Search

Fractures, especially when they occur in hand, are one of the traumas that significantly affect the quality of daily life. Metacarpal fractures are among the most common types of hand fractures, and it is essential to treat them effectively to restore normal hand function. This study uses the finite element method to analyze the effectiveness of locked plates, Kirschner wires, and a combination of both in treating intra-articular metacarpal head fractures. Using computed tomography data from an individual who suffered hand trauma, a three-dimensional metacarpal bone model and fracture line were created. Finite element-based analyses were conducted for models created for three different treatments, and the equivalent stress results obtained from the analyses were evaluated. The findings indicate that combining a locking plate and two crossed Kirschner wires produces lower stress values than the other two methods. This result demonstrates that the combined method provides relatively greater stability than the locking plate alone. Additionally, the method using only the Kirschner wire was found to have the highest stress values among the three methods examined, indicating it is the least stable method. Consequently, it has been concluded that the combination of a locking plate and two crossed Kirschner wires is more effective for the treatment of intra-articular metacarpal head fractures. [ABSTRACT FROM AUTHOR]

Objective: Consultations requested by the forensic medicine clinic and fulfilled by the otorhinolaryngology clinic were discussed in the context of literature findings, taking into account their characteristics and the issues to be considered in reporting. Material and Methods: The cases which were examined retrospectively in terms of sociodemographic characteristics and contents were divided into groups based on trauma to the face-head-neck region, otological symptoms, and injuries that could be resolved with basic medical intervention (BMI) versus those that could not be resolved with BMI. Results: The mean age of the 134 cases evaluated was 41.13±16.02 years, with the youngest being 18 and the oldest 82 years old. Fifty-eight cases (43.2%) had injuries that could be resolved with BMI. Forty-two cases (31.3%) had fractures in the facial or nasal bones. 10 cases (7.5%) with traumatic tympanic membrane perforation, 19 cases (14.1%) without tympanic membrane perforation were consulted for hearing evaluation, and 9 cases (6.7%) were consulted for acoustic trauma. The evaluation of sequelae conditions was conducted on average 9.27±1.34 months after the date of incident, with the shortest duration being 7 months and the longest being 11 months. Conclusion: It should be noted that radiological imaging accompanying physical examination in facial and nasal bone fractures is considered evidentiary, and it should not be forgotten that the clinical findings must be supported by properly interpreted imaging methods. It is crucial that reports are prepared with an accurate approach in line with the criteria in the Forensic Medical Guide in order to prevent the cases from experiencing the loss of rights during the ongoing legal process and to protect the physician from investigations that may arise from incomplete or incorrect medical practices. [ABSTRACT FROM AUTHOR]

Background: 5th metacarpal neck fractures constitute 20% of hand bone fractures. It is called "boxer fracture" because it usually occurs as a result of punching. That is why, this study was carried out in order to begin a discussion on how the forensic medical approach should be in those cases and ultimately to provide a consensus on this issue. Materials and Methods: The study was carried out among people who were diagnosed with metacarpal fracture and for whom a forensic report was issued in 2017-2022. The obtained data were analyzed as numbers and percentage. Results: There were 15 case applications in total. All of the cases were male. The age range of the cases was between 12-68 and the mean age was 36.26. Fracture was found in the 5th metacarpal in 11 cases (73.33%). 5th metacarpal fracture was in the dominant hand in 7 cases. Conclusions: It was emphasized that fractures can occur in other metacarpals by direct mechanisms as a result of hand trauma, and the importance of forensic medicine specialists to approach those cases on the basis of anamnesis-origin-examination-investigation quartet. On the other hand, the issue of the dominant hand was also critical. [ABSTRACT FROM AUTHOR]

Copyright of Ahi Evran Medical Journal is the property of Ahi Evran University and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Physical Medicine & Rehabilitation Sciences is the property of Turkiye Klinikleri and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: Balloon Kyphoplasty is one of the important minimal invasive surgical treatments of osteoporotic vertebral compression fractures. In this study, we aimed to evaluate preoperative and postoperative VAS scores and vertebral height measurements in patients whom applied unilateral or bilateral kyphoplasty. Material and Method: We evaluated preoperative, postoperative early (2nd day) and late period (3rd month) VAS scores and preoperative, postoperative 3rd month vertebral height measurements in 26 patients whom single level Balloon Kyphoplasty was applied due to osteoporotic vertebra fracture, in 14 unilateral (Group 1) and 12 bilateral (Group 2). The vertebral height measurements were performed from the anterior, middle and posterior parts of the vertebral corpus in the sagittal images of the plain graphs or computed tomographies of the patients, where the vertebraes were seen to be mostly compressed. Statistical differences between variables were evaluated by Chi-Square test. p <0.05 was found as statistically significant. Results: Compared to preoperative values, in the postoperative early and late periods, significantly decreased VAS scores were observed in both unilateral and bilateral kyphoplasty patients. There was no difference in comparison between the groups. Compared to preoperative values, the postoperative vertebral height values were significantly increased in both groups in the anterior and the middle parts of the corpus. No significant difference was observed in the posterior parts. Again, there was no difference in comparison between two groups. Conclusion: Kyphoplasty is an effective treatment that reduces pain in vertebral compression fractures and restores height loss. When applied unilaterally or bilaterally, clinical and radiological results are similar. [ABSTRACT FROM AUTHOR]

Copyright of Turkiye Klinikleri Journal of Forensic Medicine & Forensic Sciences / Türkiye Klinikleri Adli Tıp ve Adli Bilimler Dergisi is the property of Turkiye Klinikleri and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: The shape of the proximal ulna is one of the factors affecting the stabilization of the fractures and the rehabilitation of functions after surgery. If normal anatomical structuring can not be achieved during reduction, this may cause joint dislocations, arthritis and loss of function. In small fragmented fractures where reduction can not be performed completely, the anatomical structuring can be supported with the help of an appropriate plate. In cases where plate use is required, it is important to know the proximal ulna structure in detail. Materials and Methods: This study was carried out on 62 (unspecified gender, 26 right and 36 left ulna) ulnas in the bone collection of Necmettin Erbakan University, Meram Medical Faculty, Department of Anatomy. In our study, angle measurements were performed along with the length and width measurements of the proximal ulna. Results: In our study, the mean total ulna length (UU) was determined as 24.59±2.00 cm. The mean radial notch height (IRY) and width (IRG) measurements were determined as 9.69±1.64 mm and 15.22±2.18 mm, respectively. Trochlear notch depth (ITD) was determined to vary between 7.30 and 13.70 mm (average 10.15 mm). The mean proximal ulna torsion angle (PUTA), varus angle (VA), articular angle (AA), dorsal angle (PUDA), tubercular angle(TA) and olecranon-diaphysis angle (ODA) were determined as 13.40±1.230, 9.20±1.850, 20.37±1.020, 5.85±2.210, 18.99±0.830, 15.49±3.100, respectively. Conclusions: Implants and prostheses, which are designed considering individual differences, increase the success rate of compatibility in the elbow joint and ensure the proper functioning of the joint. [ABSTRACT FROM AUTHOR]

Copyright of Dokuz Eylül Üniversitesi Hemsirelik Fakültesi Elektronik Dergisi is the property of Dokuz Eylul Universitesi Hemsirelik Fakultesi Elektronik Dergisi and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: Osteoporosis (OP) is a skeletal disease characterised by low bone mass, which may occur due to primary or secondary reasons, and is known to increase the risk of fracture. The present study aimed to investigate the frequency and reasons for the diagnosis of secondary OP in patients presenting to our clinic and its relationship with fracture. Materials and Methods: Medical records of patients who came to our outpatient clinic with OP diagnosis were retrospectively reviewed. Demographic data (age, sex, etc.), comorbidities, drugs and fracture history of patients with secondary OP were obtained from the file information. Results: A total of 2,199 patients with OP were reviewed and 341 patients with secondary OP were included in the study. The most common causes of secondary OP were malignancy (38.4%), drug use (24.6%), rheumatologic diseases (17.3%). In addition, 94 patients had fractures and the mean age of these patients was statistically higher than those without fractures (p=0.008). Furthermore, the fracture rate was significantly higher in patients with chronic renal failure (CRF) (p= 0.034) and parathyroid adenoma (p=0.031) than those without these conditions. Conclusion: Causes of secondary OP and fracture rates were determined in patients with OF? Age was associated with CRF and parathyroid adenoma fracture rates. These situations should not be ignored while evaluating patients. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study is to investigate the frequency of fractures and related factors in children with spina bifida who were followed up in our hospital. Materials and Methods: By retrospectively examination of the medical records of 450 patients with spina bifida, who were followed up by our clinic between 2000 and 2018, the patients were evaluated in terms of factors such as frequency of fracture, age of the first fracture, lesion level, ambulation capacity, physical therapy initiation age, fracture site and mechanism. Results: In the 450 patients examined, the fracture rate was 5.7%. While there was a relationship between low ambulatory capacity and high-level lesions and fracture risk, the early initiation of physical therapy did not protect against fracture. Conclusion: According to these data, fractures are more common in patients with spina bifida. It was concluded that the quality of mobilisation, not the duration, was the more important risk factor for fracture. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Academic Research in Nursing (JAREN) is the property of Hemsirelikte Egitim ve Arastirma Dergisi and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aim: The goal of treatment of spinal fractures is to provide anatomical reduction, prevention of spinal deformity, pain relief, reconstruction of the height of the spinal column, and early mobilization to return to the patient's daily activities. We aimed to evaluate the preoperative and postoperative clinical and radiological results of percutaneous vertebroplasty and percutaneous balloon kyphoplasty in patients with osteoporosis or tumor-induced vertebral fractures. Material and Method: Percutaneous vertebroplasty and percutaneous balloon kyphoplasty were performed 44 female (67.7%) and 21 males (32.3%) of the 65 patients with single-level vertebra fracture. The cases were evaluated radiologically by Magnetic Resonance Image, Computerized Tomography, and X-ray preoperatively and postoperatively. Visual Analog Scale (VAS) was evaluated the pain before and after the operation. Results: The main symptom of the cases was pain, and the mean VAS scores decreased from 7,9 to 2 with PVP and PBKP (p <0,05). The mean improvement rate of the vertebral corpus was measured as 2.2 degrees. There was a significant increase in the anterior, middle, and posterior vertebra corpus heights (p=0.0001). Conclusion: In patients with osteoporosis and tumor-related vertebral corpus fractures, PVP or PBKP operation is a reliable and effective treatment for reducing pain, increasing vertebral corpus height, and Cobb angle correction. Increasing the amount of PMMA given; It did not contribute significantly to the decrease of VAS, improvement of Cobb angle, and increase of vertebral corpus height. [ABSTRACT FROM AUTHOR]

Orthopedic biomaterials are used in replacement of joints or bones that are damaged by a disease such as osteoporosis or fixation of broken bones. Majority of these materials are metals. Non-metallic materials can be separated into three groups as ceramics, polymers and composites. In this study, the types, fundamental properties, advantages and disadvantages of biomaterials used in the production of orthopedic implants are summarized. [ABSTRACT FROM AUTHOR]

Background: To compare the proximal humerus fractures regarding interobserver reliability and reproducibility using Neer and AO / ASIF classifications. Materials and Methods: Of 102 cases operated between 2003-2016 due to proximal humerus fracture, 42 cases were included in the study. A total of 168 serial images of 42 patients were evaluated by two observers, one of whom was an experienced upper extremity surgeon and the other was a general orthopedic surgeon, along with direct graphs, 2D axial-coronal-sagittal tomography, and 3D tomography sections. Results: Consistency between observers, direct X-ray, 2 and 3-dimensional tomography imaging types; weak in the AO classification, moderate in the Neer classification (μ: 0.220, μ: 0.522, respectively). Conclusions: Interobserver reliability and reproducibility was determined as weak / medium according to AO and Neer classification systems. Despite all current imaging modalities, the experience of the evaluator is an essential factor in determining the type of fracture and treatment. In post-operative diagnoses, the re-examination of the images will increase the experience of the observer in this area. [ABSTRACT FROM AUTHOR]

Objective: The aim of the present study was to evaluate the clinical and radiological results of surgically treated pediatric medial humeral epicondyle fractures which were fixed with screw or K wire. Materials and Methods: The study was designed retrospectively. Twenty two patients were evaluated clinically and radiologically. Functional outcomes were assessed with the Mayo elbow performance index (MEPI) and the Turkish language version of the shortened version of the Disabilities of Arm, Shoulder, and Hand (Quick DASH) scale. Results: All fractures were healed. The mean MEPI was 99.3 points (range, 85-100), with 21 patients as excellent and 1 good results. The mean MEPI was 100 points for patient who was fixed with K wires (group A). Excellent results were obtained for all patients. The mean MEPI was 97.9 points (range, 85-100) for patients with screw fixation (group B). Excellent results were obtained for all patients, except one. The mean Quick DASH score was 0.63 (range, 0-9). It was found 0.33 (range 0-5) and 1.3 (range, 0-9) for group A and group B, respectively. Two (13%) minor complications were developed in group A and 4 (57.3%) in group B. The difference for Quick DASH and MEPI scores were statistically insignificant (p>0.05). Conclusion: Both of fixations with K wire or screw provide enough stability until the fracture healed. Fracture union could be obtained for both fixation type and the clinical and radiological results were similar. The need for secondary operation for implant removal and higher complication rates seems the negative side of screw fixation. [ABSTRACT FROM AUTHOR]

Aim: It was aimed to determine the amount of wasted time and radiation exposure in intertrochanteric femur fracture surgeries for the use of C-arm fluoroscopy device during surgery. Methods: Records of 62 patients sustaining femur intertrochanteric fracture who were treated with closed reduction and internal femoral fixation were evaluated. Total operative time, time wasted for the use of C-arm fluoroscopy device use, number of shots done, surgeon's seniority, number of shots performed until the desired image was obtained, number of guide wire applications made before implant placement and total amount of fluoroscopy images were recorded by the assistant healthcare personnel. Results: It was found that 53% of the operative time was wasted for the use of the C-arm fluoroscopy device, the average number of fluoroscopy scans to obtain true anteroposterior and lateral images of a specific level was 10, and the guide wire could be placed in the desired position after- an average of 3.7 attempts. Conclusion: We believe that C-arm fluoroscopy devices should be used by trained technical personnel, a common language of terms should be established between the surgeon and the X-ray technician and more practical imaging units should be improved in order to shorten the duration of surgery and to avoid unnecessary radiation exposure. [ABSTRACT FROM AUTHOR]

Aim: We aimed to evaluate functional and radiographic outcomes of patients with proximal humeral fractures treated with proximal anatomic locking plate and were classified according to the Arbeitsgemeinschaft für Osteosynthesefragen/Orthopaedic Trauma Association (AO/OTA) classification. Methods:In this study we included 29 patients (13 females, 16 males) aged 16-82 years who were treated with proximal anatomic locking plate between February 2010 and July 2014. The mean follow up time was 17.76±8.31 months. The right shoulder was operated in 20 patients and the left shoulder in nine patients. Functional outcomes were assessed using the Constant-Murley and University of California at Los Angeles (UCLA) shoulder score and radiologic outcomes were assessed using anteroposterior radyograph. Results:At the final follow up, the mean Constant-Murley score was 75.48±18.69. The result was poor in 31.0% (n=9), moderate in 24.1% (n=7), 13.8% (n=4) good and excellent in 31.0% (n=9) of patients. The mean UCLA score was 30.10±5.73. The outcome was poor in 17.2% (n=5), good in 31.0% (n=9) and excellent in 51.7% (n=15) of patients. In 21 patients there were no complications, but complications occurred in eight. When we compared the patients per age groups (<65 and >65), there was no difference in collo-diaphyseal angle (p=0,097, p>0,05), but the Constant- Murley scores (p=0,001) and UCLA scores (p=0,01) were statistically higher in patients below 65 years of age than in those above 65 years. Conclusion: Treathment with proximal anatomic locking plate is preferred since it supports early motion and leads to good functional results in partial proximal humeral fractures. [ABSTRACT FROM AUTHOR]

Background: Hip fractures are an important cause of morbidity and mortality in elderly patients. There are many studies on the factors affecting the post-operative course of disease. One of the factors examined is pre-operative waiting time. In this study, we investigated the effects of age, sex, preoperative hemoglobin, presence of comorbid diseases and preoperative waiting time on mortality and hospital stay Material and Methods: The Ethics Committee of Adiyaman University Faculty of Medicine approved this study (21 /11 /2017, 2017 / 8-23). 133 cases older than 60 years and diagnosed with minor post traumatic femur fracture and treated with combined spinal epidural (CSE) and spinal anesthesia between 2015 and 2016 were included in the study. Patients' age, sex, preoperative hemoglobin, presence of comorbid diseases and preoperative waiting time were examined and the effects of these variables on mortality and hospital stay were examined. Results: Age, sex, preoperative waiting time, presence of comorbid diseases, preoperative albumin, hemoglobin and hematocrit values were analyzed retrospectively to determine the factors affecting the mortality and hospital stay. Low hemoclobin and hematocrit (p = 0,010) were found to be effective factors on mortality. The preoperative waiting time was found to has no effects on mortality but only has effects on hospital stay (p = 0,00). Conclusions: There are many factors affecting mortality and hospital stay in hip fracture patients. In this study, we think that it is very important to correct hypertension and anemia in elderly patients with hip fractures in the preoperative period and it will be beneficial to perform surgery in a short time with good preoperative preparation. [ABSTRACT FROM AUTHOR]

The majority of patients who undergoes lower extremity surgery are elder patients with higher risks. In these patients, regional anesthesia is usually preferred to general anesthesia however with this technique the risk of hypotension and bradycardia increases. The position of spinal anesthesia might also provoke pain. The intravenous analgesic agents applied before the procedure or regional anesthesia might improve patient comfort. In this case report, we aimed to present a semi-spinal anesthesia procedure with low dose heavy bupivacaine and opioid, after femoral block in a high-risk patient who underwent surgery for femoral neck fracture. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study is to determine the demographic and clinical characteristics of patients who underwent kyphoplasty due to osteoporotic fractures. Materials and Methods: This retrospective study included 55 patients who underwent kyphoplasty due to osteoporotic fracture between the years 2011 and 2014. The patients divided into two groups according to their ages (under/over 65 years), and divided into three groups according to fracture regions (T10 and above; between T11-L1; L2 and under). Thus the age and gender distributions of the patients were made. Resting pain scores of all patients were determined by using visual analog scale (VAS) and daily life activities by Oswetry Disability Index (ODI) before and in the first month of treatment. Results: Seventeen of the all patients were male (30.9%) and 38 were female (69.1%), with a mean age of 69.9±8.7 years (between 50-88 ages). 90% of the patients older than 65 years had fracture in T11 and below. In 45.5% of all patients, the fracture was in the T11- L1 (thoracolomber junction) region. Resting VAS and ODI scores significantly improved from 8.7±1.5 to 2.1±1.2 and 44.7±7.2 to 15.4±3.5 respectively in the first month after kyphoplasty (p<0.05). Kyphoplasty material extravasated to the disc space in 7 (12.7%) patients and in 4 (7.3%) patients to cerebrospinal fluid. Conclusion: Osteoporotic fractures affect patients over 65 years of age and are frequently occur in the thoracolumbar junction and lower vertebras. Kyphoplasty is a minimally invasive treatment option to relieve pain and to improve functional status. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study is to evaluate the clinical results and necessary of olecranon osteotomy by open reduction and internal fixation by parallel plating of distal humerus located close to intra-articular surface of distal humerus. Materials and Methods: 43 patients were evaluated in this study separated into two groups. In group 1 olecranon osteotomy was performed and in group 2 paratricipital approach was performed to all patients. All patients were evaluated by hospital stay time, follow-up, surgical time, range of motion (ROM), complications and Mayo elbow performance scoring system functions. Results: Mean age was 44.35±11.61 (19-62) years. There was no statistically significant difference by age, sex, side distribution, hospital stay, follow-up time and ROM. Operation time was 133.04±18.14 minutes in Group 1 and 171±15.1 minutes in Group 2. There was statistically significant decrease in surgical time in Group 1 compared to group 2 (p:0.001; p<0.05). There was not any postoperative complication and union was achieved clinically and radiologically in both groups. Mayo elbow score was 85.65±4.34 while 90.25±4.13 in group 2 (p:0.001;p<0.05). Conclusion: There was better ROM and functional scores in paratrisipital approach group while only surgical time increased in this group. In conclusion, olecranon osteotomy should not be performed in intra-articular fractures of distal humerus whom treated by open reduction and parallel plating if it is not necessary to protect congruity of joint. [ABSTRACT FROM AUTHOR]

Objective: Osteoporosis (OP) is a major cause of disability, morbidity and mortaliy. Causes are significant economic burden with fractures. Dual energy X-ray absorptiometry (DXA) is the only technique that is defined as the gold standard that the World Health Organization currently recommends in determining the fracture risk. The use of direct radiographic examinations is recommended for the causes of false negative results in densitometric examination and for the detection of fracture presenting as OP indicator in clinical practice. The purpose of this study is a retrospective investigation of the need for DXA methodology, which we routinely use for diagnosis, treatment and follow-up of OP, in patients with fractures by direct radiography. Materials and Methods: The data of 189 postmenopausal women with DXA, lateral thoracic and lumbar graphy without trauma history, retrospectively evaluated. Patients were divided into two groups according to DXA results, group 1 consisted 167 postmenopausal women with OP and group 2 consisted 22 postmenopausal women with no OP. In both groups, patients who have at least one fracture according to thoracic and lumbar graphy were evaluated. Results: At least one vertebrae height loss was detected in 61 (32.28%) of 189 postmenopausal women included in the study. At least one fracture was detected in 49 (29.34%) of 167 patients with OP according to DXA results and 12 (54.55%) of 22 patients without OP. Conclusion: With this study; retrospectively demonstrated the need for follow-up of patients with fractures by direct radiography in conjunction with DXA, the gold standard for OP diagnosis and treatment planning in postmenopausal women. [ABSTRACT FROM AUTHOR]

Many side effects are encountered during the use of glucocorticoids. Osteoporosis is a common side effect of bone metabolism. The side effect increase with high dose and long-term use of steroids. In this article, we report a case of uncontrolled glucocorticoid use for 6 years due to ocular involvement due to Behçet's disease and a young male with osteoporotic fracture of the dorsal and lumbar vertebrae due to cyclosporine use for 3 years. To sum up, this case shows that steroids and combination treatments should be used with appropriate dose and duration in absolute indications and patients should be monitored in order. [ABSTRACT FROM AUTHOR]

In the 2015 season of the excavations in Pisidia Antiokheia (Yalvaç/Isparta) skeleton remains were found in the cemetery in the main nef of the Aedilicus chuch. As an anthropological analysis, it has been estimated that the skeletal remains belong to a man and also he was 56 years old. It has been found to have healed fractures in his postcranial bones. It has been applied to radiographic analyzes for these fracture traces. The fracture traces are on the 9th, 10th and 11th of rib bones (costae), on the neck of the right femur, on the proximal epiphysis of the right tibia, and at two places in the diaphysis of the right humerus, and they have been defined as incomplete fractures. Their similar morphologies have indicated likely occurrencing with contemporary traumas. Their position on the right side of the body supports the possibility that the individual probably falls on his right side in his life. In particular, the fracture finding on the femoral neck supports the possibility that this knockdown occurs on the passenger animal. [ABSTRACT FROM AUTHOR]

Objective: The aim of our study was to investigate safety and effectiveness of titanium elastic nailing (TEN) in paediatric tibia shaft fractures caused by high-energy pedestrian versus motor vehicle accidents. Material and Methods: We conducted a retrospective review for children with unstable tibial shaft fractures treated with TEN caused by pedestrian versus motor vehicle accidents between June 2010 and December 2012. Eleven patients were included in study. Six patients (54.5%) were boys and five patients (45.5%) were girls. The mean age of the patients was 7.4 years (3-12). Five patients (45.5%) had closed and six patients (54.5%) had open fractures according to Gustilo-Anderson classification. At the follow-ups, patients were evaluated clinically and radiologically. Also, we investigated tibial torsion deformity by using MRI in our patients at last follow-up. Results: In all patients were obtained complete bone healing radiologically and clinically. In our patients, the average angulation was 1.5 degrees (0-3.9) on the coronal plane and the average angulation was 2.6 degrees (0-8.4) on the sagittal plane at the last follow-up. In four patients (36.4%) were found more than 10 mm the tibial length discrepancy. Also, we encountered more than 10 degrees the external tibial torsion deformity in three patients. Conclusion: TEN is a safe and effective treatment options in the high-energy pediatric open or closed tibia shaft fractures caused by pedestrian versus motor vehicle accidents. It should be kept in mind that these fractures also might develop in the tibial torsional deformity. [ABSTRACT FROM AUTHOR]

A 36 years old male patient, diagnosed with radial head fracture had conservative treatment with long arm circular cast for one month. After long arm circular cast was removed, swelling of the dorsum of the hand and forearm pain evolved gradually. A venous color duplex ultrasonography revealed an acute thrombus of the right radial vein. After anticoagulant therapy, symptoms decreased significantly. Upper extremity deep venous thrombosis, although not as common as lower extremity deep venous thrombosis, is a clinical entity with considerable morbidity and may lead to pulmonary embolism and post thrombotic syndrome. Early recognition and appropriate treatment is important to prevent these complications. Immobilization is usually known as a risk factor for lower extremity thrombosis and it may also cause thrombosis in upper extremity veins since it causes statis which is among the component of Virchow's triad. This case report was presented to emphasize that upper extremity deep venous thrombosis may be encountered not only in lower extremity but also in upper extremity during and after immobilization period due to arm casts. [ABSTRACT FROM AUTHOR]

A 58-year-old male patient with a diagnosis of multiple sclerosis (MS) who had been operated due to a low-energy subtrochanteric femoral fracture was admitted in order to plan anti-osteoporotic treatment and rehabilitation at post-operative first week. Although the patient had a history of glucocorticoid use, he had never received any preventative treatment for osteoporosis. T-scores detected by Dual energy x-ray absorptiometry (DXA) method were -4.7, -4.9 and -3.3 at femoral neck, total hip and L1-L4 vertebrae, respectively. Since the patient had severe osteoporosis, teriparatide treatment was planned. Following vitamin D supplementation, teriparatide 20 mcg/day was started. After 6 months of treatment, patient improved significantly in terms of symptoms and DXA scores. T-scores of the femoral neck, total hip and L1-L4 vertebrae improved to -3.4, -3.9 and -3.0, respectively. When teriparatide therapy was continued up to 18 months, further increase in DXA values was observed (T-scores of femoral neck, total hip and L1-L4 vertebrae were -2.9, -2.4 and -2.2, respectively). No adverse event was seen during the treatment period. Following the cessation of teriparatide therapy, alendronate and cholecalciferol combination (70 mg/2800 IU) was started. Bone health and vitamin D level are affected negatively in patients with MS due to multifactorial reasons. In order to avoid serious consequences such as hip fracture, awareness about osteoporosis should be increased and preventative strategies should be tailored from the early stages of the disease. [ABSTRACT FROM AUTHOR]

Compared to adult studies, there are a limited number of pediatric studies exploring the effects of hypercalciuria on bone mineral density. The aim of this paper was to report a case of low-energy multilevel vertebral fracture in a pediatric patient during follow-up for idiopathic hypercalciuria (IH); it was also attempted to remind clinicians that IH-induced fractures may also occur in children. A 10-year-old male child presented to our outpatient clinic with back pain after jumping off from a height of approximately 50 cm. History of the patient showed that the patient had been followed-up for idiopathic hypercalciuria for 8 years and his father had renal stones and hypercalciuria. There was no abnormality on physical examination, with an exception for tenderness and limitation of movement in lower thoracic and lumbar vertebrae. Complete blood count and biochemical parameters were normal except for an elevated alkaline phosphatase level. Dorsal and lumbar lateral plain graphs showed compression fractures of T4, T6, T8, and L3 vertebrae, therefore, lumbar and dorsal vertebral magnetic resonance imaging (MRI), bone mineral densitometry (BMD), and vitamin D level measurement were ordered. MRI revealed acute compression fracture and medullary edema in L3; there were also chronic osteoporotic fractures in T4, T6, and T8. BMD showed a lumbar total Z score of -2.9 and the Vitamin D level was 13.7 ng/mL (10-24 ng/mL indicates moderate deficiency). A control renal ultrasonography revealed no kidney stones or calcification. The patient was prescribed polyethylene mold thoracolumbar corset and vitamin D support at a dose not to enhance hypercalciuria and nephrocalcinosis. His pain was alleviated at follow-up. Considering that most of the total bone mass is acquired at childhood, identification of causative factors and taking necessary measures at an early stage may prevent future complications of IH. [ABSTRACT FROM AUTHOR]

Objective: Osteoporotic hip fractures decrease the life expectancy for 20% about 20-50% of the patients become permanently dependent in terms of walking for the rest of their life. Life expectancy is increasing in Turkey in the last 20 years. We investigated the impact of osteoporotic hip fractures which increase the morbidity and mortality on the national economy. Materials and Methods: A total of 81 patients admitted to our emergency department with the diagnosis of femur intertrochanteric fracture and femoral neck fracture between 2008 and 2012 were included in this study. We retrospectively evaluated the medical records and the medical costs of these patients from hospital information management system. Results: Of the 81 patients 32 (39.6%) males and 49 (60.4%) females meeting the inclusion criteria were included in this study. The mean age was 80.1 years (range, 61-103). Twenty-three (27.5%) patients had femoral neck fracture and 58 (72.5%) patients had intertrochanteric femur fracture. The mean length of hospital stay was 13.4 days in intertrochanteric femur fracture and 15.5 days in femoral neck fracture; average of the total days of hospitalization of all patients was 13.9 days. The average treatment cost per patient was 5,912.36 TL for intertrochanteric fractures, 5,753.00 TL for neck fractures, and 5,863.09 TL for the whole patient population. Conclusion: Hip fracture is a substantial cause of morbidity and mortality in elderly. Taking preventive measures before the fracture occurs may help to prevent this problem which has a high cost treatment and which is a substantial burden for the national economy. [ABSTRACT FROM AUTHOR]

81 year old female patient with diagnosis of right femur intertrochanteric fracture was performed partial hip arthroplasty. Left femur intertrochanteric fracture and dislocation of the prosthesis was deteced as a result of trauma. in the early postoperative period. She was hospitalized. Closed reduction was performed to right side and partial hip replacement surgery was performed for femur intertrochanteric fracture. No pathology was detected in the postoperative period. Goal of this case report is to discuss the complications due to incision and hip prosthesis that may arise during and after hip fracture surgery in elderly patients. [ABSTRACT FROM AUTHOR]

The most commonly injured nerve during the supracondylar fractures in children is controversially reported as the median nerve (%28-60), followed by radial and ulnar nerves. The median nerve injury is usually seen in the fractures with posterolaterally displacement and the anterior interosseous branch (AIN) of this nerve is often injured. Here, we present a supracondylar humeral fracture of a 7 years old male child who had a neuropraxia postoperatively, which probably developed intraoperatively during the reposition of the median nerve which was migrated from anterior compartment to the posterior. Although the cause of the nerve stretching is reported to be fracture displacement in the literature, there is no report on stretching of median nerve by migrating to the posterior compartment. Neuropraxia of the AIN can occur in the situations where the median nerve is found to migrate from anterior to posterior compartment in the supracondylar humeral fractures of children. We believe that during the posterior surgical approach for the treatment of the supracondylar fractures of the humerus in children, the tissues over the periosteum must be bluntly dissected to avoid from an iatrogenic median nerve cut. [ABSTRACT FROM AUTHOR]

Osteogenesis imperfecta is a hereditary disorder characterized by increased bone fragility. The production of type I collagen and endochondral bone development are disturbed. The disease is also considered a systemic syndrome affecting several organs besides skeletal system. Here, we present a case of osteogenesis imperfecta in a 13-year-old child with femoral fracture after a minor trauma on his left femur and ipsilateral deformity that were treated simultaneously by locked intramedullary nailing. Furthermore, the deformity on the right femur was treated using the same technique three months later. In this paper, the treatment of fractures and deformity correction in patients with osteogenesis imperfecta using locked intramedullary nailing technique is discussed in the light of the literature. [ABSTRACT FROM AUTHOR]

Foot drop is often seen as a result of lumbar disc herniation or entrapment neuropathies. Parasagittal cranial rarely affecting the region; isolated head trauma, cerebral space-occupying lesion or demyelinating disease may develop depending on the drop foot. Plant-induced spastic drop foot, hyperreflexia, pathological reflex, headache has been accompanied by other clinical and neurological findings. Careful clinical examination, radiological and electrophysical studies are important tools for the differential diagnosis. [ABSTRACT FROM AUTHOR]

Objective: In this study we aimed to investigate the efficacy, long term result and associated complications of Halo Vest treatment for patients with upper cervical spine fractures. Methods: This study included 13 patients (11 men and 2 women) who applied Halo Vest treatment for traumatic upper cervical vertebral fracture between 2006 and 2011. We reviewed the radiological and clinical findings of patients before and after the treatment. Results: Six of 13 patients had odontoid type 3 fracture, 2 patients had odontoid type 2 fracture with C1 type 1 fracture, 2 patients had odontoid type 2 fracture with Jefferson fracture, one patient had type 2 hangman fracture and two patients had unclassified C2 corpus fractures. The mean follow-up time with Halo Vest was 14 weeks (10-21 weeks). Ten patients had bone fusion and the mean time of bone fusion was 12 weeks. Conclusions: Halo Vest treatment for upper cervical spine fracture is a safe and effective method but the patients comfort and satisfaction are low. [ABSTRACT FROM AUTHOR]

Aim: To determine blood transfusion in elderly patients with collum femoris fracture and intertrochanteric femur fracture who underwent hemiarthroplasty and to compare the two fracture groups for the amount of blood transfusion. Methods: Hemoglobin and hematocrit values were determined preoperatively and in the last control before hospital discharge. T-test for non-parametric Mann-Whitney U test and paired t-test for non-parametric Wilcoxon test were performed for statistical analysis. Results: The mean age of patients with fracture of collum femoris and those with femur intertrochanteric fracture were 84.3 years (range: 77-96) and 83.3 years (78-89), respectively., The mean preoperative hemoglobin and hematocrit levels of collum femoris fracture group were 12g/dl (10.5-15.2) and 37.6 (31.1-48.4), respectively. The mean predischarge value for hemoglobin was 11.1g/dl (9.2-12.6) and for hematocrit was 34.2 (29.5-38.8). The mean preoperative hemoglobin value was 11.4g/dl (9.9-13) and hematocrit value was 35.6 (31-41.3) in the intertrochanteric femur fracture group. The mean predischarge value for hemoglobin was 11g/dl (9.5-12.6) and for hematocrit was 33.4 (29.9-38.9). The average number of blood units transfused in collum femoris fracture group and intertrochanteric femur fracture group were 1.7 (0-5) and 1,9 (1-5), respectively. Conclusion: There was no statistically significant difference between the groups in amount of blood transfusion. Two units of packed red blood cells should be prepared prior to surgery. [ABSTRACT FROM AUTHOR]

Objective: In our study, we aimed to assess the effect of the conservative treatment for clavicular midshaft fractures to shoulder functions in adults. Methods: A total of 19 patients with clavicular midshaft fracture were evaluated. Clinical and radiological follow-up was performed for all patients. The length of fractured and intact clavicle was measured using computed tomography. Shoulder functions were assessed with DASH and Constant scores. Results: The patients comprised of 15 males and 4 females; the mean age was 35.5 years. The mean follow-up period was 20.6 months. While complete union was achieved in 11 patients, 6 patiens developed malunion and 1 patient developed non-union. All patients having a malunion reported discomfort arising in a process over the clavicle. When the mean DASH score was measured as 6.6, the mean constant score of 84.4 points was assessed as a good result. Conclusion: Most clavicular midshaft fractures can be effectively treated with conservative therapy. Although mal-union occurs at a higher rate, it does not affect the shoulder functions. [ABSTRACT FROM AUTHOR]

Aim: We aimed to show that successful results can be obtained by combining the fractured parts over the operating table and fixing them with an anatomic plate in Mason type 3 - 4 mtdti-fragmented and / or displaced radial head fractures. Materials and Methods: Eleven cases of the 29 patients, operated in Yfldlnm Beyazlt University Ankara Atatiirk Education a Research hospital with the diagnosis of Mason type 3-4 radius head fracture, between June 2005-October 2011, in which fracture reducted outside, than providing the head reconstruction and fixing with radius head plate; were evaluated retrospectively. Results: Eight patients were male, 3 were female. Patient's ages ranged from 24 to 47 years of age with a mean age of 35 years. Me follow-up was 44,9 months. Patients were evaluated for elbow with disabilities of the arm, shoulder and hand outcome measures and Mayo elbow performance index with radiological examination of the fractures. Conclusion: Radial head is secondary stabilizer to the elbow and forearm. In the cases of undergoing resection and/or prostetic replacement after unsuccessfial reduction of radius head fractures because of crash or deplacement such as Mason type 3 - 4, trying to combine the parts of the fracture at the surgery table, than reconstruction of the head following by fixation with anatomic plate, can be an operational alternative especially in younger patients. [ABSTRACT FROM AUTHOR]

Objective: Results of surgical treatment for unstable disial end radius fractures with articular involvement in adults as comparing with unlocked and locked anatomic plate by volar approach were evaluated. Materials and Methods: According to AO classification type C with 35 patient treated open reduclion and two different volar plate fixation for distal end of the radius fractures retrospectively reviewed between January 2005 and May 2009. All type C fractures were evaluated 16 (% 46) Cl. 9 (% 29) C 2. 10 (% 28) C3. The median follow-up period was 20 month (6-50). Volar locked plate treatment was used for 13 patient in Group 1 and volar unlocked anatomic plated was used 22 patient in Group 2. There were no statiscally differences in age. gender, fracture type among groups. Results: According to Gardland and Werley cilinically evaluation criters: excellent-good was %86. fair was % 14 in group 1; excellent-good % 77, fair was % 23 in Group 2 respectively. Wrist range of motion and forearm rotation was similar statistically for 2 groups as were clinical scoring and grip strenght. According to radiological evaluation system of Steward el al. excellent-good were % 100; in Group 1 and % 91 in Group 2 respectively. Although there was no statistically differences among groups, but in locked plate group radiological improvement was better. Conclusion: Treatment of complex distal end fractures of radius involment articular with volar unlocked or locked plate provide good functional results and late period follow up there were no difference in terms of functional and radiologic results among two method. Locked anatomic plates provide good radiologic correction because of including multiple screws with low profile and allow to early joint movement because of rigidity. [ABSTRACT FROM AUTHOR]

Osteogenesis imperfecta is the most common connective tissue disorder that causes osteoporosis and it is characterized by distransformation of fetal collagen to mature collagen. Anatomic deformities and platelet dysfunction influence the choice of anesthetic technique. Besides the attention to the airway related problems, succinylcholine, inhalation agents, and anticholinergic agents that could trigger malignant hyperthermia should be avoided. In this case report, it was aimed to discuss the anesthetic management in an osteogenesis imperfecta patient who had operated for femur fracture. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Physical Medicine & Rehabilitation Sciences is the property of Turkiye Klinikleri and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

OBJECTIVES In this article, insufficiency fractures (IF) after pelvic radiotherapy were examined. METHODS We studied nine gynecologic malignancy patients who underwent pelvic radiotherapy. Patients' ages, menopausal status, external pelvic radiotherapy dose, IF localization area and development time, treatment, and treatment response time were investigated. RESULTS The mean age was 54 years. Five patients were postmenopausal, and five patients had osteoporosis. The mean follow-up and development period of IF were 49 and 26.8 months, respectively. The IF field was located in the sacrum in 8 patients and the sacroiliac joint in 1 patient. Pelvic pain was the initial complaint in 8 patients. One patient was asymptomatic. IF formation time ranged from 6-156 months. After symptomatic medical therapy and resting, the visual analogue scale (VAS) score decreased from 7 initially to 2. Treatment response time was 3.4 months. CONCLUSION IF should be considered as a late complication of external radiotherapy in patients experiencing pelvic pain after pelvic radiotherapy. [ABSTRACT FROM AUTHOR]

Fat embolism is a syndrome which is caused by oil particles introduce into the systemic circulation and consists of respiratory distress, altered consciousness and petechial rashes. It may occur following traumatic, surgical and non-traumatic clinical conditions. The most common occurrence develops following the long bone fractures within 24-72 hours. The clinical picture of syndrome may vary slightly condition as well as respiratory failure and coma. The diagnosis is done based on mostly clinical criteria. There is no specific laboratory and radiographic findings. The suggested supportive approaches in the treatment of this syndrome are early fixation of the fracture, maintenance of fluid and electrolyte balance and treatment of hypoxia. We aimed to present two cases of successful diagnosis and treatment process with fat embolism syndrome following multiple fractures due to in-vehicle traffic accidents. [ABSTRACT FROM AUTHOR]

It was aimed to investigate the relationships between hospitalization period, level of patient satisfaction with treatments, and levels of anxiety, and depression in hospitalized patients with fractures. Hospitalized thirty two fracture patients who were treated for fractures between the years 2008 and 2009 in the Orthopedics and Traumatology Service of Pamukkale University were evaluated. Questionnaires for General health, level of satisfaction with operation and physical therapy, and Hospital anxiety and depression Scale (HAD) were applied to all patients before discharge. Eleven female, and 21 male patients with mean age of 46.31 ± 19.19 years were evaluated. It was detected that there was no significant relationship between duration of hospitalization and HAD scale (for anxiety scale: r= -237 p>0.05, for depression scale: r=-016 p>0.05 respectively). There was negative relationship between education level and depression (r= -484 p<0.01). It was detected that there were negative significant relationships between general health and anxiety, depression levels (r= -482 p<0.01, r= -451 p<0.01), satisfaction with operation and depression level (r= -386 p<0.05), satisfaction with physical therapy and depression level (r= -440 p<0.05). Although there were no relationships between hospitalization period, anxiety, and depression levels, relationships were detected between satisfaction level with therapies, anxiety and depression levels. [ABSTRACT FROM AUTHOR]

Anterior tooth fracture is a common type of dental injury, and its treatment is an important issue in dentistry. When the restorative alternatives are evaluated, loss of tooth structure, the eruptive condition of the fractured tooth, function and patient demands should be considered. If an excessive crown fracture occurs during trauma, the root canal treatment and the post application could be needed in order to increase the retention. Moreover, complicate fractured anterior teeth supported post that can be restored by adhesive bonding of the fragment to the remaining tooth structure; it is possible that restoration of such teeth using the fractured fragment may produce esthetic result. This case report presents a tooth with complicated crown fracture caused by trauma has been restored with its fracture fragment. The treatment has been found to be successful with clinical controls performed at 1, 3, 6 and 12 months. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to evaluate the results of reamed and locked intramedullary nailing for tibial diaphysis fractures. Materials and methods: The study included 38 patients (26 males, 12 females) who were treated with reamed and locked intramedullary nailing for tibial diaphysis fractures. Fractures were classified according to Gustilo-Anderson classification and functional results were assessed using the Johner-Wrush criteria. Results: The mean age was 36 years (range 18-61). There were 21 AO/ASIF type A, 16 type B, and 1 type C fractures. Twenty-four fracture were closed (63.1%) and 14 (36.9%) were open fractures. According to the Gustilo-Anderson classification, 9 were grade I, 4 patients grade II, and one grade IIIA open fractures. Intramedullary nailing was performed following open reduction in 18 patients, and closed reduction in 20. The mean time to surgery was 9.4 days and the mean follow-up was 29 months. Union was achieved in all patients within a mean of 17.6 weeks. Anterior knee pain developed in 18 patients and infection developed in three patients. Angular deformity less than 10° was developed 12 patients (31.6%). There were screw breakacge and synostosis in four and two patients respectively. According to the Johner-Wrush criteria, functional results were very good in 23 patients (60.5%), good in 12 patients (31.6%) and fair in 3 (7.9%) patients. Conclusion: Treatment of tibial diaphysis fractures with reamed and locked intramedullary nailing gives satisfactory results. It should be considered as first choice in the treatment of these fractures. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study was to analyze retrospectively 196 patients whose facial fractures were treated in our clinic and to investigate the relationships between the severity score and fracture type and the etiology. Materials and methods: Totally 196 patients (155 males, 42 females, avarage age of 33,96 ) , who applied to the plastic surgery clinic of Haydarpaşa Numune Research and Training State Hospital during four years (2004-2007) period and were found at least one facial fracture in their maxillofacial bones after the radiological examination, have been evaluated in this study. One-way ANOVA test and Chi-square test were used for statistical analysis. Results: As a result of performed one-way ANOVA test, It is found that mechanism of trauma is important for estimation in severity score of facial injury (p<0.001) but when the Chi-square test was applied for statistical analysisno significant relationship between the mechanism of trauma and patterns of fracture was found (p>0.05). Conclusion: Trauma mechanism was found as effective on fracture severity, however no relationship was found between etiology of trauma and fracture type. [ABSTRACT FROM AUTHOR]