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Median nerve and carpal tunnel volume changes after two different surgical methods: A comparative magnetic resonance imaging study of mini-open and endoscopic carpal tunnel release. 两种不同手术方式后正中神经和腕管体积的变化:一项磁共振成像对比研究小开放和内窥镜腕管释放。
IF 1.6 4区 医学 Q2 Medicine Pub Date : 2019-12-01 DOI: 10.5606/ehc.2019.70229
N. Alp, G. Akdağ, A. Macunluoglu
OBJECTIVESThis study aims to compare endoscopic carpal tunnel release versus mini-open carpal tunnel release regarding volume changes in the carpal tunnel and median nerve by magnetic resonance imaging (MRI).PATIENTS AND METHODSThe study included 17 wrists of 13 patients (1 male, 12 females; mean age 55 years; range, 51 to 64 years) who were diagnosed with carpal syndrome. Ten wrists underwent mini-open carpal tunnel release, while seven wrists underwent uni-portal endoscopic carpal tunnel release. Carpal tunnel and median nerve volumetric changes were evaluated by MRI pre- and postoperatively.RESULTSSurgical section of transverse carpal ligament significantly increased the postoperative volume of the carpal tunnel and median nerve compared to preoperative (p<0.05). However, the endoscopic and mini-open carpal tunnel techniques had no superiority over one another regarding volume expansion (p>0.05).CONCLUSIONBoth methods can be preferred to release the transverse carpal ligament in patients with idiopathic carpal tunnel syndrome. The surgeon should decide on which method to use considering the advantages and disadvantages reported in the literature.
目的:本研究旨在通过磁共振成像(MRI)比较内窥镜下腕管释放与迷你开放式腕管释放对腕管和正中神经体积变化的影响。患者与方法本研究纳入13例患者17腕关节(男性1例,女性12例;平均年龄55岁;年龄在51岁到64岁之间)。10只腕关节进行了迷你开放腕管松解术,7只腕关节进行了单门内窥镜腕管松解术。术前、术后行MRI检查腕管及正中神经体积变化。结果切开腕横韧带术后腕管及正中神经体积较术前明显增加(p0.05)。结论两种方法均可有效解除特发性腕管综合征患者的腕横韧带。外科医生应考虑文献中报道的优点和缺点来决定使用哪种方法。
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引用次数: 5
The effects of focal brain damage on fracture healing: An experimental rat study. 局灶性脑损伤对骨折愈合的影响:大鼠实验研究
IF 1.6 4区 医学 Q2 Medicine Pub Date : 2019-12-01 DOI: 10.5606/ehc.2019.66041
Mustafa Arık, Yakup Ekinci, Kaan Gürbüz, Sabri Batın

Objectives: This study aims to investigate whether the motor cortex (MC) or the somatosensory cortex (SC) is more active during the course of bone healing after traumatic brain injury (TBI).

Materials and methods: Thirty-three male Wistar albino rats (age, 8 to 10 months; weighing, 250 to 300 g) were randomized into three groups as the control group, MC damage group and SC damage group. Two rats from each brain damage group were sacrificed to verify the locations of the cortical injuries. Callus formation, callus/diaphysis ratios, and serum alkaline phosphatase (ALP) levels were measured at one, three and six weeks.

Results: The increases in callus masses in the control, MC, and SC groups were statistically significantly different between one and three weeks (p<0.05). Although this increase in the MC and SC groups was significant compared to the control group at the end of one week, no statistically significant difference was found between the MC and SC groups (p>0.05). There was a statistically significant difference in callus/diaphysis ratio between control, MC and SC groups in favor of MC group only at one week (p<0.05). The increase in serum ALP levels at three weeks was statistically significantly different in the MC and SC groups compared to the control group and significantly higher in the MC group compared to the SC group (p<0.05).

Conclusion: There is a possible relationship between enhanced fracture healing after TBI and damage in the MC. Motor cortex plays a more active role on fracture healing in TBI.

研究目的本研究旨在探讨在创伤性脑损伤(TBI)后骨愈合过程中,是运动皮层(MC)更活跃还是体感皮层(SC)更活跃:将 33 只雄性 Wistar 白化大鼠(年龄 8 至 10 个月,体重 250 至 300 克)随机分为三组,即对照组、MC 损伤组和 SC 损伤组。每个脑损伤组牺牲两只大鼠以验证皮层损伤的位置。分别在一周、三周和六周时测量胼胝体形成、胼胝体/骨骺比例和血清碱性磷酸酶(ALP)水平:结果:对照组、MC 组和 SC 组的胼胝体增加量在一周和三周之间有显著统计学差异(P0.05)。对照组、MC 组和 SC 组的胼胝体/干骺端比仅在一周时有统计学意义的差异,而 MC 组更明显(p 结论:骨折的增强可能与骨骼的损伤有关:创伤性脑损伤后骨折愈合的增强可能与 MC 损伤有关。运动皮层在创伤性脑损伤骨折愈合中发挥着更积极的作用。
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引用次数: 0
Endoscopic treatment of bilateral hallux saltans in an ordinary woman. 普通妇女双侧拇趾畸形的内窥镜治疗。
IF 1.6 4区 医学 Q2 Medicine Pub Date : 2019-12-01 DOI: 10.5606/ehc.2019.70192
M. Tokgöz, U. Kanatlı, A. Vural, M. Ataoğlu, A. Yapar, Yılmaz Ergişi
In this article, we present a 47-year-old female patient applying with pain in posteromedial of ankle and trigger toe complaints. There was no predisposing factor such as dance or sports or any radiological sign such as os trigonum. Posterior ankle endoscopy technique was used for evaluation and it was observed that the FHL tendon was triggered. Fibrous thickening around the tendon was released with endoscopic instruments. After release, it was observed that the FHL tendon was not triggered with toe movements. Hallux saltans can be treated by posterior endoscopic methods with an attention to the tibial nerve such as other joint and soft tissue pathologies. To the best of our knowledge, this is the first case report of endoscopic treatment of bilateral HS in an ordinary female patient.
在这篇文章中,我们提出了一个47岁的女性患者应用疼痛在踝关节后内侧和触发脚趾投诉。没有易感因素,如舞蹈或运动或任何放射征象,如三角肌。使用后踝内窥镜技术进行评估,观察到FHL肌腱被触发。用内窥镜器械解除肌腱周围纤维增厚。释放后,观察到FHL肌腱不受脚趾运动的触发。拇趾畸形可以通过后路内窥镜治疗,注意胫骨神经,如其他关节和软组织病变。据我们所知,这是第一例内镜治疗双侧HS的普通女性患者。
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引用次数: 1
Comparison of three surgical methods in the treatment of intraarticular comminuted distal radius fractures: Volar locking plate, non-bridging external fixator, and bridging external fixator. 掌侧锁定钢板、非桥式外固定架和桥式外固定架治疗桡骨远端关节内粉碎性骨折三种手术方法的比较。
IF 1.6 4区 医学 Q2 Medicine Pub Date : 2019-10-24 DOI: 10.5606/ehc.2019.66955
M. A. Talmaç, Mehmet Akif Görgel, M. Kanar, O. Tok, H. Özdemir
OBJECTIVES The aim of this study was to evaluate both clinical and radiological results of intraarticular comminuted distal radius fractures treated with volar locking plate (VLP), non-bridging external fixator (NbEF), and bridging external fixator (BEF). PATIENTS AND METHODS 95 patients (44 males, 51 females; median age 49 years; interquartile range (IQR), 37 to 60 years) who were treated with VLP, NbEF, or BEF due to intraarticular comminuted distal radius fractures between January 2010 and April 2014 were evaluated retrospectively. 34 of these patients were treated with a VLP (VLP group), 30 with a NbEF (NbEF group) and 31 with a BEF (BEF group). In the final follow-up, all patients were evaluated according to clinical and radiological parameters. RESULTS The median follow-up was 5 (IQR, 4 to 6) years. The VLP and NbEF groups had better results than the BEF group in terms of wrist range of motion, loss of grip strength, Green O'Brien, Mayo Modified Wrist, The Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) and VAS scores. The VLP group had the most significant radiological improvement. CONCLUSION Although clinical and radiological results for intraarticular comminuted distal radius fractures are more significantly improved in patients treated with VLP, favorable results close to VLP can be also obtained with NbEF. The BEF seems to be the least effective treatment option among the three surgical methods.
目的:本研究的目的是评估掌侧锁定钢板(VLP)、非桥式外固定架(NbEF)和桥式外固定架(BEF)治疗桡骨远端关节内粉碎性骨折的临床和影像学结果。患者与方法95例患者(男44例,女51例;中位年龄49岁;回顾性评价2010年1月至2014年4月期间因桡骨远端关节内粉碎性骨折而接受VLP、NbEF或BEF治疗的患者的四分位间距(IQR)(37 ~ 60岁)。其中34例采用VLP (VLP组),30例采用NbEF (NbEF组),31例采用BEF (BEF组)。在最后的随访中,根据临床和放射学参数对所有患者进行评估。结果中位随访时间为5 (IQR, 4 ~ 6)年。VLP组和NbEF组在腕关节活动度、握力丧失、Green O'Brien、Mayo改良腕关节、手臂、肩膀和手的快速残疾(QuickDASH)和VAS评分方面均优于BEF组。VLP组放射学改善最为显著。结论虽然VLP治疗桡骨远端关节内粉碎性骨折的临床和影像学结果更明显改善,但NbEF也可以获得接近VLP的良好结果。BEF似乎是三种手术方法中最不有效的治疗选择。
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引用次数: 16
The forelock sign: A new arthroscopic finding in partial subscapularis tears. 额锁征:肩胛下肌部分撕裂的关节镜新发现。
IF 1.6 4区 医学 Q2 Medicine Pub Date : 2019-10-24 DOI: 10.5606/ehc.2019.66814
M. Çetinkaya, U. Kanatlı, M. Ataoğlu, M. Özer, Tacettin Ayanoğlu, S. Bölükbaşı
OBJECTIVESThis study aims to identify the forelock sign of partial tears of the subscapularis and to compare the incidences of this sign and air bag sign.PATIENTS AND METHODSOne hundred and twenty patients (39 males, 81 females; mean age 51.3 years; range, 25 to 79) diagnosed as isolated subscapularis tear or isolated supraspinatus tear from among patients who underwent shoulder arthroscopy between January 2013 and January 2016 were divided into four groups of 30 patients each as the subscapularis tear (group 1), full-thickness supraspinatus tear (group 2), bursal-side supraspinatus tear (group 3), and articular-side supraspinatus tear (group 4) groups. All patients had video records of their operation. The integrity of the long head of biceps tendon (LHBT), Lafosse classification of the subscapularis tear, and the incidence of the forelock and air bag signs were evaluated.RESULTSThe incidence of the air bag sign in group 1 was 10% and that of the forelock sign was 60%. The forelock sign was significantly more frequent in group 1 than in the other groups (odds ratio 10.46: 3.9-27.8 with 95% confidence interval) and the air bag sign (p<0.001). The LHBT was mostly pathologic in this group, which was also statistically significant (p<0.01). The incidence of the forelock sign in group 1 was similar in each LHBT pathology and Lafosse subgroups.CONCLUSIONThe forelock sign identified in this study was significantly frequent (60%) in partial subscapularis tendon tears with strong inter- and intra-observer consistency while the air bag sign was rare (10%). The LHBT disorders were strongly associated with subscapularis tears; however, the forelock sign was not an indicator of the condition of the LHBT and type of partial subscapularis tendon tear according to the Lafosse classification.
目的探讨肩胛下肌部分撕裂的额锁征,并比较其与气囊征的发生率。患者与方法120例患者(男39例,女81例;平均年龄51.3岁;将2013年1月至2016年1月接受肩关节镜检查的患者中诊断为孤立性肩胛下肌撕裂或孤立性冈上肌撕裂的患者分为4组,每组30例,分别为肩胛下肌撕裂(1组)、全层冈上肌撕裂(2组)、法氏囊侧冈上肌撕裂(3组)和关节侧冈上肌撕裂(4组)。所有患者都有手术的视频记录。评估肱二头肌肌腱长头(LHBT)的完整性、肩胛下肌撕裂的Lafosse分类、额锁和气囊征象的发生率。结果1组气囊征发生率为10%,额毛征发生率为60%。1组的额锁征明显多于其他组(优势比10.46:3.9 ~ 27.8,95%可信区间)和气囊征(p<0.001)。本组LHBT多为病理性,差异亦有统计学意义(p<0.01)。在LHBT病理和Lafosse亚组中,1组额发征的发生率相似。结论本研究中发现的额锁征在部分肩胛下肌腱撕裂中明显常见(60%),观察者之间和内部的一致性强,而气囊征罕见(10%)。LHBT障碍与肩胛下肌撕裂密切相关;然而,根据Lafosse分类,额锁征并不是LHBT状况和部分肩胛下肌腱撕裂类型的指标。
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引用次数: 0
Alkaptonuria: Spontaneous Achilles tendon rupture: Case report. 尿尿:自发性跟腱断裂1例。
IF 1.6 4区 医学 Q2 Medicine Pub Date : 2019-10-24 DOI: 10.5606/ehc.2019.66155
E. Baca, A. Kural, N. Ziroğlu, Cemal Kural
Alkaptonuria is an autosomal recessive disease caused by the accumulation of homogentisic acid (HGA) products in the ligament, cartilage, skin and various organs due to the lack of HGA oxidase enzyme. In this article, we present a 61-year-old male patient operated on due to a diagnosis of spontaneous Achilles tendon rupture and diagnosed as alkaptonuria due to the intraoperative color of the tissues and the subsequent examinations. We also reviewed alkaptonuria and its accompanying pathologies in light of the literature.
尿酸是一种常染色体隐性遗传病,由均质酸(HGA)氧化酶缺乏导致韧带、软骨、皮肤及各脏器中均质酸(HGA)产物积累引起。在这篇文章中,我们报告了一位61岁的男性患者,由于诊断为自发性跟腱断裂而手术,并根据术中组织的颜色和随后的检查诊断为尿酸尿。我们也回顾了尿酸及其伴随的病理根据文献。
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引用次数: 4
Comparison of two-dimensional shear wave elastography and point shear wave elastography techniques with magnetic resonance findings in detection of patellar tendinopathy. 二维剪切波弹性成像和点剪切波弹性成像技术与磁共振检查髌骨肌腱病变的比较。
IF 1.6 4区 医学 Q2 Medicine Pub Date : 2019-10-24 DOI: 10.5606/ehc.2019.70076
I. Yurdaışık
OBJECTIVESThis study aims to evaluate the accuracy of point shear wave elastography (pSWE) and two-dimensional shear wave elastography (SWE) techniques in the diagnosis of patellar tendinopathy in comparison with magnetic resonance imaging (MRI).PATIENTS AND METHODSThe study included 77 patients (32 males, 45 females; mean age 47.1±9.47 years; range, 33 to 65 years) referred to our clinic for MRI and diagnosed with patellar tendinopathy. Patients' demographic data such as age and gender, and patellar tendon grades found on MRI, SWE and pSWE values were recorded.RESULTSPatellar tendinopathies were found as grade I in 20, grade II in 37, and grade III in 20 patients. The mean SWE value was 83.83±34.27 kPa, while the mean pSWE value was 79.25±33.75 kPa. There was a strong correlation between SWE and pSWE values.CONCLUSIONShear wave elastography and pSWE techniques can be safely used as non-invasive and quantitative imaging modalities in detection of patellar tendinopathy. Our results indicated that SWE and pSWE were helpful to confirm stiffness of patellar tendon in patients with patellar tendinopathy.
目的本研究旨在评价点剪切波弹性成像(pSWE)和二维剪切波弹性成像(SWE)技术与磁共振成像(MRI)诊断髌骨肌腱病变的准确性。患者与方法纳入77例患者(男性32例,女性45例;平均年龄47.1±9.47岁;年龄在33岁到65岁之间)到我们诊所做MRI检查,诊断为髌骨肌腱病。记录患者的年龄、性别、MRI髌腱分级、SWE和pSWE值等人口统计学数据。结果髌腱病变1级20例,2级37例,3级20例。SWE平均值为83.83±34.27 kPa, pSWE平均值为79.25±33.75 kPa。SWE值与pSWE值有很强的相关性。结论横波弹性成像和pSWE技术可作为一种无创、定量的髌腱病变诊断方法。我们的结果表明,SWE和pSWE有助于确认髌骨肌腱病变患者的髌骨肌腱僵硬程度。
{"title":"Comparison of two-dimensional shear wave elastography and point shear wave elastography techniques with magnetic resonance findings in detection of patellar tendinopathy.","authors":"I. Yurdaışık","doi":"10.5606/ehc.2019.70076","DOIUrl":"https://doi.org/10.5606/ehc.2019.70076","url":null,"abstract":"OBJECTIVES\u0000This study aims to evaluate the accuracy of point shear wave elastography (pSWE) and two-dimensional shear wave elastography (SWE) techniques in the diagnosis of patellar tendinopathy in comparison with magnetic resonance imaging (MRI).\u0000\u0000\u0000PATIENTS AND METHODS\u0000The study included 77 patients (32 males, 45 females; mean age 47.1±9.47 years; range, 33 to 65 years) referred to our clinic for MRI and diagnosed with patellar tendinopathy. Patients' demographic data such as age and gender, and patellar tendon grades found on MRI, SWE and pSWE values were recorded.\u0000\u0000\u0000RESULTS\u0000Patellar tendinopathies were found as grade I in 20, grade II in 37, and grade III in 20 patients. The mean SWE value was 83.83±34.27 kPa, while the mean pSWE value was 79.25±33.75 kPa. There was a strong correlation between SWE and pSWE values.\u0000\u0000\u0000CONCLUSION\u0000Shear wave elastography and pSWE techniques can be safely used as non-invasive and quantitative imaging modalities in detection of patellar tendinopathy. Our results indicated that SWE and pSWE were helpful to confirm stiffness of patellar tendon in patients with patellar tendinopathy.","PeriodicalId":50551,"journal":{"name":"Eklem Hastaliklari Ve Cerrahisi-Joint Diseases and Related Surgery","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2019-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85276776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 3
Every new technique either conservative or surgical is good? 每一种新技术无论是保守的还是手术的都是好的吗?
IF 1.6 4区 医学 Q2 Medicine Pub Date : 2019-10-24 DOI: 10.5606/ehc.2019.19001
O. Atik
In a study, the possible effects of leukocyte concentration in the content of PRP and the administration of PRP using a drug delivery system on chondrocyte proliferation are searched in vitro conditions. Authors showed that leukocyte-rich PRP administered with a delivery system such as hydrogel is more efficient than conventional applications of PRP in the treatment of cartilage damage in vitro.[11]
在一项研究中,在体外条件下,研究白细胞浓度在PRP含量中的可能影响,以及使用药物递送系统给药PRP对软骨细胞增殖的影响。作者表明,与水凝胶等递送系统一起施用富含白细胞的PRP在体外治疗软骨损伤方面比传统的PRP应用更有效。[11]
{"title":"Every new technique either conservative or surgical is good?","authors":"O. Atik","doi":"10.5606/ehc.2019.19001","DOIUrl":"https://doi.org/10.5606/ehc.2019.19001","url":null,"abstract":"In a study, the possible effects of leukocyte concentration in the content of PRP and the administration of PRP using a drug delivery system on chondrocyte proliferation are searched in vitro conditions. Authors showed that leukocyte-rich PRP administered with a delivery system such as hydrogel is more efficient than conventional applications of PRP in the treatment of cartilage damage in vitro.[11]","PeriodicalId":50551,"journal":{"name":"Eklem Hastaliklari Ve Cerrahisi-Joint Diseases and Related Surgery","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2019-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83301447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 11
The long-term results of cemented Oxford unicompartmental knee arthroplasty: A single-center experience. 骨水泥牛津单室膝关节置换术的长期效果:单中心经验。
IF 1.6 4区 医学 Q2 Medicine Pub Date : 2019-10-24 DOI: 10.5606/ehc.2019.66429
G. Sever, Cenk Cankuş
OBJECTIVESThis study aims to investigate the long-term clinical outcomes, complications and survival rates of cemented Oxford medial unicompartmental knee arthroplasty (UKA) and to compare the findings with the reported outcomes of UKA and total knee arthroplasty (TKA) in the literature.PATIENTS AND METHODSIn the study, 133 knees of 115 patients (16 males, 99 females; mean age 65.5±8.3 years; range, 50 to 88 years) who underwent Oxford medial UKA between May 2007 and August 2013 were followed-up for an average of 126 months. Prosthetic complications and revisions were evaluated. While Kaplan-Meier method was used to evaluate implant survival, Knee Society, Functional Knee Society and visual analog scale scores were used for determining final functional outcomes.RESULTSTotally 29 prosthetic complications (21.6% of total patients) were observed and the most common one was insert dislocation observed in 17 knees (12.6%). Revision surgeries were performed for all of these patients. Among the 17 patients who underwent insert replacement surgeries, the inserts were stable in eight during the follow-up while insert dislocation reoccurred in nine. Revision surgeries were performed in a total of 21 patients (15.6%). There were statistically significant improvements in final follow-up functional knee scores of patients without complications compared to preoperative scores.CONCLUSIONAccording to our findings, while reoperation and early aseptic revision rates of Oxford medial UKA are high compared to the TKA results reported in the literature, functional results are satisfactory for patients with no revision.
目的本研究旨在探讨骨水泥牛津内侧单室膝关节置换术(UKA)的长期临床结果、并发症和生存率,并与文献报道的UKA和全膝关节置换术(TKA)的结果进行比较。患者与方法在研究中,115例患者133个膝关节(男性16例,女性99例;平均年龄65.5±8.3岁;在2007年5月至2013年8月期间接受牛津医学UKA的患者平均随访126个月。评估假体并发症和修复。Kaplan-Meier法用于评估植入物存活,膝关节协会、功能性膝关节协会和视觉模拟量表评分用于确定最终功能预后。结果共发生假体并发症29例(占21.6%),其中假体脱位17例(占12.6%)。所有患者都进行了翻修手术。在17例接受假体置换手术的患者中,随访期间8例假体稳定,9例假体脱位。翻修手术共21例(15.6%)。与术前评分相比,无并发症患者的最终随访功能膝关节评分有统计学显著改善。结论根据我们的研究结果,虽然与文献报道的TKA结果相比,牛津内侧UKA的再手术率和早期无菌翻修率较高,但未翻修的患者功能结果令人满意。
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引用次数: 6
What is the importance of canal-to-diaphysis ratio on osteoporosis-related hip fractures? 管骨干比在骨质疏松相关髋部骨折中的重要性是什么?
IF 1.6 4区 医学 Q2 Medicine Pub Date : 2019-10-24 DOI: 10.5606/ehc.2019.70745
H. H. Bozkurt, M. Tokgöz, A. Yapar, O. Atik
OBJECTIVESThis study aims to investigate whether the ratio of the canal-to-diaphysis in femoral subtrochanteric region is helpful in determining risk before hip fracture.PATIENTS AND METHODSThe study group consisted of 116 patients with osteoporotic hip fractures (26 males, 90 females; mean age 77.8 years; range, 61 to 89 years) and the control group consisted of 56 subjects (11 males, 45 females; mean age 75.3 years; range, 60 to 83 years). The canal-to-diaphysis ratio of patients in the study group was measured on plain radiographs. The results of the affected side and intact side were compared. To ensure the interobserver reliability of the measurements and to minimize technical errors, the assessments were performed twice (two weeks apart) by two different orthopedic surgeons.RESULTSThe canal-to-diaphysis ratio was significantly increased in patients with hip fracture compared with the intact side of same patient (p<0.001) and control subjects (p<0.001). According to the results of the receiver operating characteristic analysis, canal-to-diaphysis ratio had a diagnostic value in predicting hip fracture in osteoporosis patients, and the limit value was approximately 0.53 (sensitivity: 81%, specificity: 86%). An index of 0.53 represents a risk of intertrochanteric hip fracture of 89%.CONCLUSIONThis method can be easily applied by all physicians as X-ray device is readily accessible with low cost. The risk of hip fracture should be determined, osteoporosis should be evaluated, and treatment should be started in patients with high risk to take the necessary precautions before the fracture develops.
目的本研究旨在探讨股骨粗隆下区管与骨干的比例是否有助于确定髋部骨折前的风险。患者与方法研究对象为116例骨质疏松性髋部骨折患者(男性26例,女性90例;平均年龄77.8岁;年龄范围61 - 89岁),对照组包括56名受试者(11名男性,45名女性;平均年龄75.3岁;范围:60至83岁)。研究组患者的管-干比率通过x线平片测量。比较患侧和完整侧的结果。为了确保测量结果在观察者之间的可靠性并尽量减少技术错误,评估由两名不同的骨科医生进行两次(间隔两周)。结果髋部骨折患者的管干比明显高于同侧患者(p<0.001)和对照组(p<0.001)。根据受术者操作特征分析结果,管骨干比对骨质疏松患者髋部骨折有诊断价值,极限值约为0.53(敏感性81%,特异性86%)。指数为0.53表示股骨粗隆间髋部骨折的风险为89%。结论该方法简便易行,成本低,可广泛应用于临床。应确定髋部骨折的风险,评估骨质疏松症,高危患者应开始治疗,在骨折发生前采取必要的预防措施。
{"title":"What is the importance of canal-to-diaphysis ratio on osteoporosis-related hip fractures?","authors":"H. H. Bozkurt, M. Tokgöz, A. Yapar, O. Atik","doi":"10.5606/ehc.2019.70745","DOIUrl":"https://doi.org/10.5606/ehc.2019.70745","url":null,"abstract":"OBJECTIVES\u0000This study aims to investigate whether the ratio of the canal-to-diaphysis in femoral subtrochanteric region is helpful in determining risk before hip fracture.\u0000\u0000\u0000PATIENTS AND METHODS\u0000The study group consisted of 116 patients with osteoporotic hip fractures (26 males, 90 females; mean age 77.8 years; range, 61 to 89 years) and the control group consisted of 56 subjects (11 males, 45 females; mean age 75.3 years; range, 60 to 83 years). The canal-to-diaphysis ratio of patients in the study group was measured on plain radiographs. The results of the affected side and intact side were compared. To ensure the interobserver reliability of the measurements and to minimize technical errors, the assessments were performed twice (two weeks apart) by two different orthopedic surgeons.\u0000\u0000\u0000RESULTS\u0000The canal-to-diaphysis ratio was significantly increased in patients with hip fracture compared with the intact side of same patient (p<0.001) and control subjects (p<0.001). According to the results of the receiver operating characteristic analysis, canal-to-diaphysis ratio had a diagnostic value in predicting hip fracture in osteoporosis patients, and the limit value was approximately 0.53 (sensitivity: 81%, specificity: 86%). An index of 0.53 represents a risk of intertrochanteric hip fracture of 89%.\u0000\u0000\u0000CONCLUSION\u0000This method can be easily applied by all physicians as X-ray device is readily accessible with low cost. The risk of hip fracture should be determined, osteoporosis should be evaluated, and treatment should be started in patients with high risk to take the necessary precautions before the fracture develops.","PeriodicalId":50551,"journal":{"name":"Eklem Hastaliklari Ve Cerrahisi-Joint Diseases and Related Surgery","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2019-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81721793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 12
期刊
Eklem Hastaliklari Ve Cerrahisi-Joint Diseases and Related Surgery
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