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The aim: type 2B clavicle fractures with conoid ligament rupture are considered unstable. Although surgical treatment is recommended as the standard treatment modality for type 2B fractures, there is no consensus about the type of operative treatment. We aimed to evaluate results of surgical treatment with an anatomical distal clavicle plate using CC ligament augmentation. Materials and methods: 15 patients that diagnosed with distal clavicle fractures, who underwent surgery for unstable type 2 fractures. The average patient age was 38 years (range 24–52 years). All patients were male; the right clavicle was injured in 10 patients whereas the left clavicle was injured in 5 cases. Surgical treatment was done with a distal clavicle anatomic locked plate augmentation (ZipTight™) at all cases. The mean follow-up period was 24 months (range, 12–40 months). Results: bony union was achieved at a mean follow-up of 8 weeks (range 6-10 weeks). The mean Constant score was 97 (range, 92–100). There were no complications or no need to second operation. All patients achieved satisfactory full range of shoulder motion. Hardware removal was performed for prominence in one case after the union was completed. Conclusion: the augmented technique reported here, provides early motion, increased stability and anatomic healing compared to other conventional options. We recommend augmentative CC ligament repair techniques over the distal locking anatomic plate for type 2 fractures, Цель: переломы ключицы типа 2В с разрывом коноидной связки считаются нестабильными. Хотя хирургическое лечение рекомендуется как стандартный способ лечения переломов типа 2B, единого мнения относительно типа оперативного лечения нет. Мы имели целью оценить результаты хирургического лечения анатомической дистальной пластины ключицы с использованием аугментации КК связки. Материалы и методы: 15 пациентов с диагнозом перелом дистальной части ключицы, которые прошли операцию из-за нестабильных переломов 2 типа. Хирургическое лечение во всех случаях проводилось с использованием анатомического блокировки пластины дистальной части ключицы (ZipTight™). Средний период наблюдения составил 24 месяца (диапазон - 12-40 месяцев). Результаты: сращивание костей было достигнуто при среднем наблюдении 8 недель (диапазон 6-10 недель). Средний показатель постоянной оценки составил 97 (диапазон 92-100). Осложнений или необходимости повторной операции не было. Выводы: техника аугментации, о которой сообщается здесь, обеспечивает более ранние движения, повышенную стабильность и ускоренное анатомическое заживления по сравнению с другими обычными вариантами., Мета: переломи ключиці типу 2В з розривом коноїдної зв’язки вважаються нестабільними. Хоча хірургічне лікування рекомендується як стандартний спосіб лікування переломів типу 2B, єдиної думки щодо типу оперативного лікування немає. Ми мали на меті оцінити результати хірургічного лікування анатомічної дистальної пластини ключиці з використанням аугментації КК зв’язок. Матеріали та методи: 15 пацієнтів з діагнозом перелом дистальної частини ключиці, які пройшли операцію з приводу нестабільних переломів 2 типу. Хірургічне лікування у всіх випадках проводилось з використанням анатомічного блокування пластини дистальної частини ключиці (ZipTight™). Середній період спостереження становив 24 місяці (діапазон - 12–40 місяців). Результати: зростання кісток було досягнуто при середньому спостереженні 8 тижнів (діапазон 6-10 тижнів). Середній показник постійної оцінки становив 97 (діапазон 92-100). Ускладнень або необхідності повторної операції не було. Висновки: техніка аугментації, про яку повідомляється тут, забезпечує більш ранні рухи, підвищену стабільність та прискорене анатомічне загоєння порівняно з іншими звичайними варіантами.

In this study, the design of the electric powered VTOL Flying car was made in the CAD program, and the longitudinal, vertical and lateral flight dynamics were examined and aerodynamic analysis was made. In the design, the power and propulsion systems of the flying car, avionic systems, security systems, magnetic sensors, navigation landing and take-off methods, requirement verification methods, flight performance values were determined. Our design work for flying cars, which will soon start real-time flights, will guide the people and institutions that will design and produce in this field.A practical flying car should be able to operate safely and environmentally both in public spaces and in the air. For widespread adoption, it must be able to fly without a qualified pilot as we know it as a controller, and must have appropriate purchase and operating costs. Being a qualified car driver and having a pilot license, which certification processes are extremely difficult, is an important obstacle to the adoption and widespread process of the flying car concept. The certification processes of many different countries have been examined for the flying car we will design. Examination of these processes has been guiding in the creation of detailed data on many issues, and in this context, care has been taken to meet the requested competencies on a common ground. In order to overcome these procedures, a VTOL platform with high autonomy has been designed thanks to its subsystems as well as a stable flight dynamics., Bu çalışmada, elektrikle çalışan VTOL Uçan arabanın tasarımı CAD programında yapılarak boylamsal, dikey ve yanal uçuş dinamikleri incelenerek aerodinamik analizleri yapılmıştır. Tasarımda uçan arabanın güç ve tahrik sistemleri, aviyonik sistemler, güvenlik sistemleri, manyetik sensörler, seyrüsefer iniş ve kalkış yöntemleri, gereksinim doğrulama yöntemleri, uçuş performans değerleri belirlendi. Yakında gerçek zamanlı uçuşlara başlayacak olan uçan arabalara yönelik tasarım çalışmalarımız, bu alanda tasarım ve üretim yapacak kişi ve kurumlara yol gösterecek.Pratik bir uçan araba, hem kamusal alanlarda hem de havada güvenli ve çevreci bir şekilde çalışabilmelidir. Yaygın olarak benimsenmesi için, kontrolör olarak bildiğimiz nitelikli bir pilot olmadan uçabilmesi ve uygun satın alma ve işletme maliyetlerine sahip olması gerekir. Sertifikasyon süreçleri son derece zor olan kalifiye araç sürücüsü ve pilot ehliyetine sahip olmak, uçan araba kavramının benimsenmesi ve yaygınlaşmasının önünde önemli bir engeldir. Tasarlayacağımız uçan araba için birçok farklı ülkenin sertifikasyon süreçleri incelendi. Bu süreçlerin incelenmesi birçok konuda detaylı verilerin oluşturulmasında yol gösterici olmuş ve bu kapsamda talep edilen yetkinliklerin ortak bir paydada karşılanmasına özen gösterilmiştir. Bu prosedürlerin üstesinden gelebilmek için alt sistemleri ve stabil uçuş dinamiği sayesinde yüksek otonomiye sahip bir VTOL platformu tasarlanmıştır.

Aim: Morton’s neuroma is a paroxysmal neuralgia of forefoot and when nonsurgical treatment is unsuccessful, neuroma excision is indicated. The purpose of the present study was to evaluate the outcomes, complications and existing symptoms following an excision of the neuroma using dorsal approach.Methods: The study evaluated 27 patients (21 women) with an average age of 49 years (range, 24-74) and an average follow-up of 52 months (range, 24-96). The clinical diagnosis was confirmed by history and clinical evaluation. Clinical outcomes were assessed using the interdigital neuroma score and the patients were asked in terms of the level of pain, shoe modification, and sensorial problems. Results: Average interdigital neuroma score improved from 20 to 62 points following the surgery (p

Background: Carpal tunnel syndrome(CTS) is the most frequent compressive neuropathy of upper extremity .Median nerve is compressed under flexor retinaculum because of primary or secondary reasons. Although primary CTS may have different causes, idiopathic CTS's ethiology is unclear We aimed to evaluate tenosynovial tissue change under flexor retinaculum as a cause of idiopathic CTS even more as a possible cause of recurrent CTS. Materials and Methods: We operated 175 patients with carpal tunnel syndrome who had median nerve compression. 110 patients were diagnosed as idiopathic CTS were included at our study. Open carpal tunnel release was performed by same surgeon and synovial samples were taken from synovial connective tissue under median nerve for pathological examination. Results: All patients were followed-up 22 months ( 12 to 35 months ) prospectively. Mean age was 45 years( 22 to 65). Preop VAS score was 6 post op VAS score was 1. Synovial hypertrophy was detected at 38 of 110 patients(34%). Other pathological results were; 13 reactive synovitis (11%), 8 ganglion(7.2%) , 51 fibrohyaline nodulation(46.3%). Conclusions: We recommend the evalution of tenosynovial tissue under flexor retinaculum after releasing the retinaculum. If there is an inflammation or a hypertrofi or a mass effect, surgeon must do partial tenosynovectomy to decrease the volume of the carpal tunnel and to prevent recurrence.

Purpose The aim of this paper is to redesign of morphing unmanned aerial vehicle (UAV) using neural network for simultaneous improvement of roll stability coefficient and maximum lift/drag ratio. Design/methodology/approach Redesign of a morphing our UAV manufactured in Faculty of Aeronautics and Astronautics, Erciyes University is performed with using artificial intelligence techniques. For this purpose, an objective function based on artificial neural network (ANN) is obtained to get optimum values of roll stability coefficient (Clβ) and maximum lift/drag ratio (Emax). The aim here is to save time and obtain satisfactory errors in the optimization process in which the ANN trained with the selected data is used as the objective function. First, dihedral angle (φ) and taper ratio (λ) are selected as input parameters, C*lβ and Emax are selected as output parameters for ANN. Then, ANN is trained with selected input and output data sets. Training of the ANN is possible by adjusting ANN weights. Here, ANN weights are adjusted with artificial bee colony (ABC) algorithm. After adjusting process, the objective function based on ANN is optimized with ABC algorithm to get better Clβ and Emax, i.e. the ABC algorithm is used for two different purposes. Findings By using artificial intelligence methods for redesigning of morphing UAV, the objective function consisting of C*lβ and Emax is maximized. Research limitations/implications It takes quite a long time for Emax data to be obtained realistically by using the computational fluid dynamics approach. Practical implications Neural network incorporation with the optimization method idea is beneficial for improving Clβ and Emax. By using this approach, low cost, time saving and practicality in applications are achieved. Social implications This method based on artificial intelligence methods can be useful for better aircraft design and production. Originality/value It is creating a novel method in order to redesign of morphing UAV and improving UAV performance.

Bu calismada govde surukleme katsayisinin en uygun degerini hesaplamak icin yapay zeki bir yontem olan Yapay Sinir Aglari (YSA), hizli bir yontem olan Eszamanli Dagilim Rassal Yaklasim (EDRY) algoritmasi icerisine yerlestirilerek yeni bir algoritma tasarlanmistir. EDRY en iyi cozume oldukca hizli bir sekilde yakinsayabilmektedir. Ancak tek basina EDRY cozumu bulabilmek icin problemin bir fonksiyonuna ihtiyac duymaktadir. YSA ise problemin bir fonksiyonu olmaksizin da cozumu bulabilmektedir. Ancak YSA’nin iyi egitilebilmesi icin belirli bir veri kumesine ihtiyac vardir. Ayrica problemin degisen her veri kumesi icin en iyi sonucu veren uygun ag yapisi ve parametreleri de degisebilmektedir. Bu nedenle YSA yalniz basina kullanilarak tek bir ag yapisi ile her farkli veri kumesi icin en iyi sonuca ulasmak mumkun degildir. Bu calismanin temel amaci YSA’nin ogrenme kabiliyetinden faydalanarak EDRY’yi bir amac fonksiyonu olmayan problemler icin de kullanilabilir hale getirmektir. Bu amacla, oncelikle daha once ruzgâr tunelinde yapilmis deneysel calismalar neticesinde elde edilen govde sekillerine gore govde surukleme katsayisinin degisimi verileri ile YSA egitilmistir. Boylece YSA sekil degerlerine gore govde surukleme katsayisini kendisi tahmin edebilecek yetenege gelmistir. YSA artik herhangi bir deneysel hesaplamaya ihtiyac duymadan giris degerlerine gore govde surukleme katsayisini tahmin edebilmektedir. Fakat burada YSA ile en uygun deger degil, her giris degeri icin bir cikis degeri bulunmaktadir. EDRY’nin her adimda hesaplamaya ihtiyac duydugu maliyet fonksiyonu bu sekilde YSA, EDRY’ye gomulerek giderilmistir. Yani burada tasarlanan yeni algoritma YSA’yi hangi durumlarda govde surukleme katsayisinin ne olacagini bulmak icin kullanirken EDRY’yi de en iyi katsayinin olusmasi icin en uygun durumlarin ne oldugunu bulmak icin kullanmaktadir. Bu sekilde egitilen YSA, EDRY’ye gomulerek, govde surukleme katsayisini bir bagintiya ihtiyac olmaksizin hizli ve dogru bir sekilde hesaplayan, basarili ve yeni bir algoritma gelistirilmistir.

WOS: 000392918400014, PubMed: 27836497, Objective: Anatomic volar rim locking plates are designed with the aim of treating intraarticular distal radius fractures. When used to treat comminuted distal radius fractures, these plates can damage the flexor tendons. In this study, we sought to determine the radiological and functional results and rate of complications of these plates. Methods: We retrospectively reviewed the records of 36 patients (28 males, 8 females; mean age: 46.4 years) with AO/OTA Type C2-C3 distal radius fractures treated with anatomic volar rim distal radius plates between January 2011 and December 2014. Radial length, radial inclination and palmar tilt were compared with the intact wrist. Results were evaluated with the Mayo wrist and Lidstrom scores. Complications were documented throughout the follow-up period of 23.8 (range: 12 to 48) months. Results: Postoperative measurements of the radial length, inclination and palmar tilt did not differ significantly. Mayo wrist and Lidstrom scores were good and excellent in 27 and 32 patients, respectively. Flexor tenosynovitis was symptomatic in 15 patients and asymptomatic (localized swelling only) in 21. Plates were removed from 15 patients due to symptomatic tenosynovitis and from six patients due to partial rupture of the flexor pollicis longus tendon. The flexor digitorum profundus tendon of the second finger was also partially ruptured in three patients. Conclusion: Anatomic volar rim locking plates provide satisfying radiological and functional results in treating AO/OTA Type C2-C3 comminuted distal radius fractures. However, if these plates interfere with the union of the fracture, they should be removed to avoid potential tendon problems caused by their placement in the rim region. (C) 2016 Publishing services by Elsevier B.V. on behalf of Turkish Association of Orthopaedics and Traumatology.

Objectives: To evaluate the results of ligament reconstruction tendon interposition arthroplasty in osteoarthritis of the carpometacarpal joint of the thumb. Methods: Ten thumbs of eight patients who underwent arthroplasty for osteoarthritis at the base of the thumb evaluated grip, key pinch strengths, ROM and radiologically which did not respond satisfactorily to conservative treatment modalities. Results: All patients had improved pain, increase in grip %45, key pinch strengths %56, mean ROM were 30 degrees. Radiographically, any of the thumb was detected migration, subluxation. Conclusion: In our applied technique, successfull results were achieved in the treatment with use the fcr tendon in CMC osteoarthritis. [Hand Microsurg 2012; 1(1.000): 22-24]

Aim. To evaluate whether aseptic hypertrophic nonunion in the long bones of the lower extremity can be treated successfully with LISS applied with closed methods without grafting. Materials and Methods. The study included 7 tibias and 9 femurs of 16 patients. All cases had hypertrophic nonunion. Initial surgical treatment was with intramedullary nailing in 14 cases, 6 of which had required an exchange of intramedullary nail. All the patients were treated with LISS plate with closed methods. Results. Union was obtained at mean 7 months in all patients. No implant loosening or breakage of the implant was observed and there was no requirement for secondary surgery. Conclusion. Cases of hypertrophic nonunion have excellent blood supply and biological potential. Therefore, there is no need for bone grafting and the addition of fracture stability is enough to achieve full union. Using a limited approach and percutaneous screw insertion, LISS provides fracture stabilization with soft tissue protection.

WOS: 000366662600012, PubMed: 26542987, Introduction: Perilunate injuries are rare entities which can be difficult to diagnose. Most common type is dorsal perilunate fracture dislocation (97%). The purpose of treatment is anatomic reduction and stable fixation. We aimed to present the radiologic and functional results of surgically treated dorsal perilunate fracture-dislocations and discuss the factors influencing the prognosis. Methods: Between 2007 and 2013, 17 patients were operated for perilunate fracture-dislocations. The mechanism of injuries, soft tissue traumas, etiologic factors and stages according to Herzberg classification were determined. The MAYO wrist score was used for functional evaluation. Scapholunate distance and scapholunate angle were measured and, degenerative changes were investigated by comparing with contralateral side on plain x-ray images in terms of radiologic evaluation. Results: Mean follow-up was 37,8 (range, 16-84) months. The average age at surgery was 35.1 (range, 18-51) years. Fifteen patients were male and two were female. Functional results were excellent in four (23.5%), good in two (11.8%), satisfactory in five (29.4%) and poor in six (35.3%) patients. Degenerative changes were determined in radiocarpal and mid-carpal joints of 14 wrists (82.4%). Scapholunate dissociation more than 2 mm was detected in three wrists. In four wrists osteochondral fragments were determined on the head of the capitate. Stage 2 lesions, delayed presentations, open fractures, scapholunate dissociations more than 2 mm had worse functional results. Conclusion: Despite anatomic reduction, ligamentous and chondral injuries that occured at the time of trauma may cause persistant wrist pain in patients who suffer perilunate fracture dislocation. Mechanism of injury, presence of soft tissue defects and the time between injury and treatment can affect clinical and radiologic results. (C) 2015 IJS Publishing Group Limited. Published by Elsevier Ltd. All rights reserved.

Objectives: We aimed to evaluate radiographic complications occurring after treatment of unstable intertrochanteric hip fractures with the Proximal Femoral Nail (PFN) and their effect on functional results.Methods: The study included 35 patients (23 women, 12 men; mean age 71 years; range 62 to 111 years) who were treated with the PFN for unstable intertrochanteric hip fractures. According to the AO classification, there were 12 type AII-1, 12 AII-2, 3 AII-3, 3 AIII-1, 5 AIII-3 fractures. The mean time to surgery was 13 days (range 5 to 32 days). Closed reduction was achieved in 31 patients. The patients were evaluated clinically (Harris hip score) and radiographically after a mean follow-up of 32.4 months (range 26 to 52 months) and complications were recorded.Results: Reduction was assessed as good or acceptable in all the patients. The mean tip-apex distance was measured as 24.2 mm (range 16 to 40 mm). Complete union was achieved in all but two patients. The mean Harris hip score was 82.1. The results were excellent in 11 patients (31.4%), good in 15 patients (42.9%), fair in seven patients (20%), and poor in two patients (5.7%). Radiographic complications mainly included secondary varus displacement in nine patients (25.7%), and calcification at the tip of the greater trochanter in two patients (5.7%). Secondary varus displacement was due to cut-out of the proximal screws (n=2), screw loosening due to collapse of the fracture site (n=2), and reverse Z-effect (n=5). Clinical results were good in two patients with calcification at the tip of the greater trochanter. Of nine patients with secondary varus displacement, the results were excellent or good in six patients, fair in two patients, and poor in one patient. Five patients (14.3%) required a subsequent operation.Conclusion: The correct position of the osteosynthesis material and use of an intramedullary nail providing a stronger fixation of the proximal part may reduce mechanical complications following the treatment of unstable intertrochanteric hip fractures., Amaç: Dengesiz (instabil) intertrokanterik kalça kırıklarının Proksimal Femoral Çivi (PFN) ile tedavisi sonrasında gelişen radyografik komplikasyonlar ve bu komplikasyonların fonksiyonel sonuçlara etkileri değerlendirildi.Çalışma planı: Dengesiz intertrokanterik kırık nedeniyle 35 hasta (23 kadın, 12 erkek; ort. yaş 71; dağılım 62-111) PFN ile tedavi edildi. AO sınıflamasına göre 12 kırık tip AII-1, 12 kırık AII-2, 3 kırık AII-3, 3 kırık AIII-1, 5 kırık AIII-3 idi. Hastalar travma tarihinden sonra ortalama 13. günde (dağılım 5-32 gün) ameliyat edildi. Otuz bir hastada kapalı redüksiyon uygulandı. Olgular ortalama 32.4 ay (dağılım 26-52 ay) takip sonunda klinik (Harris kalça skoru) ve radyografik olarak incelendi ve oluşan komplikasyonlar belirlendi.Sonuçlar: Tüm olgularda iyi ya da kabul edilebilir redüksiyonun sağlandığı görüldü. İmplant ucu-apeks mesafesi ortalama 24.2 mm (dağılım 16-40 mm) ölçüldü. İkisi hariç tüm olgularda tam kaynama elde edildi. Olguların Harris kalça skoru ortalaması 82.1 bulundu. On bir hastada (%31.4) çok iyi, 15 hastada (%42.9) iyi, yedi hastada (%20) orta, iki hastada (%5.7) kötü sonuç alındı. Radyografik komplikasyon olarak, dokuz olguda (%25.7) ikincil varus gelişimi, iki olguda (%5.7) trokanter majör ucunda kalsifikasyon oluşumu görüldü. İkincil varusun proksimal vida sıyrılması (n=2), kırık hattında çökmeye bağlı vidaların geri gelmesi (n=2) ve ters Z etkisine (n=5) bağlı meydana geldiği görüldü. Trokanter majörde kalsifikasyon görülen iki olguda klinik sonuçlar iyi bulundu. İkincil varusu olan dokuz olgunun altısında Harris kalça skoru çok iyi veya iyi, iki olguda orta, bir olguda ise kötü idi. Beş olguda (%14.3) ikinci ameliyat uygulandı.Çıkarımlar: Osteosentez materyalinin doğru pozisyonda yerleştirilmesi ve proksimal parçanın daha kuvvetli tespitini sağlayan intramedüller çivi kullanımı dengesiz intertrokanterik kalça kırıklarının tedavisinde mekanik komplikasyonları azaltacaktır.

Purpose. We evaluated whether intramedullary nail fixation for tibial diaphysis fractures with concomitant fibula fractures (except at the distal one-third level) managed conservatively with an associated fibula fracture resulted in ankle deformity and assessed the impact of the ankle deformity on lower extremity function.Methods. Sixty middle one-third tibial shaft fractures with associated fibular fractures, except the distal one-third level, were included in this study. All tibial shaft fractures were anatomically reduced and fixed with interlocking intramedullary nails. Fibular fractures were managed conservatively. Hindfoot alignment was assessed clinically. Tibia and fibular lengths were compared to contralateral measurements using radiographs. Functional results were evaluated using the Knee Injury and Osteoarthritis Outcome Score (KOOS) and the Foot and Ankle Disability Index Score (FADI).Results. Anatomic union, defined as equal length in operative and contralateral tibias, was achieved in 60 fractures (100%). Fibular shortening was identified in 42 fractures (68%). Mean fibular shortening was 1.2 cm (range, 0.5–2 cm). Clinical exams showed increased hindfoot valgus in 42 fractures (68%). The mean KOOS was 88.4, and the mean FADI score was 90.Conclusion. Fibular fractures in the middle or proximal one-third may need to be stabilized at the time of tibial intramedullary nail fixation to prevent development of hindfoot valgus due to fibular shortening.

We investigated the functional and radiological outcomes of conservatively treated simple traumatic elbow dislocations and subsequent incidence of cubitus valgus development in children. Eleven patients (one female, ten male; mean age 9.8 years, range seven to 12 years) who presented to our hospital with simple elbow dislocations and were conservatively treated between July 2008 and September 2010 were included in the study. All were posterolateral closed dislocations. None of the patients had accompanying elbow fractures. All patients had pre- and postoperative radiographic examinations. The carrying angle of the involved elbow was measured and compared to the contralateral non-injured elbow during follow-up. The incidence and severity of cubitus valgus development was assessed. The functional and clinical outcomes were evaluated using the Mayo Elbow Performance Scale. The mean monitoring period was 24.3 months (range 19-30 months). All patients had satisfactory good and excellent results (85-100 points; mean 96.8 points) according to the Mayo Elbow Performance Scale. The final average elbow flexion was 137A degrees (range, 130-145A degrees) and average extension was 8.6A degrees (range 0-20A degrees) with full supination and pronation in traumatic elbow. Four patients (36.4 %) had an average increase (cubitus valgus) of 14.5A degrees (10-20A degrees) in carrying angle compared to the other elbow. While isolated traumatic dislocation of the elbow is uncommon among children, it can be successfully treated by urgent closed reduction, proper fixation of the elbow and appropriate timely rehabilitation. However, it should be considered that some patients may develop cubitus valgus deformity in a later period. Therefore, each patient with a simple traumatic elbow dislocation should be followed, and the parents should be informed of the potential for any deformity development.

Aim: To investigate in fractures of the fifth metacarpal neck whether there is any difference in functional results of non-operative treatments with dorsal angulation either below or above 30°. Methods: After closed reduction, fractures were treated with plaster splints for 5 weeks. Cases were divided into two groups, with dorsal angulation either below (group 1) or above (group 2) 30°, according to oblique radiography, and were evaluated at 6 months. Grip strength, range of passive joint movement and distance from fingertip to distal crease were measured and compared. A scoring system assessed function, and occupational adequacy, patient satisfaction and presence of pain were recorded. Results: Functional outcome was good or very good in both groups and occupational adequacy was not reduced in any case. Full patient satisfaction was achieved except for one person in group 1 and two people in group 2, regarding cosmetic results. There was no statistically significant difference between the two hands in either group except for one man from group 2, who had mild pain during coercive use of the injured hand. Conclusions: With non-operative treatment of fractures of the neck of the fifth metacarpal, similar results were achieved with dorsal angulation either above or below 30°. A dorsal angulation less than 45° may be treated conservatively. © 2008 Elsevier Ltd. All rights reserved.

Highlights • Achilles tendon ruptures are generally observed after sport traumas and results of primary repair are good. • Several complications after surgery were reported. • In tendon repairs generally nonabsorbable sutures are used. • Ethibond suture is a strong and safe material for Achilles tendon repairs it may cause soft tissue problems such as granuloma., INTRODUCTION Several complications can be observed after Achilles tendon repairs. In this study we aimed to report granuloma formation secondary to Achilles tendon repair with Ethibond (Ethicon INC, Somerville, New Jersey) suture. PRESENTATION OF CASE A 31 year-old man operated for Achilles tendon rupture. The Ethibond suture was used for primary repair. The patient attended to polyclinic with the complaints of swelling and discharge around the operation site four months after operation. A mass around distal portion of the Achilles tendon was detected. The granulomatous tissue was excised. Inside the mass Ethibond suture was detected. On histopathologic examination, typical findings of the foreign body reaction were observed. No microorganism was cultivated in the tissue culture. The patient has no complaint on the twelfth month control after surgery. DISCUSSION The results of primary repair of Achilles tendon are good but several complications were reported. In tendon repairs generally nonabsorbable sutures are used. The Ethibond is nonabsorbable, braided suture. In the literature, granuloma formations secondary to the suture materials such as polygylactine and braided polyethylen–polyester after Achilles tendon repair were reported but granuloma secondary to the Ethibond is very rare. CONCLUSION Although Ethibond suture is a strong and safe material for Achilles tendon repairs it may cause soft tissue problems such as granuloma.