Relationship between the tilt angle of bipolar radial head prostheses and radiological radiocapitellar instability
Background: Fifth metatarsal basis fractures are the most commonly seen fractures of the foot. Ankle sprains occur with inversion and plantar flexion mechanisms, like most of the fifth metatarsal basis fractures. Our aim was to investigate the possible accompanying ankle injuries about the fifth metatarsal basis fractures.Methods: Hospital's digital database was searched for the ICD 10 codes of the metatarsal bone fractures such as 'S92.30 and S92.35' between January 2015 and January 2018. Thirty nine patients with fifth metatarsal basis fracture who had an ankle magnetic resonance imaging (MRI) within 14 days of the injury were included in the study. MRI findings were evaluated and comparison was performed according to the fracture zones, gender and age.Results: The most common finding on MRI was talocrural joint effusion (TTJE) which was observed in 28 patients (71.8%). Bone marrow edema was observed in 16 patients (41%). Chondral injury at the medial dome of talus was observed in three patients (7.7%). Grade 1 ligament sprain was observed in 6 of the patients (15.4%). Lateral ligament sprain was observed only in two patients, while four of the sprains were about the deltoid ligament.Conclusions: Although most of the fifth metatarsal basis fractures and ankle sprains occur as a result of a common mechanism, physical examination and patients' complaints are very important. Routine MRI imaging should be unnecessary for most patients. If a patient with a fifth metatarsal basis fracture has complaints about his/her ankle joint, one should be aware of bone marrow edema which was observed in 41% of our study population.
Background The study aimed to determine the level of retraction and atrophy according to the time elapsed in traumatic isolated full-thickness supraspinatus (SS) tears in young patients. Methods One thousand twenty-six patients, who underwent arthroscopic shoulder surgery, were retrospectively reviewed. Pre-operative magnetic resonance imaging (MRI) of 69 patients aged 18 to 40 years with isolated traumatic full-thickness SS lesions remaining after exclusion criteria were evaluated for tendon retraction and atrophy levels. SS retraction was determined from a T2-weighted oblique coronal MRI section, and the atrophy level was determined from the T1-weighted oblique sagittal MRI section. The patients were divided into four groups 0–1 month, 1–3 months, 3–6 months, and 6–12 months according to the time between trauma and MRI. The relationship of tendon retraction and muscle atrophy with elapsed time was evaluated, in addition, comparisons between groups were made. Results Thirty-one (45%) of the patients were female and their mean age was 30 ± 7.3 (18–40) years. The mean age of men was 30.5 ± 6.9 (18–39) years (p = 0.880). The time between rupture and MRI was moderately correlated with retraction and strongly correlated with atrophy levels (r = 0.599, .751, respectively). It was observed that there was a statistically significant difference between the 1st (0–1 month) and 2nd (1–3 months) groups (p = 0.003, .001, respectively), and between the 2nd and 3rd (3–6 months) groups (p = 0.032, .002, respectively), but there was no significant difference between the 3rd and 4th (6–12 months) groups (p = 0.118, .057, respectively). In addition, there was a moderate correlation between tendon retraction and atrophy levels (r = 0.668). Power (1- b) in post hoc analysis was calculated as 0.826. Conclusions In traumatic full-thickness SS tears, the moderate positive correlation between the time elapsed after trauma with the level of retraction, and a strong correlation with the level of atrophy showed the importance of early surgical repair in young patients.
Background The aim of the current study was to determine the changes in pre-and postoperative Pittsburg sleep quality index (PSQI) and Tampa scale of kinesiophobia (TSK) values according to the Hamada classification in patients who underwent reverse shoulder arthroplasty (RSA) for rotator cuff tear arthropathy (RCTA). Methods One hundred and eight patients who underwent RSA for RCTA were reviewed retrospectively. The patients were divided into two groups with low grade (stages 1-2-3) (n = 49) and high grade (stages 4a-4b-5) (n = 59) according to the Hamada classification, which is the radiographic evaluation of RCTA. PSQI and TSK values were calculated preoperatively, and post-operatively at the 6th week, 6th month, and 1st year. The change in PSQI and TSK values between the evaluations and the effect of staging according to the Hamada classification on this change was examined. Results When compared in preoperative evaluations, PSQI and TSK scores were found to be lower in low-grade group 1 (7.39 ± 1.56, 51.88 ± 4.62, respectively) than in high-grade group 2 (10.47 ± 2.39, 57.05 ± 3.25, respectively) according to Hamada classification (both p < 0.001). In the postoperative evaluations, PSQI and TSK results decreased gradually compared to the preoperative evaluations, and there was a dramatic decrease in both parameters between the 6th-week and 6th-month evaluations (both p < 0.001). Preoperatively, 102 (95%) patients had sleep disturbance (PSQI ≥ 6), and 108 (100%) patients had high kinesiophobia (TSK > 37). In the 1st year follow-ups, sleep disturbance was observed in 5 (5%) patients and kinesiophobia in 1 (1%) patient. When the Hamada stages were compared, it was seen that there was a significant difference before the operation (both p < 0.001), but the statistically significant difference disappeared in the PSQI value in the 1st year (p = 0.092) and in the TSK value in the 6th month (p = 0.164) post-operatively. It was observed that Hamada staging caused significant differences in PSQI and TSK values in the preoperative period but did not affect the clinical results after treatment. Conclusions RSA performed based on RCTA improves sleep quality and reduces kinesiophobia. RCTA stage negatively affects PSQI and TSK before the operation but does not show any effect after the treatment.
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