RESUMO
Background Chainsaws cause injuries mostly on the upper extremities, then on the face and lower extremities. In the literature, there are many studies about hand and face injuries; however, articles about lower extremity injuries are limited. The aim of the study is to define injury patterns, treatments, and results of the cases that we have encountered in our hospital and to evaluate precautions after reviewing the literature. Methods Patients admitted to our hospital's Emergency Department with chainsaw-related lower extremity injuries between 2016 and 2021 are evaluated. Patients' demographic data, pathologies, treatments, length of stay in hospital, return to work time, and functional scores are calculated retrospectively. Results There were 39 male and two female patients, with a minimum follow-up of 12 months. Their mean age was 42.6 ± SD (16-62). Thirty-two patients (78.04%) had injuries on the left lower extremity, and nine patients (21.9%) had injuries on the right lower extremity. 93.75% (30/32) of the patients with left lower extremity injuries had the right hand as the dominant extremity. The most frequently observed injury pattern was extensor hallucis longus (EHL) tendon disruption, with a percentage of 58.5% (24/41). 29.2% (13/41) of the cases had bone pathologies present as well. Patients' average AOFAS score was 97.4 ± 4.4 (74-100) at the end of one year. The average hospitalization length of stay was 2.95 ± 2.7 (0-15) days, and the time interval of return to work was 6.17 ± 1.4 (2-15) weeks, excluding one patient who had to change his workplace. Conclusion Saw-related injuries of the lower extremities are the injuries that can be seen mostly in male patients. Among the right dominant-handed patients, left foot dorsum injuries were the most common EHL tendon disruptions observed. We have seen that the reason for this is foot injuries remaining in the projection of the saw due to incorrect positioning of the foot. Protective gear and shoes must be used as precautions. More preventive measures could be taken while using chainsaws and similar tools, as they may cause serious injuries. Requirements for the use and sale of this tool should be introduced, and training should be given as it can be easily purchased by the public.
RESUMO
BACKGROUND: Within this study, we aimed to investigate the radiological and functional outcomes of acetabular fractures involving quadrilateral surface using 105° drill attachment in the anterior intrapelvic approach. METHODS: The 35 patients who underwent surgical treatment from January 2016 and January 2020 for acetabular fractures involving quadrilateral surface with anterior intrapelvic approach using 105° drill attachment and a minimum of 12 months of postoperative follow-up were included. Perioperative complications, operation duration, and the quality of reduction were evaluated. Reduction quality was classified as poor, imperfect, and anatomic. Functional evaluation was performed according to the Harris Hip Score (HHS) and Merle d'Aubigne Score. RESULTS: Among 35 patients (median age 36 (21-80)), radiological results of the acetabular fixations were anatomic, imperfect, and poor in 28 (80%), 5 (14.3%), and 2 (5.7%) patients, respectively. Postoperative 1-year functional outcomes with Merle d'Aubigne scores and HHS were median 18 (10-18) and 90 (60-96), respectively. The clinical outcomes of the patients showed concordance with reduction quality. The median operation duration was 180 minutes (range 125-270). Iatrogenic neurovascular damage was not noted in any patients. DISCUSSION: Reduction and fixation of deep intrapelvic fractures are risky and difficult due to the narrow anatomy and adjacent crucial neurovascular structures. As the 105-degree drill application is safe and easy to intervene in, short surgery duration and satisfactory results with minimum complications can be obtained with a 105 angulated drill in the deep pelvic region.
