Biomechanical assessment of brachioradialis pronatorplasty

Objective: Transfer of the brachioradialis muscle, proposed by Ozkan et al. can be applied to cases, in which, the biceps rerouting technique is not appropriate for the correction of forearm supination contracture and restoration of active pronation. We have aimed to assess the biomechanical effects of the brachioradialis transfer

Chronic wrist pain in a goalkeeper; bilateral scaphoid stress fracture: A case report

Introduction: Bilateral scaphoid stress fractures are uncommon, and rarely presented with chronic wrist pain. Most fractures of the scaphoid heal with immobilization. Presentation of case The case presented here is of a bilateral stress fractures of the carpal scaphoid in a 19-year-old male.The patient had been playing as a goalkeeper and presented with a 4-year history of chronic pain in both wrists. We had a successful result in the treatment of these stress fractures with long- arm thumb plaster cast.Discussion Most fractures of the scaphoid in the immature skeleton heal with immobilization. Approximately 88–95% of acute scaphoid fractures are said to heal with conservative treatment using cast immobilisation. Non-surgical treatment is successful for scaphoid fractures in children and for those fractures which are non-displaced, stable, and where there is no damage to other bones or ligaments. In stable fractures, union is achieved within 8–12 weeks.Conclusion Bilateral stress fractures of the scaphoid can be considered for the wrist pain, especially for the patients that had repetitive minor wrist trauma, and in spite of developments in surgical techniques and materials used, treatment by plaster casting should still be considered initially for non-displaced, stable scaphoid stress fractures

Surgical treatment of type III acromioclavicular dislocation: Bosworth technique versus hook plating

WOS: 000453318400010PubMed ID: 30859165OBJECTIVE: In this study, it was compared the clinical results of the Bosworth technique and hook plating in acromioclavicular (AC) dislocations. METHODS: 44 patients are retrospectively evaluated in this study whom diagnosed as type III AC dislocations and treated by two different surgical methods in two different clinics. The patients were 30 males and 14 females with a mean age of 44 years (range, 18-80 years). The patients were divided into 2 groups according to the applied surgical technique. Group I comprised 25 patients to whom coracoclavicular fixation was applied by using the Bosworth technique. Group II comprised 19 patients to whom acromioclavicular fixation was applied by using hook plate. All patients are evaulated by The University of California at Los Angeles Shoulder Score (UCLA) and The disabilities of the arm, shoulder and hand (DASH) scoring system. RESULTS: The mean follow-up period was 23 months (range, 12-42 months). A statistically significant diffference was determined between the surgical groups in respect of the modified UCLA scale (p=0.012) and Quick DASH score (p=0.008). Hook plating group had better clinical results according to Bosworth group in terms of both UCLA and DASH score. A statistically highly significant negative correlation was determined between the UCLA and DASH scores (r=0.677, p=0.000). CONCLUSION: Although hook plating had better clinic outcomes compared to Bosworth technique, there is not seen difference between two groups in terms of the time of return to work. Treatment of the AC dislocation should perform early reconstruction for better reduction, fewer complications and higher levels of patient satisfaction

Effect of bone mineral density on functional and radiological results in conservatively treated distal radius fractures

WOS: 000409955700002Amaç: Bu çalışma, kapalı redüksiyon ve alçılama ile tedavi edilen distal radius kırıklarının, fonksiyonel ve radyografik sonuçları üzerine kemik mineral yoğunluğunun etkisini değerlendirmek üzere tasarlanmıştır. Gereç ve Yöntem: Distal radius kırığı nedeniyle kapalı redüksiyon ve kısa kol alçı ile tedavi edilen 52 hasta (21 erkek, 31 kadın, 31 sağ, 21 sol el bileği, ortalama yaş 63,4 (50-84)) çalışmaya alındı. Hastalar kemik mineral yoğunluğu ölçüm sonuçlarına göre düşük (grup 1, n=31) ve normal (grup 2, n=21) şeklinde gruplara ayrıldı. Gruplar iyileşme zamanı, son kontrollerin radyografik parametreleri ve Gartland-Werley fonksiyonel skorlarına göre karşılaştırıldı. Bulgular: Her iki grup kırık tipi, baskın taraf, cinsiyet dağılımı ve ortalama yaş bakımından homojendi (p=0,18; p=0,96, p=0,38 ve p=0,42). İki grup arasında radyal eğim kaybı (p=0,17), volar tilt kaybı (p=0,24) ve radyal kısalma miktarı (p=0,14) bakımından anlamlı farklılık yoktu. Aynı zamanda kaynama zamanı açısından gruplar arasında anlamlı farklılık yoktu (p=0,87). Düşük kemik mineral yoğunluğu olanlarda fonksiyonel skorlar anlamlı düzeyde daha düşüktü (p=0,03) ve kemik mineral yoğunluğu ve fonksiyonel sonuçlar arasında anlamlı pozitif bir ilişki bulundu (r=0,29, p=0,04). Fonksiyonel skorlar ile radyal kısalma miktarı, radyal inklinasyon ve volar tilt kaybı arasında anlamlı ilişki yoktu (p=0,53, p=0,38, p=0,57). Sonuç: Bu çalışma konservatif olarak tedavi edilen distal radius kırıklarında daha düşük kemik mineral yoğunluğu değerlerinin kaynama zamanı ve redüksiyon kaybı gelişimi üzerine anlamlı etkisi olmadığını ancak fonksiyonel sonuçları olumsuz etkilediğini göstermiştir.Objective: This study was designed to evaluate the effect of bone mineral density on functional and radiographic results of distal radius fractures, which were treated with closed reduction and casting. Materials and Methods: Fifty-two patients [21 males, 31 females, 31 right, 21 left-wrist mean age: 63.4 years (range, 50-84)] who were treated with closed reduction and short arm casting due to fracture of distal radius were included in this study. Patients were divided into groups according to bone mineral density (BMD) measurement results as low (group 1, n=31) and normal (group 2, n=21). Groups were compared according to healing times, radiographic parameters of the last controls and Gartland-Werley functional scores. Results: The fracture type, dominant side, gender distribution and mean age were homogeneous in both group (p=0.18; p=0.96, p=0.38 and p=0.42). There were no significant differences in terms of loss of radial inclination (p=0.17), the volar tilt loss (p=0.24) and the amount of radial shortening (p=0.14) between two groups. There was also no significant difference between the groups in terms of time to union (p=0.87). Functional scores were significantly lower in group with low BMD (p=0.03) and a significant positive correlation was found between BMD and functional results (r=0.29, p=0.04). There was no significant correlation between functional scores and amount of shortening, loss of radial inclination and volar tilt (p=0.53, p=0.38 and p=0.57). Conclusion: This study showed that, lower BMD scores have no significant effect on healing time and loss of reduction of conservatively treated distal radius fractures, however affect adversely the functional results