The determination of acetabular parameters in a Turkish population sample: CT-based retrospective analysis of side and gender differences.

Determination of the acetabular morphology and orientation is important for the total hip arthroplasty applications. In general, preoperative planning for these patients is done on true hip X-rays in orthopedics clinics. But those evaluations may not represent the acetabular architecture in detail, because of 2 dimensional images. The aim of this study is to determine the acetabular morphology of a healthy Turkish adult population sample through examination of acetabular parameters on 3-dimensional computed tomography (CT)-based images according to side and gender. A retrospective evaluation was made of acetabulum CT scans taken for various reasons in a healthy Turkish population sample. The examination parameters were defined as measurements of the acetabular anteversion angle, acetabular abduction angle, lateral center edge angle, acetabular width, acetabular depth, sagittal acetabular angle, and medial wall thickness values. The CT scans including the bone structure were examined of a total of 252 hips of 126 patients. The acetabular index was calculated as depth/width × 100. Lateral center edge angle of < 20° with medial wall thickness > 5 mm was accepted as a criterion of dysplasia of the acetabulum. Evaluation was made of the acetabular CT scans of 73 females and 53 males with a mean age of 44.64 ± 12.31 (19-68) years. A statistically significant difference was determined between the sides in respect of acetabular anteversion angle (P = .007) and between the genders in respect of acetabular depth and acetabular width (P = .001, P = .001). The prevalence of dysplasia was determined to be 1.6% for the whole study group, as 1.9% in males and 1.4% in females. In the current study sample there were parametric differences between sides and genders in terms of acetabulum morphology and orientation. Further studies of larger series will be able to provide a better representation of the Turkish population.

Examination of Upper Extremity Length Discrepancy in Patients with Obstetric Brachial Plexus Paralysis.

Since the natural course of obstetric brachial plexus palsy is variable, several problems are encountered. One important question, in considering patients with OBPP under observation in outpatient clinical settings, is whether children will have length discrepancies in their arms. The aim of this study was to determine differences in the length of the affected extremity, in comparison to the opposite upper extremity. As such, 45 patients, aged 6 months to 18 years, with unilateral brachial plexus palsy developed due to obstetric reasons, were included in the study. Affected and healthy side humerus, ulna, radius, 2nd metacarpal and 5th metacarpal lengths were evaluated according to gender, age, side, Narakas classification, primary and secondary surgery. Statistically significant differences were found in the change rates of affected/healthy humerus, radius, 2nd metacarpal and 5th metacarpal lengths according to age (93%, 95%, 92%, 90% and 90%, respectively). Affected/healthy change rates of ulna, radius, 2nd metacarpal and 5th metacarpal lengths were found to differ statistically (p < 0.05) according to the Narakas classification variable (94%, 92%, 95%, 94% and 94%, respectively). There were no statistically significant differences in the ratios of affected/healthy change in the lengths of the humerus, ulna, radius and 5th metacarpal compared to the primary surgery (p > 0.05). The ratios of affected/healthy change in ulna, radius and 5th metacarpal lengths were found to differ statistically (p < 0.05) according to secondary surgeries (93%, 91%, 91% and 92%, respectively). Joint and bone deformities and bone shortening were observed after changes that occurred in the postnatal and growing periods due to obstetric brachial plexus palsy. Every increase in function to be gained in the upper extremity musculature was also potentially able to reduce problems, such as shortness.

CT-based analysis of posterior tibial slope in a Turkish population sample: A retrospective observational study.

Posterior tibial slope (PTS) is important for the success of high tibial osteotomy and unicondylar knee arthroplasty applications, as it provides anterior cruciate ligament function. In the literature, different studies have been carried out with various imaging methods to measure PTS in populations of different ethnic origins. In this study, it was aimed to detect PTS in the medial (MPTS) and lateral (LPTS) tibial condyles with computed tomography in a Turkish population sample and to compare the results between age groups (<65, ≥ 65), genders, sides, and literature data. In our sample, 39 left and 33 right knee images of 37 men and 35 women with a mean age of 52.01 ±â€…21.27 were evaluated. The tibial proximal anatomical axis was determined by the midpoint method. The MPTS and LPTS was evaluated by two different observers according to this axis. Thereby the global PTS (GPTS) was calculated as an arithmetic mean of MPTS and LPTS values. Measurements were repeated 2 weeks after the first measurement and values were analyzed. A significant difference was found between the mean of MPTS, LPTS, and GPTS in the whole population (P = .002), in men (P = .02) and in women (P = .02). On the other hand, there was no significant difference compared according to age, gender, and side by mean of same parameters. In comparison of the results of our Turkish population sample with other studies in the literature, MPTS and LPTS were similar to Chinese (P = .22, P = .07) and Japanese (P = .96, P = .67) populations, while different to White Asian (P < .001, P < .001) and Korean (P < .001, P < .001) populations. The midpoint method is a safe measurement method in computed tomography-based studies for the evaluation of PTS. Implant designs produces for different populations may not be suitable for the Turkish population. More comprehensive and detailed studies are needed to represent the Turkish population.

Is tendinitis in volar plating related to the dorsally protruding screw length and its compartment?

OBJECTIVES: The aim of this study was to evaluate the relationship between the length of the protruded screws from the dorsal cortex and extensor tendon damage in all compartments. PATIENTS AND METHODS: Between May 2020 and April 2021, a total of 29 patients (13 males, 16 females; mean age: 52.3±13.0 years; range, 30 to 78 years) who were operated and followed in our clinic for AO A2 and A3 distal radius fractures were included in this prospective study. Surface ultrasound (US) imaging was made to the dorsal sides of both wrists of the operated patients at different timepoints postoperatively. The length of screws with radius dorsal cortex penetration and the presence of tendinitis were recorded. RESULTS: In 15 of 23 patients, the presence of 29 protruding screws was accompanied by tendinitis and, in eight patients, no tendinitis was observed, despite the partial protrusion of screws. A statistically significant correlation was found between the screw protrusion and presence of tendinitis (p<0.05). The number of protruding screws and tendinitis were seen mostly in the second compartment. There was a statistically significant correlation between the protruding screw length of >1.6 mm and the presence tendinitis (p<0.05). CONCLUSION: Dorsal cortex screw protrusions in the application of volar plate for distal radius fractures can cause tendinitis. Screw protrusions occur more frequently in the second compartment and the development of tendinitis in this compartment is associated with a screw length of >1.6 mm. Screw penetration can be easily identified with intraoperative US to prevent tendinitis and potential tendon ruptures.

Open Fractures from Gustilo and Anderson to the Present: A Bibliometric Analysis with Global Productivity and Research Trends.

Background/Objective: Despite the increase in global research on open fractures, which continue to be a significant cause of morbidity and mortality, seriously affecting the health and quality of life of patients, there has not been any bibliometric research on this subject. The aim of this study was to make a holistic analysis of scientific articles published on the subject of open fractures using bibliometric methods. Methods: Articles published on the subject of open fractures between 1980 and 2021 were downloaded from the Web of Science (WoS) database, and were analysed using various statistical methods. Network visualisation maps were used to determine international collaborations and trend topics, and citation analyses to determine the most effective studies. Spearman's correlation coefficient was used to determine correlations, and exponential smoothing predictors to estimate the number of articles to be published in the next 5 years. Results: A total of 1742 articles were analysed. The 3 countries making the greatest contribution to literature were the USA (591, 33.9%), UK (219, 12.5%) and Germany (132, 7.5%). The most active author was Bhandari M. (n = 22). The 3 most productive institutions were determined to be the University of California System (n = 57), University of Washington (31), and Harborview Medical Center (29). The most active journal was Injury (n = 143). Conclusion: According to the analysis applied to identify trend topics, the topics most studied in recent years were determined to be surgical site infection, orthoplastics, intramedullary nail, Masquelet technique, BOAST, bone healing, closed reduction, classification, outcomes, and lower limb.

Ewing sarcoma: what trends in recent works? A holistic analysis with global productivity: A cross-sectional study.

Advances in the biology of Ewing sarcoma, which continues to be an important cause of mortality, have caused an increase in information in the literature related to the underlying molecular base of the disease and discussions of new treatment approaches. In this study, we aimed to comprehensively analyze the published scientific articles on Ewing sarcoma. The Web of Science database was used to obtain and statistically analysis articles on Ewing sarcoma that were published between 1980 and 2021. Maps of network visualization were used to reveal trending topics, global collaborations, and the most effective studies. Correlation analysis was performed using Spearman's correlation coefficient. A total of 3236 articles were analyzed. The first 3 countries that contributed the most to the literature and cooperated most intensively were USA (1194, 36.8%), Germany (293, 9%), Italy (254, 7.8%). Pediatric Blood & Cancer (n = 122), Cancer (87), Journal of Pediatric Hematology Oncology (71) were among the top 3 journals with the most articles. The most active author was Piero Picci (n = 94). High-income countries have a great effect on the literature on this subject. The most studied trend topics in recent years were pediatric oncology, EWS RNA Binding Protein 1 (EWSR1), EWSR1-FL1, epigenetics, bioinformatics, microRNA, gene expression, metastasis, migration, biomarker, immunotherapy, survival, outcomes, surveillance epidemiology and end results (SEER), nomogram, temozolomide, irinotecan, and drug resistance. Genetic studies, metastasis, immunotherapy, life analyses/nomogram based on new data obtained from SEER, and chemotherapy with irinotecan and temozolomide combination, were seen to be the topics researched in recent years.

An Evaluation of the Effect of the Use of N95 Respirators by Surgical Teams on Early Surgical Site Infections in Orthopedic Cases.

Background Surgical site infections (SSIs) are seen in the postoperative period in orthopedic and traumatology clinics. Just as in all surgical clinics, SSIs lead to patient dissatisfaction with the results, prolong the length of stay in the hospital, and increase treatment costs. SSIs are known to occur as a result of wound contamination through inoculation of microorganisms found mainly in the air or in the surgical area. Because of the coronavirus disease 2019 pandemic, N95 masks have been widely used in the operating rooms of our hospital by nurses, residents, and surgeons since March 2020. This study aims to evaluate the effect of N95 respirator use by the surgical team on SSIs determined in patients operated on in our clinic compared to surgical mask use. Methodology In this retrospective study, the use of N95 respirators by the surgical team was compared with the use of surgical masks to evaluate the effect on SSIs in patients operated on in our clinic. Two groups were formed of patients operated on by the surgical team wearing surgical masks between February 2019 and February 2020 and those operated on with the surgical team using N95 respirators between March 2020 and March 2021. Each patient was diagnosed with postoperative SSIs by two different surgeons in the same clinic and by an infection clinic specialist based on clinical and laboratory findings. Results A total of 1,486 patients were examined; 729 patients in February 2019-February 2020 period (Group 1) and 757 in March 2020-March 2021 period (Group 2). In total, 124 and 104 patients were excluded from the first and second groups, respectively, for various reasons, including revision surgery, open fractures, diabetes, smoking, peripheral vascular disease, or other comorbidities that could affect infection rates. SSIs were determined in 35 patients in Group 1 and 13 patients in Group 2. The SSI rates in the second period in both types of procedures (arthroplasty and trauma surgeries) were determined to be significantly lower. Conclusions Because of the use of intraoperative N95 respiratory masks by surgical teams in orthopedics and traumatology procedures, the number of SSIs decreased significantly compared to the use of surgical masks.

Blade expandable intramedullary nails for fixation of tibial shaft fractures.

This study is aimed to compare the clinical and radiological differences between classic locked intra- medullary nailing (LIN) and blade expandable intra- medullary nailing (BEIN) at tibia shaft fractures. Operation time, exposing of radiation time and fracture healing times were recorded. Pain visual anolog scale (VAS), shortening of tibia and angulation of fracture line were compared. All patients healed. In LIN group operation time, exposing of radiation time was longer (statistically significant). Because of shorter operation time and lower radiation exposure we recommend the BEIN technique as a preferable technique in tibia intramedullary nailing.