Is the proximal femoral nail a favourable option for trochanteric femur fractures in osteopenic elderly patients?

Primary aim of this study to evaluate the functional results and complications of the patients aged 70 and over whom are treated with proximal femoral nail (PFN) because of hip fracture. 128 patients out of 223 patients were included in the study, who were aged 70 and over, to whom treated with proximal femoral nail because of hip fracture in our clinic between 2006 and 2014. Since 26 of these 128 patients who were included in this study passed away before the follow up period of 1 year, they were excluded from the study. Fractures were evaluated by AO/OTA classification. Their Singh index and morphological cortical indexes were calculated from the pre-surgery radiographies. The functional situations of the patients were evaluated by Harris hip score. Average age of the evaluated 102 patients was 81.13 (70-98), 44 of them were male, 58 of them were female. According to AO/OTA fracture classification 48 of them were 31-A1, 25 of them were 31-A2, 29 of them were 31-A3. 54 fractures were on the left hip, 48 fractures were on the right hip. Average Singh index was 2.72 (1-5), average morphological cortical index was 2.94 (2.1-3.7), average Harris hip score was 74.3 (49-88). 4 patients have had complications after surgery and revised with other treatment modalities. Since the functional results are on a satisfactory level, in our opinion as well, proximal femoral nail should be considered among the surgical treatments in the elderly patients with hip fracture. [Med-Science 2023; 12(2.000): 378-82

Effects of Sleeping Positions on the Rotator Cuff Pathology

The rotator cuff tear aetiology is still unclear. Especially for atraumatic ruptures, degenerative processes come into prominence. This study aims to correlate between four most commonly-seen sleeping positions and patients with rotator cuff pathology. 87 patients who applied to the institute for suffering from shoulder pain for more than 6 months without a trauma and 93 voluntary people (as control group) above the age of 50 who applied to the institution for reasons other than shoulder pain included in the study. Rotator cuff ruptures and acromion types of the patients are diagnosed via magnetic resonance imaging. In face-to-face interviews, all the patients are asked to show their favourite sleeping positions on the visual cards and also questioned about their smoking habits and overhead activities. There is not any statistically substantive parameters between the patients and the control group in terms of age and sex. 83.9% of the patients with rotator cuff rupture have stated prefering lateral decubitus position while this rate is %61.3 among the control group (p=0.003). Atraumatic rotator cuff tears are increase with age. The increase pressure in the subacromial space can lead distribution in microvascular circulation of rotator cuff. Decrease in the microvascular circulation also affect the regeneration potential of rotator cuff. Laboratory studies demonstrated that lateral decubitus position has the most prominent increase in the subacromial pressure over all sleeping positions. We consider that sleeping in the lateral decubitus position causes long-term high subacromial pressure, leading to a microcirculatory disorder in the rotator cuff, which is a risk factor for the rotator cuff aetiology. [Med-Science 2015; 4(4.000): 2825-33

An observational, prospective, multicenter study on rescue high-frequency oscillatory ventilation in neonates failing with conventional ventilation

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