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This prospective study was conducted for the clinical evaluation of pain severity and knee functionality following PRP injections with different leukocyte (WBC) concentrations applied to cases diagnosed with knee osteoarthritis. A total of 109 patients were included in the study. According to the leukocyte content the PRP injections were prepared as low-leukocyte content PRP (P-PRP) and high concentration leukocyte content PRP (L-PRP). Patients were divided into 2 groups. Group 1 (n=44) received low-leukocyte content PRP and Group II (n = 65) received high-leukocyte content PRP. The patients were evaluated clinically with Visual Analog Scale (VAS) and Knee Society Score (KSS). The changes in the PLT levels of the L-PRP group after the procedure compared to the levels prior to the procedure were found to be statistically significantly greater than the changes in the PPRP group. The mean VAS score of all the cases before treatment was 9.05±0.91 and this score decreased to 3.71±1.46 within 12 months. The increases in the mean Knee Society Score (KSS) values were determined as 16.92±1.97 within 6 months and 16.89±2.97 within 12 months in the P-PRP group and 19.71±1.24 within 6 months and 19.86±0.42 within 12 months in the L-PRP group. The most important aspect of this study is that, in contrast to many other studies, the results continued after the 6th month and were reported to be good in the 12th month. It was also recorded that L-PRP was clinically superior to P-PRP in the treatment of early stage knee osteoarthritis.

Volar locking plating treatment results in fragmented intra-articular distal radius fractures in adults. Twenty-five patients (14 men, 11 women; mean age, 44.32±12.12 years) who were treated with volar locking plates due to distal radius fractures were prospectively studied. Among the fractures, 44% were C2 and 56% were C3, according to the AO classification system. Clinical analyses were performed using the Gartland and Werley scale, the short version of the Arm, Shoulder, and Hand Questionnaire (QuickDASH), and the visual analogue scale (VAS); radiological evaluations were performed using the Stewart evaluation criteria. The mean patient follow-up time was 20.36±7.62 months. According to the Gartland and Werley assessment scale, 68.0% of the patients (n = 17) had excellent results, 28.0% (n =7) had good results, and 4.0% (n =1) had poor results. The mean VAS score was 0.84±1.07, and the quick-average DASH subjective question score was 7.07±12.95. According to the Stewart score, the percentages of patients with perfect and good results were 92% and 8%, respectively. Among the patients, the mean grip strength was 77.3% when it was evaluated on the healthy side. One patient was diagnosed with complex regional pain syndrome, while another patient was diagnosed with flexor tenosynovitis and paraesthesia in the distribution of the median nerve; two patients were diagnosed with flexor tenosynovitis. Volar locking plating is an effective surgical method for treating distal radius fractures. The plate should be properly placed during surgery, and post-operative movement should begin early.

Phalangeal brachydactyly, which is caused by the abnormal development of the metacarpal, is characterized by shortness that can be seen in a single finger or in all fingers of the hands. Although brachydactyly is usually thought of as congenital, it can occur due to metabolic disorders or trauma. A twelve-year-old girl was admitted to our clinic with complaints of shortness in the fourth finger of the left hand. Osteotomy was applied with the drilling-osteotomy technique. The screws holding the upper and lower segments were adapted to the external fixator. Lengthening began one week after the osteotomy. The lengthening rate was organized as 0.25×2 mm/day. The amount of elongation was planned not to exceed 40% of the original bone length. Distraction was terminated after the planned elongation amount was reached, and the bone was allowed to heal. In patients under twenty years of age, the results from progressive distraction without bone grafting are close to perfect. Although the technique of successfully lengthening metacarpal fractures in children is simple, strict rules should not be ignored. Primarily, the external fixator and the distraction system should be sufficiently stable, lightweight, and should be appropriate for the size of a child’s hand.

Plantar fasciitis is a disorder caused by inflammation of the insertion point of the plantar fascia over the medial tubercle of the calcaneus. Foot orthotics are used to treat plantar fasciitis. Heel pads medialise the centre of force, whereas medial arch supporting insoles lateralise the force. We assessed the clinical results of the treatment of plantar fasciitis with silicone heel pads and medial arch-supported silicone insoles. We retrospectively reviewed 75 patients with heel pain. A total of 35 patients in the first group were treated with medial arch supporting insoles, and 40 patients in the second group were treated with heel pads. The patients were evaluated with the Visual Analogue Scale (VAS) and the Foot and Ankle Ability Measure (FAAM) at the first and last examinations. The mean VAS score in the first group was 8.6±1,2 (6-10); the FAAM daily activity score was 66.2±16 (41.2-95.0), and the sporting activity score was 45.4±24,4 (0.1-81) before treatment. At the last follow-up in this group, the mean VAS score was 5.3±1,5 (0-9); the FAAM daily activity score was 83,0±15,1 (55,9-100), and the sporting activity score was 73,5±26,2 (25-100). The mean VAS score in the second group was 8,6±0,9 (7-10); the FAAM daily activity score was 66.4±17 (41.4-95.2), and the sporting activity score was 45.8±24,2 (0.8-81, 3) before the treatment. At the last followup in this group, the mean VAS score was 5.5±1,2 (0-9); the FAAM daily activity score was 83.4±14,9 (60, 2-100), and the sporting activity score was 73.8±26 (28-100). There was no significant difference in the clinical results of both groups. The force distribution by the use of silicone heel pads and medial arch-supported silicone insoles had no effect on the clinical results of the treatment of plantar fasciitis. Plantarni fascitis je poremećaj koji nastaje usled zapaljenja pripoja plantarne fascije za medijalni tuberkulum petne kosti. Za lečenje plantarnog fascitisa se koriste ortoze za stopala. Petni ulošci pomeraju mesto opterećenja ka unutra, dok ulošci za podupiranje medijalnog luka pomeraju mesto opterećenja upolje. Klinički rezultati se bave ispitivanjem lečenja plantarnog fascitisa silikonskim petnim ulošcima i silikonskim ulošcima za podupiranje medijalnog luka stopala. Retrospektivno je ispitano 75 pacijenata sa bolom u peti. 35 pacijenata u prvoj grupi su lečeni sa ulošcima za podupiranje medijalnog luka stopala. 40 pacijenata u drugoj grupi je lečeno petnim ulošcima. Pacijenti su ocenjivani pomoću Visual Analogue Scale (VAS) i Foot and Ankle Ability Measure (FAAM) na prvom i na poslednjem pregledu. Pre lečenja, srednja vrednost VAS skora u prvoj grupi je bila 8,6 ± 1,2 (6 - 10), FAAM skora adnevne aktivnosti 66,2 ± 16 (42,1 – 95,0) i skora sportske aktivnosti 45,4 ± 24,4 (0,1 - 81). Srednje vrednosti na poslednjem pregledu VAS skora su iznosile 5,3 ± 1,5 (0 - 9), FAAM skora adnevne aktivnosti 83,0 ± 15,1 (55,9 – 100) i skora sportske aktivnosti 73,5 ± 26,2 (25 - 100). Pre lečenja, srednja vrednost VAS skora u drugoj grupi je iznosila 8,6 ± 0,9 (7 - 10), FAAM skora adnevne aktivnosti 66,4 ± 17 (41,4 – 95,2) i skora sportske aktivnosti 45,8 ± 24,2 (0,8 – 81,3). Na poslednjem pregledu srednja vrednost VAS skora je bila 5,5 ± 1,2 (0 - 9), FAAM skora adnevne aktivnosti 83,4 ± 14,9 (60,2 - 100) i skora sportske aktivnosti 73,8 ± 26 (28 – 100). Nema statistički značajne razlike u kliničkim rezultatima između grupa. Raspodela sile pritiska upotrebom silikonskih petnih uložaka ili silikonskih uložaka za podupiranje medijalnog luka stopala nema uticaj na kliničke rezultate lečenja plantarnog fascitisa.

Trapezium fractures and dislocations of the trapezium are both extremely rare injuries whether they occured with or without fractures of the surrounding bones. Specific radiological images can be difficult to help for the diagnosis. CT scan may be necessary for the diagnosis and adequate treatment. We are presenting an unusual case of volar and radial isolated trapezium dislocation concomitant second metacarpal basis fracture in which is treated by using open reduction and Kirschner wire fixation. In our case, isolated dislocation of trapezium was a result of violent and direct trauma. Different techniques have been proposed to achieve a stable fixation and the treatment outcomes. In our case, open reduction, Kirschner wire fixation and intercarpal ligament repair through dorsal approach are recommended for satisfactory outcomes in similiar cases.