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Elderly patients are espcialy at high risk for postoperative complications. This is even more important following hip fracture surgery due to its fragility and comorbidities. Using certain biomarkers may be an interesting way of tackling the question of optimal patient management. In this study we aimed to determine the status of values such as NLR, PLR, albumin, and CRP, which can be easily accessed from blood tests that we routinely use, in predicting mortality in patients who underwent partial prosthesis after hip fractures. Patients over 70 years of age with intertrochanteric femur and collum femoris fractures and who underwent partial endoprosthesis were included in the study. The neutrophil lymphocyte and platelet lymphocyte ratios, albumin values, and CRP values were recorded by examining the hemogram and biochemistry tests taken routinely at the time of admission to the hospital, 1 day before the surgery and on the 1st post-operative day. The distribution of clinical and socio-demographic characteristics of individuals according to their survival within the scope of the study has elaborated that there is a statistically significant difference in terms of age, gender, diagnosis, time to surgery (days) of the deceased and surviving individuals. It is observed that the majority of the patients who died were women and were diagnosed with collum femoris. It was determined that there was a statistically significant difference only in CRP and albumin values between the two groups in postoperative parameters. According to the outcomes of this analysis one can conclude that NLR and PLR values measured preoperatively on the hemogram panel can be used to predict 1-year mortality. Regardless of the fracture period, low albumin value is seen as an independent variable in predicting mortality. [Med-Science 2022; 11(2.000): 729-33]

The sinus tarsi approach (STA) is a relatively novel and minimally invasive procedure that reduces soft tissue complications during surgery for displaced intra-articular calcaneal fractures (DIACF). We aimed to evaluate the effectiveness of this approach by comparing the functional and radiographic outcomes obtained after the STA and the extensile lateral approach (ELA) in DIACF. The medical records of 73 patients underwent surgery for displaced intra-articular calcaneal fractures between 2013 and 2018 were retrospectively analyzed. The cases were divided into two groups. The first group classified as STA (n: 39) and the second one classified as ELA (n: 34). Pre-Postoperative Boehler-Gissane angle, calcaneal length, height and width, postoperative AOFAS scores, and postoperative complication rates for each case were recorded and statistically compared. The AOFAS score was 82.5±4.4 points in the STA group whereas it was 79.5±5.4 points in the ELA group (p: 0.01). According to AOFAS scoring, 74.4% of patients in the STA group had an excellent-good outcome, whereas it was 55.9% in the ELA group. The postoperative Boehler angles were 28.5±8.4 degrees in the STA group and 26.3±8.3 degrees in the ELA group (p: 0.26). The postoperative Gissane angles were 122.2±8.9 degrees in the STA group and 128.7±10.5 degrees in the ELA group (p:0.005). Superficial infection was observed in one patient in STA group. Wound infections and necrosis in four patients and non-union was seen in one patient in ELA group. Minimally invasive surgery with STA is a feasible and effective surgical treatment method that provides adequate postoperative radiological alignment and functional results and minimizes soft tissue dissection in DIACFs. [Med-Science 2021; 10(3.000): 752-57]

The surgeon and the surgical approach of the clinic where the surgeon was trained may have an impact on perioperative outcomes. In this study, among the surgeons with similar surgical experiences, we aimed to investigate the association of open-closed reduction rates, postoperative sagittal, coronal and axial plan deformities, and preference of open surgical approaches to surgeons and the clinics they were trained. We evaluated 90 cases retrospectively who underwent surgery upon diagnosis of Gartland type 3 pediatric supracondylar humerus fractures associated with extension deformity. Those whose surgery was performed after 24 hours, or patients with open fractures, flexion type supracondylar fractures, non-Gartland type 3 supracondylar fractures, fractures with neurovascular deficits, multiple comminuted fractures, pathologic fractures, or additional injury and fractures were not included to the study. All the surgeons who had >5 years of surgical experience as a specialist and >15 of pediatric elbow fracture surgery as an operator (n=12) were numbered between 1 and 12. The clinics of these surgeons were classified from A to F (n=6). Data on patients age, gender, duration of surgery, follow-up time, postoperative sagittal, coronal angulation, postoperative rotational deformity, operation time, rates of open-closed surgery, the surgical approach in those open surgery was performed, the number and characteristics of the pins used were collected to analyze in relation with their assigned surgeons and the clinics they were trained. Among the 90 cases, 54 (59.3%) were male patients. The mean age was 6.21 ± 3.03 years. There was no significant difference between the clinics in terms of sagittal and rotational deformities and open reduction rates (p>0.05). The clinics significantly differed in preference of the side of incisions (medial, lateral, posterior), (p [Med-Science 2020; 9(1.000): 103-8]