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

Objectives: This study aims to compare the radiological, clinical and patient-reported outcomes of patients with intra-articular calcaneus fractures treated conservatively or surgically.

Patients and methods: Fifty-four patients (30 males, 24 females; mean age 41.0 years; range, 18 to 73 years) treated due to calcaneus fracture were included in the study. Twenty-nine patients underwent conservative treatment (group 1) and 25 patients underwent surgical treatment (group 2). The fractures were classified according to Sanders. At the final follow-up, patients' Bohler's angle, The American Orthopedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Score and Foot Function Index (FFI) were used to evaluate their radiological, clinical and patient-reported outcomes. Postoperative complications were also noted.

Results: The fracture was at the right foot in 28 patients and the left foot in 26 patients. The mean follow-up duration was 41.1±23.2 months (range, 24 to 126 months). No statistically significant differences were found between the groups in terms of gender, fracture side, mean age, or follow-up duration (p=0.951, p=0.571, p=0.326, and p=0.620, respectively). According to Sanders classification, 18 patients were type 2 and 11 patients were type 3 in group 1, while 11 patients were type 2 and 14 patients were type 3 in group 2. However, there was no statistically significant difference between the groups in terms of the type of the fracture (p=0.184). On the other hand, the outcomes were significantly better for group 2 compared to group 1 in terms of the Bohler's angle, AOFAS and FFI scores (p=0.004, p=0.003 and p=0.006, respectively). In group 1, subtalar arthritis developed in three patients. In group 2, wound healing problems and superficial infection developed in three patients, while subtalar arthritis developed in two patients.

Conclusion: Surgical treatment is more effective in intra-articular calcaneus fractures compared to conservative treatment according to clinical, radiological and patient-reported outcomes. In addition, wound problems should be considered in surgical management.

Objectives: This study aims to compare the annual impact factors (IFs) for the period 1999-2017 and the tri-annual IFs in 2011, 2014 and 2017 of the subscription access (SA) and open access (OA) journals published in the field of orthopedics, traumatology and sports medicine according to the SCImago Journal Rank (SJR).

Material and methods: All data for this study were obtained from the SCImago Journal & Country Rank database. We compared the change in the mean annual IFs of 197 SA journals with 52 OA journals in the field of orthopedics and sports medicine for the period between 1999 and 2017. In addition, we determined and compared the changes in the mean tri-annual IFs of these journals in 2011, 2014 and 2017. The mean publication fee values of the OA journals as well as the correlation between the three-year IFs of the year 2017 and the publication fee values were evaluated.

Results: From 1999 to 2017, the mean IF of SA journals increased 0.47-fold to 0.69, while the mean IF of the OA journals increased 0.85-fold to 0.63. Significant positive correlation was observed between the tri-annual IF and publication fee of OA journals in 2017 (r=0.458, p=0.001).

Conclusion: We can predict that the mean IFs of OA journals in the field of orthopedics and sports medicine will reach the mean IFs of SA journals after several years. Choosing OA journals becomes advantageous when the desire for a higher number of citations is the most important factor.

Objectives: This study aims to compare two single-step arthroscopic techniques, microfracture and cell-free scaffold implantation, in the treatment of talar osteochondral lesions (OCLs) clinically and radiologically.

Patients and methods: This retrospective study included 62 patients (35 males, 27 females; mean age 41±13 years; range, 15 to 65 years) diagnosed with talar OCLs between March 2007 and January 2015. Patients who were followed-up with a minimum of 24 months with lesions larger than 1 cm2 were included. Pre- and postoperative clinical evaluations were performed according to the American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot scale and radiological evaluations according to the magnetic resonance observation of cartilage repair tissue (MOCART) scale.

Results: Patients were divided into microfracture (n=22) and scaffold (n=40) groups. The mean follow-up duration was 36.1±14.9 months. The mean preoperative AOFAS score increased from 60.6±13.9 to 82.1±11.8 in the microfracture group (p<0.001) and from 53.8±13.6 to 89.4±9.9 in the scaffold group (p<0.001). The scaffold group had superior results than the microfracture group clinically (p=0.011). Clinical results were superior in younger patients (<45 years) (p=0.018), male patients (p=0.020), and traumatic lesions (p=0.014). There was no significant difference between the two techniques according to the total MOCART scores (p=0.199). However, the scaffold technique was more successful in terms of lesion border and effusion subgoups of MOCART scale.

Conclusion: Both single-step arthroscopic techniques are effective and safe in the treatment of talar OCLs. The scaffold technique showed superior clinical results than the microfracture technique in short-term follow-up. Age, trauma history and gender significantly affected the treatment outcomes. The scaffold technique can be considered as a safe and good alternative particularly in the treatment of large lesions.

Objectives: This study aims to investigate the fitness of two anatomic distal femoral plates with cadaveric femurs and to show whether current plates optimally match each femur.

Materials and methods: Two different sets of plates with five, seven and nine shaft holes were applicated on 62 cadaveric femurs. Ball clay was molded onto the entire inner surfaces of the plates and then the plates were fixed to the bones using two self-locking nylon cable zip ties. The volume of ball clay sandwiched in between the plate and bone was calculated and used as a quantitative fit parameter. Data of each plate were analyzed separately.

Results: Using Double Medical Technology IncorporatedTM plates, the mean plate to bone volumes were calculated as 8.4 mL (range, 5-14 mL), 10.0 mL (range, 6-17 mL), and 13.1 mL (range, 7-25 mL) in five, seven and nine-hole plates, respectively. Using Zimmer Biomet IncorporatedTM plates, the mean volumes were 10.5 mL (range, 6-21 mL), 12.7 mL (range, 7-22 mL) and 16.3 mL (range, 8-30 mL) in five, seven and nine-hole plates, respectively. Within each group, the measurements were significantly correlated positively with femoral length.

Conclusion: Optimal fit may not be achieved in each femur using current distal femoral plate implant sets. Thus additional sizes of plates should be supplied in the implant sets.

Objectives: This study aims to evaluate the reliability of the assessment of radiological X-ray images of traumatic injuries in the elbows of children using WhatsApp application, compared to true-size images on a Picture Archiving and Communication System (PACS) screen.

Patients and methods: Between November 2017 and March 2018, X-ray images of a total of 90 pediatric patients (53 males, 37 females; mean age 6.2 years; range, 2 to 10 years) with an elbow injury were retrospectively evaluated. The images were captured and sent to three orthopedic surgeons via the WhatsApp instant messaging application on an iPhone 7S smartphone. Observers were asked to diagnose and classify for each case over their personal smartphones. The three observers independently assessed the images with a seven-day interval. Following one-week interval, revaluation was conducted using the PACS. Intra- and interobserver reliability were calculated by Cohen Kappa statistics.

Results: There was a good agreement between the first and second evaluations by the physicians via WhatsApp (k=0.74). The intraobserver reliability was very good (k=0.8), moderate (k=0.55), and good (k=0.67). There was no significant difference in the intra- and interobserver reliability between the groups.

Conclusion: Using WhatsApp for consulting is a reliable method which can be used in the emergency setting for decision-making. Using WhatsApp can improve the efficacy of medical assessment and reduce waiting time in emergency admissions, although this method is not a substitution for evaluation of the images using computer-based PACS.