Background The decision of fasciotomy or amputation in crush syndrome is controversial and challenging for surgeons. We aimed to share our experiences after the Kahramanmaraş earthquake, to predict the severity of crush syndrome and mortality, and to guide the surgical decision. Methods The clinical data of patients during their first week of hospitalization were analyzed retrospectively. Totally, 233 crush syndrome patients were included. Demographic data, physical and laboratory findings, surgical treatments, and outcomes were recorded. Results The mean time under the rubble was 41.89 ± 29.75 h. Fasciotomy and amputation were performed in 41 (17.6%) and 72 (30.9%) patients. One hundred and two patients (56.7%) underwent hemodialysis. Fifteen patients (6.4%) died. Lower extremity injury, abdominal trauma, and thoracic trauma were associated with mortality. Mortality was significantly increased in patients with thigh injuries (p = 0.028). The mean peak CK concentration was 69.817.69 ± 134.812.04 U/L. Peak CK concentration increased substantially with amputation (p = 0.002), lower limb injury (p < 0.001), abdominal trauma (p = 0.011), and thoracic trauma (p = 0.048). Conclusions Thigh injury is associated with the severity of crush syndrome and mortality. Late fasciotomy should not be preferred in crush syndrome. Amputation is life-saving, especially in desperate lower extremity injuries.

Amaç: Enkondrom, falanks ve metakarpusun en sık görülen tümörüdür. Çeşitli teknikler ve yöntemler uzun süredir araştırılmaktadır. Enkondromlu geniş bir hasta yelpazesinde yapılan küretaj ve kullanılan kemik greftinin klinik ve radyolojik sonuçlarını incelemeyi amaçladık. Yöntem: Çalışmaya enkondrom tanısı ile ameliyat edilen 47 hasta dahil edildi. Küretaj sonrası oluşan kavite kemik greftleri ile dolduruldu. Hastaların ortalama yaşı 29.32±15.08 yıl, takip süresi 28.47±25.10 aydı. Standart takip protokolüne uymayan hastalar çalışma dışı bırakıldı. Deneyimli bir ortopedik cerrah radyolojik sonuçları değerlendirdi ve nüksleri olan hastalar için MRG görüntüleri ve raporları hastane veri tabanından alındı. Eklem hareket açıklığı ve gözlenen deformiteye göre klinik değerlendirme yapıldı. Bulgular: Ortalama konsolidasyon süresi 3.08±2.19 aydı. Nüks oranı %6.4’tü. Kırık ile ya da kırıksız başvuran gruplar arasında, allogreft ve otogreft grubu arasında klinik ve radyolojik sonuçlar açısından fark yoktu. Sonuç: Küretaj ve greftleme, enkondrom için hala güncel ve güvenilir bir yöntemdir.

Purpose: We aimed to evaluate the radiological and functional results of humeral shaft fractures treated with minimally invasive percutaneous plate osteosynthesis (MIPPO) in our clinic. Materials and Methods: Data of 21 humeral shaft fractures of 20 patients treated with MIPPO were evaluated retrospectively. Demographic data, type of injury, fracture classification according to AO classification and fracture location, smoking, radial nerve injury were recorded. Radiographically, the union at 6th month and alignment were evaluated. Objective results were evaluated in terms of shoulder and elbow range of motion. Subjective results were assessed by the American Shoulder and Elbow Society Score (ASES), University of California, Los Angles (UCLA) score, Mayo Elbow Performance Index (MEPI), the Disability of The Arm, Shoulder and Hand (DASH) Score and Constant Shoulder Score. Results: The average elbow motion was 131.4° ± 19.8°. The mean ASES and UCLA scores were 88.5 ± 16.4 and 32.1 ± 5.2, respectively. The mean MEPI and DASH scores were 93.1 ± 11.3 and 11.8 ± 20.0, respectively, and the Constant score was mean 9.1 ± 15.3. Nonunion was observed in two patient at 6th month. Conclusion: We believe that MIPPO is a successful technique for the treatment of humeral shaft fractures with minimal soft tissue damage, intact shoulder and elbow motion function.

Background: The decision of fasciotomy or amputation in crush syndrome is controversial and challenging for surgeons. We aimed to share our experiences after the Kahramanmaraş Earthquake, to predict the severity of crush syndrome and mortality, and to guide the surgical decision. Methods: The clinical data of patients during their first week of hospitalization were analyzed retrospectively. Totally 233 crush syndrome patients were included. Demographic data, physical and laboratory findings, surgical treatments, and outcomes were recorded. Results: The mean time under the rubble was 41.89±29.75 hours. Fasciotomy and amputation were performed in 41 (17.6 %) and 72 (30.9%) patients. One hundred and two patients (56.7%) underwent hemodialysis. Fifteen patients (6.4%) died. Lower extremity injury, abdominal trauma, and thoracic trauma were associated with mortality. Mortality was significantly increased in patients with thigh injuries (p=0.028). The mean peak CK concentration was 69.817,69 ± 134.812,04 U/L. Peak CK concentration increased substantially with amputation (p=0,002), lower limb injury (p<0.001), abdominal trauma (p=0.011), and thoracic trauma (p=0.048). Conclusions: Thigh injury is associated with the severity of crush syndrome and mortality. Late fasciotomy should not be preferred in crush syndrome. Amputation is life-saving, especially in desperate lower extremity injuries.