Total Hip Replacement in Developmental Dysplasia of the Hip: Pitfalls and Challenges

Introduction: Surgical treatment methods for developmental dysplasia of the hip (DDH) in the elderly patients contain pelvic or periacetabular osteotomy and hip arthroplasty. Total hip arthroplasty (THA) is the last and definitive surgical treatment modality for the end stage developmental dysplasia of the hip

Biomechanical comparison of straight and helical compression plates for fixation of transverse and oblique bone fractures: Modeling and experiments

Total deformation and stability of straight and helical compression plates were studied by means of the finite element method (FEM) and in vitro biomechanical experiments. Fixations of transverse (TF) and oblique (45°) bone (OF) fractures have been analyzed on sheep tibias by designing the straight compression (SP) and Helical Compression Plate (HP) models. The effects of axial compression, bending and torsion loads on both plating systems were analyzed in terms of total displacements. Numerical models and experimental models suggested that under compression loadings, bone fracture gap closures for both fracture types were found to be in the favor of helical plate designs. The helical plate (HP) fixations provided maximum torsional resistance compared to the (SP) fixations. The fracture gap closure and stability of helical plate fixation for transverse fractures was determined to be higher than that found for the oblique fractures. The comparison of average compression stress, bending and torsion moments showed that the FEM and experimental results are in good agreement and such designs are likely to have a positive impact in future bone fracture fixation designs

Fibula allograft sandwich technique for the reconstruction of sternal nonunion after cardiac surgery

Sternal dehiscence is an untoward complication of cardiac surgery that leads to increased morbidity as well as length of hospital stay and costs. Although many different conventional and creative techniques have been described using both synthetic and biologic materials, the ideal method of sternal reconstruction is still controversial. In this case, we describe a simple and reproducible "fibula allograft sandwich technique" for the reconstruction of sternal nonunion in a cardiac surgery patient. This technique also facilitates the conventional wiring by creating bilateral landing zones for the wires at both sides of the sternum

Management of persistent coccydynia with transrectal manipulation: Results of a combined procedure

WOS: 000431533600030PubMed ID: 29234884We compared the results of manual therapy combined with steroid injection with single steroid injection in the treatment of persistent coccydynia. Combined therapy was performed in 21 patients (Group 1) and steroid injection in 23 patients (Group 2). We compared two groups and investigated the combined therapy group in details. Patients were classified according to the underlying cause, BMI, anatomic type of coccyx and duration of symptoms (<6 or 6 months). Mean age was 30.5 years at the time of procedures. Mean followup time was 27.8 months. VAS scores were decreased in both groups but combined therapy group had much more better results. Complete pain relief was achieved in 61.9% of patients in Group 1 whereas it was only 17.4% in Group 2. In 23.8% of Group 1, the VAS score was significantly decreased but the feeling of uncomfortability persisted. This was 73.9% in Group 2. We had no relapse in Group 1 but in Group 2 the relapse rate was 56.5%. Underlying cause, body mass index, anatomic type of coccyx and duration of symptoms had no effect on results. Manual therapy combined with steroid injection would be an alternative method in case of persistent coccydynia. It is a safe and easy option before surgical treatment

Evaluating the features of interdigital neuroma using 3-Tesla magnetic resonance imaging

Interdigital neuroma is an entrapment neurop-athy of the interdigital nerve. Previously, studies on interdigital neuroma were done with 1 Tesla Magnetic Resonance Imaging and more often 1.5 Tesla Magnetic Resonance Imaging. We used 3 Tesla Magnetic Resonance Imaging in our study and we did not encounter as much as we know about the study with 3 Tesla Magnetic Resonance Imaging in the literature. Between 2013 and 2019, the 3 Tesla Magnetic Resonance Imaging results of 39 consecutive surgically-confirmed interdigi- tal neuromas and patients' files were retrospec- tively evaluated. The soft tissue surrounding the prominent interdigital nerve "target sign" were assessed. Spearman's rho, Pearson's correlation tests, and Mann-Whitney U-tests were used. Of the 39 cases (mean transverse dimension = 4.64 mm), 35 (89.7%) were hypointense on T1-weight - ed sequencing, 34 were intermediate (87.1%) on short tau inversion recovery sequencing, and 29 (74.3%) had slightly-moderately enhanced neuro-mas on post-contrast spectral presaturation with inversion recovery sequences. A statistically sig-nificant negative relationship was found between contrast enhancement and disease duration (p = 0.020). On short tau inversion recovery or spec-tral presaturation with inversion recovery series, the intralesional nerve view "target sign" was ob-served in 23 (58.98 %) of 39 neuromas. This is the first study in the literature with 3 Tesla Magnetic Resonance Imaging that shows the visual charac-teristics of interdigital neuroma and its possible contribution to the diagnosis of the disease

Düzensiz spor aktivitesi olan ofis çalışanlarında sentetik zeminli yüzeylerde ortaya çıkan ön çapraz bağ yaralanmaları

Aim: The aim of this study is to evaluate the anterior cruciate ligament (ACL) tears in Turkish office workers on the artificial playing surfaces. Materials and Methods: Eighty-seven patients who were operated for anterior cruciate ligament tear that had injuries on artificial surfaced playing areas (ASPA)s were evaluated retrospectively. Evaluations were undertaken using Lysholm and Tegner Activity Scale pre-operatively and in the last follow-up. Injury mechanisms, shoe types, frequency of sporting activity, time of warm-up exercises before sporting activity were assessed. Types of ASPA's, body mass index (BMI) and return to work period were also determined. Results: Increase in Lysholm and Tegner activity scale between the preoperative and postoperative scores was found to be statistically significant (p&lt;0.001). ACL tear occurred with non-contact injury in 65 patients, 22 patients had ACL tear with direct contact trauma. Football activity on the ASPAs is social allocation rather than a sportive activity. The rate of wearing special designed shoes for ASPA in sporting activities was low. The mean frequency of sporting activity was 1.4 times/month and the mean warm-up exercise time was 6.42 minutes. Sixty-nine ASPAs were made with 3th generation turf, 18 were 2nd generation turf. The mean BMI was 23.32 kg/m&sup2;. The mean period for return to work was 17.41 weeks. Conclusion: Irregular sportive activity with insufficient equipment on the ASPA causes serious ACL injuries that have to be managed by surgical procedures with loss of working time and economical casualties.Amaç: Sentetik zeminli spor alanlarında ofis çalışanlarında ortaya çıkan ön çapraz bağ yaralanmalarını değerlendirmek. Gereç ve Yöntem: Sentetik yüzeyli zeminlerde spor esnasında ön çapraz bağ yaralanması olan ve opere edilen 87 hasta retrospektif olarak değerlendirildi. Hastaların opere edilen dizleri ameliyat öncesi ve son kontrollerde Lysholm ve Tegner Aktivite Skalaları ile değerlendirildi. Yaralanma mekanizması, yaralanma esnasında kullanılan ayakkabı tipi, sportif aktivite sıklığı, sportif aktivite öncesi ısınma süresi, spor yapılan sahanın zemin tipi, vücut kitle endeksi ve işe dönüş süresi araştırıldı. Bulgular: Ameliyat öncesi ve son kontrollerdeki Lysholm ve Tegner aktivite skalalarında istatistiksel olarak anlamlı artış tespit edildi (p<0.001). Altmış beş hastada temassız travmalar sonucunda, 22 hastada ise direkt temaslı travmalar sonucunda ön çapraz bağ yırtığı oluştuğu tespit edildi. Hastaların sentetik zeminli yüzeylerde yaptıkları sportif aktiviteleri sosyal aktivite olarak gördükleri tespit edildi. Sentetik zeminli yüzeyler için uygun ayakkabı kullanımı düşük oranda idi. Hastaların aylık ortalama sportif aktivite sayıları 1.4, ortalama ısınma süresi 6.42 dk olarak bulundu. Sentetik yüzeyli sahaların 69'u 3. jenerasyon, 18'inin ise 2. jenerasyon yüzeyler idi. Hastaların ortalama vücut kitle endeksi 23.32 kg/m² idi. Cerrahi girişim sonrası işe dönüş süresi 17.41 hafta olarak belirlendi. Sonuç: Uygunsuz ekipman ve düzensiz spor aktivitesi olan kişilerin sentetik zeminli yüzeylerde yaptıkları sportif aktiviteler cerrahi tedavi gerektiren ön çapraz bağ yaralanmalarına neden olabilmektedir. Bunun sonucunda çalışma zamanında azalma ve ekonomik kayıplar ortaya çıkmaktadır

Results of arthroscopic synovectomy for treatment of synovial lipomatosis (lipoma arborescens) of the knee

WOS: 000435603200009PubMed ID: 28738431Synovial lipomatosis (SL; lipoma arborescens) is a tumor-like condition with villous proliferation of the synovium. The exact etiology of SL is still unknown. The knee is the most commonly involved part. The goal of this retrospective study was to report the results of arthroscopic synovectomy in patients with SL in their knee joints as well as to emphasize the importance of considering this pathology when treating patients with recurrent knee joint effusions. In total, 21 patients (8 females and 13 males) were evaluated retrospectively from May 2009 to July 2014. The mean follow-up period was 29.13 (range, 12-61) months. The mean duration of compliance was 22.76 (range, 7-61) months. All patients were evaluated by Knee Society score pre- and postoperatively. The mean preoperative and last follow-up Knee Society scores were 67.82 and 88.23 points, respectively. There was a significant difference between the preoperative and postoperative Knee Society scores (p = 0.0001). Histopathological examinations showed that the subsynovial layer exhibited diffuse replacement by mature fat cells that had formed villous projections. In addition, infiltration of mononuclear inflammatory cells was observed at different stages. SL is a nondestructive and benign tumor pathology of the knee joint without a clearly identified etiology. The main difficulty in diagnosis is lack of clinical practice

Intrauterine lower extremity gangrene in a newborn with tetralogy of fallot

DESCRIPTION: Intrauterine gangrene of an extremity is a rare problem. Lower extremity gangrene is even rarer. We present a case of lower extremity gangrene in combination with Tetralogy of Fallot (TOF) and postaxial polydactyly of the hand. A live male infant was delivered by caesarean section. Delivery occurred at the 34th week of gestation due to meconium aspiration and intrauterine growth retardation

A pictorial view to tarsal coalition: The presentation of two children with foot pain

Two male patients aged 9 and 16 years were admitted with complaints of ankle pain and intoeing. There was no history of trauma and arthritis. In the first case, radiography examination revealed a “C sign” (a cortical continuity from the medial portion of the talus to the sustentaculum tali), a narrowing in the middle subtalar joint space, and convexity in the lower margin of the sustentaculum tali (Figure 1). Magnetic resonance imaging (MRI) showed triple coalition in the anterior subtalar joint (talocalcaneonavicular joint) in the first case (Figures 2 and 3) and fibrocartilaginous coalition at the posterior subtalar joint in the second case (Figure 4). Narrowing in the joint spaces, findings of early degeneration, and medullary edema in the adjacent bone were observed at the sites of coalition (Figures 3 and 4). Nonoperative treatment, such as physical therapy, exercises, and analgesic medication were applied