ObjectiveThe aim of this study was to compare midterm functional and radiographic results of minimal invasive plate osteosynthesis (MIPO) with intramedullary nailing (IMN) of simple intra-articular distal tibial fractures (AO-OTA type 43 C1-C2).MethodsSeventy-three simple intra-articular distal tibial fracture patients were evaluated retrospectively. All were treated between 2009 and 2014. The average age of the patients was 40.3 years. Thirty-seven patients were treated with IMN and 36 patients were treated with MIPO. Fibular plate osteosynthesis was applied in 5 cases (13.5%) in the IMN group and in 23 patients (63.9%) in the MIPO group.ResultsFunctional results and complications of IMN and MIPO methods were assessed in 73 patients. The average union time was 16.4 ± 2.7 weeks in the IMN group and 15.2 ± 1.8 weeks in the MIPO group (p = 0.079). The average Olerud-Molander Ankle Score was 87.8 ± 8.1 in the IMN group and 81.5 ± 11.8 in the MIPO group (p = 0.013). Four patients in the IMN group experienced valgus malunion, while it was not observed in any patients in the MIPO group (p = 0.042). Recurvatum malunion was detected in 10 patients in the MIPO group and not seen in the IMN group (p = 0.001). Ankle dorsiflexion angle was 25.8 ± 4.5° in the IMN group and 33.3 ± 8.9° in the MIPO group (p = 0.000).ConclusionSimple intra-articular distal tibial fractures are successfully treated with IMN and MIPO. Prevalence of valgus malunion was higher in the IMN group and recurvatum was more prevalent in the MIPO group. MIPO is the first preference according to the literature; however, successful results have been obtained with IMN in this fracture pattern.Level of EvidenceLevel III, Therapeutic Study.
Bu çalışmada diyabetik ayaklı hastalarda ve yeni tanı konulmuş tip 2 diabetes mellitus (DM)'lu hastalarda osteoprotegerin (OPG) ve 25-hidroksi D vitamini (25(OH)D) düzeyleri karşılaştırıldı ve diyabetik ayaklı hastalarda 25(OH)D eksikliğinin yaygınlığı ve şiddeti araştırıldı. Hastalar ve yöntemler: Bu ileriye dönük çalışma Haziran 2014 ve Mayıs 2015 tarihleri arasında hastanemize başvuran 58 diyabetik ayaklı hasta (42 erkek, 16 kadın; ort. yaş 63.6 yıl; dağılım, 31-90 yıl) ve 47 yeni tanı konulmuş tip 2 DM'li hasta (27 erkek, 20 kadın; ort. yaş 51.4 yıl; dağılım, 29-85 yıl) (kontrol grubu) olmak üzere 105 hasta üzerinde gerçekleştirildi. Her iki grupta 25(OH)D ve OPG serum düzeyleri ölçüldü ve karşılaştırıldı. Bulgular: Diyabetik ayak grubunda OPG düzeyleri kontrol grubundan anlamlı olarak daha yüksekti (p<0.05). Diyabetik ayak grubunda 25(OH)D düzeyleri kontrol grubundan anlamlı olarak daha düşüktü (p<0.05). Diyabetik ayaklı hastalarda OPG düzeyleri ve C-reaktif protein (CRP) ve kreatinin düzeyleri arasında pozitif ilişkiler vardı. Sonuç: Diyabetik ayaklı hastalarda yükselmiş OPG düzeyleri, OPG'nin CRP ve kreatinin ile pozitif ilişkisine bağlı olarak klinik durumun şiddetini gösterebilir. Diyabetik ayaklı hastaların çoğunluğunda ciddi 25(OH)D eksikliği tespit edildi. Diyabetik ayaklı hastalarda istenmeyen immünolojik değişiklikleri önlemek için D vitamini suplemantasyonu gerekli olabilir.
Tenosynovial giant cell tumor is a locally aggressive tumor arising from the synovia of the fibrous tissue surrounding the joints, tendon sheaths, mucosal bursas, and tendons. Although it is often to be observed at the hand, localized form is very rare in the knee joint. In this case report, we aimed to present a very rare case of a surgically treated intra-articular giant cell tenosynovial tumor arising from the hoffa's infrapatellar fat pad of a 19-year-old male patient, by reviewing the literature. The patient we have treated with marginal excision was asymptomatic at the 14th month in the controls and recurrence was not detected.
AIM: Surgical treatment options of dislocations of acromioclavicular joints vary. We aimed to evaluate the surgical and functional results of clavicle hook plate technique used in our patients suffered from acromioclavicular joint dislocation including Rockwood grade 3 and 5 injuries. METHODS:In this retrospective study, the records of 24 patients, operated with the same technique were evaluated. During data analysis, the characteristics were presented with descriptive statistics.RESULTS: There were 20 male and 4 female patients. Rockwood grade 3 and 5 injuries were seen in 11 and 13 patients, respectively, and all of them were treated by using clavicle hook plaque technique. The mean follow up time was 27.6 (6-50) months by using direct X ray graph. The functional results were evaluated using Constant-Murley scores.The plates were removed from a patient complicated with infection and another patient with movement limitation in the postoperative fi fth and third months, respectively. In addition, one of the plates was removed at the thirteenth month after one portion of the plate was broken. The rest of the patients were without any complaint. We demonstrated degenerative changes in the X-rays of four patients. Constant -Murley shoulder score was perfect in 20 (83.3%) patients and good in 4 (16.7%) patients. CONCLUSION:Clavicle hook plate technique used in the surgical management of acromioclavicular joint dislocations seems easy to apply and has favorite outcomes with a low incidence of obligatory removal.
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