Effects on patellar chondromalacia of the size of the infrapatellar fat pad

Infrapatellar fat tissue (IPFP), which is placed in the anterior compartment, has a vital role in the biomechanics of knee. It is thought that infrapatellar fat pad, which also functions as a storage for repair cells after injury, has a protective effect in mechanical and inflammatory knee pain. In this study, the relationship between patellar chondromalacia, which is among significant causes of anterior knee pain, and the sizes of IPFP was investigated. MRI images of patients over 18 years of age, who underwent MRI examination in June 2017 - December 2017, were examined retrospectively by recovering from the electronic patient registration system in the hospital. Eighty-three cases had patellar chondromalacia with normal-healthy IPFP tissue in the examination of knee MRI, and 53 cases without chondromalacia were included in the study. The average age of all evaluated 134 patients was 37.8 (22-68) years. The degree of chondromalacia patella was made according to Outerbridge classification. The height and depths of IPFP in all cases were measured from the widest site on the T1-weighted MRI images in the sagittal plane. The relationship among age, gender, the degree of patellar chondromalacia and IPFP sizes were evaluated. While the average of 51 patients without patellar chondromalacia was 29.04 (22-51) years, the average of 83 patients with chondromalacia was 43.20 (27-68) years. According to Outerbridge classification, patellar chondromalacia grade 3 in 14 patients, grade 2 in 41 patients, grade 1 in 26 patients and grade 4 in 2 patients were observed. It was not seen a significant difference between the groups in terms of gender (p = 0.78). It was seen a significant increase in between patellar chondromalacia and increasing age (p [Med-Science 2019; 8(1.000): 138-42

Unusual Localization of a Primary Hydatid Cyst: Scaphoid Bone A Case Report

WOS: 000376925600007PubMed: 27124019Because hydatidosis of the bone (echinococcus infection) is a rare parasitic infection, its diagnosis and treatment poses great difficulties. Radiologic imaging findings are generally helpful to make the diagnosis. But occurrence of disease in atypical places and lack of specific radiological findings may complicate differential diagnosis. Nevertheless, familiarity with imaging findings in patients living at endemic areas provides advantages for diagnosis and treatment. We present a cyst hydatic case in scaphoid bone which has been reported in the literature only once previously

Synovial chondromatosis of the wrist

Synovial chondromatosis is the process of progressive metaplasia associated with formation of cartilage in synovial mem-branes of joints, tendon sheaths or bursae. It is a rare, chronic, benign disease with unknown etiology which involves single joint. It is generally seen in large joints like knee, hip and, ankle. Wrist involvement is very rare. More common diagnoses with calcified foci and effusion in a joint like rheumatoid arthritis, osteoarthritis, synovial osteochondromatosis, chondrocal-cinosis, calcifications that occur after septic arthritis and synovial chondrosarcoma may interfere with this condition. and high recurrence rate makes the treatment challenging for orthopaedic surgeon. Treatment consists of surgically removing loose bodies and partial or total synovectomy. Here, we present a 31 years old male patient referred to our clinic with painfull recurrent wrist mass. and patient was reoperated for synovial chondromatosis of wrist 17 months after the first op-eration. We represented the preoperative findings and histopathologic confirmation of synovial chondromatosis. We didn’t encounter any recurrence in the follow up period nearly 5 years after tumor removal and synovectomy. We will also discuss differential diagnosis and treatment according to updated literature

Fixator-assisted tibial lengthening over a plate in a patient with sequelae of poliomyelitis

WOS: 000388566200051PubMed: 27858886There are many techniques for limb lengthening. Lengthening over a plate is an alternative choice of fixation in children or when nailing is difficult. We present a new technique for tibial lengthening with using a monolateral external fixator over a lengthening plate. Lengthening over an intramedullary nail is a commonly used method in patients with short stature or limb-length discrepancy. However, in patients with a narrow and excessively sclerotic intramedullary cavity in the pediatric age group where the skeletal system has not yet fully developed, difficulties have been observed in lengthening methods with nailing. Therefore, in these cases, the use of lengthening techniques over a plate is an alternative treatment option. Nevertheless, in lengthening techniques over a plate, if one side of the osteotomy area cannot be fixed, associated mechanical axis problems have been reported. We applied tibia lengthening with external fixator assistance over a custom-made lengthening plate in a patient with sequelae of poliomyelitis. This new lengthening technique applied over a plate could be the solution to the problems observed in other lengthening techniques over a plate

Comparison of Enoxaparin and Rivaroxaban in the Prophylaxis of Deep Venous Thrombosis in Arthroplasty

Background. Pulmonary embolism is a serious early complication of arthroplasty procedures that can develop after deep venous thrombosis. The present study aimed to compare rivaroxaban and enoxaparin in terms of preventing DV and PE, and also in this study, we compared the complications due to these drugs in patients undergoing elective arthroplasty. Materials and Methods. 214 patients were divided into three groups based on their treatment regimens. In group I, enoxaparin was used, in group II, rivaroxaban was used, and in group III, enoxaparin was used throughout hospitalization, and after hospital discharge, rivaroxaban was used. These three groups were compared according to the occurrence of deep venous thrombosis, pulmonary embolism, and major and minor complications. Results. Major postoperative complications occurred in 5, 15, and 6 patients in group I, II, and III, respectively. Minor postoperative complications occurred in 10, 24, and 11 patients in group I, II, and III, respectively. No significant difference was found among the three groups. Deep venous thrombosis or pulmonary embolism was not observed in any patient. Conclusion. Rivaroxaban was found to be as effective as enoxaparin in the prevention of deep venous thrombosis and other complications after arthroplasty. Moreover, oral rivaroxaban provided greater ease of use compared to subcutaneous enoxaparin. Based on these findings, we consider that rivaroxaban could be an effective alternative to enoxaparin

Congenital Clasped Thumb That Is Forgetten a Syndrome in Clinical Practice A Case Report

WOS: 000369533200041PubMed: 26402835Congenital clasped thumb is a progressive flexion and adduction deformity presenting with heterogeneous congenital anomalies. Although the disease is rare, diagnosis is usually delayed due to natural location of thumb within the palm in first 3 months of life.A 4-year-old girl with congenital clasped thumb deformity due to absence of extensor pollicis brevis tendon whose treatment consisted of extensor indicis proprius (EIP) transfer and z-plasty reconstruction to first web space.The patient was so happy with both cosmetic appearance and functional status. There was not any limitation at interphalangeal or metacarpophalangeal (MCP) joints of the thumb and the result was. Stability of MCP joint was full and power for grasping any object was much better than the original status.In cases of isolated clasped thumb deformity associated with absence of tendon whose treatment attempts with splinting and physical treatment have failed, EIP tendon transfer and reconstruction of contracture in first web space with z-plasty is an easy and successful method to obtain functional improvement

Learning Curve for Surgical Treatment of Acetabular Fractures: A Retrospective Clinical Study of a Practical and Theoretical Training Course

WOS: 000414707200001PubMed: 29093436Background: Surgical treatment of acetabular fracture and the anatomic reconstruction of the hip joint are difficult to achieve due to the complex pelvic anatomy, and surgical training requires a prolonged and steep learning curve. The aim of this study was to evaluate the effects of an applied training course, including cadaveric dissection, for the surgical treatment of acetabular fractures. Material/Methods: This retrospective study included 35 patients who underwent surgical treatment for acetabulum fractures between 2012-2016. Patients were divided into three groups during two training courses, for the first two years and second two years. The surgical treatment was performed through single or combined standard approaches, according to the fracture pattern. The radiological outcome was evaluated using Matta's criteria to grade postoperative reduction and final radiological outcome and the restoration of the hip joint center (HJC). The clinical outcome was evaluated using the modified the Merle d'Aubigne-Postel (DAP) hip score. Results: Both post-course groups had statistically better functional and radiological outcomes compared with the precourse group. Depending on the learning curve, the mean duration of surgery decreased from 153 minutes to 82.3 minutes. Although there was no statistical difference between groups in the vertical shift of the HJC, there was a statistically significant in the amount of horizontal shift of the HJC in the second two years of training, compared with the other groups. Conclusions: Functional and radiological outcome of surgical treatment of acetabular fracture may be improved with increased training, depending on the learning curve

Is there a relationship between fracture healing and mean platelet volume?

WOS: 000379677300001PubMed: 27471388Objectives: Platelet volume has been defined to be a marker that shows thrombocyte activation and function and it is measured as mean platelet volume (MPV). MPV shows the mean volume of circulating thrombocytes and it is one of the routine parameters in complete blood count. Increased thrombocyte volume is associated with thrombocyte activation. Patients and methods: This study included 76 patients who were operated on due to fractures of long tubular bones. Patients who had union without any additional interventions were defined as group I, and patients who needed additional interventions due to nonunion or inadequate union were defined as group II. The control group included healthy volunteers who did not have a fracture. Hematologic test values of the patients that were obtained at admission to emergency ward were recorded. Results: The groups were not statistically different in terms of age, sex, and the affected extremity. There were significant differences between group I and group II in terms of mean erythrocyte sedimentation rate, C-reactive protein, and MPV values (P<0.001), but there were no significant differences between group I and the control group. There was also no statistically significant difference among groups in terms of hematologic and biochemical variables. Conclusion: In our study, fractures in patients who had lower MPV values than controls during the inflammation process healed without any problem, but fractures in patients with high MPV values more frequently needed additional surgical interventions

Giant malignant peripheral nerve sheath tumor of thigh in an adolescent with neurofibromatosis type 1: a case report

WOS: 000215307400056PubMed: 26604833Malignant peripheral nerve sheath tumors (MPNSTs) are rare sarcomas of children and adolescents, and they are aggressive tumors with a high rate of local recurrence. We present a 15-year-old boy with neurofibromatosis type 1 (NF1), who had a giant MPNST on the right thigh taking into account the available literature. Diagnosis of MPNST may be delayed in NF1 patients due to confusion with a neurofibroma and/or a plexiform neurofibroma. Malignancy should be considered, especially in cases with big masses, with heterogeneous involvement, or in the presence of cysts or necrotic nodules. The aim of surgical treatment is complete surgical excision