Eklem Hastaliklari Ve Cerrahisi-Joint Diseases and Related Surgery最新文献

Objectives: This study aims to compare the results of talon tibial intramedullary (IM) nailing with the results of conventional distal locked tibial IM nailing.

Patients and methods: The study included 60 patients (37 males, 23 females; mean age 42.2 years; range 18 to 92 years) who underwent tibial IM nailing with the diagnosis of unilateral, closed or open (Gustilo-Anderson type 1) tibial diaphyseal fracture (Orthopaedic Trauma Association 42) between January 2013 and January 2016. Patients were separated into two groups as talon tibial IM nailing group (group 1, n=30) and distal locked tibial IM nailing group (group 2, n=30). All patients' operative and total radiation exposure times were recorded. At last control, American Orthopaedic Foot and Ankle Society and Tegner Lysholm scores were evaluated for clinical outcomes. All complications were recorded.

Results: Mean operative time was 43.8 minutes in group 1 and 50.2 minutes in group 2. Mean radiation exposure time in group 1 was 5.4 minutes, which was three times shorter than the time of group 2, which was 17.5 minutes. Mean time until union was 16.9 weeks in group 1 and 12.2 weeks in group 2. Statistically significant differences were present between two groups in operative, radiation exposure time and time until union (p=0.019, p=0.001, p=0.001, respectively). When American Orthopaedic Foot and Ankle Society and Tegner Lysholm scores were compared, there were no statistically significant differences (p=0.951 and p=0.896).

Conclusion: Talon tibial IM nailing is an easier and safer alternative to conventional distal locked tibial IM nailing with shorter operative and radiation exposure times. However, it should be kept in mind that the time until radiographic union may be longer compared to conventional tibial IM nailing.

Objectives: This study aims to investigate whether or not metabolic syndrome (MS) affects recurrence in patients who had undergone surgery for carpal tunnel syndrome (CTS).

Patients and methods: The study included 86 hands of 78 patients (19 males, 59 females; mean age 52.0±8.2 years; range 36 to 78 years) who underwent CTS surgery. Patients were examined clinically and demographically for the presence of MS. Patients were also evaluated using a visual analog scale and the Boston Carpal Tunnel Syndrome Questionnaire. Diagnoses of recurrence were established using electromyography in patients with clinical CTS and Tinel and/or Phalen test positivity. The effect of MS on recurrent CTS was examined statistically by independent t-test.

Results: At the end of a mean follow-up period of 36.2±19.2 months (range 12 to 60 months), recurrence was identified in 31 (36%) of the 86 hands. Of these 31 hands, MS was present in 23 (74.2%). In the 55 hands (64%) without recurrence, MS was present in 10 (18.2%). According to these differences, the effect of MS on recurrent CTS was statistically significant (p<0.001).

Conclusion: Our study indicated that MS affected recurrence in patients who had undergone CTS surgery.

Objectives: This study aims to compare the effects of anterior cruciate ligament (ACL) reconstruction using autogenous hamstring or patellar tendon graft on the peak torque angle.

Patients and methods: The study included 132 patients (103 males, 29 females; mean age 29±9 year) who were performed ACL reconstruction with autogenous hamstring or patellar tendon graft. The peak torque angles in the quadriceps and hamstring muscles were recorded using an isokinetic dynamometer.

Results: Angle of peak knee flexion torque occurred significantly earlier within the range of motion on the operated side than nonoperated side at 180°/second in the hamstring tendon group. Angle of peak knee extension torque occurred significantly earlier within the range of motion on the operated side than nonoperated side at 180°/second in the patellar tendon group. There were no statistically significant differences in the flexion and extension peak torque angles between the operated and nonoperated knees at 60°/second in both groups.

Conclusion: The angle of peak torque at relatively high angular velocities is affected after ACL reconstruction in patients with hamstring or patellar tendon grafts. The graft donor site directly influences this parameter. This finding may be important for clinicians in terms of preventing re-injury.

Liposclerosing myxofibrous tumor is a very rarely observed benign fibro-osseous lesion, which contains complex histological structures. It was first described in the year 1986. Histopathological examination of the lesion may show myxoid areas, osteoclastic activity, bone trabeculae similar to fibrous dysplasia, fat necrosis, ischemic ossification and rarely cartilage components. This lesion, which is particularly localized to the proximal femur, is thought to be associated with fibrous dysplasia. In this case report, we aim to present a liposclerosing myxofibrous tumor case, which was treated surgically, in light of the literature review. The patient who was treated with curettage, grafting and 95-degree dynamic condylar screw-plate system was asymptomatic at the 16th month control and recurrence was not detected.

Objectives: This study aims to investigate the durations of scientific presentations and factors affecting the rates of exceeding the time limit in presentations at 26th Turkish National Congress of Orthopedics and Traumatology, which is one of Turkey's largest nationally organized orthopedics and traumatology meetings in terms of the numbers of speakers and participators.

Materials and methods: Speech durations of Turkish orthopedists and the rates of these durations against the durations specified in the schedule were calculated. Any relationships between factors related to speakers who made presentations (age and place of work) and factors such as the day, auditorium, and hour of presentation with speech durations were investigated. Durations of sessions of sub-associations and branches were classified and statistically compared.

Results: Out of 480 speakers with a mean age of 47 years (range 28 to 71 years), only 171 (35.6%) completed their presentations within the time specified in the schedule. Speech durations statistically significantly increased as the age of the speakers increased. Rates of non-compliance with time limit were higher in presentations performed on the first day. There was no significant difference between meeting auditoriums and meeting hours with regards to compliance with time limit percentages. An analysis based on places of work of speakers revealed no significant difference in terms of time usage percentages. A significant difference was present between the given and used times in the sessions of Society of Bone and Soft Tissue Tumors, Sports Traumatology Branch, and Turkish Society of Orthopaedics and Traumatology. Rates of compliance with time limit were higher in the sessions of Foot and Ankle Surgery Branch, Turkish Society of Shoulder and Elbow Surgery, and Turkish Society of Orthopaedic Research.

Conclusion: Turkish orthopedists are unsuccessful in complying with time limit in scientific presentations. Awareness should be raised on this subject and time discipline should be established with various measures and training.

Instabilities of the cervical spine after complete or incomplete corpectomy may be the result from resection due to stenosis induced myelopathy, tumors, infections or fractures. In this article, we report a 49-year-old female patient after surgical decompression and stabilization at C5/7 with permanent cervicobrachialgia due to cervical stenosis at C5/7. Corpectomy of C6 and stabilization of C5/7 were performed with a combination of cage and plate. At an outpatient control 16 months after reoperation, the patient complained of neck pain, while the control X-ray showed a fracture of the implant. Due to instability of the device, a revision was indicated, resulting in removal of all components with restabilization. Definitive stabilization was performed with a PINA® cage, discectomy and cage implantation at C4/5 and C7/Th1 and a plate from C4 to Th1 with screw fixation in C4/5/Th1. Postoperative course was complication free and the patient was without pain or neurological symptoms at follow-up after 12 months with all implants in radiologically regular position. To the best of our knowledge, this is the first case report to describe such a complication.

Objectives: This study aims to retrospectively evaluate and compare the mid-term clinical follow-up results of patients who were treated with open or closed reduction due to carpometacarpal (CMC) fracture dislocation.

Patients and methods: Medical charts of 15 patients (1 male, 14 females; mean age 32.5±10.5 years; range 18 to 55 years) who were operated for fourth and fifth finger CMC fracture dislocations were examined. Patients were divided into two groups according to applied treatment as closed reduction and percutaneous pinning (CRPP, n=6) and open reduction and percutaneous pinning (ORPP, n=9). Patients were assessed by a hand therapist blinded to the treatment groups. Patients were compared in respect of visual analog scale (VAS), Quick Disabilities of the Arm, Shoulder and Hand (Q-DASH) scores, and grip strength. Complications were recorded.

Results: Mean VAS values of ORPP group and CRPP group were 2.33±0.50 and 1.67±0.52, respectively. Mean Q-DASH values of ORPP group and CRPP group were 13.63±3.21 and 9.05±2.36, respectively. Mean grip strength values of ORPP group and CRPP group were 65.78±3.70 and 75.17±6.11, respectively. Mean VAS and Q-DASH scores of ORPP group were statistically significantly higher compared to CRPP group. Mean grip strength value of CRPP group was statistically significantly higher compared to ORPP group.

Conclusion: Treatment of fourth and fifth finger CMC fracture dislocations with CRPP results in statistically superior VAS, Q-DASH and grip strength values in the early post-injury period.

Objectives: This study aims to compare early postoperative functional activities of obese or non-obese patients who underwent total hip arthroplasty (THA).

Patients and methods: The study included 45 patients (17 males, 28 females; mean age 64.6±8.6 years; range 45 to 78 years) who were operated due to coxarthrosis. Patients were assigned to two groups as obese (body mass index [BMI] >30 kg/m2, n=21) and non-obese (BMI <30 kg/m2, n=24) based on their preoperative BMI. Obese and non-obese patients' functional movements (lie-to-sit, sit-to-stand, ambulation, stair climbing) were assessed with Iowa Level of Assistance Scale while ambulation velocity was assessed with Iowa Ambulation Velocity Scale preoperatively, on postoperative second and sixth days and at discharge.

Results: While there was significant difference between non-obese patients' intragroup functional movement levels preoperatively and at discharge (p<0.05), there were no difference in the same intragroup values of obese patients (p>0.05). There was no significant difference between obese and non-obese patients in terms of functional movements and ambulation velocities on postoperative second and sixth days and at discharge (p>0.05).

Conclusion: According to our study findings, obesity has no effect in early postoperative period on functional activities in patients who underwent THA.

Objectives: This study aims to evaluate whether the use of headless compression screws is appropriate in arthroscopic ankle arthrodesis.

Patients and methods: Twenty-two feet of 22 patients (12 males, 10 females; mean age 43.7 years; range 21 to 63 years) in whom we applied arthroscopic ankle arthrodesis were examined retrospectively. Mean follow-up duration was 59.3 months (range 36 to 92 months). Coronal and sagittal plane alignment and concomitant pathologies were evaluated on patients' radiographs. Assessments related to pain and functionality were performed by the American Orthopaedic Foot and Ankle Society (AOFAS) scoring.

Results: Radiographic union was achieved in 21 of the total 22 ankles (95.4%). Mean time to union was 10.3±3.5 weeks (range 6.6 to 13.8 weeks). Mean AOFAS pain score increased from 8.1±10.2 to 35.0±6.3 and functional score increased from 21.3±5.5 to 43.4±3.8 (p<0.001). On coronal plane, preoperative tibiotalar angle of 6.6±5.5° decreased to 2.3±2.1° postoperatively. On sagittal plane, while preoperative tibiotalar angle was 17±4.9°, it was 17±4.5° postoperatively. One patient had subtalar pain and one patient had nonunion postoperatively.

Conclusion: The use of headless compression screws is an appropriate choice in the ankle area owing to their advantages of providing successful fixation whilst not causing screw head irritation or pain.