Procedural Outcomes of Double Vs. Single Fluoroscopy for Fixing Supracondylar Humerus Fractures in Children: A Case-Control Study

Background: Supracondylar humerus fractures (SHFs) are frequently seen in the pediatric population. The aim of this study was to compare single- and double-fluoroscopy methods for the closed reduction and percutaneous pinning (CRPP) of Gartland type 2 and type 3 SHFs. Materials and Methods: Forty patients who underwent surgery between March 2016 and April 2018 were evaluated retrospectively. Twenty-one patients (group 1) who received double fluoroscopy and 19 patients (group 2) who had single fluoroscopy were evaluated. The preparation period, surgical duration, radiation exposure time, fracture types, sex distributions, distribution of sides, radiologic results at the third month, cosmetic and functional results, and the incidence of complications were recorded. Results: The mean age of the patients in group 1 and group 2 was 4.76 and 4.68 years, respectively. The mean preparation time of group 1 was 11.3 min; whereas in group 2, it was 8.7 min (p < 0.01). The mean surgical duration was 31.76 min in group 1, and 40.47 min in group 2 (p < 0.01). The mean radiation exposure time in group 1 and group 2 was 41.19 and 47.36 s, respectively (p = 0.04). There were statistically significant differences between the two groups in terms of the preparation period, surgical duration, and radiation exposure time. Radiation exposure time and surgical duration were significantly shorter in group 1; the preparation period was shorter in group 2. Conclusions: The double-fluoroscopy technique can significantly reduce surgical duration and radiation exposure time during surgery while treating SHFs of children. © 2020, Indian Orthopaedics Association

Is Cyclic Exercise Performed before Tibial Fixation Effective on Grafts during Anterior Cruciate Ligament Reconstruction?

Objectives: The necessity of cyclic exercise to pre-stretch the autograft before tibial fixation during ACL reconstruction is unknown. In this study, we evaluated whether there was a statistically significant difference between the results of patients whounderwent cyclic exercise by way of physical examinations, knee joint stability tests, and functional evaluation tests, comparedwith the patients who underwent ACL reconstructions with or without cyclic exercise.Methods: Between March 2016 and May 2018, 59 patients with at least eight months’ follow-up of an ACL reconstruction wereidentified. Thirty patients (Group 1) who underwent cyclic exercise before tibial fixation and 29 patients (Group 2) who did notundergo cyclic exercise were evaluated and compared.Results: The mean age of the patients in Group 1 and Group 2 was 25.9 (range, 18-36) years and 25.2 (range, 18-35) years, respectively. The mean follow-up period in Group 1 was 14.6 (range, 8-22) months and 13.5 months in Group 2 (range, 8-21 months).The mean Lysholm scores of Group 1 and 2 were 95.1 (range, 83-100) and 87.1 (range, 78-100), respectively. The modified Cincinnati scores of Groups 1 and 2 were 28.7 (range, 24-30) and 26.2 (range, 21-30). The mean IKDC subjective knee evaluation scoresin Groups 1 and 2 were 91.9 (range, 83-100) and 86.7 (range, 75-100). The mean thigh atrophy was 1.5 cm in Group 1 and 2.5 cm inGroup 2. In Group 1, 23 patients jumped 85% of the distance compared with the intact side in the single-legged hop test, and 12patients in Group 2 were able to hop this distance successfully.Group 1 had statistically significantly better results in Lysholm activity scores, modified Cincinnati scores, IKDC subjective kneeassessment scores, two-time IKDC activity scale results, comparison of thigh diameters, and single-legged hop tests (p<0.05). Nosignificant difference was found in other examinations and tests.Conclusion: Cyclic exercise during the operation had a positive effect on functional scores. We believe that cyclic exercise shouldbe added to the operative procedur

Primary Arthrodesis in the Treatment of High Grade Hallux Rigidus with Single Cortical Screw

Aim: The aim of this study was to evaluate the clinical and radiological results in patients with severe hallux rigidus who underwent arthrodesis using single cortical screw. Methods: We retrospectively evaluated 18 patients (16 females, 2 males) who underwent arthrodesis for severe hallux rigidus using single cortical screw. The mean age of the patients was 58.1 (range: 44-69) years. According to the Coughlin and Shurnas classification, 5 feet were rated as stage 3 and 13 feet were stage 4. 3 of the stage 3 patients had cheilectomy previously. The American Orthopaedic Foot and Ankle Society (AOFAS) clinical rating scale for the metatarsophalangeal - interphalangeal joints was used for clinical evaluation. Hallux valgus angles and hallux dorsiflexion angles were measured on X-rays. Results: The mean follow-up period was 32.4 (range: 15-69) months. Radiological signs of non-union was found in one patient. The mean preoperative AOFAS score was 56.1 (range: 38-72). The mean final follow-up AOFAS score was found to be 81.1. Moderate results in 2 patients (11.1%), good results in 11 patients (61.1%) and excellent results in 5 patients (27.8%) were obtained. When the last X-rays were evaluated, 15.1° (7-24) valgus at the metatarsophalangeal joint and 11.9° (8-18) extension (to the floor) at the metatarsophalangeal joint were detected. Late surgical wound healing was observed in one patient. The screws were removed due to irritation in 8 (44%) patients. Conclusion: We assume that in the treatment of severe hallux rigidus, arthrodesis using a single cortical screw may be considered as a favorable surgical technique with its high union rates and increased functional results. (The Me­di­cal Bul­le­tin of Ha­se­ki 2014; 52:158-63

THE EFFECTIVENESS OF SHOCK WAVE TREATMENT IN SUBCALCANEAL PAIN SYNDROME

The aim of this study was to evaluate the effectiveness of extracorporeal shock wave therapy (ESWT) in patients with subcalcaneal pain syndrome. A total of 23 women and seven men aged 20 to 60 yrs, with subcalcaneal pain were enrolled in the study. Patients had not received any steroid injections within the last six months and could not be relieved with medical treatment. AOFAS, FADI, Roles and Maudsley scores were compared using dependent groups’ t-test. Mann-Whitney U test was used to compare patients with morning pain and those with all day long lasting pain, and patients having symptoms for shorter or longer than a year. AOFAS, FADI, Roles and Maudsley scores before and following the treatments were significantly different (

Treatment of acromioclavicular joint dislocations by using synthetic polyester ligament

Objective: The aim of the study was to determine whether radiographic fixation with synthetic polyester ligament was achieved after fixation and to evaluate the functional results in the medium term. Methods: Between 2011 and 2015, 16 male patients were treated with surgical fixation with Surgilig synthetic ligament for Type 3 (n=1), Type 4 (n=1) and Type 5 (n=14) acromioclavicular (AK) All of the patients were acute cases admitted within the first 3 weeks after injury. Visual analogue scale (VAS) form was used to evaluate preoperative and postoperative pain. The Constant shoulder function assessment score was used for clinical evaluation in the postoperative period. Results: The mean age of the patients was 38.5 (range: 22-58) years. All patients were male. The mean follow-up period of the patients was 20 (range: 7-54) months. At the last follow-up, the mean Constant score was 82.78 points (range: 72-92). The mean preoperative VAS score was 8.6 (range: 7-10), with a mean of 1.4 (range: 0-3) at the last follow-up. The decrease in VAS score was statistically significant (p < 0.05). Radiologically, there was osteolytic appearance around the screw in 1 patient but there was no patient with complete loss of reduction or fracture. Conclusion: How to make optimal surgical treatment of ACJ dislocation is not clear yet. In the treatment, coracoclavicular fixation with Surgilig is successful both clinically and radiologically