BACKGROUND AND OBJECTIVE: Tibia fracture is one of the most common long bone fractures in body and primary treatment of open fracture always worries surgeons. The aim of this study was to evaluate the treatment of open tibia fractures by FLEXIBLE MEDULLARY NAILing.METHODS: This descriptive-analytical study was performed on 44 patients suffering from open tibial fractures treated with FLEXIBLE MEDULLARY NAILs in Shahid Beheshti and Yahyanejad hospitals from 1998-2001. In this study with limited incision, fixation of open fractures (gustilo type I to type IIIA) was done by 2-3 NAILs (3mm or 3.5mm). Demographic information associated with variables such as infection, for 1.5 years followed up in patients and data was analyzed by ANOVA test.FINDINGS: Mean age of patients was 29.8 years and 37(84.1%) patients were male. The average time of union was 6.1 months. There were 2(4.5%) patients with deep infection and 7(15.9%) with superfacial infection. Delayed union was seen in 4(9.1%) patients and malunion was seen in 1(2.3%) patient and there was not non-union.CONCLUSION: Results of this study showed that FLEXIBLE MEDULLARY NAILing is a reliable method for treatment of open tibia fractures.

Background: Forearm shaft fractures are common in developing countries. Anatomical reduction of these fractures using plates and screws is considered an accepted treatment mode. Like other shaft fractures, this can be treated with intraMEDULLARY NAILs like square NAILs, Rush NAILs, and interlocking NAILs. This study evaluates radiological and functional treatment results using square NAILing. Methods: A prospective study was conducted on 100 adult patients with diaphyseal forearm fractures over 3 years. Out of 100 patients, 68 were men, and 32 were women. Patients were followed up at 2 weeks, 6 weeks, 8 weeks, and then every 3 months till 1 to 1. 5 years. We have used criteria described by Anderson et al. and the shortened version of the Disabilities of the Arm, Shoulder, and Hand (QuickDASH) score for functional evaluation of the patients. Results: Out of 100 patients, the union was achieved in 88 patients, while the rest 12 patients required re-surgery. 4 patients had delayed union, 4 patients developed an infection at the ulnar entry site, and 3 patients developed bursitis of olecranon bursa. Conclusion: IntraMEDULLARY NAILing of both bone forearm shaft fractures using square NAILs can give satisfactory results in most cases, comparable with treatment by plates and screws, and provides an alternative, cost-effective treatment of both bone forearm shafts fractures with good cosmesis owing to small incisions.

Introduction: Pediatric forearm fracture is one of the most common upper extremity fractures in young sters. The treatment is often non-surgical. In patients, who need surgical intervention, intraMEDULLARY NAILs are used. Growth disturbances in long bones of the lower extremity occur in youngsters however. Longitudinal overgrowth is very rare in the upper extremity. Case Presentation: This report presents a five-year-old child, who had radius and ulna shaft fracture in the distal one third of his forearm. This child was treated with radius fracture fixation by FLEXIBLE intraMEDULLARY NAILs. After six months, the child had wrist pain and limitation in range of motion. On the radiography, 4mmincrease in radius was observed. Conclusions: Overgrowth of long bones after application of intraMEDULLARY NAILs is known in the lower extremity however it is uncommon in the upper extremity and the exact mechanism of this phenomenon has not yet been determined and needs further investigation.

Although skin manifestations of COVID-19 were reported later than major organs affected, but it seems that they have gained relatively defined and definite described patterns. Regardless of strength and quantity of published papers and reports of rare cases, generally reported cutaneous manifestations are similar. However affection of vairous NAIL lesions have been mentioned recently. Even though no skin finding is recognized as specific, this does not mean not to look for and describe skin and NAIL changes. Common skin findings could be observed in many cutaneous diseases. In this issue, we decided to review literature about NAIL apparatus affected by COVID-19.

MEDULLARY thyroid carcinoma accounts for 4% of thyroid carcinoma and originates from parafollicular cells, secreting calcitonin and carcinoembryonic antigen (CEA). Conventional radiographic modalities such as Computerized Tomography (CT), Magnetic Resonance Imaging (MRI), and Ultrasonography (U/S), are used for detecting recurrences following total thyroidectomy. However, metastatic disease frequently escapes detection by the above modalities, even when its presence is suggested by persistently elevated serum calcitonin levels. In this paper, we report a case of MEDULLARY thyroid carcinoma in a 40 year-old woman who had whole body octreotide scintigraphy to evaluate and detect the origin of calcitonin and CEA secretion.

MEDULLARY thyroid carcinoma (MTC) is an infrequent calcitonin-producing neuroendocrine tumor that initiates from the parafollicular C cells of the thyroid gland. Several genetic and epigenetic alterations are collaterally responsible for MEDULLARY thyroid carcinogenesis. In this review article, we shed light on all the genetic and epigenetic hallmarks of MTC. From the genetic perspective, RET, HRAS, and KRAS are the most important genes that are characterized in MTC. From the epigenetic perspective, Ras-association domain family member 1A, telomerase reverse transcriptase promoter methylations, overexpression of histone methyltransferases, EZH2 and SMYD3, and wide ranging increase and decrease in non-coding RNAs can be responsible for MEDULLARY thyroid carcinogenesis.