Bilek güreşi sırasında humerusun spiral kırığı

Arm wrestling contests have become a common pub and even professional sport. Although armwrestling injuries are not common, several have been reported in the medical literature. In this case, spiral fracture of the humerus with large free fragments which had occurred during arm wrestling and occurring mechanism of injury was attracted attention. It is concluded that arm wrestling should not be considered a completely harmless sport and it appears appropriate to warn public and arm wrestler against arm wrestling.Bilek güreşi müsabakaları halk arasında ve hatta profesyonel sporcular arasında yaygın bir şekilde yapılmaktadır. Bilek güreşi yaralanmaları çok sık olmamasına rağmen, tıbbi literatürde bir kaç yayın rapor edilmiştir. Bu vakada bilek gü- reşi sırasında meydana gelen, serbest kemik parçası olan humerusun spiral cisim kırığına ve travmanın oluş mekanizmasına dikkat çekildi. Bilek güreşinin tamamiyle zarasız bir spor olarak düşünülmemesi gerektiği ve bilek güreşine karşı bu sporla uğraşan profesyonel sporcuların ve halkın uyarılmasının uygun olduğu sonucuna varıldı

The comparison of the effects of intraoperative bleeding control and postoperative drain clamping methods on the postoperative blood loss and the need for transfusion following total knee arthroplasty

WOS: 000294278700010PubMed: 21765233Objective: We aimed to determine and compare the effects of intraoperative bleeding control and two hours postoperative drain clamping method on postoperative wound drainage and the need for donor blood transfusion following total knee arthroplasty (TKA). Methods: Seventy-one patients who underwent TKA were randomly assigned into two groups. Fourty-four knees of 32 patients comprised Group A and 51 knees of 39 patients comprised Group B. In Group A, no bleeding control was done and postoperatively, the drain was clamped for 2 hours. Then it was unclamped to begin aspiration after the 2nd hour. In Group B, the bleeding was controlled intraoperatively, and the drain was not clamped after the surgery. Drains were removed 48 hours after the surgery in both groups. Bilateral and unilateral arthroplasty patients were evaluated separately. The groups were compared for their preoperative and postoperative 3-day haemoglobin (Hb) levels, total drainage amount and total number of blood transfusions. Results: The haemoglobin levels were similar in both groups preoperatively and at the 1st, 2nd and 3rd postoperative days. In Group A, the wound drainage was 696.1 +/- 235.4 ml in unilateral TKA patients and was 1010.8 +/- 535.5 ml in bilateral arthroplasty patients. In Group B, the wound drainage was 710.1 +/- 380.1 ml in unilateral TKA patients and was 878.3 +/- 489.6 ml in bilateral arthroplasty patients. The mean number of transfusions was 1.41 units with no significant differences between the groups. Conclusion: The two hour drain clamping method without intraoperative bleeding control does not seem to affect the amount of blood loss and the need for transfusion when compared to intraoperative bleeding control in total knee arthroplasty patients. Hovewer, it is a simple and feasible method and can be used to decrease the operation time

Bilek güreşi sırasında humerusun spiral kırığı

Arm wrestling contests have become a common pub and even professional sport. Although armwrestling injuries are not common, several have been reported in the medical literature. In this case, spiral fracture of the humerus with large free fragments which had occurred during arm wrestling and occurring mechanism of injury was attracted attention. It is concluded that arm wrestling should not be considered a completely harmless sport and it appears appropriate to warn public and arm wrestler against arm wrestling.Bilek güreşi müsabakaları halk arasında ve hatta profesyonel sporcular arasında yaygın bir şekilde yapılmaktadır. Bilek güreşi yaralanmaları çok sık olmamasına rağmen, tıbbi literatürde bir kaç yayın rapor edilmiştir. Bu vakada bilek gü- reşi sırasında meydana gelen, serbest kemik parçası olan humerusun spiral cisim kırığına ve travmanın oluş mekanizmasına dikkat çekildi. Bilek güreşinin tamamiyle zarasız bir spor olarak düşünülmemesi gerektiği ve bilek güreşine karşı bu sporla uğraşan profesyonel sporcuların ve halkın uyarılmasının uygun olduğu sonucuna varıldı

Bilateral simultaneous mallet finger: An unusual case

Mallet finger is a deformity that a result of sudden and extreme forced flexion on extensor mechanism at the base of distal phalanx. In acute stage, it can be treated successfully by immobilization of distal interphalangeal joint with hyperextension splints. However, if there is volar subluxation of distal phalanx or fracture including more than 1/3 of articular surface of distal interphalangeal joint and in delayed cases, surgery is indicated. In this paper, 35 year old female patient who was treated by closed reduction and extension block technique in two weeks after the trauma because of the mallet finger deformity of 4th fingers of both hands is presented. Pins were removed after 6 weeks of the operation and range of motion of distal interphalangel joint was evaluated as full on the three months follow-up. Although conservative treatment is the choice for acute phase of trauma, we recommend surgical treatment in delayed cases and in the injuries involving the fractures more than 1/3 of articular surface

Meperidine, As An Effective Adjuvant Agentin Unilateral Spinal Anaesthesia For Knee Arthroscopy

Aim: Unilateral spinal anaesthesia permits early recovery and short ambulatory stay. Our study aimed to search if meperidine may prolong sensory block time when added to hyperbaric bupivacaine. Methods: This is a prospective, double blinded study: Ambulatory, 46 consenting patients aged 18-60 years, undergoing unilateral knee arthroscopy were randomized in two groups. saline group (n=20): 1.3 ml of hyperbaric bupivacaine and 0.2 ml of serum physiologic was used. Meperidine group (n=20): 1.3 ml of hyperbaric bupivacaine and 0.2 ml of 5% meperidine was used. Sensory block times, duration of spinal anaesthesia, intraoperative adverse effects and patient satisfaction were recorded. Results: Mean duration of sensory block was greater in the meperidine group compared with the saline group. Strict unilateral block and hypotension were comparable among groups. Conclusion: Addition of meperidine to hyperbaric bupivacaine in unilateral spinal anaesthesia prolonged analgesia without effecting total anesthesia time with minimal adverse effects

The frequently encountered orthopedic problems in playschool children and the level of avareness of their parents

Amaç: Afyon il merkezinde anaokulunda eğitim gören çocukların edinsel veya doğuştan gelen ortopedik problemleri saptamak ve ebeveynleri bu dönemde sıklıkla hekime getiren; düztabanlık, içe çarpık yürüme ve edinsel kalça çıkığı konularındaki bilgi düzeylerini ortaya koymaktı. Gereç ve yöntem: Afyon il merkezinde eğitim veren 26 anaokulda 1134 anasınıfı öğrencisinin ailelerine anket formu gönderilerek doldurulması istendi. Anket formu demografik ve ailesel bilgiler haricinde iki ana kısımdan oluşuyordu. İlk kısımda ortopedik özür listesi, ikinci kısımda bilgi soruları mevcuttu. Bilgi düzeyi saptanmasında düztabanlık için 10, içe çarpık yürüme için 5 ve edinsel kalça çıkığı için 10 soru soruldu. Yanıtlar doğru ve yanlış şeklinde belirtildi. Bilgi soruları her bir soruya eşit puan verilerek toplam 100 puan üzerinden değerlendirildi. Altmış puan ve üzeri alanlar başarılı kabul edildi. Bulgular: 810 (%71.4) anket formuna yanıt alınabildi. Toplam başarı puan ortalaması 32.8±18.8 bulunmuş, olup aileler araştırılan konuda yeterli bilgiye sahip bulunmamıştır. Annelerin %57.1’si lise ve yüksekokul mezunu iken, babalarının %74.2’si lise ve yüksek okul mezunu idi. Annelerin eğitim seviyesi arttıkça bilgi düzeyleri artmakta olup, ilköğretim ile lise (p=0.003) ve ilköğretim ile yüksekokul eğitimi (p=0.001) alan anneler arasında fark anlamlıydı. Ailelerin bildirimiyle elde edilen ortopedik problem içinde en fazla oranda içe çarpık yürüme ve düztabanlık saptanmıştır. Sonuç: Anaokulu döneminde içe çarpık yürüme ve düztabanlık sık görülen ve daha ziyade aile psikolojisini etkileyen sosyal içerikli problemlerdir. Kalça çıkığı ise erken tanı ile tedavi edilebilecek ciddi bir ortopedik rahatsızlıktır. Çalışma sonucunda saptanan ileri düzeyde ki bilgi yetersizlikleri verilecek eğitimlerle giderilebilir.Aim: The aim of this study is first to determine the congenital and acquired orthopedic problems in playschool children and second to determine the level of avareness of their parents about frequently seen orthopedics problems like pes planus, intoeing and developmental dysplasia of the hip (DDH) in Afyon city in Turkey. Material and Methods: A questionnaire was sent to the parents of 1134 playschool kids in 26 playschools in Af¬yon city center. The questionnaire comprised of two parts: the first part consisted of a list of orthopedic disorders and the second part included questions about these problems. Ten true or false questions were asked regarding pes planus; 5 for intoeing, another 10 for DDH. The overall evaluation was done over 100 points. Parents scoring over 60 were regarded as successful. Result: Eight hundred and 810 (%71.4) parents answered the questionnaire. The mean score was 32.8±18.8 which showed a lack of knowledge of the families. Fiftyseven point one of the mothers were undergraduates, whereas 74.2% of the fathers were graduates. As the level of mothers education increased, so did the level of knowledge. The difference between primary school graduates and high school graduates was significant (P=0.003). The difference between the primary school graduates and college graduates was also significant (P=0.001). The families most successfully reported pes planus and intoeing. Conclusions: Intoeing and pes planus are two commonly encountered problems in playschool children which are readily recognized by the families. DDH is another problem which needs early diagnosis for a timely and successful treatment. There is still lack of knowledge among the families of the playschool kids which can be improved by proper training of the families

Healing of osteochondral defects in canine knee with avocado/soybean unsaponifiables: a morphometric comparative analysis

Amaç: Bu çalışmada avocado/soya fasülyesinin sabunlaşmayan ekstresinin (ASE) köpek osteokondral defekt modelinde iyileşmeye etkisi belirlendi. Gereç ve yöntemler: On dört köpek çalışmaya alındı ve rastgele olarak iki gruba ayrıldı. Diz ekleminin troklear oluğunun lateral yüzünde iki adet osteokondral defekt oluşturuldu. Tedavi grubuna (grup 1; n=7) her üç günde bir 300 mg’lik ASE kapsülleri, kontrol grubuna (grup 2; n=7) ise normal diyet verildi. On beş hafta sonrasında ötenazi yapılana kadar hayvanlar kafesler içinde serbest gezinmeye bırakıldı. Dizler açılarak defektli troklear oluklar patolojik inceleme için çıkarıldı. Rejenere doku miktarı görüntü analiz yöntemiyle kantitatif olarak, doku içeriği ise Safranin-O ve Masson trikrom histokimyasal boyamaları ile semikantitatif olarak değerlendirildi. Transforme edici büyüme faktörü-beta (TGF-b) artışı, immünhistokimyasal boyama yöntemiyle semikantitatif olarak değerlendirildi. Bulgular: Morfometrik analiz sonucunda grup 1’de anlamlı ölçüde daha fazla immatür iyileşme dokusu saptandı (p<0.002). Grup 1’de rejenere dokuda hem kollajen hem de kondral doku içeriği anlamlı ölçüde artmıştı (p<0.002). Grup 2’ye kıyasla grup 1’de kıkırdak dokusunda TGF-b immün boyanma reaksiyonu çok daha belirgindi. Sonuç: Avocado/soya fasülyesinin sabunlaşmayan ekstresi ile yapılan tedavi, köpek dizinde osteokondral defekt iyileşmesini uyarmakta ve muhtemelen dokuda TGF-b’yı artırarak bu etkiyi sağlamaktadır.Objectives: This study aims to determine the effects of avocado/ soybean unsaponifiables (ASU) on healing in a canine osteochondral defect model. Materials and methods: Fourteen dogs were included in the study and randomly divided into two groups. Two osteochondral defects were produced in the lateral aspect of the trochlear groove of the knee joint. The treatment group (group 1; n=7) was given 300 mg ASU capsules every three days whereas the control group (group 2; n=7) was given a normal diet. Animals were then allowed to ambulate normally until euthanasia at 15 weeks. The knees were dissected and the trochlear grooves with defects were removed for pathological examination. The amount of regenerated tissue was determined quantitatively using image analysis and the tissue content was evaluated semi-quantitatively using Safranin-O and Masson trichrome histochemical stains. Transforming growth factor beta (TGF-b) increase was evaluated semiquantitatively with immunohistochemical staining methods. Results: Morphometric analysis revealed a significantly more immature repair tissue in group 1 (p<0.002). Both collagen and chondral tissue content of the regenerated tissue were significantly increased in group 1 (p<0.002). Compared to that in group 2, cartilage tissue in group 1 showed a much more marked immunostaining reaction of TGF-b. Conclusion: Avocado/soybean unsaponifiables treatment stimulates t he healing of t he osteochondral d efects in canine knee possibly by increasing TGF-b i n t he t issues