Effect of Ankaferd Blood Stopper on muscle healing.

PURPOSE: Ankaferd Blood Stopper (ABS), which is a standardized mixture of herbal extracts obtained from five plants, has been proven as an efficient hemostatic agent and is still used in emergency situations. It is not known exactly if decreased bleeding has positive or negative effects on muscle healing and fibrosis, so the purpose of this study was to test the effect of ABS on muscle healing and morphology. METHODS: A total of 66 outbred Wistar rats were divided into three control and three experimental subgroups. In the experimental groups, ABS was sprayed on the cut surface of the soleus. In the control groups, a saline solution was sprayed on the cut surface of the soleus. Subgroups were euthanized after 2 weeks, 3 weeks and 4 weeks, respectively. In each subgroup, eight rats were used for the biomechanical study to determine muscle healing and three rats were used for the histopathological investigation. RESULTS: Although muscle strength in the control groups was lower than that of the experimental groups in early weeks, no differences were found between the control and the experimental groups at 4 weeks. CONCLUSIONS: ABS has no negative effect on muscle healing. We also observed that ABS accelerated muscle healing compared to the control group. ABS could be used in hemostasis of open fractures and elective orthopedic surgeries.

A new measurement method in Graf technique: prediction of future acetabular development is possible in physiologically immature hips.

BACKGROUND: Universal ultrasound screening has led to overtreatment and higher follow-up rates than are found with clinical examination alone because of high incidence of physiologically immature hips (type IIa) in the first weeks of life. The ability to predict future acetabular development in physiologically immature hips (type IIa) would therefore help to reduce overtreatment and unnecessary follow-up. METHODS: We described the γ-angle to assess the femoral head coverage by the acetabular roof, which is measured between the baseline defined by Graf and the cartilaginous edge line connecting the inferior point of the iliac bone (lower limb) to the medial corner of the acetabular labrum. We retrospectively analyzed ultrasonographic findings of infants with developmental dysplasia of the hip diagnosed in our hospital and infants with normal hips screened in our hospital. Group 1 (35 hips) consists of type IIa hips at initial examination and went on to develop into dysplastic hips at follow-up. Group 2 (279 hips) consists of type IIa hips at initial examination and went on to develop into normal hips (type I) at follow-up. RESULTS: The γ-angles of type IIa hips that developed into type I hip at follow-up ranged between 77 and 82. The γ-angles of type IIa hips that developed into hip dysplasia ranged between 72 and 78. All type IIa hips that had γ-angles >78 degrees developed into normal hips. We also observed that all type IIa hips that had γ-angles <77 degrees developed into dysplasia. CONCLUSIONS: The amount of cartilage mass covering the femoral head, which is a part of the acetabular roof, can therefore provide information about future acetabular development. This paper describes a new method of measurement (the γ-angle) that assesses the extent of the cartilage coverage of the femoral head, which can predict acetabular development. Its use would decrease the rates of unnecessary follow-up and treatment. LEVEL OF EVIDENCE: Level II (development of diagnostic criteria on the basis of consecutive patients).

Avulsion fracture of the anterior inferior iliac spine.

A 14-year-old was admitted with right groin pain which has started after kicking ball in a football game one week before. He had limited active and passive hip extension. A plain AP radiograph of the pelvis revealed a bone fragment displaced inferiorly about 1 cm from the right anterior inferior iliac spine. The patient was treated conservatively with analgesics and limited weight bearing. Four weeks later, range of motion was normal without pain and at eighth week the hip flexors regained full strength.

[Phalanx-like osseous structure posterior to the cervical vertebrae: a hitherto unreported location for a rare anomaly]. / Servikal vertebra posteriorunda falanks benzeri ektopik kemik yapi: Nadir bir anomali için bildirilmemis bir yerlesim bölgesi.

Several types of abnormalities of the vertebral column have been reported. Pelvic rib or pelvic digit is a rare congenital anomaly of the spine. A 58-year-old male patient presented with a complaint of a firm mass in the neck. He had no history of trauma and had been aware of the mass for years. Physical examination showed a painless and immobile mass in the neck, measuring 4 x 1 cm. About 10 to 15 degrees of restriction was noted in neck movements, with slight pain. A plain radiograph of the cervical region showed two bony formations resembling a coccygeal segment or a phalanx, posterior to the spinous process of the C6 vertebra. They had well-defined cortices and medullae and pseudo-articulation between each other and with the spinous process. These findings were confirmed by three-dimensional computed tomography and magnetic resonance images. The patient did not accept surgery for the lesions were not associated with a significant discomfort. To our knowledge, such a digit has hitherto not been reported in the cervical region.

External application of hypertonic salt solution for treatment of posttraumatic oedema.

In 20 New Zealand rabbits (two groups of 10 rabbits each), hind limb circumference and anterior compartment pressure were measured following ketamin anaesthesia (time zero). During the same anaesthesia, closed transverse proximal tibial shaft fractures were created in both groups. Twenty-four hours after the fractures, during a second anaesthesia, limb circumference and compartment pressure were measured as before, and fractured limbs were fixed to the rabbits' bodies. At the same time, treatment was started: one group received external application of saturated salt solution and the other group received intermittent ice application. During 48 hours of treatment (from 24 to 72 hours) in the saturated salt solution group, the mean limb circumference decreased from 125.70 +/- 9.93 mm to 115.70 +/- 8.78 mm (p = 0.005) and the mean compartment pressure decreased from 18.30 +/- 1.70 mmHg to 12.40 +/- 1.77 mmHg (p = 0.005). In the control group, the mean limb circumference decreased from 127.85 +/- 7.47 mm to 122.00 +/- 6.83 mm (not significant) and the mean compartment pressure decreased from 19.57 +/- 1.27 mmHg to 17.85 +/- 2.67 mmHg (not significant). In short, differences in compartment pressure and limb circumference before and after treatment were statistically significant in the saturated salt solution group (p = 0.005) but not in the control group.