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Background:Ultrasonography is accepted as a useful imaging modality in the early detection of developmental dysplasia of the hip (DDH). Early detection and early treatment of DDH prevents hip dislocation and related physical, social, economic, and psychological problems. The purpose of this study was to evaluate the reliability of ultrasonographic and roentgenographic measurements measured by seven different observers.Materials and Methods:The alpha angles of 66 hips in 33 patients were measured using the Graf method by seven different observers. Acetabular index degrees on plane roentgenograms were measured in order to assess the correlation between the ultrasonographic alpha angle and the radiographic acetabular index, which both show the bony acetabular depth, retrospectively.Results:The interclass correlation coefficient, measuring the interobserver reliability, was high and statistically significant for the ultrasonographic measurements. There was a negative correlation between the alpha angle and the acetabular index.Conclusions:Ultrasonography, when applied properly, is a reliable technique between different observers, in the diagnosis and follow up of DDH. When assessed concomitantly with the roentgenographic measurements, the results are reliable and statistically meaningful.

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A AB BS ST TR RA AC CT T O Ob bj je ec ct ti iv ve e: : Determining the type of anesthesia is a complex medical decision that depends on many factors including co-morbidity, age, type of surgery performed, and the risk of the anesthetic techniques. This study evaluated the effects of anesthesia type on postoperative mortality and morbidity in hip fractures. M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : One hundred eighty-five patients older than 60 years who were operated for hip fracture between 2005-2009 were retrospectively analyzed. Patients received general anesthesia (n=67), spinal anesthesia (n=67), or epidural anesthesia (n=51). The clinical features of the patients were obtained from the hospital records. Morbidity outcomes were assessed on postoperative day 7. Mortality rates were calculated on postoperative day 7 and postoperative day 30. R Re es su ul lt ts s: : There were no significant differences between the three groups with regard to intraoperative blood loss, intraoperative blood transfusion, smoking status, length of stay in hospital, American Society of Anesthesiology (ASA) physical status, and Charlson Comorbidity Index (CCI) (p=0.393, p=0.088, p=0.369, p=0.228, p=0.491, p=0.371 respectively). Similarly, no difference was detected between the three groups regarding patient mortality rates for day 7 and 30 (p=0.738, p=0.805 respectively). C Co on nc cl lu us si io on n: : No technique was superior to the others. Due to the similar mortality rates among the groups, we suggest that the proper anesthetic technique selected according to the clinical features of the patient combined with adequate monitorization would yield successful results with all three techniques. K Ke ey y W Wo or rd ds s: : Hip fractures; mortality; anesthesia Ö ÖZ ZE ET T A Am ma aç ç: : Anestezi tipinin belirlenmesi, yaş, uygulanacak cerrahi tipi ve anestezi tekniklerinin riski gibi birçok faktörün göz önüne alınmasını gerektiren, kompleks bir tıbbi karardır. Bu çal-ışmada, kalça kırıklarında anestezi tipinin cerrahi sonrası mortalite ve morbidite üzerindeki etkileri değerlendirilmiştir. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : Çalışmada, 2005-2009 yılları arasında kalça kırığı operasyonu geçiren 60 yaş üzeri 185 hasta retrospektif olarak analiz edilmiştir. Hastalara genel anestezi (n=67), spinal anestezi (n=67) ve epidural anestezi (n=51) yöntemlerinden biri uygulanmıştır. Hastalara ait klinik bilgiler hastane kayıtlarından elde edilmiştir. Morbidite sonuç-ları operasyon sonrası yedinci günde değerlendirilmiştir. Mortalite oranı ise operasyon sonrası 7. ve 30. günlerde hesaplanmıştır. B Bu ul lg gu ul la ar r: : Her üç grupta cerrahi sırasındaki kan kaybı ve kan transfüzyonu, sigara içme durumu, hastanede kalış süresi, American Society of Anesthesiology (ASA) skoru ve Charlson morbidite indeksi skoru açısından anlamlı bir fark bulunmamıştır (sırasıyla p=0,393, p=0,088, p=0,369, p=0,228, p=0,491, p=0,371). Hastaların 7. ve 30. günlerdeki mortalite oranları açısından gruplar arasında anlamlı bir f...

Background. The aim of the study is to analyze the major agricultural injuries related to the extremities. Patients. We evaluated a 3-year period including 41 patients. Data on age, sex, injury patterns, anatomical localizations, injury season, length of stay in the hospital, and infections were evaluated, and the patients were examined with SF-36 in the follow-up period. Results. Hand was the most commonly injured part (n: 9) followed by the distal part of the lower limb (cruris) (n: 7) and foot (n: 7). Mean time between trauma and emergency-department arrival was 115 minutes (60–360). Mean length of stay was 24 days (4–150), and mean number of operations during hospitalization was 2.4 (1–30). Deep wound infection was seen in 8 patients. Seasonal distribution for accidents was even for spring and fall (27% each), high for summer (36%), and less for winter (10%). Conclusions. Distal parts of the elbow and knee were affected more frequently. Due to the high microbiological load and high incidence of crush-type injuries, repetitive debridements and long duration of hospital stay were needed. Attention should be paid in the harvesting times to the farmyard injuries. Due to the seasonal variation, more resources should be allocated to treat the increasing incidence of injury over the period from spring to fall.

Ipsilateral femur fracture, patellar fracture, and tibial avulsion fractures of anterior and posterior cruciate ligament injuries are reported. We know of no other report of an injury such as this in the literature. We sutured the tibial avulsion fractures by transtibial suturing technique and internally fixated the femur by intramedullary interlocking nailing 2 weeks after the trauma. After 1 year the results were evaluated as very good. Early surgical repair is valuable in these injuries.

Scapular spine fractures are rare injuries. The aim of this study was to evaluate a late-diagnosed scapular spine pseudo-arthrotic patient. Because of the surrounding soft tissue mass and overlapping of the scapula with the thoracal bones on a roentgenogram, diagnosis may be missed or delayed for years. We present a case of scapular spine pseudo-arthrosis in a 50-year-old man, who sustained a traffic accident 2 years ago. He was treated as a soft tissue injury of the left shoulder and later as a rotator cuff tear. His scapular spine fracture was diagnosed as pseudo-arthrosis of the scapular spine with a diagnostic delay of 2 years. Isolated scapular spine fractures are rare, usually associated with other injuries and frequently treated non-operatively. Sagging of the acromion as a result of a scapular spine fracture may mimic supraspinatus outlet impingement. If a painful pseudo-arthrosis limits the function of a shoulder, fractured ends should be fixed until union occurs. Although scapular spine fractures are rarely seen, they must take place in the differential diagnosis of impingement syndromes of the shoulder.