Procedural outcomes of double vs. single fluoroscopy for fixing intertrochanteric femur fractures

WOS: 000378564500006PubMed: 27155881Objective This study compares reducing radiation and operation time between single and double C-arm fluoroscopy in the treatment of intertrochanteric femur fractures with intramedullary nails. Patients and methods Forty four patients participated in the study. Patients were divided into two groups as single (23 patients) and double fluoroscope (21 patients). The time of preparation, the duration of the surgery, the total amount of blood loss, and the total duration of radiation exposure were compared, retrospectively. The collo-diaphyseal angle was compared with that of the contralateral hip on postoperative radiographs. Furthermore, the tip-apex distance and the position of the screws in the femoral head were recorded. Results The mean preparation periods, collo-diaphyseal angles and blood loss did not differ between groups. In the double-fluoroscopy group, the duration of surgery was 15.9 min shorter (p < 0.001), and the radiation time was 25.7 s shorter (p < 0.001). Conclusion The double fluoroscopy technique can significantly reduce surgical and radiation exposure times during surgery

Comparison of conservative and surgical treatment methods in patients with meniscopathy

Objective: Arthroscopic surgery is currently a well-known treatment method for meniscal pathologies. This study aims to compare conservative and surgical methods in patients with meniscopathy. Materials and Methods: The retrospective analyses of 68 patients with meniscal tear were included in this study. Patients were divided into two groups: a medical treatment group (MTG) and a surgical treatment group (STG). Diagnosis was perfomed by physical examination and magnetic resonance imaging (MRI). All patients were evaluated before and after treatment with main pain score (MPS), International Knee Documentation Committee (IKDC) score, body mass index (BMI), and Ultrasensitive C-reactive protein (US-CRP). In the MTG group, 31 patients underwent medical treatment with naproxen sodium for three days, ice application, activity modification, and muscle exercises. In the STG group, 37 patients underwent arthroscopic partial menisectomy and naproxen sodium for three days. Parameters characterizing pretreatment and posttreatment states were compared statistically. The MPS, IKDC, BMI, and US-CRP values of both groups were recorded at baseline and three months after treatment. Results: Surgical treatment group (STG): In this group, after three months of treatment, MPS decreased and IKDC scores increased significantly when compared with baseline (P < 0.0001 and P < 0.0001, respectively). The difference for the US-CRP levels and BMI values was not statistically significant (P = 0.1500 and P > 0.1799, respectively). Medical treatment group (MTG): In this group, MPS decreased and BMI increased significantly after three months compared with preoperative scores (P < 0.0001 and P < 0.0001, respectively). However, the difference between average IKDC scores and US-CRP levels was not statistically significant (P = 0.1828 and P > 0.05, respectively). Conclusion: IKDC and pain scores of patients with meniscal tear improved by arthroscopic knee surgery. [Arch Clin Exp Surg 2016; 5(2.000): 78-84

The Results of Core Decompression Treatment in Avascular Necrosis of the Femoral Head

Objective: Avascular necrosis of the femoral head (AVNFH) is a progressive disease seen in young, active patients, leaving significant disability in the joint when untreated. We retrospectively examined the results of patients with early stage AVNFH who had been operated in our clinic

Isolated Carpal Dislocation Of The Trapezium

Trapezium fractures and dislocations of the trapezium are both extremely rare injuries whether they occured with or without fractures of the surrounding bones. Specific radiological images can be difficult to help for the diagnosis. CT scan may be necessary for the diagnosis and adequate treatment. We are presenting an unusual case of volar and radial isolated trapezium dislocation concomitant second metacarpal basis fracture in which is treated by using open reduction and Kirschner wire fixation. In our case, isolated dislocation of trapezium was a result of violent and direct trauma. Different techniques have been proposed to achieve a stable fixation and the treatment outcomes. In our case, open reduction, Kirschner wire fixation and intercarpal ligament repair through dorsal approach are recommended for satisfactory outcomes in similiar cases

Accuracy of anterior glenohumeral injections: a cadaver study

Intra-articular glenohumeral injections have an important role for therapeutic benefit and diagnostic information. Therefore, it is very important that the injected material should reach its desired target. This study assessed the accuracy of an anterior intra-articular injection in fresh cadavers

Total diz protezi uygulanan hastaların orta dönem klinik ve radyolojik sonuçlarının değerlendirilmesi

Amaç: Çalışmada, kliniğimizde total diz protezi uygulanan olguların retrospektif olarak incelenmesi ve orta dönem klinik sonuçlarının ortaya konulması amaçlanmıştır.Gereç ve Yöntem: Gonartroz tanısı ile Ocak 1996 - Aralık 2003 tarihleri arasında kliniğimizde total diz protezi uygulanan 54 hastadan yeterli takipleri yapılan 31 (27 kadın, 4 erkek) hastanın 36 dizi bu çalışmaya dahil edilmiştir. Hastaların ameliyat tarihindeki yaş ortalaması 66.6 (41-80) idi. Ameliyat öncesi tanı 27 hastada primer osteoartrit, 3 hastada romatoid artrit ve bir hastada karşı taraf gelişimsel kalça displazisi zemininde ortaya çıkan artroz idi. Ortalama takip süresi 74.3 ay (49-135) olarak saptandı. Hastalar "Amerikan Diz Cemiyeti Kriterlerine" göre; diz skoru ve diz fonksiyonel skoru bakımından değerlendirildi. Radyolojik değerlendirme ise, "Total Diz Protezi Radyolojik Değerlendirme Kriterlerine" göre yapıldı.Bulgular: Diz skoru ameliyat öncesi ortalama 60.8 iken, ameliyat sonrası ortalama 89.7 (56-100) olarak saptandı. Diz skoru bakımından dizlerin 30'unda (%83.3) mükemmel, 5'inde (%13.8) iyi, 1'inde (%2.7) kötü sonuç tespit edildi. Fonksiyonel skoru ameliyat öncesi ortalama 35.6 (15-60) iken, ameliyat sonrası ortalama 71.5 (45-95) olarak bulundu. Fonksiyonel skor bakımından dizlerin 9'unda (%25) mükemmel, 11'inde (%30.5) iyi, 11'inde (%30.5) orta, 5'inde (%13.9) kötü sonuç alındığı gözlendi. Diz protezi uygulaması ile eklem hareket açıklığının, stabilitesinin ve hastaların yürüme mesafelerinin anlamlı olarak arttırıldığı ortaya kondu.Sonuç: Gonartroz, hastaların yaşam kalitesini ve günlük fonksiyonlarını ileri derecede kısıtlayan bir hastalıktır. Uygun hasta seçimi, yeterli ameliyat öncesi hazırlık, hastaya uygun protez seçimi ve dikkatli cerrahi teknik kullanıldığında, total diz protezi uygulamaları, gonartrozun tedavisinde son derece etkili bir tedavi seçeneği oluşturmaktadırMidterm clinical and radiological outcomes of total knee arthroplastyPurpose: The aim of this study is to investigate retrospectively the midterm clinical and radiological outcomes of total knee arthroplasty (TKA) which were performed in our clinic.Method: Thirty-one (27 women, 4 men) of 54 patients were included in the study. At midterm, a minimum of 4 years (49-135 months) after surgery, Knee Society scores (KSSs), Knee Society Functional scores (KSFSs), range of motion (ROM), and radiographic results of 36 knees of 31 patients were assessed and reported in this study.Results: The preoperative mean knee score was 60.8 , while after the surgery it was 89.7 (56100), respectively. In terms of knee score, 30 knees (83.3%) had excellent, 5 (13.8%) had good and 1 (2.7%) had poor results. The average preoperative functional score was 35.6 , while average postoperative score was 71.5 , respectively. In terms of functional knee scores, 9 (25%) were excellent, 11 (30.5%) were good, 11 (30.5%) were moderate, and 5 (13.9%) were poor. The range of motion (ROM) of the knees and stability were significantly increased.Conclusion: Osteoarthritis is a disease that limits severely the quality of life and daily functioning of patients. With the appropriate patient selection, adequate preoperative preparation, appropriate prosthesis selection and careful surgical technique, the treatment of knee osteoarthritis in patients with total knee arthroplasty (TKA) constitutes a highly effective treatment optio

Comparison of four different intra-articular injection sites in the knee: a cadaver study

Although intra-articular knee injection is not a complicated procedure, it could be difficult to assess whether the tip of the needle lies free in the joint or is embedded in synovium or other intra-articular soft tissues. The purpose of this study was to evaluate the accuracy rate of intra-articular injection using anteromedial (AM), anterolateral (AL), lateral midpatellar (LMP), and medial midpatellar (MMP) portals in cadavers. In this study 156 knees of 78 fresh cadavers were included. Anterolateral and AM injection to both knees of 39 cadavers (78 knees) were performed. MMP and LMP injection to both knees of other 39 cadavers were also performed. Accuracy rate was the highest (85%) in the AL injection portal and lowest in the MMP portal (56%). In conclusion, the accuracy obtained with use of the MMP portal was significantly lower than that obtained with the use of either the AM (P < 0.05), AL (P < 0.0001), or LMP (P < 0.05) portal. Although AL injection site resulted in good intra-articular delivery with 85% accuracy rate and with a lower incidence of soft tissue infiltration, the results were not statistically significant when compared to AM and LMP portals. Therefore, any of these three portals might be preferred depending on the experience of the physician. On the other hand, 100% accuracy could not be obtained through any portals in the study, which should be kept in mind when treating knee problems with intra-articular medications

Correlation between HJHS and HEAD-US Scores during Prophylaxis in Turkish Patients with Hemophilia: National Prospective Observational Study

WOS: 000536674800086[No abstract available

Evaluation of the Superior Gluteal Nerve During Proximal Femoral Nailing

WOS: 000402382500013Aim: The superior gluteal nerve may be compromised during hip surgery. We retrospectively evaluated the patients who underwent proximal femoral nailing for unstable trochanteric fractures in order to investigate the presence of superior gluteal nerve injury and its clinical findings. Material and Method: Twenty five patients (14 women, 11 men) were included in the study who had femoral nailing between January 2004 and March 2010 at Hamidiye Sisli Etfal Training and Research Hospital Department of Orthopaedics. Two different types of nails which have similar designs and surgical techniques were used for fracture fixation. Patients who had a history of cerebrovascular disease, electromyography findings of polyneuropathy, or degenerative vertebral disease were excluded from the study. Patients were evaluated clinically and radiologically. Findings related to acute denervation in the gluteus medius muscle and motor unit action potential changes were accepted as signs of superior gluteal nerve injury. Results: Eight patients were using support during walking and three of these patients had positive Trendelenburg sign, but only one patient had acute denervation signs of the superior gluteal nerve. Discussion: Based on the present study the incidence of iatrogenic nerve injury is a rare complication of proximal femoral nailing. Elderly patients, regardless of whether they have nerve injury, may limp and need to use a walking support