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Controversy exists with regards to the etiology and treatment of lateral epicondylitis and the role of the lateral capsule in this pathology. The aim of this study was to compare arthroscopic lateral capsule resection with or without extensor carpi radialis brevis (ECRB) tendon debridement for treatment of lateral epicondylitis. This is a retrospective study of 38 patients who underwent arthroscopic surgery for LE with two different techniques: Eighteen patients were treated with arthroscopic lateral capsular resection (LCR) + ECRB debridement and 20 patients were treated with arthroscopic LCR alone, without ECRB debridement. Both groups were assessed with Quick Disabilities of the Arm, Shoulder and Hand (QDASH) score for function and Visual Analog Scale (VAS) score for pain. Quick DASH scores were 12 $$\pm $$ 5 and 13 $$\pm $$ 4 at Groups 1 and 2, respectively, without any statistically significant difference. VAS pain scores were 15 $$\pm $$ 2 for both groups. VAS function scores were 85 $$\pm $$ 22 and 86 $$\pm $$ 18 at Groups 1 and 2 respectively. Sick leave periods in terms of weeks were 7 $$\pm $$ 5 and 7 $$\pm $$ 4 at Groups 1 and 2, respectively. There was no statistically significant difference in outcome of the two groups compared in terms of VAS pain, function scores, failure (re-operation) rates and sick leave period at the end of final follow-up. Both arthroscopic LCR alone and Arthroscopic LCR with ECRB debridement for the management of refractory LE provide significant improvement in pain and function. Isolated Arthroscopic LCR could be a sufficient surgical treatment for refractory LE. Thus, ECRB debridement or release may not be necessary in every case. IV.

Objective: The purpose of the study is to evaluate the treatment results of reverse oblique AO/OTA 31A1 fractures that have highly mechanical instability risk with two third generation intramedullary nails. Methods: Twenty-eight patients (8 men, 20 women) treated by third generation proximal femoral nails {[}proximal femoral anti-rotation (PFNA)(R) or Intertan (R)] followed minimum one year were included. Average age was 65.0 (31-93) years. Clinical and radiological results, screw migration at one year and complications were recorded. Results: Mean operation time was 72.2 and 72.5 minutes, flouroscopy time was 64.4 and 64.7 seconds, mobilisation time was 2.1 and 2.2 days, full weight bearing time was 8.6 and 8.5 weeks, tip-apex distance was 20.1 and 20.2 mm, fracture healing time was 10.5 and 10.2 weeks, Harris hip score at one year was 80.5 and 83.5, neck-shaft angle difference at one year was 1.6 and 1.1 mm, screw migration at one year was found in 10 and 3 patients and mean migration distance was 3.1 and 0.4 mm for PFNA and Intertan nails respectively. No complications recorded that needs secondary intervention. Fracture healing obtained in all patients. Conclusion: Reverse oblique intertrochanteric fractures can be effectively treated with third generation intramedullary nails. More screw migration was seen in PFNA than Intertan nails after the operation in this study.

Hand and especially finger injuries are very common in basketball. Most injuries can be treated with simple conservative methods and do not cause a major decrease in the player’s performance. However, some injuries can have catastrophic results when underestimated or treated with inappropriate methods. Therefore, it is crucial to make the correct diagnosis in finger injuries and to choose the correct method of treatment for the adequate period of time to protect the player’s health and reduce performance loss.

OBJECTIVES The aim of this study was to evaluate both clinical and radiological results of intraarticular comminuted distal radius fractures treated with volar locking plate (VLP), non-bridging external fixator (NbEF), and bridging external fixator (BEF). PATIENTS AND METHODS 95 patients (44 males, 51 females; median age 49 years; interquartile range (IQR), 37 to 60 years) who were treated with VLP, NbEF, or BEF due to intraarticular comminuted distal radius fractures between January 2010 and April 2014 were evaluated retrospectively. 34 of these patients were treated with a VLP (VLP group), 30 with a NbEF (NbEF group) and 31 with a BEF (BEF group). In the final follow-up, all patients were evaluated according to clinical and radiological parameters. RESULTS The median follow-up was 5 (IQR, 4 to 6) years. The VLP and NbEF groups had better results than the BEF group in terms of wrist range of motion, loss of grip strength, Green O'Brien, Mayo Modified Wrist, The Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) and VAS scores. The VLP group had the most significant radiological improvement. CONCLUSION Although clinical and radiological results for intraarticular comminuted distal radius fractures are more significantly improved in patients treated with VLP, favorable results close to VLP can be also obtained with NbEF. The BEF seems to be the least effective treatment option among the three surgical methods.

The aim of the study was to compare the intermediate-term clinical outcomes between lateral ligaments augmentation using suture-tape and modified Brostrom repair in a selected cohort of patients. The hypothesis of the presented study is that suture-tape augmentation technique has comparable clinical and radiological outcomes with arthroscopic Brostrom repair technique. Sixty-one consecutive patients with chronic ankle instability were operated between 2012 and 2016 randomized to 2 groups. First group was composed of 31 patients whom were operated using an arthroscopic Brostrom repair technique (ABR) and second group was composed of 30 Patients whom were operated using arthroscopic lateral ligaments augmentation using suture-tape internal bracing (AST). At the end of total follow-up time, all patients were evaluated clinically using the Foot and Ankle Outcome Score (FAOS) and Foot and Ankle Ability Measure (FAAM). Radiological evaluation was performed using anterior drawer and varus stress radiographs with standard Telos device in 150 N. Talar tilt angles and anterior talar translation were measured both preoperatively, 1 year postoperatively and at the final follow-up. Preoperative total FAOS scores for ABR and AST groups were 66.2 ± 12 and 67.1 ± 11, respectively. Postoperative Total FAOS scores for ABR and AST groups were 90.6 ± 5.2 and 91.5 ± 7.7, respectively. There was no statistical difference in between 2 groups both pre- and postoperatively (n.s). According to FAAM, sports activity scores of ABR and AST groups were 84.9 ± 14 and 90.4 ± 12 at the final follow-up, which showed that AST group was significantly superior (p = 0.02). There were no significant differences in preoperative and postoperative stress radiographs between the two groups. Mean operation time for AST and ABR groups were 35.2 min and 48.6 min, respectively, which shows statistically significantly difference (p

Objectives: Vitamin D has an important effect on calcium (Ca) and phosphorus (P) metabolism and bone health. It helps regulate the ratio of Ca and P. The aim of this study was to investigate the effects of vitamin D and minor surgical stress on Ca and P levels in the liver, kidneys, and serum in 24 New Zealand rabbits with cartilage defects. Methods: Experimental groups of MFS (only microfracture surgery), Vit D (only oral vitamin D supplementation), and MFS+Vit D (both microfracture surgery and oral vitamin D supplementation) were created. The levels of Ca and P in serum, liver, and kidney samples were measured using a spectrophotometric method. Results: The kidney Ca/P ratio was lower and the serum Ca/P ratio was higher in the MFS+Vit D groups than in the control group. The serum P level was significantly lower in the MFS and MFS+Vit D groups when compared with the control group. Conclusion: To the best of our knowledge, this is a novel study examining microfracture surgery and the effect on Ca and P. The Ca/P ratio revealed clinically valuable information about the important balance between Ca/P ratio and the adequacy of vitamin D. Vitamin D supplementation before microfracture surgery may be beneficial and may prevent a de creased Ca/P ratio due to the effect of surgical stress.

Stable fracture fixation is important in the treatment of intertrochanteric femur (ITF) fractures in the elderly population to prevent the loss of reduction, achieve early mobility, and restore independence. The aim of this study was to present the results of surgical treatment of stable and unstable ITF fractures using a trochanteric antegrade intramedullary nail with two cephalocervical screws in an integrated mechanism (Intertan®; SmithNephew, Memphis, TN) and evaluate the relationship between the loss of reduction and screw position in the femoral neck in two planes.The authors investigated all varus misalignments and losses of reduction in 57 patients (22 males, 35 females) treated for ITF fractures with the Intertan® between 2010 and 2011. Two indices (screw alignment index in the frontal projection [SAIcoronal] and screw alignment index in the lateral projection [SAIsagittal]) were defined to evaluate the loss of reduction. Patients were also evaluated according to the Harris hip score and Barthel independence index.The mean patient age was 77.1 years. The mean follow-up period was 21.7 months. All patients achieved complete union. We did not detect any varus collapse or loss of reduction. At the end of the follow-up period, the mean Barthel independence index was 90.7, and the mean Harris hip score was 83.7.The use of a trochanteric antegrade intramedullary nail with two cephalocervical screws allows for linear intraoperative compression and rotational stability of the head/neck fragment, prevents reduction loss, and has a wide application area in the femoral head. Its inherent continuous stability permits early weight-bearing and mobilization. It is a safe and an efficient option for the treatment of ITF fractures.

Background Stable fracture fixation is important in the treatment of intertrochanteric femur (ITF) fractures in the elderly population to prevent the loss of reduction, achieve early mobility, and restore independence. The aim of this study was to present the results of surgical treatment of stable and unstable ITF fractures using a trochanteric antegrade intramedullary nail with two cephalocervical screws in an integrated mechanism (Intertan®; Smith & Nephew, Memphis, TN) and evaluate the relationship between the loss of reduction and screw position in the femoral neck in two planes. Methods The authors investigated all varus misalignments and losses of reduction in 57 patients (22 males, 35 females) treated for ITF fractures with the Intertan® between 2010 and 2011. Two indices (screw alignment index in the frontal projection [SAIcoronal] and screw alignment index in the lateral projection [SAIsagittal]) were defined to evaluate the loss of reduction. Patients were also evaluated according to the Harris hip score and Barthel independence index. Results The mean patient age was 77.1 years. The mean follow-up period was 21.7 months. All patients achieved complete union. We did not detect any varus collapse or loss of reduction. At the end of the follow-up period, the mean Barthel independence index was 90.7, and the mean Harris hip score was 83.7. Conclusion The use of a trochanteric antegrade intramedullary nail with two cephalocervical screws allows for linear intraoperative compression and rotational stability of the head/neck fragment, prevents reduction loss, and has a wide application area in the femoral head. Its inherent continuous stability permits early weight-bearing and mobilization. It is a safe and an efficient option for the treatment of ITF fractures.

BACKGROUND Coplaning means the removal of medial acromial spurs and inferior aspect of the distal clavicle. The aim of the study was to evaluate the outcomes of arthroscopic acromioplasty with and without coplaning in patients without acromioclavicular (AC) joint arthritis. METHODS Because of impingement syndrome, arthroscopic subacromial decompression and acromioplasty was performed in Group 1 (9 males/31 female). In addition, coplaning was performed in Group 2 (8 males/21 females) by two different surgeons. The mean age was 48 in Group 1, 46 in Group 2. The mean follow-up was 50 months and 44 months, respectively. RESULTS Constant score, cross-body adduction test and AC joint tenderness was used for follow-up. The mean preoperative Constant scores were 45 points (range: 34-76 points) in Group 1, 39 points (range: 32-69 points) in Group 2. The mean Constant scores at the latest follow-up was 78 points (range: 68-100 points) for Group 1, 84 points (range: 72-100 points) for Group 2. There was no statistically difference between two groups at the latest follow-up (p

Objective We aimed to evaluate the efficiency of O-(beta-Hydroxyethyl)-rutosides (Oxerutin) in reducing the incidence of venous system disease among patients with calf muscle pump dysfunction secondary to immobilization due to lower-limb fractures. Methods A total of 60 patients with lower-limb fractures and immobilized in plaster casts were included in this study randomized into control (n = 30; mean: 30.37 ± 6.03 years; 73.3% males; no treatment) and experiment (n = 30; mean: 31.67 ± 4.76 years; 66.6% males; Oxerutin, 500 mg po q12hr) treatment groups. Doppler ultrasound was performed to evaluate the effect of oxerutin on the alterations in the venous circulation. Results Patients in the control group were determined to be more commonly affected from the below-knee immobilization in terms of venous dysfunction in the great saphenous vein in the below-knee region when compared with the patients in the oxerutin treatment group (46.7 vs. 13.3%, respectively; p = 0.011). Incidence of reflux in the small saphenous vein was more common in the control group during the healing period when compared with the experiment group (40.0 vs. 10.0%, respectively; p = 0.017). None of the patients developed venous thrombosis. Conclusions In conclusion, the impairment of the lower extremity muscle pump should be considered as an important risk factor for venous disease, and should be evaluated. O-(beta-Hydroxyethyl)-rutosides during 6–8 week cast immobilization for a lower limb fracture may be an effective prophylactic regimen in reducing the incidence of reflux in the below-knee superficial veins.

The term rotator cuff tear arthropathy is a broad spectrum pathology but it involves common characteristic features as rotator cuff tear, leading to glenohumeral joint arthritis and superior migration of the humeral head. Although there are several factors described causing rotator cuff tear arthropathy, the exact mechanism is still unknown because the rotator cuff tear arthropathy develops in only a group of patients with chronic rotator cuff tear. The aim of this article is to review pathophysiology of rotator cuff tear arthropathy, to explain the diagnostic features and to discuss the management of the disease.