A New Repair Technique in Pronator Quadratus in Management of Distal Radius Fracture: Comparison with Primary Repair and Unrepaired Techniques

Objective We aimed to compare the functional and clinical results between our new repair technique in the groups with and without pronator quadratus (PQ) repair in distal radius fractures treated with plate fixation using the volar approach.Methods The medical records of patients who underwent open reduction and volar plate fixation due to distal radius fracture between 2018 and 2020 were studied. In group A, PQ cannot be sutured or tension may occur, the intact radial fascia of the deep anterior fascia (DAF) was placed under the flexors toward the PQ and it was sutured with a 3-0 slow-absorbable monofilament suture to DAF. In group B, no repair was performed. In group C, PQ was sutured with traditional method. Range of motion (ROM) of wrist and handgrip strengths were measured at final examination. Pain was assessed with Visual Analogue Score (VAS), and functional status was evaluated with Quick - Disabilities of the Arm, Shoulder, and Hand (DASH). Complications which included tendinopathy, neuritis, tendon rupture due to plate irritation, implant failure, and malunion were also compared.Results Seventy-seven patients (group A, 21, group B, 24, group C, 32 patients) were included in the final follow-up examination who met our inclusion criteria. Among the clinical, functional, and radiological results such as ROM, VAS, DASH, grip strength, and complications in the all group at a mean postoperative of 16.6 months no significant difference was observed.Conclusion Although there was no significant difference between the groups in this study, we think that covering the plate may prevent long-term complications

KARPAL TÜNEL SENDROMU OLAN BİR HASTADA STEROİD ENJEKSİYONUNUN KOMPLİKASYONU OLARAK "PERİTENDİNÖZ FİBROZİS"

Karpal tünel sendromunun tedavisi konservatif ve cerrahi metodlar olmak üzere iki büyük gruba ayrılır. Steroid enjeksiyonu bu hastalarda ağrıyı azaltmak amacıyla kullanılabilmektedir. Bu enjeksiyon literatürde iğne ucu sinire temas etmediği takdirde oldukça güvenli bir metod olarak görülmektedir. Bu çalışmada karpal tünele steroid enjeksiyonu yapılmış bir hastanın tedavi sonuçlarını sunmaktayız. Dış merkezde karpal tünele steroid enjeksiyonu yapılan hastanın  el bileği harektleri kısıtlanmış, ağrısı ise giderek artmış. Bu şikayetler ile tarafımıza başvuran hastada enjeksiyon nedeni ile oluşan fibröz dokular cerrahi olarak temizlendi. Debritman sonrası el ve el bileği eklem hareket açıklıkları normale dönen hastanın şikayetleri geriledi. Biz bu çalışmamızda karpal tünel enjeksiyonunun tamamen güvenli bir metod olmadığını, sendromun tedavisinde etkisinin kısıtlı ve geçici olduğunu vurgulamayı amaçlıyoruz

ULNAR SİNİRİN KOMMON PALMAR DİJİTAL DALININ NADİR GÖRÜLEN NÖROFİBROLİPOMU

Nörofibrolipom nadir görülen bir ortopedik patolojidir ve pekçok terim bu kitleyi tanımlamak için tarih boyunca kullanılmıştır. Nörofibrolipom sıklıkla el ve ayak parmaklarını tutar. Muayene esnasında saptanan bir kitleye bu tanıyı koyabilmek için biopsi sonrası patolojik inceleme şarttır. Nörofibrolipomlar sadece semptomatik olduklarında çıkarılmaları önerilmektedir. Asemptomatik vakalar güvenle takip edilebilir. Sunmuş olduğumuz vakamızda biopsi sonrası hastanın tüm şikayetleri gerilemesi üzerine kitle çıkarımı için ikincil operasyon yapılmadı. Biopsi sonrası nörofibrolipom tanısı doğrulanan hastalarda kitle çıkarılması için çok acele edilmemesinin gereksiz ikincil operasyonların önüne geçeceğine inanmaktayız

Efficacy and safety of folfiri plus aflibercept in second-line treatment of metastatic colorectal cancer: Real-life data from Turkish oncology group

Aims: The addition of aflibercept to the fluorouracil and irinotecan (FOLFIRI) regimen significantly improved clinical outcomes in patients with metastatic colorectal cancer (CRC) previously treated with oxaliplatin. We aimed to investigate the efficacy and safety of second-line FOLFIRI and aflibercept combination in patients with metastatic CRC in real-life experience. Materials and Methods: Four hundred and thirty-three patients who treated with FOLFIRI and aflibercept in the second-line were included in the study. The clinical and pathological features of the patients were recorded retrospectively. Survival (overall and progression-free survival [PFS]), response rates, and safety data were analyzed. Results: The median age was 61. Majority of patients (87.5%) received first-line bevacizumab and 10.1% of patients received anti-epidermal growth factor receptor agents. About 80% of patients had KRAS, 18.6% of patients had NRAS, and 6.4% of patients had BRAF mutations. The median OS was 11.6 months (95% confidence interval [CI], 10.6-12.6) and the median PFS was 6 months (95% CI, 5.5-6.5). About 4.6% of patients had complete response and 30.6% of patients had partial response as best tumor response. Grade 1-2 toxicities were seen in 33.4% of patients, while grade 3-4 toxicities were recorded in 27% of patients. Eight patients (2%) died due to treatment toxicity. Conclusions: Overall and PFS were similar in routine clinical practice compared to phase III pivotal VELOUR trial. However, response rates were found to be higher. It was observed that there were fewer adverse events compared to the VELOUR trial