Pub Date : 2022-05-01DOI: 10.5152/j.aott.2022.22023
Utku Gürhan, Yakup Kahve, Multehan Evran, Olgun Bingöl, N. Erdem Yaşar, K. Erler
Objective: The aim of this study was to assess the self-confidence of newly graduated orthopedic surgeons on performing essential surgical procedures. Methods: The study included 151 orthopedics and traumatology surgeons who had completed their (orthopedics and traumatology) training within the last year. They were asked to complete an online questionnaire which was available from February 2020 to May 2021. In the questionnaire, newly graduated orthopedic surgeons were asked whether they could do the 18 listed essential adult and 8 listed essential pediatric cases independently. They were asked about patient follow-up systems and who these were supervised by, the demographic data of the city and about the institution they were trained in, and how many times they performed the listed surgeries during their training. Results: 74 (49%) of the participants received their training in training and research hospitals, 69 (45.7%) in state university hospitals, and 8 (5.3%) in foundation university hospitals. More than 80% of the participants answered, “I can do it independently” for 13 (81.6%) out of 16 adult cases and 7 (87.5%) out of 8 paediatric cases. The average self-efficacy score of the participants was 32.22 out of 36 for adult cases and 15.3 out of 16 for paediatric cases. The total average self-efficacy score was 47.52 out of 52. Conclusion: This study has shown us that newly graduated orthopedic surgeons have the self-confidence to handle many of the essential types of cases independently.
{"title":"The self-assessment of newly graduated orthopedic surgeons on essential surgical procedures","authors":"Utku Gürhan, Yakup Kahve, Multehan Evran, Olgun Bingöl, N. Erdem Yaşar, K. Erler","doi":"10.5152/j.aott.2022.22023","DOIUrl":"https://doi.org/10.5152/j.aott.2022.22023","url":null,"abstract":"Objective: The aim of this study was to assess the self-confidence of newly graduated orthopedic surgeons on performing essential surgical procedures. Methods: The study included 151 orthopedics and traumatology surgeons who had completed their (orthopedics and traumatology) training within the last year. They were asked to complete an online questionnaire which was available from February 2020 to May 2021. In the questionnaire, newly graduated orthopedic surgeons were asked whether they could do the 18 listed essential adult and 8 listed essential pediatric cases independently. They were asked about patient follow-up systems and who these were supervised by, the demographic data of the city and about the institution they were trained in, and how many times they performed the listed surgeries during their training. Results: 74 (49%) of the participants received their training in training and research hospitals, 69 (45.7%) in state university hospitals, and 8 (5.3%) in foundation university hospitals. More than 80% of the participants answered, “I can do it independently” for 13 (81.6%) out of 16 adult cases and 7 (87.5%) out of 8 paediatric cases. The average self-efficacy score of the participants was 32.22 out of 36 for adult cases and 15.3 out of 16 for paediatric cases. The total average self-efficacy score was 47.52 out of 52. Conclusion: This study has shown us that newly graduated orthopedic surgeons have the self-confidence to handle many of the essential types of cases independently.","PeriodicalId":7097,"journal":{"name":"Acta orthopaedica et traumatologica turcica","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49429312","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}
Pub Date : 2022-05-01DOI: 10.5152/j.aott.2022.21255
Xuexin Han, Jiabin Ren
Objective: This study aimed to conduct a systematic review and meta-analysis to assess the risk factors for proximal junctional kyphosis after the correction surgery of adult spinal deformity. Methods: Relevant studies were systematically retrieved from databases including Cochrane Library, PubMed, and Embase. Based on inclusion and exclusion criteria, literature screening, quality evaluation, and data extraction were conducted. Analysis was performed with Revman 5.3 software. Results: Sixteen studies with 2388 patients, covering 905 cases with proximal junctional kyphosis and 1483 cases without proximal junctional kyphosis, were included in the study. The high-risk factors for the development of proximal junctional kyphosis were found to be high body mass index, osteoporosis, severe fatty infiltration of paravertebral muscles, small functional area of paravertebral muscles, lumbar lordosis over-correction, lack of ligament reinforcement device at the proximal vertebrae and upper instrumented vertebra at the thoracolumbar segment, and pelvic fixation. The results were statistically significant. Conclusion: Evidence from this study has revealed that the independent risk factors for proximal junctional kyphosis complications after correction surgery of adult spinal deformity are high body mass index, osteoporosis, severe degeneration of paravertebral muscles, lumbar lordosis overcorrection, fixed fusion to the pelvis, and lack of ligament reinforcement device at the proximal vertebrae and upper instrumented vertebra at the thoracolumbar segment. Level of Evidence: Level IV, Therapeutic Study
{"title":"Risk factors for proximal junctional kyphosis in adult spinal deformity after correction surgery: A systematic review and meta-analysis","authors":"Xuexin Han, Jiabin Ren","doi":"10.5152/j.aott.2022.21255","DOIUrl":"https://doi.org/10.5152/j.aott.2022.21255","url":null,"abstract":"Objective: This study aimed to conduct a systematic review and meta-analysis to assess the risk factors for proximal junctional kyphosis after the correction surgery of adult spinal deformity. Methods: Relevant studies were systematically retrieved from databases including Cochrane Library, PubMed, and Embase. Based on inclusion and exclusion criteria, literature screening, quality evaluation, and data extraction were conducted. Analysis was performed with Revman 5.3 software. Results: Sixteen studies with 2388 patients, covering 905 cases with proximal junctional kyphosis and 1483 cases without proximal junctional kyphosis, were included in the study. The high-risk factors for the development of proximal junctional kyphosis were found to be high body mass index, osteoporosis, severe fatty infiltration of paravertebral muscles, small functional area of paravertebral muscles, lumbar lordosis over-correction, lack of ligament reinforcement device at the proximal vertebrae and upper instrumented vertebra at the thoracolumbar segment, and pelvic fixation. The results were statistically significant. Conclusion: Evidence from this study has revealed that the independent risk factors for proximal junctional kyphosis complications after correction surgery of adult spinal deformity are high body mass index, osteoporosis, severe degeneration of paravertebral muscles, lumbar lordosis overcorrection, fixed fusion to the pelvis, and lack of ligament reinforcement device at the proximal vertebrae and upper instrumented vertebra at the thoracolumbar segment. Level of Evidence: Level IV, Therapeutic Study","PeriodicalId":7097,"journal":{"name":"Acta orthopaedica et traumatologica turcica","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47275985","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}
Pub Date : 2022-04-25DOI: 10.5152/j.aott.2022.21344
Yoon-Chung Kim, C. Kim, B. Kim, Jae-Jung Jeong
Compared to other lateral soft tissue release methods during hallux valgus surgery, the medial transarticular approach has the advantages of being reproducible, safe, and simple. However, a few reports have described the disadvantages of medial transarticular lateral soft tissue release, including only inadequate lateral soft tissue release. Herein, we report a case of intermetatarsal neuroma in the first web space after hallux valgus correction using distal chevron metatarsal osteotomy and medial transarticular lateral soft tissue release. This case report aimed to highlight the possibility of nerve damage due to medial transarticular lateral soft tissue release during hallux valgus correction surgery.
{"title":"Neuroma as an unusual complication of transarticular lateral release and distal chevron metatarsal osteotomy for hallux valgus: A case report","authors":"Yoon-Chung Kim, C. Kim, B. Kim, Jae-Jung Jeong","doi":"10.5152/j.aott.2022.21344","DOIUrl":"https://doi.org/10.5152/j.aott.2022.21344","url":null,"abstract":"Compared to other lateral soft tissue release methods during hallux valgus surgery, the medial transarticular approach has the advantages of being reproducible, safe, and simple. However, a few reports have described the disadvantages of medial transarticular lateral soft tissue release, including only inadequate lateral soft tissue release. Herein, we report a case of intermetatarsal neuroma in the first web space after hallux valgus correction using distal chevron metatarsal osteotomy and medial transarticular lateral soft tissue release. This case report aimed to highlight the possibility of nerve damage due to medial transarticular lateral soft tissue release during hallux valgus correction surgery.","PeriodicalId":7097,"journal":{"name":"Acta orthopaedica et traumatologica turcica","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2022-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41947309","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}
Pub Date : 2022-04-25DOI: 10.5152/j.aott.2022.21325
Y. Mochizuki, N. Yamamoto, T. Noda, Toshifumi Ozaki
Osteochondral fractures of the medial femoral condyle accompanied by medial wall fracture are rare. Surgeons often have difficulty in selecting the most appropriate treatment, especially the plating technique for internal fixation since the available femoral locking plates are made to fit the femoral lateral condyle and there is no anatomical plate for the medial condyle. We, herein, report a case of a 44-year-old female patient who suffered from an osteochondral fracture of the medial femoral condyle accompanied by medial wall fracture treated by a low-profile mesh plate contoured to fit around the fracture site. Bone union was achieved at postoperative week 12 and the patient was able to return to her normal activities. At the 16-month follow-up exam, the patient’s functional and clinical outcomes were satisfactory. Her Oxford knee score was 47 points, and the Western Ontario and McMaster Universities Arthritis Index scores were 2 points for pain and 5 points for physical function. We believe that the mesh plate has several advantages. This is the first report of using a mesh plate for the femur, and we were able to achieve good results. We conclude that treatment with a mesh plate can be applied in well-selected patients with medial femoral condyle osteochondral fracture and has the potential to be applied to the treatment of fractures in various regions in the future.
{"title":"Application of mesh plate for the treatment of an osteochondral fracture of the medial femoral condyle with medial wall fracture: A case report","authors":"Y. Mochizuki, N. Yamamoto, T. Noda, Toshifumi Ozaki","doi":"10.5152/j.aott.2022.21325","DOIUrl":"https://doi.org/10.5152/j.aott.2022.21325","url":null,"abstract":"Osteochondral fractures of the medial femoral condyle accompanied by medial wall fracture are rare. Surgeons often have difficulty in selecting the most appropriate treatment, especially the plating technique for internal fixation since the available femoral locking plates are made to fit the femoral lateral condyle and there is no anatomical plate for the medial condyle. We, herein, report a case of a 44-year-old female patient who suffered from an osteochondral fracture of the medial femoral condyle accompanied by medial wall fracture treated by a low-profile mesh plate contoured to fit around the fracture site. Bone union was achieved at postoperative week 12 and the patient was able to return to her normal activities. At the 16-month follow-up exam, the patient’s functional and clinical outcomes were satisfactory. Her Oxford knee score was 47 points, and the Western Ontario and McMaster Universities Arthritis Index scores were 2 points for pain and 5 points for physical function. We believe that the mesh plate has several advantages. This is the first report of using a mesh plate for the femur, and we were able to achieve good results. We conclude that treatment with a mesh plate can be applied in well-selected patients with medial femoral condyle osteochondral fracture and has the potential to be applied to the treatment of fractures in various regions in the future.","PeriodicalId":7097,"journal":{"name":"Acta orthopaedica et traumatologica turcica","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2022-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47080670","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}
Pub Date : 2022-03-01DOI: 10.5152/j.aott.2022.21102
Anil Kc, W. Tian, Liao Shi Jie, D. Fei
Dysplasia epiphysealis hemimelica (DEH) or Trevor's disease is a rare, nonhereditary developmental disorder of skeleton affecting epiphysis and short bones of limbs and characterized by a benign overgrowth of the medial half of the epiphysis resembling osteochondroma. We herein report an unconventional presentation of Trevor's disease of the hip with the involvement of the whole epiphysis. Only a few cases of DEH with such unusual features were found in the literature. The aim of this case report is to spread the awareness among the doctors about an unusual case of DEH with the involvement of the whole capital femoral epiphysis which has been neglected for 10 years. We also discuss the natural history of the development of disease, challenges faced during the course of treatment, clinical results, and complications.
{"title":"An unconventional presentation of Hip Joint Trevor disease with the involvement of the whole capital femoral epiphysis: A case report and literature review.","authors":"Anil Kc, W. Tian, Liao Shi Jie, D. Fei","doi":"10.5152/j.aott.2022.21102","DOIUrl":"https://doi.org/10.5152/j.aott.2022.21102","url":null,"abstract":"Dysplasia epiphysealis hemimelica (DEH) or Trevor's disease is a rare, nonhereditary developmental disorder of skeleton affecting epiphysis and short bones of limbs and characterized by a benign overgrowth of the medial half of the epiphysis resembling osteochondroma. We herein report an unconventional presentation of Trevor's disease of the hip with the involvement of the whole epiphysis. Only a few cases of DEH with such unusual features were found in the literature. The aim of this case report is to spread the awareness among the doctors about an unusual case of DEH with the involvement of the whole capital femoral epiphysis which has been neglected for 10 years. We also discuss the natural history of the development of disease, challenges faced during the course of treatment, clinical results, and complications.","PeriodicalId":7097,"journal":{"name":"Acta orthopaedica et traumatologica turcica","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41328217","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}
Pub Date : 2022-03-01DOI: 10.5152/j.aott.2022.21131
Muhammet Kalkışım, A. Okutan, Ünal Saraç, S. Kerimoglu
Objective: This study aimed to evaluate the mid-term clinical outcomes of total knee arthroplasty (TKA) in the management of end-stage hemophilic arthropathy. Methods: Eleven patients (15 knees) undergoing TKA with stiff knees were retrospectively evaluated. TKA was performed in all patients without additional surgical interventions such as posterior capsular release, hamstring release, synovectomy, VY quadricepsplasty, or tibial tubercle osteotomy. All patients were evaluated for clinical and radiological results at follow-ups. Functional evaluation and pain status were assessed using the Knee Society Score and Visual Analogue Scale. Results: The mean age at the time of operation was 40.8 ± 11.8 years (range = 30–64 years). The mean follow-up was 51.2 ± 20.6 months (range = 24–95). The mean flexion contracture significantly decreased from 17.6 ± 11.3 to 1.7 ± 2.8 degrees, and the mean maximum flexion increased dramatically from 55.6 ± 20.5 to 109.2 ± 16.2 degrees (P < 0.001). Statistical significant improvement in flexion and flexion contracture degrees continued up to the postoperatively 18 months. The mean Knee Society Score increased from 22.7 ± 2.4 points preoperatively to 87.8 ± 3.8 points at the last follow-up (P < 0.001). The mean cost of coagulation factor consumption and blood transfusion accounted for 78% of the total cost. Conclusion: This study has shown that TKA is an effective treatment for relieving pain and improving both ranges of motion and quality of life in managing end-stage hemophilic arthropathy of the knee joint. Level of Evidence: Level IV, Therapeutic Study
{"title":"The mid-term clinical outcomes of total knee arthroplasty in the management of end-stage hemophilic arthropathy","authors":"Muhammet Kalkışım, A. Okutan, Ünal Saraç, S. Kerimoglu","doi":"10.5152/j.aott.2022.21131","DOIUrl":"https://doi.org/10.5152/j.aott.2022.21131","url":null,"abstract":"Objective: This study aimed to evaluate the mid-term clinical outcomes of total knee arthroplasty (TKA) in the management of end-stage hemophilic arthropathy. Methods: Eleven patients (15 knees) undergoing TKA with stiff knees were retrospectively evaluated. TKA was performed in all patients without additional surgical interventions such as posterior capsular release, hamstring release, synovectomy, VY quadricepsplasty, or tibial tubercle osteotomy. All patients were evaluated for clinical and radiological results at follow-ups. Functional evaluation and pain status were assessed using the Knee Society Score and Visual Analogue Scale. Results: The mean age at the time of operation was 40.8 ± 11.8 years (range = 30–64 years). The mean follow-up was 51.2 ± 20.6 months (range = 24–95). The mean flexion contracture significantly decreased from 17.6 ± 11.3 to 1.7 ± 2.8 degrees, and the mean maximum flexion increased dramatically from 55.6 ± 20.5 to 109.2 ± 16.2 degrees (P < 0.001). Statistical significant improvement in flexion and flexion contracture degrees continued up to the postoperatively 18 months. The mean Knee Society Score increased from 22.7 ± 2.4 points preoperatively to 87.8 ± 3.8 points at the last follow-up (P < 0.001). The mean cost of coagulation factor consumption and blood transfusion accounted for 78% of the total cost. Conclusion: This study has shown that TKA is an effective treatment for relieving pain and improving both ranges of motion and quality of life in managing end-stage hemophilic arthropathy of the knee joint. Level of Evidence: Level IV, Therapeutic Study","PeriodicalId":7097,"journal":{"name":"Acta orthopaedica et traumatologica turcica","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44437325","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}
Pub Date : 2022-03-01DOI: 10.5152/j.aott.2022.21217
Taku Fujita, Kazunari Takeuchi, T. Yokoyama, Kanichiro Wada, Gentaro Kumagai, Y. Ishibashi
Objective: This study aimed to investigate whether disruption of the repaired nuchal ligament (NL) affects clinical outcomes following posterior cervical spine surgery. Methods: This retrospective study included 101 patients (65 males, 36 females) who underwent posterior cervical spine surgery, 69 of whom received laminoplasty (LP), and 32 posterior decompression and fusion (PDF). The NL was split during the surgical approach and repaired at the time of wound closure. The frequency and spinal levels of NL disruption at one month, six months, and one year postoperatively were evaluated on mid-sagittal and axial magnetic resonance images. Postoperative axial symptoms, Neck Disability Index, T1 slope, flexion and extension angle, C2-C7 lordotic angle, and decrease rate of C2-C7 range of motion (ROM) were examined at six months and/or one year postoperatively. Based on the NL disruption levels, the patients were divided into the upper group (C2-C5), lower group (C6-T1), and non-disruption group. Results: Although the lower group contained patients with NL disruption (10%) after LP at final follow-up, all PDF patients belonged to the non-disruption group. For the LP patients, the postoperative axial symptoms, Neck Disability Index, T1 slope, flexion and extension angle, and C2-C7 lordotic angle did not significantly differ between the lower and non-disruption groups; however, the rate of C2-C7 ROM decrease in the lower group (48%) was considerably larger than that in the non-disruption group (33%) after LP. Conclusion: Evidence from this study has shown that postoperative disruption of the repaired NL has no significant effect on postoperative axial symptoms and C2-C7 alignment, but it can affect the rate of decrease in C2-C7 ROM after LP. Level of Evidence: Level III, Therapeutic Study
{"title":"The effect of disruption of the repaired nuchal ligament on clinical outcomes after posterior cervical spine surgery: A retrospective comparative study","authors":"Taku Fujita, Kazunari Takeuchi, T. Yokoyama, Kanichiro Wada, Gentaro Kumagai, Y. Ishibashi","doi":"10.5152/j.aott.2022.21217","DOIUrl":"https://doi.org/10.5152/j.aott.2022.21217","url":null,"abstract":"Objective: This study aimed to investigate whether disruption of the repaired nuchal ligament (NL) affects clinical outcomes following posterior cervical spine surgery. Methods: This retrospective study included 101 patients (65 males, 36 females) who underwent posterior cervical spine surgery, 69 of whom received laminoplasty (LP), and 32 posterior decompression and fusion (PDF). The NL was split during the surgical approach and repaired at the time of wound closure. The frequency and spinal levels of NL disruption at one month, six months, and one year postoperatively were evaluated on mid-sagittal and axial magnetic resonance images. Postoperative axial symptoms, Neck Disability Index, T1 slope, flexion and extension angle, C2-C7 lordotic angle, and decrease rate of C2-C7 range of motion (ROM) were examined at six months and/or one year postoperatively. Based on the NL disruption levels, the patients were divided into the upper group (C2-C5), lower group (C6-T1), and non-disruption group. Results: Although the lower group contained patients with NL disruption (10%) after LP at final follow-up, all PDF patients belonged to the non-disruption group. For the LP patients, the postoperative axial symptoms, Neck Disability Index, T1 slope, flexion and extension angle, and C2-C7 lordotic angle did not significantly differ between the lower and non-disruption groups; however, the rate of C2-C7 ROM decrease in the lower group (48%) was considerably larger than that in the non-disruption group (33%) after LP. Conclusion: Evidence from this study has shown that postoperative disruption of the repaired NL has no significant effect on postoperative axial symptoms and C2-C7 alignment, but it can affect the rate of decrease in C2-C7 ROM after LP. Level of Evidence: Level III, Therapeutic Study","PeriodicalId":7097,"journal":{"name":"Acta orthopaedica et traumatologica turcica","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43429939","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}
Pub Date : 2022-03-01DOI: 10.5152/j.aott.2022.20401
Akif Mirioğlu, Ö. Biçer, Mustafa Tekin, M. Deveci, Cenk Özkan, M. Bağır
OBJECTIVE The aim of this study was to investigate whether there is a relationship between Salter and Pemberton pelvic osteotomies and avascular necrosis of femoral head in the management of developmental dysplasia of the hip (DDH). METHODS This retrospective study included 69 hips of 52 patients aged between 12-36 months, diagnosed as DDH who had undergone either Salter or Pemberton pelvic osteotomy with Smith Petersen approach. There were 35 patients in Salter Pelvic Osteotomy and 34 patients in Pemberton Pelvic Osteotomy groups. Before the treatment of DDH, Tönnis classification was used, preoperative and 24th month postoperative Acetabular Index (AI) angles were measured. Kalamchi-MacEwen grades of avascular necrosis were determined in terms of presence of avascular necrosis of the femoral head. RESULTS There were no significant differences between two osteotomy groups at the end of mid-term follow up in terms of the radiological parameters and avascular necrosis of femoral head. However it was found that the increased avascular necrosis incidence was significantly associated with Tönnis grade 4 hips. CONCLUSION Salter and Pemberton osteotomies can be both used safely in the treatment of DDH regarding their effect on the femoral head. LEVEL OF EVIDENCE Level III, Therapeutic Study.
{"title":"Clinical and radiological outcomes of Salter versus Pemberton osteotomies in the management of developmental dysplasia of the hip: A retrospective comparative study.","authors":"Akif Mirioğlu, Ö. Biçer, Mustafa Tekin, M. Deveci, Cenk Özkan, M. Bağır","doi":"10.5152/j.aott.2022.20401","DOIUrl":"https://doi.org/10.5152/j.aott.2022.20401","url":null,"abstract":"OBJECTIVE\u0000The aim of this study was to investigate whether there is a relationship between Salter and Pemberton pelvic osteotomies and avascular necrosis of femoral head in the management of developmental dysplasia of the hip (DDH).\u0000\u0000\u0000METHODS\u0000This retrospective study included 69 hips of 52 patients aged between 12-36 months, diagnosed as DDH who had undergone either Salter or Pemberton pelvic osteotomy with Smith Petersen approach. There were 35 patients in Salter Pelvic Osteotomy and 34 patients in Pemberton Pelvic Osteotomy groups. Before the treatment of DDH, Tönnis classification was used, preoperative and 24th month postoperative Acetabular Index (AI) angles were measured. Kalamchi-MacEwen grades of avascular necrosis were determined in terms of presence of avascular necrosis of the femoral head.\u0000\u0000\u0000RESULTS\u0000There were no significant differences between two osteotomy groups at the end of mid-term follow up in terms of the radiological parameters and avascular necrosis of femoral head. However it was found that the increased avascular necrosis incidence was significantly associated with Tönnis grade 4 hips.\u0000\u0000\u0000CONCLUSION\u0000Salter and Pemberton osteotomies can be both used safely in the treatment of DDH regarding their effect on the femoral head.\u0000\u0000\u0000LEVEL OF EVIDENCE\u0000Level III, Therapeutic Study.","PeriodicalId":7097,"journal":{"name":"Acta orthopaedica et traumatologica turcica","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46649610","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}
Pub Date : 2022-03-01DOI: 10.5152/j.aott.2022.21107
Burcu Erçakmak Güneş, Hasan Barış Ilgaz, N. Ciledag, Hakan Özsoy, M. Hayran, D. Demiryürek
Objective: This anatomical study aimed to investigate the possible relationships between the proximal femur parameters and verify the optimal entry point in line with the medullary canal. Methods: Both in single image series and 3D-MPR views, 63 femur bones were evaluated. One-millimeter multidetector computed tomography scans were collected and assessed by OsiriX-Lite version 8 and Horos v3.3.5. Entry point locations, projected and true femoral neck-shaft, anteversion, and newly defined nail entrance angles were measured. Results: The entry points of 16 femurs were placed at the tip of the greater trochanter, and the remaining 47 femurs were in the trochanteric fossa (i.e., piriformis fossa). Thirty-three of the entry points found in the trochanteric fossa were overlapped by the greater trochanter. When the parameters of the right and left sides were compared, it was found that; projected neck angle, nail entrance angle, and the differences between true neck angle and nail entrance angle were found significantly different. The relationship between nail entrance angle and entry point localization was assessed, and the probability of the entry point being at the tip of the greater trochanter is 63 times greater when the NEA is below 90. Conclusion: This study has demonstrated that the ideal entry point for straight nails, which is based on the anatomic axis of the femur, is found mainly at the trochanteric fossa, and the greater trochanter overlapped 70.21% of them. Level of Evidence: Level IV, Diagnostic Study
{"title":"Estimating the optimal entry point of the antegrade femoral nailing: Previous and novel morphometric measurements","authors":"Burcu Erçakmak Güneş, Hasan Barış Ilgaz, N. Ciledag, Hakan Özsoy, M. Hayran, D. Demiryürek","doi":"10.5152/j.aott.2022.21107","DOIUrl":"https://doi.org/10.5152/j.aott.2022.21107","url":null,"abstract":"Objective: This anatomical study aimed to investigate the possible relationships between the proximal femur parameters and verify the optimal entry point in line with the medullary canal. Methods: Both in single image series and 3D-MPR views, 63 femur bones were evaluated. One-millimeter multidetector computed tomography scans were collected and assessed by OsiriX-Lite version 8 and Horos v3.3.5. Entry point locations, projected and true femoral neck-shaft, anteversion, and newly defined nail entrance angles were measured. Results: The entry points of 16 femurs were placed at the tip of the greater trochanter, and the remaining 47 femurs were in the trochanteric fossa (i.e., piriformis fossa). Thirty-three of the entry points found in the trochanteric fossa were overlapped by the greater trochanter. When the parameters of the right and left sides were compared, it was found that; projected neck angle, nail entrance angle, and the differences between true neck angle and nail entrance angle were found significantly different. The relationship between nail entrance angle and entry point localization was assessed, and the probability of the entry point being at the tip of the greater trochanter is 63 times greater when the NEA is below 90. Conclusion: This study has demonstrated that the ideal entry point for straight nails, which is based on the anatomic axis of the femur, is found mainly at the trochanteric fossa, and the greater trochanter overlapped 70.21% of them. Level of Evidence: Level IV, Diagnostic Study","PeriodicalId":7097,"journal":{"name":"Acta orthopaedica et traumatologica turcica","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43450963","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}
Pub Date : 2022-03-01DOI: 10.5152/j.aott.2022.21138
W. Luo, Xin Fu, Jingmin Huang, Jiang Wu, Xin-long Ma
Objective: This study aimed to evaluate the efficacy and safety of intravenous combined with topical application of tranexamic acid (TXA) in reducing blood loss in opening wedge high tibial osteotomy (OWHTO). Methods: A total of 60 patients who underwent unilateral OWHTO between May 2018 and May 2019 were retrospectively reviewed. All the patients were then divided into one of the two groups (30 per group): the TXA group, patients receiving intravenous combined with topical application of TXA, and the control group, patients receiving no TXA. Outcome measures were drain volume, total blood loss, hidden blood loss, transfusion requirements, and incidence of complications. Results: The mean follow-up of TXA group was 14.2 2.3 months (range, 13-16 months) and the mean follow-up for the control group was 14.4 2.1 months (range, 13-17 months). No significant difference was found for the follow-up of two groups (P = 0.829). Drainage volume (143.3 65.4 ml vs 307.8 51.4 mL, P < 0.001), hidden blood loss (156.7 63.8 mL vs 286.4 79.1 mL, P < 0.001) and knee swelling (3.2 0.9 vs 6.5 2.1, P < 0.001) in the TXA group was clearly less than that in the control group, and there was no statistical significance with regard to hospitalization time (P = 0.746), transfusion requirements (P = 1.000), wound complications (P = 0.386), deep venous thrombosis (P = 1.000), postoperative Lysholm knee score (P = 0.681) and Knee Injury & Osteoarthritis Outcome subscales pain (P = 0.752), symptoms (P = 0.673), activities of daily living (P = 0.871), sport/recreation function (P = 0.816), and knee-related quality of life (P = 0.576) at 6 months postoperatively. Conclusion: This study has shown that administration of intravenous combined with topical TXA in OWHTO can effectively reduce perioperative blood loss without increasing the incidence of postoperative complications.
{"title":"Efficacy and safety of intravenous combined with topical administration of tranexamic acid in reducing blood loss in opening wedge high tibial osteotomy procedure: A retrospective case-control study","authors":"W. Luo, Xin Fu, Jingmin Huang, Jiang Wu, Xin-long Ma","doi":"10.5152/j.aott.2022.21138","DOIUrl":"https://doi.org/10.5152/j.aott.2022.21138","url":null,"abstract":"Objective: This study aimed to evaluate the efficacy and safety of intravenous combined with topical application of tranexamic acid (TXA) in reducing blood loss in opening wedge high tibial osteotomy (OWHTO). Methods: A total of 60 patients who underwent unilateral OWHTO between May 2018 and May 2019 were retrospectively reviewed. All the patients were then divided into one of the two groups (30 per group): the TXA group, patients receiving intravenous combined with topical application of TXA, and the control group, patients receiving no TXA. Outcome measures were drain volume, total blood loss, hidden blood loss, transfusion requirements, and incidence of complications. Results: The mean follow-up of TXA group was 14.2 2.3 months (range, 13-16 months) and the mean follow-up for the control group was 14.4 2.1 months (range, 13-17 months). No significant difference was found for the follow-up of two groups (P = 0.829). Drainage volume (143.3 65.4 ml vs 307.8 51.4 mL, P < 0.001), hidden blood loss (156.7 63.8 mL vs 286.4 79.1 mL, P < 0.001) and knee swelling (3.2 0.9 vs 6.5 2.1, P < 0.001) in the TXA group was clearly less than that in the control group, and there was no statistical significance with regard to hospitalization time (P = 0.746), transfusion requirements (P = 1.000), wound complications (P = 0.386), deep venous thrombosis (P = 1.000), postoperative Lysholm knee score (P = 0.681) and Knee Injury & Osteoarthritis Outcome subscales pain (P = 0.752), symptoms (P = 0.673), activities of daily living (P = 0.871), sport/recreation function (P = 0.816), and knee-related quality of life (P = 0.576) at 6 months postoperatively. Conclusion: This study has shown that administration of intravenous combined with topical TXA in OWHTO can effectively reduce perioperative blood loss without increasing the incidence of postoperative complications.","PeriodicalId":7097,"journal":{"name":"Acta orthopaedica et traumatologica turcica","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46012802","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}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：