While being one of the most frequent parental complained deformities, flatfoot does not have a universally accepted description. The reasons of flexible flatfoot are still on debate, but they must be differentiated from rigid flatfoot which occurs secondary to other pathologies. These children are commonly brought up to a physician without any complaint. It should be kept in mind that the etiology may vary from general soft tissue laxities to intrinsic foot pathologies. Every flexible flatfoot does not require radiological examination or treatment if there is no complaint. Otherwise further investigation and conservative or surgical treatment may necessitate.
ObjectivesBursitis of the olecranon and the patella are not rare disorders, and conservative management is successful in most cases. However, when patients do not respond to conservative treatment, open excisional surgery or, recently, endoscopic bursectomy, can be used. The aim of this study was to evaluate the results of open and endoscopic treatments of olecranon and prepatellar bursitis.Patients and methodsForty-nine patients (37 male and 12 female), who were treated with endoscopic bursectomy (25 patients) or open bursectomy (24 patients) were included in this study. Thirty patients had olecranon bursitis, while 19 patients had prepatellar bursitis. The patients’ average age was 61.1 ± 12.3 (range 33-81) years. All of the patients’ hospitalization and surgery times were recorded.The satisfaction of the patients was evaluated with a satisfaction scoring system, as well as by evaluating residual pain, the range of joint movement, and the cosmetic results of the procedure.ResultsThe average follow-up time was 16 ± 9 months (range 12–27). The median operation time was 23.2 ± 3.5 minutes for the endoscopic bursectomy group and 26.4 ± 6.8 minutes for the open bursectomy group. The median hospitalization time was 0.56 ± 0.5 days (range 0-1 day) for the endoscopic group and 1 ± 0 days for the open bursectomy group (P<0.01).According to the patient satisfaction questionnaire, the endoscopic bursectomy group’s score was 8.5 ± 1.3 (range 5-10), and the open bursectomy group’s score was 5.29 ± 1.8 (range 1-9) (P<0.01).ConclusionEndoscopic bursectomy is a time-saving and efficient surgical treatment option for patients with prepatellar and olecranon bursitis.
Vascularized fibular grafts (VFG) are used for the treatment of femoral head avascular necrosis, osteomyelitis, nonunions, and excessive bone defects. Mostly the ascending branch of the lateral circumflex femoral artery (LCFA) or first or second perforating branch of the profound femoral artery is used for the customary recipient vessel. In this report, an alternative technique of using descending branch of LCFA in VFG surgery and its clinical results are reported. Sixteen patients (13 men and 3 women) underwent VFG surgery between the years 2005 and 2012. Predicted etiologies were: ANFH in 10 hips, traumatic femur neck pseudoarthrosis in 4 hips, tumor in 1 hip, and 1 femur shaft defect due to osteomyelitis. Patients' average age at the time of surgery was 29 years (range, 14-43 years). All patients were treated with VFG. All of the grafts survived and none of the patients needed any revision surgery. One had superficial wound infection, one developed peroneal nerve palsy, and one had trochanteric bursitis. The follow-up time was 36 months (range 20-72). It is believed that the descending branch of LCFA is a reliable alternative for anastomosis in VFG surgery.
Objective: In this study, it was aimed to investigate the demographic features, administration reasons and educational status of the patients who were presented to the bonesetters for orthopedic complaints.Methods: 96 (26 males, 70 females) patients were included in this study, who filled a questionnaire out of 1926 patients went to bonesetters between June and December 2012. All the patients were recorded regarding demographic features, first application places, educational status, administration reasons, and complication rates.Results: 87 patients (90.6%) preferred bonesetters as the first application place. The mean age of the patients was 31±16.1 years. The most common reason was advices of the family members or relatives (40.6%). The educational status was not significant in administration rate, but low educational status has significant correlation with more complication rates. Sixteen patients developed sequels (16.6%). The effect of bonesetters' treatment was mostly found to be placebo.
Conclusion:Bonesetter is a country reality when prevalence was taken in notice. However, the similarity of their results to placebo ones, having no education, having no legal rights, paying no tax make this issue a great problem. The solution of this problem is depended to increase health programs to inform public and to increase government superintension.
Failed back surgery syndrome (FBSS, failed back syndrome) is a chronic disorder that has many impacts on the patients and health care systems. The predisposing factors may occur in the preoperative, intraoperative, and postoperative periods. The term FBSS is often misused. It is not actually a syndrome, but is a very generalized term that is often used to describe the condition of patients who had unsuccessful results with back surgery or spine surgery, or experienced continued pain after surgery. Patients describe uncontrolled persistent back, back/leg or leg pain with functional insufficiency with or without sciatica after 10-40% of the all spinal surgeries. Literature about the FBSS is insufficient, due to the complexity of this entity with variety of the underlying etiology and lack of high-quality clinical trials determining response to treatment modalities. This review aims to summarize current concepts in the ligthnings of literature findings.
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