Erişkin kalça displazisinin değerlendirilmesinde normal radyolojik ölçüm değerleri; Anadolu toplumunda 1732 sağlıklı kalçanın değerlendirilmesi

Objectives: The purpose of this study is to determine the normal values of radiographic measurements used for the assessment of hip joint, particularly focusing on the hip dysplasia, on healthy young adults in Anatolian population. Materials and methods: This prospective study consisted 866 subjects ( > 18 years of age) without clinical evidence of hip disorder who underwent anterior-posterior (AP) x-ray of pelvic region for routine screening in our institution. Acetabular angle of Sharp, center edge angle, ACM angle, acetabular index, and Reimer's migration index were measured. Normative data regarding radiographic parameters were presented for both gender and body side and statistical comparison was performed between gender and body sides. Results: CE angles (M: 30.3±3.4 vs F: 28.8±2.7) and ACM (M: 41.0±1.8 vs F: 40.5±1.8) angles were higher in male subjects; AI (M: 3.5±0.6 vs F: 3.8±0.9) and Sharp angle (M: 37.9±2.5 vs F: 38.5±2.1) was higher in female subjects. Reimer's migration index was similar between genders (M: 12.6±3.5 vs F: 13.0±3.6). All measured variables were statistically different between body sides, except AI in male subjects. Conclusion: We emphasize that normal limits of acetabular angles obtained from our own population should be used as reference values in various orthopedic operations regarding acetabular region.Çalışmanın amacı, sağlıklı Anadolu insanında kalça ekleminin, özellikle de kalça displazinin değerlendirilmesi amacı ile normal radyolojik parametrelerinin saptanmasıdır. Hastalar ve metot: Prospektif olarak yapılan çalışmamıza, klinik olarak herhangi kalça rahatsızlığı bulunmayan ve merkezimizde rutin tarama amaçlı pelvik bölgeyi içeren, ön-arka direkt grafisi çekilmiş 866 erişkin hasta ( 18 yaşından büyük) dahil edilmiştir. Asetabular Sharp açısı, CE açısı, asetabular indeks (AI), ACM açısı ve Reimer’in migrasyon indeksi standart radyografiler üzerinden ölçüldü. Her iki cinsiyet ve her iki taraf kalça için ayrı olarak normal değerler saptanıp istatistiksel karşılaştırma yapılmıştır. Sonuçlar: CE (E: 30.3±3.4 - K: 28.8±2.7) ve ACM açıları (E: 41.0±1.8 - K: 40.5±1.8) erkek hastalarda istatistiksel olarak yüksek iken; AI (E: 3.5±0.6 -K: 3.8±0.9) ve Sharp açıları (E: 37.9±2.5 -K: 38.5±2.1) bayanlarda daha fazla idi. Reimer’in migrasyon indeksi cinsiyetler arasında benzer değerlere sahipti (E: 12.6±3.5-K: 13.0±3.6). Erkek hastalardaki AI (asetabular indeks) açıları haricinde tüm parametreler her iki cinste de sağ ve sol kalça için farklı idi. Çıkarımlar: Asetabular bölgeyi içeren ortopedik cerrahi işlemlerde kendi toplumumuzdan elde edilmiş normal asetabular açı değerlerinin kullanılmasını vurgulamaktayız

Effect of long-term use of bisphosphonates on forearm bone: Atypical ulna fractures in elderly woman with osteoporosis

Osteoporosis is a common musculoskeletal disease of the elderly population characterized by decreased bone mineral density and subsequent fractures. Bisphosphonates are a widely accepted drug therapy which act through inhibition of bone resorption and prevent fractures. However, in long-term use, atypical bisphosphonate induced fractures may occur, particularly involving the lower weight bearing extremity. Atypical ulna fracture associated with long-term bisphosphonate use is rarely reported in current literature. We present a 62-year-old woman with atypical ulna due to long-term alendronate therapy without a history of trauma or fall. Clinicians should be aware of stress fracture in a patient who has complaints of upper extremity pain and history of long-term bisphosphonate therapy

Predicción de la presencia del tendón del músculo plantar mediante el examen del tendón del músculo palmar largo. ¿hay una relación?

WOS: 000339241600035The purpose of this study was to investigate the relationship between palmaris longus (PL) and plantaris (P) tendons and test the clinical usefulness of symmetry patterns between these tendons in Turkish population. This prospective study comprised a total of 240 adult patients (120 men and 120 women) who were admitted to our outpatient clinic with bilateral knee complaints that required bilateral knee MR examination during two years. Standard test (Schaefer's test, oppose the thumb to the little finger while flexing the wrist) was used to assess the presence of the PL tendon both with inspection and palpation. Knee MRI was used to determine the presence of P muscle belly on both sides. We have analyzed symmetric distribution pattern using Mc-Nemar test. The PL was absent unilaterally in 34 subjects (14.2%), while it was absent bilaterally in 17 subjects (7.1%). The P was absent unilaterally in 51 subjects (21.3%), while it was absent bilaterally in 10 subjects (4.2%). If PL was absent in one hand, the chance of having an ipsilateral P tendon was 70.6%. If PL was present in one hand, the chance of having an ipsilateral P tendon was 87.6%. The Mc-Nemar test for symmetry yielded a p value of 0.841 for ipsilateral PL and P muscles. A clear-cut link between Palmaris longus and plantaris tendons could not be demonstrated in this study. Both muscles show different variations independent from each other.El propósito de este estudio fue investigar la relación entre los tendones del músculo palmar largo (MPL ) y músculo plantar (MP) y poner a prueba la utilidad clínica de los patrones de simetría entre estos tendones de la población turca. Estudio prospectivo realizado sobre 240 pacientes adultos (120 hombres y 120 mujeres) que ingresaron en la clínica por síntomas de dolor en la rodilla bilateralmente, quienes requerían un examen de RM de rodilla durante dos años. Se utilizó la prueba estándar (prueba de Schaefer, se oponen el pulgar hasta el dedo mínimo, mientras se flexiona la muñeca) para evaluar la presencia del tendón MPL tanto con la inspección y palpación. La RM de la rodilla se utilizó para determinar la presencia de vientre muscular plantar en ambos lados. Se analizó el patrón de distribución simétrica mediante la prueba de McNemar. El tendón del MPL estuvo ausente de manera unilateral en 34 pacientes (14,2%) y bilateralmente en 17 pacientes (7,1%). El tendón del MP estuvo ausente de manera unilateral en 51 pacientes ( 21,3 %) mientras que bilateralmente no estaba en 10 pacientes (4,2%). Si el tendón del MPL estuvo ausente en un lado, la probabilidad de tener un tendón del MP ipsilateral fue del 70,6 %. Si el tendón del MPL estaba presente en un lado, la probabilidad de tener un tendón del MP ipsilateral fue 87,6%. La prueba de McNemar - simetría produjo un valor p de 0,841 para los músculos PL y P ipsilaterales. Una relación directa claro entre los tendones de los músculos PL y P no se pudo demostrar en este estudio. Ambos músculos muestran diferentes variaciones independiente uno del otro

Long-Term results of mini-open repair technique in the treatment of acute achilles tendon rupture: A prospective study

WOS: 000382257000018PubMed ID: 27289216An ideal surgical treatment of acute Achilles tendon rupture includes restoring the original length of the tendon, minimizing possible adhesions with the surrounding tissues, minimizing the risk of repeat rupture, alleviating wound problems, and providing an acceptable cosmetic outcome. In the mini-open repair technique, unlike the percutaneous repair technique, the quality of the tenodesis can be visualized without disturbing the healing potential of the surrounding tissues, thus minimizing wound problems. The purpose of the present study was to assess the long-term results of the mini-open repair technique in patients with acute Achilles tendon rupture. A total of 20 consecutive patients with acute Achilles tendon rupture, admitted to our inpatient clinic from October 2003 to March 2008, were included in the present study. The patients underwent Achilles tenodesis with the mini-open repair technique, and each patient was followed up for 5 years. The study was completed in April 2013. The surgical procedure was performed with the assistance of a device designed in our orthosis laboratories, similarly to that defined by Assal et al. Of the 20 patients, 18 were male and 2 were female. Their mean age was 39.3 (range 21 to 55) years. The Achilles tendon rupture was located on the left side in 15 patients (75%) and on the right side in 5 patients (25%). The mean follow-up duration was 58.5 (range 18 to 60) months and no complications occurred during the follow-up period, including repeat rupture, wound site infection, and sural nerve injury. The mean American Orthopaedic Foot and Ankle Society scale score for the patients was 99.2 (range 94 to 100) points at the final follow-up visit. All our patients were able to return to work and sporting activities. According to the Trillat scores, the outcome was excellent in 19 patients and good in 1 patient at the 18th postoperative month. No complaint, such as pain or loss of function, that might have a negative effect on the patients' business or social life was detected in 18 patients who were assessed at 5 years after surgery; 2 patients could not be reached at 5 years. In conclusion, as a technique combining percutaneous and open surgical techniques, mini-open repair of Achilles tendon rupture allows a satisfactory end-to-end approximation of the tendon just in the open surgery and provides the wound healing advantages of percutaneous surgery

Comparing Dimensions of Four-Strand Hamstring Tendon Grafts with Native Anterior and Posterior Cruciate Ligaments

Background. The aim of the study was to evaluate whether or not there was any incompatibility between four-strand hamstring tendons taken from the same knee and the dimensions of the ACL and PCL. Methods. 15 fresh frozen cadaver hamstrings were prepared as four-strand grafts and measurements made of the ACL and PCL circumferences in the midsection were made in the narrowest part of the midsection. The cross-section areas and diameters were calculated with geometric calculations used to measure the cross-sectional area of cylinders. Accepting that the geometric insertions were elliptical, the length, width, and area were calculated for entry areas. Results. A significant relationship at 96.2% was determined between the ACL mid and the hamstring diameter. A significant relationship at 96.7% was determined between the ACL and the hamstring mid area. A significant relationship at 96.4% was determined between the PCL mid and the hamstring diameter. A significant relationship at 95.7% was determined between the PCL and the hamstring mid area. Conclusion. For the reconstruction of ACL and PCL, it was determined that there is less incompatibility between the four-strand hamstring tendons taken from the same knee and the dimensions of the midsection PCL compared to the ACL dimensions

Is denervation surgery possible in the treatment of hallux rigidus? An anatomic study of cadaveric specimens

Objective: The aim of this study was to provide anatomic considerations in the first metatarsophalangeal joint (FMPJ) innervation and to evaluate the feasibility of the denervation surgery in the treatment of hallux rigidus. Methods: In this cadaveric study, 14 fresh frozen cadaveric transtibial amputation specimens was used. For nerve dissection, dorsal and plantar longitudinal incision centered over the FMPJ were performed. Deep peroneal and dorsomedial cutaneous nerves were dissected in the dorsal aspect of the joint. Medial plantar nerve branches, medial and lateral hallucal nerves, were dissected in the plantar aspect of the joint. The presence, number, and location of articular branches to the FMPJ capsule were recorded. Dorsal and plantar incision length for proper dissection were also recorded. Results: Nerve dissection of the 14 specimens revealed the following number of articular branches from the relevant nerves: 14 from dorsomedial cutaneous nerves, 11 from deep peroneal nerves, 6 from medial hallucal nerve, and 5 from lateral hallucal nerve. Dorsal incision mean length was 60.53 (range, 42.48-85.12) mm, and the plantar incision mean length was 88.08 (range, 77.32-111.21) mm. Conclusion: Evidence from this study has shown that partial dorsal denervation of the FMPJ may be a technically feasible procedure along with the presence of superficially easily dissected nerves with relatively small incision

Soft tissue tumors

Soft tissue tumors constitute a large group of tumors with diverse histopathological types. Mesenchymal tissues such as fibrous, lipomatous, vascular, synovial, and muscular tissues are described within this group. Neural sarcomas of neuroectodermal origin are also considered in this group due to their similar clinical and pathological characteristics (Enzinger FM, Weis SW (1995) Soft tissue tumors, 3rd edn. Mosby, St Louis). Soft tissue tumors may present with different histological, clinical, radiological, and pathological features within a wide range of anatomical locations, and thus diagnosis and treatment of these tumors require a multidisciplinary approach. Diagnostic evaluation of soft tissue tumors is critical as many benign soft tissue lesions may be confused with rare sarcomas

Turkish version of the body image quality of life inventory (BIQLI): A validity and reliability study

Amaç: Beden imgesi sadece kişinin fiziksel görünüşü ile sınırlı olmayan, kişinin bedeni ve kendilik algısına karşı tutumlarını da içeren çok boyutlu bir yapıdır. Bu çalışmada, Beden İmgesinin Yaşam Niteliğine Etkisi Ölçeği'nin (BİYNEÖ) Türkçe formunun geçerlilik ve güvenilirliğinin incelenmesi ve psikometrik özelliklerinin değerlendirilmesi amaçlanmıştır. Yöntem: Gerekli izinlerin alınmasından sonra, ölçeğin önce Türkçe dil ve kültür uygunluğu çalışılmış, daha sonra Ankara'da bir üniversitede yüksekokula devam eden, araştırmaya katılmaya gönüllü 275 kız öğrenciye uygulanmıştır. BİYNEÖ'nün faktör yapısını ortaya koymak üzere faktör analizi yapılmıştır. Ölçüt geçerliliğini sınamak amacıyla eş zamanlı Sosyal Görünüş Kaygısı Ölçeği (SGKÖ) uygulanmış, iç tutarlılığına bakılarak testtekrar test güvenilirliği sınanmıştır. Sonuçlar: Faktör analizi sonuçlarına göre, ölçeğin özgün formundan farklı olarak bir faktörlü olmayıp dört faktörlü (kendilik değeri üzerine etki, günlük yaşantı üzerine etki, karşı cinsle etkileşime etki, davranış/tutum üzerine etki) bir yapıda olduğu belirlenmiştir. BİYNEÖ için iç tutarlılık katsayısı 0.89, test-tekrar test güvenilirlik katsayısı 0.92 olarak bulunmuştur. BİYNEÖ ile SGKÖ arasında -0.62 değerinde negatif yönde, güçlü ve anlamlı bir ilişki olduğu saptanmıştır. Tartışma: Beden İmgesinin Yaşam Niteliğine Etkisi Ölçeğinin Türkçe sürümü (BİYNEÖ), Türk toplumunda kullanılmak için yeterli düzeyde geçerlilik ve güvenilirlik değerlerine sahip bir ölçektir.Objective: Body image is a multidimensional structure that not only limited with person's physical appearance but also contains person's attitudes towards one's body and self-perception. The Body Image Quality of Life Inventory (BIQLI) was developed to measure the quantities the effects of one's body image on various self-experience and life contexts. In this study, it is aimed to examine the validity and reliability of the Turkish version of BIQLI and to evaluate the psychometric properties. Methods: After obtaining the necessary permissions, Turkish language and cultural appropriateness of the inventory has been studied firstly. Research was conducted with 275 volunteers who attend a university college education female student in Ankara. The Social Appearance Anxiety Scale (SAAS) was used for the criterion validity. In order to determine the construct validity of Body Image Quality of Life Inventory (BIQLI), factor analysis was conducted. Results: Factor analysis yielded four factors: effect on the self-value, effect on daily life, and effect on interaction with opposite sex, effect on behavior/attitude. The Cronbach's alpha for the BIQLI was 0.89. The computed test-retest reliability coefficient for the BIQLI was 0.92. It was found a correlation which was strong negative and significant (r=-0.62) between BIQLI and SAAS. Discussion: The Turkish version of BIQLI is an inventory which has sufficient reliability and validity for use in Turkish society

Reconstruction of traumatic composite tissue defect of medial longitudinal arch with free osteocutaneous fibular graft

WOS: 000370657600029PubMed ID: 25459091A 34-year-old male sustained a crush injury resulting in bone and soft tissue loss along the medial longitudinal arch of his left foot. Specifically, the injury resulted in loss of first metatarsal without injury to the medial cuneiform or proximal phalanx, fracture of the third metatarsal, and a 5-cm x 9-cm soft tissue defect overlying the dorsomedial aspect of the right foot. After debridement and daily wound care, the defect was subsequently reconstructed using a free osteocutaneous fibular graft. Approximately 6 months after reconstructive surgery, the patient returned to his job without pain, and his pedogram showed almost equal weightbearing distribution on both feet