Does pelvic injury trigger erectile dysfunction in men?

WOS: 000442089500008PubMed ID: 26764545Purpose: Pelvic ring fractures constitute 3%-8% of all fractures of the skeletal system and are generally related with high energy trauma. Sexual dysfunction following pelvic fracture has a high incidence, and affects the male patients both physically and psychologically. In this study, we aimed to investigate the impact and frequencies of comorbidities such as erectile dysfunction (ED) with adverse sociocultural and psychological consequences for the patient who had a pelvic ring fracture. Methods: This study included 26 men who corresponded to the inclusion criteria and agreed to participate our study. Results: According to fracture types, most of our cases were Tile type A1 and type A2. Severe and moderate ED were detected in 46.1% (12/26) of these patients via the International Index of Erectile Function-5 questionnaire. Conclusion: ED develops following pelvic fractures, especially in Tile type B and C pelvic fractures

Comparisons between ultrasonographic screening results and risk factors of developmental dysplasia of the hip

Amaç: Çalışmamızın amacı ultrasonografik taramanın seçilmiş hastalarda mı (risk faktörleri ya da muayene bulguları olan) ya da genel popülasyon üzerinde mi yapılması gerektiğini değerlendirmektir. Gereç ve Yöntem: Kliniğimize 2010-2012 gelişimsel kalça displazisi (GKD) taraması amacıyla başvuran 634 bebek çalışmaya dâhil edildi. Risk faktörleri olarak aile öyküsü, makat gelişi, tortikollis, ilk gebelik, oligohidramniyos, çarpık ayak, kız cinsiyet olarak belirlendi. Graf metodu ile yenidoğan kalçaları taranarak, hastalardaki risk faktörleri ve klinik muayene bulguları istatistiksel olarak duyarlılık ve özgüllük açısından karşılaştırıldı. Bulgular: Çalışmaya alınan 634 bebeğin 403'ü kız, 231'i erkekti. Hastaların ortalama yaşı 87,45±49,6 gündü. Ortalama anne yaşı 29,6±5,4 yıldı. Ultrasonografik tarama sonucunda 66 bebeğin 71 kalçası displazik bulundu. Bu kalçalardan 30'u Tip 2b, 8 kalça Tip 2c, 3 kalça Tip d, 23 kalça Tip 3, 7 kalça Tip 4 olarak tespit edildi. Sonuç: Çalışmamızda klinik bulguların GKD taraması açısından yeterli olmadığı sonucuna ulaşılmıştır. Bu nedenle de özellikle ülkemiz gibi GKD prevelansının sık görüldüğü ülkelerde seçilmiş hastalara ultrasonografik tarama yapmaktansa tüm popülasyonun ultrasonografik taramasının yapılması gerektiği düşüncesindeyiz.Objective: The aim of the study is to evaluate the efficacy of ultrasonographic screening in general population and selected patients (who had risk factors or clinical findings) for developmental dysplasia of the hip (DDH).Material and Methods: 634 babies who had been admittted to our clinic between 2010 and 2012 were included in the study. Family history, breech presentation, torticollis, first child, oligohydramnios, club foot, and female gender were accepted as risk factors. The newborns patients were evaluated with Graf method. Risk factors and clinical findings of the patients were compared with these results for sensitivity and specificity. Results: 403 patients were female and 231 patients were male. The mean age of the patients were 87.45±49.6 days and the mean maternal age was 29.6±5.4 years. In the screeening of the patients 66 babies with 71 hips were dysplasic (30 hips Type 2b, 8 hips Type 2c, 3 hips Type d, 23 hips Type 3, and 7 hips Type 4).Conclusion: According to our study, clinical examination of the patients is not sufficient for the screening of the babies for DDH. We think that the ultrasonographic screening of the babies for DDH is recommended for general population of high risk countries like Turkey

The influence and role of healthcare personnel in the football industry

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Compartment syndrome following arthroscopic removal of a bullet in the knee joint after a low-velocity gunshot injury

WOS: 000411019200017PubMed ID: 26929809Gunshot injuries are getting more frequently reported while the civilian (nongovernmental) armament increases in the world. A 42-year-old male patient presented to emergency room of Istanbul Medipol University Hospital due to a low-velocity gunshot injury. We detected one entry point on the posterior aspect of the thigh, just superior to the popliteal groove. No exit wound was detected on his physical examination. There was swelling around the knee and range of motion was limited due to pain and swelling. Neurological and vascular examinations were intact. Following the initial assessment, the vascular examination was confirmed by doppler ultrasonography of the related extremity. There were no signs of compartment syndrome in the preoperative physical examination. A bullet was detected in the knee joint on the initial X-rays. Immediately after releasing the tourniquet, swelling of the anterolateral compartment of the leg and pulse deficiency was detected on foot in the dorsalis pedis artery. Although the arthroscopic removal of intra-articular bullets following gunshot injuries seems to have low morbidity rates, it should always be considered that the articular capsule may have been ruptured and the fluids used during the operation may leak into surrounding tissues and result in compartment syndrome

Hybrid external fixation via a minimally invasive method for tibial pilon fractures -Technical note

Introduction: We aimed to present the clinical and radiological outcomes of patients with tibial pilon fractures who were treated with hybrid external fixators. Shanz screws were applied synchronously and used as joysticks for fracture reduction. Radiological evaluations were conducted on roentgenograms at the second week, sixth week, third month and first year. Material and methods: The study group included 42 patients with tibial pilon fractures that were classified as 43C according to the AO/OTA classification system. We used 2-hydroxyapatite-coated Schanz screws for the tibial pilon reduction. Schanz screws fixated to two separate motors were synchronously passed through the fracture fragments. An external fixator was applied after the fracture was stabilized with Schanz screws. Results and discussion: The mean operation duration was 45 min Fracture healing was observed in all patients, and the mean fracture healing time was 17 (range, 12-32 weeks) weeks. The mean lateral distal tibial angle was 89°. Joint surface irregularity was not observed in any patient. All of the patients had 0-15° of ankle dorsiflexion. None of the patients had restricted ankle plantar flexion. No wound complications were observed. According to the AOFAS scoring system, the clinical evaluation was excellent in 26 patients, good in 14 patients and fair in 2 patients. Malunion and nonunion may necessitate additional surgical procedures, delay the return to activities of daily living, and increase treatment costs. Good alignment was achieved, with a mean lateral distal tibial angle of 89 (range, 84-92) degrees. Conclusion: Permanent hybrid external fixator applied using Schanz screws via a mini open technique is a fast, easily applied alternative with low morbidity and satisfying results

A new mini-external fixator for treating hallux valgus: A preclinical, biomechanical study

WOS: 000367071200010PubMed ID: 26190777Proximal metatarsal osteotomy is the most effective technique for correcting hallux valgus deformities, especially in metatarsus primus varus. However, these surgeries are technically demanding and prone to complications, such as nonunion, implant failure, and unexpected extension of the osteotomy to the tarsometatarsal joint. In a preclinical study, we evaluated the biomechanical properties of the fixator and compared it with compression screws for treating hallux valgus with a proximal metatarsal osteotomy. Of 18 metatarsal composite bone models proximally osteotomized, 9 were fixed with a headless compression screw and 9 with the mini-external fixator. A dorsal angulation of 10 degrees and displacement of 10 mm were defined as the failure threshold values. Construct stiffness and the amount of interfragmentary angulation were calculated at various load cycles. All screw models failed before completing 1000 load cycles. In the fixator group, only 2 of 9 models (22.2%) failed before 1000 cycles, both between the 600th and 700th load cycles. The stability of fixation differed significantly between the groups (p < .001). The stability provided by the mini-external fixator was superior to that of compression screw fixation. Additional testing of the fixator is indicated.Bezmialem Vakif University, Scientific Research Projects Department [9.2012/8]The present study was funded by Bezmialem Vakif University, Scientific Research Projects Department (grant 9.2012/8)

The effect of anterior cruciate ligament reconstruction and RAMP lesion repair on psychological status

Background: There are few studies examining anterior cruciate ligament reconstruction (ACLR) and RAMP lesion repair. However, no studies have investigated the level of functional performance and psychological state after ACLR and all-inside RAMP lesion repair. Hypothesis/Purpose: The aim of this study is to determine the effect of ACLR and RAMP lesion repair on psychological status. ACLR and meniscal RAMP lesion repair were hypothesized to be associated with better psychological outcomes. Study Design: This is a cohort study. Methods: Patients who underwent ACLR with semitendinosus and gracilis autografts by a single surgeon were determined retrospectively. Fifteen patients who underwent ACLR and all-inside meniscus RAMP lesion repair (ACLR-RR) and 15 patients who underwent isolated ACLR were compared. Patients were evaluated by a physiotherapist at least 9 months after surgery. The primary outcome measure was anterior cruciate ligament-return to sports after injury (ACL-RSI), and the psychological status of the patients was examined. Secondary outcomes were visual analog scale (VAS), Tegner activity score, Lysholm knee score, single hop tests, and limb symmetry index (LSI). While pain intensity at rest and during movement was evaluated with VAS, functional performance level was evaluated with the Tegner activity score, the Lysholm knee score, single hop tests, and limb symmetry index (LSI). Results: A significant difference was found in the ACL-RSI values in the ACLR-RR group compared to the isolated ACLR group (p = 0.02). The results of the groups in VAS scores at rest and during movement, Tegner activity levels, and Lysholm knee scores, in the intact and operated leg single hop tests (single leg hop, cross hop, triple hop, and six-meter hop test), and the LSI values in the single leg hop tests showed no significant difference. Conclusions: This study revealed different psychological outcomes and similar functional levels for ACLR and all-inside meniscus RAMP repair compared with isolated ACLR. It was observed that the psychological status of patients with RAMP lesions should also be evaluated