Documents published in Scipedia

• The primary factor for suture configuration at rotator cuff repair: Width of mattress or distance from tear edge

  O. Hapa, A. Karakaşli, O. Başçı, H. Cici, B. Çeçen, H. Havitçioğlu

  Collection of Acta Orthopaedica et Traumatologica Turcica (2017).

  
  

  Abstract

  The aims of this study was first to investigate whether the bite size or the bite distance from the tear edge is of primary importance in mattress suture configuration for rotator cuff repair. Secondly, whether the use of a 450 left side bent Arthro-Pierce™ (Smith & Nephew, Andover, USA) during suture passage can be more effective on the strength of the configuration compared to a straight Arthro-Pierce™. Twenty-eight bovine infraspinatus muscle tendons were randomized into four groups. Group 1, 5 mm wide ‘bite size’ × 15 mm length ‘distance from the tear edges mattress’, Group 2: 7.5 mm × 10 mm, Group 3: 15 mm × 5 mm ‘using straight Arthro-Pierce™’ and Group 4: 5 mm × 15 mm using left sided 450 bent Arthro-Pierce™. The repair specimens underwent cyclic loading prior to loading the failure testing. Cyclic elongation (mm), peak-to-peak displacement (mm), ultimate load (N), stiffness (N/mm) and failure mode were recorded for each specimen. The mean ultimate load in Group 1 was higher compared to group 3. The peak to peak displacement was higher in Group 4 compared to Group 1 (p < 0.05). The predominant failure mode in Groups 1, 2 and 4 was suture rupture. The Group 3 most specimens failed due to suture cut through the tendon. Bite size from the edge of the tendon seems to be more important than the width of the mattress. The curve of the suture passing device may also have an effect on the strength of the suture tendon interface.

  Abstract
  The aims of this study was first to investigate whether the bite size or the bite distance from the tear edge is of primary importance in mattress suture configuration for [...]

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• Comment on: Measurement of the knee joint line in Turkish population

  H. Gungor, N. Ok, K. Agladioglu

  Collection of Acta Orthopaedica et Traumatologica Turcica (2017).

  
  

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• The effects of low-dose radiotherapy on fresh osteochondral allografts: An experimental study in rabbits

  U. Gönç, M. Çetinkaya, M. Atabek

  Collection of Acta Orthopaedica et Traumatologica Turcica (2017).

  
  

  Abstract

  The aim of this study was to investigate the effects of low-dose fractionated radiotherapy on cartilage degeneration after distal femoral fresh massive osteochondral allograft transplantation. Twenty-four New Zealand White rabbits were divided into three groups of 8 rabbits each. All rabbits underwent distal femoral medial condyle fresh massive osteochondral allograft transplantation from California rabbits. The group 1 underwent transplantation without any preliminary process. The group 2 underwent fractionated local radiotherapy of 100 cGy for five days starting on the transplantation day. The group 3 included the rabbits to which the grafts transplanted after radiating in vitro by a single dose radiation of 1500 cGy. The hosts were sacrificed twelve weeks later. Anteroposterior and lateral radiographs were taken. Synovial tissue, cartilaginous tissue, and subchondral bone were assessed histopathologically. Nonunion was present in three cases of group 2 and one of group 3 in which cartilage degeneration was more severe. Synovial hypertrophy and pannus formation were more obvious in non-radiated rabbits. Hypocellularity and necrosis of the subchondral bone were rare in group 2. More cartilage tissue impairment was present in group 3 compared to group 1. In osteochondral massive allograft transplantations, the immune reaction of the host could be precluded with radiotherapy, and the side-effects can be prevented by low-dose fractionated regimen. The total dose of fractionated radiotherapy for an immune suppression should be adjusted not to damage the cartilage tissue, but to avoid articular degeneration in the long term.

  Abstract
  The aim of this study was to investigate the effects of low-dose fractionated radiotherapy on cartilage degeneration after distal femoral fresh massive osteochondral allograft [...]

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• Minimally invasive plate osteosynthesis with PHILOS plate for proximal humerus fractures

  U. Gönç, M. Atabek, K. Teker, A. Tanrıöver

  Collection of Acta Orthopaedica et Traumatologica Turcica (2017).

  
  

  Abstract

  The aim of the present study was to evaluate results, including clinical and radiological outcomes and number of complications, following minimally invasive plate osteosynthesis (MIPO) of proximal humerus fractures, using the PHILOS® proximal humerus internal locking system (Synthes Holding AG, Solothurn, Switzerland). Retrospectively evaluated were 31 patients treated with MIPO (12 male, 19 female, average age: 58.4 years). Four patients had 2-part fractures, 14 patients had 3-part fractures, and 13 patients had 4-part fractures, according to Neer classification. Healing, complications, and head-shaft angle (HSA) were radiographically evaluated. Clinical outcomes were assessed at 1-year follow-up with Constant score. Average Constant scores for fractured and normal shoulders were 73.2 ± 10.9 and 84.8 ± 5.1, respectively. Varus progression, fracture type, and age had no significant effect on functional outcome. Average postoperative and follow-up HSAs were 130.80 ± 7.70 and 128.80 ± 10.00, respectively. Significant varus progression was observed during follow-up (p = 0.01). Varus progression was more prominent in patients with postoperative HSA < 130° (p < 0.001). Inferomedial calcar screw usage, fracture type, and age had no significant effect on varus progression. Complications included 2 implant failures, 1 case of avascular necrosis (AVN), 1 primary screw cut-out, 1 axillary nerve injury, and 1 radial nerve injury (22.6% overall). MIPO is a safe and effective option for the treatment of proximal humerus fractures, with good functional recovery and fewer complications, which are typically technique dependent. Reduction may be difficult, resulting in varus progression. Another disadvantage is risk of axillary nerve injury. Careful surgical technique and correct implant selection is important in the prevention of nerve injury. Level IV, Therapeutic study.

  Abstract
  The aim of the present study was to evaluate results, including clinical and radiological outcomes and number of complications, following minimally invasive plate osteosynthesis [...]

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• The comparative efficacy of kinesio taping and local injection therapy in patients with subacromial impingement syndrome

  H. Göksu, F. Tuncay, P. Borman

  Collection of Acta Orthopaedica et Traumatologica Turcica (2017).

  
  

  Abstract

  The aim of this study was to compare the therapeutic effects of kinesio taping (KT) and local subacromial injection in patients with subacromial impingement, syndrome (SIS) with regard to pain, range of motion (ROM) and disability. Sixty-one patients (48 females and 13 males, mean age: 43.04 ± 6.31, years) with SIS were enrolled into the study. The patients were randomized into two treatment groups receiving either a single corticosteroid and local anesthetic (LA) injection, or kinesio taping performed three times by intervals of 3 day. Visual analog scale (VAS) was used to assess pain intensity, range of motion (ROM) degrees of, shoulder were recorded and Shoulder Pain and Disability Index (SPADI) was, performed to evaluate functional disability, before treatment, at the first and fourth, weeks after therapies. A exercise program was prescribed for both groups including pendulum, active range of motion (ROM) and strengthening exercises. Pain, functional outcome measures were determined to have improved significantly in both groups at the end of therapies at first and fourth weeks (p < 0.05), but these improvements were more significant in the injection group than in kinesio taping group (p < 0.05). The improvements in pain at rest, shoulder abduction degrees, and SPADI scores at first and fourth weeks were statistically higher in injection group than in kinesio taping group. Although the improvement in pain intensity at rest, ROM and disability were better with local injection, KT may be an alternative noninvasive method to local subacromial injection for patients suffering from subacromial impingement syndrome. Level I, Therapeutic study.

  Abstract
  The aim of this study was to compare the therapeutic effects of kinesio taping (KT) and local subacromial injection in patients with subacromial impingement, syndrome (SIS) [...]

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• Total hip arthroplasty-related pelvic pseudotumor: Unusual presentation with hydronephrosis

  Z. Kilicoglu, O. Kilicoglu, M. Simsek

  Collection of Acta Orthopaedica et Traumatologica Turcica (2017).

  
  

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• Anterior tibial artery pseudoaneurysm due to interlocking bolt of tibial nail: A case report and review

  N. Gahlot, R. Kanojia

  Collection of Acta Orthopaedica et Traumatologica Turcica (2017).

  
  

  Abstract

  Vascular injuries associated with the tibial nailing have been reported in few case reports. We here report a unique case of anterior tibial artery (ATA) pseudoaneurysm caused by the second proximal coronal interlocking bolt. We found that the position of interlocking bolts on the nail brings them very close to the anatomical positions of arteries in leg. The reports of ATA injury by interlocking bolts highlight the need for reconsidering the nail design and screw hole positions.

  Abstract
  Vascular injuries associated with the tibial nailing have been reported in few case reports. We here report a unique case of anterior tibial artery (ATA) pseudoaneurysm caused [...]

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• Minimally invasive intramedullary nailing of clavicular fractures by a new titanium elastic nail

  B. Fu

  Collection of Acta Orthopaedica et Traumatologica Turcica (2017).

  
  

  Abstract

  The aim of this study was to evaluate clinical results of a new design titanium elastic nail (TEN) for displaced midshaft clavicular fractures. Between February 2012 and December 2013, a total 36 patients with displaced midshaft clavicular fractures were treated with intramedullary nailing stabilization with our new design TEN. Blood loss, mean times of operation, postoperative complications, hospital stays and time to bone union was recorded. The outcomes were evaluated with radiographic assessment, visual analog scale (VAS) score, the Constant-Murley, and the disabilities of the arm, shoulder, and hand (DASH) scores. The mean blood loss was 50.278 ± 10.753 ml, while the mean operation, hospital stay and bone union times were 46.417 ± 9.232 min, 10.056 ± 2.672 days and 11.583 ± 2.729 weeks, respectively. After removal of the TENs at a mean of 10.2 months (range, 8-13 months) after surgery, no re-fracture and nonunion was found in any patient. Two cases of shoulder back stabbing pain were spontaneously resolved later. The mean fracture healing time was 12 weeks. The VAS score and motion ranges of shoulder joint were significantly improved postoperatively (P < 0.001). The shoulder function recovery showed the excellent results with the mean Constant-Murley score of 93.389 ± 2.749 and DASH scores of 2.528 ± 1.567. Our new TEN design used in intramedullary fixation might be a safe and effective technique for treatment of displaced midshaft clavicular fractures. Level of evidence: Level IV, therapeutic study .

  Abstract
  The aim of this study was to evaluate clinical results of a new design titanium elastic nail (TEN) for displaced midshaft clavicular fractures. Between February 2012 and December [...]

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• Soft-tissue osteoma of the thenar eminence

  B. Ersoy

  Collection of Acta Orthopaedica et Traumatologica Turcica (2017).

  
  

  Abstract

  The development of osteoma in soft tissues without a direct contact with the adjacent osseous and articular structures is a very rare event. The involvement of the hand is even rarer, with only two previous cases reported so far. A 25-year-old man presented with a painless solid mass in the thenar region of his right palm, which appeared almost 2 years ago and showed a progressive enlargement in the last months. Under regional anesthesia an excisional biopsy was performed and the histopathological evaluation of the lesion confirmed the diagnosis of soft tissue osteoma. The postoperative follow-up period was uneventful without any complication or recurrence. Following a brief period of hand physiotherapy the patient has returned to normal daily activities.

  Abstract
  The development of osteoma in soft tissues without a direct contact with the adjacent osseous and articular structures is a very rare event. The involvement of the hand is [...]

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• Safety of modified Stoppa approach for Ganz periacetabular osteotomy: A preliminary cadaveric study

  M. Elmadağ, G. Uzer, F. Yıldız, H. Ceylan, M. Acar

  Collection of Acta Orthopaedica et Traumatologica Turcica (2017).

  
  

  Abstract

  The aim of this cadaveric study was to investigate the efficacy of the modified Stoppa approach in Ganz periacetabular osteotomy (PAO). The Ganz PAO was performed on 10 hemipelvises with normal hips, from 5 cadavers using the modified Stoppa approach through the Pfannenstiel incision. All of the osteotomies were performed under fluoroscopic control and direct visualizing the osteotomy site from the same incision. After the osteotomy, the acetabulum was medialized and redirected anterolaterally, and fixed with 2 screws. The neurovascular structures and the joints were examined by dissecting the soft tissues after fixation of the osteotomies. Outcome parameters were center-edge (CE) angle, the distances between the osteotomy and anterior superior iliac spine (ASIS), and between the osteotomy and the sciatic notch, neurovascular and joint penetrations. After the osteotomy, the mean CE angle was improved from 19.8° to 25.2°, mean distance between the osteotomy and ASIS was 3.1 cm, and the mean distance between the osteotomy and the sciatic notch was 10.2 mm. The neurovascular structures and the joints were examined by dissecting the soft tissues after fixation of the osteotomies. No damage to the joint, surrounding arteries, veins or nerves was detected in any of the cadavers. Bilateral dysplastic hips can be treated with a 10 cm, cosmetically more acceptable incision in the same session using this approach. Quadrilateral surface of the acetabulum can be directly seen using this approach and the osteotomy can be safely performed.

  Abstract
  The aim of this cadaveric study was to investigate the efficacy of the modified Stoppa approach in Ganz periacetabular osteotomy (PAO). The Ganz PAO was performed on 10 hemipelvises [...]

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