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Background: This study evaluates the radiological parameters of developing subsequent contralateral slips in unilateral slipped capital femoral epiphysis (SCFE) patients at the time of initial presentation., Methods: The study group included the review of unilateral SCFE patients treated between June 2007 and August 2018. Age, gen-der, side, stability, posterior slope angle, grade of slip, modified Oxford bone age score (mOBAS), the Risser classification, and the ap-pearance of the triradiate cartilage were evaluated retrospectively. Data were analyzed between two groups: subsequent contralateral SCFE (SCFESC) patients that developed contralateral slip during follow-up and unilateral SCFE (SCFEU) patients that did not develop contralateral slip up to skeletal maturity. Descriptive statistics were used to compare risk factors between groups., Results: This study included 48 patients and 6 patients (12.5%) developed a SCFESC. Only mOBAS was significantly different be-tween groups. The mOBAS scores in SCFESC were 18 in 2 patients (33.3%), 19 in 4 patients (66.7%). The mOBAS scores in SCFEU were 18 in 1 patient (2.4%), 19 in 24 patients (57.1%), and >20 in 17 patients (40.5%). In the SCFESC group, all patients had a Risser score of 0 and all had open triradiate cartilage., Conclusion: Patients with unilateral SCFE are at risk for SCFESC, and the mOBAS is the best predictor of risk assessment. We agree that mOBAS score of 16,17 or 18 patients' contralateral hips can be prophylactically pinned. We also suggest pinning or close screening of mOBAS 19 patients that some carry relatively high risk of subsequent contralateral slip.

Background: The aim of this study to compare three cephalomedullary nails (CMNs) with different designs in terms of complica-tion, reoperation, implant failure, mortality rates, and functional outcomes in the treatment of unstable intertrochanteric fractures (UIFs)., Methods: This retrospective study included patients with UIFs (AO/OTA type 31-A2 and 31-A3) who were treated with one of these CMNs (74 patients with Talon-PFN, 70 patients with PFN-III, and 69 patients with Intertan) between October 2014 and October 2018., Results: A total of 213 patients (122 females and 91 males) with a mean age of 81.0±9.3 years have participated in this study. The mean follow-up time was 26.1±6.3 months. Malfixation was the most common complication and the most common reason of reop-eration for each type of CMN. Complication and reoperation rates, post-operative functional status, mean union times, and overall mortality rates were similar between groups. Mean operation/fluoroscopy time and mean blood loss were low in the Talon-PFN group, whereas the highest means of these parameters were in the PFN-III group. There were six (8.2%) implant failures in the Talon-PFN group and one (1.5%) in PFN-III group. No implant failure was seen in the Intertan group. The highest rate (58.6%) of anatomic reduc-tion was detected in PFN-III group., Conclusion: Our study results showed that each implant type had its own advantages and disadvantages in the treatment of UIFs with similar functional and reoperation outcomes. Intertan was advantageous with its absence of implant failures. Talon-PFN decreased the operation/fluoroscopy time and intraoperative blood loss but had the highest implant failure rate. There was a need for more anatomic reduction to centralize two separate parallel lag screws in the femoral neck in PFN-III group, and that costs operation/fluo-roscopy time and blood loss. Malfixation, which was the most common cause of complications and reoperations, should be avoided.

Background: A novel-design femoral nail (FN) with distal talon deployment (Talon-FN) has emerged in the market to cope with problematic distal locking. We aimed to compare the radiological and functional outcomes of the Talon-FN with a conventional FN (Con-FN) for the treatment of femoral shaft fracture (FSFs)., Methods: This retrospective study included 85 patients (57 men, 28 women; mean age: 46.8±23.9 years) with FSFs (AO types 32-A and B) who were treated with FNs (Talon-FN: 41, Con-FN: 44) during October 2014-2018. Knee injury and Osteoarthritis Outcome Score Physical Function Shortform, Hip injury and Osteoarthritis Outcome Score Physical Function Shortform, Short musculoskeletal function assessment bother and dysfunction indexes were used for functional assessment., Results: The mean follow-up time was 25.8±6.7 months. The complication rates were 19.6% and 20.5% for Talon-FN and Con-FN, respectively (p=0.92). Malunion was the most common complication for each FN type (Talon-FN: 9.8%, Con-FN: 9.1%). All of the Talon-FN group's malunions were axial (shortening and malrotation) and happened gradually. In contrast, the Con-FN group's malu-nions were angular (varus and valgus) and caused by initial malreduction. The Talon-FN group's two patients with shortening (4.9%) had AO 32-B type fractures, and the other two with malrotation (4.9%) had AO 32-A3 type fractures, all of four fractures were localized distal to the femoral isthmus. The post-operative functional outcomes were similar between the groups (all p>0.05). The mean op-eration/fluoroscopy time and the mean blood loss were lower in the Talon-FN group, while the mean union time was shorter in the Con-FN group (all p<0.01). No nonunion was noted in either group. The reoperation rates were similar at approximately 5% (p=0.95)., Conclusion: Our study results revealed that the Talon-FN shortens the operation/fluoroscopy time and decreases the intra-operative blood loss with similar functional outcomes. However, the Con-FN seems to offer a more stable construct against axial malunion with a shorter bone union time. The Talon-FN should not be used in FSFs distal to the femoral isthmus with certain types of fractures prone to shortening and malrotation.