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VERGILI, OZGE/0000-0002-5312-7684 WOS: 000513233500011 PubMed ID: 30644769 Introduction: Due to the continual increase in the number of children engaging in sports today, physicians encounter finger injuries at an increasing frequency. This study sought to investigate the effectiveness of the method of Kinesio taping versus classic finger splint technique on pediatric patients with PIP (proximal interphalangeal) joint sprains of the fingers. Method: This is a retrospective cohort study. Forty-nine pediatric patients with PIP joint sprains were included in the study. The patients were divided into two groups, Group 1 being those treated with Kinesio taping and Group 2, those treated with splints. The area around the PIP joint was measured before and after treatment. Visual analog scale (VAS) evaluation: nighttime pain, numbness, pain at rest, and pain during activity were each separately evaluated before and after treatment. Also, flexion was measured at rest and in active motion before and after treatment. Results: The patients' periarticular measurements of the affected joint were statistically significant in both groups after treatment (p < 0.001). In the comparison between the groups, it was found that the group treated with Kinesio taping displayed a better outcome (p < 0.021). According to the VAS for PIP joint pain, it was observed that in both groups, pain at rest, pain during activity, nighttime pain, and numbness were statistically significant after treatment (p < 0.001). In the comparison of the groups, it was seen that the difference was statistically significant only in terms of nighttime pain (p < 0.013). Conclusions: The study conducted supported the literature that Kinesio taping method does not restrict the function of the extremity to which it is applied and also does not produce the complications reported in other treatment techniques. Kinesio taping was found to have a higher patient compliance and the outcomes were better in terms of edema and joint range of motion as well as night time pain when compared to the group treated with splint.

Gultac, Emre/0000-0003-1943-2199; Serbest, Sancar/0000-0003-2696-8303 WOS:000571509200016 PubMed: 30644789 Background:Here we have defined a novel technique for repairing posterior acetabular wall fractures called the "crescent technique," in which dual C-shaped reconstruction plates overlap at the distal ends and, if necessary, at the proximal ends. We also analyzed the efficacy and reliability of this method.Patients and Methods:This was a retrospective analysis of 27 patients undergoing the crescent technique. All of the fractures were treated by the senior author for a mean of 7.9 days (0-15 days) after the trauma. The mean follow-up period was 19 months (13-29 months). The clinical results were evaluated using the modified clinical grading system developed by Merle d'Aubigne and Postel, and then modified by Matta. The radiographs were graded according to the criteria described by Matta.Results:In the clinical grading, 16 (59%) of the patients were excellent and very good, 5 (19%) were good, 3 (11%) were moderate, and 3 (11%) were poor. According to the Matta radiological evaluation criteria, 19 (70%) were excellent, 4 (15%) were good, 4 (15%) were fair, and none were poor. Statistically significant consistency was seen between the clinical and radiological results (p = 0.002).Conclusions:The crescent technique is a dual plate technique modification that can provide a stable fixation. It appears to be an effective and reliable method for treating posterior wall fractures of the acetabulum.

Sleep disturbance is a frequent symptom of carpal tunnel syndrome. The aim of this study was to investigate the effect of median nerve decompression on sleep quality of patients with this condition. The study sample consisted of 41 patients with severe carpal tunnel syndrome who were admitted to our clinic and treated with open median nerve decompression. Sensation and functional recovery of the patients were followed using the Boston Function Questionnaire, the Semmes–Weinstein monofilament test and the two-point discrimination test. Symptomatic recovery of the patients was followed by the Boston Symptom Questionnaire. The tests were used before surgery and at three and six months afterwards. Sensory, functional and symptomatic recovery from the third month to the sixth month following surgery also affected sleep parameters and improved the sleep quality of patients with carpal tunnel syndrome. Level of evidence: IV

Background:The aim of this study was to show the effects on the meniscus of repair applied from the femoral, the femoral-tibial and the tibial surfaces.Methods:In the treatment of meniscocapsular separation, although the accepted gold standard technique in the past was the inside-out suture technique, the current treatment method is all-inside repair methods. The all-inside techniques include the hook method and applications with a meniscus suture device. The hook method is difficult with a steep learning curve. In meniscus repair applied with the all-inside meniscus devices, the application of the suture can change the anatomic structure and position of the meniscus.Results:The suturing method applied from the tibial section of the meniscus does not disrupt the anatomic position of the meniscus in meniscocapsular separation. Thus, the optimum conditions are provided for restoration of the functions of the meniscus.Conclusion:The optimal repair in meniscocapsular separations can be considered to be that made with sutures from the tibial section of the meniscus. This technique may be helpful in obtaining better clinical results.

The aim of this study is to investigate thepotential for improvement of the collagen scaffold in the repair of horizontalmeniscus tears in the rabbit model. Mature 21 New Zealand white male rabbitsweighing 2.5-3 kg were divided into 3 equal groups, with 7 animals in eachgroup. The medial meniscus was anteriorly horizontal torn from the horn to themiddle. In accordance with the study protocol, Group 1 (n=7); only thehorizontal meniscus was tilted in the control group. Group 2 (n=7); horizontalmeniscus rupture primer repair. Group 3; horizontal meniscus were repaired witha colloidal scaffold. All experimental animals were sacrificed at the end ofthe 12th week. 1/3 anterior area of medial meniscus was measured. Histologicalanalysis of the tissues was performed with Ishida score consisting of threecomponents. Surface area of meniscus in group I was significantly lower thangroup II (p, Bu çalışmanın amacı, tavşan modelinde horizontalmenisküs yırtıklarının onarımında kollajen skafold kullanımı sonrası menisküsüniyileşme potansiyelini araştırmak ve skafold ile tamirin primer tamirden dahaüstün olup olmadığını göstermektir. Ağırlıkları 2.5-3 kg arasında değişen olgun21 adet New Zealand White cinsi erkek tavşanlar her grupta 7 hayvan olacakşekilde 3 eşit gruba ayrıldı. Medial menisküs anterior boynuzdan orta kısmınakadar horizontal yırtık modeli yapıldı. Çalışma protokolüne uygun olarak, Grup1 (n=7); kontrol grubu sadece horizontal menisküs yırtığı olan tavşanlardanoluşturuldu. Grup 2 (n=7); horizontal menisküs yırtığa primer tamir yapılırken,Grup 3; horizontal menisküs yırtığa kollajen skafold ile tamir yapılanlar idi.Tüm deney hayvanları 12. haftanın sonunda sakrifiye edildi. Medial menisküsün1/3 anterior alanı ölçüldü. Dokuların histolojik analizi, üç bileşenden oluşanIshida skoru ile gerçekleştirildi. Grup I'deki menisküsün yüzey alanı grup II’den(p

WOS: 000403179100001 PubMed: 28599660 Background: Meniscocapsular separation (MCS) is a lesion of the area which is attached from the peripheral section of the meniscus to the capsule and is seen less often than other meniscus injuries. The aim of this study was to investigate which of the different side applications of all-inside MCS repair of the meniscus was better in respect of clinical and functional results. Methods: In this retrospective study, 53 patients with MCS pattern in their knee joints were treated with arthroscopic meniscus repair made with the all-inside method. The patients were separated into three groups according to the surface from which the fixation was applied: group 1, from the femoral joint surface of the meniscus (n = 17), group 2, from the tibial joint surface of the meniscus (n = 21) and group 3, from the femoral and tibial joint surfaces of the meniscus (n = 15). The participants were assessed using the subjective International Knee Documentation Committee Scoring (IKDC), Lysholm Knee Scale, Tegner Activity Level Scale, Barrett criteria and Kellgren-Lawrence classification after a 45 +/- 12.1 months (range, 24-70 months) follow-up. Results: Postoperatively, all the groups exhibited significantly increased subjective IKDC score, Lysholm score and Tegner activity score compared with their preoperative results (p < 0.001). At 6 months postoperatively, a statistically significant difference was determined between the groups in respect of the subjective IKDC score, Tegner activity score and Lysholm score with group 2 showing better results than the other groups (p < 0.001). At the final follow-up examination, no statistically significant difference was determined between the groups in respect of the subjective IKDC score, Tegner activity score or Lysholm score. A statistically significantly lower level of pulling and stress sensation was determined in group 2 (p < 0.001). Conclusions: MCS repair made with the all-inside method is successful clinically and functionally and in respect of MRI findings. In addition, it was seen that the fixation method applied from the tibial surface of the meniscus does not disturb the anatomic position of the meniscus in MCS repair. The tibial joint surface is the most appropriate area for suturation in all-inside repair of MCS.

INAL, MIKAIL/0000-0003-0642-7913 WOS: 000457679200001 PubMed: 30798723 Purpose: The purpose of this study was to investigate the clinical results of arthroscopic rotator cuff repair in patients with anterior greater tubercle cyst in magnetic resonance imaging (MRI). Methods: The cyst-present group comprised 38 patients with anterior greater tubercle cyst in MRI, and age- and sex-matched 30 patients without cyst in humeral head were included in the control group. The cystic group was divided into two groups, smaller than 5 mm (21 patients) and larger than 5 mm (17 patients), according to the cyst size. A total of three groups were created. In the evaluation of clinical outcomes, modified University of California at Los Angeles (UCLA) and the Western Ontario Rotator Cuff Index (WORC) were used. The visual analog scale (VAS) was used to assess pain. One-way analysis of variance was used to compare VAS, UCLA, and WORC scores among the groups. Results: There was a statistically significant difference in the clinical results of VAS, UCLA, and WORC among the cystic and noncystic groups in the anterior greater tubercle (p < 0.05). There was also a statistically significant difference in the clinical results of UCLA, WORC, and VAS scores according to the cyst sizes in the anterior greater tubercle cyst group (p < 0.05). Conclusion: Anterior greater tubercle cysts have negative effects on rotator cuff repair results. If the anterior greater tubercle cyst size is greater than 5 mm, the negative effects of rotator cuff repair results are more pronounced. An understanding of anterior greater tubercle cysts has a critical importance for rotator cuff surgery planning.

WOS: 000386308300001 PubMed: 27793159 Background: This study aimed to consider the use of a meniscal repair in patients in order to close the horizontal cleavage extending up to the avascular zone. The hypothesis was to examine the clinical and arthroscopic outcomes following meniscal repair of degenerative horizontal cleavage tears with new-generation all-inside suture materials using the overlock method. Methods: We retrospectively reviewed a consecutive series of 55 patients which had a horizontal pattern, and finally, 27 patients with a horizontal tear only which required no additional intra-articular surgical intervention were included in the study. Arthroscopic meniscal repair was performed using the overlock method. Functional outcomes were evaluated using Lysholm knee scoring scale, Cincinnati scores, subjective International Knee Documentation Committee (IKDC) criteria and Tegner activity scale. Assessment of meniscal healing was evaluated clinically by the presence of meniscal signs. The preoperative and postoperative MRIs were examined. Results: The mean follow-up period was 29 months (range, 24-38). The mean Lysholm score improved significantly from 59.5 +/- 12.4 points preoperatively to 90.0 +/- 4.7 points postoperatively (P < 0.0001). The Cincinnati score increased from 14.8 +/- 5.3 to 26.9 +/- 1.6 (P < 0.0001). The Tegner activity score increased from 3.7 +/- 1.4 to 6.4 +/- 1. 6 (P < 0.0001). The mean IKDC subjective score also improved significantly from 48.5 +/- 9.8 preoperatively to 90.4 +/- 5.0 postoperatively (P < 0.0001). Conclusion: Meniscal repair of degenerative horizontal tears using the overlock method resulted in improved Lysholm and IKDC subjective scores. With careful selection of the patients and the horizontal meniscus tears, the success of the meniscus repairs increases. Repair can be recommended for all horizontal meniscus tears which can be repaired arthroscopically.

Yaman, Ferda/0000-0001-6847-1720 WOS: 000404569600018 PubMed: 27401007 The aim of this study was to examine the potential relationship between subjective sleep quality and degree of pain in patients with rotator cuff repair. Thirty-one patients who underwent rotator cuff repair prospectively completed the Pittsburgh Sleep Quality Index, the Western Ontario Rotator Cuff Index, and the Constant and Murley shoulder scores before surgery and at 6 months after surgery. Preoperative demographic, clinical, and radiologic parameters were also evaluated. The study analysed 31 patients with a median age of 61 years. There was a significant difference preoperatively versus post-operatively in terms of all PSQI global scores and subdivisions (p < 0.001). A statistically significant improvement was determined by the Western Ontario Rotator Cuff Scale and the Constant and Murley shoulder scores (p E, 0.001). Sleep disorders are commonly seen in patients with rotator cuff tear, and after repair, there is an increase in the quality of sleep with a parallel improvement in shoulder functions. However, no statistically significant correlation was determined between arthroscopic procedures and the size of the tear and sleep quality. It is suggested that rotator cuff tear repair improves the quality of sleep and the quality of life. IV.

WOS: 000366562000001 PubMed: 26719683 A femoral artery aneurysm is a very rare complication of hip surgery treatment. In this presentation, we report a rare case of bone destruction caused by the femoral artery aneurysm after a hip hemiarthroplasty operation as a late stage complication. A 77-year-old male patient presented with swelling and pain in the hip without any signs of ischemia. X-ray showed a 7 cm bone destruction in the medial cortex of the proximal femur. After ultrasound imaging, a femoral artery aneurysm was diagnosed. The patient was operated on by vascular surgeons, and a large amount of organized hematoma with artery aneurysm was removed. The diagnosis of femoral aneurysm after hip surgery treatment can be difficult. Femoral aneurysm is rare and usually secondary to trauma, infection, or iatrogenic injury. We assumed that this case occurred during the hemiarthroplasty operation, caused by a compressing effect to the bone causing destruction. The patient was followed for 2 years, during which time the preoperative symptoms reduced dramatically and Harris Hip Score improved. After a hip arthroplasty operation, it must be kept in mind that a femoral arterial aneurysm can cause persistent symptoms. This case illustrates the importance of considering a pseudoaneurysm as a possible cause of periprosthetic osteolysis, particularly if rapid progressive growth has occurred. If this vascular injury had not been correctly diagnosed, the method of treatment could have been much different, probably with catastrophic consequences.

Sancar Serbest,1 Ugur Tiftikci,1 Haci Bayram Tosun,2 Seyit Ali Gumustas,2 Abuzer Uludag2 1Department of Orthopaedics and Traumatology, Faculty of Medicine, Kırıkkale University, Kırıkkale, 2Department of Orthopaedics and Traumatology, Faculty of Medicine, Adiyaman University, Adiyaman, Turkey Objectives: Platelet volume has been defined to be a marker that shows thrombocyte activation and function and it is measured as mean platelet volume (MPV). MPV shows the mean volume of circulating thrombocytes and it is one of the routine parameters in complete blood count. Increased thrombocyte volume is associated with thrombocyte activation. Patients and methods: This study included 76 patients who were operated on due to fractures of long tubular bones. Patients who had union without any additional interventions were defined as group I, and patients who needed additional interventions due to nonunion or inadequate union were defined as group II. The control group included healthy volunteers who did not have a fracture. Hematologic test values of the patients that were obtained at admission to emergency ward were recorded Results: The groups were not statistically different in terms of age, sex, and the affected extremity. There were significant differences between group I and group II in terms of mean erythrocyte sedimentation rate, C-reactive protein, and MPV values (P

KARABICAK, GUL OZNUR/0000-0003-3248-0638; karabicak, gul oznur/0000-0003-3248-0638 WOS: 000376790800001 PubMed: 26918069 Introduction: The aim of the study is retrospectively investigated durations for returning to work following anatomic ACL reconstruction by hamstring autograft in miners and the reasons in patients who were delayed to return to work. Methods: Miners with symptomatic anterior cruciate ligament rupture underwent arthroscopic reconstruction. Patients were evaluated in terms of range of motion (ROM) values; Lysholm, Cincinati and Tegner activity scales; laxity testing and complications. By modifying the method used by Fitzgerald et al. we decided for the criteria returning to work. Results: Thirty three patients were evaluated with mean followup of 22.7 +/- 8.3 months (range 13-46 months). Mean age at the surgery was 27.8 (18-38) years. Lysholm, Cincinati and Tegner activity scales were signifi cantly higher from preoperative scores (Lysholm scores: preoperative: 60.7 +/- 12.5, postoperative: 90.3 +/- 4.8 (P < 0.001); Tegner activity scores: Preoperative 3.5 +/- 1.4, postoperative: 6.2 +/- 1.5 (P < 0.001); Cincinati scores: Preoperative: 14.8 +/- 5.3, postoperative: 26.9 +/- 1.6 (P < 0.001). The average time for returning to work was determined as 15,3 +/- 4 weeks. There was no significant difference for knee scores and time for returning to work between patients with meniscal injuries and don't have meniscus lesions. Conclusion: The reasons for delays in returning to work was work accident. Hematoma or effusion and pain inside the knee were the most significant reason which affected returning to work.

WOS: 000369533200041 PubMed: 26402835 Congenital clasped thumb is a progressive flexion and adduction deformity presenting with heterogeneous congenital anomalies. Although the disease is rare, diagnosis is usually delayed due to natural location of thumb within the palm in first 3 months of life.A 4-year-old girl with congenital clasped thumb deformity due to absence of extensor pollicis brevis tendon whose treatment consisted of extensor indicis proprius (EIP) transfer and z-plasty reconstruction to first web space.The patient was so happy with both cosmetic appearance and functional status. There was not any limitation at interphalangeal or metacarpophalangeal (MCP) joints of the thumb and the result was. Stability of MCP joint was full and power for grasping any object was much better than the original status.In cases of isolated clasped thumb deformity associated with absence of tendon whose treatment attempts with splinting and physical treatment have failed, EIP tendon transfer and reconstruction of contracture in first web space with z-plasty is an easy and successful method to obtain functional improvement.

Synovial chondromatosis is a rare benign condition arising from the synovial membrane of the joints, synovial sheaths or bursae around the joints. Primary synovial chondromatosis typically affects the large joints in the third to fifth decade of life. The purpose of this case report is to document this rare synovial pathology, which required open synovectomy and debridement to eradicate it. In our case, the biggest sized SOC was 20x19x6 cm, although there were many joint mice. Our case had the biggest SOC ever extracted, which to the best of my knowledge has not been reported earlier.Key words: Synovial chondromatosis, giant, loose body, knee Joint, surgery

WOS: 000376558100004 PubMed: 26097627 Sprain of the ankle is undoubtedly a common injury during athletic activity, and the sprain can be also associated with fracture of the ankle. Isolated posterior malleolus fracture is a very rare condition, which is usually missed. Here, we are presenting a 37 years old female patient, who suffered injury secondary pressing on brake pedal during collision in a traffic accident. Clinical evaluation is based on Ottawa Ankle Rules and a fracture is diagnosed; patient is started on daily activities at postoperative Week 8. This study aims to emphasize that Ottawa Ankle Rules are usually efficient for evaluating fractures of ankle, but clinicians should always make a detailed physical examination.

Amici, Adolfo/0000-0002-1081-7749 WOS: 000350116000025 PubMed: 25700329 Avulsion fractures of the pelvic apophyses rarely occur in adolescent athletes in the course of sudden strong contraction of muscle attached to growth cartilage. This injury may usually be misdiagnosed for tendon or muscle strain. Patient's history, physical examination, and radiologic studies are important for diagnosis. The literature includes only a few case reports but no case series as yet. The aim of this study was to present the results of 5 cases of anterior inferior iliac spine (AIIS) avulsion fractures treated conservatively. The study included 5 patients (4 male, 1 female, mean age 13.6 years) who underwent conservative treatment for AIIS avulsion fractures and had an adequate follow-up. All patients were admitted to the emergency department and misdiagnosed as muscle strain. Three of them were football player, 1 skier, and 1 fighter. Each patient was treated with immobilization and nonsteroidal anti-inflammatory drugs. At follow-up, all patients showed relief from their pain and mechanical symptoms and regained full range of motion and returned to their previous levels of activity. Diagnosis requires careful attention to the physical examination and imaging. In this series, all pelvic avulsion fractures (100%) were managed successfully with a conservative approach. Good results and return to previous levels of activity can be achieved with conservative treatment.

Introduction: In distal radial fractures in adults, factors affecting instability have been investigated in many studies in an effort to shorten the preoperative waiting period for the fractures requiring surgery. Numerous factors, aside from the alignment-related indices, have been searched to predict redisplacement. Unlike as in paediatric counterparts, the casting technique and casting-related indices have not been appropriately considered in adults. The aim of this study was to determine the impact of the various previously investigated factors in addition to casting technique-related indices such as threepoint index, cast index, padding index and gap index, in predicting the risk of redisplacement of extraarticular distal radial fractures in adults and the presence of the ulnar deviation of the cast. Patients and methods: Seventy-five patients over 18 years who were treated with a cast in our emergency department within 24 h after a displaced distal radial fracture, were recruited into the study. Age, alignment-related indices, cast-related indices, extent of the ulnar deviation of the cast, having a nonanatomical reduction, co-existing ulnar fracture, dorsal comminution and obliquity of the fracture line were investigated. Casting technique according to three-point index, obliquity of the fracture line, degree of the ulnar deviation of the cast, and reduction accuracy were the significant factors affecting redisplacement. Results: The three-point index had a sensitivity of 95.8%, specificity of 96.1%, positive predictive value of 92%, and negative predictive value of 98% in predicting redisplacement. Logistic regression revealed that having an inadequate cast according to the three-point index (p < 0.001), degree of obliquity of the fracture line (p = 0.018), decreased ulnar deviation of the cast (p = 0.002), and having a non-anatomical reduction (p = 0.029) were the significant predictive factors in redisplacement. Conclusions: Our results suggest that the casting technique plays a major role in the success of conservative treatment, which can best be examined with the three-point index. Ulnar deviation of the cast and fracture obliquity are the other dominant factors affecting redisplacement.

This study aims to analyse the contribution of various risk factors for the delay of tibial shaft fractures treated by circular external fixator and predicting the high risk fractures for delayed union. 32 extraarticular tibial shaft fractures of 31 adult patients treated with circular external fixator were included. The patients were analysed according to age, energy of trauma, having an open fracture or not, AO classification, obliquity, use of supplementary fixation techniques in surgery, distance of fracture line to neighbouring rings, having a pin-track infection or not, reduction score, and smoking. There were eight delayed unions and two non-unions in our study. Consolidation time was significantly shorter (p=0.01) between the supplementary fixation group and the others. There was a significant difference in fracture healing time between pin-track-infected patients and the patients who did not have pin-track infection (p=0.037). In conclusion, our results indicate that non-union infection and not using supplementary fixation techniques are the major factors that delay the healing time. Supplementary fixation enhances the reduction rate and a low reduction score is related with the occurrence of a pin-track infection.

Actinomycotic hepatic abscess was diagnosed in a 46-year-old male driver from Ukraine presenting with the symptoms of malaise, loss of appetite, upper right quadrant pain, weight loss, and night sweats which had been present for last 2 months. Computed tomography (CT) of the abdomen revealed a hypodense mass in the left liver lobe which was suspected as hepatocellular carcinoma. Histopathological examination of the CT guided biopsy specimen yielded a diagnosis of actinomycotic abscess of the liver. Treatment with intravenous penicillin for 6 weeks followed by a course of oral penicillin for 14 weeks resulted in complete cure as evidenced by clinical improvement and radiological disappearance of the lesion.