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Bilateral spontaneous rupture of the quadriceps tendon is a rarely seen clinical condition occuring in patients with chronic diseases. Patients with chronic renal insufficiency and undergoing haemodialysis associated with that are at risk. Weakening of the tendons develops with the accumulation of amyloid and uremic toxins in patients with chronic renal insufficiency and undergoing haemodialysis. In addition, secondary hyperparathyroidism, which develops from decreased phosphorous discharge in these patients, can lead to tendon rupture by causing bone resorption. The case presented here is a patient with an 8-year history of haemodialysis due to chronic renal insufficiency. Bilateral quadri-ceps rupture developed spontaneously in the patient, with the rupture of the left triceps tendon and after a fall in the follow-up period, the right acromioclavicular joint separation occurred. In conclusion, as patients with chronic renal insufficiency are known to be vulnerable to tendon injuries from simple trauma or even mild force, if there is renal insufficiency and haemodialysis in the patient anamnesis taken in the emergency department or polyclinic, there should be more careful examination and no hesitation in requesting tests for suspicious patients., Biletaral kuadriseps tendon spontan rüptürü nadir görülen sıklıkla kronik hastalığı olan hastalarda ortaya çıkan klinik bir durumdur. Kronik böbrek yetmezliği ve buna bağlı hemodializ tedavisi gören hastalar da risk altındaki hastalardır. Kronik böbrek yetmezliği olan ve hemodializ tedavisi gören hastalarda amiloid birikimi ve üremik toksinlerin etkisi ile tendonlarda zayıflama gelişir. Bunun yanısıra bu hastalarda azalmış fosfor atılımına bağlı gelişen sekonder hiperparatiroidizm de kemik rezorpsiyonu yaparak kemik tendon yapışma yerlerinden kopmalara yol açabilir. Olgumuz 8 yıldır kronik böbrek yetmezliği için hemodializ tedavisi gören bir hastadır. Hastada spontan gelişen bilateral kuadriseps, sol triseps tendon kopması ve takip eden dönemde düşme sonrası gelişen sağ akromioklaviküler eklem seperasyonu oluşmuştur. Sonuç olarak KRY' li hastaların çok basit travmalarla veya hafif zorlamalarla bile kas tendon yaralanmalarına açık hastalar olduğu bilinmeli, acil serviste veya poliklinikte değerlendirdiğimiz hastaların anamnezinde böbrek yetmezliği ve hemodializ tedavisi varsa bu hastaları daha dik-katli muayene etmemiz ve şüphelendiğimiz olgularda tetkik istemekten çekinmememiz gerektiği kanaatindeyiz.

Background The aim of this study was to evaluate the functional and clinical results of early total hip arthroplasty performed to treat acetabulum fracture. Methods Evaluation of 17 patients who were diagnosed with acetabulum fracture and treated with early total hip arthroplasty between January 2008 and October 2013 was performed. In all, 14 patients were male, and 3 were female, with mean age of 52 years (range: 29-80 years). Time elapsed between trauma and operation was mean of 13 days (range: 2-21 days). Observation period was average of 48.2 months (range: 24-70 months). Mean Harris Hip Score was 89.6 (range: 70-100). Results In 13 patients, score was good or excellent. Total of 7 of 10 patients had returned to their pre-trauma jobs. Mean length of time for return to work was determined to be 7.2 months (range: 1.5-24 months). Of the total, 9 (52.9%) patients were diagnosed with heterotopic ossification according to Brooker Classification. Conclusion After acetabulum fracture, early total hip arthroplasty with the correct indications and appropriate patient can result in functional, pain-free hip joint with the advantages of early mobilization, early return to work, and decrease in reoperation risk. Heterotopic ossification prophylaxis should be considered in the presence of 1 or more risk factors, such as a head injury, high-energy trauma, or associated musculoskeletal injuries.

Synovial sarcoma (SS) is a type of soft-tissue sarcoma, often linked to poor survival. Although overexpression of enhancer of zeste homologue 2 (EZH2) has been associated with poor prognosis in different tumors, a few studies investigated this link in SS. Here, we analyzed the relationship between EZH2 expression and prognostic factors in SS. We included 29 patients with SS. Immunostaining of EZH2 was performed with (D2C9) XPTM Rabbit mAb antibody, and the results were classified as low EZH2 expression (negative or weak expression) and high EZH2 expression category (moderate or strong expression). Analysis of survival in relation to prognostic factors was performed with Kaplan-Meier survival curves and Cox proportional hazard regression analysis. Our sample included 19/29 female and 10/29 male patients, with age range 16-63 years. The tumor diameter ranged from 2 to 15 cm. Necrosis was observed in 15/29 cases. Sixteen cases had >10 mitoses per 50 high-power fields (HPFs). Out of 29 cases, 14 showed low and 15 had high EZH2 expression. Statistically significant results were obtained for the association between the presence of metastasis and necrosis (p = 0.042), high EZH2 expression and distant metastasis (p = 0.018), high EZH2 expression and necrosis (p = 0.016), and high EZH2 expression and the tumor size >5 cm versus tumor size ≤5 cm (p = 0.014). Patients with all of the following: the tumor size ≤5 cm, low EZH2 expression, and without necrosis and distant metastasis had significantly longer survival time. Our results are consistent with previous studies, suggesting that EZH2 overexpression is an indicator of poor prognosis in SS.

Objective: The aim of this study was to evaluate the results of cement and kirschner wire augmentation in the management of bone defects in primary TKA. Methods: Twenty-four patients (10 male, 14 female; mean age: 66 years) with uncontained unilateral medial tibial articular bone defect who underwent TKA between 2010 and 2014 were included in this study. The average follow up time was 33.7 months. Patients were divided to two groups according to the size of the bone defect (Group 1: 20 mm). The tibial defect was reconstructed by using cement and K-wires. We used posterior stabilized prosthesis with no tibial stem extension. Results: The preoperative and postoperative lower extremity mechanical axis in Group I was in a mean varus of 15° and mean varus of 3°, respectively (p

WOS: 000288968900012, PubMed: 21644095, BACKGROUND We aimed to compare two (plate-screws and locked intramedullary nail) biological internal fixation techniques in the treatment of adult femur shaft fractures. METHODS Group I included 28 patients operated with biological internal fixation with plate and screws. Group II consisted of 31 patients operated with locked intramedullary nailing technique. During the follow-up period in Group I, 1 patient died and 3 patients dropped out of the study, so the results of 24 patients were evaluated. During the follow-up period in Group II, 2 patients died and 3 patients dropped out of the study, so the results of 26 patients were evaluated in this group. RESULTS Age, sex, injury mechanism, fracture type, time to operation, duration of operation, amount of bleeding, fluoroscopy usage time, early and late complications, duration of hospitalization, fracture union time, and functional results of all patients were comparatively evaluated. CONCLUSION According to our results, no superiority of either technique was demonstrated with respect to fracture union time, complication rate and functional results. Biological internal fixation with plate and screws is an alternative technique to locked intramedullary nailing in patients with multi-trauma or compromised pulmonary or cardiac function, or in complex comminuted or segmented diaphyseal or metaphyseal fractures.

Objectives: We evaluated the changes in electrophysiological characteristics of the contraction forces of the gastrosoleus complex due to stretching in experimental tibial lengthening.Methods: Distraction histiogenesis was performed in 22 guinea pigs weighing 600 to 800 g. Following the application of a semicircular external fixator and right tibial osteotomy, distraction was applied at a rate of 0.25 mm two times a day for 15 days without a latency period. The animals were randomized to two groups. In the study group, a foot plate preventing ankle plantar flexion was affixed to the external fixator, while ankle motions were unrestricted in the control group. On days 5, 10, and 15, the posterior tibial nerve was stimulated with a nerve stimulator at a constant frequency. Gastrosoleus muscle contractions were measured with a transducer and contraction forces were recorded.Results: On day 5, muscle contraction forces measured in the study group were much higher than the control group (p, Amaç: Deneysel tibial uzatma sırasında gastrosoleus kas grubunda gerilmeye bağlı meydana gelen kas kasılma kuvvetlerindeki değişiklikler elektrofizyolojik olarak değerlendirildi.Çalışma planı: Ağırlıkları 600-800 gr arasında değişen 22 kobay (guinea pig) üzerinde distraksiyon histiogenezi uygulandı. Kobayların sağ tibialarına, semisürküler eksternal fiksatör uygulanmasından sonra osteotomi yapıldı ve latent periyot beklenmeden 15 gün boyunca günde iki kez 0.25 mm hızla distraksiyon gerçekleştirildi. Hayvanlar rastgele iki gruba ayrıldı. Bir gruba eksternal fiksatöre sabitlenen ve plantar fleksiyonu engelleyen ayak pedalı eklendi. Kontrol grubundaki deneklerin ayak bilek hareketleri serbest bırakıldı. Distraksiyonun 5, 10 ve 15. günlerinde posterior tibial sinir, sinir uyarıcısı ile sabit frekansta uyarıldı. Gastrosoleus kas kontraksiyonları elektriksel uyarım çeviricisi ile ölçülerek kaydedildi.Sonuçlar: Beşinci günde, deney grubunda ölçülen ortalama kas kasılma kuvvetleri kontrol grubuna göre anlamlı derecede yüksek bulundu (p

Biletaral kuadriseps tendon spontan rüptürü nadir görülen sıklıkla kronik hastalığı olan hastalarda ortaya çıkan klinik bir durumdur. Kronik böbrek yetmezliği ve buna bağlı hemodializ tedavisi gören hastalar da risk altındaki hastalardır. Kronik böbrek yetmezliği olan ve hemodializ tedavisi gören hastalarda amiloid birikimi ve üremik toksinlerin etkisi ile tendonlarda zayıflama gelişir. Bunun yanısıra bu hastalarda azalmış fosfor atılımına bağlı gelişen sekonder hiperparatiroidizm de kemik rezorpsiyonu yaparak kemik tendon yapışma yerlerinden kopmalara yol açabilir. Olgumuz 8 yıldır kronik böbrek yetmezliği için hemodializ tedavisi gören bir hastadır. Hastada spontan gelişen bilateral kuadriseps, sol triseps tendon kopması ve takip eden dönemde düşme sonrası gelişen sağ akromioklaviküler eklem seperasyonu oluşmuştur. Sonuç olarak KRY’ li hastaların çok basit travmalarla veya hafif zorlamalarla bile kas tendon yaralanmalarına açık hastalar olduğu bilinmeli, acil serviste veya poliklinikte değerlendirdiğimiz hastaların anamnezinde böbrek yetmezliği ve hemodializ tedavisi varsa bu hastaları daha dik katli muayene etmemiz ve şüphelendiğimiz olgularda tetkik istemekten çekinmememiz gerektiği kanaatindeyiz. Bilateral spontaneous rupture of the quadriceps tendon is a rarely seen clinical condition occuring in patients with chronic diseases. Patients with chronic renal insufficiency and undergoing haemodialysis associated with that are at risk. Weakening of the tendons develops with the accumulation of amyloid and uremic toxins in patients with chronic renal insufficiency and undergoing haemodialysis. In addition, secondary hyperparathyroidism, which develops from decreased phosphorous discharge in these patients, can lead to tendon rupture by causing bone resorption. The case presented here is a patient with an 8-year history of haemodialysis due to chronic renal insufficiency. Bilateral quadri ceps rupture developed spontaneously in the patient, with the rupture of the left triceps tendon and after a fall in the follow-up period, the right acromioclavicular joint separation occurred. In conclusion, as patients with chronic renal insufficiency are known to be vulnerable to tendon injuries from simple trauma or even mild force, if there is renal insufficiency and haemodialysis in the patient anamnesis taken in the emergency department or polyclinic, there should be more careful examination and no hesitation in requesting tests for suspicious patients.

Çalışmanın amacı, ileri varus deformiteli dizlerde bir küçük boy tibial komponent kullanılması ve komponentin lateralizasyonu ile uygulanan total diz protezi (TDP) sonuçlarını klinik ve radyografik olarak değerlendirmek ve bu sonuçları ameliyat öncesi belirgin açısal deformitesi olmayan kontrol grubu ile karşılaştırmaktır. Kliniğimizde, Şubat 2003-Ocak 2008 yılları arasında çalışma grubu olarak, ameliyat öncesi varus açısal deformitesi 20° den büyük 15 hastanın 23 dizine ve kontrol grubu olarak, ameliyat öncesi 10° den küçük varus deformitesi olan ve 15° den az fleksiyon kontraktürüne sahip 156 hastanın 182 dizine TDP uygulaması gerçekleştirildi. İleri varus grubunda, ameliyat öncesi ve sonrası diz değerlendirme skorları arasında istatistiksel olarak anlamlı fark gözlendi (p

Studies have shown that cardiac ruptures due to blunt trauma are seen more often than expected. However, epicardial injuries and atrial ruptures are common findings in deaths due to falls. Our aim is to present a unique, isolated cardiac rupture in a 1 year-old child resulting from a fall from a bed, to evaluate autopsy findings among the literature from a medico-legal point of view.