OBJECTIVES This 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 METHODS The 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. RESULTS Surgical 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). CONCLUSION Both 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.
{"title":"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.","authors":"N. Alp, G. Akdağ, A. Macunluoglu","doi":"10.5606/ehc.2019.70229","DOIUrl":"https://doi.org/10.5606/ehc.2019.70229","url":null,"abstract":"OBJECTIVES\u0000This 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).\u0000\u0000\u0000PATIENTS AND METHODS\u0000The 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.\u0000\u0000\u0000RESULTS\u0000Surgical 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).\u0000\u0000\u0000CONCLUSION\u0000Both 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.","PeriodicalId":50551,"journal":{"name":"Eklem Hastaliklari Ve Cerrahisi-Joint Diseases and Related Surgery","volume":"51 1","pages":"212-6"},"PeriodicalIF":1.6,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91359467","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}
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.
{"title":"Endoscopic treatment of bilateral hallux saltans in an ordinary woman.","authors":"M. Tokgöz, U. Kanatlı, A. Vural, M. Ataoğlu, A. Yapar, Yılmaz Ergişi","doi":"10.5606/ehc.2019.70192","DOIUrl":"https://doi.org/10.5606/ehc.2019.70192","url":null,"abstract":"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.","PeriodicalId":50551,"journal":{"name":"Eklem Hastaliklari Ve Cerrahisi-Joint Diseases and Related Surgery","volume":"24 1","pages":"322-4"},"PeriodicalIF":1.6,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85909657","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}
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.
{"title":"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.","authors":"M. A. Talmaç, Mehmet Akif Görgel, M. Kanar, O. Tok, H. Özdemir","doi":"10.5606/ehc.2019.66955","DOIUrl":"https://doi.org/10.5606/ehc.2019.66955","url":null,"abstract":"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.","PeriodicalId":50551,"journal":{"name":"Eklem Hastaliklari Ve Cerrahisi-Joint Diseases and Related Surgery","volume":"580 1","pages":"224-32"},"PeriodicalIF":1.6,"publicationDate":"2019-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76414710","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}
M. Çetinkaya, U. Kanatlı, M. Ataoğlu, M. Özer, Tacettin Ayanoğlu, S. Bölükbaşı
OBJECTIVES This 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 METHODS One 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. RESULTS The 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. CONCLUSION The 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.
{"title":"The forelock sign: A new arthroscopic finding in partial subscapularis tears.","authors":"M. Çetinkaya, U. Kanatlı, M. Ataoğlu, M. Özer, Tacettin Ayanoğlu, S. Bölükbaşı","doi":"10.5606/ehc.2019.66814","DOIUrl":"https://doi.org/10.5606/ehc.2019.66814","url":null,"abstract":"OBJECTIVES\u0000This 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.\u0000\u0000\u0000PATIENTS AND METHODS\u0000One 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.\u0000\u0000\u0000RESULTS\u0000The 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.\u0000\u0000\u0000CONCLUSION\u0000The 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.","PeriodicalId":50551,"journal":{"name":"Eklem Hastaliklari Ve Cerrahisi-Joint Diseases and Related Surgery","volume":"127 1","pages":"185-92"},"PeriodicalIF":1.6,"publicationDate":"2019-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82727895","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}
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.
{"title":"Alkaptonuria: Spontaneous Achilles tendon rupture: Case report.","authors":"E. Baca, A. Kural, N. Ziroğlu, Cemal Kural","doi":"10.5606/ehc.2019.66155","DOIUrl":"https://doi.org/10.5606/ehc.2019.66155","url":null,"abstract":"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.","PeriodicalId":50551,"journal":{"name":"Eklem Hastaliklari Ve Cerrahisi-Joint Diseases and Related Surgery","volume":"20 1","pages":"325-8"},"PeriodicalIF":1.6,"publicationDate":"2019-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87249575","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}
OBJECTIVES This 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 METHODS The 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. RESULTS Patellar 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. CONCLUSION Shear 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.
{"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":"10 1","pages":"275-81"},"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}
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]
{"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":"76 1","pages":"183-4"},"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}
OBJECTIVES This 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 METHODS In 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. RESULTS Totally 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. CONCLUSION According 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.
{"title":"The long-term results of cemented Oxford unicompartmental knee arthroplasty: A single-center experience.","authors":"G. Sever, Cenk Cankuş","doi":"10.5606/ehc.2019.66429","DOIUrl":"https://doi.org/10.5606/ehc.2019.66429","url":null,"abstract":"OBJECTIVES\u0000This 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.\u0000\u0000\u0000PATIENTS AND METHODS\u0000In 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.\u0000\u0000\u0000RESULTS\u0000Totally 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.\u0000\u0000\u0000CONCLUSION\u0000According 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.","PeriodicalId":50551,"journal":{"name":"Eklem Hastaliklari Ve Cerrahisi-Joint Diseases and Related Surgery","volume":"111 1","pages":"233-40"},"PeriodicalIF":1.6,"publicationDate":"2019-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79285059","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}
OBJECTIVES This 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 METHODS The 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. RESULTS The 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%. CONCLUSION This 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.
{"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":"29 1","pages":"296-300"},"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}
A. Şahin, K. Özturan, A. Cirakli, F. Yılmaz, M. Boz, Hasan Kizilay
OBJECTIVES This study aims to evaluate the potential effects of pentoxifylline (PTX) on tendon healing and to compare the histopathological and biomechanical findings of the healed tendon among the groups. MATERIALS AND METHODS The study was conducted on 36 male New Zealand albino rabbits (age, 3 months; weighing, 2.5±0.5 kg). Rabbits were randomized into two groups of 18 rabbits each. Partial Achilles tenotomy was performed 1.5 cm proximally from the calcaneal insertion of the tendon in both lower extremities of each rabbit and all groups were repaired primarily. After the operation, saline was injected intramuscularly to the control group and PTX was injected into the PTX group daily. Nine rabbits from each group were euthanized at weeks four and six postoperatively for histopathological (n=4) and biomechanical (n=5) testing. The histopathological findings were evaluated using the staging method of Curtis and Delee. Biomechanical effects were assessed by tensile testing. RESULTS In the biomechanical evaluation results, the maximum displacement and maximum breaking force in the PTX group at fourth week were significantly higher than the control group. In the sixth week, the maximum breaking force in the control group was significantly higher than the PTX group. In the histopathological examination, collagen fiber alignment was more regular and vascularization was more frequent in the PTX group at both fourth and sixth weeks and the difference was significant. CONCLUSION Pentoxifylline increased healing and strength in rabbit Achilles tendon by stimulating collagen synthesis, increasing vascularity and reducing inflammation, particularly in the early period both histopathologically and biomechanically. According to our study, PTX may be favorable for the treatment of human Achilles tendon injuries and tendinopathies.
{"title":"The effect of pentoxifylline on Achilles tendon healing in tenotomized rabbits.","authors":"A. Şahin, K. Özturan, A. Cirakli, F. Yılmaz, M. Boz, Hasan Kizilay","doi":"10.5606/ehc.2019.66859","DOIUrl":"https://doi.org/10.5606/ehc.2019.66859","url":null,"abstract":"OBJECTIVES\u0000This study aims to evaluate the potential effects of pentoxifylline (PTX) on tendon healing and to compare the histopathological and biomechanical findings of the healed tendon among the groups.\u0000\u0000\u0000MATERIALS AND METHODS\u0000The study was conducted on 36 male New Zealand albino rabbits (age, 3 months; weighing, 2.5±0.5 kg). Rabbits were randomized into two groups of 18 rabbits each. Partial Achilles tenotomy was performed 1.5 cm proximally from the calcaneal insertion of the tendon in both lower extremities of each rabbit and all groups were repaired primarily. After the operation, saline was injected intramuscularly to the control group and PTX was injected into the PTX group daily. Nine rabbits from each group were euthanized at weeks four and six postoperatively for histopathological (n=4) and biomechanical (n=5) testing. The histopathological findings were evaluated using the staging method of Curtis and Delee. Biomechanical effects were assessed by tensile testing.\u0000\u0000\u0000RESULTS\u0000In the biomechanical evaluation results, the maximum displacement and maximum breaking force in the PTX group at fourth week were significantly higher than the control group. In the sixth week, the maximum breaking force in the control group was significantly higher than the PTX group. In the histopathological examination, collagen fiber alignment was more regular and vascularization was more frequent in the PTX group at both fourth and sixth weeks and the difference was significant.\u0000\u0000\u0000CONCLUSION\u0000Pentoxifylline increased healing and strength in rabbit Achilles tendon by stimulating collagen synthesis, increasing vascularity and reducing inflammation, particularly in the early period both histopathologically and biomechanically. According to our study, PTX may be favorable for the treatment of human Achilles tendon injuries and tendinopathies.","PeriodicalId":50551,"journal":{"name":"Eklem Hastaliklari Ve Cerrahisi-Joint Diseases and Related Surgery","volume":"187 1","pages":"259-66"},"PeriodicalIF":1.6,"publicationDate":"2019-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73736853","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}
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