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

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

Does anterolateral ligament rupture affect functional outcomes in patients who underwent an anterior cruciate ligament reconstruction?

Background: Studies have shown that the anterolateral ligament contributes to knee stability. This study aims to compare the results of postoperative physical examinations, knee joint stability tests, and functional assessment tests of patients with intact anterolateral (AL) ligaments and patients with ruptured anterolateral (AL) ligaments. Material and method: This study consisted of 101 patients, with at least a 12-month follow-up period, who underwent an anterior cruciate ligament reconstruction between 2010 and 2016, and whose AL ligaments were evaluated by the radiologist with the preoperative and postoperative magnetic resonance images (MRI). Of these patients, 41 had intact AL ligament (Group 1) in MRI and other 60 had ruptured AL ligament (Group 2). Groups were compared according to postoperative physical examinations, knee joint stability tests, and functional assessment tests. Results: The average Lysholm score of Group 1 was 94.9 (range: 81–100), and the score of Group 2 was 87.2 (range: 74–100). The modified Cincinnati score of Group 1 was 28.7 (24–30), while the score of Group 2 was 25.6 (21–30). The average IKDC subjective knee evaluation score of Group 1 was 91.9 (range: 83–100), and the score of Group 2 was 86.6 (range: 75–100). The average thigh atrophy value was 1.5 centimeters (cm) in Group 1 and 2.4 cm in Group 2. Thirty-three patients in Group 1 were able to jump over 85% of the distance in single-legged hop test compared to the intact side, while 16 patients in Group 2 were able to jump over this distance successfully. As a result of the analysis, it was determined that the Lysholm activity scoring results, the Modified Cincinnati scoring results, IKDC subjective knee evaluation results, two-cycle IKDC activity scale results, comparison of thigh diameters and one leg hop tests of two groups showed a statistically significant difference, and the results of the patients with intact AL ligaments who underwent an ACL reconstruction were found to be better (p < 0.05). No significant difference was found in other examinations and tests. Conclusion: Since the rupture of the AL ligament has negative effects on functional outcomes, we think that the reconstruction of the AL ligament in the same session with the ACL reconstruction or later will have a positive effect on functional outcomes. © 2019 IJS Publishing Group Lt

Corrigendum to “A new method for diagnosis of anterior cruciate ligament tear: MRI with maximum flexion of knee in the prone position: A case control study” (International Journal of Surgery (2019) 68 (142–147), (S1743919119301451), (10.1016/j.ijsu.2019.06.017))

The authors regret that the figure captions in this article appeared incorrectly and should have been displayed as follows: Fig. 3. First patient's suspected partial tear in the sagittal section in the supine position with the knee in extension (knee MRI image) Fig. 4. The first patient's total tear image in a sagittal section in the prone position with the knee in maximum flexion (knee MRI image) Fig. 5. The second patient's suspected partial tear in a sagittal section in the supine position with the knee in extension (knee MRI image) Fig. 6. The second patient's total tear image in a sagittal section in the prone position with the knee in maximum flexion (knee MRI image) Fig. 7. The third patient's suspected partial tear in a sagittal section in the supine position with the knee in extension (knee MRI image) Fig. 8. The third patient's partial tear image in a sagittal section in the prone position with the knee in maximum flexion (knee MRI image)The authors would like to apologise for any inconvenience caused

A new method for diagnosis of anterior cruciate ligament tear: MRI with maximum flexion of knee in the prone position: A case control study

Background: The diagnosis of anterior cruciate ligament tear can be made by physical examination and magnetic resonance imaging (MRI) in the supine position. In cases where the tear is partially evaluated on MRI, the choice of treatment may vary. The purpose of the study was to investigate the efficiency of MRI at maximum knee flexion in the prone position and to compare the images with findings of the ACL detected during surgery. Materials and methods: Sixty-one patients with partial ACL tears with meniscal and cartilage lesions requiring arthroscopic knee surgery were included in the study between 2017 and 2019. MRI of these patients was prescribed at maximum knee flexion in the prone position. Then, an arthroscopic operation was performed on 61 patients and the findings (intact, partial or total tear of ACL) were recorded. The ACL was evaluated as being intact and partial or total tear. The statistical significance of the efficacy of MRI in the supine position with the knee at maximum flexion in the prone position was compared. Results: It was found that, of 61 patients with suspected partial ACL tears, 25 patients had intact ACLs, 22 patients had partial tears and 14 patients had total ACL tears, through the interpretation of MRIs of the prone position by the radiologist. In the arthroscopic surgery of 61 patients, 20 patients had intact ACLs, 27 patients had a partial tear and 14 patients had a total tear. The MRI results with maximum knee flexion in the prone position were more compatible with the findings of the arthroscopic surgery. Conclusions: It could be considered that MRI with maximum knee flexion in the prone position may also be guiding in the diagnosis and treatment of patients with partial anterior cruciate ligament rupture