A Comprehensive Coronal and Axial Bone Dimension and Cartilage Thickness Evaluation of the Distal Humerus: Age and Sex Differences

Objective: There are limited data on bone dimension and cartilage thickness of the distal humeral articular surface. This study aimed to evaluate sex- and age-related bone dimension and cartilage thickness differences and assess the effect of cartilage thickness on distal humeral shape. Design: Elbow magnetic resonance images of 180 healthy participants were evaluated. Cartilage thicknesses of the trochlea and capitellum were measured at 19 points using coronal and axial images. In addition, bone diameters were measured from the flexion-extension axis to the 19 points on the coronal and axial magnetic resonance images. Sex differences were evaluated, and the correlation between age and measurement parameters was assessed. Results: Significant sex differences regarding the diameters of the axial trochlear bone, coronal lateral trochlear bone, and medial capitellar bone, cartilage thickness at the apex of the lateral trochlear ridge in the axial and coronal plane and at the most lateral point of the capitellar articular surface in the axial plane were observed. A negative correlation was observed between age and axial plane trochlear bone dimensions and between age and coronal plane lateral trochlear and medial capitellar bone dimensions. No significant correlation was found between cartilage thickness and bone dimensions. Conclusions: Bone dimension and cartilage thickness at the distal humerus vary according to sex and age. The data could be used in the donor site selection and graft preparation while osteochondral autograft transfer and allograft transplantation, and in the development of gender-compatible hemiarthroplasty implants. © The Author(s) 2020

Atraumatic diplaced bilateral femoral neck fracture in a patient with hypophosphatemic rickets in postpartum period: A missed diagnosis

INTRODUCTION: Simultaneous bilateral femoral neck fracture is an uncommon condition. There are very few cases reported in the literature and most of these cases have underlying bone pathologies such as renal osteodystrophy and osteomalacia. In some cases bilateral femoral neck fractures occur due to generalized seizures or high-energy trauma.IntroductionSimultaneous bilateral femoral neck fracture is an uncommon condition. There are very few cases reported in the literature and most of these cases have underlying bone pathologies such as renal osteodystrophy and osteomalacia. In some cases bilateral femoral neck fractures occur due to generalized seizures or high-energy trauma.Presentation of caseIn this case report &ldquo;atraumatic bilateral femoral neck fracture in a 26&nbsp;year old woman in postpartum period with hypophosphatemic rickets disease&rdquo; is presented.DiscussionFemoral neck fractures are more frequently seen in elderly because of the reduction of bone quality and developing osteoporosis. In the literature generalized epilepsy, osteomalacia, hypovitaminosis D and chronic renal failure&nbsp;</p

Factors affecting dislocation after bipolar hemiarthroplasty in patients with femoral neck fracture

Purpose: This study aimed to investigate the anatomic risk factors associated with dislocation following bipolar hemiarthroplasty for the treatment of femoral neck fracture

Neopterin, Interleukin-6, Procalcitonin, C-reactive protein and PET-CT staining as markers in infected total knee prosthesis, a retrospective analysis

WOS: 000482218200018PubMed ID: 30423671Diagnosis in prosthetic joint infections is challenging as symptoms are variable, and currently most of the diagnostic tests are non-specific. Normal inflammatory reactions after orthopedic prosthetic surgery may generate false positives, as these tests have high sensitivity, but low specificity. Thus, specific tests, as alpha defensin, are needed to distinguish bacterial infections from reactions to surgical trauma. The aim of this study was to determine the sensitivity and specificity of several diagnostic tools for detecting bacterial infection in prostheses. Between April 2010 and December 2012, we analyzed white blood cell count, erythrocyte sedimentation rate, C-reactive protein, neopterin, interleukin-6, and procalcitonin in 45 patients with prosthetic infection confirmed by positive cultures of joint aspirate and deep tissue biopsy. In addition, these patients underwent PET-CT imaging, in accordance with infection protocols in place at our clinic. The suitability and diagnostic power of these tests were assessed by using Shapiro-Wilk test, Mann-Whitney U test, and ROC curve analysis, and by comparing to 40 age- and gender-matched volunteers who underwent unilateral total knee prosthesis with normal serum indices and without known diseases. Significant differences were observed between infected patients and control volunteers (p < 0.05) for all parameters examined. Highest sensitivity (99%) and specificity (98%) were achieved using a combination of interleukin-6 and C-reactive protein. However, PET-CT imaging had diagnostic accuracy of 93.3%. A combination of interleukin-6 and C-reactive protein also enables accurate diagnosis. PET-CT may be an important imaging modality for detecting prosthesis infection. But, these markers were found neither sensitive nor specific in the diagnosis of periprosthetic infection as alpha defensin

Comparison of clinical and radiological outcomes of Lindgren-Turan and Chevron osteotomies in the treatment of Hallux valgus

Purpose: The aim of this study was to evaluate clinical and radiological outcomes of Lindgren-Turan and Chevron osteotomies in the treatment of hallux valgus

Traction radiographs versus CT in the evaluation of fracture morphology and consecutive treatment decisions in OTA/AO 43C3 fractures

WOS: 000459920100016PubMed ID: 30449460Background: Standard radiographs are limited in the evaluation of fracture characteristics and preoperative planning of OTA/AO 43C3 fractures. Therefore, CT imaging is an accepted as a useful method. CT is however expensive and has high radiation, and traction radiographs could be an alternative. This study aimed to compare fracture fragment and comminution zone visualization between traction radiographs and CT and any potentially resulting differences in consecutive treatment and surgical approach recommendations. Methods: Twenty orthopaedic surgeons assessed traction radiographs and CT images of 12 OTA/AO 43C3 type fractures. Each observer was required to identify the anterolateral, posterolateral, and medial malleolus fragments and the lateral, central, and medial shoulder comminution zones. They then had to recommend treatment (nonoperative, ORIF, closed reduction and external fixation, percutaneous screw fixation, or primary tibiotalar arthrodesis) with the best surgical approach (medial, anterolateral, posterolateral, posteromedial, or combined). Intra- and interobserver reliability, correct identification of fracture fragments and comminution zones on both images, and consistency of treatment recommendations and surgical approaches were analyzed. Results: The agreement of each observer's assessment of the presence or absence of specific fracture fragments and comminution zones was substantially increased for CT as compared to traction radiographs, particularly for the posterolateral (p = 0.000) and anterolateral fragment (p = 0.000), and the lateral (p = 0.000), central (p = 0.000), and medial shoulder comminution zone (p = 0.000). The interobserver reliability when assessing the three fracture fragments and comminution zones on the traction radiographs was moderate, whereas it was substantial when assessing these characteristics on CT. The medial malleolus fragment was more often correctly identified on traction radiographs than CT images (p = 0.001). The ability to correctly identify lateral, central, and medial shoulder comminution zones was higher for CT than traction radiographs (p = 0.000). The treatment and surgical approach recommendations after traction radiograph and CT evaluation were similar (p < 0.05). Conclusions: Traction radiographs may be a useful alternative to CT imaging in the preoperative planning of pilon fracture repair. Despite less reliable fracture fragment and comminution zone identification on traction radiographs, treatment recommendations and surgical approach were not influenced. (C) 2018 Elsevier Ltd. All rights reserved

Arthroscopic medial meniscal repair with or without concurrent anterior cruciate ligament reconstruction: A subgroup analysis

WOS: 000430159800014PubMed ID: 29162378Background: There are few large-scale, long-term studies comparing medial meniscal repairs with or without concurrent anterior cruciate ligament (ACL) reconstruction. Methods: A total of 140 patients who underwent arthroscopic medial meniscal repair were divided into two groups: Group A, meniscus repair only and Group B, meniscus repair with concurrent ACL reconstruction. Clinical assessments in- cluded physical examination findings, Lysholm score, and the International Knee Documentation Committee (IKDC) form. Barret criteria were used for the clinical assessment of healing status. Magnetic resonance imaging (MRI)was obtained to confirmhealing and failure. Subgroups of participants were compared in terms of suture technique, type of tear, and location of tear. KT-2000 arthrometer testing was used for objective evaluation of anterior-posterior knee movement. Results: Mean follow-up duration was 61 (34-85) months. Clinical outcomes in both groups were significantly improved compared to baseline (P = .0.001 vs. P = 0.001); however, there was no significant between-group difference in postoperative Lysholm and IKDC scores (P = 0.830). The outcomes of three participants (seven percent) in Group A and 11 (11.3%) in Group B were considered as treatment failures (P = 0.55). Red-red zone tears had higher scores. Mean postoperative KT2000 arthrometer values of failed participants in Groups A and B were 4.66 mm (range, four to six) and 5.2 mm (range, two to seven), respectively. Conclusion: Concurrentmedialmeniscus repair and ACL reconstruction did not have clinical superiority over meniscus repair alone. Repairs in the red-red zone appeared to be associated with better outcomes. (C) 2017 Elsevier B.V. All rights reserved