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Copyright of Medical Journal of Istanbul Kanuni Sultan Süleyman / İstanbul Kanuni Sultan Süleyman Tıp Dergisi is the property of Logos Medical Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: Diabetes mellitus is a common health issue with an increasingly rampant incidence all over the world. Diabetic foot ulcers raise morbidity, reduce the quality of life, prolong hospital stay, and cause a high rate of lower extremity amputation. Our aim in this study is to evaluate the patients presented to the hospital with the diabetic foot diagnosis. Methods: 147 diabetic foot patients were evaluated retrospectively in the chronic wound council between 2016--2017 at our hospital. Wagner was used for wound classification, whereas Infectious Diseases Society of America (IDSA) was for infection classification. Results: Evaluating the cases according to the Wagner classification, 1 patient was observed to be on stage 1, 19 were on stage 2, 58 were on stage 3, 58 were on stage 4, 11 were on stage 5. Patients on stage 3 and above accounted for 86.4% of all cases. 66 patients (45%) underwent minor amputation, whereas 18 (21%) were below-knee amputation and 2 (1%) were above-knee amputation. 44 patients recovered with debridement and wound care. Conclusion: Lower extremity ulcers and infections in diabetic patients are one of the most common causes of hospitalization and non-traumatic amputation in diabetic patients. The amputation rate, which was determined as 58.5% in our study, is higher compared to similar studies. We consider that this is due to patients who presented late, who had higher grades of Wagner wound stages, who had osteomyelitis, who had vascular problems and were referred to our center for decision of amputation. [ABSTRACT FROM AUTHOR]

Objective: Amputations lead to major changes in one's life in terms of daily life and functionality. Limitations in body structures and bodily functions due to amputation affect the level of activity and social participation of the individual. In this study, the Turkish version of the Trinity Amputation and Experience Scale (TAPES) questionnaire was aimed to investigate the relationship between the quality of life and functional level of re-participation after normal amputation. Methods: A total of 48 patients who were admitted to the Orthopedics and Traumatology Clinic of our tertiary care hospital, regardless of age and sex, underwent lower extremity amputation due to diabetic foot were included in the study. Trinity Amputation and Experience Scale (TAPES) questionnaires of all patients were recorded and filled out. Results: Of the 48 patients included in the questionnaire, 36 (75.0%) were male and 12 (25.0%) were female. A total of eight (16.7%) patients were amputated above the knee level and 40 (83.3%) patients under the knee. There were 14 (29.2%) patients who used the prosthesis for more than 12 hours a day, and 34 (70.8%) patients who used the prosthesis for less. The mean age of the patients was 54.4±19.4 years (range: 11--86 years). The total satisfaction score rate was 63.1±20.5% (range: 20--92%). Conclusion: Our study is one of the rare studies in Turkey about the satisfaction of prosthesis and some other compliance criteria in amputated patients. Our study data showed that especially stump and phantom pain were significantly related to both daily utilization of the prosthesis, compliance scores, and satisfaction scores for the prosthesis, and these pains affect the psychological state of the amputees. [ABSTRACT FROM AUTHOR]

Objective: Forearm fractures account for approximately 40% of child fractures. The elbow is treated conservatively with a 90° flexion cast. The aim of this study was to determine whether patients with forearm fractures who underwent open or closed reduction and fixation after loss of reduction in plaster follow-up is to make interobserver, and intraobserver comparisons of the radiological measurements of fracture angulations and to investigate the effect of these measurements on surgical decision. Method: In the medical records of our clinic between 2013 and 2014, 36 forearm fractures were detected in 35 patients aged 10-15 years who had undergone open reduction, and fixation because of loss of reduction. Patients who had a 1/3 mid-diaphyseal fracture of the radia and ulna and whose radiological controls on days 5, 10, 15 and 31 revealed displacement fractures were retrospectively included in the study. Results: Twenty-two patients who underwent open reduction and fixation were evaluated in terms of concordance between preoperative radiological measurements. ICC (Intraclass correlation coefficient) coefficients were 0.84 (0.69-0.92) for AP radius, 0.95 (0.91-0.97) for AP ulna, and 0.89 (0.80-0.95) for lateral radius, and 0.79 (0.60-0.90) for lateral ulna. According to this, there was a high level of concordance between these four parameters. Conclusion: The decision for surgical treatment of the patients made by different surgeons who are responsible for the treatment is based on the evaluation of the patients as a whole, but not based on measurement of radiological parameters. Although it is considered that the measurement technique may change by experience, there is no statistical difference between the measurements performed by the same person at different times. [ABSTRACT FROM AUTHOR]

Copyright of Turkish Journal of Trauma & Emergency Surgery / Ulusal Travma ve Acil Cerrahi Dergisi is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objectives: When the risk factors of symptomatic osteoarthritis (OA) are evaluated, it has been shown that increased body mass index, lower educational levels and social support, depressive mood are associated with reporting more pain. The aim of this study was to investigate the relationship with radiological grade of osteoarthritis of knee at symptomatic obese patients and body mass index, functional status. Materials and Methods: Forty-one patients whose BMI was more than 30 kg/m2 and diagnosed as primary knee OA due to knee pain complaints were included in the study. The anatomic tibiofemoral angle (aTFA) was measured on orthoro- entgenography by Picture Archiving Communication Systems (PACS). Western Ontario McMaster Osteoarthritis Index (WOMAC) and knee Visual Analogue Scale (VAS) were evaluated according to the knee which has more pain complaint. Results: A statistically significant correlation in the positive direction was found between the decrease in BMI and the decrease in the Lumbar VAS (Initial-3rd month difference). However, there was a correlation between the decrease in BMI and the decrease in knee function and VAS which was not statistically significant. Conclusion: It is suggested that short term knee pain due to knee OA is not directly associated with weight loss and irreversible mechanical factors (knee varus, cartilage damage in knee joint) caused by obesity can be the effective factor. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study was to evaluate the consistency of the angle between the posterior condylar line (PCL) and the transepicondylar axis (TEA) measured during surgery (sTEA) with that of the clinical transepicondylar axis (cTEA) measured using computerized tomography (CT) before primary total knee arthroplasty (TKA). Methods: The records of patients who had undergone primary TKA between 2013 and 2105 and with a preoperative CT measurement of the knee were evaluated. During surgery, following the distal femoral incision, PCL and sTEA lines were drawn on the surface with a ruler and a pencil and recorded with a digital camera. The angle between the cTEA, or the line joining the most prominent points of the medial and lateral epicondyles, and the PCL was measured using a picture archiving communication system (PACS). Results: The study group consisted of 9 knees of 9 patients (1 male, 8 female; mean age: 67 years, range: 59-80 years). The photographs indicating the angle between the sTEA line and the PCL revealed external rotation in 9 knees (100%), with a mean angle of 2.67±1.41° (range: 1-6°). The preoperative axial CT images also demonstrated external rotation in 9 knees (100%), with a mean angle of 4.67±1.41° (range: 2-7°). Conclusion: There was a difference between the sTEA, which is used to determine the rotation of femoral component during TKA, and the cTEA measured preoperatively using CT. It is safe to use 1 of these 2 techniques to check the result of the other. In the future, measurements made using CT will be used to design personalized anatomical prostheses. [ABSTRACT FROM AUTHOR]

Copyright of Turkish Journal of Trauma & Emergency Surgery / Ulusal Travma ve Acil Cerrahi Dergisi is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Forearm fractures constitute approximately 40% of all pediatric fractures. Generally, in conservative treatment,a plaster cast is applied with the elbow in 90° flexion. Success of the treatment depends on theprevention of the reduction in the correct position and suitable duration of the plaster cast. Failure, or the risk of angulation within the cast, is associated with movement within the cast. The aim of this study was to evaluate the applicability of the Cast Index (CI) and Three-Point Index (TPI) measurements, which indicate the loss of reduction, in pediatric mid-third forearm fractures. The hypothesis of the study was that as edema decreases and deformity of the plaster cast occurs after fracture reduction, TPI and CI should be examined during follow-up, as they indicate shifting due to movement within the plaster cast., Methods: This retrospective study included a total of 48 patients, who were treated with closed reduction and long-arm plaster cast for a mid-third forearm diaphyseal fracture at our Emergency Polyclinic between March and September 2014. The mean age of the patients was 8.15±3.19 years (range, 5-14 years). Patients were excluded from the study if they had isolated radial or ulnar fracture, open fractures, concomitant fracture or systemic disease (bone metabolism disease, etc), and <10° fracture angulation in the ulna and radius on the initial radiograph and if they did not followup. TPI and CI values were calculated on anterioposterior (AP) and lateral radiographs in the Picture Archiving Communication Systems., Results: In the AP plane, compared with TPI values after reduction, statistically significant increases were observed in TPI values 10 days after reduction (p<0.01). However, no significant difference was observed between those with and without reduction loss in TPI values in the AP plane (p>0.05). Although there was a statistically significant increase in TPI values 15 daysafter reduction compared with the values immediately after reduction, a significant difference between those with and without reduction loss was observed only on lateral TPI., Conclusion: In cases of pediatric forearm diaphyseal fracture, ulnar TPI examined in the lateral plane can be used in monitoring the fracture in a plaster cast applied after the reduction.

Background: Treatment of the distal tibial fractures are challenging due to the limited soft tissue, subcutaneous location and poor vascularity. In this control-matched study, it was aimed to compare the traditional open reduction and internal fixation with minimal invasive plating (MIPO). We hypothesized that superior results may be achieved with MIPO technique., Methods: 22 patients treated with traditional open reduction and internal fixation were matched with 22 patients treated with closed reduction and MIPO on the basis of age (±3), gender, and fracture pattern (AO classification). Evaluation was assed according to the wound problems, the American Orthopaedic Foot and Ankle surgery (AOFAS) scoring, radiological union, malunion, delayed union, hospitalisation time, time from injury to surgery, and operation time., Results: There was no significant difference in the distribution of AO/OTA classification, age, gender, AOFAS score, time from injury to operation, follow-up, bone union time, delayed union, malunion and infection (p>0.05). The operation time was significantly longer in the open group than in the MIPO group: 69.59±7.21 min. for the ORIF, and 61.14±5.61 for the MIPO group (p<0.01).The hospitalisation time was significantly longer in the open group than in the MIPO group: 7.64±4.71 days for the MIPO, and 10.18±4.32 days for the ORIF group (p<0.05)., Conclusion: MIPO technique can be beneficial for the treatment of distal tibia AO/OTA A and B type fractures with reduced hospital stay, cost-effectiveness, and infection rate.

Objective: The aim of this study is to report our institution's experience regarding the use of open tibial inlay technique in patients undergoing single-stage combined posterior cruciate ligament (PCL) reconstruction., Methods: Records of 17 patients who underwent PCL reconstruction with tibial inlay technique were retrospectively reviewed. Patients with ipsilateral femoral or tibial osteochondral avulsion fractures or ipsilateral concomitant tibia and femur shaft fractures were excluded. Out of these 17 patients, six cases underwent anterior cruciate ligament (ACL) + PCL reconstruction, nine cases underwent ACL+ PCL + posterolateral corner reconstruction, one case underwent ACL + PCL + MCL reconstruction and one case underwent ACL+ PCL + posterolateral corner + MCL reconstruction. Mean follow-up was 14.27±6.77 (range: 6-30) months., Results: In preoperative assessments, all patients had 3+ posterior laxity in posterior drawer test; at final follow-up, 6 patients had 0 laxity, 7 patients had 1+ laxity, and 4 patients had 2+ laxity (p<0.001). International Knee Documentation Committee (IKDC) objective evaluation showed severe disability in all patients preoperatively, whereas 5 knees were grade A, 8 knees were grade B, 3 knees were grade C, and 1 knee was grade D at final follow-up. Mean IKDC subjective score was 75.22±7.53 at final follow-up. Postoperatively, mean side-to-side difference in KT-1000 arthrometer measurement was 2.45±1.80 mm. At final follow-up, mean range of motion (ROM) was 0º on extension and 123.56±6.31º on flexion., Conclusion: Open tibial inlay approach is beneficial during PCL reconstruction. Further study is warranted to establish its effectiveness on functional outcomes and prevention of complications.

Simultaneous bilateral locked posterior dislocation of the shoulder is a rare injury. Herein, we present a 59-year-old male case with a three-month history of an irreducible locked bilateral posterior dislocation of the shoulders with an associated large impression fracture on the anteromedial aspect of both humeral heads after a grand mal type epileptic seizure. Plain X-ray and computed tomograph revealed a defect on the right side more than 40% of the articular surface, and on the left side, 30%. He was treated with a one-stage operation with a reconstruction of femoral head osteochondral allograft on the right side and transfer of the osteotomized tuberculum minus with its attached subscapularis tendon into the defect (modified McLaughlin technique) on the left side. At 14 months during follow-up, the patient was pain-free with stable shoulder joints and satisfactory functionality.

Objective: Two drilling techniques of the femoral tunnel are commonly used in anterior cruciate ligament (ACL) reconstruction: through the transtibial (TT) portal or through the anteromedial (AM) portal. The aim of the present study is to investigate the radiological and clinical outcomes of arthroscopic single-bundle ACL reconstruction using AM and TT portal techniques for drilling the femoral tunnel in nonprofessional athletes., Methods: A retrospective review was made of 44 nonprofessional athletes undergoing ACL reconstruction using AM and TT techniques between 2011-2013. The femoral tunnel clock position on axial magnetic resonance imaging (MRI) and the anterior-posterior position of the tibial tunnel on sagittal-cut MRI scan were measured. Radiological femoral tunnel and tibial tunnel anterior-posterior inclination angles were assessed. At final follow-up, the Lachman test and pivot-shift test were used in the evaluation of the anterior-posterior stability of the knee and the rotational stability of the knee. For clinical and functional evaluation, the modified Cincinnati knee grading system, Lysholm knee scoring scale, and International Knee Documentation Committee (IKDC) form were used., Results: No statistically significant difference was determined between the groups in terms of patient age, follow-up period, gender, and affected side distribution. There were 6 outliers in the TT group due to the clock face position. The mean femoral tunnel inclination angle was 31.07°±8.44° in the AM group and 19.02°±8.93° in the TT group. The tibial tunnel inclination angle was 21.08°±5.42° in the TT group and 16.58°±7.02° in the AM group. A statistically significant difference was determined between the 2 groups. No statistically significant difference was observed between the 2 groups in terms of Lachman test, pivot-shift test, Lysholm score, IKDC score, and modified Cincinnati score results., Conclusion: The AM technique has no clinical superiority compared to the TT technique in ACL reconstruction in nonprofessional athletes.