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1.
J Am Podiatr Med Assoc ; 110(1): Article3, 2020 Jan.
Article in English | MEDLINE | ID: mdl-29131653

ABSTRACT

BACKGROUND: Surgical or nonsurgical treatment of an Achilles tendon rupture includes a period of immobilization that is a well-documented risk factor for deep venous thrombosis (DVT). The DVT is a source of morbidity in orthopedic surgery because it can progress to pulmonary embolism. The aim of this study was to investigate the incidence of DVT and pulmonary embolism after surgical treatment of an Achilles tendon rupture. METHODS: A retrospective analysis was made of patients who underwent surgical treatment of Achilles tendon rupture between January 1, 2006, and November 30, 2014. Patient data were collected from the hospital medical record system. RESULTS: Of 238 patients with a mean age of 39 years (range, 18-66 years), 18 (7.6%) were diagnosed as having symptomatic DVT. The average body mass index of the patients with DVT was 31.8 (range, 24-33). Of the patients with DVT, 11 were older than 40 years and two-thirds had a body mass index of 30 or greater. Pulmonary embolism was diagnosed in four patients (1.7%), none of whom had DVT symptoms. CONCLUSIONS: Venous thrombosis continues to be a major cause of morbidity and mortality in postoperative patients. Limited data are available for the use of thromboprophylaxis in foot and ankle surgery. In light of the literature review and results of this study, we suggest that routine thromboembolism prophylaxis should be considered for patients with Achilles tendon rupture.


Subject(s)
Achilles Tendon/surgery , Antithrombins/therapeutic use , Postoperative Complications/epidemiology , Venous Thrombosis/epidemiology , Achilles Tendon/injuries , Adolescent , Adult , Aged , Female , Humans , Incidence , Male , Middle Aged , Orthopedic Procedures/adverse effects , Postoperative Complications/diagnostic imaging , Postoperative Complications/prevention & control , Pulmonary Embolism/diagnostic imaging , Pulmonary Embolism/epidemiology , Pulmonary Embolism/etiology , Retrospective Studies , Rupture , Tendon Injuries/surgery , Venous Thromboembolism/epidemiology , Venous Thrombosis/etiology , Venous Thrombosis/prevention & control , Young Adult
2.
Ulus Travma Acil Cerrahi Derg ; 24(5): 474-480, 2018 Sep.
Article in English | MEDLINE | ID: mdl-30394504

ABSTRACT

BACKGROUND: Forearm fractures constitute approximately 40% of all pediatric fractures. Generally, in conservative treatment,a plaster cast is applied with the elbow in 90° flexion. Success of the treatment depends on theprevention of the reduction in the correct position and suitable duration of the plaster cast. Failure, or the risk of angulation within the cast, is associated with movement within the cast. The aim of this study was to evaluate the applicability of the Cast Index (CI) and Three-Point Index (TPI) measurements, which indicate the loss of reduction, in pediatric mid-third forearm fractures. The hypothesis of the study was that as edema decreases and deformity of the plaster cast occurs after fracture reduction, TPI and CI should be examined during follow-up, as they indicate shifting due to movement within the plaster cast. METHODS: This retrospective study included a total of 48 patients, who were treated with closed reduction and long-arm plaster cast for a mid-third forearm diaphyseal fracture at our Emergency Polyclinic between March and September 2014. The mean age of the patients was 8.15±3.19 years (range, 5-14 years). Patients were excluded from the study if they had isolated radial or ulnar fracture, open fractures, concomitant fracture or systemic disease (bone metabolism disease, etc), and <10° fracture angulation in the ulna and radius on the initial radiograph and if they did not followup. TPI and CI values were calculated on anterioposterior (AP) and lateral radiographs in the Picture Archiving Communication Systems. RESULTS: In the AP plane, compared with TPI values after reduction, statistically significant increases were observed in TPI values 10 days after reduction (p<0.01). However, no significant difference was observed between those with and without reduction loss in TPI values in the AP plane (p>0.05). Although there was a statistically significant increase in TPI values 15 daysafter reduction compared with the values immediately after reduction, a significant difference between those with and without reduction loss was observed only on lateral TPI. CONCLUSION: In cases of pediatric forearm diaphyseal fracture, ulnar TPI examined in the lateral plane can be used in monitoring the fracture in a plaster cast applied after the reduction.


Subject(s)
Forearm Injuries , Fractures, Bone , Adolescent , Child , Forearm Injuries/diagnostic imaging , Forearm Injuries/surgery , Fractures, Bone/diagnostic imaging , Fractures, Bone/surgery , Humans , Radiography , Range of Motion, Articular , Retrospective Studies
3.
Eklem Hastalik Cerrahisi ; 28(3): 164-70, 2017 Dec.
Article in English | MEDLINE | ID: mdl-29125814

ABSTRACT

OBJECTIVES: This study aims to retrospectively evaluate and compare the mid-term clinical follow-up results of patients who were treated with open or closed reduction due to carpometacarpal (CMC) fracture dislocation. PATIENTS AND METHODS: Medical charts of 15 patients (1 male, 14 females; mean age 32.5±10.5 years; range 18 to 55 years) who were operated for fourth and fifth finger CMC fracture dislocations were examined. Patients were divided into two groups according to applied treatment as closed reduction and percutaneous pinning (CRPP, n=6) and open reduction and percutaneous pinning (ORPP, n=9). Patients were assessed by a hand therapist blinded to the treatment groups. Patients were compared in respect of visual analog scale (VAS), Quick Disabilities of the Arm, Shoulder and Hand (Q-DASH) scores, and grip strength. Complications were recorded. RESULTS: Mean VAS values of ORPP group and CRPP group were 2.33±0.50 and 1.67±0.52, respectively. Mean Q-DASH values of ORPP group and CRPP group were 13.63±3.21 and 9.05±2.36, respectively. Mean grip strength values of ORPP group and CRPP group were 65.78±3.70 and 75.17±6.11, respectively. Mean VAS and Q-DASH scores of ORPP group were statistically significantly higher compared to CRPP group. Mean grip strength value of CRPP group was statistically significantly higher compared to ORPP group. CONCLUSION: Treatment of fourth and fifth finger CMC fracture dislocations with CRPP results in statistically superior VAS, Q-DASH and grip strength values in the early post-injury period.


Subject(s)
Carpometacarpal Joints/injuries , Fracture Dislocation/therapy , Adolescent , Adult , Bone Wires , Carpometacarpal Joints/surgery , Closed Fracture Reduction , Disability Evaluation , Female , Hand Strength , Humans , Male , Middle Aged , Open Fracture Reduction , Retrospective Studies , Visual Analog Scale , Young Adult
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