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AbstractThe purpose of this study is to investigate the severity of symptoms of Post-Traumatic Stress Disorder (PTSD), depression, psychache, and coping styles in individuals who have experienced limb loss or have not sustained any permanent injuries while trapped under rubble following an earthquake. Furthermore, the study aims to explore the differences between groups in terms of sociodemographic and event characteristics. The study included individuals who were trapped under rubble during the earthquake and had a limb amputated, as well as those who were trapped under rubble but did not experience any permanent physical function loss. Semi-structured sociodemographic form, PTSD Checklist for DSM-5 (PCL-5), Psychache Scale, Coping with Earthquake Stress Scale (CESS), and Beck Depression Inventory (BDI) assessment tools were used. A total of 64 participants, 32 with and 32 without limb loss, were included in the study. It was found that the severities of traumatic stress and depressive symptoms and psychache were significantly higher in the earthquake survivors with limb loss than those without limb loss (p < 0.001, p < 0.001, and p = 0.005, respectively). It was found that earthquake survivors with limb loss made fewer positive reappraisals than those without limb loss (p = 0.012). According to the multiple linear regression analysis, having limb loss predicted BDI and PCL-5 scores (β = -12,239, p < 0,001; β = -10,105, p = 0,008, respectively). Additionally, suicidal ideation exacerbates the severity of psychache in individuals who are were trapped under rubble. Identifying the factors related to the mental state of these individuals is useful for determining those who are most likely to need psychological support. [ABSTRACT FROM AUTHOR]

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Background: This study aimed to retrospectively evaluate the effectiveness of hydroxyapatite-coated (HA-coated) implants and other caput-collum implants in preventing cut-out observed in treatment with proximal femoral nail (PFN) of intertrochanteric femur fractures in elderly patients., Methods: A total of 98 consecutive patients (56 males and 42 females; mean age: 79.42 (61-115) years) treated with three differ-ent PFNs for intertrochanteric femoral fractures were retrospectively examined. The mean of the follow-up period was 7.87 (4-48) months. It was used a threaded lag screw in 40 patients, an HA-coated helical blade in 28 patients and a non-coated helical blade in 30 patients for PFN. The reduction quality, fracture type, and radiological outcomes among all groups were evaluated., Results: Unstable type was seen in 50 (52.1%) patients according to AO Foundation/Orthopedic Trauma Association fracture classi-fication. An acceptable-good reduction quality was seen in 87 (88.8%) of all patients. The average of tip-apex distance (TAD) value was 27.61 mm, calcar-referenced TAD (CalTAD) value was 28.72 mm, caput-collum diaphyseal angle was 128,° Parker's anteroposterior ratio was 46.36%, and Parker's lateral ratio was 46.82%. The best suitable implant position was observed in 49 (50%) patients. Cut-out was observed in 7 (7.14%) patients, and secondary varus displacement of more than 10° was observed in 12 (12.24%) patients. Correlation analysis and multivariate logistic regression analysis showed a significant difference between HA-coated and other implants in cut-out. Furthermore, implant type was the strongest predictive factor for cut-out complications in the multivariate logistic regression analysis., Conclusion: HA-coated implants may reduce the long-term cut-out risk due to increased osteointegration and bone ingrowth in elderly patients with intertrochanteric femoral fractures with poor bone quality. However, this alone is not enough; a suitable screw position, optimal TAD values, and excellent reduction quality are other important factors.