Background:the aim of this study is to evaluate the prevalence and effect of depression and anxiety on the shoulder range of motion, as well as the objective and subjective symptoms in patients suffering from frozen shoulder.Methods:Between 2013 and 2014, in a cross-sectional study, we evaluated 120 patients with idiopathic frozen shoulder. We collected the demographic data for each patient and measured shoulder range of motion in four directions in both limbs. All patients filled out visual analog scale (VAS) for pain and the disabilities of the arm, shoulder, and hand (DASH) questionnaires. Both Hamilton anxiety and depression questionnaires were filled out for each patient.Results:A total of 92 patients (77%) with idiopathic frozen shoulder showed symptoms of depression, while only 32 (27%) of them experienced anxiety. Thirty-two patients (27%) showed symptoms of both depression and anxiety. Although elevation and abduction were not affected by depression, internal and external rotations were more restricted among patients who had symptoms of depression. DASH and VAS scores were higher in patients with symptoms of depression. In terms of anxiety, only VAS and DASH were different between two groups. In multivariable analysis, DASH score was correlated with severity of both anxiety and depression symptoms.Conclusion:While there is no definitive relationship between symptoms of depression or anxiety and shoulder range of motion in patients suffering from frozen shoulder, patients who suffer from depression or anxiety experienced increased pain and limb disability.

Nonunion after intramedullary nailing of femoral and tibial fractures, although infrequent, remains a challenge for orthopedic surgeons. Augmentation plate fixation can be a reasonable choice in this situation. From 2003 to 2005, 38 patients (25 femoral nonunions and 13 tibial nonunions) were treated after intramedullary nailing with augmentation plate fixation, leaving the nail in situ, with or without autogenous cancellous bone graft. Patients were followed for at least 1 year postoperatively. All 25 femoral nonunions healed with solid union (100% union rate), but 2 of 13 tibial nonunions remained symptomatic and did not achieve union (84.6% union rate) at a mean 4.78 months postoperatively (range, 1-6 months). No serious complications were encountered at 1-year follow-up. We suggest augmentation plate fixation for femoral and tibial nonunion after intramedullary nailing.

Background:Recently, investigations have indicated that caring of a chronically ill family member strongly influences the health status and the quality of life (QOL) of the caregiving family members.Objectives:The purpose of this study was to examine the relationship between health-related QOL of veterans with chronic spinal cord injury and their caregiving spouses.Patients and Methods:We designed a cross-sectional study including two groups; veterans with chronic spinal cord injury and their caregiving wives who were living in the city of Mashhad, Iran. The patients with spinal cord injury were veterans from the Iran-Iraq war (1980-1988). All the participants filled out the short form 36 (SF-36) health survey questionnaire. A Pearson correlation coefficient was calculated for the scales of the two groups.Results:The mean age and standard deviation of veterans and their spouses were 48.5 ± 5.9 and 44.8 ± 7.2, respectively and their number of children ranged between 0-6. Our data analysis showed that there was a significant difference between the two groups in some domains of the SF-36, including PF, MH, PCS, MCS, BP and GH (P < 0.05), but there was no significant difference in RP, VT, SF and RE between the two groups.Conclusions:The results indicate that a decrease in health status level of veterans, physically and mentally, can affect the health-related QOL of their caregiving spouses.

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