In Silico and In Vitro Studies of Novel Azomethines on DNA Repair Genes in Gastric Cell Lines.

We herein report the determination of the cytotoxic activity and expression profiles of some DNA repair genes of newly synthesized azomethines in the gastric cancer cell line (AGS). The studied novel compounds were synthesized by a condensation reaction and received compounds were characterized by 1H and 13C NMR spectroscopy methods. Furthermore, they were applied to the AGS cell line at eight different concentrations (0.1-50 µg/mL). Anticancer activities were determined using the MTT method. Expression levels of ATR, ERCC1, TOP2A, and ABCB1 genes were determined by the RT-PCR method. Biochemical parameters were also examined. The interaction of proteins with other proteins was investigated with the String v11 program. The IC50 values of compounds 1, 2, and 3 obtained after 72 h were 23.10, 8.93, and 1.58 µg/mL, respectively. The results demonstrate that the cytotoxic activity of compound 3 on AGS cancer cells is higher in comparison with other molecules. It was determined that the expression levels of ATR, TOP2A, and ABCB1 genes in compounds 1, 2, and 3 were decreased compared to the control group. In addition, it was determined that ERCC1 gene expression increased in compound 3, decreased in compound 2, and remained unchanged in compound 1 (p < 0.001). In AGS gastric cancer cells, a 64% decrease was detected for GST levels in compound 1, while a 38% decrease in GSH levels in compound 2. In addition, compounds 1-3 were examined at the molecular level with computational techniques and the docking studies revealed 4LN0 as a target protein.

Patella scores are similar both with gap balancing and measured resection after total knee arthroplasty: a randomized single-centre study.

PURPOSE: The purpose of this prospective study was to compare femoral component rotation (FCR) values when adjusted with 'gap balancing' (GB) and 'measured resection' (MR) techniques following total knee arthroplasty (TKA). The study hypothesis was that the GB technique would be better on FCR than MR in TKA. METHODS: From a total of 93 unilateral TKAs performed between August 2019 and November 2020, the FCR values were adjusted by GB in 46 cases and MR in 47. Post-TKA magnetic resonance imaging (MRI) was applied for FCR assessment. Orthoroentgenograms and lateral knee radiographs were taken to determine the mechanical axis and posterior condylar offset (PCO) ratio, respectively. Both groups were compared radiologically. The Western Ontario and Mcmaster Universities Osteoarthritis Index (WOMAC), Knee Society Score (KSS), and Hospital for Special Surgery (HSS) patella scores were calculated and compared between the groups preoperatively and at the end of 6 months, and 1 and 2 years postoperatively. RESULTS: There was no difference between the groups in respect of the demographic data. The mean HSS patella score was 86.4 ± 4.1 in the GB group and 84.6 ± 3.8 in the MR group in the 2nd year (p = 0.047). A higher degree of external rotation in the FC was determined in the GB group [2.2° (1.7°-4.3°)] compared to the MR group [1.7° (0.8°-3.0°)] (p = 0.009). The postoperative increase in PCO ratio was higher in the GB group (p = 0.005). All other variables were similar in both groups. CONCLUSION: The results of this study showed that at the end of the 2nd year, the HSS patella scores were better, FCs were more externally rotated and PCO ratios were higher in TKAs using the GB technique. However, taking into account that the difference between the 2nd year HSS patella scores was too small to be considered clinically significant, it was shown that both the GB and MR techniques can be used for FCR in clinical practice without any hesitation.

The effects of prolactin on the immune system, its relationship with the severity of COVID-19, and its potential immunomodulatory therapeutic effect.

Prolactin (PRL) is an endocrine hormone secreted by the anterior pituitary gland that has a variety of physiological effects, including milk production, immune system regulation, and anti-inflammatory effects. Elevated levels of PRL have been found in several viral infections, including 2019 coronavirus disease (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV2), a viral pathogen that has recently spread worldwide. PRL production is increased in SARS-CoV2 infection. While PRL can trigger the production of proinflammatory cytokines, it also has several anti-inflammatory effects that can reduce hyperinflammation. The exact mechanism of PRL's contribution to the severity of COVID-19 is unknown. The purpose of this review is to discuss the interaction between PRL and SARS-CoV2 infection and its possible association with the severity of COVID-19.

The Effect of Systemic Tranexamic Acid on Blood Loss and Blood Transfusion Requirement in Elective Total Hip Arthroplasty.

BACKGROUND: Although total hip arthroplasty (THA) is one of the most successful surgical procedures of the last century, high rates of bleeding and allogeneic blood transfusion may be required. Tranexamic acid (TXA) is an antifibrinolytic agent that has been increasingly used in THA in recent years to reduce blood loss and the need for transfusion. In this study, the effect of two doses of TXA, which was administered intravenously (iv) before and after surgery in unilateral THA patients, on total blood loss and blood transfusion need was compared retrospectively. MATERIAL AND METHODS: A total of 327 patients who underwent elective THA at our department between January 2011 and January 2020 were identified. Demographic data, blood parameters before and after surgery and complications seen during a 90-day follow-up period were recorded from patient files. Total blood loss amounts were calculated according to Nadler's formula. The amount of transfused blood was recorded. 127 patients treated with IV TXA and 119 patients not given TXA were assigned to separate groups and compared. RESULTS: Total mean blood loss, decrease in hemoglobin levels and amount of blood transfusion were lower in the TXA group compared to the control group (p=0.001; p=0.001; p=0.001, respectively). The length of stay hospital was shorter in the TXA group than the control group (p=0.001). CONCLUSION: We think that it is an effective and reliable method in THA since giving IV TXA twice, as 15 mg / kg preoperatively and 10 mg / kg after the operation significantly reduces blood loss and the need for blood transfusion without causing an increase in thromboembolic complications.

Role of annexin A3 in breast cancer (Review).

Annexins are a large group of proteins occurring in numerous cell types. Annexins have roles in events such as coagulation inhibition, endocytosis, exocytosis, signal transduction, proliferation and programmed cell death. The association of annexins with numerous diseases has been reported. There are 12 annexin proteins in total and the association of annexin A3 (ANXA3) with numerous malignant tumor types, such as breast cancer, prostate cancer, lung cancer, stomach cancer and colon cancer, has been reported. Studies investigating the relationship between ANXA3 and breast cancer were analyzed in the present review and it was observed that ANXA3 is expressed at higher levels in breast cancer cells. Furthermore, high ANXA3 levels are a poor prognostic factor, increase the invasion ability of breast cancer cells and may be a novel therapeutic target.

Comparison of Cases with Anterior Cruciate Ligament Reconstruction Accompanied by Simultaneous Medial Meniscus Bucket Handle Tear Repair and Isolated Medial Meniscus Bucket Handle Tear Repair.

The aim of this study was to evaluate the success of the all-inside repair technique for medial bucket-handle meniscus tear (BHMT) and the factors affecting healing. A total of 36 patients with BHMT who were operated between 2012 and 2018 and completed final follow-up examinations were included in the study. Functional evaluation was made with the International Knee Documentation Committee (IKDC) score, Lysholm score, and Tegner score. Healing was evaluated on magnetic resonance imaging (MRI) slices. The patients were evaluated with respect to the effect on healing of factors such as demographic data, body mass index (BMI), smoking status, anterior cruciate ligament tear reconstruction (ACLTR) applied at the same time as BHMT repair, and the tear being chronic or acute. The mean age of the patients was 28.6 ± 8.6 years (range,18-46 years), the mean follow-up period was 25.8 ± 13.9 months (range, 13-59 months), and BMI was mean 25.6 ± 3.5 kg/m2 (range, 20.1-30.5 kg/m2). The meniscus tears were acute in 16 (44.4%) patients and chronic in 20 (55.6%). ACLTR was applied together with BHMT repair in 25 patients. The hybrid technique, as the outside-in technique in addition to the all-inside technique, was applied to 12 (33.3%) patients, where there was seen to be extension to the anterior horn. The failure rate was determined as 27.8% according to the postoperative MRI evaluation and the Barrett criteria. No positive or negative statistically significant effect on healing was determined of chronic BHMT or of simultaneous application of ACLTR (p = 1.00 and 0.457, respectively). Cigarette smoking and high BMI were determined to have a statistically significant negative effect on healing (p = 0.026 and 0.007, respectively). In conclusion, it can be seen that the success of the all-inside technique for BHMT remains controversial. Due to the features of the application, it can be used in meniscus tears of the posterior horn only. In the current study, with the success rate of 72.2% of the all-inside technique in meniscus body tears, it was seen that a high success rate could not be achieved.

Tranexamic acid use in simultaneous bilateral total knee arthroplasty : a comparison of intravenous and intra-articular applications, which is more effective?

Patients applied with simultaneous bilateral total knee arthroplasty (SBTKA) with the administration of intravenous or intra-articular tranexamic acid (TXA) were compared in respect of blood loss and the need for allogenic blood transfusion. Of a total 53 patients applied with SBTKA, 32(60%) were administered intravenous TXA and 21(40%) intra-articular TXA. The patients were evaluated in respect of age, gender, height, weight, body mass index (BMI), body blood volume, preoperative and 1,2,3 and 4 days postoperative levels of hemoglobin (Hb) and hematocrit (Htc) and the change in Hb levels, estimated blood loss, mean actual blood loss, the need for allogenic blood transfusion (ABT) and the use or not of a drain. No difference was determined between the intravenous and intra-articular groups in respect of mean age, gender, height, weight, and body blood volume. No difference was determined between the groups in preoperative and postoperative mean Hb and Hct values, the reduction in mean Hb postoperatively, estimated blood loss, or the need for ABT. No deep vein thrombosis or pulmonary embolism was determined in any patient. In the application of SBTKA, TXA can be safely administered by the intravenous or intra-articular route to reduce the need for ABT. The results of this study determined no difference in efficacy between the routes of application. For patients with a risk of intravenous use, intra-articular application can be preferred.

Two-stage Reimplantation in Infected Total Knee Arthroplasty by Using Resterilized Femoral and Tibial Components with a New Polyethylene Insert: Report of 4 Cases with at Least 15 Years' Follow-up.

BACKGROUND:  This study evaluates 15 years' results of the implantation of autoclaved femoral and tibial prosthesis components together with a new same brand polyethylene insert which were used as a temporary articulating spacer in patients with periprosthetic infection of total knee arthroplasty (TKA) in a two-stage reimplantation procedure in 6 patients.  Material and methods. The femoral and tibial prostheses of 6 patients with deep chronic periprosthetic infection of TKA who underwent elective two-stage exchange arthroplasty were autoclaved and reinserted with a new polyethylene insert of the same brand and bone cement mixed with tecoplanin in 2004. RESULTS: Four patients were followed for 15 years. They were all female and between 47-70 years old. The infectious agent was meticillin-resistant Staphylococcus aureus (MRSA) in 3 and coagulase negative Staphy-lococcus in one patient. Patients were invited for second stage reimplantation, but they refused to undergo the second stage. Three of them had their second stage reimplantation after 15, 13 and 10 years while one patient was reinfected after 5 years, in 2009, and arthrodesis was performed. They were all happy with the result and infection free at last follow-up.  Conclusions. 1. Regarding the results of our patients, reinsertion of autoclaved femoral and tibial prostheses together with a new same brand polyethylene insert with teicoplanin loaded bone cement can be used cautiously in the management of periprosthetic deep infection of TKA. 2. That is because patients might not want the second stage reimplantation. 3. We believe that the refusal of patients to undergo the surgery shows that the single-stage treatment is effective.

Locking compression plate fixation versus intramedullary nailing of humeral shaft fractures: which one is better? A single-centre prospective randomized study.

PURPOSE: To compare the radiological and clinical outcomes of interlocking nail (ILN) and locking plate fixation (LCP) for humeral shaft fractures. METHODS: A total of 63 patients with displaced humeral shaft fractures between October 2014 and January 2017 were evaluated prospectively. They were divided randomly into two as LCP fixation (group 1) and interlocking nail (ILN) (group 2). Functional outcomes were evaluated using the Disabilities of the Arm, Shoulder, and Hand (DASH), American Shoulder and Elbow Surgeons (ASES), the University of California at Los Angeles (UCLA) shoulder scores, and Short Form-36 (SF-36) questionnaires, and pain was assessed with visual analogue scale (VAS). RESULTS: After fracture callus was radiologically observed, DASH, ASES, and UCLA scores as well as SF-36 questionnaires and VAS results were noted to have no significant difference between the two groups (p = 0.109, p = 0.082, p = 0.146, p = 0.322, and p = 0.175, respectively). At the last follow-up (post-operative 24 months), the UCLA score was significantly better in group 1 (p = 0.034), whereas VAS result was significantly worse in group 2 (p = 0.017). DASH, ASES scores, and SF-36 questionnaires had no difference (p = 0.193, p = 0.088, p = 0.289). Other parameters revealed no significant differences. Fracture consolidation was observed at a mean of four months in both groups (3 to 7 months in group 1 and 3 to 8 months in group 2) (p = 0.189). Four patients in group 1 and five patients in group 2 underwent surgery for nonunion (p = 0.725). Post-operative radial nerve palsy was seen in one patient in group 2. Two patients in group 1 with superficial infection were treated with antibiotics, and they recovered. CONCLUSIONS: Regarding our results, the LCP group had significantly better shoulder function than the ILN group, whereas the ILN group had significantly less pain, with similar complication rates. Therefore, both procedures are favourable surgical options for patients with humeral shaft fractures.

An evaluation of the results of locked plate osteosynthesis applied without the use of bone graft in Sanders type III and IV intra-articular calcaneus fractures.

PURPOSE: The clinical and radiological results of locked plate osteosynthesis with an extensive lateral approach without bone graft in Sanders type III and IV intra-articular calcaneus fractures and the factors affecting these results were evaluated retrospectively. METHODS: A total of 61 patients with Sanders type 3 and 4 calcaneus fractures who underwent a lateral approach with locked plate osteosynthesis were included in the study. The mean follow-up was 44.8 months. RESULTS: The mean pre- and post-operative Gissane and Bohler's angles were 113.5° ± 13.9° and 106.7° ± 13.6° (p = 0.006) and 2.8° ± 14.1° and 19.6° ± 13.1° (p < 0.001), respectively. The mean post-operative AOFAS scores, SF-36, and Maryland were 80.5 ± 13.6 in type IIIAB, 89.4 ± 6.3 in IIIAC, and 82.4 ± 12.5 in IV; 58.6 ± 14.5 in type IIIAB, 60.3 ± 11.7 in IIIAC, and 58.0 ± 15.6 in IV; and 63.8 ± 7.2 in type IIIAB, 64.3 ± 7.1 in IIIAC, and 62.8 ± 11.7 in IV (p = 0.173, p = 0.932, p = 0.824, respectively). Wound problems were observed in 15 (28.6%) patients. Deep infection was not observed in any patient. CONCLUSION: The clinical results were similar in type III and IV intra-articular calcaneus fractures applied with locked plate osteosynthesis in an extensive lateral approach and without the use of bone graft. Intra-articular calcaneus fracture fixation with a lateral locked plate is an effective treatment method.

Interpositional Arthroplasty With Extensor Digitorum Brevis Tendon in Freiberg Disease.

BACKGROUND: No consensus has been reached in the treatment of Frieberg disease. Our aim was to evaluate medium- to long-term results of patients with advanced Freiberg disease managed with extensor digitorum brevis tendon interpositional arthroplasty. METHODS: There were 24 patients (19 females, 5 males) managed with interpositional arthroplasty for advanced Freiberg disease between 2003 and 2015. The mean follow-up was 133.8 (range, 60-198) months. According to Smillie classification, there were 4 grade 3, 13 grade 4, and 7 grade 5 patients. Patients were evaluated preoperatively and at the final follow-up with the American Orthopaedic Foot & Ankle Society (AOFAS) score and metatarsophalangeal joint range of motion and postoperatively with visual analog scale (VAS) and subjective satisfaction evaluation. Joint space was evaluated on x-rays. RESULTS: Mean AOFAS score increased (53.9 to 80.3, P = .001). Eight patients had excellent, 14 had good, and 2 had fair scores. A significant increase was found in dorsiflexion (38.1° [24°-52°] vs 55.3° [34°-65°]; P = .001) and plantarflexion (19.0° [10°-28°] vs 28.6° [19°-39°]; P = .001). Narrowing of the joint space was not seen in any patient, but expansion was determined in all patients (0.39 [0.35-0.47] vs 0.44 [0.41-0.47] cm; P = .002). Of the patients, 9 were very satisfied, 12 were satisfied, 2 were moderately satisfied, and 1 was dissatisfied. The mean postoperative VAS pain score was 1.7 ± 0.9 (0-4). CONCLUSION: After a minimum 5-year follow-up, most patients with Freiberg disease managed with interpositional arthroplasty using the extensor digitorum brevis tendon had excellent to good functional results with a widening of the joint space. LEVEL OF EVIDENCE: Level IV, retrospective case series.

Does Not Use of Closed Suction Drainage in Total Knee Arthroplasty with Tranexamic Acid Reduce Blood Loss?

BACKGROUND: The aim of this study was to compare outcomes in patients who received intravenous tranexamic acid just before and after total knee arthroplasty with or without drains and to analyze whether there is any difference in terms of blood loss. MATERIAL AND METHODS: This is a retrospective analysis of prospectively collected data of patients undergoing unilateral total knee arthroplasty. Between March 2017 and March 2019, 97 knees of 94 consecutive patients with osteoarthritis were divided into two groups (Group 1, with drain; and 2, without drain). Drainage group (53 knees; average age, 66,1±7,0 years; male, 10; female, 43) and a drainless group (44 knees; average age, 63,7± 7,5 years; male, 4; female, 40). All patients received systemic tranexamic acid (in 100 mL saline infusion iv in 30 minutes prior to the tourniquet inflation and 3 hours after the operation). Blood loss, allogeneic blood transfusion rates, complications such as swelling of the cruris, infection (deep or superficial), thromboembolic incidents (Deep venous thrombosis or pulmoner thromboembolism) and length of hospital stay were assessed postoperatively. RESULTS: There was no difference in demographic parameters, body mass index, side ofsurgery, ASA score and anesthesia type between 2 groups. The preoperative Hb levels were comparable but on the postoperative day one, Hb level was lower in the drain group (p=0,017). Total blood loss (TBL) and allogeneic transfusion rates were lower in the drainless group, although did not differ significantly between the two groups [TBL: 1360,9±502,5 / 646,1-2641,6 (1251,6) mL in the Group 1, 1205,6±505,0 / 396,6-2521,0 (1157,5) mL in Group 2 (p=0,134); Transfusion rates: 11 out of 53 cases (%20,8) in group 1 and 5 out of 44 cases (%11,4) in group 2]. The infection rate and length of hospital stay were lower in the drainless group. But there were no statistical difference was found in terms of complications and length of hospital stay between 2 groups. CONCLUSIONS: 1. Performing Total Knee Arthroplasty with preoperative and postoperative ivtranexamic acid and without drain decreased postoperative reduction in Hb level on the day after surgery in the current study. 2. But blood loss and blood transfusion rates when compared to patients with drain, no significant difference was found. 3. Drain use in knee replacements does not offer an advantage over drainless TKAs regarding the findings of our study. 4. Future studies with longer follow-up are needed in our opinion.

Joint line reestablishment in revision total knee arthroplasty.

BACKGROUND: In this study, the traditional "Anatomical Landmark-Distance Method (AL-DM)" in the formation of joint line (JL) was compared with "Adductor Tubercle-Ratios method" (AT-RM), and the effect of reestablishment of JL on clinical and functional outcomes were evaluated. MATERIALS AND METHODS: 16 revision total knee arthroplasties (rTKAs) were performed by using "AT-RM" (group 1) and 16 rTKA by using "AL-DM" (group 2) in our clinic between 2015 and 2018. The data were prospectively collected and a total of 32 knees of 31 patients were analyzed. At the final follow-up, knee functions were evaluated by using Knee Society Score (KSS) knee and function, Western Ontario and McMaster Universities Arthritis Index (WOMAC) scores, Short Form-36 (SF-36) questionnaires and physical examinations. RESULTS: Postoperative flexion arc was higher in Group 1. KSS knee and function scores were better in group 1. In group1, JL was reestablished successfully in all revision rTKAs in terms of ATJL and the tibial tubercle TT-JL ratios. The improvement in KSS knee and function scores and WOMAC scores were also better in group 1. Measurements showed that the improvement in KSS scores increased as AT-JL and TT-JL distances approached the calculated values. CONCLUSION: "AT-RM" was shown to be superior to the traditional distance method in terms of JL reestablishment. Functional results and patient satisfaction increased when JL was reestablished.

Tranexamic acid in total knee replacement which protocol? which application form? A prospective randomised study.

The aim of this study was to prospectively compare different delivery forms, doses and combined application forms of TXA for the reduction of blood loss and prevention of the allogeneic blood transfusion in patients with TKA and evaluate the results. The study included patients with knee joint osteoarthritis who were unresponsive to conservative management and 168 patients met the inclusion criteria. They were divided into 5 groups randomly as, Control (1), Local (2), Systemic+short infusion (3), Systemic+long infusion (4) and Systemic+oral TXA (5). When compared with the Control group, blood loss was significantly reduced in Groups 2, 3 and 4 (p=0.001, 0.001, 0.003) but not in Group 5. Twenty- four hour drainage output was lower in all treatment groups (p=0.001, 0.001, 0.001, 0.004). Although TXA groups had no difference in terms of blood loss, 24- hour drainage outputs of the local TXA group were less than Group 4 and 5 and it yielded similar amounts in comparison with group 3. It was determined that TXA use whether local or systemic gave rise to decreased blood loss and prevent allogeneic blood transfusion. But, regarding the results above, local TXA seemed to have favorable effects when compared with systemic+long infusion and systemic+oral TXA usage, whereas local use had similar results with systemic+short infusion. Additionally, there found no difference between systemic+short, systemic+long infusion and systemic+oral combined TXA usage with respect to blood loss, transfusion rates and drain follow-up. We recommend further prospective randomized controlled studies to make clear these differences. Systemic+oral combined TXA use have promising results when compared with other systemic multiple deliveries.

The Effect of Pentoxifylline and Hyperbaric Oxygen on Achilles Osteotendinous Junction Injury: An experimental animal model study.

BACKGROUND: To investigate the effects of hyperbaric oxygen (HBO) and pentoxifylline (PTX) treatment on osteotendinous junction healing of Achilles tendon in an animal model. MATERIALS AND METHODS: Thirty-six adult female Wistar-albino rats were randomly divided into three groups as control, PTX and HBO groups with a total of 12 rats per group. Under general anesthesia, the Achilles tendons were cut at the level of the osteotendinous junction and repaired. After the surgery, no treatment was given to the control group. Fifty mg/kg intraperitoneal PTX was administered to the PTX group daily for 1 week. The HBO group was exposed to 2,5 atmospheric pressure, 100% oxygen for 2 hours daily for 1 week. All animals were sacrificed at the end of sixth week. Biomechanical tests and histological examinations were performed. RESULTS: Energy absorption was significantly higher in the PTX group than that in the control group after biomechanical tests (p=0.010). Histopathological evaluation results revealed no difference between the groups: however, hyalinization level was relatively better in the HBO group than that in the control group (p=0.026). CONCLUSIONS: 1. We concluded that PTX has a positive effect on the treatment of osteotendinous junction injuries based on our results. 2. Although HBO therapy did not provide statistically significant differences, it might have some positive effects on these injuries. 3. Further experimental studies and clinical trials should be conducted.

Functional and radiological results of percutaneous K-wire aided Métaizeau technique in the treatment of displaced radial neck fractures in children.

OBJECTIVES: The aim of the present study was to determine the radiological and functional results and the efficiency of paediatric radial neck fracture fixation following reduction with the Métaizeau technique together with percutaneous K-wire applied under fluoroscopy to ensure minimum soft tissue damage. METHODS: The study included 20 patients with Judet Type 3, Type 4a and Type 4b fractures operated on with the Métaizeau technique aided by percutaneous K-wire between 2007 and 2014. The mean age of the patients was 9.75 years (range, 4-13 years). Mean preoperative angulation was measured as 52.4° (range, 35°-85°). The average postoperative follow-up time was 34.65 months (range, 13-84) months. Postoperative radiological evaluations were made according to the Ursei classification and functional assessment with the Tibone - Stoltz classification system. RESULTS: Radiologically, the difference between preoperative and postoperative radius head angulation was found statistically significant (p0.001). In the clinical assessment of injured and uninjured arms, there was no statistically significant difference between flexion-extension (p = 0.330) and supination-pronation range of motion (p = 0.330) and carrying angles (p = 0.094). According to the radiological Ursei evaluation, 17 (85%) patients were in perfect condition and 3 (15%) were good. In the classification of Tibone - Stoltz, 16 (80%) patients were evaluated as perfect, 3 (15%) as good and 1 (5%) as fair. CONCLUSION: From the results of this study and related literature, the use of the Métaizeau technique in displaced radial neck fractures requiring surgical treatment in children can be recommended since it creates minimum damage to the soft tissue, is easy to apply and the results are satisfactory. LEVEL OF EVIDENCE: Level IV, therapeutic study.

The Efficacy Of 1,2- Intercompartmental Supraretinacular Artery Pedicled Vascularised Bone Graft For Scaphoid Proximal End Non-Union And Avascular Necrosis.

The aim is to show the efficacy of 1,2-intercompartmental supraretinacular artery pedicled vascularised bone graft in treatment of scaphoid non-union with concomitant proximal end avascular necrosis retrospectively. Twentytwo cases of scaphoid nonunion with concomitant proximal end avascular necrosis were evaluated. Radiographic evaluation was made with radiographs, computed tomography, and magnetic resonance imaging. Clinical evaluation was made according to the Disabilities of the Arm, Shoulder and Hand (DASH) score, the Mayo wrist score, and the Short Form-36. Union was achieved in 18 81.8%. The mean age was 31.13 ± 5.29 years and the mean follow-up was 34.95±16.87 months. The median wrist flexionextension range was 123.5° (100°-144°) preoperatively and 128° (82°-146°) postoperatively. The median radial-ulnar deviation was measured as 41.5° (24°- 55°) preoperatively and 42° (24°-58°) postoperatively. The dominant hand was measured as 92% (p = 0.061) grip strength compared to the healthy side and the non-dominant side as 74% (p = 0.012). Improvement was observed in all patients in SF-36,DASH,Mayo score and in patients with union (p < 0.001). The radiological and clinical results of this study showed that 1,2- intercompartmental supraretinacular artery pedicled vascularised bone graft is an effective method in the treatment of scaphoid nonunion with concomitant proximal end avascular necrosis.

Simultaneous posterior dislocation of primary total knee arthroplasty with ipsilateral tibial shaft fracture: A case report and review of literature.

Dislocation following total knee arthroplasty (TKA) is a rare but serious complication. Here, a 74-year-old woman with posterior dislocation of her right cruciate-retaining TKA and ipsilateral tibia diaphysis fracture was presented. She only slipped down on the ground with a quick twist of her right leg. She underwent revision semiconstrained TKA and osteosynthesis of tibial fracture with plate and screw. Her partially avulsed patellar tendon was repaired as well. She was ambulatory with a cane and satisfied with revision operation at last control. Extensor mechanism and functional posterior cruciate ligament is especially important in patients receiving cruciate-retaining TKA. As far as we know, simultaneous dislocation of TKA with fracture of tibia diaphysis has never been reported before.