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.
Bu çalışmada diyabetik ayaklı hastalarda ve yeni tanı konulmuş tip 2 diabetes mellitus (DM)'lu hastalarda osteoprotegerin (OPG) ve 25-hidroksi D vitamini (25(OH)D) düzeyleri karşılaştırıldı ve diyabetik ayaklı hastalarda 25(OH)D eksikliğinin yaygınlığı ve şiddeti araştırıldı. Hastalar ve yöntemler: Bu ileriye dönük çalışma Haziran 2014 ve Mayıs 2015 tarihleri arasında hastanemize başvuran 58 diyabetik ayaklı hasta (42 erkek, 16 kadın; ort. yaş 63.6 yıl; dağılım, 31-90 yıl) ve 47 yeni tanı konulmuş tip 2 DM'li hasta (27 erkek, 20 kadın; ort. yaş 51.4 yıl; dağılım, 29-85 yıl) (kontrol grubu) olmak üzere 105 hasta üzerinde gerçekleştirildi. Her iki grupta 25(OH)D ve OPG serum düzeyleri ölçüldü ve karşılaştırıldı. Bulgular: Diyabetik ayak grubunda OPG düzeyleri kontrol grubundan anlamlı olarak daha yüksekti (p<0.05). Diyabetik ayak grubunda 25(OH)D düzeyleri kontrol grubundan anlamlı olarak daha düşüktü (p<0.05). Diyabetik ayaklı hastalarda OPG düzeyleri ve C-reaktif protein (CRP) ve kreatinin düzeyleri arasında pozitif ilişkiler vardı. Sonuç: Diyabetik ayaklı hastalarda yükselmiş OPG düzeyleri, OPG'nin CRP ve kreatinin ile pozitif ilişkisine bağlı olarak klinik durumun şiddetini gösterebilir. Diyabetik ayaklı hastaların çoğunluğunda ciddi 25(OH)D eksikliği tespit edildi. Diyabetik ayaklı hastalarda istenmeyen immünolojik değişiklikleri önlemek için D vitamini suplemantasyonu gerekli olabilir.
Traumatic hip dislocations are very rare in the pediatric population, and they are real emergent cases that can occur with minimal trauma. If they are not diagnosed immediately and reduction is not performed as soon as possible, they may cause problems such as avascular necrosis and degenerative arthritis. Performing reduction within the first 6 hours is of vital importance.
We aim to present the functional outcomes and radiographic results of 2 pediatric traumatic hip dislocation cases with 36 months of follow-up who were treated with abduction orthosis after the reduction. We want to emphasize the importance of reduction time in the outcome of posterior traumatic hip dislocations followed with abduction orthesis even if there is a trend and suggestion to treat these patients with spica cast with the review of the recent literature.
Tenosynovial giant cell tumor is a locally aggressive tumor arising from the synovia of the fibrous tissue surrounding the joints, tendon sheaths, mucosal bursas, and tendons. Although it is often to be observed at the hand, localized form is very rare in the knee joint. In this case report, we aimed to present a very rare case of a surgically treated intra-articular giant cell tenosynovial tumor arising from the hoffa's infrapatellar fat pad of a 19-year-old male patient, by reviewing the literature. The patient we have treated with marginal excision was asymptomatic at the 14th month in the controls and recurrence was not detected.
The most common foreign bodies seen in the foot are sewing needles, toothpicks, glass, and materials such as sand or silica. Foreign bodies in the foot are usually embedded, and surgical exploration and removal is usually necessary. Penetrating foreign bodies in the foot-particularly of organic origin, like wood-can cause cellulitis, osteomyelitis, abscess formation, and pseudotumor formation. Identification of foreign bodies in the foot can be challenging because they are often not radiopaque. However, foreign bodies in the foot do not migrate, in contrast to upper extremities, where foreign bodies are known to migrate. We report a case of a toothpick penetrating a child's foot and moving proximally along the tendon sheath.
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