A study on relations between soil and plant species in alpine zone at Kazdaği National Park, Turkey

This study examines the plant species distribution and cover abundance scales relations with soil and other environmental factors such as elevation, exposure, slope in the alpine region. 10 sample areas were determined for experimental field study in the alpine region. Plant species and their cover abundance scales and 0-5 and 5-15cm soil depth analysis were conducted in the field study. C, N, pH, soil salinity, soil texture, C/N and CaCO3 (%) were determined in soil laboratory analysis. To examine the effect of land use by the local people; sample areas were determined both on used area and non-used area in the alpine region.publisher versio

Injuries of foot and ankle in front seat passengers

The number of injuries sustained by car occupants involving the head, thorax, spine, pelvis and the upper limbs have been reduced significantly during recent years. This is probably due to better safety features in the cars, especially the availability and usage of safety belts, airbags etc. Therefore one can notice clinically a relative increase in survivors of severe frontal crashes, but many of them have injuries to the lower extremities. To verify this, we analyzed the foot and ankle injuries of front seat passengers

The Circular Arc Internal Fixation for Tibio-Talo-Calcaneal Arthrodesis

Category: Ankle Arthritis Introduction/Purpose: Stabilizing a tibio-talo-calcaneal arthrodesis in anatomical alignment allowing for weight bearing is a technical challenge. Normal anatomy demonstrates alignment of the heel, the subtalar facet, the talus, the ankle joint and the distal tibia on a regular curve. This curve lies on a vertical plane which is slightly angulated inwards in relation to the sagittal plane. Today’s hindfoot nails are either straight or bent. The hole which accommodates the implant is always straight and thus does not respect the normal alignment of the hindfoot. This technique may cause a plantar neurapraxia, the nail holds poorly the calcaneus and tends to create a hindfoot varus. Purpose of the study is to optimize the technique to stabilize the hindfoot in anatomical alignment. Methods: A preliminary trial using 15 cadaveric feet was performed to find the optimal shape of a central hindfoot nail. An instrumentation was designed to create a circular arc bore hole crossing the heel, the posterior subtalar facet, the tibio-talar joint and the distal tibia metaphysis. At the operation, the desired definitive position of the hindfoot is fixed temporarily with Kirschner wires. A guiding frame is fixed to three critical spots of the hindfoot to drill the central hole. Using an image amplifier the hole is bored using a motor driven end cutting flexible reamer which is seated within a rigid curved hull. The nail has the same shape than the hull and is impacted up to the distal tibia. A distal locking screw crossing the subtalar joint and a proximal locking screw within the tibia concludes the central fixation. 9 patients have been treated so far using this technique. Results: In vitro trials demonstrated an excellent spontaneous stability of the hindfoot after introduction of the nail. The pathology of the operated patients include post-traumatic, congenital and metabolic (diabetes) conditions. The mean follow-up is 12 months. We did observe 3 ruptures of the tibial locking screw which allowed for more spontaneous impaction. All cases went to consolidation without malunion or other complications. One diabetic patient developed a stable pseudarthrosis at the midfoot joints. All patients were treated for 2 weeks post-op with a closed circular cast without weight bearing. After 2 weeks our patients did practise partial weight bearing using a cam walker for other 6 weeks. Conclusion: The tibio-talo-calcaneal arthrodesis can be successfully treated using a central circular arc shaped nail respecting form fit function. The anatomical bony alignment of the hindfoot is preserved. Due to the safe approaches, the technique may prevent shortcomings such as neurological complications and non-unions. We expect a shorter period between surgical fixation and full weight bearing

Histological Analysis of the Structural Composition of Ankle Ligaments

Background: Various ankle ligaments have different structural composition. The aim of this study was to analyze the morphological structure of ankle ligaments to further understand their function in ankle stability. Methods: One hundred forty ligaments from 10 fresh-frozen cadaver ankle joints were dissected: the calcaneofibular, anterior, and posterior talofibular ligaments; the inferior extensor retinaculum, the talocalcaneal oblique ligament, the canalis tarsi ligament; the deltoid ligament; and the anterior tibiofibular ligament. Hematoxylin-eosin and Elastica van Gieson stains were used for determination of tissue morphology. Results: Three different morphological compositions were identified: dense, mixed, and interlaced compositions. Densely packed ligaments, characterized by parallel bundles of collagen, were primarily seen in the lateral region, the canalis tarsi, and the anterior tibiofibular ligaments. Ligaments with mixed tight and loose parallel bundles of collagenous connective tissue were mainly found in the inferior extensor retinaculum and talocalcaneal oblique ligament. Densely packed and fiberrich interlacing collagen was primarily seen in the areas of ligament insertion into bone of the deltoid ligament. Conclusions: Ligaments of the lateral region, the canalis tarsi, and the anterior tibiofibular ligaments have tightly packed, parallel collagen bundles and thus can resist high tensile forces. The mixed tight and loose, parallel oriented collagenous connective tissue of the inferior extensor retinaculum and the talocalcaneal oblique ligament support the dynamic positioning of the foot on the ground. The interlacing collagen bundles seen at the insertion of the deltoid ligament suggest that these insertion areas are susceptible to tension in a multitude of directions. Clinical Relevance: The morphology and mechanical properties of ankle ligaments may provide an understanding of their response to the loads to which they are subjected

Foot and ankle fractures during childhood: review of the literature and scientific evidence for appropriate treatment

ABSTRACT Foot and ankle fractures represent 12% of all pediatric fractures. Malleolar fractures are the most frequent injuries of the lower limbs. Hindfoot and midfoot fractures are rare, but inadequate treatment for these fractures may results in compartment syndrome, three-dimensional deformities, avascular necrosis and early post-traumatic arthritis, which have a significant impact on overall foot and ankle function. Therefore, the challenges in treating these injuries in children are to achieve adequate diagnosis and precise treatment, while avoiding complications. The objective of the treatment is to restore normal anatomy and the correct articular relationship between the bones in this region. Moreover, the treatment needs to be planned according to articular involvement, lower-limb alignment, ligament stability and age. This article provides a review on this topic and presents the scientific evidence for appropriate treatment of these lesions