ACTA ORTHOPAEDICA ET TRAUMATOLOGICA TURCICA

Objective: The aim of this study was to biomechanically compare 3 different cannulated screw configurations used in internal fixation of unstable femoral neck fractures. Methods: The study included 28 synthetic left femurs randomly divided into 4 equal groups. Samples in the first 3 groups were osteotomized in the basicervical region to create Pauwels Type 3 fractures. Fixation was carried out using cannulated screws. In Group 1, four screws were used including 3 in an inverted triangle configuration in parallel with the neck and the fourth screw transversely into the calcar. In Group 2, three screws were used including 2 in parallel with the neck and the third transversely into the calcar. In Group 3, three screws were used in an inverted triangle configuration in parallel with the neck. No osteotomy or fixation was carried out in Group 4. Load test was performed on all the groups and the strength of the screw fixations against axial load and their amount of relocation were measured. Results: Average maximum strength was 36.1 +/- 3.2 N/mm(2) in Group 1, 27.3 +/- 4.1 N/mm(2) in Group 2 and 21.9 +/- 3.2 N/mm(2) in Group 3. The average relocation in the line of osteotomy in the moment of average maximum stress (21.9 +/- 3.2 N/mm(2)) was 11.5 +/- 2.1 mm in Group 3,6 +/- 1.3 mm in Group 2 and 5.8 +/- 1.1 mm in Group 1 (p0.05). Conclusion: The use of a transverse screw in the calcar in addition to cannulated screws parallel to the neck appear to provide stability benefit in the treatment of unstable femoral neck fractures

of attention-deficit/hyperactivity disorder

Purpose: Methylphenidate (MPH) derivative drugs are used because of psychostimulants effects on attention-deficit hyperactivity disorder in children and adults. As far as we know, toxic or anti-proliferative effects of MPH against cartilage tissue were not studied in the literature. The present study was carried out to investigate the possible effects of MPH on the proliferation, viability and differentiation of primary human chondrocytes, in vitro.Methods: Monolayer primary chondrocyte cultures were prepared using osteochondral tissue obtained from patients who underwent a total knee prosthesis operation. Stock solution of MPH was prepared and aliquots having 1-1000 mu M concentrations of the drug was composed. These solutions were applied to the wells containing cultured chondrocyte samples within the well plates. Control groups were composed of pure chondrocyte culture and no solution was added into them. All groups were evaluated at 24, 48 and 72 h in order to determine the possible negative effects of the drug on the chondrocytes. The data were evaluated by Tukey's honestly significantly different test following analysis of variance.Results: In the group where MPH was applied, it was found that viability, proliferation and stage-specific embryonic antigen-1 protein expression were decreased in comparison to the control group.Conclusions: It was emphasized that clinicians should not disregard the fact that this drug might suppress chondrocyte cell proliferation and chondrogenic differentiation

Chondrocyte proliferation, viability and differentiation is declined following administration of methylphenidate utilized for the treatment of attention-deficit/hyperactivity disorder.

PURPOSE: Methylphenidate (MPH) derivative drugs are used because of psychostimulants effects on attention-deficit hyperactivity disorder in children and adults. As far as we know, toxic or anti-proliferative effects of MPH against cartilage tissue were not studied in the literature. The present study was carried out to investigate the possible effects of MPH on the proliferation, viability and differentiation of primary human chondrocytes, in vitro. METHODS: Monolayer primary chondrocyte cultures were prepared using osteochondral tissue obtained from patients who underwent a total knee prosthesis operation. Stock solution of MPH was prepared and aliquots having 1-1000 µM concentrations of the drug was composed. These solutions were applied to the wells containing cultured chondrocyte samples within the well plates. Control groups were composed of pure chondrocyte culture and no solution was added into them. All groups were evaluated at 24, 48 and 72 h in order to determine the possible negative effects of the drug on the chondrocytes. The data were evaluated by Tukey's honestly significantly different test following analysis of variance. RESULTS: In the group where MPH was applied, it was found that viability, proliferation and stage-specific embryonic antigen-1 protein expression were decreased in comparison to the control group. CONCLUSIONS: It was emphasized that clinicians should not disregard the fact that this drug might suppress chondrocyte cell proliferation and chondrogenic differentiation

Is there a relationship between fracture healing and mean platelet volume?

Sancar Serbest,1 Ugur Tiftikci,1 Haci Bayram Tosun,2 Seyit Ali Gumustas,2 Abuzer Uludag2 1Department of Orthopaedics and Traumatology, Faculty of Medicine, Kırıkkale University, Kırıkkale, 2Department of Orthopaedics and Traumatology, Faculty of Medicine, Adiyaman University, Adiyaman, Turkey Objectives: Platelet volume has been defined to be a marker that shows thrombocyte activation and function and it is measured as mean platelet volume (MPV). MPV shows the mean volume of circulating thrombocytes and it is one of the routine parameters in complete blood count. Increased thrombocyte volume is associated with thrombocyte activation. Patients and methods: This study included 76 patients who were operated on due to fractures of long tubular bones. Patients who had union without any additional interventions were defined as group I, and patients who needed additional interventions due to nonunion or inadequate union were defined as group II. The control group included healthy volunteers who did not have a fracture. Hematologic test values of the patients that were obtained at admission to emergency ward were recorded Results: The groups were not statistically different in terms of age, sex, and the affected extremity. There were significant differences between group I and group II in terms of mean erythrocyte sedimentation rate, C-reactive protein, and MPV values (P<0.001), but there were no significant differences between group I and the control group. There was also no statistically significant difference among groups in terms of hematologic and biochemical variables. Conclusion: In our study, fractures in patients who had lower MPV values than controls during the inflammation process healed without any problem, but fractures in patients with high MPV values more frequently needed additional surgical interventions. Keywords: fracture healing, bone tissue, mean platelet volume, platelet activation, inflammatio

according to gender? A look from another perspective

Aim The aim of the present study was to examine if there were gender differences in risk factors in 4415 infants who were evaluated through a physical examination and hip ultrasonography (USG). Methods Physical examination of the hip and hip USG were performed on 4415 infants by the same paediatric orthopaedics specialist. Barlow and Ortolani tests were performed together with the evaluation for the limitation of abduction. Ultrasonographic hip examination was performed according to the Graf technique. The birth records of all the infants were examined, and anamneses (genetic disease, maternal age, delivery type, swaddling, multiple pregnancies, duration of gestation period, gravida, birthweight, breech presentation, oligohydramnios and family history) were obtained from the families. Any accompanying musculoskeletal (torticollis, pes equinovarus, congenital knee dislocation) abnormality was recorded. Results Pathological hip was determined in 149 (3.37%) of 4415 infants. In males, gestational week, family history, breech presentation, swaddling, congenital knee dislocation and limited abduction were observed to be significant for the presence of developmental dysplasia of the hip (DDH). In females, significant factors for the presence of DDH were determined to include birthweight, gestational week, breech presentation, multiple pregnancy, accompanying oligohydramnios, torticollis, pes equinovarus and limited abduction. Conclusion Risk factors for DDH can differ according to gender.C1 [Onay, Tolga] Marmara Univ, Pendik Training & Res Hosp, Dept Orthopaed & Traumatol, Istanbul, Turkey.[Gumustas, Seyit A.; Cagirmaz, Talat; Orak, Mehmet M.] Lutfi Kirdar Kartal Training & Res Hosp, Dept Orthopaed & Traumatol, Istanbul, Turkey.[Aydemir, Ahmet N.] Pamukkale Univ, Sch Med, Dept Orthopaed & Traumatol, Denizli, Turkey

Giant malignant peripheral nerve sheath tumor of thigh in an adolescent with neurofibromatosis type 1: a case report

Haci Bayram Tosun,1 Sancar Serbest,2 Bilge Aydin Turk,3 Seyit Ali Gumustas,1 Abuzer Uludag1 1Department of Orthopaedics and Traumatology, Faculty of Medicine, Adiyaman University, Adiyaman, 2Department of Orthopaedics and Traumatology, Faculty of Medicine, Kirikkale University, Kirikkale, 3Department of Pathology, Faculty of Medicine, Adiyaman University, Adiyaman, Turkey Abstract: Malignant peripheral nerve sheath tumors (MPNSTs) are rare sarcomas of children and adolescents, and they are aggressive tumors with a high rate of local recurrence. We present a 15-year-old boy with neurofibromatosis type 1 (NF1), who had a giant MPNST on the right thigh taking into account the available literature. Diagnosis of MPNST may be delayed in NF1 patients due to confusion with a neurofibroma and/or a plexiform neurofibroma. Malignancy should be considered, especially in cases with big masses, with heterogeneous involvement, or in the presence of cysts or necrotic nodules. The aim of surgical treatment is complete surgical excision. Keywords: nerve sheath neoplasm, sarcoma, adolescent, neurofibromatosis, lower extremit

Do the risk factors for developmental dysplasia of the hip differ according to gender? A look from another perspective.

AIM: The aim of the present study was to examine if there were gender differences in risk factors in 4415 infants who were evaluated through a physical examination and hip ultrasonography (USG). METHODS: Physical examination of the hip and hip USG were performed on 4415 infants by the same paediatric orthopaedics specialist. Barlow and Ortolani tests were performed together with the evaluation for the limitation of abduction. Ultrasonographic hip examination was performed according to the Graf technique. The birth records of all the infants were examined, and anamneses (genetic disease, maternal age, delivery type, swaddling, multiple pregnancies, duration of gestation period, gravida, birthweight, breech presentation, oligohydramnios and family history) were obtained from the families. Any accompanying musculoskeletal (torticollis, pes equinovarus, congenital knee dislocation) abnormality was recorded. RESULTS: Pathological hip was determined in 149 (3.37%) of 4415 infants. In males, gestational week, family history, breech presentation, swaddling, congenital knee dislocation and limited abduction were observed to be significant for the presence of developmental dysplasia of the hip (DDH). In females, significant factors for the presence of DDH were determined to include birthweight, gestational week, breech presentation, multiple pregnancy, accompanying oligohydramnios, torticollis, pes equinovarus and limited abduction. CONCLUSION: Risk factors for DDH can differ according to gender