Documents published in Scipedia

• Prevalence of flatfoot among school students and its relationship with BMI

  M. Pourghasem, N. Kamali, M. Farsi, N. Soltanpour

  Collection of Acta Orthopaedica et Traumatologica Turcica (2017).

  
  

  Abstract

  The aim of this study was to analyze the relation between the flat-footedness and obesity. A total of 1158 school children (653 male and 505 female) participated in this cross sectional descriptive study. According to their age, children were divided into three groups for each gender (6–10, 11–13, 14–18 years old). Diagnosis and severity of flatfoot was assessed in using the Dennis method. BMI of children were calculated as body weight divided by height squared (kg*m−2 ). Majority (83.9%) of respondents had normal feet. The prevalence of flatfoot was 16.1% with a decreasing trend with age. Boys had a higher frequency of flatfoot than girls, however the difference was not significant (p > 0.05). The prevalence of flatfoot was 17.5% in boys and 14.5% in girls. The percentage of overweight and obese children was 10.3%. A significant difference in the prevalence of flatfoot occurred between, under-weight (13.9%), normal-weight (16.1%), overweight (26.9%), and obese (30.8%), children. The increasing prevalence of childhood obesity is one of the most serious health challenges across the globe, and a positive correlation between increased BMI, and flatfoot is one of the potential complications.

  Abstract
  The aim of this study was to analyze the relation between the flat-footedness and obesity. A total of 1158 school children (653 male and 505 female) participated in this cross [...]

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• Treatment of post-traumatic elbow deformities in children with the Ilizarov distraction osteogenesis technique

  C. Özkan, M. Deveci, M. Tekin, Ö. Biçer, K. Gökçe, M. Gülşen

  Collection of Acta Orthopaedica et Traumatologica Turcica (2017).

  
  

  Abstract

  The present study assessed functional and radiographic outcomes of distraction osteogenesis treatment of post-traumatic elbow deformities in children. Eight children were treated between 2008 and 2013 for post-traumatic elbow deformities using distraction osteogenesis. Mean age at time of operation was 10.9 years. Six patients had varus and 2 had valgus deformity. Magnitude of correction, fixator index, complications, carrying angle, and elbow range of motion were assessed. Functional results were graded according to protocol of Bellemore et al. Mean follow-up was 43 months. Mean preoperative varus deformity in 6 patients was 29.2° and valgus deformity in 2 patients was 28.5°. Preoperative flexion and extension of elbow were 123.8° and −10.6°, respectively. Mean carrying angle was 9° valgus at last follow-up. Mean flexion and extension were 134.4° and −6.0°, respectively. Change in carrying angle was statistically significant (p = 0.002). There were 2 grade 1 pin tract infections and 1 diaphyseal fracture of humerus. Functional outcome was rated excellent in 7 patients and good in 1 patient. Ilizarov distraction osteogenesis is a valuable alternative in treatment of elbow deformities in children. The surgical technique is simple and correction is adjustable. Gradual correction prevents possible neurovascular complications and minimally invasive surgery produces less scarring. Compliance of patient and family is key factor in the success of the outcome. Level IV, therapeutic study

  Abstract
  The present study assessed functional and radiographic outcomes of distraction osteogenesis treatment of post-traumatic elbow deformities in children. Eight children were [...]

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• Tibiotalocalcaneal arthrodesis by using proximal humeral locking plate

  D. Özer, A. Bayhan, A. Keskin, S. Sarı, M. Kaygusuz

  Collection of Acta Orthopaedica et Traumatologica Turcica (2017).

  
  

  Abstract

  The aim of this study was to evaluate the short-term clinical and radiological results of tibiotalocalcaneal arthrodesis (TTCA) with proximal humeral locking plate. Eight patients (7 female, 1 male, average age 53 years (range: 24–67)) who underwent TTCA with proximal humeral locking plate between 2009 and 2011, were retrospectively evaluated with AOFAS hindfoot scale and Maryland foot score system. The mean follow up was 32.6 months (range: 23–54). Complete fusion was achieved in 7 patients. Soft tissue infection was observed in 2 patients and reflex sympathetic dystrophy in 3 patients. All patients recovered with medical treatment. At the final follow-up, mean AOFAS Hindfoot score was 60 (range: 41–81) and Maryland Foot Score was 67.8 (range: 41–85). The satisfactory rates of AOFAS and MFS were found as 12.5% (1/8) and 50% (4/8), respectively. One patient had an incomplete union with 5 degrees of heel varus deformity and 5 degrees of equinus deformity was observed in another. There were no implant failure or deformation of the plate during the follow-up period. Our study suggests that proximal humeral plate may be an alternative for fixation in tibiotalocalcaneal fusion surgery.

  Abstract
  The aim of this study was to evaluate the short-term clinical and radiological results of tibiotalocalcaneal arthrodesis (TTCA) with proximal humeral locking plate. Eight [...]

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• A rare complication of total knee arthroplasty: Type l complex regional pain syndrome of the foot and ankle

  G. Söylev, H. Boya

  Collection of Acta Orthopaedica et Traumatologica Turcica (2017).

  
  

  Abstract

  Complex regional pain syndrome (CRPS) is a painful and disabling disorder that usually affects the extremities. This complication may affect the knee joint after total knee arthroplasty (TKA). We report a unique case of CRPS of the foot and ankle, which was an unusual involvement site for CRPS after TKA.

  Abstract
  Complex regional pain syndrome (CRPS) is a painful and disabling disorder that usually affects the extremities. This complication may affect the knee joint after total knee [...]

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• Midterm outcomes of high-flexion total knee arthroplasty on Japanese lifestyle

  H. Ohno, M. Murata, S. Ozu, N. Matsuoka, H. Kawamura, H. Iida

  Collection of Acta Orthopaedica et Traumatologica Turcica (2017).

  
  

  Abstract

  To evaluate the clinical outcomes after total knee arthroplasty (TKA) using the Genesis II posterior stabilized prosthesis with a high-flex insert during the mid-term follow-up and to assess its effect on the Japanese lifestyle. Fifty-three consecutive patients (8 men and 45 women) underwent primary TKA. The mean follow-up time was 76 months (5–9 years). Clinical results were assessed with the Japanese Orthopedic Association osteoarthritis knee rating score (JOA knee score), range of motion, and lifestyle changes. The postoperative JOA knee score improved significantly compared to the preoperative JOA knee score. The mean preoperative flexion range improved from 112° to 123° postoperatively (p < 0.05). Additionally, our findings showed that 39% of patients enjoyed a floor-sitting life preoperatively, but only 30% of patients enjoyed floor-sitting life postoperatively. The postoperative range of knee motion and JOA knee score improved after TKA using the Genesis II posterior stabilized prosthesis with a high-flex insert, but the number of patients who enjoyed floor-sitting life decreased from 39% to 30% because of feelings of fear and discomfort. Level of Evidence : Level IV, Therapeutic study

  Abstract
  To evaluate the clinical outcomes after total knee arthroplasty (TKA) using the Genesis II posterior stabilized prosthesis with a high-flex insert during the mid-term follow-up [...]

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• An analysis of postoperative hemoglobin levels in patients with a fractured neck of femur

  N. Nagra, D. Popta, S. Whiteside, E. Holt

  Collection of Acta Orthopaedica et Traumatologica Turcica (2017).

  
  

  Abstract

  The aim of this study was to analyze the changes in hemoglobin level and to determine a suitable timeline for post-operative hemoglobin monitoring in patients undergoing fixation of femoral neck fracture. Patients who underwent either dynamic hip screw (DHS) fixation (n = 74, mean age: 80 years) or hip hemiarthroplasty (n = 104, mean age: 84 years) for femoral neck fracture were included into the study. The hemoglobin level of the patients was monitored perioperatively. Analysis found a statistically and clinically significant mean drop in hemoglobin of 31.1 g/L over time from pre-operatively (D0) to day-5 post-operatively (p < 0.001), with significant reductions from D0 to day-1 and day-1 to day-2 (p < 0.001). At each post-operative time point, DHS patients had lower hemoglobin values over hemiarthroplasty patients (p = 0.046). The decrease in hemoglobin in the first 24-h post-operative period (D0 to day-1) is an underestimation of the ultimate lowest value in hemoglobin found at day-2. Relying on the day-1 hemoglobin could be detrimental to patient care. We propose a method of predicting patients likely to be transfused, and recommend a protocol for patients undergoing femoral neck fracture surgery to standardize postoperative hemoglobin monitoring. Level IV Prognostic study.

  Abstract
  The aim of this study was to analyze the changes in hemoglobin level and to determine a suitable timeline for post-operative hemoglobin monitoring in patients undergoing fixation [...]

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• Is there a correlation between the change in the interscrew angle of the eight-plate and the delta joint orientation angles?

  S. Marangoz, K. Buyukdogan, S. Karahan

  Collection of Acta Orthopaedica et Traumatologica Turcica (2017).

  
  

  Abstract

  It is known that the screws of the eight-plate hemiepiphysiodesis construct diverge as growth occurs through the physis. Our objective was to investigate whether there is a correlation between the amount of change of the joint orientation angle (JOA) and that of the interscrew angle (ISA) of the eight-plate hemiepiphysiodesis construct before and after correction. After the institutional review board approval, medical charts and X-rays of all patients operated for either genu valgum or genu varum with eight-plate hemiepiphysiodesis were analyzed retrospectively. All consecutive patients at various ages with miscellaneous diagnoses were included. JOA and ISA were measured before and after correction. After review of the X-rays, statistical analyses were performed which included Pearson correlation coefficient and regression analyses. There were 53 segments of 30 patients included in the study. Eighteen were males, and 12 were females. Mean age at surgery was 9.1 (range 3–17). Mean follow-up time was 21.5 (range, 7–46) months. The diagnoses were diverse. A strong correlation was found between the delta JOA (d-JOA) and delta ISA (d-ISA) of the eight-plate hemiepiphysiodesis construct (r = 0.759 (0.615–0.854, 95%CI), p < 0.001). This correlation was independent of the age and gender of the patient. There is a strong correlation between the d-ISA and the d-JOA. The d-ISA follows the d-JOA at a predictable amount through formulas which regression analysis yielded. This study confirms the clinical observation of the diverging angle between the screws is in correlation with the correction of the JOA. Level IV, Therapeutic study.

  Abstract
  It is known that the screws of the eight-plate hemiepiphysiodesis construct diverge as growth occurs through the physis. Our objective was to investigate whether there is [...]

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• Fracture of the femoral component after a lightning strike injury: A case report

  X. Lizano-Díez, E. Alentorn-Geli, A. León-García, F. Marqués-López

  Collection of Acta Orthopaedica et Traumatologica Turcica (2017).

  
  

  Abstract

  A fracture of the stem in a total hip arthroplasty (THA) is an uncommon complication. We report a case of femoral stem fracture in a 55-year-old male patient after a lightning strike. A revision was conducted using a Wagner osteotomy and a revision prosthesis. Dall-Milles cerclages were used to close the osteotomy. The postoperative evolution was satisfactory, with an immediate partial weight bearing, consolidation of the osteotomy after three months and return to daily activity without pain.

  Abstract
  A fracture of the stem in a total hip arthroplasty (THA) is an uncommon complication. We report a case of femoral stem fracture in a 55-year-old male patient after a lightning [...]

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• Incidence of second hip fractures and associated mortality in Taiwan: A nationwide population-based study of 95,484 patients during 2006–2010

  S. Lee, I. Chen, Y. Li, C. Chiang, C. Chang, P. Hsieh

  Collection of Acta Orthopaedica et Traumatologica Turcica (2017).

  
  

  Abstract

  The aim of the study is was to determine the incidence and mortality of second hip fracture using a nationwide database. A nationwide epidemiological study was conducted using the Taiwan National Health Insurance Research Database from 2001 to 2011. Patients older than 50 years with hip fractures from 2006 to 2011 were included in the study. A total of 95, 484 hip fractures were identified, with subsequent second hip fracture occurred in 4102 of them. The incidence rate ratio of second hip fracture showed a 7.13 fold of risk of further hip fracture in 3 months, 5.21 fold in one year, and remained more than 2 fold in the end of 6th year when compared with the general population. The 6-year cumulative incidence of a second hip fracture was higher in female (8.0%) than in male (6.2%). A significantly higher 1-year mortality rate was seen after a second hip fracture (18.8%) compared to the first hip fracture (14.1%) (p < 0.05). Men had higher 1- and 5-year mortality rates after second hip fractures (12.1% and 41.2%, respectively) than women (17.4% and 47.3%, respectively). Patients with hip fractures would have a 2–7 fold of risk of a second fracture within 6 years. Women were more prone to a second hip fracture than men but men had a higher mortality rate.

  Abstract
  The aim of the study is was to determine the incidence and mortality of second hip fracture using a nationwide database. A nationwide epidemiological study was conducted using [...]

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• A novel intramedullary nail for use in the treatment of supramalleolar malunion and nonunion: A preliminary report of three cases

  F. Küçükdurmaz, N. Sağlam, T. Kurtulmuş, F. Akpınar

  Collection of Acta Orthopaedica et Traumatologica Turcica (2017).

  
  

  Abstract

  The fractures around the supramalleolar region are difficult to manage and deformities may occur following insufficient or inadequate treatment attempts. The treatment of those deformities is even more challenging. The available options for surgical fixation have inherent problems considering the soft tissue problems, infection and compliance of the patients. In this study, we report the preliminary outcome of new IMN system in use of supramalleolar deformities. Three patients with supramalleolar deformities were recruited for this study. Two patients had periarticular distal tibia malunions and one patient had nonunion in same region. All patients were operated with using newly designed intramedullary nail system with a unique distal interlocking bolt screw. The outcome for each patient was followed-up and evaluated with using AOFAS score. The patients were followed up for 3 years, 3 months, and 6 months, respectively. The AOFAS scores were 36, 33, and 21 preoperatively, and 75, 68, and 75 postoperatively in Patients 1, 2 and 3, respectively. In our patient series, adequate fixation following correction of the deformity was seen. Although the number of the cases are limited this study provides encouraging results regarding the outcome of new IMN system in use of supramalleolar deformities.

  Abstract
  The fractures around the supramalleolar region are difficult to manage and deformities may occur following insufficient or inadequate treatment attempts. The treatment of [...]

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