ObjectiveThis study was performed to compare the clinical and radiological outcomes of displaced femoral neck fractures (FNFs) treated with either hemiarthroplasty or total hip arthroplasty (THA) in elderly patients. Morbidity and mortality were also evaluated.MethodsTwenty-two patients who underwent hemiarthroplasty and 16 patients who underwent THA for treatment of Garden type 3–4 FNFs from 2012 to 2015 were enrolled in this study. All patients were >65 years of age. Cox regression analysis was performed for mortality evaluation.ResultsThe postoperative blood loss volume, decrease in the hemoglobin level, and transfusion rate were significantly higher in the THA group. The univariate mortality risk was higher in patients with a Charlson comorbidity score of >4, American Society of Anesthesiologists score of >2, Singh index of <3, and postoperative hospitalization of >1 week.ConclusionThis study revealed no significant difference in the short-term clinical and radiological results between cementless hemiarthroplasty and THA in elderly patients with displaced FNFs. However, morbidity and mortality were associated with the presence of additional systemic diseases. THA is the preferred surgical technique in patients with displaced FNFs and low comorbidities.
Background. Free tendon grafts are frequently used in zone 2 flexor pollicis longus tendon reconstructions. However, pedicled tendon grafts have less risk of adhesion than free tendon grafts. The aim of this study was to evaluate the results of two-stage flexor pollicis longus tendon reconstruction using a pedicled palmaris longus tendon graft. Methods. Six patients who underwent two-stage flexor pollicis longus tendon reconstruction using a pedicled palmaris longus tendon graft between 2016 and 2018 were retrospectively evaluated in this study. The mean follow-up was 17 months (range: 13-25 months). Results. In the final follow-ups, the Buck-Gramcko score was excellent in three patients, good in two patients, and fair in one patient. Mean Disabilities of the Arm, Shoulder and Hand score was 12.9 (8.3-26.7). Conclusions. We conclude that good results can be achieved with two-stage flexor pollicis longus tendon reconstruction using a pedicled palmaris longus tendon graft. This method appears to be an alternative for flexor pollicis longus tendon reconstruction using free tendon graft.
Introduction Evaluating AIS patients with shoulder imbalance, radiologic angular parameters generally used are: radiographically costoclavicular intersection angle (CCA), angle of the line connecting the coracoids (Corac), the angle of line connecting the upper limit of the first costal angle (FRA), and the tilt angle of the first thoracic vertebra line (T1T). The angles shown on digital photographs are axillary folds line (ax), deltoids peak line (d) and midtrapezial line angle (tra) between the horizontal line. Material and Methods A total of 29 cases with AIS are separated into two groups, having distance of horizontal lines drawn from coraciods with 2cm shoulder height differences (SHD) and others. Statistics; paired-samples t-test or wilcoxon tests are used depending on normalization of variables. For each variable ROC analysis is performed. Pearsons correlation analyses used with the changes of shd valvues for each parameter. Results Sensitivity of ax is the highest value with 90% than to tra and cca of 80%. Tra and cca angles has highest spesifity valvues with 63.16% than to ax of 57,89%. All radiologic parameters changes found strongly correlated with the changes of shoulder height differences. Conclusion The mid trapezial and axillary fold angles over 2,8 and 2,9 degrees respectively is found in shoulder imbalance by cosmetic parameters. The costoclavicular intersection angle over 4 degree is found to be the radiologic shoulder imbalance parameter for ais. These cut off valvues can be usefull for determining the the shoulder imbalance for selection of upper enstrumantation levels in AIS. Midtrapezial angle can be used as a parameter of clinical cosmetic shoulder imbalance in adolescent idiopathic scoliosis. Axillary fold angles and costoclavicular intersection angle can also helpfull for defining shoulder imbalance in adolescent idiopathic scoliosis.
Anthropological studies show that human beings have been using the "amputation" technique for over 30,000 years. Amputation flap survival has increased with the development of anesthetics, surgical facilities, improved techniques, and with the discovery of antibiotics. In addition, the quality of life for amputation patients has improved significantly with the development of prosthetics. Today, amputation surgeries can frequently occur due to diabetes and peripheral vascular disease and delay in treatment can be fatal. During surgery for vasculopathies, retractors are needed to shorten the surgical time for less damage to soft tissues during bone incision, to protect the vessels of the flap and to make bone incision easier and faster. In this study, 7 different designs of amputation retractors were compared to the Percy retractor, which is considered the reference design, in terms of physical properties, usage and marketing. Until the First World War, retractors based on guillotine-like flap-prioritized incisions were used and allowed for more rapid surgeries. The development of antibiotics led to widespread use of amputation surgery flap applications, the development of surgical techniques and external surgical instruments. However, with the scientific advances after the Second World War, retractors were designed to offer both bone incision and flap incision prioritized surgery. In our study, we aimed to determine the development of amputation retractors in the 19th century and presented suggestions for the design of new retractors to the literature. For new retractors to be developed, the basic features recommended were those that:Protect the vessels of the flap while retracting the flap.Do not to interfere with the surgeon during bone incision.Offer ease of use with one person. Can be restabilized.Do not damage surgical sterile gloves.Have a large surface area.Hemostatic.
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