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It is claimed that Morton Neuroma (MN) is symptomatic if it is greater than 5mm. In contrast, significant amounts of Morton neuroma that do not reach this critical level may become symptomatic. Therefore, it is thought that MN size and intensity of symptoms do not show a positive correlation. Twenty patients who were operated at Medipol University School of Medicine between 2015-2019 for the diagnosis of Morton neuroma and whose disease was diagnosed as Morton Neuroma by MRI and pathological evaluation and were evaluated retrospectively. Pathological tissue size measurements and MRI measurements were compared. The mean age of the operated patients was 47, 14 were female and 6 were male. The average of the pathological tissue dimensions after the measurements was 16,6 mm. The average of the radiological image dimensions after the measurements was 8,5 mm. The pathologic dimension was significantly higher (p [Med-Science 2023; 12(2.000): 475-8]

Osteoarthritis (OA) is a prevalent joint condition that affects areas such as the knee, hip, hand, and spine. In treating mild to moderate cases of OA, treatment options such as intraarticular corticosteroids, viscosupplementation, glucosamine and chondroitin sulfate, PRP, and IL-1Ra are commonly used. This study aimed to compare the effects of IL-1 receptor antagonist (IL-1Ra) and platelet-rich plasma (PRP) on patients with Kellgren-Lawrence (KG) stage 2-3 knee osteoarthritis in terms of Visual Analog Scale (VAS) and Knee injury and osteoarthritis outcome score (KOOS). Ninety patients with KG stage 2-3 knee primary osteoarthritis were divided into two groups, with one group receiving three intraarticular IL-1Ra injections and the other group receiving three PRP injections. VAS and KOOS scores were recorded at the beginning and after six months to evaluate clinical improvement. Both the IL-1Ra and PRP groups showed statistically significant improvement in all scores, including the VAS and KOOS. After six months, the KOOS score in the IL-1Ra group was significantly higher than the PRP group, while the first-year VAS score after treatment in the IL-1Ra group was significantly lower compared to the PRP group. The mean KOOS scores increased from 44.1 to 87.8 and 46.04 to 84.43 at the end of six months in both groups, while the mean VAS scores decreased from 7.27 to 1.02 and 7.29 to 1.71 in the IL-1Ra and PRP groups, respectively. Administering intra-articular IL-1Ra once a week for three weeks can effectively improve function and reduce pain in patients with Kellgren-Lawrence stage 2-3 osteoarthritis. However, more research is necessary to validate the use of IL-1 receptor antagonists in OA treatment. [Med-Science 2023; 12(2.000): 542-7]

We aimed to figured out the risk factors of one year mortality in intertrochanteric hip fractures with delayed operation more than 72 hours. 96 out of 226 patients with proximal femoral fracture included in this study. Hemogram, blood urine nitrogen (BUN), creatinine, sodium, potassium and serum albumin levels are recorded from their blood test at administration of hospital. Time to theatre and postoperative needs for intensive care are recorded. Mobility functions before fracture and after 3 months of operation are assessed by mobility part of Barthel index. Multiple logistic regression analysis was performed to estimate the simultaneous effects of important covariates. In univariate model, age(p=0.0027), ASA(p=0.00), loss of mobility(p=0.00), bone union time(p=0.001), blood transfusion(p=0.026), albumin(p=0.004) and mobility after operation (p=0.001) were associated with mortality but in the final model for multivariate regression analysis loss of mobility level (p=0.001) and bone union time (p=0.02) were found to be independent risk factors of mortality. In postoperative period mobilization is the most important variable that we could changed in intertrochanteric fractures to decrease mortality. Whatever the timing of operation, gaining the mobility as soon as possible should be the goal of our treatment. [Med-Science 2017; 6(3.000): 521-5]

The aim was to evaluate effects of simple section of transverse carpal ligament on intercarpal stability by radiological parameters in patients with carpal tunnel syndrome those are refractory to conservative treatment. Patients with suspected diagnosis of carpal tunnel syndrome upon medical history and physical examination underwent neurodiagnostic tests (EMG). All 47 subjects, comprising 39 female and 8 male patients, were operated, followed, and assessed by the same surgical team between January 2014 and May 2015 after written informed consent was obtained. Wrist range of motion and general physical examination findings were recorded at both preoperatively and postoperative week 8. Besides, conventional MRI were obtained at the same time points. Trapeziohamate distance, scaphopisiform distance, scapholunate angle, and carpal angle were measured preoperatively and at 12thweek postoperatively. The mean age of the subjects was 49(range: 36-65).Mean preoperative trapeziohamate distance was measured as 25.2 mm (range:20-33), while postoperative trapeziohamate distance was 26.4 mm (range:22-34), (p=0.031). Mean preoperative scaphopisiform distance was 32 mm (range:23-34), as compared to postoperative scaphopisiform distance being 33.6 mm (range:24- 36) (p=0.001). While mean scapholunate angle was 44°(range: 36-60) preoperatively, it was measured as 45.1° (range: 33-60) in the postoperative period (p=0.001). Both preoperative and postoperative mean carpal angles was 127° (range 118-134 and 119-134, respectively). Simple section of transverse carpal ligament is associated with a significant increase in carpal arch distance. We consider that whether or not increases in intercarpal distances may lead to a degenerative process at the wrist in future warrants further research. [Med-Science 2017; 6(3.000): 410-4]

The rotator cuff tear aetiology is still unclear. Especially for atraumatic ruptures, degenerative processes come into prominence. This study aims to correlate between four most commonly-seen sleeping positions and patients with rotator cuff pathology. 87 patients who applied to the institute for suffering from shoulder pain for more than 6 months without a trauma and 93 voluntary people (as control group) above the age of 50 who applied to the institution for reasons other than shoulder pain included in the study. Rotator cuff ruptures and acromion types of the patients are diagnosed via magnetic resonance imaging. In face-to-face interviews, all the patients are asked to show their favourite sleeping positions on the visual cards and also questioned about their smoking habits and overhead activities. There is not any statistically substantive parameters between the patients and the control group in terms of age and sex. 83.9% of the patients with rotator cuff rupture have stated prefering lateral decubitus position while this rate is %61.3 among the control group (p=0.003). Atraumatic rotator cuff tears are increase with age. The increase pressure in the subacromial space can lead distribution in microvascular circulation of rotator cuff. Decrease in the microvascular circulation also affect the regeneration potential of rotator cuff. Laboratory studies demonstrated that lateral decubitus position has the most prominent increase in the subacromial pressure over all sleeping positions. We consider that sleeping in the lateral decubitus position causes long-term high subacromial pressure, leading to a microcirculatory disorder in the rotator cuff, which is a risk factor for the rotator cuff aetiology. [Med-Science 2015; 4(4.000): 2825-33]