ABSTRACT
OBJECTIVE: As diabetic patients live longer and there are more effective treatments available, the incidence of diabetes and its complications is increasing. The effects of oxidative stress and antioxidant processes on diabetes behavior, especially diabetic foot, are really direct. The goal of this research is to investigate the effects of oxidative stress and antioxidant mechanism on the outcome of amputation by examining the levels of 8-hydroxy-2'-deoxyguanosine (8-OHdG) and thiol/disulfide in the blood of patients diagnosed with diabetic foot. METHODS: The research consisted of 76 patients with type 2 diabetes with associated diabetic foot, ages 40-65 (51 men, 25 women). Patients with diabetic foot wounds and accompanying peripheral artery disease were not included in the study. After a mean follow-up of 9.6 months, 28 patients resulted in amputation. Between patients who required amputation and those who did not, the levels of 8-OHdG, native thiol, total thiol, disulfide, native thiol/total thiol ratio, disulfide/native thiol ratio, and disulfide/total thiol ratio were compared. Additionally, the age, sex, Wagner stage, and amputation outcome of these 2 patient groups were compared. RESULTS: The outcomes of amputation in diabetic foot patients were not related to the levels of native thiol, total thiol, disulfide, native thiol/total thiol ratio, disulfide/native thiol ratio, total thiol/disulfide ratio, or 8-OHdG (P > .05). However, patients with diabetic foot who were male, older, and at a more advanced Wagner stage had a higher rate of amputations (P < .05). CONCLUSION: Oxidative stress and antioxidant mechanism are effective on diabetes complications. However, since there are many factors affecting the outcome of amputation, they are not directly effective in terms of resulting amputation in patients with diabetic foot ulcer.
ABSTRACT
BACKGROUND: The coexistence of supracondylar humerus fracture and forearm fracture is a rare trauma (3-13%) and it is called floating elbow. The aim of this study is to clinically compare the treatment outcomes of the patients diagnosed with floating elbow who underwent surgical treatment and who were followed up forearm with immobilization with splint. MATERIALS AND METHODS: When scanned retrospectively, 60 patients who were treated with the diagnosis of floating elbow due to traumatic causes and followed up for at least 1 year were included in our study. Surgical treatment was performed on 42 patients for forearm fracture. Eighteen patients followed up with immobilization with a long arm splint. The results were evaluated according to the criteria modified by Templeton and Graham, in comparison with the patient's intact side. RESULTS: In the patients whose forearms were followed up conservatively, the mean age was 5.67 ± 2.25 years, and the mean follow-up period was 62.17 ± 45.91 months. In the patients who underwent surgery for the forearm, the mean age was 8.79 ± 2.01 years, and the mean follow-up was 47.14 ± 34.25 months. Eighteen patients whose forearms followed up conservatively, 12 had excellent and good clinical results and 6 had poor and moderate clinical results. Excellent and good clinical results in 27 patients who underwent surgical treatment for their forearms, moderate and poor clinical results obtained in 15 of them. There was no significant difference between the two groups (p = 0.357). CONCLUSIONS: In conclusion, satisfactory clinical and radiological outcomes can be obtained with immobilization of the forearm fracture with splint, if acceptable reduction can be provided for the forearm following fixation of the supracondylar humerus fracture with the K-wire for treatment of floating elbow injury.
