Objective: Low back pain is spreading both in older and younger people in a fast manner. Discogenic pain resulting from degeneration of the intervertebral disc is responsible for 40% or more of the cases of low back pain. We hypothesized that single one level intradiscal autologous platelet rich plasma (PRP) injection might provide remarkable pain relief and return to pre-illness activity level in the patients suffering from discogenic pain. Material and Methods: Twenty-two patients underwent injections of just one 3ml dose of PRP into one intervertebral disc space (single one level intradiscal autologous PRP injection) for discogenic pain. The patients were evaluated by visual analogue score (VAS) and Oswestry Disability Index (ODI) score before intradiscal PRP treatment and at six months after intradiscal PRP treatment. Results: The average pre-treatment VAS and ODI scores were 5.6±1.0 and 55.0% ± 11.6% respectively. The average VAS and ODI scores at six months after intradiscal PRP treatment were 1.3±1.0 and 23.2% ± 11.2% respectively and the differences were statistically significant (p<0.01). Conclusion: The present study demonstrates that single one level intradiscal PRP injection may provide remarkable pain relief and may increase the return to pre-illness activity level in the patients suffering from discogenic pain. For evaluation of the efficacy of this treatment, randomized placebo-controlled trials are needed. Amaç: Bel ağrısı hem genç hem de yaşlı nüfusta gittikçe artan bir oranda görülmektedir. İntervertebral disk dejenerasyonu neticesinde gelişen diskojenik ağrı, kronik bel ağrısı şikayetlerinin yaklaşık %40'ının sebebidir. Bizim bu çalışmadaki hipotezimiz diskojenik ağrı tedavisinde bir seviye tek sefer otolog intradiskal plateletten zengin plazma (PZP) uygulamasının hastaların fiziksel aktiviteye dönüşü ve ağrı üzerinde belirgin bir iyileşme sağlayabileceğidir. Gereç ve Yöntemler: Diskojenik ağrı tedavisi için 22 hastaya bir seviye tek sefer 3ml intradiskal otolog platelet zengin plazma (PZP) uygulaması yapıldı. Hastalar tedavi öncesi ve tedaviden 6 ay sonra vizüel analog skor (VAS) ve Oswestry disabilite index (ODI) ile değerlendirildi. Bulgular: Tedavi öncesi ortalama VAS ve ODI skorları sırası ile 5.6±1.0 ve %55.0 ± %11.6 idi. Tedaviden 6 ay sonra ortalama VAS ve ODI skorları sırası ile 1.3±1.0 ve %23.2 ± %11.2 idi ve fark istatistiksel olarak anlamlı bulundu (p<0.01). Sonuç: Çalışmamız kronik diskojenik ağrı hastalarında bir seviye tek sefer intradiskal PZP uygulamasının hastaların fiziksel aktiviteye dönüşü ve ağrı üzerinde belirgin bir iyileşme sağlayabileceğini göstermiştir. Intradiskal PZP tedavisnin etkinliğini daha derinlemesine araştırmak için randomize plasebo kontrollü çalışmalara ihtiyaç vardır.

Amaç: Ayak bileği ekleminin ve bu eklemi oluşturan kemik yüzeylerin morfolojik ölçümleri ayak bileği protez tasarımları için temel kılavuzdur. Çalışmamızın amacı Niğde bölgesinin sahip olduğu ayak bileği eklemi morfolojik ölçümlerini belirlemek ve ulusal ayak bileği protez tasarımları geliştirmeyi amaçlayan araştırmacılar için bir veri kaynağı oluşturmaktır. Gereç ve Yöntemler: Niğde Ömer Halisdemir Üniversitesi Tıp Fakültesi Hastanesi Ortopedi ve Travmatoloji polikliniğine 2 Ocak 2018-30 Haziran 2018 tarihleri arasında başvuran ve herhangi bir sebepten dolayı ayak bileği Manyetik Rezonans Görüntülemesi (MRG) çekilen hastalar geriye dönük olarak incelenmiştir. Bu görüntülerden ayak bileği boyut ölçümleri, ayak bileği en-boy oranları, distal tibia eğim ölçümleri ve komplikasyonla ilişkili anatomi ölçümleri ve 15 indekse ait değerlendirmeler yapılmıştır. Bulgular: Çalışmamızda 100 hastaya ait 100 MRG tetkiki üzerinde ölçümler tamamlanmıştır. Hastalardan 71'i kadın ve 29'u erkektir. Ortalama yaş tüm çalışma grubunda 43.75±14.80 (14-75), kadın cinsiyette 44.37±15.06 (14-75) ve erkek cinsiyette 42.24±14.28 (18-73) olarak bulunmuştur. Tibia ve talus boyut ölçüm parametreleri TiAL, MTiTh, SRTi, TiW, TaAL, TaW, MalW erkeklerde kadınlara nazaran anlamlı şekilde yüksek bulunmuştur. Ancak sırası ile tibia ve talus en-boy oranlarını ifade eden MTiTh/TiW ve TaAL/TaW parametreleri ve komplikasyon ile ilişkili anatomi ölçüm parametreleri APG, MDV, MDA ve MalW/TiW cinsiyetler arasında anlamlı farklılık göstermemiştir. Sonuç: Bu sonuçlar erkeklerde kadınlara nazaran daha büyük boy protez bileşenlerinin gerekebileceğini ancak tek tip protez tasarımının her iki cinsiyette de kullanılabileceğini göstermektedir. Objective: The modern designs of the total ankle prosthesis systems depend heavily on the available information on the morphology of the bones of the ankle joint. However, to our knowledge there is no study describing the characteristics of ankle morphometry in Turkish population. The aim of the present study was to determine the morphology of the ankle joint in healthy subjects in Niğde province of Turkey and to reveal a dataset for the innovation of the national total ankle prosthetic system designs. Material and Methods: We reviewed all ankle Magnetic Resonance Imaging (MRI) scans of the patients from the digital archive of our hospital from October 2, 2018 to June 30, 2018 to obtain 100 eligible ankle MRI scans. Fifteen indexes were measured and size diversity, aspect (anteroposterior/mediolateral) ratio, distal anteroposterior inclination angle, and complication-related anatomy of the ankle were determined. Results: MRI of 71 female and 29 male ankles were retrospectively analyzed. The mean age in the whole study group was 43.75±14.80 (14-75). The size parameters of the tibia and talus; TiAL, MTiTh, SRTi, TiW, TaAL, TaW, MalW were greater in male group than in female group significantly. However, aspect ratio parameters of the ankle MTiTh/TiW and TaAL/TaW and the complication related anatomy parameters APG, MDV, MDA and ...

Objectives. To identify the effect of treatment protocol on calcaneus bone mineral density of calceneal fractures treated with different methods. Methods. Sixty-three patients with intra-articular calcaneal fractures were observed prospectively. Patients were classified according to their treatment protocols such as; conservative treatment with short leg plaster cast (Group C), closed reduction and fixation with cannulated screws (Group S) and open reduction internal fixation with plate and screws (Group P). All patients' bilateral radiographies, CT scans, the American Orthopaedic Foot and Ankle Society (AOFAS) scores and calcaneus bone mineral density measurements by G&E Archilles Quantitative Ultrasound method were obtained at 15th month of follow up period. Results. Fourteen (22%) patients were female and 49 (88%) were male. The mean age was 43.7±12.1 years. The mean follow-up was 33.7±14.7 months. Bone mineral density measurements were calculated as; t scores; -1.48±1.24 for group C, -1.48±1.31 for group S, -0.27±1.68 for group P and z scores; -0.18±1.41 for group C, -0.17±1.9 for group S, 0.96 ± 1.54 for group P. Group P had the higher t and z scores of injured sides than other groups (p=0.008 and p=0.026, respectively). Average AOFAS scores were 78.13±13.04 in group S, 82.58±10.81 in group P and 79.82±11.75 in group C. No significant differences were detected between groups regarding AOFAS scores. Conclusion. Measurement of calcaneus bone mineral density which we used in our study is a method for evaluation of calcaneal fracture treatments and higher density values were found in open reduction and internal fixation group. This may be owing to better control of defect with the allograft and early mobilization by the evident improvement in angular correction..Eur Res J 2016;2(2):116-120

Objective: Recently, an innovative intramedullary device was introduced for the fixation of the capital fragment in the distal metatarsal chevron osteotomy. The aim of the present study was to compare the outcomes of locking plate and intramedullary device fixation in the distal metatarsal chevron osteotomy in the surgical treatment of hallux valgus. Material and Methods: We reviewed 29 patients (29 feet) treated with distal metatarsal chevron osteotomies fixated by locking plate or intramedullary device for hallux valgus. Locking plate fixation were used for 14 patients (14 feet) and intramedullary device fixation were used for 15 patients (15 feet). Results: The mean follow-up period was 31 (6-56) months. The locking plate and intramedullary device groups did not differ significantly with respect to age, affected side, surgical time, duration of hospital stay, followup period or postoperative American Orthopedic Foot and Ankle Society scores (p>0.05). The hallux valgus angle and the intermetatarsal angle decreased significantly in both the locking plate and the intramedullary device groups (p<0.01). Two patients (14.3%) in the locking plate group and 5 patients (33.3%) in the intramedullary device group had implant removal surgery because of implant irritation but the difference in implant removal rates were not statistically significant. Conclusion: We found both locking plate and intramedullary device fixation methods were effective in the fixation of distal metatarsal chevron osteotomy for correction of moderate hallux valgus. However, both locking plate and intramedullary device fixation methods were associated with a relatively high implant removal rate.