Irritant contact dermatitis due to synthetic undercast padding is rare complication of plaster ca... more Irritant contact dermatitis due to synthetic undercast padding is rare complication of plaster cast treatment which is underreported in orthopedic literature. Pruritis was the main symptom a few days following the application of the cast in our patient. However, the symptoms were underestimated by the treating physician. Severe irritant contact dermatitis can occur against the polyester undercast padding and should be kept in mind in patients whom complaining of pruritis under the treatment of casting. INTRODUCTION The danger of severe irritant contact dermatitis after the application of casts is not generally appreciated. Because of its apparent rarity, we decided to report the following case of severe irritant contact dermatitis due to synthetic undercast padding in a patient under fracture treatment.
Biphalangeal toe is a normal anatomic variant where distal and middle phalanges fuse to each othe... more Biphalangeal toe is a normal anatomic variant where distal and middle phalanges fuse to each other. In the context of trauma, biphalangeal toes may pose a diagnostic challenge and fractures may be interpreted as normal which can lead to misdiagnosis and under treatment. Here, we present a rare Q1 case of fracture through a biphalangeal fifth toe with delayed diagnosis. This variation should be kept in mind during the evaluation of a patient with foot trauma and assessment of foot radiographs, particularly in the emergency department where the majority of initial cases are presented.
The purpose of this study is to examine the plain knee radiographs in Turkish subjects in order t... more The purpose of this study is to examine the plain knee radiographs in Turkish subjects in order to determine the prevalence of fabella and analyze the differences between age, gender, laterality and its symmetry pattern.
The Foot and Ankle Online Journal 9 (4): 3 Talar body fractures usually occur as a result of high... more The Foot and Ankle Online Journal 9 (4): 3 Talar body fractures usually occur as a result of high-energy trauma and variety of different type of talar fractures may occur. Most of the talar fractures are included in classification systems. Even though it is possible to observe talar fractures with concomitant dislocations, together by reason of their functional relationship with the tibiotalar, subtalar and talonavicular joints, such observations are only addressed in literature in the form of case studies. The present case, exhibiting talar body fracture in the coronal plane observed together with subtalar and talonavicular dislocations, is of importance due to the rarity of the diagnosis, treatment, and 2-year follow-up results.
Introduction: The debate regarding the description on classification and nomenclature of the inju... more Introduction: The debate regarding the description on classification and nomenclature of the injury which includes olecranon fracture associated with radial neck fractures in children is ongoing. We report two pediatric cases that could not be classified in a Monteggia-equivalents system and were treated with open reduction and k-wire fixation. The aim of this study was to perform a systematic review regarding pediatric radial neck fractures associated with olecranon fractures and presentation of two pediatric cases of olecranon fractures associated with radial neck fractures with radiocapitellar dislocation. Case Presentation: Two boys, aged 7 and 12, came to two separate clinics on the same day after initial injury. On physical examination , the patients' elbow range of motion was limited and painful. Their upper extremities were intact. Radiographs revealed the radial neck fracture with prominent anterolateral radiocapitellar dislocation of radial head-associated with non-displaced olecra-non fracture. Radial neck fracture was reduced easily by pushing posteromedially manually with the finger and secured with two K-wires .The olecranon fracture was visualized and confirmed that it was non-displaced and secured with two k-wires in the first case and one k-wire in the second case. After 2 months of follow-up, both patients had no pain in their elbow and a full functionality with a full range of motion of the elbow. The posterior intraosseous nerve functions were normal. Conclusions: The fracture of olecranon if it does not extend into the metaphyseal region; it could not fascilitate diastasis of the proximal radioulnar joint and radial head dislocation. So this type of fracture must not be addressed as a Monteggia-fracture dislo-cation. The description of radioulnar diastasis must be included when this type of injury is to be classified.
Background: We sought to report the clinical results of a new conservative treatment modality tha... more Background: We sought to report the clinical results of a new conservative treatment modality that uses a shape memory alloy device in patients with ingrown toenail.
Objective: Total knee arthroplasty (TKA) is an effective and commonly performed procedure in knee... more Objective: Total knee arthroplasty (TKA) is an effective and commonly performed procedure in knee arthritis. The most common wound complications in TKA are erythema, infection, prolonged drainage, and skin necrosis. Disruption of the operative wound is a rare complication. This paper presents a case where knee prostheses were exposed 17 days after the knee replacement operation. Case Report: A 67-year-old male patient was admitted to our hospital for bilateral osteoarthritis of the knee. Simultaneous bilateral total knee arthroplasty was applied. The postoperative hospital stay reached ten days, and with 90º of flexion and mobilization, the patient was discharged. 17 days after the operation the patient was re-admitted to hospital after having a fall. A physical examination revealed dehiscence of the wound and median parapatellar arthrotomy sutures. Both prostheses were exposed and visible. Under general anesthesia P/E was repeated and stress tests revealed medial collateral ligament injury on the right knee and a lateral collateral ligament injury on the left knee. Conclusion: The role of the extensor mechanism is important in knee prosthesis. Any weakness in the extensor mechanism may lead to prosthetic instability and concurrent complications. If the strength of the quadriceps mechanism is not sufficient, it must be strengthened postoperatively, and rehabilitation and mobilization should be applied carefully until collagen maturation is complete.
SUMMARY: Çekiç B, Erdem-Toslak İ, Sertkaya Ö, Filiz S, Kılar Y, Köroğlu M, Köse Ö. Incidence and ... more SUMMARY: Çekiç B, Erdem-Toslak İ, Sertkaya Ö, Filiz S, Kılar Y, Köroğlu M, Köse Ö. Incidence and follow-up outcomes of developmental hip dysplasia of neworns in the Western Mediterranean Region. Turk. J Pediatr 2015; 57: 353-358. 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.
Avulsion fractures of the anterior inferior tibiofibular ligament from its tibial attachment, Til... more Avulsion fractures of the anterior inferior tibiofibular ligament from its tibial attachment, Tillaux fractures, are usually seen in adolescents during the interval of the distal tibial epiphyseal closure. However, this pattern of fracture is rare in adult patients, because the ligaments will usually fail before the bone fails. Avulsion fracture of the posterior inferior tibiofibular ligament from its tibial attachment, Volkmann fracture, is the posterolateral counterpart of a similar injury. In the present study, the cases of 2 adult patients with simultaneous Tillaux and Volkmann fractures are reported and the mechanism of injury, diagnosis, and treatment discussed. This fracture pattern is extremely rare and, to the best of our knowledge, has not been previously reported.
Reverse Segond fracture is originally described as an indirect radiographic clue for a specific i... more Reverse Segond fracture is originally described as an indirect radiographic clue for a specific injury complex of the knee joint that includes posterior cruciate ligament (PCL) rupture and medial meniscal tear. Herein, we describe a case with reverse Segond fracture associated with PCL avulsion fracture instead of PCL rupture. According to current literature review, reverse Segond fracture is not only associated with PCL and medial meniscal injuries, but also frequently associated with anterior cruciate ligament (ACL) and medial collateral ligament (MCL) injuries. Furthermore, medial meniscus and PCL may remain intact.
Purpose The purpose of this study was to assess the
publication rate of the abstracts presented a... more Purpose The purpose of this study was to assess the publication rate of the abstracts presented at the 6th Mediterranean Emergency Medicine Congress, 2011 and the 7th European Congress on Emergency Medicine, 2012. Materials and methods All abstracts, both posters and oral presentations, from the international emergency medicine congresses held by the European Society for Emergency Medicine (EUSEM) in 2011 and 2012 were identified. To establish whether these abstracts were subsequently published in peer-reviewed medical journals, the names of all the authors and the title of the abstracts were searched for in the databases of Clinical Key/Elsevier, EBSCO Discovery Service, MD Consult, Science Direct, Scopus, EMBASE, Medscape, Google Scholar and local ULAKBIM. The year of publication, consistency of author names and titles, the type of study, the journals in which papers were published and countries from which reports were submitted were all recorded. Results A total of 1721 abstracts were examined; 626 from 2011 (307 oral presentations and 319 posters) and 1095 from 2012 (154 oral presentations and 941 posters). Of all abstracts in 2011, 172 (27.5%) and of all abstracts in 2012, 265 (24.2%) were subsequently published as full-text reports in peer-reviewed journals. Of the 172 papers published in 2011, 152 (88.4%) were accepted by Science Citation Index (SCI) and/or SCI Expanded (SCI-E) journals and 155 (58.5%) of 265 papers were accepted by SCI and/or SCI-E journals in 2012 (p=0.0001). Conclusions The publication rate of abstracts submitted to international emergency medicine congresses held by EUSEM over those 2 years was low compared with that of abstracts presented in other emergency medicine congresses. Presenters should be encouraged to send their studies to peer-reviewed journals. During the selection process by the scientific panel, constructive critics should be notified to the presenters instead of simply accepting or rejecting the studies that submitted to the congress, which may increase the subsequent publication rate.
Introduction The purpose of this study was to compare
two different modes of administration (tele... more Introduction The purpose of this study was to compare two different modes of administration (telephone versus face to face) for Lysholm knee score (LKS) to test their multi-mode equivalence and reliability. Materials and methods Two LKSs were obtained in 100 patients who underwent ACL reconstruction surgery. First LKS was completed through telephone interview, and second LKS, which was at least 2 weeks later, was completed face-to-face interview at the hospital. To analyze the test–retest reliability, the relative level of agreement between the two modes of administration for LKS was calculated using interclass correlation coefficient (ICC) in 95 % confidence interval. Results The mean LKS was 93.01 ± 9.12 (range 59–100) at telephone interview and 93.56 ± 7.93 (range 59–100) at face-to-face interview (p = 0.130). Both the total point and the each item’s point were statistically similar (p\0.05 for each item). The total score was same in 66 (66 %) subjects. The mean difference between two scoring was only 1.83 ± 3.14 points (range 0–15). However, eight (8 %) patients were assigned to different grading groups (excellent, good, fair, and poor). The overall LKS and the each item of the LKS had acceptable test–retest reliability [ICC = 0.954 (95 % CI 0.931–0.969)]. Conclusions LKS can be reliably completed through telephone interview, which would provide accurate data similar to face-to-face interview. Researchers can design studies using telephone interview as a mode of administration for LKS or use mix-mode designs. Keywords Lysholm knee score Telephone Face to face Interview Mode of administration
Introduction Successful anterior cruciate ligament (ACL)
reconstruction is dependent on correct p... more Introduction Successful anterior cruciate ligament (ACL) reconstruction is dependent on correct placement of both tibial and femoral tunnels. The purpose of this study is to investigate whether we can use intraoperative femoral tunnel length measurement to estimate the correct femoral tunnel placement on coronal plane. Methods This prospective study comprised 164 consecutive patients who underwent ACL reconstruction surgery. Transtibial or anteromedial portal technique is used for drilling the femoral tunnels. The length of the femoral tunnel was measured during the operation. The femoral tunnel coronal plane angle was calculated on the postoperative tunnel radiographs. A statistical comparison was made of the lengths of the tunnel, the techniques used drilling and the femoral tunnel angles. Results The far anteromedial portal was used in 81 (49 %) cases and the transtibial technique in 83 (51 %) cases. The mean femoral tunnel length was 42 ± 6.4 mm and the mean femoral tunnel coronal angle was 41.1 ± 11.6. The tunnel angle in the transtibial technique was determined as significantly low compared to the far anteromedial portal technique (32.6:49.8) and the tunnel length was significantly longer (45.8:38.1 mm) (p\0.001). In the statistical analysis, it was found that a patient with a tunnel length of 41 mm and above had a 92.1 % likelihood of femoral tunnel angle below 45. Conclusion Femoral tunnel length can be used as a clue for intraoperative evaluation of the femoral tunnel position. If the femoral tunnel length is greater than 41 mm, the coronal plane orientation of the femoral tunnel will be improper and not at a desired position. Keywords ACL ACL reconstruction Femoral tunnel length Transtibial technique Far anteromedial technique
Purpose The purpose of this randomized clinical trial is
to compare intramedullary nailing (IMN) ... more Purpose The purpose of this randomized clinical trial is to compare intramedullary nailing (IMN) versus minimally invasive plate osteosynthesis (MIPO) for the treatment of extra-articular distal tibial shaft fractures. Materials and methods Twenty-five consecutive patients with distal extra-articular tibial fractures which were located between 4 and 12 cm from the tibial plafond (AO 42A1 and 43A1) were randomly assigned into IMN (n: 10) or MIPO (n: 15) treatment groups. All patients were followed for at least 1 year. Foot function index, time to weight bearing, union time, duration of operation, length of incision, intra-operative blood loss, intra-operative fluoroscopy time, rotational and angular malalignment, rate of infection, secondary interventions and complications were compared between groups. Results All patients completed the trial and were followed with a mean of 23.1 ± 9.4 months (range 12–52). Foot function index, weight bearing time, union time, rate of malunion, rate of infection and rate of secondary interventions were all similar between groups (p = 0.807, p = 0.177, p = 0.402, p = 0.358, p = 0.404, p = 0.404, respectively). Intra-operative blood loss, length of surgical incision, radiation time and rotational malalignment were higher in the IMN group (p = 0.012, p = 0.019, p = 0.004 and p = 0.027, respectively). Conclusions Results of our study showed that both treatment methods have similar therapeutic efficacy regarding functional outcomes and can be used safely for extra-articular distal tibial shaft fractures, and none of the techniques had a major advantage over the other. LEVEL I
Plantar fasciitis is a common
cause of plantar heel pain; however,
a broad spectrum of disorders ... more Plantar fasciitis is a common cause of plantar heel pain; however, a broad spectrum of disorders may also present with plantar heel pain. A detailed history, physical examination, laboratory testing, and imaging studies may be necessary to reach an accurate diagnosis. Herein, the clinical presentation of a 33-year-old woman with calcaneal insufficiency fracture secondary to celiac disease–induced osteomalacia is presented, and its diagnosis and treatment are discussed. Calcaneal insufficiency fractures should be kept in mind in a patient with celiac disease that presents with heel pain.
Purpose The purpose of this retrospective study was to
evaluate the results and prognostic factor... more Purpose The purpose of this retrospective study was to evaluate the results and prognostic factors affecting the outcome of arthroscopic saucerization for discoid lateral meniscus (DLM). Methods Forty-eight patients who underwent arthroscopic saucerization for DLM between January 2009 and January 2012 in two hospitals were included. There were 21 (43.8 %) male and 27 (56.3 %) female patients with a mean age of 36.02 ± 14.5 (range 9–65) years at the time of operation. According to Watanabe classification, 33 (68.7 %) patients had type II (incomplete) discoid meniscus and 15 (31.3 %) had type I (complete) discoid meniscus. Of the 48 patients, 26 (54.2 %) had an associated lateral meniscal tear. Seventeen patients (35.4 %) had accompanying ligamentous, chondral and/or medial meniscal lesions. The symptoms were present for a mean of 8.04 ± 4.48 (range 1–24) months before the operation. All patients were followed up with a mean of 27.7 ± 10.7 (range 12–47) months using Lysholm knee score. We analyzed the relationship between the outcome variable (Lysholm knee score at the final follow-up) and the predictor variables (age, gender, type of DLM, presence of meniscal tear, duration of symptoms, follow-up and accompanying intra-articular lesions). Results The mean preoperative Lysholm knee score was 46.6 ± 10.2 points and increased to 85.08 ± 13.45 points at the final follow-up (p = 0.0001). Twenty (41.7 %) excellent, seven (14.6 %) good, nineteen (39.6 %) fair and two (4.2 %) poor results have obtained. No complications were observed in any patient. Regression analysis showed that age was the only predictor of the Lysholm score at the final follow-up (R2 = 0.545, p = 0.0001). The linear regression equation was (Lysholm score at final followup) = 106.1 - [0.58 9 (age of patient)]. Conclusions This study demonstrated that arthroscopic saucerization is an effective and safe treatment modality for DLM. Furthermore, age of the patient was shown to be the most important prognostic factor over the final clinical outcome. An excellent or a good result can be expected when the patient is young at the time of operation. Level of evidence IV.
Introduction: Anterior Talofibular Ligament (ATFL) rupture is the most commonly injured anatomic ... more Introduction: Anterior Talofibular Ligament (ATFL) rupture is the most commonly injured anatomic structure in lateral ankle sprain. In some cases, ATFL avulsion fracture from the lateral malleolus may occur instead of purely ligamentous injuries. The ATFL avulsion fracture is detected as a small ossicle at the tip of lateral malleolus on direct radiographs, which is called os subfibulare in chronic cases. Case Presentation: Severe displacement of this ossicle to the tibiotalar joint space is an extremely rare injury. Herein, a case of intra-articular entrapment of os subfibulare following a severe inversion injury of the ankle, which caused a diagnostic challenge was presented. Conclusions: To the best of our knowledge, this is the first case of entrapment of os subfibulare in the talotibial joint space. Fixation of the os subfibulare to lateral malleolus resulted in union and excellent functional results.
Irritant contact dermatitis due to synthetic undercast padding is rare complication of plaster ca... more Irritant contact dermatitis due to synthetic undercast padding is rare complication of plaster cast treatment which is underreported in orthopedic literature. Pruritis was the main symptom a few days following the application of the cast in our patient. However, the symptoms were underestimated by the treating physician. Severe irritant contact dermatitis can occur against the polyester undercast padding and should be kept in mind in patients whom complaining of pruritis under the treatment of casting. INTRODUCTION The danger of severe irritant contact dermatitis after the application of casts is not generally appreciated. Because of its apparent rarity, we decided to report the following case of severe irritant contact dermatitis due to synthetic undercast padding in a patient under fracture treatment.
Biphalangeal toe is a normal anatomic variant where distal and middle phalanges fuse to each othe... more Biphalangeal toe is a normal anatomic variant where distal and middle phalanges fuse to each other. In the context of trauma, biphalangeal toes may pose a diagnostic challenge and fractures may be interpreted as normal which can lead to misdiagnosis and under treatment. Here, we present a rare Q1 case of fracture through a biphalangeal fifth toe with delayed diagnosis. This variation should be kept in mind during the evaluation of a patient with foot trauma and assessment of foot radiographs, particularly in the emergency department where the majority of initial cases are presented.
The purpose of this study is to examine the plain knee radiographs in Turkish subjects in order t... more The purpose of this study is to examine the plain knee radiographs in Turkish subjects in order to determine the prevalence of fabella and analyze the differences between age, gender, laterality and its symmetry pattern.
The Foot and Ankle Online Journal 9 (4): 3 Talar body fractures usually occur as a result of high... more The Foot and Ankle Online Journal 9 (4): 3 Talar body fractures usually occur as a result of high-energy trauma and variety of different type of talar fractures may occur. Most of the talar fractures are included in classification systems. Even though it is possible to observe talar fractures with concomitant dislocations, together by reason of their functional relationship with the tibiotalar, subtalar and talonavicular joints, such observations are only addressed in literature in the form of case studies. The present case, exhibiting talar body fracture in the coronal plane observed together with subtalar and talonavicular dislocations, is of importance due to the rarity of the diagnosis, treatment, and 2-year follow-up results.
Introduction: The debate regarding the description on classification and nomenclature of the inju... more Introduction: The debate regarding the description on classification and nomenclature of the injury which includes olecranon fracture associated with radial neck fractures in children is ongoing. We report two pediatric cases that could not be classified in a Monteggia-equivalents system and were treated with open reduction and k-wire fixation. The aim of this study was to perform a systematic review regarding pediatric radial neck fractures associated with olecranon fractures and presentation of two pediatric cases of olecranon fractures associated with radial neck fractures with radiocapitellar dislocation. Case Presentation: Two boys, aged 7 and 12, came to two separate clinics on the same day after initial injury. On physical examination , the patients' elbow range of motion was limited and painful. Their upper extremities were intact. Radiographs revealed the radial neck fracture with prominent anterolateral radiocapitellar dislocation of radial head-associated with non-displaced olecra-non fracture. Radial neck fracture was reduced easily by pushing posteromedially manually with the finger and secured with two K-wires .The olecranon fracture was visualized and confirmed that it was non-displaced and secured with two k-wires in the first case and one k-wire in the second case. After 2 months of follow-up, both patients had no pain in their elbow and a full functionality with a full range of motion of the elbow. The posterior intraosseous nerve functions were normal. Conclusions: The fracture of olecranon if it does not extend into the metaphyseal region; it could not fascilitate diastasis of the proximal radioulnar joint and radial head dislocation. So this type of fracture must not be addressed as a Monteggia-fracture dislo-cation. The description of radioulnar diastasis must be included when this type of injury is to be classified.
Background: We sought to report the clinical results of a new conservative treatment modality tha... more Background: We sought to report the clinical results of a new conservative treatment modality that uses a shape memory alloy device in patients with ingrown toenail.
Objective: Total knee arthroplasty (TKA) is an effective and commonly performed procedure in knee... more Objective: Total knee arthroplasty (TKA) is an effective and commonly performed procedure in knee arthritis. The most common wound complications in TKA are erythema, infection, prolonged drainage, and skin necrosis. Disruption of the operative wound is a rare complication. This paper presents a case where knee prostheses were exposed 17 days after the knee replacement operation. Case Report: A 67-year-old male patient was admitted to our hospital for bilateral osteoarthritis of the knee. Simultaneous bilateral total knee arthroplasty was applied. The postoperative hospital stay reached ten days, and with 90º of flexion and mobilization, the patient was discharged. 17 days after the operation the patient was re-admitted to hospital after having a fall. A physical examination revealed dehiscence of the wound and median parapatellar arthrotomy sutures. Both prostheses were exposed and visible. Under general anesthesia P/E was repeated and stress tests revealed medial collateral ligament injury on the right knee and a lateral collateral ligament injury on the left knee. Conclusion: The role of the extensor mechanism is important in knee prosthesis. Any weakness in the extensor mechanism may lead to prosthetic instability and concurrent complications. If the strength of the quadriceps mechanism is not sufficient, it must be strengthened postoperatively, and rehabilitation and mobilization should be applied carefully until collagen maturation is complete.
SUMMARY: Çekiç B, Erdem-Toslak İ, Sertkaya Ö, Filiz S, Kılar Y, Köroğlu M, Köse Ö. Incidence and ... more SUMMARY: Çekiç B, Erdem-Toslak İ, Sertkaya Ö, Filiz S, Kılar Y, Köroğlu M, Köse Ö. Incidence and follow-up outcomes of developmental hip dysplasia of neworns in the Western Mediterranean Region. Turk. J Pediatr 2015; 57: 353-358. 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.
Avulsion fractures of the anterior inferior tibiofibular ligament from its tibial attachment, Til... more Avulsion fractures of the anterior inferior tibiofibular ligament from its tibial attachment, Tillaux fractures, are usually seen in adolescents during the interval of the distal tibial epiphyseal closure. However, this pattern of fracture is rare in adult patients, because the ligaments will usually fail before the bone fails. Avulsion fracture of the posterior inferior tibiofibular ligament from its tibial attachment, Volkmann fracture, is the posterolateral counterpart of a similar injury. In the present study, the cases of 2 adult patients with simultaneous Tillaux and Volkmann fractures are reported and the mechanism of injury, diagnosis, and treatment discussed. This fracture pattern is extremely rare and, to the best of our knowledge, has not been previously reported.
Reverse Segond fracture is originally described as an indirect radiographic clue for a specific i... more Reverse Segond fracture is originally described as an indirect radiographic clue for a specific injury complex of the knee joint that includes posterior cruciate ligament (PCL) rupture and medial meniscal tear. Herein, we describe a case with reverse Segond fracture associated with PCL avulsion fracture instead of PCL rupture. According to current literature review, reverse Segond fracture is not only associated with PCL and medial meniscal injuries, but also frequently associated with anterior cruciate ligament (ACL) and medial collateral ligament (MCL) injuries. Furthermore, medial meniscus and PCL may remain intact.
Purpose The purpose of this study was to assess the
publication rate of the abstracts presented a... more Purpose The purpose of this study was to assess the publication rate of the abstracts presented at the 6th Mediterranean Emergency Medicine Congress, 2011 and the 7th European Congress on Emergency Medicine, 2012. Materials and methods All abstracts, both posters and oral presentations, from the international emergency medicine congresses held by the European Society for Emergency Medicine (EUSEM) in 2011 and 2012 were identified. To establish whether these abstracts were subsequently published in peer-reviewed medical journals, the names of all the authors and the title of the abstracts were searched for in the databases of Clinical Key/Elsevier, EBSCO Discovery Service, MD Consult, Science Direct, Scopus, EMBASE, Medscape, Google Scholar and local ULAKBIM. The year of publication, consistency of author names and titles, the type of study, the journals in which papers were published and countries from which reports were submitted were all recorded. Results A total of 1721 abstracts were examined; 626 from 2011 (307 oral presentations and 319 posters) and 1095 from 2012 (154 oral presentations and 941 posters). Of all abstracts in 2011, 172 (27.5%) and of all abstracts in 2012, 265 (24.2%) were subsequently published as full-text reports in peer-reviewed journals. Of the 172 papers published in 2011, 152 (88.4%) were accepted by Science Citation Index (SCI) and/or SCI Expanded (SCI-E) journals and 155 (58.5%) of 265 papers were accepted by SCI and/or SCI-E journals in 2012 (p=0.0001). Conclusions The publication rate of abstracts submitted to international emergency medicine congresses held by EUSEM over those 2 years was low compared with that of abstracts presented in other emergency medicine congresses. Presenters should be encouraged to send their studies to peer-reviewed journals. During the selection process by the scientific panel, constructive critics should be notified to the presenters instead of simply accepting or rejecting the studies that submitted to the congress, which may increase the subsequent publication rate.
Introduction The purpose of this study was to compare
two different modes of administration (tele... more Introduction The purpose of this study was to compare two different modes of administration (telephone versus face to face) for Lysholm knee score (LKS) to test their multi-mode equivalence and reliability. Materials and methods Two LKSs were obtained in 100 patients who underwent ACL reconstruction surgery. First LKS was completed through telephone interview, and second LKS, which was at least 2 weeks later, was completed face-to-face interview at the hospital. To analyze the test–retest reliability, the relative level of agreement between the two modes of administration for LKS was calculated using interclass correlation coefficient (ICC) in 95 % confidence interval. Results The mean LKS was 93.01 ± 9.12 (range 59–100) at telephone interview and 93.56 ± 7.93 (range 59–100) at face-to-face interview (p = 0.130). Both the total point and the each item’s point were statistically similar (p\0.05 for each item). The total score was same in 66 (66 %) subjects. The mean difference between two scoring was only 1.83 ± 3.14 points (range 0–15). However, eight (8 %) patients were assigned to different grading groups (excellent, good, fair, and poor). The overall LKS and the each item of the LKS had acceptable test–retest reliability [ICC = 0.954 (95 % CI 0.931–0.969)]. Conclusions LKS can be reliably completed through telephone interview, which would provide accurate data similar to face-to-face interview. Researchers can design studies using telephone interview as a mode of administration for LKS or use mix-mode designs. Keywords Lysholm knee score Telephone Face to face Interview Mode of administration
Introduction Successful anterior cruciate ligament (ACL)
reconstruction is dependent on correct p... more Introduction Successful anterior cruciate ligament (ACL) reconstruction is dependent on correct placement of both tibial and femoral tunnels. The purpose of this study is to investigate whether we can use intraoperative femoral tunnel length measurement to estimate the correct femoral tunnel placement on coronal plane. Methods This prospective study comprised 164 consecutive patients who underwent ACL reconstruction surgery. Transtibial or anteromedial portal technique is used for drilling the femoral tunnels. The length of the femoral tunnel was measured during the operation. The femoral tunnel coronal plane angle was calculated on the postoperative tunnel radiographs. A statistical comparison was made of the lengths of the tunnel, the techniques used drilling and the femoral tunnel angles. Results The far anteromedial portal was used in 81 (49 %) cases and the transtibial technique in 83 (51 %) cases. The mean femoral tunnel length was 42 ± 6.4 mm and the mean femoral tunnel coronal angle was 41.1 ± 11.6. The tunnel angle in the transtibial technique was determined as significantly low compared to the far anteromedial portal technique (32.6:49.8) and the tunnel length was significantly longer (45.8:38.1 mm) (p\0.001). In the statistical analysis, it was found that a patient with a tunnel length of 41 mm and above had a 92.1 % likelihood of femoral tunnel angle below 45. Conclusion Femoral tunnel length can be used as a clue for intraoperative evaluation of the femoral tunnel position. If the femoral tunnel length is greater than 41 mm, the coronal plane orientation of the femoral tunnel will be improper and not at a desired position. Keywords ACL ACL reconstruction Femoral tunnel length Transtibial technique Far anteromedial technique
Purpose The purpose of this randomized clinical trial is
to compare intramedullary nailing (IMN) ... more Purpose The purpose of this randomized clinical trial is to compare intramedullary nailing (IMN) versus minimally invasive plate osteosynthesis (MIPO) for the treatment of extra-articular distal tibial shaft fractures. Materials and methods Twenty-five consecutive patients with distal extra-articular tibial fractures which were located between 4 and 12 cm from the tibial plafond (AO 42A1 and 43A1) were randomly assigned into IMN (n: 10) or MIPO (n: 15) treatment groups. All patients were followed for at least 1 year. Foot function index, time to weight bearing, union time, duration of operation, length of incision, intra-operative blood loss, intra-operative fluoroscopy time, rotational and angular malalignment, rate of infection, secondary interventions and complications were compared between groups. Results All patients completed the trial and were followed with a mean of 23.1 ± 9.4 months (range 12–52). Foot function index, weight bearing time, union time, rate of malunion, rate of infection and rate of secondary interventions were all similar between groups (p = 0.807, p = 0.177, p = 0.402, p = 0.358, p = 0.404, p = 0.404, respectively). Intra-operative blood loss, length of surgical incision, radiation time and rotational malalignment were higher in the IMN group (p = 0.012, p = 0.019, p = 0.004 and p = 0.027, respectively). Conclusions Results of our study showed that both treatment methods have similar therapeutic efficacy regarding functional outcomes and can be used safely for extra-articular distal tibial shaft fractures, and none of the techniques had a major advantage over the other. LEVEL I
Plantar fasciitis is a common
cause of plantar heel pain; however,
a broad spectrum of disorders ... more Plantar fasciitis is a common cause of plantar heel pain; however, a broad spectrum of disorders may also present with plantar heel pain. A detailed history, physical examination, laboratory testing, and imaging studies may be necessary to reach an accurate diagnosis. Herein, the clinical presentation of a 33-year-old woman with calcaneal insufficiency fracture secondary to celiac disease–induced osteomalacia is presented, and its diagnosis and treatment are discussed. Calcaneal insufficiency fractures should be kept in mind in a patient with celiac disease that presents with heel pain.
Purpose The purpose of this retrospective study was to
evaluate the results and prognostic factor... more Purpose The purpose of this retrospective study was to evaluate the results and prognostic factors affecting the outcome of arthroscopic saucerization for discoid lateral meniscus (DLM). Methods Forty-eight patients who underwent arthroscopic saucerization for DLM between January 2009 and January 2012 in two hospitals were included. There were 21 (43.8 %) male and 27 (56.3 %) female patients with a mean age of 36.02 ± 14.5 (range 9–65) years at the time of operation. According to Watanabe classification, 33 (68.7 %) patients had type II (incomplete) discoid meniscus and 15 (31.3 %) had type I (complete) discoid meniscus. Of the 48 patients, 26 (54.2 %) had an associated lateral meniscal tear. Seventeen patients (35.4 %) had accompanying ligamentous, chondral and/or medial meniscal lesions. The symptoms were present for a mean of 8.04 ± 4.48 (range 1–24) months before the operation. All patients were followed up with a mean of 27.7 ± 10.7 (range 12–47) months using Lysholm knee score. We analyzed the relationship between the outcome variable (Lysholm knee score at the final follow-up) and the predictor variables (age, gender, type of DLM, presence of meniscal tear, duration of symptoms, follow-up and accompanying intra-articular lesions). Results The mean preoperative Lysholm knee score was 46.6 ± 10.2 points and increased to 85.08 ± 13.45 points at the final follow-up (p = 0.0001). Twenty (41.7 %) excellent, seven (14.6 %) good, nineteen (39.6 %) fair and two (4.2 %) poor results have obtained. No complications were observed in any patient. Regression analysis showed that age was the only predictor of the Lysholm score at the final follow-up (R2 = 0.545, p = 0.0001). The linear regression equation was (Lysholm score at final followup) = 106.1 - [0.58 9 (age of patient)]. Conclusions This study demonstrated that arthroscopic saucerization is an effective and safe treatment modality for DLM. Furthermore, age of the patient was shown to be the most important prognostic factor over the final clinical outcome. An excellent or a good result can be expected when the patient is young at the time of operation. Level of evidence IV.
Introduction: Anterior Talofibular Ligament (ATFL) rupture is the most commonly injured anatomic ... more Introduction: Anterior Talofibular Ligament (ATFL) rupture is the most commonly injured anatomic structure in lateral ankle sprain. In some cases, ATFL avulsion fracture from the lateral malleolus may occur instead of purely ligamentous injuries. The ATFL avulsion fracture is detected as a small ossicle at the tip of lateral malleolus on direct radiographs, which is called os subfibulare in chronic cases. Case Presentation: Severe displacement of this ossicle to the tibiotalar joint space is an extremely rare injury. Herein, a case of intra-articular entrapment of os subfibulare following a severe inversion injury of the ankle, which caused a diagnostic challenge was presented. Conclusions: To the best of our knowledge, this is the first case of entrapment of os subfibulare in the talotibial joint space. Fixation of the os subfibulare to lateral malleolus resulted in union and excellent functional results.
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Papers by Özkan Köse
publication rate of the abstracts presented at the 6th
Mediterranean Emergency Medicine Congress, 2011 and
the 7th European Congress on Emergency Medicine,
2012.
Materials and methods All abstracts, both posters
and oral presentations, from the international emergency
medicine congresses held by the European Society for
Emergency Medicine (EUSEM) in 2011 and 2012 were
identified. To establish whether these abstracts were
subsequently published in peer-reviewed medical
journals, the names of all the authors and the title of
the abstracts were searched for in the databases of
Clinical Key/Elsevier, EBSCO Discovery Service, MD
Consult, Science Direct, Scopus, EMBASE, Medscape,
Google Scholar and local ULAKBIM. The year of
publication, consistency of author names and titles, the
type of study, the journals in which papers were
published and countries from which reports were
submitted were all recorded.
Results A total of 1721 abstracts were examined; 626
from 2011 (307 oral presentations and 319 posters) and
1095 from 2012 (154 oral presentations and 941
posters). Of all abstracts in 2011, 172 (27.5%) and of
all abstracts in 2012, 265 (24.2%) were subsequently
published as full-text reports in peer-reviewed journals.
Of the 172 papers published in 2011, 152 (88.4%)
were accepted by Science Citation Index (SCI) and/or SCI
Expanded (SCI-E) journals and 155 (58.5%) of 265
papers were accepted by SCI and/or SCI-E journals in
2012 (p=0.0001).
Conclusions The publication rate of abstracts
submitted to international emergency medicine
congresses held by EUSEM over those 2 years was low
compared with that of abstracts presented in other
emergency medicine congresses. Presenters should be
encouraged to send their studies to peer-reviewed
journals. During the selection process by the scientific
panel, constructive critics should be notified to the
presenters instead of simply accepting or rejecting the
studies that submitted to the congress, which may
increase the subsequent publication rate.
two different modes of administration (telephone versus
face to face) for Lysholm knee score (LKS) to test their
multi-mode equivalence and reliability.
Materials and methods Two LKSs were obtained in 100
patients who underwent ACL reconstruction surgery. First
LKS was completed through telephone interview, and
second LKS, which was at least 2 weeks later, was completed
face-to-face interview at the hospital. To analyze the
test–retest reliability, the relative level of agreement between
the two modes of administration for LKS was calculated
using interclass correlation coefficient (ICC) in
95 % confidence interval.
Results The mean LKS was 93.01 ± 9.12 (range 59–100)
at telephone interview and 93.56 ± 7.93 (range 59–100) at
face-to-face interview (p = 0.130). Both the total point and
the each item’s point were statistically similar (p\0.05
for each item). The total score was same in 66 (66 %)
subjects. The mean difference between two scoring was
only 1.83 ± 3.14 points (range 0–15). However, eight
(8 %) patients were assigned to different grading groups
(excellent, good, fair, and poor). The overall LKS and the each item of the LKS had acceptable test–retest reliability
[ICC = 0.954 (95 % CI 0.931–0.969)].
Conclusions LKS can be reliably completed through
telephone interview, which would provide accurate data
similar to face-to-face interview. Researchers can design
studies using telephone interview as a mode of administration
for LKS or use mix-mode designs.
Keywords Lysholm knee score Telephone Face to
face Interview Mode of administration
reconstruction is dependent on correct placement of both
tibial and femoral tunnels. The purpose of this study is to
investigate whether we can use intraoperative femoral
tunnel length measurement to estimate the correct femoral
tunnel placement on coronal plane.
Methods This prospective study comprised 164 consecutive
patients who underwent ACL reconstruction surgery.
Transtibial or anteromedial portal technique is used
for drilling the femoral tunnels. The length of the femoral
tunnel was measured during the operation. The femoral
tunnel coronal plane angle was calculated on the postoperative
tunnel radiographs. A statistical comparison was
made of the lengths of the tunnel, the techniques used
drilling and the femoral tunnel angles.
Results The far anteromedial portal was used in 81
(49 %) cases and the transtibial technique in 83 (51 %)
cases. The mean femoral tunnel length was 42 ± 6.4 mm
and the mean femoral tunnel coronal angle was
41.1 ± 11.6. The tunnel angle in the transtibial technique
was determined as significantly low compared to the far
anteromedial portal technique (32.6:49.8) and the tunnel length was significantly longer (45.8:38.1 mm)
(p\0.001). In the statistical analysis, it was found that a
patient with a tunnel length of 41 mm and above had a
92.1 % likelihood of femoral tunnel angle below 45.
Conclusion Femoral tunnel length can be used as a clue
for intraoperative evaluation of the femoral tunnel position.
If the femoral tunnel length is greater than 41 mm, the
coronal plane orientation of the femoral tunnel will be
improper and not at a desired position.
Keywords ACL ACL reconstruction Femoral tunnel
length Transtibial technique Far anteromedial technique
to compare intramedullary nailing (IMN) versus minimally
invasive plate osteosynthesis (MIPO) for the treatment of
extra-articular distal tibial shaft fractures.
Materials and methods Twenty-five consecutive patients
with distal extra-articular tibial fractures which were
located between 4 and 12 cm from the tibial plafond (AO
42A1 and 43A1) were randomly assigned into IMN (n:
10) or MIPO (n: 15) treatment groups. All patients were
followed for at least 1 year. Foot function index, time to
weight bearing, union time, duration of operation, length
of incision, intra-operative blood loss, intra-operative fluoroscopy
time, rotational and angular malalignment, rate of
infection, secondary interventions and complications were
compared between groups.
Results All patients completed the trial and were followed
with a mean of 23.1 ± 9.4 months (range 12–52).
Foot function index, weight bearing time, union time,
rate of malunion, rate of infection and rate of secondary
interventions were all similar between groups (p = 0.807,
p = 0.177, p = 0.402, p = 0.358, p = 0.404, p = 0.404,
respectively). Intra-operative blood loss, length of surgical
incision, radiation time and rotational malalignment were higher in the IMN group (p = 0.012, p = 0.019, p = 0.004
and p = 0.027, respectively).
Conclusions Results of our study showed that both treatment
methods have similar therapeutic efficacy regarding
functional outcomes and can be used safely for extra-articular
distal tibial shaft fractures, and none of the techniques
had a major advantage over the other. LEVEL I
cause of plantar heel pain; however,
a broad spectrum of disorders may
also present with plantar heel pain. A
detailed history, physical examination,
laboratory testing, and imaging
studies may be necessary to reach an
accurate diagnosis. Herein, the clinical
presentation of a 33-year-old woman
with calcaneal insufficiency fracture
secondary to celiac disease–induced
osteomalacia is presented, and its
diagnosis and treatment are discussed.
Calcaneal insufficiency fractures should
be kept in mind in a patient with celiac
disease that presents with heel pain.
evaluate the results and prognostic factors affecting the
outcome of arthroscopic saucerization for discoid lateral
meniscus (DLM).
Methods Forty-eight patients who underwent arthroscopic
saucerization for DLM between January 2009 and
January 2012 in two hospitals were included. There were
21 (43.8 %) male and 27 (56.3 %) female patients with a
mean age of 36.02 ± 14.5 (range 9–65) years at the time of
operation. According to Watanabe classification, 33
(68.7 %) patients had type II (incomplete) discoid meniscus
and 15 (31.3 %) had type I (complete) discoid meniscus.
Of the 48 patients, 26 (54.2 %) had an associated
lateral meniscal tear. Seventeen patients (35.4 %) had accompanying
ligamentous, chondral and/or medial meniscal
lesions. The symptoms were present for a mean of
8.04 ± 4.48 (range 1–24) months before the operation. All
patients were followed up with a mean of 27.7 ± 10.7
(range 12–47) months using Lysholm knee score. We
analyzed the relationship between the outcome variable
(Lysholm knee score at the final follow-up) and the predictor
variables (age, gender, type of DLM, presence of meniscal tear, duration of symptoms, follow-up and accompanying
intra-articular lesions).
Results The mean preoperative Lysholm knee score was
46.6 ± 10.2 points and increased to 85.08 ± 13.45 points
at the final follow-up (p = 0.0001). Twenty (41.7 %) excellent,
seven (14.6 %) good, nineteen (39.6 %) fair and
two (4.2 %) poor results have obtained. No complications
were observed in any patient. Regression analysis showed
that age was the only predictor of the Lysholm score at the
final follow-up (R2 = 0.545, p = 0.0001). The linear regression
equation was (Lysholm score at final followup)
= 106.1 - [0.58 9 (age of patient)].
Conclusions This study demonstrated that arthroscopic
saucerization is an effective and safe treatment modality
for DLM. Furthermore, age of the patient was shown to be
the most important prognostic factor over the final clinical
outcome. An excellent or a good result can be expected
when the patient is young at the time of operation.
Level of evidence IV.
Case Presentation: Severe displacement of this ossicle to the tibiotalar joint space is an extremely rare injury. Herein, a case of intra-articular entrapment of os subfibulare following a severe inversion injury of the ankle, which caused a diagnostic challenge was presented.
Conclusions: To the best of our knowledge, this is the first case of entrapment of os subfibulare in the talotibial joint space. Fixation of the os subfibulare to lateral malleolus resulted in union and excellent functional results.
publication rate of the abstracts presented at the 6th
Mediterranean Emergency Medicine Congress, 2011 and
the 7th European Congress on Emergency Medicine,
2012.
Materials and methods All abstracts, both posters
and oral presentations, from the international emergency
medicine congresses held by the European Society for
Emergency Medicine (EUSEM) in 2011 and 2012 were
identified. To establish whether these abstracts were
subsequently published in peer-reviewed medical
journals, the names of all the authors and the title of
the abstracts were searched for in the databases of
Clinical Key/Elsevier, EBSCO Discovery Service, MD
Consult, Science Direct, Scopus, EMBASE, Medscape,
Google Scholar and local ULAKBIM. The year of
publication, consistency of author names and titles, the
type of study, the journals in which papers were
published and countries from which reports were
submitted were all recorded.
Results A total of 1721 abstracts were examined; 626
from 2011 (307 oral presentations and 319 posters) and
1095 from 2012 (154 oral presentations and 941
posters). Of all abstracts in 2011, 172 (27.5%) and of
all abstracts in 2012, 265 (24.2%) were subsequently
published as full-text reports in peer-reviewed journals.
Of the 172 papers published in 2011, 152 (88.4%)
were accepted by Science Citation Index (SCI) and/or SCI
Expanded (SCI-E) journals and 155 (58.5%) of 265
papers were accepted by SCI and/or SCI-E journals in
2012 (p=0.0001).
Conclusions The publication rate of abstracts
submitted to international emergency medicine
congresses held by EUSEM over those 2 years was low
compared with that of abstracts presented in other
emergency medicine congresses. Presenters should be
encouraged to send their studies to peer-reviewed
journals. During the selection process by the scientific
panel, constructive critics should be notified to the
presenters instead of simply accepting or rejecting the
studies that submitted to the congress, which may
increase the subsequent publication rate.
two different modes of administration (telephone versus
face to face) for Lysholm knee score (LKS) to test their
multi-mode equivalence and reliability.
Materials and methods Two LKSs were obtained in 100
patients who underwent ACL reconstruction surgery. First
LKS was completed through telephone interview, and
second LKS, which was at least 2 weeks later, was completed
face-to-face interview at the hospital. To analyze the
test–retest reliability, the relative level of agreement between
the two modes of administration for LKS was calculated
using interclass correlation coefficient (ICC) in
95 % confidence interval.
Results The mean LKS was 93.01 ± 9.12 (range 59–100)
at telephone interview and 93.56 ± 7.93 (range 59–100) at
face-to-face interview (p = 0.130). Both the total point and
the each item’s point were statistically similar (p\0.05
for each item). The total score was same in 66 (66 %)
subjects. The mean difference between two scoring was
only 1.83 ± 3.14 points (range 0–15). However, eight
(8 %) patients were assigned to different grading groups
(excellent, good, fair, and poor). The overall LKS and the each item of the LKS had acceptable test–retest reliability
[ICC = 0.954 (95 % CI 0.931–0.969)].
Conclusions LKS can be reliably completed through
telephone interview, which would provide accurate data
similar to face-to-face interview. Researchers can design
studies using telephone interview as a mode of administration
for LKS or use mix-mode designs.
Keywords Lysholm knee score Telephone Face to
face Interview Mode of administration
reconstruction is dependent on correct placement of both
tibial and femoral tunnels. The purpose of this study is to
investigate whether we can use intraoperative femoral
tunnel length measurement to estimate the correct femoral
tunnel placement on coronal plane.
Methods This prospective study comprised 164 consecutive
patients who underwent ACL reconstruction surgery.
Transtibial or anteromedial portal technique is used
for drilling the femoral tunnels. The length of the femoral
tunnel was measured during the operation. The femoral
tunnel coronal plane angle was calculated on the postoperative
tunnel radiographs. A statistical comparison was
made of the lengths of the tunnel, the techniques used
drilling and the femoral tunnel angles.
Results The far anteromedial portal was used in 81
(49 %) cases and the transtibial technique in 83 (51 %)
cases. The mean femoral tunnel length was 42 ± 6.4 mm
and the mean femoral tunnel coronal angle was
41.1 ± 11.6. The tunnel angle in the transtibial technique
was determined as significantly low compared to the far
anteromedial portal technique (32.6:49.8) and the tunnel length was significantly longer (45.8:38.1 mm)
(p\0.001). In the statistical analysis, it was found that a
patient with a tunnel length of 41 mm and above had a
92.1 % likelihood of femoral tunnel angle below 45.
Conclusion Femoral tunnel length can be used as a clue
for intraoperative evaluation of the femoral tunnel position.
If the femoral tunnel length is greater than 41 mm, the
coronal plane orientation of the femoral tunnel will be
improper and not at a desired position.
Keywords ACL ACL reconstruction Femoral tunnel
length Transtibial technique Far anteromedial technique
to compare intramedullary nailing (IMN) versus minimally
invasive plate osteosynthesis (MIPO) for the treatment of
extra-articular distal tibial shaft fractures.
Materials and methods Twenty-five consecutive patients
with distal extra-articular tibial fractures which were
located between 4 and 12 cm from the tibial plafond (AO
42A1 and 43A1) were randomly assigned into IMN (n:
10) or MIPO (n: 15) treatment groups. All patients were
followed for at least 1 year. Foot function index, time to
weight bearing, union time, duration of operation, length
of incision, intra-operative blood loss, intra-operative fluoroscopy
time, rotational and angular malalignment, rate of
infection, secondary interventions and complications were
compared between groups.
Results All patients completed the trial and were followed
with a mean of 23.1 ± 9.4 months (range 12–52).
Foot function index, weight bearing time, union time,
rate of malunion, rate of infection and rate of secondary
interventions were all similar between groups (p = 0.807,
p = 0.177, p = 0.402, p = 0.358, p = 0.404, p = 0.404,
respectively). Intra-operative blood loss, length of surgical
incision, radiation time and rotational malalignment were higher in the IMN group (p = 0.012, p = 0.019, p = 0.004
and p = 0.027, respectively).
Conclusions Results of our study showed that both treatment
methods have similar therapeutic efficacy regarding
functional outcomes and can be used safely for extra-articular
distal tibial shaft fractures, and none of the techniques
had a major advantage over the other. LEVEL I
cause of plantar heel pain; however,
a broad spectrum of disorders may
also present with plantar heel pain. A
detailed history, physical examination,
laboratory testing, and imaging
studies may be necessary to reach an
accurate diagnosis. Herein, the clinical
presentation of a 33-year-old woman
with calcaneal insufficiency fracture
secondary to celiac disease–induced
osteomalacia is presented, and its
diagnosis and treatment are discussed.
Calcaneal insufficiency fractures should
be kept in mind in a patient with celiac
disease that presents with heel pain.
evaluate the results and prognostic factors affecting the
outcome of arthroscopic saucerization for discoid lateral
meniscus (DLM).
Methods Forty-eight patients who underwent arthroscopic
saucerization for DLM between January 2009 and
January 2012 in two hospitals were included. There were
21 (43.8 %) male and 27 (56.3 %) female patients with a
mean age of 36.02 ± 14.5 (range 9–65) years at the time of
operation. According to Watanabe classification, 33
(68.7 %) patients had type II (incomplete) discoid meniscus
and 15 (31.3 %) had type I (complete) discoid meniscus.
Of the 48 patients, 26 (54.2 %) had an associated
lateral meniscal tear. Seventeen patients (35.4 %) had accompanying
ligamentous, chondral and/or medial meniscal
lesions. The symptoms were present for a mean of
8.04 ± 4.48 (range 1–24) months before the operation. All
patients were followed up with a mean of 27.7 ± 10.7
(range 12–47) months using Lysholm knee score. We
analyzed the relationship between the outcome variable
(Lysholm knee score at the final follow-up) and the predictor
variables (age, gender, type of DLM, presence of meniscal tear, duration of symptoms, follow-up and accompanying
intra-articular lesions).
Results The mean preoperative Lysholm knee score was
46.6 ± 10.2 points and increased to 85.08 ± 13.45 points
at the final follow-up (p = 0.0001). Twenty (41.7 %) excellent,
seven (14.6 %) good, nineteen (39.6 %) fair and
two (4.2 %) poor results have obtained. No complications
were observed in any patient. Regression analysis showed
that age was the only predictor of the Lysholm score at the
final follow-up (R2 = 0.545, p = 0.0001). The linear regression
equation was (Lysholm score at final followup)
= 106.1 - [0.58 9 (age of patient)].
Conclusions This study demonstrated that arthroscopic
saucerization is an effective and safe treatment modality
for DLM. Furthermore, age of the patient was shown to be
the most important prognostic factor over the final clinical
outcome. An excellent or a good result can be expected
when the patient is young at the time of operation.
Level of evidence IV.
Case Presentation: Severe displacement of this ossicle to the tibiotalar joint space is an extremely rare injury. Herein, a case of intra-articular entrapment of os subfibulare following a severe inversion injury of the ankle, which caused a diagnostic challenge was presented.
Conclusions: To the best of our knowledge, this is the first case of entrapment of os subfibulare in the talotibial joint space. Fixation of the os subfibulare to lateral malleolus resulted in union and excellent functional results.