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dorsi muscle flap is also among the frequently used flaps for lum-bosacral defects. According to the defect, the latissimus dorsi muscle can be elevated as a major pedi-cle from over the thoracodorsal artery and vein, as well as segmental pedicles from over the intercostal artery perforators. Latissimus dorsi muscle flap elevated as a segmental pedicle is not frequently used; however, it is very useful in closing lumbosacral defects that do not have many alternatives for their closure. In this study, a case of reconstruction with reverse turnover latissimus dorsi muscle flap and bilateral bipedicle skin flap of a patient, who was previously operated due to scoliosis and had tissue defect with the exposed fixator in the midline back. A 35-year-old female patient with scoliosis de-formity was previously operated due to scoliosis when she was 1-year old. About one year ago, a revision was required and new fixators were placed at an external center. Afterwards, the patient who developed tissue defect with the exposed fixator underwent debridement three times and vacuum-assisted closure (VAC) device treatment was performed. The patient, who was referred to us due to the defect which was not closing, was reconstructed with reverse turnover latissimus dorsi muscle flap and bilateral bipedicle skin flap. The procedures applied during the operation and postoperative follow-up results were examined. Latissimus dorsi flaps resting on secondary segmental vessels, which are named as “reverse” or “distal-based” latissimus dorsi flaps, were used to repair defects of spinal, lumbar and upper sacral regions. In most cases, the skin is not required and it is transferred as a muscle flap, and is performed as a transposition flap. The reverse turnover latissimus dorsi muscle flap ensures the successful repair of large defects of the lumbar region without microvascular anasto-mosis.

Objectives: This study aims to compare the clinical and radiological outcomes of the two fixation methods frequently used in the treatment of Schatzker type II fractures: lag screw fixation and lateral anatomic plate fixation. Patients and methods: This retrospective study, which was conducted between January 2005 and December 2014, included 61 patients (41 males, 20 females; mean age 43.4±13.1 years; range, 20 to 76 years) with Schatzker type II (Orthopaedic Trauma Association (OTA)/Arbeitsgemeinschaft für Osteosynthesefragen (AO) 41-B3) fractures. Patients were divided into two groups according to the type of surgery as cannulated lag screw fixation group (group 1, n=24, 39.4%) and lateral locking plate fixation group (group 2, n=37, 60.6%). Intraoperative mediolateral and anteroposterior instability were measured. Final knee flexionextention range of motion (ROM), single-leg hop test, Knee Society Score (KSS), Hospital for Special Surgery (HSS) and short form 36 (SF36) scores were obtained at the last follow-up. Results: The mean age of patients was 42.1±13.8 years in group 2 and 45.5±12.2 years in group 1. The mean follow-up period was 34±4 months. Minimal or no arthritis was detected in 75% (n=18) of patients in group 1 and 78% (n=29) of patients in group 2 (p=0.27). Single leg-hop test results (p=0.55), final follow-up knee ROM (p=0.40), KSS (p=0.21), HSS (p=0.15), and SF36 scores of group 1 were similar to group 2. In group 1, the duration of surgery was shorter (p

ÖZETAmaç: Bu çalışmanın amacı, femur boyun kırığı nedeniyle sementli veya sementsiz bipolar hemiartroplastiile tedavi edilmiş 65 yaş ve üstü hastalarda mortalite oranlarını geriye dönük olarak karşılaştırmak ve mortaliteyietkileyen faktörleri belirlemektir.Gereç ve Yöntem: 2006 ve 2013 yılları arasında, 65 yaş ve üstü olup femur boyun kırığı teşhisiyle bipolarhemiartroplasti ile tedavi edilen hastaların verileri geriye yönelik incelendi. Patolojik kırığı olan, aynı andabirden çok yerde kırığı olan, yetersiz verisi olan ve takibi olmayan hastalar çalışma dışı bırakıldı. Tüm hastalarınbaşvuru anında yaşı, cinsiyeti, kırık tipleri, ek hastalık sayıları, ASA (American Society of Anesthesiologists)skorları, ameliyata kadar beklediği süre hastanemiz elektronik kayıtlarından belirlendi. Ek olarakanestezi tipi, ameliyat süresi, kan transfüzyon miktarı, toplam yatış süresi kayıtlardan incelendi. Hastalartakipte ölenler ve sağ kalanlar olarak gruplandırıldı ve mortalite üzerine etkili temel demografik belirleyicilerkarşılaştırıldı.Bulgular: Sementli veya sementsiz bipolar hemiartroplasti uygulanan hastalar klinik özelliklerine göre karşılaştırıldığındasadece kırık tipi açısından gruplar arasında anlamlı fark saptandı (p=0.003). Takip süresince104 hastadan 65 hasta sağ iken, 39 hasta ölmüştü. Sementli bipolar hemiartroplasti uygulanan hastalardamortalite oranı istatistiksel olarak anlamlı düzeyde daha yüksekti (p=0.010). Demografik özelliklerden sadeceileri yaşın (p=0.010) mortaliteyi anlamlı olarak artırdığı tespit edildi.Sonuç: Bulgularımız ışığında sementli hemiartroplasti uygulamasının gerekli haller dışında ileri yaş hastalardamümkün olduğunca tercih edilmemesini öneriyoruz.Anahtar Kelimeler: Hemiartroplasti; femur boyun kırıkları; mortalite oranı; yaşlıABSTRACTAim: The aim of this study was to retrospectively compare the mortality rates and determine the factorsaffecting mortality in patients aged 65 years or older treated with cemented or non-cemented bipolarhemiarthroplasty for femoral neck fractures.Material and Methods: The data of patients who were treated with bipolar hemiarthroplasty betweenthe years of 2006 and 2013 with the diagnosis of femoral neck fracture aged 65 years and over wereretrospectively reviewed. Patients with pathological fractures, multiple fractures at the same time,insufficient data and no follow-up were excluded from the study. The age, sex, fracture types, numberof additional diseases, ASA (American Society of Anesthesiologists) scores of all patients at the time ofadmission were determined from the electronic records of our hospital. In addition to that; anesthesiatype, operation time, blood transfusion amount, total hospitalization time were examined from records.The patients were grouped as survivors and deceased, and the main demographic determinants ofmortality were compared.Results: When the patients who underwent cemented or non-cemented bipolar hemiarthroplasty werecompared according to their clinical characteristics, a significant difference was found only between thegroups in terms of fracture type (p = 0.003). During the follow-up period, 65 patients of 104 patientswere alive and 39 patients died. Mortality rate was significantly higher in patients with cemented bipolarhemiarthroplasty (p = 0.010). According to demographic characteristics, only older age (p = 0.010)significantly increased mortality.Conclusion: In the light of our findings, we suggest that cemented hemiarthroplasty should not be preferredas much as possible in elderly patients except when necessary.Key Words: Hemiarthroplasty; femur neck fractures; mortality rate; elderly

Cleidocranial dysostosis is a skeletal dysplasia inherited in an autosomal dominant manner and may lead to complications such as scoliosis and kyphosis, concurrent with various orthopedic involvements. Since concurrent spinal deformities are of progressive nature, surgical treatment may be necessary. In addition to other orthopedic problems, possible accompanying complications such as atlanto-axial subluxation, myelopathy, syringomyelia, congenital spine deformities, spondylosis, and spondylolisthesis should be kept in mind while planning for the treatment of scoliosis and kyphosis. Lengthening the use of growth-friendly systems (growing rod) in patients, like ours, with an early onset of symptoms, and performing posterior instrumentation and fusion once the spinal growth is complete will yield successful results with no complications in the middle and the long term. Further multicenter studies with more comprehensive assessments are required to find solutions to spinal problems related to this rare skeletal dysplasia. 30123598

Preoperatif ve postoperatif düşük hemoglobin değerlerinin kalça cerrahisi sonrası morbidite, mortalite, erken fonksiyonel sonuçlara ve yürüme mesafesine olan etkisine dair farklı sonuçlar bildirilmiştir. Biz bu çalışmada ameliyat öncesi aneminin kalça kırıklı hastalarda cerrahi sonrası mortalite ve hastanede kalış süresi üzerinde etkisi olup olmadığını inceledik. Çalışmaya kliniğimizde parsiyel protez yapılarak tedavi edilen 135 kalça dahil edildi. Hasta dosyaları retrospektif olarak incelendi ve hastalara ameliyat öncesi anemisi olanlar ve olmayanlar olarak iki gruba ayrıldı. Heriki hasta grubu ortalama yaş, morbidite dağılımı, preoperatif ve postoperatif hemoglobin değerleri, cerrahi öncesi ve sonrası hastane yatış süreleri ve transfüzyon gerekliliği açısından istatistiksel olarak değerlendirildi. Yaptığımız çalışmada anemisi olan hastalarda preoperatif dönemde yatış süresinin anemisi olmayan gruba göre anlamlı derecede fazla olduğunu, ancak iki grup arasında postoperatif yatış süresi arasında anlamlı fark olmadığını saptadık., Objective: The objective of this study was analysing the correlation between preoperative anemia and duration of hospitay stay at preoperative and postoperative stage among patients that had been treated with partial endoprosthesis for treatment of pertrochanteric femoral fractures. Methods: Medical records of 152 individuals were reviewed retrospectively and 135 patients were included to the study. Preoperative anemia was detected in 87 of patients. Remaining 48 patients hemoglobin levels were within normal ranges. Both patient groups were statistically examined with respect to mean age, distribution of morbidity, preoperative and postoperative hemoglobin values, duration of hospital stay before and after surgery and transfusion requirement. Results: When hypertension, coronary artery disease, diabetes mellitus, Alzheimer's disease and transfusion ratios are examined, no statistically significant difference was found between groups (p>0,05). No statistically significant difference was found between the age averages of anemic and non-anemic patients (p>0,05). Preoperative and postoperative hemoglobin values of patients in the anemic group were found to be significantly low compared to the averages of patients in the non-anemic group (p