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Abstract Recent studies on fibular osteotomy for varus gonarthrosis and possible subsequent biomechanical changes have attracted increasing attention to the topic. Existing studies have focused mainly on proximal fibular osteotomy with short follow-up periods. The aim of this study was to investigate changes in the alignment of the coronal plane of the ankle and knee joints in patients who underwent vascularized fibula graft harvest (VFGH). The evaluation was based on functional outcomes and radiological measurements.In the comparison between the VFGH side and the contralateral side, no significant differences in the knee inclination (KI) or talar inclination (TI) angle, knee medial clear space (K-MCS) or ankle medial clear space (A-MCS) distance were noted. However, a significant difference in the hip knee (HKA) angle was observed between the operated and nonoperated sides (0.3° ± 1.8° and 1.5° ± 1.9°, respectively [p = 0.019]). Statistically significant differences in both the knee society score (KSS) and the AOFAS scores were found between the ipsilateral donor limb and the contralateral healthy limb. Although the contralateral healthy side had better clinical scores than the VFGH side, the outcomes of the VFGH side were still satisfactory or excellent.

Introduction: This study evaluated hand and forearm injuries caused by angle grinders and identify the risk factors. Methods: Between 2020 and 2022, 79 patients with hand and forearm injuries due to angle grinder were retrospectively evaluated. Data were obtained from the hospital database and telephone interviews with patients. Age, gender, education level, employment status and work experience, smoking, and alcohol use were recorded. The injury location and structures were evaluated. The time of injury and use of protective gloves were recorded. The Modified Hand Injury Severity Score (MHISS) was used to determine the severity of the injury. The return to work times of actively working patients were recorded. Results: Seventy-nine patients with angle grinder injuries were included in the study. All patients were male. Dominant side injury was in 17 (21.5%) patients. The most frequently injured area was the dorsal hand, and the most frequently injured structure was the extensor tendon. The mean MHISS was 49.15 (4-280) and 39 (49.4%) patients had minor injuries. The mean return to work was 7.13 (2-32) weeks. No correlation was found between age, work experience, and MHISS (p=0.167 p=0.389). There was a correlation between the use of protective gloves and MHISS (p=0.002). Conclusion: Injuries to the hand and forearm caused by angle grinder usage can result in serious work-related disabilities. These injuries can be reduced by increasing safety precautions and training.

Objective: AO (Arbeitsgemeinschaft für Osteosynthesefragen) type C distal humerus fractures are difficult fractures to reduce and fix due to the difficulty of the elbow anatomy and small size of the broken bone parts. We hypothesize that although parallel plating technique is biomechanically superior for humerus distal fracture, orthogonal plating technique in clinical conditions is as reliable and effective as a method of parallel plating for Type C humerus fractures. Materials and Methods: Between 2012 and 2018, 36 patients who underwent operations for AO type C distal humerus fractures and met the inclusion criteria were evaluated retrospectively. Parallel plating was performed in 20 patients and orthogonal plating (medial and posterolateral plating) in 16 patients. All patients were fixed with LC-DCP plates. Quick DASH, Mayo elbow, and VAS scores; grip strength; elbow ROM (Range of Motion); extension loss; and evaluations complications at the last visit. Results: There was no statistically significant difference between the groups in terms of the Quick DASH, Mayo elbow, or VAS scores, grip strength, elbow ROM, extension loss, union time, postoperative heterotrophic ossification, elbow and olecranon nonunion, post-op neuropraxia, or other complications (P > 0.05). There was a statistically significant difference between the two groups regarding ulnar nerve transposition (P

Tibia is vulnerable to open fractures due to its relative inadequacy of soft tissue coverage. The optimal treatment method of open tibial fractures is still controversial. External fixators are widely used as a definitive treatment method for open fractures. The aim of the current study was to evaluate the outcomes of external fixators applied for open tibial shaft fractures. All open tibial fractures treated with external fixators between December 1999 and October 2008 were reviewed retrospectively. 48 limbs of 47 patients were included in this study. Fractures were classified as Type I in 4 (8.3%), Type II in 18 (37.5%), and Type III in 26 (54.2%) according to Gustilo-Anderson classification. The mean follow-up period was 58.3 months. 28 patients (29 limbs) underwent unilateral external fixation, and 19 patients received Ilizarov ring fixator. Fracture healing rates were 100% in Type I fractures, 88.9% in Type II fractures, 81.8% in Type IIIA fractures, 28.6% in Type IIIB fractures, and 62% in Type IIIC fractures. The mean time for removal of the external fixator was 24.06±12.44 weeks. The mean time to fracture union was 27.27±13.19 weeks. According to Karlstrom and Olerud criteria, the mean functional score was 31.04±3.77. Functional results were excellent in 6 limbs (12.5 %), good in 16 limbs (33.3 %), acceptable in 8 limbs (16.7%), moderate in 10 limbs (20.8%), and poor in 8 limbs (16.7%). Deep tissue infection developed in 5 limbs (10.4%). Osteomyelitis developed in 4 limbs (8.3%). The findings of our study suggest that satisfactory results can be obtained by using external fixators for the treatment of open tibial shaft fractures. [Med-Science 2022; 11(1.000): 254-8]

ABSTRACT Introduction We evaluated the clinical and radiological outcomes of capitellar fractures treated with modified screw insertion (inserting the first fixation screw anteroposteriorly and the second screw posteroanteriorly), a technique that can be applied with a minimally invasive lateral elbow approach. Materials and Methods Twenty-one isolated capitellum fractures that were surgically treated were included in the study. Fixation was achieved with two headless cannulated compression screws placed in anteroposterior and posteroanterior order using the modified lateral elbow approach. The Broberg-Morrey rating system was used to assess the post-operative functional status of the patients. Results According to the Broberg-Morrey criteria, the mean score was 92.7 (77-100) and 13 cases had excellent, 7 had good, and 1 had fair results. None of the patients developed avascular necrosis or heterotopic ossification. According to the Broberg-Morrey arthrosis score, two cases had Grade 1 and one had Grade 2 arthrosis. One patient had a superficial wound site infection that was treated with antibiotics, and in one case a 60° extension loss was observed in the elbow. Conclusion Treatment of isolated capitellar fractures with 2 headless screws placed anteroposteriorly and posteroanteriorly can provide stable fixation and is less traumatic for the elbow joint. Level of Evidence IV; Therapeutic Studies - Investigating the results of treatment.

ABSTRACT OBJECTIVE: To present the results of our cases of Dupuytren's disease treated with regional selective fasciectomy in light of the literature. METHODS: Patients diagnosed with Dupuytren's contracture and surgically treated with regional selective fasciectomy at our institution with adequate follow-up data were included in the study. All patients were routinely followed after surgery to assess results and complications. QuickDASH scoring was used to evaluate the patients and recurrences and complications were recorded. RESULTS: Twenty-one hands of 19 patients (13 males, 6 females) who underwent surgery and received adequate follow-up were retrospectively evaluated. Mean patient age was 65.8 (range: 41 to 86) and the mean follow-up period was 48.2 months (range: 24 to 86). Fourteen (66.6%) hands had excellent results, five (23%) hands had good results and two (9.4%) had fair results. The mean QuickDASH score for the patients at the final follow-up was 6.58 (range: 0 to 20.4). CONCLUSION: Our study results demonstrated that regional selective fasciectomy is a reliable and efficient method to treat Dupuytren's disease with low rates of complications and recurrence and the technique can be considered the gold standard. Level of Evidence IV, Case Series.