PurposeTo evaluate whether surgeons' experience affect inter- and intra-observer reliability among mostly used classification systems for femoral neck fractures.Material and methodsA power point presentation was prepared with 107 slides which were antero-posterior radiographs of each femoral neck fracture. Five residents, 5 orthopaedic surgeons and 5 senior orthopaedic surgeons reviewed this presentation and classified the fractures according to Garden, Pauwels and AO classifications. The order of the slides was changed and reviews were repeated after 3 months. Fleiss kappa and intraclass correlation coefficient values were calculated to evaluate inter and intra-observer reliability.ResultsGarden and AO classifications' inter-observer reliabilities were similar and higher than Pauwels classification. Among three experience groups, the inter-observer reliability for Garden classification was highest in senior surgeon group, the interobserver reliability for AO classification was highest in surgeon group, and interobserver reliability of Pauwels classification was highest in low experienced groups (residents and surgeons). Intra-observer reliability was highest for Garden and lowest for Pauwels classifications. Surgical experience was found to be not effective for intraobserver reliability.ConclusionBoth Garden and AO classifications were more reliable than Pauwels classification. Surgical experience was not significantly important on these three classification systems' evaluation.Level of Evidence: Level IV, Diagnostic study

Background: Angiolipomas are benign tumors usually seen in patients during their 2 nd and 3 rd decades. The subcutaneous region of the trunk, neck and extremities are the places where they generally settle. There is only one case report on angiolipoma in the knee joint that was resected by arthroscopic procedure in the English literature. Case Report: We present a case of a giant-size multilobular non-infiltrating angiolipoma, extending outside of the right knee joint and causing lateral patellar dislocation in a thirteen-year-old boy. A large encapsulated mass with fatty and soft-tissue components on magnetic resonance imaging was suggestive of a liposarcoma. However, the diagnosis after the tru-cut biopsy was angiolipoma. The Quadriceps angle was 25°. Complete resection of the tumoral mass and repair of the medial retinaculum were performed with open surgery. Patellofemoral alignment was provided by transferring the tibial tuberosity medially. One year after the surgery, there was no evidence of recurrence. Conclusion: Intra-articular angiolipomas are rarely seen masses in the knee joint. To our knowledge, this case report is the first to demonstrate that angiolipoma causes patellar dislocation.

Objective: To evaluate the demographic characteristics of paediatric pelvic fractures. Materials and Methods:Retrospective analysis of 26 patients who were hospitalized with the diagnosis of paediatric pelvic fracture between 2000 and 2010 was performed. Age, gender, hospitalization time, mechanism of injury, fracture type, associated injuries, haemoglobin level drop in the first 24 hours, management and blood transfusion requirement, injuries time (month) information were gathered from hospital records.Results: There were 16 male and 10 female patients. Average age was 10.5 (2-16). Average hospitalization time was 3.5 days (1-17). Average haemoglobin level drop in the first 24 hours was 1.51 (0.3-3.6) gr/dL. Mechanisms of the injuries were as following; 14 patients were struck by a car, 10 patients fell from height and 2 patients involved in a vehicle traffic accident. According to the classification of Torode and Zeig; there was 1 type 2, 22 type 3 and 3 type 4 injuries. Injuries' occurrence season were; 12 in spring, 7 in summer and 7 in autumn. All of the patients had been managed conservatively. Conclusion:These injuries are rarely seen in children. Their management can be mostly conservative and even with a simple and stable pelvic injury marked bleeding can occur.

Background This study aims to determine the change in functional capacity and quality of life in patients who underwent reverse shoulder arthroplasty (RSA) due to rotator cuff tear arthropathy (RCTA). Methodology A total of 89 patients who underwent RSA due to RCTA between 2016 and 2022 were included in the study, as examined by the senior author. The Constant-Murley Score (CMS) was used for functional assessment, whereas the Short Form-36 (SF-36) was used for quality-of-life evaluation. The assessment scores before and after the surgery were compared to the reference values of CMS and SF-36 scores, as determined by reference studies, based on age groups. The change in functional capacity and quality of life with RSA was calculated. In addition, the impact of age and body mass index (BMI) on the results was examined. Results No differences were found in demographic data except for BMI (p = 0.026). CMS did not reach the reference values of a normal shoulder during the 12-month postoperative period. However, a significant increase of 156% in comparison to the preoperative values was detected (p < 0.001). In the postoperative period, there was a statistically significant improvement in SF-36 scores compared to preoperative scores, except for social functioning (p = 0.099) and vitality (p = 0.255) (for all other parameters, p < 0.001). In patients under the age of 65 years, all parameters except for physical functioning, physical role, and social functioning statistically reached the reference values. A decrease in CMS scores was noted with an increase in BMI, and the negative correlation further increased in the postoperative period (preoperative: r = -0.274, 12-month postoperative: r = -0.476). Conclusions RSA performed for RCTA leads to an improvement in functional outcomes and quality of life. Although there was a considerable improvement after surgery for CMS compared to preoperatively, it was observed that normal shoulder reference values ​​could not be reached. For SF-36, it was observed that it reached normal shoulder reference values, especially in patients over 65 years of age.

PURPOSE OF THE STUDYPauwels classification system is widely used to classify the femoral neck fractures. Even its widely usage there are severals debates about its reliability. After the femoral neck fracture occured the lower extremity rotates externally and this external rotation deformity could lead to misevaluation of Pauwels angle at the initial radiographs. The purpose of our study is to investigate whether the reliability of Pauwels classification increases after reduction of femoral neck fractures. MATERIAL AND METHODSTwo power point presentation was prepared with 117 slides that include antero-posterior radiographs of each femoral neck fracture. The first one included preoperatively taken radiographs and the second one included early postoperatively taken radiographs. Eight observers evaluated these radiographs and they classified the fractures according to Pauwels classification system. After 3 months, the order of the slides were changed for each presentation and the observers were asked to evaluate the radiographs again. Intraclass correlation coefficient values were calculated for evaluation of inter-and intra-observer reliability. RESULTSThe mean intra-observer agreement of preoperative evaluation was 0.406 (0.071-0.626) and the interobserver agreements were 0.263 (0.197-0.342) and 0.359 (0.287-0.447), respectively. The intra-observer agreement of postoperative evaluation was 0.508 (0.393-0.757), inter-observer agreements were 0.427 (0.353-0.509) and 0.431 (0.356-0.513), respectively. According to preoperative and postoperative evaluations, 6 of 8 observers' intra-observer agreements were found to be increased and the remaining 2 decreased. Interobserver reliability was improved from poor to fair-good values after evaluating the reducted fracture radiographs. DISCUSSIONFemoral neck fractures(FNF) are common and anatomical reduction and internal fixation are preferred as a treatment option in young people and patients have good bone quality. Pauwels classification system is used for classify the FNF based on the shearing angle of the fracture line. As this angle increases, the fracture becomes unstable and nowadays stronger fixation devices are preferred for unstable fractures. Therefore, misevaluation of the fracture can lead to wrong treatment method selection. Non-optimal X-rays taken in the emergency rooms may cause misinterpretation of femoral neck fractures according to Pauwels classification system. We hypothized that the reliability of this classification system could be improved after reduction of the fracture. CONCLUSIONSOur study showed that classifying the femoral neck fracture according to Pauwels classification system is more confidential after the reduction, however we can not state that it's reliability is adequate.

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Objective: Although various treatment options have been described for treating this injury, in our study common types of treatment methods for 132 Gartner Type III supracondylar humerus fractures were examined. Cross pinning and Lateral Pinning (Lateral Divergent or Dorgan's Lateral pinning) methods were included and fluoroscopy time, reduction time and pinning time were examined among other parameters. , we retrospectively included all children between 2 and 12 years of age who had surgery for Gartland type III supracondylar humerus fracture within 12 hours after the injury. From 132 patients, 68 patients were in cross-pinning group and 64 patients were in lateral pinning group which consisted of 31 patients in the divergent pinning and 34 patients in Dorgan's type pinning group. Minimum follow-up time was 6 months after surgery and operation time, fluoroscopy time, reduction time, pinning time, neurovascular status of the extremity before and after treatment, Flynn criteria and postoperative complications were evaluated among other parameters. Results: In both groups satisfactory results were obtained according to Flynn criteria. Application of lateral pinning techniques lasted statistically significantly longer to achieve final pinning configuration than cross-pinning group (p:0,007). Though not statistically significant fluoroscopy time and total surgery time were longer in the lateral pinning. In subgroup analysis there weren't any statistically difference in any compared parameter between lateral divergent pin placement and Dorgan's lateral pin placement. Two patients, who were treated with cross-pinning technique had ulnar palsy which completely resolved conservatively at fifth month postoperatively. Conclusion: It takes more attempt thus more time to achieve good configuration when lateral pinning methods are sellected to treat Gartland type 3 injuries. In the other hand iatrojenic ulnar nerve injury is a problem with cross pinning technique. ÖZAmaç: Bu yaralanma için çeşitli tedavi yöntemleri tanımlanmışsa da çalışmamızda 132 Gartner tip III kırık için sıklıkla kullanılan tedavi yöntemleri incelenmiştir. Çapraz telleme ve lateralden telleme (Lateral diverjan veya Dorgan metodu) yöntemleri dahil edilerek floroskopi süresi, redüksiyon süresi ve tel tespiti süresi birçok diğer parametreyle birlikte incelenmiştir. Yöntem: Ocak 2013'ten Ocak 2014'e kadar 2 ile 12 yaş arası Gartland tip III suprakondiler humerus kırığı sonrası 12 saat içinde cerrahi geçiren tüm hastalar çalışmaya alındı. Yüz otuz iki hastadan 68'i çapraz telleme grubundayken, 64 hasta lateralden telleme grubunu oluşturmaktaydı. Lateral telleme grubu 31 diverjan telleme grubu ile 34 Dorgan tipi telleme grubundan oluşmaktaydı. Cerrahi sonrası minimum takip süresi 6 ay olmakla beraber, ameliyat süresi, floroskopi süresi, redüksiyon süresi, tel tespit süresi, tedavi öncesi ve sonrası nörovasküler durum, Flynn kriterleri ve ameliyat sonrası komplikasyonlar diğer paramatrelerle beraber değerlendirildi. Bulgular: Her iki grupta da Flynn kriterlerine ...