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Aim: The use of social media, especially Instagram, has become widespread in the medical field. The aim of this study was to evaluate Achilles tendon surgery from patients' perspectives by examining public posts on Instagram. Material and Methods: A retrospective analysis was made of the Instagram posts of patients with the hashtags #achillestendonsurgery and #achillestendonrepair between December 2018 and October 2021. In total, 234 posts (181 photographs, 53 videos) were evaluated and compared in terms of gender, sharing format (video, photo), sharing tone (negative, positive, neutral), content (activities of daily living, rehabilitation, cast/brace, hospital room, surgical site), country and popularity (the number of views for videos, the number of likes for photographs). Results: Posts in video format and a positive tone, posts on the rehabilitation process, and posts about male patients were found to have higher numbers of likes and views than other posts. The content of the shares were respectively; activity of daily living 36.8%(n=86), physical therapy 29.9%(n=70), cast/brace 20.1%(n=47), surgical site 7.7%(n=18), and hospital room 5.6%(n=13). The media tone of the posts was 40.2%(n=94) positive, 6.4%(n=15) negative, and 53.4%(n=125) neutral. Conclusions: Patients avoided making negative posts on their Instagram after Achilles tendon surgery, and often shared experiences of postoperative rehabilitation processes and daily living activities.

Acute arterial occlusions are uncommon complications in total knee arthroplasty (TKA). This complication is seen more in TKA revision surgery, and when appropriate treatment cannot be made, amputation may be necessary. The present case is here presented of a patient applied with TKA revision because of instability following a simple fall one year after primary TKA, and popliteal artery occlusion developed in the early postoperative period. The patient was a 70-year old female not actively working. In the patient history there was deep vein thrombosis in the ipsilateral lower extremity after primary TKA and associated with that, pulmonary embolism. The diagnosis of popliteal artery occlusion, which formed after the revision surgery, was diagnosed with advanced tests in the 3rd hour postoperatively, and in the 4th hour, exploration was made. No arterial active bleeding had been observed intraoperatively. Popliteal thrombectomy were applied of popliteal artery trombosis. Acute arterial occlusion is a rarely encountered complication, but it requires emergency intervention. To prevent the development of acute occlusive disease in revision knee surgery, preoperative evaluation of arterial status is recommended, especially in patients with a history of surgery.

The aim of this study was to compare the symptomatic, functional and satisfaction outcomes of patients with different temperaments undergoing carpal tunnel surgery by a single surgeon. Dominant temperaments of 171 patients with carpal tunnel syndrome were determined using the Temperament Evaluation of Memphis, Pisa, Paris and San Diego Autoquestionnaire (TEMPS-A). Patients were divided into six temperament groups, and the impact of their respective group measured against preoperative and postoperative symptom severity and functional capacity using the Boston Carpal Tunnel Questionnaire (BCTQ] and satisfaction using the Patient Evaluation Measure (PEM). Patients in the depressive group had the largest improvement in symptoms (BCTQ score change, –2.2) as well as a significant improvement in function (BCTQ score change, –2.1), yet had the lowest postoperative satisfaction (mean PEM score 9). Determination of patient temperament before surgery for carpal tunnel syndrome (CTS) may be useful as an ancillary technique to help predict postoperative satisfaction, which may in turn help guide preoperative communication and expectation setting. Level of evidence: III

Background We aimed to determine the ideal surgical timing in the first 24 hours after admission to the hospital of pediatric supracondylar humerus fractures (SHF) that do not require emergent intervention. Materials and Methods Patients who underwent surgery in our institution between January 2011 and January 2019 due to pediatric Gartland type 3 SHFs were evaluated retrospectively. Open fractures, fractures associated with vascular injury and compartment syndrome, flexion type fractures were excluded. A total of 150 Gartland type 3 were included. The effect of early (12 hours) surgical interventions, daytime or night-time surgeries, working or non-working hour surgeries on operative parameters (operative duration and open reduction rate, reduction quality on postoperative early radiographs) were evaluated in pediatric SHFs. Results Early (12 hours), daytime or nighttime, working or non-working hour surgeries were found to be similar in Gartland type 3 patients regarding early postoperative reduction quality, duration of surgery, open reduction rate (p>0.05). Mean times passed from first admission to hospital until surgery were longer in working hour, late (>12 hours) and daytime surgery groups than non-working hour, early ( Conclusion Although delaying the operation to the working hours seems to prolong the time until surgery in pediatric Gartland type 3 SHF patients who do not require emergent intervention such as open fractures, neurovascular impairment and compartment syndrome, there may not be a time interval that makes a difference for the patients if surgery is performed within the first 24 hours, thus the surgery could be scheduled according to the surgeons’ preference. Level of Evidence: Level 3, Retrospective cohort study

Objectives: Metacarpal fractures are common, and several surgical treatment methods have been described. This study aims to compare the clinical and economic aspects of two different surgical methods, closed reduction and K-wire fixation (CRPF) and open reduction and plate screw fixation (ORIF). Methods: Between January 2009 and March 2014, 51 patients who received surgical treatment for metacarpal fractures were retrospectively evaluated. Of them, 36 patients (29M, 7F) performed CRPF, and 15 (12M, 3F) performed ORIF. Patients were followed up for an average of 17.6 weeks. All patients were assessed according to the union, operation time, complications, cost-effectiveness, and the Michigan hand outcome questionnaire scores. Results: The mean operation time was 13.7 minutes (5-37 minutes) in the CRPF group and 32.2 minutes (23-62 minutes) in the ORIF group (p

The objective of our study was to assess the functional and sensory outcomes of the primary repair of 138 digital nerve injuries in 48 consecutive patients between January 2012 and November 2014, and to determine whether there were any relationships between demographics, clinical characteristics, or functional test results and post-operative sensory recovery outcomes. Mean follow-up was 14 (range, 10 to 20) months. Sensory evaluation was performed using the static two-point discrimination test, and post-operative sensoryrecovery results were classified according to the Seddon Classification: 69 (50%) injuries were S3+, 3 (2%) were S3, 15 (11%) were S2, 18 (13%) were S1, and 33 (24%) were S0. Sensory recovery was associated with time between surgery and testing and with objective functional recovery. More than half of digits sustaining nerve injuries had good intermediate-term recovery of sensation after early primary surgical repair. Surgeon experience and early primary repair may have a favorable impact on results.

Background: Crowe type IV developmental dysplasia of hip (DDH), subtrochanteric shortening osteotomy is required to restore the hip joint. Several approaches have been described for subtrochanteric shortening osteotomy. Several osteotomy fixation techniques have been defined for Crowe type IV DDH. This study evaluates the outcomes of subtrochanteric shortening osteotomy fixed with a combination of split onlay autograft and distal fluted femoral stem. Materials and Methods: A retrospective study was carried out on 41 hips of 37 patients treated with total hip replacement for Crowe type IV developmental dysplasia of the hip by subtrochanteric transverse osteotomy and fixed with split intercalary autograft by two cables. A femoral stem with proximal coated and distally fluted was used. The patients were evaluated at a mean of 34 months (range 12–68 months) for union time, leg equalization, and clinical outcomes. Results: Mean time of union was 13.5 ± 4.6 weeks (range 6–24 weeks). Intraoperative instability of the osteotomy site (n = 16) that was encountered at the trial stage was restored properly by this surgical protocol. Leg length discrepancies were improved to 1.4 ± 0.8 cm (range 0–3 cm). Harris scores were improved from 47.7 ± 10.8 (range 30–68) to 88 ± 5.6 (range 72–98) (P < 0.05) points. There was no nonunion. Conclusions: Distally well-fitted stem and strengthening of fixation with split intercalary autograft promote additional rotational stability and improve bone union.

This study aimed to determine the fate of the lateral femoral cutaneous nerve (LFCN) after anterior reduction of the hip with or without pelvic or proximal femoral osteotomy for acetabular dysplasia. Using the antidromic technique, recording the response using standard electromyography equipment, evaluation was made of the LFCN in 36 hips of 24 patients (18 female and six male). The response was absent in six patients (25%) and nine patients (37.5%) had a somatosensory evoked potential latency greater than 40 ms. There was no relationship between somatosensory evoked potential latency or absent response with the type of incision or procedure (P=0.229 and 0.794, respectively). LFCN injury after anterior open reduction of the hip has an unexpectedly high incidence in the young paediatric age group. Exposure of the nerve during surgery can negatively affect the nerve nutrition leading to neuropraxia.

To compare short and mid-term results in the treatment of chronic elbow tendinosis with platelet-rich plasma (PRP) or Nirschl surgical technique.A retrospective study was conducted on patients with chronic lateral epicondylitis, treated by Nirschl surgical technique (50 elbows) or PRP (60 elbows). Outcome was evaluated with Visual Analog Score (VAS), Mayo Elbow Scores and grip strength measurements.VAS and Mayo Elbow Scores of the PRP group had improved as a mean of 83% (p = 0.0001), 74% (p = 0.0001) over baseline and 34.2 pounds gain of grip strength.The PRP seems to be better for pain relief and functionality in the short and mid-term periods.

Objective: The aim of this study was to compare the effects of the use of a single anterior portal in the arthroscopic surgery treatment of traumatic anterior shoulder instability with those in the literature.Methods: The study included 72 patients (60 males, 12 females; mean age: 23.9 years) who underwent surgery using a single arthroscopic anterior portal for the treatment of traumatic anterior shoulder instability between 2002 and 2011. Clinical outcomes were assessed using the Rowe and Oxford scales, forward flexion range and external rotation limitation. Redislocation was considered failure.Results: Mean follow-up was 49.3 months. Bankart lesion was determined in 38 patients and Bankart and SLAP lesions in 34. An average of 3.7 (range: 2 to 5) anchors were used. Redislocation was observed in 4 (5.6%) patients in the postoperative period. Postoperative Rowe and Oxford scores were 93.4 and 42.6, respectively.Conclusion: Instability surgery performed using a single arthroscopic anterior portal provided findings comparable with the literature regarding clinical outcomes, postoperative shoulder movements and low recurrence rates, emphasizing the importance of appropriate patient selection rather than the number of the portals. The use of a single portal is less invasive and reduces the surgical period., Amaç: Artroskopik instabilite cerrahisinde tek anterior portal kullanılarak yapılan cerrahi sonuçlarını değerlendirip literatürle karşılaştırması amaçlamıştır.Çalışma planı: Dahil etme kriterlerine sahip travmatik anterior omuz instabilitesi tanısı olan 72 (60 erkek, 12 kadın; ortalama yaş:23.9) hasta çalışmaya dahil edilmiştir. Bu hastalar 2002 -2011 yılla¬rı arasında tek artroskopik anterior portal kullanılarak tedavi edilmişlerdir. Klinik değerlendirmeler Oxford ve Rowe skalaları, öne doğru olan fleksiyon eklem hareket açıklığı, dış rotasyondaki kısıtlılık kullanılarak yapılmıştır. Tekrar çıkık başarısızlık olarak değerlendirilmiştir.Bulgular: Ortalama takip süresi 49.3 aydır. Hastaların 38 tanesinde Bankart lezyonu, 34 tanesinde Bankart ile birlikte SLAP lezyonu saptanmıştır. Ortalama 3.7 (2-5) ankor kullanılmıştır. Postoperatif periyotta tekrar çıkık 4 (%5.6) hastada gözlenmiştir. Postoperatif periyotta Rowe skoru 93.4 ve Ox¬ford skoru 42.6 olarak saptanmıştır. Bu çalışmada hastaların kullanılan artroskopik yöntemden fayda gördükleri saptanmıştır.Çıkarımlar: Tek anterior portal kullanılarak yapılan instabilite cerrahisi sonuçları, literatürdeki klinik sonuçlar, postoperatif omuz hareketleri ve düşük rekürens oranları ile karşılaştırılabilir sonuçlara sa¬hiptir. Bu durum, uygun hasta seçiminin kullanılan portalden daha önemli olduğunu vurgulamaktadır. Bu daha az invaziv olan metodun cerrahi süreyi kısaltıyor olması 2 portale göre bir avantaj olarak değerlendirilebilir.

In staged bilateral total knee arthroplasty (TKA), regaining functional recovery and a painless joint with fulfilment of patients’ expectations at the first stage is an integral part for a patient to progress to the second stage. As patient expectations drive postoperative satisfaction, the challenge is to match patient and surgeon expectations before surgery. Therefore, this study aimed to evaluate the postoperative patient expectations and clinical outcomes and to evaluate the rate of second stage in bilateral staged TKA. The study included 111 patients; 81 females and 30 males with a median age at surgery of 68 years (range 59–85 years) and 46 were older than 70 years. Postoperative functional data included Knee Society Scores (KSS). Expectation data were collected according to the post-visit ‘Questionnaire of Patient Expectations of Healthcare’. The overall refusal rate for the second stage was 36.9 % (n = 41). The patients older than 70 years had a higher refusal rate compared to relatively younger patients (

Bu çalışma açık karpal tünel gevşetme cerrahisi yapılmış olan 171 hastanın cerrahi sonrası klinik sonuçları ve memnuniyet derecesinin hasta mizacı ile ilişkisinin değerlendirilmesi amacıyla yapılmıştır.Ankara Üniversitesi Tıp Fakültesi Ortopedi ve Travmatoloji Kliniğinde 2009-2011 yılları arasında açık karpal tünel gevşetme cerrahisi yapılmış olan 171 hasta değerlendirmeye alındı.Bu hastaların hiç birinin psikiyatrik patoloji tanısı bulunmuyordu.Öncelikle TEMPS-A testiyle hastaların mizacı belirlendi.Mizaç belirlemesi sonrasında 1.Anksiyöz mizaç; 2. Baskın mizacı olmayan; 3.Depresif mizaç; 4.Siklotimik mizaç; 5.İrritabl mizaç; 6.Hipertimik mizaç olmak üzere 6 mizaç grubu oluştu.Bu 6 gruptan baskın mizacı olmayan 60 hastadan oluşan grup ile 111 hastadan oluşan diğer 5 grup birbirleriyle karşılaştırıldı.Sonrasında ameliyat öncesi ve ameliyat sonrası dönemde Boston Skalasına göre hastaların semptomatik ve fonksiyonel açıdan skorlamaları ve PEM Mutluluk Ölçeğine göre ameliyat sonrası dönemdeki memnuniyeti tespit edildi.Elde edilen sonuçlar Wilcoxon-Mann-Whitney, ki-kare testi, Kruskal-Wallis testleri ile istatistiksel olarak değerlendirildi.Depresif ve anksiyöz mizaca sahip hasta gruplarındaki Boston skorları ve PEM skorları değerlerinin baskın mizaca sahip olmayan grupla karşılaştırılmasında anlamlı fark saptandı (p

Cierny-Mader (C-M) Type III osteomyelitis is defined as a localised lesion with both medullary and cortical involvement that is stable mechanically after debridement. The treatment of C-M Type III osteomyelitisis is difficult and requires a precise protocol to achieve a disease-free long-term follow-up. We report here the results of our study on 26 patients (19 men and 7 women; average age: 34.7 years) with C-M Type III osteomylelitis who were treated with radical debridement, irrigation, vancomycin-impregnated custom-made beads and culture-specific systemic antibiotics. Those patients with metaphyseal involvement were treated with deroofing of the cortex and debridement by means of a “trough” (16 patients); those with diaphyseal involvement were treated with both intramedullary reaming and debridement from a trough (ten patients). Antibiotic cement rods were used as an additional therapy in five patients with diaphyseal involvement. Recurrence developed in three patients and was attributed to inadequate debridement; all three patients were treated again in the same manner with success. The mean follow-up is currently 3.6 years (range: 2–6 years). All of the patients have normal clinical, radiographic and laboratory parameters, and all are ambulatory and have returned to their pretreatment level of activity or better. We conclude that C-M Type III chronic osteomyelitis can be safely treated with this protocol.

Amaç: 14 yaşında erkek futbol maçı sonrası geçirdiği minör bir travmayla kalçada fleksiyon kısıtlılığı ve kasık ağrısı ile acil servise başvurdu. Fizik muayne ve radyolojik inceleme ile izole küçük trokanter avülziyon kırığı tanısı konuldu. Yatak istirahati ve NSAID tedavi ile başarılı bir şekilde tedavi edildi. Izole küçük trokanter kırıklarında travma öyküsü yok ise patolojik primer veya seconder tümöral oluşum araştırılmalıdır bundan dolayı Küçük trokanter kırıklarında kırığın ayırıcı tanısında en önemli dikkat edilmesi gereken nokta patolojik kırıkla ayrımını yapmaktır. Burda takdim edilen vaka 14 yaşında erkek hastada travmatik bir yaralanma sonrası oluşan izole küçük trokanter kırığı ve başarılı bir şekilde tedavi edilmesidir., Objectives: A 14 years old boy with loss of hip flexion and groin pain after a minor trauma in a soccer game was admitted to our emergency department. After physical examination and radiological evaluation, the diagnosis was an isolated avulsion of the lesser trochanteric apophysis. He was successfully treated with bed rest and NSAID treatment. When the absence of a traumatic event, an isolated fracture of the lesser trochanter should suggest an underlying pathological process, particularly a primary or metastatic tumor because of that differential diagnosis from pathological fracture of the lesser trochanter is the most important aspect in these injuries. We present here a 14 years old boy after a traumatic injury with isolated lesser trochanteric fracture and his treatment.