The Effect of Phospholipids (Surfactant) on Adhesion and Biomechanical Properties of Tendon: A Rat Achilles Tendon Repair Model.

Adhesion of the tendon is a major challenge for the orthopedic surgeon during tendon repair. Manipulation of biological environment is one of the concepts to prevent adhesion. Lots of biochemicals have been studied for this purpose. We aimed to determine the effect of phospholipids on adhesion and biomechanical properties of tendon in an animal tendon repair model. Seventy-two Wistar rats were divided into 4 groups. Achilles tendons of rats were cut and repaired. Phospholipids were applied at two different dosages. Tendon adhesion was determined histopathologically and biomechanical test was performed. At macroscopic evaluation of adhesion, there are statistically significant differences between multiple-dose phospholipid injection group and Control group and also hyaluronic acid group and Control group (p < 0.008). At microscopic evaluation of adhesion, there was no statistically significant difference (p > 0.008). Ultimate strength was highest at hyaluronic acid injection group and lowest at multiple-dose phospholipid injection group. Single-dose phospholipids (surfactant) application may have a beneficial effect on the tendon adhesion. Although multiple applications of phospholipids seem the most effective regime to reduce the tendon adhesion among groups, it deteriorated the biomechanical properties of tendon.

Incidence and follow-up outcomes of developmental hip dysplasia of newborns in the Western Mediterranean Region.

The aim of our study was to determine the incidence of developmental hip dysplasia (DHD) in the Western Mediterranean Region of Turkey and evaluate follow-up results of physiologically immature hips classified as type 2 according to Graf classification. Ultrasononographic examinations of the hips were performed using Graf's technique on 1162 infants (2324 hips) referred to our clinic for hip ultrasounds between March 2013 and March 2014. DHD was detected in 1.36% of 1162 infants. Among infants who were brought into repetitive follow-ups, 191 out of type 2a hip displasias of 201 infants were improved to type 1 and 10 type 2a hip dysplasias worsened. Sonographically worsened tip 2a group consisted of 4 type 2b, 6 type 2c DHDs. Hip ultrasound performed during neonatal period and infancy in the detection of developmental hip dysplasias and follow-up of hip dysplasias diagnosed as type 2a convey importance because of sonographically detected potential deterioration.

[Distal locking techniques without fluoroscopy in intramedullar nailing]. / Intramedüller çivilemede floroskopi olmadan distal kilitleme teknikleri.

OBJECTIVES: In this study, we present three distal locking techniques and two checking methods in intramedullar nailing. PATIENTS AND METHODS: Between January 1999 and December 2011, we performed distal locking with locked intramedullary nails on 501 femoral bone fractures using bone alignment and aspiration technique without fluoroscopy and 578 tibial bone fractures using medial malleolus alignment, bone alignment and aspiration technique without fluoroscopy at Antalya Training and Research Hospital. RESULTS: With the combination of these three locking techniques and two checking methods, locking was successful in all cases except one. In the latter case, the nail remained anteriorly, as the distal screws were not fully compliant with the surgical technique. CONCLUSION: Distal locking can be achieved in a short time using one or combining two or more techniques and methods without fluoroscopy.

Dislocated ankle fracture complicated by near total distal ischaemia.

Total arterial ischaemia is rarely seen following a dislocated ankle fracture but if it does and intervention is not made, it can lead to serious morbidity. We present a 39-year-old woman with almost total occlusion in the arteria tibialis and arteria dorsalis pedis following a dislocated ankle fracture as a result of a bicycle fall.

Isolated unilateral absent patella and contralateral small patella.

Isolated bilateral absent patella is seen very rarely. It is generally encountered as a part of nail-patella syndrome. An 18-year-old male patient presented with left absent patella and right small patella.