Comparison of two closed surgical techniques at isolated pediatric radial neck fractures

Introduction: This paper aims to compare the clinical and radiological results of children operated using elastic stable intramedullary nailing as described by Métaizeau to those with the closed reduction and percutaneous pinning (CRPP). Methods: Results of 21 pediatric patients with radial neck fracture who were treated by two pediatric surgeons between January 2011 and December 2013 were reviewed retrospectively. 10 were treated with the Métaizeau method versus 11 with the CRPP. Operation time, fluoroscopic exposure time, Mayo elbow performance score (MEPS) and radiological assessment at final follow-up 1 year or greater and complications were main outcome measures. Results: The MEPS were excellent in all the patients of both groups. Reduction quality was excellent in 8 patients and good in 2 of the Métaizeau, and excellent in 9 and good in 2 of the CRPP. The fluoroscopy and operating times were statistically significantly greater, 3-fold and 2-fold respectively, in the Métaizeau method compared to the CRPP with comparable functional and radiological results. Conclusion: Surgeon should adhere to a closed surgical method of his/her experience for excellent result. Level of evidence: Therapeutic Level III. © 2018 Elsevier LtdOn behalf of authors I hereby confirm that author Mahmut KALEM, author Kerem BAŞARIR, author Hakan KOCAOĞLU, and author Ercan ŞAHİN declare that they have no conflict of interest. Author Hakan KINIK has received a speaker honorarium from Smith&Nephew Plc. This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors

Impact of echocardiography on one-month and one-year mortality of intertrochanteric fracture patients

Objective: The aim of this study was to analyze the effects of preoperative echocardiography on patient survival, timing of surgery in length of hospital stay in patients who will undergo hip nailing for an intertrochanteric fracture. Methods: The clinical records of the patients who were admitted to a tertiary university hospital with an intertrochanteric femur fracture were retrospectively analyzed. The age, gender, American Society of Anesthesiologists (ASA) score, days to surgery, total hospital stay, cardiac drug prescription/modification, cardiac intervention and presence of an echocardiography assessment including detailed findings were reviewed. Mortality data were accessed from the national civil registration system. Results: 181 (110 women and 71 men; mean age 81 (44–98)) cases were studied whom 65 underwent pre-operative echocardiography. Time to surgery and total hospital stay was 2 days longer at transthoracic echocardiography (TTE) group (p < 0.001). At one month control group survival rate was 93.1% on contrary it was 75.4% at TTE group. One-year survival rates were 77.3% and 55.1% respectively. Likewise mean expected survival time was 21.6 ± 1.03 months for control group and 15.12 ± 1.64 months for TTE group (p < 0.001). Only increased left ventricular end diastolic diameter (LVEDD) was showed to be associated with increasing one-year mortality with a hazard ratio of 10.78 (2.572–45.19) at multivariate model. Conclusion: Cardiac findings and requisite for preoperative TTE and increased LVEDD is a strong predictor for mortality. TTE significantly lengthens the time to surgery. Also LVEDD measurement can be easily performed in the bedside which we believe would save time and reduce mortality. Level of evidence: Level III Diagnostic study. © 2017 Turkish Association of Orthopaedics and Traumatolog

P‐T‐t evolution of the Cycladic blueschist unit in Western Anatolia / Turkey: Geodynamic implications for the Aegean region

International audienceEclogite and blueschist facies rocks occurring as a tectonic unit between the underlying Menderes Massif and the overlying Afyon Zone / Lycian Nappes and the Bornova Flysch Zone in western Anatolia represent the eastward continuation of the Cycladic Blueschist Unit in Turkey. This high-P unit is attributed to the closure of the Pindos Ocean and consists of (i) a Triassic to Upper Cretaceous coherent series derived from passive continental margin sediments and (ii) the tectonically overlying Upper Cretaceous Selçuk mélange with eclogite blocks embedded in a pelitic epidote-blueschist matrix. The coherent series has experienced epidote-blueschist facies metamorphism (490 ± 25°C / 11.5 ± 1.5 kbar; 38 km depth). 40 Ar/ 39 Ar white mica and 206 Pb/ 238 U monazite dating of quartz metaconglomerate from coherent series yielded middle Eocene ages of 44 ± 0.3 and 40.1 ± 3.1 Ma for epidote-blueschist facies metamorphism, respectively. The epidote-blueschist facies metamorphism of the matrix of the Selçuk mélange culminates at 520 ± 15°C / 13 ± 1.5 kbar, 43 km depth, and is dated 57.5 ± 0.3-54.5 ± 0.1 Ma (40 Ar/ 39 Ar phengite). Eclogite facies metamorphism of the blocks (570 ± 30°C / 18 ± 2 kbar, 60 km depth) is early Eocene and dated at 56.2 ± 1.5 Ma by 206 Pb/ 238 U zircon. Eclogites experienced a nearly isothermal retrogression (490 ± 40°C / ~ 6-7 kbar) during their incorporation into the Selçuk mélange. The retrograde overprints of the coherent series (410 ± 15°C / 7 ± 1.5 kbar from Dilek Peninsula and 485 ± 33°C / ~ 6-7 kbar from Selçuk-Tire area) and the Selçuk mélange (510 ± 15°C / 6 ± 1 kbar) are dated at 35.8 ± 0.5-34.3 ± 0.1 Ma by 40 Ar/ 39 Ar white mica and 31.6 ± 6.6 Ma by 206 Pb/ 238 U allanite dating methods, respectively. Regional geological constrains reveal that the contact between the Menderes Massif and the Cycladic Blueschist Unit originally formed a lithosphere-scale transform fault zone. 40 Ar/ 39 Ar white mica age from the contact indicates that the Cycladic Blueschist Unit and the Menderes Massif were tectonically juxtaposed under greenschist facies conditions during late Eocene, 35.1 ± 0.3 Ma