We report the outcomes of mechanical prophylaxis and chemoprophylaxis in patients who underwent elective surgery for idiopathic adolescent scoliosis (AIS). We retrospectively studied the patients who underwent posterior spinal instrumentation for AIS. The patients were divided into three groups: Group A low-molecular-weight heparin (LMWH) started at 8 hours after surgery; Group B LMWH started at 24 hr after surgery; Group C did not receive chemoprophylaxis. The data about wound oozing, need for transfusion, preoperative and postoperative hemoglobin level, length of stay in hospital, interval from the surgery to removal of closed suction drainage tube, postoperative blood loss from closed suction drain, deep venous thrombosis (DVT), and pulmonary embolism (PE) were investigated. The mean age and Lenke classification for all the groups were similar. No DVT or PE was detected in any group. The mean blood loss from the drain was higher in Group A (400 mL) and Group B (450 mL) when compared to Group C (150 mL) ( P = .001). There were more wound oozing in Groups A (5) and B (6) than in Group C (3) ( P = .585). Three patients in Group B, 3 patients in Group A, and no patient in Group C had superficial infections. However, there was no statistical difference between the groups ( P = .182). Postoperative hospital stay was significantly longer in Groups A (6 days) and B (6 days) then in Group C (5 days) ( P = .001). Our current study claims that chemoprophylaxis is not necessary for the patients without risk factors after AIS surgery. Early mobilization and mechanoprophylaxis represents adequate prophylaxis in addition to pain management and well hydration in patients’ routine treatment. The complications of chemoprophylaxis are not correlated to the initiation time of prophylaxis.

This was a unique and extensive study on shoulder pain mapping. The study concluded that pain mapping could be a useful adjunct to the clinical assessment of patients with shoulder pain and can be used in the primary care setting as well as secondary care and for research.

We report the case of a 76-year-old man of the Jehovah's Witness faith who had a giant abdominal aortoiliac aneurysm that was successfully operated on using an aortoiliac Y-graft bypass technique, without the use of stored allogenic blood. Cell saver technique and recombinant human erythropoietin (epoetin beta) were used during the perioperative period. The patient had good postoperative care with a multidisciplinary approach.

ÖZAmaç: Bu çalışmada medial malleol kırıklarında en çok kullanılan üç farklı tespit yöntemi olan gergi bandı tekniği, kısmi yivli kanüllü kompresyon vida ve tam yivli başsız kanüllü kompresyon vida yöntemleri karşılaştırıldı. Hastalar ve yöntemler:Çalışmaya medial malleol kırığı olan 90 hasta dahil edildi. Hastalar üç gruba ayrıldı. Grup A gergi bandı ile ameliyat edilen hastalar (n=26), grup B kısmen yivli kanüllü kompresyon vidalar (n=32) ve grup C başsız kanüllü kompresyon vidalar ile ameliyat edilen hastalar (n=32) olarak ayrıldı. Kırığın tipi, iyileşme oranları, implanta bağlı komplikasyonlar, enfeksiyon oranı, implant tahliyesi, yükten kısıtlamaları, yaralanmadan cerrahiye kadar olan süre ve hastaların vücut kütle indeksleri (VKİ) araştırıldı. Hastaların standart ön-arka, yan ve Mortis grafileri incelendi. AOFAS (American Orthopedic Foot and Ankle Society) skorlama sistemi klinik değerlendirme için kullanıldı. Bulgular: Üç grup arasında yaş, cinsiyet, VKİ, izleme periyodu ve kırık tipi açısından anlamlı bir fark gözlenmedi. Kaynama süresi grup C'de grup A ve B'ye oranla anlamlı olarak daha kısa idi. Grup C hastalarında implant başarısızlığı veya irritasyonu görülmedi ve bu durum grup A ve B ile kıyaslayınca istatistiksel olarak anlamlı idi (p= 0.037). Ancak bu konuda, grup A ve grup B arasında anlamlı bir fark yoktu (p= 0.41). AOFAS skorlamasına göre üç grup arasında anlamlı bir fark görülmedi. A ve B grubunda VKİ'si düşük olan hastalarda yüksek oranda implanta bağlı komplikasyon görüldü. Düşük VKİ ile implanta bağlı komplikasyon oranı arasında anlamlı ilişki bulundu (p<0.001).Sonuç: Kaynama süresinin tam yivli başsız kanüllü kompresyon vidası ile ameliyat edilen grupta diğer gruplara oranla anlamlı olarak daha kısa olduğu görüldü. Bu çalışma, gergi bandı yöntemi ve kısmi yivli kanüllü kompresyon vida ile medial malleol fiksasyonu yumuşak doku irritasyonuna ve implant bölgesinde ağrıya neden olabileceğini göstermiştir. Düşük VKİ'si olan hastalar implanta bağlı komplikasyonlara daha açıktır.Anahtar sözcükler: Ayak bileği kırığı; vücut kütle indeksi; başsız kanüllü kompresyon vidası; medial malleol kırığı; kısmı yivli kanüllü kompresyon vidası; gergi bandı. ABSTRACT Objectives:This study aims to compare the three most commonly used fixation techniques: tension-band wire fixation, partially threaded cannulated screws, and fully threaded cannulated headless compression screws. Patients and methods:Ninety patients with medial malleolus fractures were included in the study. Patients were divided into three groups. Group A included patients who underwent tension-band wire fixation (n=26), Group B partially threaded cannulated compression screws (n=32), and Group C fully threaded cannulated headless compression screws (n=32). The type of medial malleolus fracture, healing rates, implant-related complications, rate of infection, hardware removal, weight-bearing restrictions, mean interval time from the injury to the surgery, and Body Mass Indexes (BMIs) were investigated. The patients' radiographs (standard anterop...

Ipsilateral injury of more than one component of the knee extensor apparatus is rare. It is mostly associated with previous trauma, surgery, immunosuppression therapy and systemic disease. We present the first documented case of a spontaneous bifocal disruption of the knee extensor apparatus (i.e. floating patella) associated with lymphoedema. This case highlights the importance of considering lymphoedema as another risk factor for rupture of the knee extensor apparatus. It also highlights the importance of assessing all components of the knee extensor apparatus in patients presenting with acute knee injuries.

The role of the platelet-to-lymphocyte ratio and neutrophil-to-lymphocyte ratio in the prediction of length and cost of hospital stay in patients with infected diabetic foot ulcers: A retrospective comparative study

No abstract

No abstract