(s) 217–221

Abstract: The aim of the study is to find the correlation between vitamin D level and the severity of slippage and bilateral development in slipped capital femoral epiphysis (SCFE) cases if any. Thirty-nine patients with moderate-severe stable SCFE were evaluated ... ...

Abstract	The aim of the study is to find the correlation between vitamin D level and the severity of slippage and bilateral development in slipped capital femoral epiphysis (SCFE) cases if any. Thirty-nine patients with moderate-severe stable SCFE were evaluated regarding their vitamin D level and to which extent the severity of vitamin D deficiency, if present, can be correlated with the severity and bilaterality of the slip. Vitamin D serum level was assessed pre- operatively for all patients. In case of deficiency, the patient underwent in situ pinning unless performed before his/her presentation. Alongside, he/she received a vitamin D course until correction prior to the definitive surgery (Imhäuser osteotomy with osteochondroplasty) 6-12 weeks after. Thereafter, osteotomy healing and physis closure were monitored radiologically. Results show that all patients but one had vitamin D deficiency, with an average of 14.39 ng/mL, necessitating vitamin D therapy before proceeding to the definitive surgery. No correlation existed between vitamin D level and Southwick angle severity with a p-value of 0.85. A negative correlation existed between vitamin D level and bilaterality, but not statistically significant (p-value 0.192). Patients' osteotomy healing was uneventful, and physeal closure was achieved in all the cases that had in situ pinning. We conclude that the severity of Vitamin D deficiency could be linked to the bilateral development of SCFE but not the severity of slippage. Treatment of Vitamin D deficiency facilitates physeal closure.
MeSH term(s)	Female ; Growth Plate ; Humans ; Male ; Osteotomy/methods ; Retrospective Studies ; Slipped Capital Femoral Epiphyses/complications ; Slipped Capital Femoral Epiphyses/diagnostic imaging ; Slipped Capital Femoral Epiphyses/surgery ; Vitamin D ; Vitamin D Deficiency/complications
Chemical Substances	Vitamin D (1406-16-2)
Language	English
Publishing date	2022-06-03
Publishing country	Belgium
Document type	Journal Article
ZDB-ID	210367-9
ISSN	0001-6462 ; 1784-407X
ISSN	0001-6462 ; 1784-407X
DOI	10.52628/88.2.8784
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Article: Mid-term results of sub-trochanteric valgus osteotomy for symptomatic late stages Legg-Calvé-Perthes disease.

Emara, Khaled M / Diab, Ramy Ahmed / Emara, Ahmed K / Eissa, Mohamed / Gemeah, Mostafa / Mahmoud, Shady Abdelghaffar

World journal of orthopedics

2023 Volume 14, Issue 5, Page(s) 328–339

Abstract: Background: The treatment of late stages of Legg-Calvé-Perthes disease (LCPD) is controversial. Although the concept of femoral head containment is a well-established technique of treatment, its use remains debatable in the late stages of the disease, ... ...

Abstract	Background: The treatment of late stages of Legg-Calvé-Perthes disease (LCPD) is controversial. Although the concept of femoral head containment is a well-established technique of treatment, its use remains debatable in the late stages of the disease, as it does not improve symptoms in terms of limb length discrepancy and gait. Aim: To assess the results of subtrochanteric valgus osteotomy in symptomatic patients with late-stage Perthes disease. Methods: From 2000 to 2007, 36 symptomatic patients with late stage of Perthes disease were surgically treated with subtrochanteric valgus osteotomy and followed-up for 8 to 11 years using the IOWA score and range of motion (ROM) variables. The Mose classification was also assessed at the last follow-up to reflect possible remodeling. The patients were 8 years old or older at the time of surgery, in the post-fragmentation stage, and complaining of pain, limited ROM, Trendelenburg gait, and/or abductor weakness. Results: The preoperative IOWA score (average: 53.3) markedly improved at the 1-year post follow-up period (average: 85.41) and then slightly improved at the last follow-up (average: 89.4) ( Conclusion: Subtrochanteric valgus osteotomy can be a good option for symptomatic relief in patients with late-stage of LCPD.
Language	English
Publishing date	2023-05-18
Publishing country	United States
Document type	Journal Article
ZDB-ID	2649712-8
ISSN	2218-5836
ISSN	2218-5836
DOI	10.5312/wjo.v14.i5.328
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Article ; Online: Naviculectomy for two ambulatory children with intractable congenital vertical talus: redefining the indications of an old technique.

El-Sobky, Tamer A / Samir, Shady / Mahmoud, Shady

Journal of pediatric orthopedics. Part B

2019 Volume 29, Issue 4, Page(s) 387–391

Abstract: Congenital vertical talus is a rare and complex foot anomaly. Serial casting with or without minimally invasive surgery is a universal management strategy especially for children in the first year of life. Nevertheless, extensive surgical treatment of ... ...

Abstract	Congenital vertical talus is a rare and complex foot anomaly. Serial casting with or without minimally invasive surgery is a universal management strategy especially for children in the first year of life. Nevertheless, extensive surgical treatment of late-presenting, neglected and multiple operated children with congenital vertical talus may be required with guarded results. The results of naviculectomy as a more conservative intervention and directed exclusively at ambulatory children with intractable congenital vertical talus have not been reported. We present the radioclinical outcomes of two ambulatory children with intractable congenital vertical talus treated by naviculectomy/midtarsal resection and limited soft tissue release. One child had an isolated congenital vertical talus whereas the other had a non-isolated etiology. Generally, naviculectomy/midtarsal resection revealed a positive benefit-risk profile in children with intractably severe congenital vertical talus on the short-term. We reported favorable results in terms of foot appearance, function and radiology. We believe that a less invasive procedure like naviculectomy/midtarsal resection is an encouraging technique to investigate in children with intractable congenital vertical talus.
MeSH term(s)	Arthroplasty/methods ; Child, Preschool ; Dissection/methods ; Female ; Foot Deformities, Congenital/diagnostic imaging ; Foot Deformities, Congenital/physiopathology ; Foot Deformities, Congenital/surgery ; Humans ; Male ; Minimally Invasive Surgical Procedures/methods ; Outcome and Process Assessment, Health Care ; Radiography/methods ; Range of Motion, Articular ; Recovery of Function ; Talus/abnormalities ; Talus/diagnostic imaging ; Talus/surgery ; Tarsal Bones/diagnostic imaging ; Tarsal Bones/surgery
Language	English
Publishing date	2019-07-29
Publishing country	United States
Document type	Case Reports ; Journal Article
ISSN	1473-5865
ISSN (online)	1473-5865
DOI	10.1097/BPB.0000000000000663
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Article: What orthopedic surgeons need to know about Covid-19 pandemic.

Emara, Khaled / Emara, Ahmed K / Farhan, Mona / Mahmoud, Shady

Journal of orthopaedics

2020 Volume 21, Page(s) 275–277

Abstract: The ongoing outbreak of COVID-19, also known as SARS-CoV-2 and coronavirus disease 2019, is considered a major public concern that propagates steadily by the increased number of the infected cases and the mortality rate. In this article, we provide a ... ...

Abstract	The ongoing outbreak of COVID-19, also known as SARS-CoV-2 and coronavirus disease 2019, is considered a major public concern that propagates steadily by the increased number of the infected cases and the mortality rate. In this article, we provide a brief review for Orthopedic surgeons as regard COVID-19 virus microbiology, epidemiology, clinical picture, and diagnosis. Moreover, what measures should be taken amid this pandemic to assess its control, maintain the urgent duties, and protect health care workers (HCW) are also discussed.
Keywords	covid19
Language	English
Publishing date	2020-05-20
Publishing country	India
Document type	Journal Article
ZDB-ID	2240839-3
ISSN	0972-978X
ISSN	0972-978X
DOI	10.1016/j.jor.2020.05.016
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Article: Multicentric Osteolysis, Nodulosis, and Arthropathy in two unrelated children with matrix metalloproteinase 2 variants: Genetic-skeletal correlations.

Elsebaie, Hanan / Mansour, Mohamed Abdelhafiz / Elsayed, Solaf M / Mahmoud, Shady / El-Sobky, Tamer A

Bone reports

2021 Volume 15, Page(s) 101106

Abstract: Multicentric Osteolysis, Nodulosis, and Arthropathy (MONA) syndrome is a rare genetic skeletal dysplasia. Its diagnosis can be deceptively similar to childhood-onset genetic skeletal dysplasias and juvenile idiopathic arthritis. We aimed to report the ... ...

Abstract	Multicentric Osteolysis, Nodulosis, and Arthropathy (MONA) syndrome is a rare genetic skeletal dysplasia. Its diagnosis can be deceptively similar to childhood-onset genetic skeletal dysplasias and juvenile idiopathic arthritis. We aimed to report the syndrome's clinical and radiologic features with emphasis on skeletal manifestations. And establish relevant phenotype-genotype correlations. We evaluated two boys, 4-and-7-years-old with MONA syndrome. Both patients had consanguineous parents. We verified the diagnosis by correlating the outcomes of clinical, radiologic and molecular analysis. We specifically evaluated the craniofacial morphology and clinical and radiographic skeletal abnormalities. We contextualized the resultant phenotype-genotype correlations to publications on MONA and its differential diagnosis. Skeletal manifestations were the presenting symptoms and mostly restricted to hands and feet in terms of fixed extension deformity of the metacarpophalangeal and flexion deformity of the interphalangeal joints with extension deformity of big toes. There were arthritic symptoms in the older patient especially of the wrists and minute pathologic fractures. The skeletal radiographs showed osteopenia/dysplastic changes of hands and feet. Both patients had variants in the matrix metalloproteinase2 gene which conformed to phenotype of previously reported literature in one patient while the other had a novel variant which conformed to MONA phenotype. Craniofacial abnormalities were present. However, minimal extra-skeletal manifestations. Overall, there is an emerging distinctive skeletal pattern of involvement in terms of both clinical and radiographic features. This includes age of onset and location of presenting skeletal manifestations, chronological order of joint affection, longitudinal disease progression, specifics of skeletal radiographic pathology and craniofacial features. Nevertheless, physicians are cautioned against differential diagnosis of similar genetic skeletal dysplasias and juvenile idiopathic arthritis.
Language	English
Publishing date	2021-07-10
Publishing country	United States
Document type	Case Reports
ZDB-ID	2821774-3
ISSN	2352-1872
ISSN	2352-1872
DOI	10.1016/j.bonr.2021.101106
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Article ; Online: The relationship between musculoskeletal health literacy and upper extremity patient-reported outcome measures (PROMs) in the setting of atraumatic shoulder pain.

Gruson, Konrad / Mahmoud, Shady / Zhu, Nina / Lo, Yungtai / Gruson, Hiroko T / Schwartz, Brittany

Orthopaedics & traumatology, surgery & research : OTSR

2021 Volume 108, Issue 5, Page(s) 103165

Abstract: Introduction: Patient-reported outcome measures (PROMs) are commonly utilized to assess patient-derived orthopaedic health status and function. The prevalence of limited musculoskeletal health literacy (MHL) has been demonstrated to be high within the ... ...

Abstract	Introduction: Patient-reported outcome measures (PROMs) are commonly utilized to assess patient-derived orthopaedic health status and function. The prevalence of limited musculoskeletal health literacy (MHL) has been demonstrated to be high within the orthopaedic literature. The purpose of this study was to evaluate the association between MHL and upper extremity-specific PROMs and to determine which patient- and symptom-related factors affect baseline PROMs in patients with atraumatic shoulder pain. Hypothesis: Patients with limited MHL would demonstrate lower median scores on baseline PROMs compared with those with adequate MHL. Materials and methods: New patients with atraumatic shoulder pain presenting to an academic practice were administered the Literacy in Musculoskeletal Problems (LiMP), in addition to the American Shoulder and Elbow Surgeons (ASES), Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH), and Single Assessment Numeric Evaluation (SANE) questionnaires. A detailed physical exam and history was performed by a fellowship-trained shoulder surgeon. Demographic patient data, in addition to prior imaging and orthopaedic treatment, was tabulated. The association between demographics, pain-related variables, and MHL with the ASES, SANE, and QuickDASH scores were examined using Spearman correlation coefficients for continuous variables and Wilcoxon rank-sum tests for categorical variables. Non-parametric analysis of covariance (ANCOVA) was used to examine the independent association of predictor variables with PROMs. Results: A total of 439 patients met the inclusion criteria and were enrolled. The mean age was 58.8±12.6years (range: 24-93) with 162 (37%) being men. Overall, 172 patients (39.2%) attained a college degree or higher and 183 (41.7%) were currently employed. MHL was significantly associated with ASES (p=0.03), but not with the QuickDASH (p=0.75) or SANE score (p=0.16). Similarly, age, having been in the medical profession or having previously visited an orthopaedist were not associated with PROMs, while employment status correlated to the SANE score (p=0.002). Visual Analogue Scale (VAS) pain level demonstrated varying strengths of association with each of the scores [ASES (r=-0.729, p<0.001), QuickDASH (r=0.557, p<0.001), and SANE (r=-0.430, p<0.001)]. MHL demonstrated no association with initial patient-derived treatment selection. Discussion: The SANE and QuickDASH may be administered to patients presenting for atraumatic shoulder pain in the outpatient setting regardless of MHL. Further research should be focused on the utility of the ASES instrument amongst patients with lower educational levels and/or limited MHL. Level of evidence: II; diagnostic.
MeSH term(s)	Aged ; Female ; Health Literacy ; Humans ; Male ; Middle Aged ; Musculoskeletal System ; Patient Reported Outcome Measures ; Shoulder Joint/surgery ; Shoulder Pain ; Treatment Outcome ; Upper Extremity
Language	English
Publishing date	2021-12-03
Publishing country	France
Document type	Journal Article
ISSN	1877-0568
ISSN (online)	1877-0568
DOI	10.1016/j.otsr.2021.103165
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Article ; Online: Double calcaneal osteotomy in treatment of flexible planovalgus foot deformity in ambulatory cerebral palsy. A case series study.

Aly, Ahmad Saeed / Abdel Rahman, Amr Farouk / Mahmoud, Shady

Foot and ankle surgery : official journal of the European Society of Foot and Ankle Surgeons

2018 Volume 25, Issue 5, Page(s) 640–645

Abstract: Background: The aim of this prospective non randomized case series study was to assess the intermediate-term outcomes of double calcaneal osteotomy (lateral column lengthening and medial slide calcaneal osteotomy) use in ambulatory cerebral palsy with ... ...

Abstract	Background: The aim of this prospective non randomized case series study was to assess the intermediate-term outcomes of double calcaneal osteotomy (lateral column lengthening and medial slide calcaneal osteotomy) use in ambulatory cerebral palsy with flexible planovalgus feet. Methods: 16 cases with planovalgus feet were surgically treated by double calcaneal osteotomy and observed over an average of 33.5months. The mean age at the time of surgery was 10.74years. The functional outcomes were assessed clinically and radiologically. Results: There were a statistical improvement of clinical heel valgus and all radiological parameters as regard talar head uncoverage, calcaneal pitch, talo-calcaneal angle, and talus 1st metatarsal angle at the end of follow up period. Conclusion: Double calcaneal osteotomy is a good option in the treatment of flexible planovalgus feet in ambulatory cerebral palsy patients.
MeSH term(s)	Adolescent ; Autografts ; Calcaneus/surgery ; Cancellous Bone/transplantation ; Cerebral Palsy/complications ; Child ; Female ; Flatfoot/etiology ; Flatfoot/surgery ; Heterografts ; Humans ; Ilium/transplantation ; Male ; Muscle, Skeletal/surgery ; Osteotomy/methods
Language	English
Publishing date	2018-08-24
Publishing country	France
Document type	Journal Article
ZDB-ID	1424533-4
ISSN	1460-9584 ; 1268-7731
ISSN (online)	1460-9584
ISSN	1268-7731
DOI	10.1016/j.fas.2018.07.003
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