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A case of intrinsic contracture of a hand of an 18-year-old thin woman following an unrecognized mild trauma is presented. The moderate intrinsic tightness of the second, third, fourth and fifth fingers had been released from the metacarpal bones using the inter-osseous muscle sliding technique. After a 2.5 years follow-up period, no signs of recurrence were recorded and the functional outcome was favorable. Even a very mild trauma in slim patients may lead to hand edema which, in the long-term, could result in intrinsic muscle atrophy of the hand. Key words: [Hand Microsurg 2016; 5(3.000): 156-159]

Dystonia is a disorder of motion; accompanied by unintentional muscle spasms leading to repetitive movements and/or aberrant posture that appears during a specific activity. Examples of focal task-specific dystonia (TSD) are and ldquo;writer's cramp and rdquo; and and ldquo;musician's dystonia and rdquo;, and it specifically involves the hand. A 54-year-old male presented with a complaint that the index finger of his right hand moved repetitively that scratched the wrist and palm when he shook hands. He could not find a solution to his problem through non-surgical treatment options. Based on the fact that the problem was limited to the index finger, non-progressive (stable) and refractory to non-surgical treatment, it was attempted to treat the patient with a tendon transfer as a last option. A case of focal TSD of the right index finger treated with tenotomy and tendon transfer is presented here. [Hand Microsurg 2016; 5(2.000): 104-106]

Background: Proximal locking screw deformation and screw fracture is a frequently seen problem for femur interlocking nailing that affects fracture healing. We realized that there is lack of literature for the right level for the proximal locking screw. We investigated the difference of locking screw bending resistance between the application of screws on different proximal femoral levels. Materials and Methods: We used a total of 80 proximal locking screws for eight groups, 10 screws for each group. Three-point bending tests were performed on four types of screws in two different trochanteric levels (the lesser trochanter and 20 mm proximal). We determined the yield points at three-point bending tests that a permanent deformation started in the locking screws using an axial compression testing machine. Results: The mean yield point value of 5 mm threaded locking screws applied 20 mm proximal of lesser trochanter was 1022 ± 49 (range 986–1057) (mean ± standard deviation, 95% confidence interval). On the other hand, the mean yield point value of the same type of locking screws applied on the lesser trochanteric level was 2089 ± 249 (range 1911–2268). Which means 103% increase of screw resistance between two levels (P = 0.000). In all screw groups, on the lesser trochanter line we determined 98–174% higher than the yield point values of the same type of locking screws in comparison with 20 mm proximal to the lesser trochanter (P = 0.000). Conclusion: According to our findings, there is twice as much difference in locking screw bending resistance between these two application levels. To avoid proximal locking screw deformation, locking screws should be placed in the level of the lesser trochanter in nailing of 1/3 middle and distal femur fractures.

Objectives: A frequent problem for interlocking nailing, that affects the treatment of the fracture is locking screw deformation. The research question is whether bending resistance is different between high, low and unthreaded locking screws of interlocking femoral nails. Materials and methods. : We used 90 screws for nine groups, ten screws for each group in this experimental study. We performed three-point bending tests on six group of 5 mm screws (titanium, stainless steel, crossed with unthreaded, low threaded and high threaded) and the same three thread types of 5.5 mm stainless steel screws in a steel tube that has 30 mm inner diameter, which imitates the level of lesser trochanter. We determined the yield points at three-point bending tests that permanent deformation started in the locking screws using an axial compression testing machine. Results: The mean yield point value at 3-point bending test of 5 mm low threaded stainless steel locking screws was 2071N and 53% less than unthreaded ones (3169 N).The mean yield point value of 5 mm high threaded stainless steel locking screws was 556 N and 272% less than low threaded ones (2071 N). Conclusion: To avoid locking screw deformation, high threaded screws must not be used as locking screws. Five mm low threaded screws in nailing of comminuted or oblique femur shaft fractures of unreliable patients should not be used. All 5 mm unthreaded screws and 5.5 mm low threaded stainless steel screws can be used safely in full weight conditions of unreliable patients.

Objectives This study aims to investigate whether there is any significant difference in bending resistance between titanium and stainless steel locking screws of femur nails and to review deformation of locking screws which is a common problem in interlocking nailing. Materials and methods In this study, a total of 60 pieces of 5 mm major diameter titanium and stainless steel locking screws were used as six groups in three different thread depth structures (high threaded, low threaded, and unthreaded). Three-point bending tests were conducted on steel screws placed inside stainless steel tube with 30 mm inner diameter, which imitated the level of lesser trochanter. We used an axial compression testing machine in order to determine the yield points that permanent deformation occurred in the locking screws. Results For low threaded locking screws, which are the most frequently used thread type for locking screws, the mean bending yield points were 1413 N on the titanium screws and this level was below 1922 N (2.8 BW) of level walking loading on femur for 70 kg person. On low threaded stainless screws, bending resistance was 2071 N, which was above the value of 1922 N. For high threaded locking screws, the mean bending yield points were 874 N on the titanium screws and 556 N on stainless screws. Conclusion In comminuted femur shaft fractures (in full load bearing conditions), using stainless steel locking screws is better instead of titanium screws to avoid locking screw deformation since low threaded stainless steel screws were 46.5% more resistant to bending deformation than titanium ones. Stainless steel or titanium high threaded locking screws may only be carefully used in non-comminuted fractures.

Background: The aim of this study is to evaluate the results of radiological and clinical data of patients treated by posterior decompression and fusion who have degenerative lomber spinal stenosis (DLSS). Materials and Method: 30 patients (17 female, 13 male) evaluated in this study who diagnosed as DLSS and underwent to surgery between 1999 and 2005. Lumbar spinal canal measured with CT scans of the operated level, one level upper and one level under from the operated level. All patients evaluated with Oswestry questionnaire and clinic examination scale (existence of back pain, leg pain, numbness, prickle, motor deficiency and sensory deficiency). Preoperative and postoperative satisfaction was evaluated by Visual Analog Scale (VAS). Results: Mean follow-up time was 4.3±3.7 years. Preoperative spinal canal diameter was 12.4±3.3 mm whereas postoperative 14.0±2.8 mm. Postoperative clinic scale and Oswestry questionnaire found to be beter significantly (p, Background: The aim of this study is to evaluate the results of radiological and clinical data of patients treated by posterior decompression and fusion who have degenerative lomber spinal stenosis (DLSS). Materials and Method: 30 patients (17 female, 13 male) evaluated in this study who diagnosed as DLSS and underwent to surgery between 1999 and 2005. Lumbar spinal canal measured with CT scans of the operated level, one level upper and one level under from the operated level. All patients evaluated with Oswestry questionnaire and clinic examination scale (existence of back pain, leg pain, numbness, prickle, motor deficiency and sensory deficiency). Preoperative and postoperative satisfaction was evaluated by Visual Analog Scale (VAS). Results: Mean follow-up time was 4.3±3.7 years. Preoperative spinal canal diameter was 12.4±3.3 mm whereas postoperative 14.0±2.8 mm. Postoperative clinic scale and Oswestry questionnaire found to be beter significantly (p

A total of 179 patients (61 female, 118 male) with diabetic foot infection who have been followed up for 3 years (March 1997-March 2000) by the “Committee of Diabetic Foot” in Ege University Medical School, were evaluated retrospectively in various aspects. The mean age and the diabetes age of the patients were 58.8 (33-85) and 14.7 (1-40) respectively. Of these 179 patients, 59 had low risk (33%), 82 had high risk (46%) and 38 had serious (21%) infection. In the low risk infection group, the patients had only soft tissue infection without osteomyelitis and there was no need for amputation. Osteomyelitis was present in 28 out of 82 (34%) patients with high risk infection and 34 out of 38 (89%) subjects with serious infection. The amputation frequencies in these two groups were 35% (29/82) and 89% (34/38) respectively. Overall, 35% (63/179) of all patients were amputated. Low risk infections were usually monomicrobial and high risk and serious infections were mostly polymicrobial. Due to the various components of the diabetic foot treatment, the requirement for a collaboration among many disciplines was emphasized and different choices for antimicrobial therapy was discussed.

Akson içine semptomatik kanama olan spinal hematom nadir bir lezyondur ve spinal veya epidural anestezinin katastrofik bir komplikasyonudur. Spinal kord basılarının tedavisinde ilk 8 saat içinde yapılacak laminektomi spinal iskeminin geri dönüşünü sağlayacaktır. Bu olgu sunumunda total diz protezi uygulanmış ve tromboemboli profilaksisi olarak düşük molekül ağırlıklı heparin kullanan bir olguda epidural kateterin çekilmesinden sonra oluşan epidural hematom olgusu sunulmuştur., The spinal hematoma, defined as symptomatic bleeding within the spinal neuraxis, is a rare and potentially catastrophic complication of spinal or epidural anesthesia. Spinal hematoma reveals itself with the signs of cord compression. In the case of spinal cord compression, laminectomy seems to be effective in reversing spinal ischemia if performed within the first eight hours. We report a case of epidural hematoma formation after the removal of the lumbar epidural catheter in a patient who underwent total knee replacement surgery and commenced to receive lowmolecular- weight heparin (LMWH) postoperatively for thromboembolic prophylaxis.

One of the problems for interlocking nailing of the femur is interfragment rotation motion, affecting fracture healing. The nails with single distal locking screw are advantageous for decreasing operation time and radiation exposure. We investigated which single distal screw nail is the best for interfragment rotational stability.We used a total of 30 composite femurs, ten for each group. We determined interfragment rotational displacement of composite femurs with three types of single distal screw nails (10 interlocking nails, 10 compression nails and 10 Mehmet anti-rotation nails compressed by tube) at 6-Nm external- 6 Nm internal and 10 Nm extern- 6 Nm internal torques, which imitating respectively the level walking and descending stairs, using an axial distraction testing machine and a custom designed rotation apparatus.Between 10 Nm external and 6 Nm internal torques with single distal locking screw, the interfragment rotational displacement in the Mehmet nail compressed by the 8 Nm torque wrench was mean 1.14 mm and 540% less than mean 7.31 mm in interlocking nails and 400% less than 5.72 mm in compression nails compressed by the 2.5 Nm torque wrench.The single distal screw Mehmet nail is superior than other single (or even some double) distal screw nails for maximum rotational stability, with no interfragment distraction gap, no superior nail migration, decreased operation time, and less radiation exposure in axially stable transverse and short oblique femur fractures in daily activities like stair descending or level walking.