Unstable distal radius fractures can be treated with closed reduction and cast application in low-demand elderly patients to avoid risks and complications of surgery.

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Osteosynthesis with an external fixator in elderly patients with a high anesthesia risk is a fast, minimally invasive procedure in the treatment of pertrochanteric fractures, resulting in fewer pre- and postoperative complications.

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The short-term results of middle-aged patients with severe developmental dysplasia of the hip treated with subtrochanteric femoral shortening and cementless large diameter metal-on-metal total hip arthroplasty were retrospectively evaluated. Clinical and radiological results of 15 hips of 13 patients with Crowe IV developmental dysplasia of the hip were enrolled in this study. The average follow-up period was 49 months (36-62 months). The average age of patients at the time of surgery was 45.5 years (range, 36-65 years). Radiographs were evaluated for component position, subsidence, loosening, and osteolysis. Intraoperatively, two patients had a small proximal femoral shaft split that was held with a cable wire. The average preoperative Harris hip score was 58; at 3 years, 82. Trendelenburg sign was negative in 11 hips at the last assessment. Loosening, subsidence, infection, dislocation, hypersensitivity and neurovascular complications were not observed. One hip had to be revised 1 year after surgery because of nonunion at the osteotomy site. Our study shows that large diameter metal-on-metal total hip arthroplasty, incorporating subtrochanteric femoral shortening, decreases dislocation rate and provides excellent results for the completely dislocated hip.

Achilles tendon xanthomas are rarely seen masses that are highly associated with hyperlipidemia. They are manifested in two types: Xanthomas developed secondary to familial hypercholesterolemia and cerebrotendinous xanthomatoses. In this report, we present a case of bilateral Achilles tendon xanthoma secondary to familial hypercholesterolemia and resection along with a portion of the Achilles tendon. The patient was a 49-year-old male who presented to our clinic with complaints of difficulty walking and swelling in both heels. The swellings had started insidiously without a trauma history. The xanthomas were operated at different time points, albeit with the same surgical technique. Quadriceps tendon graft and flexor hallucis longus transfer was used for autografting. Xanthoma should be considered in cases with swellings in the Achilles tendon. Total resection is necessary to avoid recurrence of the xanthomas. Large gaps formed after resection can be filled and reconstruction of the Achilles tendon can be realized using quadriceps tendon autografts (containing bony fragments) and the flexor hallucis longus tendon. We believe a functional ankle and an Achilles tendon can be achieved with the employment of this technique.

AMAÇBu çalışmada beşinci metakarp boyun kırıklarının konservatif tedavisinde sıklıkla uygulanan tespit yöntemle-rinden dördü değerlendirildi. GEREÇ VE YÖNTEM2008-2009 yılları arasında kliniğimize başvuran ve konservatif yöntemlerle tedavi edilen 60 hasta ileriye dönük olarak değerlendirildi. Uygulanan tespit yöntemleri; metakarpofalangeal (MF) eklemler ekstansiyonda iken distal interfalangeal (DIF) ekleme kadar uzanan sirküler alçı (Grup A), MF eklemler semifleksiyonda iken DIF ekleme kadar uzanan sirküler alçı (Grup B), el bileğinden DIF eklemin distaline kadar uzanan adeziv bandaj (Grup C) ve 4-5. MF, proksimal ve DIF eklemleri semifleksiyonda içi-ne alan "U"alçı ateli (Grup D) idi. Yerleştirme öncesi ve sonrası dönemde radyografilerle takip edilen hastaların açılanmaları ile metakarp uzunlukları ölçüldü. Hastaların eklem hareketleri ve kavrama güçleri karşılaştırmalı olarak ölçüldü ve istatistiksel değerlendirmede yapıldı. BULGULARElli iki hasta (yaş ortalaması 30) çalışmayı tamamladı. Tedavi öncesi arka-ön ve oblik radyografilerde sırasıyla; 17˚ (SD: 11), 46˚ (SD: 11,7) olan açılanması olan kırıklar, 4 hafta sonunda 5˚ (SD: 5,9), 27˚ (SD: 10,5) açılanmalı olarak kaynadı (p: 0,05). SONUÇBeşinci metakarp kırıklarının konservatif yöntemlerle tedavisinde uyguladığımız tespit yöntemleri arasında sonuç bakımından istatistiksel anlamlılıkta fark bulunamadı.Anahtar Sözcükler: Parmak yaralanmaları/metakarpal kırıklar/tedavi; metakarpofalangeal eklem/yaralanma; beşinci metakarp/boksör kırığı/ cerrahi dışı tedaviler.

Besides its topical advantages in the care of infected wounds, vacuum-assisted closure provides a more rapid and comfortable treatment opportunity, representing a reliable alternative to conventional wound care methods.