SummaryPopliteal artery entrapment syndrome (PAES) is rare in young adults. Claudication of the young patient, which is often overlooked, is a very rare symptom for orthopedic surgeons. In elder patients, the physician might expect atherosclerotic claudication, however in young patients, popliteal artery entrapment syndrome (PAES) should be considered as a possibility in the cases of claudication. Here, an unusual presentation of an uncommon disease that is not widely known by orthopedic surgeons is reported.

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Introduction: Many orthopaedic procedures require drilling of bone, especially fracture repair cases. Bone drilling results in heat generation due to the friction between the bone and the drill bit. A high level heat generation kills bone cells. Bone cell death results in resorption of bone around bone screws. Materials and methods: Many points of view of orthopaedists and neurosurgeons based upon on previous practices and clinical experience are presented. Results: Several potential complications are discussed and highlighted that lead to thermal necrosis. Discussion: Even in the face of growing evidence as to the negative effects of heatinduction during drilling, simple and effective methods for monitoring and cooling in realtime are not in widespread usage today. For that purpose, we propose some suggestions for the future of bone drilling, taking note of recent advances in autonomous robotics, intelligent systems, and computer simulation techniques. Conclusions: These advances in prevention of thermal necrosis during bone drilling surgery are expected to reduce the risk of patient injury and costs for the health service.

Trevor's disease, also known as dysplasia epiphysealis hemimelica, is a rare nonhereditary skeletal development disorder that affects epiphyses. This type of dysplastic lesion was first reported by Mouchet and Berlot in 1926 under the name 'tarsomegaly'. The main aim of this study is to raise awareness of Trevor's disease among orthopedic surgeons and underline some important aspects of treatment by a detailed presentation of four different possible manifestations of the disease. Four different treatment methods were used on four different patients (three localized in hindfoot ankle region and one classic Trevor's disease case). Treatment methods, localization of the sides involved, different characteristics of entire lower extremity, asymetry, distal femoral lateral epiphysis involvement, and hip involvement were analyzed thoroughly and the results were compared with those found in the most recent literature. Of our four patients, three were localized (hind foot ankle) cases and one was a classic dysplasia epiphysealis hemimelica with hemimelic distribution of the entire lower extremity. We used arthroscopic resection, observation, excision, and temporary hemiepiphysiodesis treatment methods in each of our cases. Clinical follow-up results were reported to be between good and excellent. In sum, our opinion is that the treatment for this condition should be customized according to lesion localization and lesion size. Majority of cases with ankle involvement show good prognosis following excision. Observation is also an alternative in patients who refuse surgery. If an intra-articular lesion is present, the surgeon should perform an arthroscopy for assessment of lesion surface. If the lesion is adapted to the joint curvature, it should be left alone and hemiepiphysiodesis should be considered for correction. The most risky involvements that are related to deformities and limb-length discrepancies are the hip and the knee. This is usually the result of corrective osteotomy targeted at the supracondylar femoral area in immature skeletons. Hemiepiphysiodesis might be a more feasible option in those cases as it provides the surgeon with the choice to remove the staples when necessary.

Background. The aim of the study was to evaluate whether or not there was any incompatibility between four-strand hamstring tendons taken from the same knee and the dimensions of the ACL and PCL. Methods. 15 fresh frozen cadaver hamstrings were prepared as four-strand grafts and measurements made of the ACL and PCL circumferences in the midsection were made in the narrowest part of the midsection. The cross-section areas and diameters were calculated with geometric calculations used to measure the cross-sectional area of cylinders. Accepting that the geometric insertions were elliptical, the length, width, and area were calculated for entry areas. Results. A significant relationship at 96.2% was determined between the ACL mid and the hamstring diameter. A significant relationship at 96.7% was determined between the ACL and the hamstring mid area. A significant relationship at 96.4% was determined between the PCL mid and the hamstring diameter. A significant relationship at 95.7% was determined between the PCL and the hamstring mid area. Conclusion. For the reconstruction of ACL and PCL, it was determined that there is less incompatibility between the four-strand hamstring tendons taken from the same knee and the dimensions of the midsection PCL compared to the ACL dimensions.

ÖZAmaç: Bu yazıda, sıra dışı yerleşimli osteokondromlu yedi olgunun klinik, radyolojik ve takip sonuçları bildirildi ve bu sıra dışı yerleşimli osteokondromların nadir ve sıra dışı özelliklerinin önemi vurgulandı. Şubat 2009 -Mart 2014 tarihleri arasında kliniğimizde (Antalya Memorial Hastanesi) tedavi edilen sıra dışı yerleşimli yedi osteokondromlu hasta bildirildi. Hastalar yerleşim yerlerine, bulgularına ve nörovasküler tutulum veya organ basısı varlığına göre sınıflandırıldı. Sonuçlar, mevcut literatür verileri eşliğinde tartışıldı. Hastalarımızın beşinde sıra dışı semptomatoloji vardı. Yedi hastanın altısına cerrahi eksizyon yapıldı. Bir hasta yalnızca planlı poliklinik viziti ile takip edildi. Klinik sonuçlarımız iyi ila mükemmeldi. Olgu serimizde, klavikula tutulumlu bir hastada omuz mekaniğinin bozulmasına bağlı omuz ağrısı; pubik tutulumlu bir diğerinde tıkalı idrar yolu bulguları ve dizüri vardı. Skapula tutulumlu bir hastada yalancı kanat skapula semptomları; fibula başı tutulumlu iki hastanın birinde peroneal sinir sıkışması ve diğerinde tibial sinir sıkışması semptomları vardı. İskiyal ramus tutulumlu bir hastada siyatalji; kaburga tutulumlu bir diğerinde ise herhangi bir semptom olmaksızın osteokondroma bağlı subklavyen arter basısının radyolojik bulguları vardı. Deneyimlerimize göre, fetal dönemde genellikle intramembranöz tipi kemikleşme yoluyla oluşan yassı kemikler (skapula, iliyum, pubik ramus, iskiyum ramus, kaburgalar ve klavikula dahil olmak üzere) nadiren çok daha az etkilenir ve sıklıkla sıra dışı semptomlar ile birlikte seyreder. Fibula başı kaynaklı osteokondromlar, ortopedi cerrahlarına masum görünebilir. Ancak, ortopedi cerrahları bu hasta grubunda tibiofibular sinositoz ve sinir basısına karşı uyanık olmalıdır.Anahtar sözcükler: Kemik doku; kıkırdak; eksizyon; neoplazma; osteokondrom. ABSTRACTHerein, we report clinical, radiological, and follow-up results of seven cases of extraordinary located osteochondromas and highlight the importance of rare and unusual properties of unusual locations of osteochondromas. Seven patients with extraordinary located osteochondromas were treated in our institution (Antalya Memorial Hospital) between the period of February 2009 and March 2014 were reported. The patients were classified according to the localization, symptomatology, and the presence of neurovascular involvement or organ compression. The results were discussed with the existing literature data. Five of our patients had unusual symptomatology. Surgical excision was performed on six of seven patients. One patient was followed with scheduled outpatient visits alone. Our clinical followup results were good to excellent. In our case series, one patient with clavicular involvement had impaired shoulder mechanic which resulted in painful shoulder, while another with pubic ramus involvement had obstructive urination symptoms and dysuria. One patient with scapular involvement had snapping scapula symptoms, while two patients with fibular head involvement had peroneal nerve compression and tibial...

Dysplasia epiphysealis hemimelica is a rare non-hereditary epiphyseal disease that mimics synovial chondromatosis of the joints. The disease mainly targets long bones of the lower extremities and tarsal bones. We report one such case manifesting in the lateral tibia of a 13-year-old boy. He presented with a 7-month history of pain and a bony mass (3x4 cm) at the right ankle. The mass restricted ankle dorsiflexion over the lateral malleolar area. It was ossific with a lobulated appearance and reached the marrow with the underlying epiphysis and adjacent bones. The mass was excised completely from the epiphysis. The detached syndesmos was sutured anatomically.

Inferior shoulder dislocation also referred to as luxatio erecta is an unusual and rare type of shoulder dislocation. Its incidence is about 0.5% among all shoulder dislocations. After an exhaustive search of all the available literature we were unable to find a swimming accident case that did not have other associated injuries and an uneventful reduction. The mechanism of the injury was mostly related to direct axial loading and indirect hyperabduction lever arm. We would like to emphasize the importance of this being a swimming accident, a type of accident that requires awareness of the possibility of dangerous asphyxia injuries caused by panic in the water (swimming pool, river, lake, sea, etc.). We described the nature of the injury and review the literature concerning the mechanism of the injury and associated neurovascular impairment at admission time. We also presented a supplemental video to contribute to the education of young residents and orthopedic surgeons.