Does the slope and length of the plantar calcaneal spur affect the clinic?

Since some of the patients with plantar calcaneal spur (PCS) do not have pain, we aimed to investigate the effect of the slope and length of the spur on this situation. The length and slope of PCS were measured by examining the radiological images of 50 patients in this prospective study. VAS, AOFAS and FFI scores of the patients were determined. Patients were divided into groups according to PCS length and slope. According to the slope of the spur, the mean AOFAS, FFI and VAS scores were, respectively; 94, 38, 1.3 in below 20 degrees; 80.1, 86.8, 4.8 in 20-30 degrees; and 70.1, 106, 6.7 in above 30 degrees. According to the length of the spur, the mean AOFAS, FFI and VAS scores were respectively; 84.9, 68.2, 3.7 in those with length 0-5 mm; 81.1, 81.7, 4.5 in those with a length of 5-10 mm; and 71.7, 102.5, 6.4 in those with a length of >10 mm. A significant correlation was found between the angle and length of the PCS with the values of VAS, AOFAS and FFI (p<0.05). We observed that PCSs with a slope of less than 30 degrees and shorter than 10 mm do not create a serious clinical picture. If there is severe pain and functional impairment in individuals with this characteristic spur, investigation of other possible causes of heel pain must be considered

Mediopatellar plika ile ilişkili medial femoral kondil dejenerasyonu

Altmış sekiz yaşında bayan hasta, yaklaşık on yıldır diz ağrısı yakınması vardı. Bu ağrılar başlangıçta lokalize değildi. Uzun yol yürüme ve ağır aktiviteler sonrasında artıyordu. Analjezikler ile çıplakdu. Birkaç yıl yakınmaları böyle devam etti. Takip eden çift, ağrı diz bükme oluşmaya ve tibiofemoral eklem iç kısımda lokalize olmaya başlayabilir

Ossification Time of Distal Humeral Epiphyses by Gender in the Pre-pubertal Period

Aim:It was aimed to determine the differences in time of physeal closure and the appearance of humeral distal epiphyses in the prepubertal period between genders.Methods:Radiological data of the first 200 healthy children in the prepubertal period, who underwent diagnostic X-ray imaging of the elbow due to the complaints of the elbow region between January 2012 and January 2017, were collected. The presence of lateral epicondyle, lateral condyle, trochlea, and medial epicondyle epiphysis cores on the elbow radiographs was classified and labeled by age and gender. The ages, in which the lines between lateral epicondyle and lateral condyle, lateral condyle and trochlea, medial epicondyle and humerus, humerus and lateral epicondyle, and lateral epicondyle and trochlea epiphyses were found to be closed, were documented by gender.Results:Examining the mean ossification time by gender for lateral epicondyle, trochlea, medial epicondyle, and lateral condyle, this time was found to be nine months early, nine months early, 10 months early, and two months late for the girls, respectively. The mean physeal closure time in girls were found to be 13 months earlier for the lateral epicondyle-lateral condyle physis, seven months earlier for lateral condyle-trochlea physis, eight months later for lateral epicondyle-lateral condyle-trochlea-humerus physis, and nine months later for medial epicondyle-humerus physis.Conclusion:In the literature, a delay was observed in ossification time of lateral condyle in girls and medial epicondyle in both genders. When compared with girls, the medial epicondyle and fusion times were found to be earlier in boys than in girls

Is there a relationship between three-dimensionally measured Baker's Cyst volume and knee pathologies?

Objective: Baker’s cyst (BC) is also known as popliteal cyst. To evaluate its effect on intra-articular pathology, it is important to have the exact volume of the cyst. As BC may change its shape due to mass effect of the surrounding anatomic structures, it is difficult to measure the exact volume of BC. This study examined the relationship between three-dimensionally measured BC volume and symptomatic intra-articular knee pathologies. Materials and Methods: The magnetic resonance (MR) images of 45 patients with symptomatic knees were retrospectively examined. The BC volumes were measured via volumetric analysis. The joint effusion was examined in the sagittal plane in T2-proton density-weighted images. The medial plicae were assessed in accordance with the modified Sakakibara classification. Using the MR images, the meniscuses were classified in accordance with the meniscus rupture classification of Stoller et al. The cartilaginous lesions were analyzed using an MR grading system. In this study, correlations between the following measures were analyzed: BC volume and effusion level, medial plica presence, medial femoral condyle, medial tibial condyle, lateral femoral condyle and lateral tibial condyle cartilage degeneration, and medial meniscus anterior horn, medial meniscus posterior horn, lateral meniscus anterior and posterior horn ruptures. Results: Cartilage degeneration, medial plicae, increase in intra-articular effusion, and increase in the BC volume were found to be statistically significant (p<0.01). Conclusion: Cartilage degeneration, medial plicae, and increase in intra-articular effusion may increase the BC volume. We believe that this study may contribute to clinicians in understanding the relationship between BC volume changes and pathologies causing intra-articular knee symptoms

Can the length of the tibia nail be predicted correctly before the operation according to the patient's height and shoe size?

Objective: Although various methods have been identified for the appropriate tibial nail length, there are disadvantages such as extra time, radiation exposure, and additional cost. We aimed to predict the ideal length of the nail according to the patient's height and shoe size in the preoperative period to eliminate these disadvantages. Materials and Methods: Between January 2018 and August 2023, the height and shoe size data of 71 patients who were diagnosed with tibial shaft fracture and had tibia intramedullary nail fixation were determined. A linear regression model was applied to the normally distributed data. The correlation coefficient between the variables was evaluated according to the Pearson correlation coefficient. Results: While 1 1 -centimeter (cm) increase in patient height causes an increase of 3.2 millimeters (mm) in nail length, it was found that it alone contributed by 89% to predicting the ideal nail length (p<0.001). An increase of 1 unit in shoe size (EU) causes an increase of 9 mm in nail length; its contribution to predicting the ideal nail length alone is 84% (p<0.001). In the evaluation of the patient's height and shoe size together, it was observed that they jointly contributed 91% to the accurate estimation of the nail length (p<0.001). Conclusion: It may be risky to determine the tibial nail length only by shoe size or the patient's height. However, the correlation between them is strong. Therefore, by estimating nail lengths before the operation, the ideal nail length can be found by making fewer fluoroscopy checks during the operation

Total kalça artroplastisi sonrası inflamatuar reaktivasyonun bir belirteçi olarak ortalama trombosit hacmi

Objectives: Mean platelet volume (MPV) is assosiated with platelet function and activation. Increased MPV values indicate elevated platelet functions and are assosiated with inflammation. We investigated postoperative MPV changes of the patients with osteoarthritis (OA) after total hip arthroplasty. Material and Method: This retrospective study was conducted on 813 patients with coxarthrosis and 152 patients without primary coxarthrosis (control group). The patients were divided into two groups. The first group was treated with total hip arthroplasty (n=312) and the second with conservative methods (n=501). MPV, ESR, and CRP were eveluated. Early phase (up to 10 days after the operation), and late phase (>30 days postoperation) data of the patients with total hip arthroplasty were recorded. Results: Statisticaly significant differences on the mean MPV values were found between control and conservative treatment groups, and also between control and early phase surgical treatment groups (p=0.001 and p=0.005, respectively). No statistically significant difference was determined between control and late phase surgical treatment groups (p=0.796). Statisticaly significant differences were determined in the mean MPV values between conservative treatment and late phase surgical treatment groups (p=0.001), but no statistically significant difference was determined between conservative treatment and late phase surgical treatment groups (p=0.057). Conclusion: We think that changes in serum MPV values can be used as a predictive marker for inflammatory reactivation following total hip replacement surgery. The serum MPV values obtained in our study may guide future studies investigating inflammatory reactivation in hip arthroplasty surgeriesAmaç: Ortalama trombosit hacmi (MPV) trombosit fonksiyonu ve aktivasyonu ile ilişkilidir. Artan MPV değerleri, trombosit fonksiyonlarının yükseldiğini ve inflamasyonu ile birlikteliği göstermektedir. Total kalça artroplastisi sonrası osteoartritli (OA) hastaların postoperatif MPV değişikliklerini araştırdık. Gereç ve Yöntem: Bu retrospektif çalışma, koksartrozlu 813 hasta ve primer koksartrozu olmayan 152 hasta üzerinde yapıldı (kontrol grubu). Hastalar iki gruba ayrıldı. Birinci grup total kalça artroplastisi (n=312) ve ikinci grup konservatif yöntemlerle (n=501) tedavi edildi. MPV, ESR ve CRP değerlendirildi. Total kalça artroplastisi uygulanan hastaların erken evre (operasyondan sonra 10 güne kadar) ve geç evre (operasyondan 30 gün sonrası) verileri kaydedildi. Bulgular: Kontrol grubu ile konservatif tedavi grubu arasında ve kontrol grubu ile erken evre cerrahi tedavi grubu arasında istatistiksel olarak anlamlı ortalama MPV değerleri bulundu (sırasıyla p=0.001 ve p=0.005). Kontrol grubu ile geç evre cerrahi tedavi grubu arasında istatistiksel olarak anlamlı fark bulunmadı (p=0.796). Konservatif tedavi grubu ile geç evre cerrahi tedavi grubu arasında ortalama MPV değerleri istatistiksel olarak anlamlı bulundu (p=0.001), ancak konservatif tedavi grubu ile geç evre cerrahi tedavi grubu arasında istatistiksel olarak anlamlı fark yoktu (p=0.057). Sonuç: Total kalça protezi ameliyatı sonrası inflamatuar reaktivasyou belirlemeye yönelik yeni çalışmalarda belirlediğimiz MPV değerlerindeki değişikliklerin katkı sağlayacağını düşünüyoru

Comparison of linear versus macrocyclic gadolinium chelates in rat skeletal muscle

OBJECTIVE: We investigated the effects on skeletal muscle of gadolinium based linear and macrocyclic radiocontrast agents applied at experimental intervals using histopathological methods. METHODS: Thirty-two male Sprague–Dawley rats were included in the study for histopathological analysis. No procedure was performed on the healthy control group. The sham group received 0.1 ml/kg intravenous (IV) saline solution through the tail vein 4 times weekly for 5 weeks. The gadodiamide group received total 2 mmol/kg IV gadodiamide through the tail vein 4 times weekly for 5 weeks. The gadoteric-acid group received 2 mmol/kg IV gadoteric acid through the tail vein 4 times weekly for 5 weeks. RESULTS: We determined no marked apoptotic myofibrils associated withcaspase-3 expression in these two groups. Furthermore, no calcineurin expression was observed in myofibrils in the two groups. However, quantitative analyses revealed a decrease in muscle-fiber area in the gadodiamide and gadoteric-acid groups compared to the control group (Respectively; p=0.001 and p=0.017). CONCLUSION: In our experimental study, linear and macrocyclic GBCAs applied at repeated doses played no role in myofibril damage induced by caspase-3 and calcineurin – nuclear factor of activated T-cells in skeletal muscle tissue

Is the mean platelet volume predictive of hip fractures in the elderly?

cure, erkan/0000-0001-7807-135X; Cure, Medine Cumhur/0000-0001-9253-6459WOS: 000324085300011PubMed: 24003430Mean platelet volume (MPV) reflects the size of platelets and is accepted as a marker of platelet function. Platelets secrete and express a large number of substances that are crucial mediators of coagulation, inflammation, thrombosis, and atherosclerosis [1

Palmar Fibromatosis: an Analysis of 25 Cases

Objective: Dupuytren’s contracture (DC) is a benign tumor that results in nodular or fibrous band-like thickening of the palmar fascia and leads to palmar and digital contractures. Although they are benign lesions, post-operative recurrence is frequent. In the present study, we retrospectively analyzed clinicopathological findings of 25 cases that underwent surgery for DC. We also aimed to determine the relationship between relapse and Ki-67 proliferation index and smooth muscle actin (SMA) staining intensity in excision materials by immunohistochemical method. Methods: The demographic characteristics, severity of contracture, treatment type, Ki-67 proliferation index, SMA staining intensity and recurrence were evaluated retrospectively in 25 patients who were operated with the diagnosis of DC at the Department of Orthopedics and Traumatology in Recep Tayyip Erdogan University between 2009 and 2015. Results: The age range of the patients was 42-75 years (mean age: 55 years), and 6 were female and 19 were male. Fifteen of the lesions were in the right hand, and 10 were in the left hand. All patients underwent extensive palmar fascia excision with regional intravenous anesthesia. Only one patient had recurrence. Ki-67 proliferation index was 1-2% in patients without recurrence, however, >5% nuclear positivity was detected in a patient with recurrence. In addition, strong positive staining for SMA was observed in this patient. Conclusion: The use of Ki-67 proliferation index and SMA staining intensity to evaluate fibroblastic proliferation in the pathological examination of surgical DC specimens may be valuable in clinical follow-up in terms of recurrence

Primitive cable car "varangel" accidents in the black sea region of Rize in Turkey

Varangels are simple and uniquely-designed cable car-like vehicles commonly used for human and cargo transportation in the Eastern Black Sea Region of Turkey, a mountainous region. Varangels cause various accidents, resulting even in death. This study investigated the characteristics of the patients with injuries caused by varangel accidents. Medical records of 78 patients (55 males) admitted with injuries due to varangel accidents to Recep Tayyip Erdogan University Training and Research Hospital between January 2010 and December 2012 were retrospectively evaluated. Data including age, gender, site and type of the injury, accident type, and outcomes were recorded. No significant differences were determined among patients in terms of the time and type of the accident, site of the injury and outcomes according to gender or age groups. According to the type of the accident, significant differences were observed regarding the site of the injury and outcomes. Compression injuries appeared to affect the extremities more, whereas head-neck injuries were encountered more often due to falling from high. While patients with impact injuries were mostly treated in the outpatient units, those with compression injuries were treated both in the inpatient and outpatient units. Although no significant difference was determined according to the injury site, two patients who died had head-neck injuries. This study evaluating cable car-related accidents in Turkey is the most comprehensive study, with the highest number of cases analyzed. Therefore, local authorities take the necessary measures in place and widely used in the region varangels is intended to provide the legal regulations