Closed posteromedial dislocation of ankle in a 12 year-old boy: a case report

Ankle fractures and fracture dislocations are common injuries in orthopaedic practice however pure ankle dislocation without an associated fracture is extremely rare. There are a few cases reporting such a lesion in the literature. Also this injuries are generally open high energy trauma injuries. Closed treatments are reported to be effective and ligament injuries are generally not reported. In this study, we report a closed pure posteromedial ankle dislocation with anterior talofibular ligament rupture and its treatment and outcome in a 12 year-old boy. We think that this is an extremely rare lesion

Humerus distal kırıklarında çift plak osteosentezi, çift gergi bandı tekniğinden daha iyi biyomekanik stabilizasyon sağlar

Objectives: In this study we evaluated the stability and effectiveness of the double tension band osteosynthesis technique compared to the double plate osteosynthesis technique used for fixation of distal humerus fractures. Materials and methods: The study was performed on two groups, and in each group eight cadaveric, elderly (mean age 70-80) human humeri was used. An osteotomy was performed in the supracondylar region using a manual saw. The first group (group 1) was fixed with double 3.5 mm reconstruction plates, while the second group (group 2) was fixed with the double tension band technique, using crossing Kirschner wires. The osteotomy was designed so that the distal fragment would allow only a single screw per plate. The constructs were evaluated using a material testing machine. A linear non-cyclic load was applied until the failure of the constructs. The force which produced a 3 mm gap (3 mm gap strength), as detected visually with the aid of operating loupes, and the maximum load prior to failure of the fixation (maximum force) were measured from all tests. Results: The mean value for the 3 mm gap strength was 1356.29&plusmn;226.97 N for group 1 and 882.63&plusmn;305.21 N for group 2. The mean value of the maximum load strength was 1487.13&plusmn;298 N for group 1 and 1232&plusmn;107.62 N for group 2. There were significant differences in 3 mm gap strengths of the two groups (p=0.005). There was also a significant difference in the maximum load between the two groups (p=0.016). Conclusion: Double plate osteosynthesis technique is superior to double tension band osteosynthesis for the fixation of distal humerus fractures.Bu çalışmada Doğu Karadeniz bölgesi hamsilerinin avlama mevsimi süresince besin bileşenleri ve yağ asitleri komposizyonundaki aylık değişim incelenmesi amaçlanmıştır. Hamsilerin nem oranı ekim ayında en düşük (%64,93) iken nisan ayında ise en yüksek seviyeyede (%74,32) olduğu hesaplanmıştır (P<0,05). Buna bağlı olarak tüm aylardaki yağ seviyeleri ve aralık ve nisan aylarındaki kül miktarlarındaki değişim istatistiksel açıdan önemli bulunmuştur. İlaveten, avlanma mevsimi süresince doymuş yağ asitlerinden (SFA) C16:0, C14:0 ve C18:0, tekli doymamış yağ asitlerinden (MUFA) C18:1n9 ve çoklu doymamış yağ asitlerinden (PUFA) C22:6n-3 (DHA, dekosahekzanoik asit) ve C20:5n-3 (EPA, eikosapentanoik asit) en yüksek oranlarda bulunmuşlardır. Avlama mevsimi boyunca, ortalama omega–3 ve omega–6 değerleri sırası ile %30,33 ve %4,43 olarak hesaplanmıştır. EPA seviyesinde tedrici olarak bir azalma meydana gelirken, DHA seviyesinde ise ekim ayından nisan ayına kadar bir artış gözlenmiştir. Yağ asitlerinde av mevsimi boyunca yağ assitlerinde özellikle de DHA oranında belirgin bir şekilde bir değişimin olduğu gözlemlenmiştir

Bilateral simultaneous femoral neck fractures secondary to a post-infarct generalized tonic-clonic seizure. A case report.

Bilateral femoral neck fractures are generally associated with high-energy trauma or defects in bone metabolism. We present a patient who had not been subjected to high-energy trauma and in whom there was no bone metabolism disorder.</jats:p

Handgun injuries with metacarpal and proximal phalangeal fractures: early definitive treatment

Most gunshot injuries to the hand involve a combination of tissue types. The goal of this study is to report the results of early definitive treatment in extra-articular metacarpal and proximal phalangeal fractures due to low velocity gunshot wounds and to analyse their outcomes. A retrospective analysis of 51 metacarpal and 41 proximal phalangeal fractures of 76 patients due to low velocity gunshot wounds treated between January 2001 and December 2004 was carried out. We applied acute fixation in the first 24 hours. The patients were evaluated with total active motion scores, radiographic control, complication rate and the need for revision surgery. The infection frequency was 10.5% and the need for a revision surgery was 7%. The plate fixation group had significantly higher total active motion scores than the external fixation group. The K wire group had the highest revision rate. The bone grafting group was associated with good total active motion scores and low complication rates. The majority of the low velocity gunshot injuries are surgically clean wounds which allow not only early fracture fixation, but also early bone grafting and soft tissue reconstruction. Plate and screw fixation is associated with significantly better functional outcomes than the minimal fixation group

Kardiyovasküler İşlemlerde Görüntüleme

Doğum sırasındaki fizyolojik değişimlerle kapanması öngörülen foramen ovale erişkin populasyonun yaklaşık %75’inde tamamen kapanmış olarak izlenirken, %25’inde ise kapanmaz ve patent foramen ovale (PFO) olarak varlığını sürdürür.1 PFO, serebrovasküler olay dahil birçok patoloji (auralı migren, dalgıçlarda dekompresyon hastalığı vs.) ile ilişkilendirilmiştir. İskemik inmelerin %25’inde standart tanısal değerlendirmeye rağmen bir neden bulunamaz ve bu grup kriptojenik inme olarak adlandırılır. PFO ve kriptojenik inme arasındaki patofizyolojik ilişki paradoksal embolizm, PFO içerisinde meydana gelen trombüs, sol atriyal disfonksiyon ve atriyal aritmiler gibi nedenlere bağlı olabilir. Epidemiyolik veriler ve klinik gözlemsel çalışmalar, PFO kapatılmasıyla inme rekürrenslerinin azaldığını gösteren randomize kontrollü çalışmalar tarafından kuvvetle desteklenmektedir.2 PFO’nun tanısında ve perkütan tedavisinde çoklu görüntüleme yöntemleri önem arz etmektedir