ObjectiveChondroblastoma is a benign aggressive tumor which needs surgical treatment and has a recurrence rate up to 35%. Extended (aggressive) curettage is the mainstay of treatment and local adjuvants have been reported to decrease the recurrence rate.MethodsThe recurrence rates and the functional results of 14 patients who were treated in our institution and 2 other patients who were treated elsewhere between the years 2004–2016 were evaluated. Seventeen cases (13 male, 3 female; mean age: 17.1 [range: 13 to 32] years) who had been diagnosed, treated and followed up in our hospital between 2004 and 2016 were evaluated in terms of recurrence rates and functional outcomes. The average follow-up period was 41.6 (range: 12 to 132) months.ResultsFive cases of recurrence were observed. Two cases had undergone their primary treatment in another institution. Seven cases were performed curettage alone whereas nine others were administered adjuvant treatments. One of the five recurrence patients was advised to undergo disarticulation. Another was treated with curettage and grafting and the remaining three patients with curettage and cementing. No recurrence was observed in their follow-up period. Their mean MSTS score was 27.3 (range: 4 to 30) over a maximum of 30 points and their functional results were good.ConclusionChondroblastoma is a tumor with high recurrence rates in the post-treatment period. However, good functional outcomes can be achieved with early diagnosis and appropriate treatment even after recurrence.Level of evidence: Level IV, therapeutic study.

Maternal diabetes mellitus, hypoxia, vitamin deficiencies, and anticonvulsant medication use have been associated with CS (9). Development of the spinal cord and organs of mesodermal origin is closely related to development of the vertebral column (1). As a result, CS is often associated with anomalies of the spinal cord, cardiovascular system, and genitourinary system (12). Previously, the incidences of intraspinal and other organ system pathologies associated with CS were reported █ INTRODUCTION C ongenital scoliosis (CS) is characterized by a spinal curvature secondary to congenital vertebral malformations. Deformity of the spine secondary to failure of normal vertebral development at 4-6 weeks of gestation is an accepted criterion (16). A multifactorial etiology of scoliosis is accepted (2,10,15). The genetic factors associated with CS remain largely unknown (8). However, environmental factors are proven to have a strong relationship with CS (1,8,9,14,23). AIM: To report the incidence and interrelationship of concomitant anomalies in congenital scoliosis (CS) patients. MATERIAL and METHODS: Whole-spine computed tomography and magnetic resonance imaging (MRI) examination, echocardiography, and renal ultrasonography (USG) evaluations of 231 patients with CS were reviewed. Additionally, intraspinal pathologies and structural cardiac and renal anomalies were recorded. RESULTS: The incidence of intraspinal pathology was 53.7%. Echocardiography was performed in 140 of 231 patients, and congenital heart disease was detected in 38 patients. Renal USG was performed in 133 of 231 patients, and a renal disease was detected in 37 patients. In 133 patients, spinal MRI, echocardiography, and renal USG were performed. In 22 of 67 (32.8%) patients with an intraspinal anomaly, an additional cardiac anomaly was detected. In 27 of 67 (40.3%) patients with an intraspinal anomaly, an additional renal anomaly was detected. In 47.3% of patients with a cardiac anomaly, an additional renal anomaly was detected. In 15 of 133 patients (11.2%) intraspinal, cardiac, and renal anomalies were identified. CONCLUSION: Surgeons should evaluate additional anomalies in CS if patients report having a congenital anomaly. Because cardiac and renal anomalies increase intra-and postoperative complication risks, a careful and comprehensive preoperative evaluation is needed.

Objective: This study was designed to define fracture lines and comminution zones in OTA/AO 23C3 distal radius fractures from axial computed tomography (CT) images that would influence surgical planning, development of new classifications, and possible implant designs. Methods: Thirty-four consecutive OTA/AO 23C3 fractures treated by a single surgeon between January 2014 and December 2014 were analyzed. For each fracture, maps of the fracture lines and zones of comminution were drawn. Each map was digitized and graphically superimposed to create a compilation of fracture lines and zones of comminution. Based on this compilation, major and minor fracture lines were identified and fracture patterns were defined. Results: All major fracture lines were distributed in the central region of the radius distal articular surface. There is a recurrent fracture pattern with a comminution zone including the scaphoid and lunate fossa; Lister's tubercle; and ulnar, volar, and radial zones. Conclusion: It is important for the practicing surgeon to understand these four main fragments. Knowledge of this constant pattern should influence the development of new classifications and possible implant designs.

THA for hips previously treated with SO is technically demanding. If careful preoperative planning is performed, successful treatment can be achieved.

Reconstruction of the lateral collateral ligament (LCL) and biceps femoris tendon following proximal fibula resection is controversial. Postoperative knee instability and peroneal nerve dysfunction affect outcome. This study aimed to determine functional, clinical, and radiological outcomes of patients who underwent en bloc proximal fibula resections and to compare clinical and radiological instability rates for primary repair after type I and type II resections. Materials and Methods: Eleven patients with primary tumors of the proximal fibula were included. Musculoskeletal Tumor Society (MSTS) score and Lysholm knee score were used in the evaluation of functional outcomes. Clinical outcome was assessed using knee range of motion and knee varus stress test. Radiological outcome was assessed using varus stress knee radiographs. Knee stability was evaluated using the varus stress test at 30 of knee flexion and varus stress knee radiographs and graded in millimeters. Results: Of the 11 tumors, 6 (54.6%) underwent type I resection. In five (45.4%) patients, type II resection was performed. The mean follow-up period was 32 + 13.9 months (range, 12-55 months; median, 27 months). The mean knee joint lateral opening, MSTS score, and Lysholm knee score with type I versus type II resection were 5.7 + 1.2 mm versus 6.4 + 1.1 mm (p ¼ 0.247), 28.7 + 1.8 (95.6%) versus 20.4 + 7.7 (68%) (p ¼ 0.011), and 92.2 + 8.8 versus 62.8 + 20.4 (p ¼ 0.026), respectively. Postoperative complications of all patients included one (9.1%) deep tissue infection and one (9.1%) long-term knee instability. In one patient (9.1%) who underwent type II resection, above-the-knee amputation was performed after local recurrence. Conclusions: Primary repair of the LCL and biceps femoris tendon to the surrounding soft tissues after resection of proximal fibular tumors provides good clinical outcomes. Primary repair is a simple technique to perform with minimal morbidity. Peroneal nerve palsy was a problem, especially in type II resections.

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Objectives: Achilles tendon lengthening (ATL) is one of the most commonly performed procedures in paediatric orthopaedic surgery. An appropriate adjustment of the amount of ATL is crucial to avoid insufficient or excessive lengthening. However, there is currently no effective method to preoperatively calculate the tendon length needed for equinus deformity correction. Thus, in this study we evaluated the accuracy of a calculation using a mathematical model based on the law of cosines. Methods: A total of 16 feet of 14 patients who were scheduled for ATL surgery due to equinus deformity were included in the study. ATL surgery was performed using a standard Z-plasty technique. Calculation of the amount of ATL using the law of cosines, and assessments of intraoperative lengthening of the tendon, were performed in a double-blind manner. The extent of lengthening resulting from the two methods was then compared. Results: The mean ATL determined intraoperatively was 23.67 ± 8.7 mm, and that obtained using the cosine-based method was 22.49 ± 8.6 mm. Thus, the new method showed excellent statistical agreement with the actual lengthening performed during surgery. Conclusions: The required dimension of ATL can be calculated preoperatively using the mathematical formula presented here. The advantages of this approach are that it allows accurate tendon lengthening and reduces the size of the surgical incision.

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