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The purpose of the study was to provide a 15-year natural history evaluation of the radiographic appearance of uninstrumented compensatory lumbar curves in patients who had undergone selective thoracic fusion (STF) for scoliosis, measure any changes in health-related quality of life scores (HRQoL) and compare them with controls matched for age, gender and body-mass index (BMI).STF group included 43 female adolescent idiopathic scoliosis (AIS) patients who underwent STF with mean age 33(27-42) years and a mean follow-up of 18.7 (15-28) years, mean BMI 22(18-29). Preop, early postop and follow-up radiographs were reviewed for behavior of lumbar curves. Control group included a random selection of healthy volunteers with no history of back pain and with mean age 33(27-41), and mean BMI 22(17-33). HRQoL scores were compared between two groups in latest f/up. Radiographs including low dose biplanar imaging with EOS were used to measure disc heights and assess for radiographic evidence of degenerative changes. Various parameters were statistically compared.Posterior fusion was performed in all 43, with all pedicle screws used in 41 and all-hook constructs in 2. Main thoracic curve correction was improved from pre-op to early-post-op and maintained at latest f/up (55.6°-16.1°-16.9°). Spontaneous lumbar curve correction (SLCC) was also maintained beyond 15 years (39.9°-16.6°-17.1°). Two patients developed coronal decompensation following surgery, but improved with time and were well compensated at final follow-up. Mean HRQoL scores, self-image and mental health scores were higher in STF group than control group (p 0.05). SRS-22r pain and function, Oswestry Disability Index and Numeric Rating Scale, marital status, number of children were similar between the groups(p 0.05). All disc heights except L5-S1 were significantly lower in STF group (p 0.05). There was no significant difference between the groups for degenerative changes in the latest radiographs.In this group of patients, the uninstrumented lumbar curve spontaneously corrected and the correction was maintained after 18 years following surgery using STF. Mild degenerative changes were seen radiographically and HRQoL scores suggest that the psychological-functional well-being are quite good in the long term in AIS patients who have undergone STF when compared with an age-gender-BMI-matched population.

Osteogenesis imperfecta (OI) is a heterogeneous group of inherited disorders characterised by susceptibility to fractures, primarily due to defects in type 1 collagen. The aim of this study is to present a novel OI phenotype and its causative candidate gene.Whole-exome sequencing and clinical evaluation were performed in five patients from two unrelated families.The common findings among the five affected children were recurrent fractures and/or osteopaenia, platyspondyly, short and bowed long bones, and widened metaphyses. Metaphyseal and vertebral changes regressed after early childhood, and no fractures occurred under bisphosphonate treatment. We identified biallelic NM_001144758.3:c.2392dup and NM_001144758.3:c.2690_2693del pathogenic variants inTwo biallelic frameshift variants in the candidate gene

Study Design: Retrospective study. Objective: The aim of this study is to evaluate the clinical, neurological, and radiological outcomes of posterior vertebral column resection (PVCR) technique for treatment of thoracic and thoracolumbar burst fractures. Methods: Fifty-one patients (18 male, 33 female) with thoracic/thoracolumbar burst fractures who had been treated with PVCR technique were retrospectively reviewed. Preoperative and most recent radiographs were evaluated and local kyphosis angle (LKA), sagittal and coronal spinal parameters were measured. Neurological and functional results were assessed by the American Spinal Injury Association (ASIA) Impairment Scale, visual analogue scale score, Oswestry Disability Index, and Short Form 36 version 2. Results: The mean age was 49 years (range 22-83 years). The mean follow-up period was 69 months (range 28-216 months). Fractures were thoracic in 16 and thoracolumbar in 35 of the patients. AO spine thoracolumbar injury morphological types were as follows: 1 type A3, 15 type A4, 4 type B1, 23 type B2, 8 type C injuries. PVCR was performed in a single level in 48 of the patients and in 2 levels in 3 patients. The mean operative time was 434 minutes (range 270-530 minutes) and mean intraoperative blood loss was 520 mL (range 360-1100 mL). The mean LKA improved from 34.7° to 4.9° (85.9%). For 27 patients, the initial neurological deficit (ASIA A in 8, ASIA B in 3, ASIA C in 5, and ASIA D in 11) improved at least 1 ASIA grade (1-3 grades) in 22 patients (81.5%). Solid fusion, assessed with computed tomography at the final follow-up, was achieved in all patients. Conclusion: Single-stage PVCR provides complete spinal canal decompression, ideal kyphosis correction with gradual lengthening of anterior column together with sequential posterior column compression. Anterior column support, avoidance of the morbidity of anterior approach and improvement of neurological deficit are the other advantages of the single stage PVCR technique in patients with thoracic/thoracolumbar burst fractures.

Introduction Sprengel deformity (SD) is the most common congenital anomaly of the shoulder. Surgery is required for moderate and severe forms. The modified Woodward procedure is the most widely used procedure for the surgical treatment. Methods SD patients who applied to our institution between 2005 and 2018 were retrospectively reviewed. A modification of the Cavendish classification was used for preoperative and postoperative evaluations. Results Eighteen shoulders of 17 (mean age: 8.5 y, range: 2 to 18 y, 5 males and 12 females) patients were included. The right, left, and bilateral shoulders were affected in 9, 7, and 1 cases, respectively. The mean follow-up time was 62.9 months (12 to 161 mo). Preoperatively, 3 shoulders were type 2, 12 shoulders were type 3, and 3 shoulders were type 4 according to the Cavendish classification and 2 shoulders were type 0, 6 shoulders were type 1, and 10 shoulders were type 2 postoperatively. Conclusions Periscapular congenital malformations play a significant role in range of motion limitation. The modified Woodward procedure is a viable alternative in the surgical treatment of SD and the proposed modification of Cavendish classification (grade 0) is functional.

Objective: Coccydynia is a disorder that decreases quality of life with significant functional failure. Extra-corporeal shock wave therapy (ESWT) is used to treat several painful musculoskeletal disorders. Subjects and Methods: The medical records of 34 patients (29 females, 5 males) who had been treated with ESWT between 2017 and 2018 for chronic coccydynia were evaluated. Visual analog scale (VAS) scores were noted at the initial consultation, at each session, and during the initial and follow-up (at 6 months) examinations after the treatment. The 36-item short form (SF-36) quality of life scale survey was conducted at the beginning and end of the treatment. MRI was performed before the start of the procedure and 1 month after the end of the treatment. Results: The mean VAS score was 9.6 (9–10) before the treatment and 3.4 (0–2) after the treatment (p < 0.05). The VAS score decreased to ≤3 in 79.4% of patients. Bone marrow edema regressed in 6% of patients. Significant improvement was observed in all of the SF-36 parameters, except for two. Conclusion: In our patient group, ESWT provided effective pain control. In order to evaluate the efficacy of ESWT more accurately and sensitively, prospective randomized studies with longer follow-up periods, in which ESWT is compared with different energy doses and different treatment methods, are needed.

BACKGROUND Total talar dislocation (TTD) is very uncommon for many orthopedic surgeons and emergency/trauma specialists. Scarce cases of TTD have been reported, mainly in the form of open fracture-dislocation injury. CASE SUMMARY We report a very rare injury of closed TTD with a follow-up period of 36 mo. Initial closed reduction was not successful because of a fractured highly unstable medial malleolus displaced into the ankle mortise, blocking the relocation of the talus. The patient was able to walk pain-free after the 3rd month of surgery. At the 36-mo follow-up, there were 10 degrees of flexion loss and 10 degrees of extension loss in the tibiotalar joint. Furthermore, 5 degrees of subtalar joint inversion-eversion loss was present. CONCLUSION Open reduction should be performed for closed TTDs unless closed reduction is successful.

STUDY DESIGN A retrospective, case series. OBJECTIVE The aim of this study is to evaluate the concomitant anomalies in patients with Sprengel deformity (SD). SUMMARY OF BACKGROUND DATA SD is the most common congenital anomaly of the shoulder. One or more associated anomalies may coexist in SD patients, similar to congenital scoliosis (CS); however, these anomalies and their relationship have not been studied in detail previously. METHODS SD patients who have applied to our institution between 2005 and 2019 were retrospectively reviewed. The patients were evaluated clinically and radiologically. The patients were divided in two groups as SD patients with CS and without CS, to analyze if these anomalies are present due to CS or SD. Physical examination findings, MRI, CT, and USG reports were analysed for accompanying pathologies. Patients with missing data were excluded. Student-t and Fisher's exact tests were used to compare the groups. Significance value was set as p = 0.05. RESULTS Ninety patients met inclusion criteria. The most common spinal anomaly was omovertebra, followed by spina bifida and Klippel-Feil. Tethered cord and diastematomiyelia were associated with CS (P = 0.0026 and P = 0.0057, respectively). The most common extra-skeletal anomaly was rib anomalies, followed by urinary and cardiac system anomalies. Rib anomalies were associated with CS (P = 0.00001). CONCLUSION Concomitant anomalies may accompany SD. The prognosis of SD may be affected by these anomalies. Therefore, patients should be evaluated for possible coexistent congenital anomalies. LEVEL OF EVIDENCE 4.

Objective Aneurysmal bone cyst (ABC) is a benign osseous tumor, with a local aggressive nature. It is rarely seen in the spine which causes a delayed diagnosis and treatment. The aim of this study is the treatment results of ABC of the spine in our clinic and investigate the current treatment options. Material and Method A search of the ABCs of the spine between 2005 and 2019 years was conducted on online hospital database system. There were 6 patients (4 male, 2 female), with a duration of symptoms until treatment 2.7 years. Results Two patients were treated with curettage, posterior instrumentation was added due to iatrogenic instability after tumor removal in three patients, and selective arterial embolization was used to control the tumor growth in a patient with comorbidities, and surgery was planned for the patient after treatment of comorbidities. Conclusion Embolization can be used in patients without neurological symptoms and in the absence of deformity. Curettage and bone grafting are the viable surgical treatment method in stage 2 lesions. However more extensive surgery may be necessary in patients with spinal instability, such as posterior instrumentation and fusion, and en bloc resection with neural structure sacrifice in recurrent or primary stage 3 lesions.

OBJECTIVE: This study aimed to investigate the academic productivity of and the obstacles encountered by orthopedic residents in Turkey. METHODS: Overall, 220 orthopedic specialists who were registered in the Ministry of Health and had started orthopedic residency between 2009 and 2010 were invited to participate in a survey through e-mail. The survey comprised a total of 19 questions to evaluate the academic works conducted and obstacles encountered during residency. Academic work was defined as an article published in the peer-reviewed journals as well as an oral or poster presentation at a national or international congress. Case reports, letters to the editor, and technical notes were excluded. RESULTS: Data were obtained from 116 respondents who completed the survey. In peer-reviewed journals in Science Citation Index (SCI) or SCI-Expanded, the mean number of articles published with and without the first name per resident was 0.09 and 0.73, respectively. In peer-reviewed journals other than those in SCI and SCI-Expanded, the mean number of articles published with and without the first name per resident was 0.37 and 1, respectively. The mean number of oral and poster presentations per resident at national and international congresses was 2.63 and 4.67, respectively. No significant difference in the number of academic works was noted between the regions and institutions (p>0.05). A significant positive correlation was observed between the number of associate professors and assistant professors in the clinic and the total number of academic works (article plus presentation) (p

Objective: Chondroblastoma is a benign aggressive tumor which needs surgical treatment and has a recurrence rate up to 35%. Extended (aggressive) curettage is the mainstay of treatment and local adjuvants have been reported to decrease the recurrence rate. Methods: The recurrence rates and the functional results of 14 patients who were treated in our institution and 2 other patients who were treated elsewhere between the years 2004–2016 were evaluated. Seventeen cases (13 male, 3 female; mean age: 17.1 [range: 13 to 32] years) who had been diagnosed, treated and followed up in our hospital between 2004 and 2016 were evaluated in terms of recurrence rates and functional outcomes. The average follow-up period was 41.6 (range: 12 to 132) months. Results: Five cases of recurrence were observed. Two cases had undergone their primary treatment in another institution. Seven cases were performed curettage alone whereas nine others were administered adjuvant treatments. One of the five recurrence patients was advised to undergo disarticulation. Another was treated with curettage and grafting and the remaining three patients with curettage and cementing. No recurrence was observed in their follow-up period. Their mean MSTS score was 27.3 (range: 4 to 30) over a maximum of 30 points and their functional results were good. Conclusion: Chondroblastoma is a tumor with high recurrence rates in the post-treatment period. However, good functional outcomes can be achieved with early diagnosis and appropriate treatment even after recurrence.Level of evidence: Level IV, therapeutic study. Keywords: Bone, Chondroblastoma, Recurrence, Treatment, Tumor

Introduction: To evaluate the clinical and radiological outcomes of anatomic volar plate application in AO type C distal radius fractures.Methods: Patients who were operated on between January 2015 and April 2016 due to AO type C distal radius fracture were screened retrospectively from the hospital file and radiology archive. Clinical outcomes were determined by the disabilities of the arm, shoulder, and hand (DASH) score from outpatient records. The Stewart radiological scores were assessed with the measurements obtained from radiology archives. The complications were noted.Results: Overall, 16 patients (mean age, 52 years) were included in the study. In total, 9 of the patients were female, and 7 of the patients were male. The mean follow-up period was 11.9 months. The mean DASH score was 33.9, and the mean Stewart radiological score was 0.9. The bone union was accomplished in all patients. One infection, one joint stiffness, one carpal tunnel syndrome, and 2 tendinitis were observed as complication.Conclusion: Volar plate fixation in the AO type C distal radius fractures provides satisfactory results in terms of either clinical or radiological outcomes. Despite that, the complications regarding surgery and the implants are not rare.

Background Pilon variant posterior malleolar (PVPM) fractures significantly disrupt joint congruency and cause tibiotalar instability. They are often underestimated and inadequately treated. Purpose This study assessed the outcomes of surgical treatment of this subtype of malleolar fracture, and examined the importance of computed tomography (CT) in diagnosis and surgical treatment. Material and methods CT images and radiographs of 67 patients with trimalleolar ankle fractures were retrospectively analyzed. Fourteen patients (6 women and 8 men) were studied. The mean age was 37.7 (range, 21–58) years, and mean follow-up period was 17.1 (range, 12–24) months. All patients underwent open reduction. Reconstruction of the joint surface was assessed with postoperative CT images. The outcomes were assessed with the American Academy of Orthopaedic Surgeons (AAOS) and Osteoarthritis (OA) scoring systems. Results The ratio of PVPM fractures to trimalleolar ankle fractures was 20.1%. Postoperative CT images demonstrated that anatomic reconstruction was achieved in 11 patients. The mean AAOS scores were 85.6 in Type 1 and 81.1 in Type 2 cases. The mean OA scores were 1 in Type 1 and 1.1 in Type 2 cases (P > 0.05). The only statistically significant difference between the 2 groups was in osteochondral impaction (P Conclusion CT imaging is essential for the accurate diagnosis and management of PVPM fractures. Posteromedial and posterolateral incisions enable direct exposure, and therefore facilitate joint surface reconstruction. Level of evidence Level IV. Retrospective study.

Purpose: The aim of this experimental study was to investigate the impact of HA–CS–NAG compound (hyaluronate, sodium chondroitin sulfate, N-acetyl-d-glucosamine) on the quality of repair tissue after micro-fracture and to compare it with HA (hyaluronat), in a rat full-thickness chondral defect model. Methods: Full-thickness chondral defects were created in a non-weight bearing area by using a handle 2.7-mm drill bit, in the right knees of 33 Sprague–Dawley rats. Each specimen then underwent micro-fracture using a needle. Two weeks after surgery, 3 groups were randomly formed among the rats (n = 33). In Group 1, 0.2 mL of sterile saline solution (0.9%) was injected. In Group 2, 0.2 mL HA with a mean molecular weight of 1.2 Mda was injected. In Group 3, 0.2 mL of HA–CS–NAG compound (hyaluronate, sodium chondroitin sulfate, N-acetyl-d-glucosamine) was injected. The injections were applied on the 14th, the 21st and the 28th postoperative days. All rats were sacrificed on the 42nd postoperative day. Histological analysis of the repair tissue was performed for each specimen by two blinded observers using Wakitani scoring system. Results: There was significantly improved repair tissue in both Group 3 and Group 2 when compared with Group 1. Group 3 showed statistically significant improvement in terms of ‘cell morphology’ and ‘integration of donor with host’ when compared to Group 2 (p

Objective: Percutaneous vertebroplasty with polymethylmethacrylate (PMMA) restores the stiffness and the strength of fractured vertebral bodies, but changes the pattern of the stress transfer. This effect may cause a secondary fracture of the adjacent vertebrae. Elastoplasty has emerged as a new technique to overcome this complication. The aim of this study is to retrospectively evaluate the clinical results of the elastoplasty procedure. Materials and methods: Thirthy nine patients (9 males, 30 females, 87 spinal levels) were clinically evaluated pre and postoperatively in terms of pain relief, leakage and silicone embolism. The mean age was 67 (range 38–84) years. The mean follow up period was 12,5 months. The patients were evaluated radiologically for the presence of adjacent level fractures postoperatively. Complications were recorded. Results: The mean VAS score decreased from 7,5 to 3,5 during the last follow-up. Symptomatic silicone pulmonary embolism was not encountered in any patients. Leakage was observed in 5 (13%) cases. There was an adjacent level fracture in 1 case and another fracture which was not at the adjacent level in another one. A hematoma occurred in the needle entry site in a patient with trombocytopenia (

Objective: The aim of this study was to retrospectively compare a series of patients surgically treated with ORIF or early resection arthroplasty due to isolated comminuted radial head fractures. Methods: Between the years 2009 and 2013, 34 patients with isolated comminuted fractures of the radial head (Mason Type 3) had been operated (ORIF in 19 patients, resection arthroplasty in 15 patients). The mean age of the patients in the ORIF group was 38.5 years and 54 years in the resection group. The carrying angle (CA) and ulnar variance were measured bilaterally, and radiographs were reviewed for degenerative elbow arthritis. The Mayo elbow performance score, Turkish version of the Disabilities of the Arm, Shoulder and Hand questionnaire (DASH-T) and visual analog scale (VAS) were used to evaluate the clinical results. Results: The mean follow-up period in the ORIF group was 40.2 months and 44.4 months in the resection group. In the ORIF group, 11 patients were clinically rated excellent, six good, and two fair. In the resection group, seven patients had excellent, five had good, and two had fair scores. We did not find a statistically significant difference between the ORIF and resection groups regarding the clinical and radiological outcomes. Conclusion: With these short-term results, resection arthroplasty may be considered an effective method in the treatment of isolated comminuted radial head fractures, as it is less technically demanding and it also allows for early postoperative motion. However, the patients should be evaluated in detail, regarding ligamentous injuries prior to resection arthroplasty. Level of evidence: Level III, Therapeutic study. Keywords: Comminuted, Isolated, Open reduction-internal fixation, Radial head fracture, Resection arthroplasty

Aim: This retrospective study is aimed to analyze the effect of ultrasound-guided platelet-rich plasma (PRP) injections on grade 2 intrasubstance meniscal degenerations (IMDs). Materials and Methods: Fifteen patients who underwent PRP injections for symptomatic grade 2 meniscal lesions were included in the study. All injections were performed with ultrasound in the degenerated menisci. Patients were evaluated with Lysholm score and magnetic resonance imaging (MRI) before the injection and after a mean of 32-month follow-up. T2-weighted MRI images were evaluated on sagittal by two authors as double-blind. Results: Lysholm score was found to be statistically significantly increased, and in 67% of the patients, grade 2 degenerations were improved to grade 1. Conclusion: Intra-meniscal PRP injection under ultrasonography guidance provides good functional scores and radiological improvement in the patients with IMD.

Objective: The aim of this study was to evaluate the number and status of national patents and utility models, which had been applied for, registered or has become invalid in the field of orthopedics and traumatology in Turkey between 2007 and 2017. In addition, we aimed to categorize these patents and identify the areas with the most inventions. Method: A61B17, A61F2, and A61F5 patent categories , which were relevant to orthopedics and traumatology and were applied for between 2007 and 2017 were investigated. In total, 341 patents and utility models which had a registration number, were pending for approval and those who lost validity were included in the study and categorized according to their subjects. Results: Of the 341 patents and utility models, 172 were registered and valid, 73 were pending for approval, and 96 were invalid due to unpaid fees. The leading fields in categorical classification were spinal surgery with 121 patents and trauma surgery with 102 patents. According to subcategorical classification, implants led the group with 207 patents, followed by auxiliary tools with 62 patents. About 1/3 of the registered patents had lost validity. Conclusions: To the best of our knowledge, this is the first study that investigates the status of the patents in the field of orthopedic and traumatology in Turkey. Spinal and trauma-related patents were the leading categories. One-third of the patent application s were invalid due to unpaid fees. Our study can be used as a reference in future studies investigating the patents and utility models.

Purpose: Reconstruction of the lateral collateral ligament (LCL) and biceps femoris tendon following proximal fibula resection is controversial. Postoperative knee instability and peroneal nerve dysfunction affect outcome. This study aimed to determine functional, clinical, and radiological outcomes of patients who underwent en bloc proximal fibula resections and to compare clinical and radiological instability rates for primary repair after type I and type II resections. Materials and Methods: Eleven patients with primary tumors of the proximal fibula were included. Musculoskeletal Tumor Society (MSTS) score and Lysholm knee score were used in the evaluation of functional outcomes. Clinical outcome was assessed using knee range of motion and knee varus stress test. Radiological outcome was assessed using varus stress knee radiographs. Knee stability was evaluated using the varus stress test at 30° of knee flexion and varus stress knee radiographs and graded in millimeters. Results: Of the 11 tumors, 6 (54.6%) underwent type I resection. In five (45.4%) patients, type II resection was performed. The mean follow-up period was 32 ± 13.9 months (range, 12–55 months; median, 27 months). The mean knee joint lateral opening, MSTS score, and Lysholm knee score with type I versus type II resection were 5.7 ± 1.2 mm versus 6.4 ± 1.1 mm ( p = 0.247), 28.7 ± 1.8 (95.6%) versus 20.4 ± 7.7 (68%) ( p = 0.011), and 92.2 ± 8.8 versus 62.8 ± 20.4 ( p = 0.026), respectively. Postoperative complications of all patients included one (9.1%) deep tissue infection and one (9.1%) long-term knee instability. In one patient (9.1%) who underwent type II resection, above-the-knee amputation was performed after local recurrence. Conclusions: Primary repair of the LCL and biceps femoris tendon to the surrounding soft tissues after resection of proximal fibular tumors provides good clinical outcomes. Primary repair is a simple technique to perform with minimal morbidity. Peroneal nerve palsy was a problem, especially in type II resections. Level of Evidence: Therapeutic Level III.

The treatment of olecranon fracture–dislocations (OFDs) remains challenging. OFDs are often misdiagnosed as Monteggia lesions, and the real frequency is actually higher. However, studies on OFDs are limited. This study aimed to report on the surgical management of OFDs and to highlight the importance of three-dimensional computed tomography (3D CT) evaluation in the treatment of OFDs. The study participants included 18 patients (11 men, 7 women, mean age 44 years (range 24–78) with OFDs. Each patient’s medical records, radiographs, and 3D CT scans were reviewed for demographics, injury details, operative findings, and information about radiological and functional outcomes. The patients were divided into 2 groups according to the direction of the dislocation: the posterior dislocation group (group 1, 7 patients) and anterior dislocation group (group 2, 11 patients). The clinical evaluation was performed according to Broberg–Morrey and the American Shoulder and Elbow Surgeons-Elbow (ASES-E) scoring systems. The mean follow-up period was 39 months (range 25–62 months). The Broberg–Morrey results were excellent in 4, good in 9, fair in 3, and poor in 2 patients. The mean ASES-E score was 84.83 (range 48–100) points. There were signs of ulna-humeral arthrosis in 5 elbows. Arthrosis was graded as grade 1, grade 2, and grade 3 in 3, 1, and 1 elbows, respectively. Partial sensory recovery was observed in one patient with postoperative ulnar neuropathy at the last follow-up visit. OFDs are complex injuries of the proximal ulna and may involve the radial head, coronoid process, and lateral collateral ligament. The effective treatment of OFDs begins with the proper identification of the injury with 3D CT. A secure fixation including the coronoid process is mandatory for the elbow joint stability. Insufficient restoration of the trochlear notch may lead to problems with loss of motion and arthrosis. Although an application of a pre-contoured locking anatomical olecranon plate can simplify the fixation procedure in most cases, the surgeons’ equipment should also include radial head implant, coronoid plates, headless screws, small cannulated screw system, suture anchors, fluoroscopy, and articulated external fixator.

Purpose: The aim of our study is to determine the alterations on coronal balance after overcorrection of Lenke type 1 curve, retrospectively. Methods: Datas of 34 patients (29 female, 5 male patients; mean age, 16.3±3.3 years; range, 13-24 years) surgically treated for scoliosis between 2004 and 2010 were reviewed, retrospectively. The adolescent idiopathic scoliosis patients with Lenke type 1 curve treated with only posterior pedicle screw and postoperative thoracic curves less than 10° by Cobb method on frontal plane were enrolled in this study. Mean follow-up period was 52.5±29.7 months. Results: The mean amount of the preoperative thoracic curves was measured as 41.2°±6.1° (range, 30°-56°). The mean amount of the early postoperative thoracic curves was measured as 6.5°±1.8° (range, 3°-9°). The mean amount of the thoracic curves was measured as 8.5°±4.6° (range, 3°-22°) during the last follow-up (p=0.01). The mean preoperative coronal balance was measured as 8.5 mm (range, 1-30 mm). The mean early postoperative coronal balance was measured as 3.5 mm (range, 0-36 mm). The mean coronal balance was measured as 5.5 mm (range, 0-38 mm) during the last follow-up (p>0.05). Conclusion: We suggest that Lenke type 1B and 1C should be carefully evaluated and the fusion levels should be accurately selected in order to maintain the correction of coronal balance. We suggest that selective fusion with overcorrection in Lenke type 1A are applied to curves that can be corrected lumbar curve at the preoperative bending radiograph and curves that not have coronal decompensation and >10° distal junctional kyphosis, preoperatively.

Highlights • Tibial plafond fractures carry a high risk for post-traumatic osteoarthritis. • Tricortical iliac crest autologous bone grafting (TCG) avoided need for arthrodesis. • TCG with internal fixation restored joint stability, congruency and alignment. • TCG should be considered for whom biological restoration is feasible., Introduction The risk for post-traumatic osteoarthritis (POA) following tibial plafond joint trauma has been reported to be as high as 70–75%. In the treatment of more severe joint pathologies, with incongruity and intra-articular defects, internal or external fixations techniques may be required. Presentation of case We report the orthopedic management of a pilon fracture in a 30-year-old male with malunion and implant failure after initial mal-reduction of the fracture 9-months earlier. Tricortical iliac crest autologous bone grafting (TCG) was used in combination with internal fixation to restore distal tibial articular. The procedure resulted in a pain free ankle, sufficient range of motion for function and patient satisfaction. Discussion Early surgical intervention and anatomical reduction with appropriate fixation are recommended for intra-articular tibial pilon fractures. Autogenous bone grafting is a reliable treatment option to augment structural stability, bone defects and bone-healing. Indications for bone grafting include delayed union or nonunion, malunion, arthrodesis, limb salvage, and reconstruction of bone voids or defects. The application of TCG in the management of a malreduced tibial plafond fracture has not been described before. Conclusion We performed TCG with internal fixation in order to restore stability, congruency and alignment in a young patient in whom a biological restoration was feasible due to good bone quality. In suitable cases, TCG might provide an alternative to arthrodesis or arthroplasty.

This article presents a 48-year-old male patient who presented with pain in the left forearm and weakness and clumsiness in the left hand of 6 months' duration. Flexor motor strength loss of the thumb and the index finger was present and neurophysiologic tests showed findings compatible with axonal injury in the anterior interosseous nerve (AIN) innervated muscles. Magnetic resonance imaging revealed a space-occupying lesion in the proximal forearm resembling a glomus tumor. Excision of the mass and release of the AIN were performed. Histopathology confirmed a glomus tumor, and the patient remains asymptomatic at 1 year postoperatively. We stress the importance of imaging studies in patients when a suspected secondary nature of nerve entrapment is present. DOI: 10.3944/AOTT.2015.15.0081This abstract belongs to the un-edited version of the article and is only for informative purposes. Published version may differ from the current version.