Comparison of Salter osteotomy and Tonnis lateral acetabuloplasty with simultaneous open reduction for the treatment of developmental dysplasia of the hip: midterm results.

The aim of this study was to compare the midterm clinical and radiological outcomes of the Salter osteotomy (SO) and Tonnis lateral acetabuloplasty (TLA) with concomitant open reduction for the treatment of developmental dysplasia of the hip. Twenty-five hips of 20 patients who underwent SO with open reduction and 26 hips of 23 patients who underwent TLA with open reduction were evaluated retrospectively. The average age of the patients at the time of the operation was 35.6 months in the SO and 36.6 months in the TLA group, without a statistically significant difference (P=0.836). The average follow-up times in the SO and TLA groups were 59.9 and 54.8 months, respectively (P=0.397). Preoperative (40.6° in the SO vs. 42.2° in the TLA, P=0.451) and last follow-up acetabular index (12° in the SO vs. 14° in the TLA, P=0.227) and center-edge angle measurements (30° in the SO vs. 26° in the TLA, P=0.069) did not show a statistically significant difference between the SO and TLA groups; however, early postoperative acetabular index improvement was better in the TLA group than in the SO group (21.2° in the SO vs. 17.2° in the TLA, P=0.014). According to the Severin grading system, both groups showed a similar number of good outcomes without a statistically significant difference (P=0.936). Clinical assessment on the basis of McKay's criteria showed similar good and excellent outcomes (P=0.936). Both osteotomy techniques showed similar satisfactory outcomes for the treatment of DDH in patients older than 18 months of age.

Comparison of splinting, splinting plus local steroid injection and open carpal tunnel release outcomes in idiopathic carpal tunnel syndrome.

The objective of this study was to compare the short- and long-term efficacies of splinting (S), splinting plus local steroid injection (SLSI), and open carpal tunnel release (OCTR) in mild or moderate idiopathic carpal tunnel syndrome (CTS). Patients with mild or moderate idiopathic CTS who experienced symptoms for over 6 months were included in the study. The patients were evaluated for the baseline and the third and sixth month scores after treatment. Follow-up criteria were ENMG parameters, Boston Questionnaire, and patient satisfaction. Fifty-seven hands completed the study. Twenty-three hands had been splinted for 3 months. Twenty-three hands were given a single steroid injection and splinted for 3 months, and 11 hands were operated. In the first 3 months, all treatment methods provided significant improvements in both clinical and EMG parameters in which OCTR had better outcomes on median sensorial nerve velocity at palm wrist segment. In the second 3 months, while the clinical and EMG parameters began to deteriorate in S and SLSI group, OCTR group continued to improve, and BQ functional capacity score of OCTR group was statistically better than that in conservative methods (P = 0.03). S and SLSI treatments improved clinical and EMG parameters comparable to OCTR in short term. However, these beneficial effects were transient in the sixth month follow-up and OCTR was superior to conservative treatments.

[Van Nes rotationplasty in two patients with congenital femoral deficiency]. / Dogustan femur yetersizliginde uygulanan Van Nes rotasyonplastisi: Iki olgu sunumu.

Congenital femoral deficiencies have a wide spectrum ranging from simple hypoplasia to complete femoral aplasia. They are often associated with congenital shortening of the tibia and fibular hemimelia. This anomaly has no known genetic transmission. There are two main treatment modalities for congenital femoral deficiency: prosthetic replacement surgery (Syme amputation or Van Nes rotationplasty followed by prosthetic fitting) and lengthening reconstruction surgery. In this report, we presented two patients (male, 26 years; girl, 7 years) with congenital femoral deficiency treated with Van Nes rotationplasty. In both cases, the treatment took 1.5 months, after which the patients were mobilized with prosthesis. No complications were encountered within a follow-up period of five years and 1.5 years, respectively. Rotationplasty enables an improved functional gait in patients with a very short femoral segment or Paley type 3 femoral deficiency.

[Simultaneous asymmetric bilateral traumatic hip dislocation: a case report]. / Asimetrik iki tarafli travmatik kalça çikigi: Olgu sunumu.

Asymmetric bilateral (one side anteriorly, the other posteriorly dislocated) traumatic hip dislocations are very rare. We present a 21-year-old male patient who had simultaneous anterior and posterior traumatic hip dislocations due to a car crash. He also suffered from a tarsometatarsal (Lisfranc's) fracture-dislocation. The patient underwent conservative treatment and was followed-up for 44 months. Final evaluations with Thompson and Epstein radiologic and clinical criteria showed an excellent result. To our knowledge, this is the first report of a case with asymmetric bilateral traumatic hip dislocations associated with Lisfranc's injury.

Hypercalcemia and Multiple Pathological Fractures in Chronic Lymphocytic Leukaemia: A Case Report.

Hypercalcemia is common in some lymphoproliferative disorders such as myeloma or T- cell leukaemialymphoma, but is rarely described in B-cell chronic lymphocytic leukaemia (CLL). A CLL patient who have been presented with multiple pathological fractures and widespread osteolytic lesions is reported. He was a 74 year old male with fractures of his bilateral humerus and radii and multiple osteolytic lesions of skull, fibula, femur and costals. On his admission to the hospital for the fractures he has been diagnosed as CLL. Hypercalcemia has also been documented. All the disorders that could be the reason of hypercalcemia have been ruled out. The open biopsy of bone marrow showed lymphocytic infiltration in which increased number of prolymphocytes are observed. Hypercalcemia arising in a patient with CLL may indicate a negative prognosis.