Reliability and Validity of Use of A Smartphone Application For The Measurement of Gissane and Bohler’s Angles in Calcaneal Fractures

Objective: Calcaneus is the most often fractured bone of all the tarsal bones in the human skeleton. Initial evaluation of a suspected calcaneal fracture is often assessed with Böhler’s and Gissane’s angles. The aim of this study was to compare the reliability and consistency of measurements of Gissane and Böhler’s angles by using a smartphone application (iPinPoint) and a computer-based program Methods: A total of 41 patients were included. The measurement of fracture angulation was done by two orthopaedic surgeons twice one month apart using iPinPoint and Sectra. The inter- and intraobserver reliability was measured using intraclass correlation coefficients (ICCs). The intraobserver variabilities between the SECTRA and iPinPoint measurements for each participant were evaluated. Interobserver variability was also determined by comparing the results of Böhler’s and Gissane angles among the surgeons Results: The mean difference between the two techniques were 0.9° and 0.4° for Gissane and Böhler’s angles, respectively. The intraobserver reliability of Gissane and Bohler’s angles between smartphone and computer for each observer was very good (ICC=0.938 vs. 0.943, ICC= 0.970 vs 0.979, respectively). Interobserver reliability between two observers for SECTRA and iPinPoint results were very good (ICC=0.955, ICC=0.905 respectively). Conclusion: iPinPoint application can be used for the measurement of Gissane and Bohler’s angles safely. In addition, there are very good results that support it as a reliable and reproducible tool for SECTRA measurements

Omuzun temelleri

A minor part of the pain and instability around shoulder region is caused by entrapment neuropathies. When dealing with pain and muscle weakness around shoulder region, entrapment neuropathies should be kept in mind. Most common nerves that are prone to entrapment neuropathies around shoulder are suprascapular, axillary, long thoracic, and accessory nerves. Entrapment neuropathies are often caused by mechanical and dynamical compression of a nerve while passing through anatomically narrow fibro-osseous tunnels. Other causes of entrapment neuropathies might be space occupying lesions such as inflammatory edema, cysts, and tumors or post-traumatic conditions such as hematoma, fibrosis, and myositis ossificans. The common clinical alterations due to a nerve entrapment are pain, muscle weakness, paresthesia around certain localizations and muscle atrophies.</p

Computational analysis of the effects of interprosthetic distance on normal and reduced cortical thickness femur models

Distal femoral fractures associated with the femoral stem in a well-fixed hip arthroplasty pose a risk of an interprosthetic fracture, the treatment of which is known as difficult. To effectively prevent and treat IP fractures, biomechanical effects must be demonstrated. We defined eight variations of the interprosthetic distance ranging from 48 mm overlap to 128 mm gap. Femoral geometries with normal and reduced cortical thickness were modeled to evaluate the effects of cortical thickness. In addition to the intact model, a total of 16 finite element models were analyzed under physiological boundary conditions. Maximum and minimum principal strains on the lateral and medial cortex surfaces were always found to be greater in models with reduced cortical thickness than in normal femurs. The model with 48 mm overlapping interprosthetic distance produced the least peak strain and the model with 16 mm interprosthetic gap produced the greatest strain with both normal and reduced cortical thickness. The screw holes produced local strain concentrations and increased the peak strains on the cortex surfaces, especially close to the stem tip. Statistically, a significant correlation (R-2 = 0.9483) was found between strain shielding and interprosthetic distance. Axial stiffness, interfragmentary shear motion, and maximum von-Mises stress on the distal plate showed a high correlation with the interprosthetic distance. It was concluded that the overlapping structures are superior to other fixations we analyzed in that they offer better mechanical stability and eliminates the local strain concentrations