ObjectiveThe aim of this study was to compare midterm functional and radiographic results of minimal invasive plate osteosynthesis (MIPO) with intramedullary nailing (IMN) of simple intra-articular distal tibial fractures (AO-OTA type 43 C1-C2).MethodsSeventy-three simple intra-articular distal tibial fracture patients were evaluated retrospectively. All were treated between 2009 and 2014. The average age of the patients was 40.3 years. Thirty-seven patients were treated with IMN and 36 patients were treated with MIPO. Fibular plate osteosynthesis was applied in 5 cases (13.5%) in the IMN group and in 23 patients (63.9%) in the MIPO group.ResultsFunctional results and complications of IMN and MIPO methods were assessed in 73 patients. The average union time was 16.4 ± 2.7 weeks in the IMN group and 15.2 ± 1.8 weeks in the MIPO group (p = 0.079). The average Olerud-Molander Ankle Score was 87.8 ± 8.1 in the IMN group and 81.5 ± 11.8 in the MIPO group (p = 0.013). Four patients in the IMN group experienced valgus malunion, while it was not observed in any patients in the MIPO group (p = 0.042). Recurvatum malunion was detected in 10 patients in the MIPO group and not seen in the IMN group (p = 0.001). Ankle dorsiflexion angle was 25.8 ± 4.5° in the IMN group and 33.3 ± 8.9° in the MIPO group (p = 0.000).ConclusionSimple intra-articular distal tibial fractures are successfully treated with IMN and MIPO. Prevalence of valgus malunion was higher in the IMN group and recurvatum was more prevalent in the MIPO group. MIPO is the first preference according to the literature; however, successful results have been obtained with IMN in this fracture pattern.Level of EvidenceLevel III, Therapeutic Study.
Xanthomas are described as deposits in the skin and subcutaneous tissues. Mostly known as pseudotumors, xanthomas consist of connective tissue containing mainly cholesterol, triglycerides, and numerous foamy macrophages. Bilateral Achilles tendon xanthomata is pathognomonic for cerebrotendinous xanthomatosis in the case of normal cholesterol levels but increased cholestanol levels in serum. In this article, we present findings regarding bilateral xanthomas of Achilles tendons in a patient with cerebrotendinous xanthomatosis.
The Results of the Winograd Method in Surgical Treatment of Ingrown Toenail Amaç: Tırnak batması; ortopedi polikliniklerinde oldukça sık rastlanılan, ağrılı bir hastalıktır. Bu hastalığın tedavisinde birçok yöntem tanımlanmıştır. Winograd tekniği en sık kullanılan cerrahi yöntemlerden biridir. Bu çalışmamızda evre 2 ve 3 tırnak batması olgularında uyguladığımız Winograd yönteminin sonuçlarını inceledik. Yöntemler: Kliniğimizde 2008-2010 yılları arasında Winograd yöntemi ile tedavi ettiğimiz 174 hastanın 204 ayak başparmak tırnak batması olgusunu geriye dönük olarak değerlendirdik. Bu hastalarda yineleme oranı, işe dönüş süresi ve memnuniyet durumları değerlendirildi. Bulgular: Hastaların yaş ortalaması 34,3 (dağılım: 12-69 yaş) idi. Heifetz sınıflamasına göre 93 olgu (%45,5) evre 2,111 olgu evre 3 (%54,5) idi. Yüz dokuz hasta (%62) erkek, 65 hasta (%38) bayan idi. Olguların 61 tanesi (%35) sol ayak 1. parmak, 83 tanesi (%47) sağ ayak 1. parmak, 30 tanesi (%18) bilateral 1. parmak idi. Doksan beş olguda (%46,5) tırnak mediyal taraf tutulumu, 66 olguda (%32,5) lateral taraf tutulumu, 43 olguda (%21) hem mediyal hem de lateral taraf tutulumu mevcut idi. Doksan olguda (%44) preoperatif dönemde akıntılı enfeksiyon nedeni ile antibiyotik kullanımı mevcut idi. Altı hastada (%3,4) periferik vasküler hastalık mevcut idi. Hastalar ortalama 16 (dağılım: 12-28 ay) ay takip edildi. Hastalar ortalama 8 gün (dağılım: 3-14 gün) içerisinde işlerine döndüler. Dikişler ortalama 12. günde (dağılım: 10-14. gün) alındı. Oniki hastada (%6,8) yineleme görüldü. Yinelemeler ortalama postoperatif 3. ayda (dağılım: 2-7 ay) görüldü. Hiçbir hastada osteomyelit veya ciddi bir komplikasyon gelişmedi. Yüz elli üç hasta (%87,9) ameliyathanede, steril şartlarda uygulanan cerrahi işlemden memnun kaldıklarını belirtti. Sonuç: Winograd yöntemi, tırnak batması olgularında oldukça başarılı bir tedavi seçeneğidir.
Results: Visual animations statistically and significantly increased the knowledge level of patients and the level of their satisfaction in informed consent (p=0.001; p<0.01, respectively). It was determined that this increase was independent of the education level of the patients (p>0.05). Conclusion: Visual animations are a simple, easy, and effective method for informing during informed consent.
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