Evaluation of symphysis pubis and sacroiliac joint distances in skeletally immature patients: A computerized tomography study of 1020 individuals.

OBJECTIVE: The aim of this study was to create a reference about normal pubic symphysis and sacroiliac joint widths of children and adolescents. METHODS: A total of 1020 computerized tomography axial scans of patients without pelvic injury between 2 and 18 year-old were studied. The narrowest width of pubic symphysis and bilateral sacroiliac joints were measured. RESULTS: The average pubic symphyseal width at 2 years old boys was 6.35 ± 1.06 mm (4.88-9.13 mm). The average of right and left sacroiliac joints' widths at 2 years old boys was 4.56 ± 0.65 mm (3.59-6.07 mm) and 4.58 ± 0.66 mm (3.44-5.74 mm), respectively. The average pubic symphyseal width of 2 years old girls was 5.85 ± 1.14 mm (4.06-8.20 mm). The average of right and left sacroiliac joints' widths at 2 years old girls was found 4.36 ± 0.56 mm (3.50-5.37 mm) and 4.42 ± 0.59 mm (3.58-5.73 mm), respectively. The average pubic symphyseal width at 18 years old boys was found 3.68 ± 1.30 mm (1.90-5.79 mm). The average of right and left sacroiliac joints' widths at 18 years old boys was found 1.97 ± 0.21 mm (1.73-2.41 mm) and 2.04 ± 0.30 mm (1.70-2.65 mm), respectively. The average pubic symphyseal width at 18 years old girls was 3.92 ± 0.52 mm (2.97-4.76 mm). The average of right and left sacroiliac joints' widths at 18 years old girls was found 2.34 ± 0.40 mm (1.58-3.34 mm) and 2.33 ± 0.37 mm (1.58-3.10 mm), respectively. CONCLUSION: Our results suggest that one should be suspicious about pelvic injury if the width of pubic symphysis is over 10 mm and width of sacroiliac joint is over 8 mm especially in patients younger than 10 years-old. LEVEL OF EVIDENCE: Level III Diagnostic study.

Which factor is most important for occurrence of cutout complications in patients treated with proximal femoral nail antirotation? Retrospective analysis of 298 patients.

INTRODUCTION: Mechanical complications, such as cut-out of the head-neck fixation device, are the most common causes of morbidity after trochanteric femur fracture treatment. The causes of cut-out complications are well defined in patients who are treated with sliding hip screws and biaxial cephalomedullary nails but there are few reports about the patients who are treated with proximal femoral nail antirotation. AIM: The purpose of this study was to evaluate the most important factor about occurance of cutout complication and also to evaluate the risks of the combination of each possible factors. PATIENTS AND METHODS: Overally 298 patients were enrolled in the study. Medical records were reviewed for patients' age, fracture type, gender, anesthesia type and occurance of cut-out complication. Postoperatively taken radiographs were reviewed for tip-apex distance, obtained collo-diaphyseal angle, the quadrant of the helical blade and Ikuta reduction subgroup. The most important factor (s) and also predicted probability of cut-out complication was calculated for each combination of factors. RESULTS: Cut-out complication was observed in 14 patients (4.7 %). The most important factor about occurrence of the cut-out complication was found as varus reduction (p: 0.01), the second important factor was found as implantation of the helical blade in the improper quadrant (p: 0.02). Tip-apex distance was found as third important factor (p: 0.10). The predicted probability of cut-out complication was calculated as 45.6 % when whole of the four surgeon dependent factors were improperly obtained. CONCLUSION: Althought obtaining proper tip-apex distance is important to prevent cutout complication in these fractures, if the fracture is not reduced in varus position and helical blade is inserted in the proper quadrant, possibility of cut-out complication is very low even in the patients with high tip-apex distance.

[Clear cell mucoepidermoid carcinoma of the parotid gland: a case report]. / Parotis Bezinin Berrak Hücreli Mukoepidermoid Karsinomu: Olgu Sunumu.

Clear cell variant of mucoepidermoid carcinoma of the salivary glands is rare. A 55-year-old male patient with recently growing left parotid mass underwent superficial parotidectomy. Although the dominant component of the tumor was composed of clear cells, mucin containing cells were also present. Histochemically, alcian blue stain supported intracellular mucin positivity. Immunohistochemically, p63 was positive. Based on the morphological, histochemical and immunohistochemical findings, the case was diagnosed as mucoepidermoid carcinoma, clear cell variant.