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Objectives: The aim of this study was to investigate the 25-hydroxyvitamin D (25(OH)D), parathyroid hormone (PTH), and calcitonin levels and lipid profiles in patients with calcaneal spurs. Patients and methods: Between March 2018 and June 2019, a total of 50 patients (30 males, 20 females; mean age: 39.8±8.1 years; range, 24 to 54 years) admitted to our clinic with heel pain and diagnosed with heel spurs based on radiographic images were included. The control group consisted of 50 age- and sex-matched healthy volunteers (32 males, 18 females; mean age: 35.7±9.6 years; range, 20 to 56 years). Blood samples were collected from all participants. Total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglyceride, phosphate, and calcium levels were measured using the colorimetric method. The PTH and 25(OH)D levels were measured using the chemiluminescent microparticle immunoassay. Calcitonin levels were detected using the chemiluminescent immunometric assay. Results: In the patients with calcaneal spurs, 25(OH)D and HDL-C levels were significantly lower (p Conclusion: Our study results suggest that calcaneal spur formation is associated not only with weight-related pressure, but also with lipid levels and hormonal alterations involved in calcium metabolism. Based on these findings, hormonal alterations and lipids should be considered in patients with calcaneal spurs.

© 2021, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.Reduced mobility due to COVID-19 prevention measures caused major changes in the number and types of orthopedic trauma cases. This study aimed to compare the profile of trauma-related general orthopedic surgery and hand surgery cases between the first six months of the COVID-19 pandemic and the corresponding periods of previous years in order to determine strategies for managing orthopedic traumas in unusual circumstances such as pandemics. Patients over 18 years old who underwent orthopedic surgery due to trauma were grouped according to sur gery date as pre-pandemic group 1 (G1, March 16–September 18, 2018), pre-pandemic group 2 (G2, March 18–September 20, 2019), and the pandemic group (G3, March 19–September 21, 2020). Between-group differences with p

Aim: Mosaicplasty is a common surgical technique performed in patients with osteochondritis dissecans (OCD) of the knee. In the present study, we aimed to investigate the effectivity of mosaicplasty followed by intraarticular hyaluronic acid (HA) injection on the functional outcomes of the knee joint in patients with osteochondral lesions of the knee. Methods: The retrospective study included 41 patients (32 men and 9 women) that underwent mosaicplasty due to the detection of an OCD lesion larger than 1 cm2 on magnetic resonance imaging (MRI). The patients were randomly divided into HA (n=22) and control (n=19) groups. The HA group received 2 ml of HA injection at two weeks after surgery and the control group received no additional treatment. At postoperative months 6 and 12, functional outcomes of the patients were graded using the Lysholm knee score and pain intensity was assessed using Visual Analog Scale (VAS) in both groups. Results: The HA group included 22 (53.7%) and the control group included 19(46.3%) patients. The mean age was 31.5 in the HA group and 31.47 years in the control group. The Lysholm scores at postoperative months 6 and 12 were significantly higher in the HA group compared to the control group (p

Background We aimed to determine the relationship of ischaemia-modified albumin (IMA) with diabetic foot ulcers and its predictive value in the Wagner classification. Methods Our cross-sectional study was conducted in 120 diabetic foot patients and 60 healthy individuals with similar body mass index (BMI) and age. Patients with a diabetic foot were classified according to the Wagner classification. Biochemical parameters, C-reactive protein (CRP) and IMA levels ​​were measured in all patients and healthy volunteers. Screening performance characteristics of CRP and IMA were calculated according to Wagner classes and the presence of osteomyelitis. Results The levels of BMI, CRP and IMA in diabetic foot patients were significantly higher than the healthy controls. When we grouped the patients according to the Wagner classification, there were no significant differences between the Wagner groups in terms of BMI. The highest IMA levels were detected in Wagner grade 5. CRP had higher sensitivity and specificity than IMA in the discrimination of other grades, except for grade 4-5 separation. For Wagner grade 4-5 distinction, IMA had 84.6% sensitivity and 94.7% specificity. Conclusion IMA had a higher predictive value in discrimination of the Wagner grade 4-5. In the management of diabetic foot patients, it may be recommended that IMA is evaluated by clinicians.

Aim: Identification and treatment management of congenital or acquired hand anomalies are serious problems for orthopedic and plastic surgeons. With the start of medical education in hand surgery as a subspecialty, the number of hand surgeons has increased, and this problem has partially been removed. This study aimed to contribute to the epidemiologic data of our country by sharing admission times and types, treatment management, and demographic data of children admitted with hand anomalies to a tertiary health center in the light of the literature. Methods: Pediatric patients who were admitted with hand anomalies to the hand surgery clinic between 01.12.2018 and 01.12.2019 were included in this cross-sectional study. They were classified by extended OMT (Oberg, Manske, and Tonkin) classification by using the data obtained from the hospital registry. Patients’ ages, genders, diagnoses, admission times, educational statuses, treatment plans and decisions of parents on the treatment were evaluated by a single hand surgeon available in the region. Results: Out of approximately 1500 patients admitted to the hand surgery clinic, 49 patients between the ages of 0 and 18 with pediatric hand anomalies were included in the study. Out of 49 patients, 7 had acquired and 42 had congenital hand anomalies. The most common congenital anomaly was trigger finger. Eleven (22.5%) of the patients were at school age, 12 (24.5%) at pre-school age, and 26 (53%) were infants, aged 2 years and below. Conclusion: It is highly important for patients with hand anomalies to reach the appropriate physician at the right time so that their treatment may be planned accordingly, the present anomaly does not delay the growth of the child, the deformity does not progress further and that these individuals can be brought into the society earlier. Therefore, we believe that the number of physicians should be increased due to the following reasons: Hand surgery is a new branch and these patients should be referred to subspecialists in accordance with the demands of the patients’ parents. This branch is vital for the region, and there are patients still waiting for their already planned surgery.

Aim: The healing time of femoral intertrochanteric fractures in the elderly population is prolonged due to the presence of osteoporosis. However, mortality is high because of major causes such as embolism due to long-term bed rest. It is particularly important that these patients be operated and given the freedom to move in the early postoperative period. In this study, we aimed to compare the clinical outcomes of Proximal Femoral Nail (PFN) and External Fixation (EF) in older patients with intertrochanteric fractures of the femur (ITFF).Methods: This study included 72 patients aged 65 years or older who were diagnosed with ITFF and underwent PFN (n=38) or EF (n=34) between 2011 and 2017. Patient data including demographic characteristics, preoperative ASA score, surgical technique, postoperative complications, and functional outcomes at final follow-up, Harris Hip Score (HHS) and Mean Mobility Score (MMS) scores were recorded for each patient.Results: The results indicated that both PFN and EF provided equally satisfactory functional outcomes in the patients. EF was found to have major advantages including significantly lower operative times, lower intraoperative blood loss, and administration of sedation only in high-risk patients. PFN was also found to have remarkable advantages such as lower reoperation risk, reduced mortality, and lower risk of superficial wound infection.Conclusion: Although both PFN and EF were found to have remarkable advantages, PFN seems to be more advantageous in terms of complications. Meaningfully, PFN could be more reliable and effective in the treatment of extracapsular ITFF in old-age patients., Amaç: Yaşlı popülasyonda intertrokanterik femur kırıklarının (ITFK) iyileşme süresi osteoporoz varlığı nedeniyle uzar. Bununla birlikte bu hastalarda uzun süreli yatak istirahati sonucu emboli gibi başlıca nedenlerden dolayı ölüm oranı yüksektir. Bu hastaların erken dönemde ameliyat edilmesi ve hareket verilmesi çok önemlidir. Bu çalışmada, ITFK olan yaşlı hastalarda uygulanan Proksimal femoral çivi (PFÇ) ve Eksternal fiksatör (EF) yöntemlerin klinik sonuçlarını karşılaştırmayı amaçladık.Yöntemler: Çalışmaya 2011-2017 yılları arasında ITFK nedeniyle ameliyat edilen 72 hasta alındı. Bu hastalardan 38 tanesine proksimal femoral çivi, 34 tanesine eksternal fiksatör uygulandı. Hastaların demografik verileri, ameliyat öncesi ASA skoru, cerrahi teknik, ameliyat sonrası komplikasyonlar, final fonksiyonel sonuçlar, Harris kalça skoru ve ortalama kalça hareket skorları herbir hasta için kaydedildi. Bulgular: Her iki grubun fonksiyonel sonuçları tatminkar olup EF uygulanan grupta ameliyat süresinin daha kısa ve kan kaybının daha az olması, sedasyonla müdahele edilmesi başlıca avantajlarıdır. PFÇ yapılan grupta ise tekrar opere edilme ve mortalite riskinin daha az olması, yüzeyel cilt enfeksiyonlarının olmaması başlıca avantajları olarak görüldü.Sonuç: PFÇ ile EF’nin karşılaştırıldığı bu çalışmada, PFÇ uygulamasında komplikasyonların daha az olduğu ve bu nedenle ekstrakapsüler ITFK’ da Proksimal femoral çivi yönteminin daha güvenli ve daha effektif bir tedavi olduğu kanaatindeyiz.

The patient presented in this study had a form of chronic sclerosing osteomyelitis (CSO) that is rarely reported in calvarial bones and has never been reported in the frontal bone in the literature. We aimed to contribute to the literature with this case study. In this study, we report a 14-year-old girl who presented with swelling and pain in the frontal bone and underwent treatment due to CSO. The patient had no history of trauma and chronic infection. We conclude that CSO should be considered in the differential diagnosis of the patients presenting with cranial swelling whose diagnosis cannot be established based on the radiological findings.

Background Osteomyelitis (OM) is a local or generalised infection of the bone and bone marrow which may be multifactorial in its causation. In this study, we aimed to determine oxidative DNA damage and antioxidant status of patients with chronic osteomyelitis. Material method In this study, patients with chronic osteomyelitis and healthy controls were compared for descriptive characteristics (age and gender) and serum levels of malondialdehyde (MDA), 8-hydroxy-2-deoxy guanosine and antioxidant enzymes catalase, glutathione and superoxide dismutase. Results This was a case-control study. About 5 mL of venous blood was collected for the estimation of biochemical parameters. This study comprised of 36 OM patients diagnosed, and 41 healthy ages (25-55 years) and sex-matched individuals. Antioxidant enzyme levels were significantly lower in patients with OM, whereas MDA and oxidative DNA damage levels were significantly higher. Conclusion The results obtained from this study have shown that the oxidant-antioxidant balance is impaired in patients with chronic osteomyelitis. It also supports that chronic osteomyelitis has associated with oxidative DNA damage.

Background:The fabella, which is generally located in the lateral head of the gastrocnemius muscle, is a sesamoid bone that articulates with the posterior face of the lateral femoral condyle. As traditional information, the prevalence of fabella is between 10-30% in the population and is usually present in both knees.Introduction:The objective of this study was to investigate the knee MRIs in the Eastern Anatolia Region of Turkey subjects in order to assess the prevalence of the fabella and analyse the differences between gender, age and laterality and its symmetry pattern.Methods:This study was a retrospective study in patients older than 18 years whose knee MRIs were taken between February 2014 and February 2016. In this study, a total of 531 patients [290 females and 241 males] were included. The radiographs were examined by two orthopedic surgeons and the fabella was located. Later, an expert radiologist made the final decision and confirmed the results.Results:The number of patients included in the study was 531. We detected os fabella in 59 (11.1%) patients. Of the 59 os fabella, 33 were in the right knee and 26 were in the left knee, 38 were female and 21were male.Conclusion:In this study, we investigated the age and gender differences besides the prevalence and the symmetry pattern of the fabella in the Eastern Anatolia Region of Turkey's population. Prevalence of the fabella was found to be 11.1% which is different than previously published studies.

Objective: To compare the levels of ischemia modified albumin between osteomyelitis patients and healthy controls. Method: The cross-sectional prospective study was conducted at Van Yüzüncü Y?l University, Van, Turkey, from May 2018 to May 2019, and comprised inpatients diagnosed with osteomyelitis, and healthy controls. Serum IMA concentrations were determined spectrophotometrically at 470nm wavelength. Serum ischemia modified albumin levels were measured and compared between the patients and the controls. Data was analysed using SPSS 20. Results: Of the 77 subjects, 37(48%) were patients and 40(52%) were controls. Serum ischemia modified albumin level in patients was significantly higher than controls (p

BACKGROUND: Osteomyelitis, followed by trauma or inflammation relates to a surgical procedure and is the concept caused by pyogenic bacteria in the bone marrow and bone. Treatment is difficult because management usually relies on a multidisciplinary approach. Up to date, there is no study in the literature investigating the effect of trauma and the causative microorganism on the duration of treatment in chronic osteomyelitis.

Aim: Surgical treatment of developmental hip dislocation is highly challenging in children of walking age. The most common complications following surgery include avascular necrosis and redislocation. In this study, we aimed to compare the preoperative and postoperative acetabular index, avascular necrosis (AVN) and redislocation rates between two age groups of open reduction and Salter osteotomy in DDH (Developmental Dysplasia of the Hip). Methods: This prospective cohort study included patients who underwent open reduction and salter osteotomy for DDH between 2014 and 2017. Patients were grouped based on age as follows: Group 1: 18 -30 months old (n=44), Group 2: 31-48 months old (n=41). Preoperative, postoperative, and final acetabular indexes, AVN and redislocation rates were compared.Results: Among 85 patients included in the study, 20 were male and 65 were female. The mean ages of Groups 1 and 2 were 21.6 months and 38.5 months, respectively. Following surgery, Group 1 mean acetabular index reduced to 25.9 degrees from 35.1 degrees, while that of Group 2 decreased to 22.1 degrees from 33 degrees. AVN was present in 10 patients (22.72%) in Group 1 and 4 patients (9.75%) in Group 2. Conclusion: The acetabular index was adequately corrected in both groups. AVN was more frequent in children who had early interventions. We believe that the higher rate of avascular necrosis in children who underwent early intervention is due to surgical technique and using tighter sutures in the hip joint capsule., Amaç: Yürüme dönemi çocuklarda gelişimsel kalça çıkığının cerrahi tedavisi oldukça zordur. Avasküler nekroz ve kalça çıkığı tekrarlaması, cerrahi sonrası en sık karşılaşılan problemlerdir. Bu çalışmadaki amacımız GKD (Gelişimsel Kalça Çıkığı) tedavisinde uyguladığımız açık redüksiyon ve Salter osteotomisi yönteminin 2 grup arasındaki ameliyat öncesi ve sonrası asetabuler indeks, avasküler nekroz (AVN) ve redislokasyon oranlarını karşılaştırmaktır.Yöntemler: Bu prospektif kohort çalışmaya 2014-2017 yılları arasında GKD nedeniyle açık redüksiyon ve salter osteotomisi yapılan hastalardan elde edilen verilerle yapıldı. Grup 1: 18 ay -30 ay (44), Grup 2: 31 ay-48 ay arası (41) hasta mevcuttu. Grupların ameliyat öncesi, ameliyat sonrası ve final asetabuler indeksleri, AVN ve redislokasyon oranları karşılaştırıldı. Bulgular: Çalışmaya alınan 85 kalçanın 20’si erkek, 65’i kadın idi. Grup 1 hastaların yaş ortalaması 21,6 ay, Grup 2 hastalarının yaş ortalaması ise 38.5 ay idi. Ameliyat sonrası Grup 1 asetabuler indeks ortalama 35.1 dereceden 25,9 dereceye düşürülürken, Grup 2 de ise 33 dereceden 22,1 dereceye kadar düşürüldü. Grup 1 de 10 hastada (%22,72), Grup 2 de ise 4 (%9,75) hastada AVN vardı. Sonuç: Asetabular indeks her iki grupta da yeterince düzeltildiği gözlendi. AVN’in erken müdahale yapılan çocuklarda daha yüksek oranda olduğu görüldü. Erken müdahale yapılan çocuklarda AVN’in daha yüksek olmasının kalça eklemi kapsülünün daha sıkı sütüre edildiği ve yapılan cerrahi teknikten kaynaklandığına inanıyoruz.

To investigate the medium-term outcomes of the patients who underwent revision total knee arthroplasty, and to come to a conclusion regarding the efficacy of the method by comparing these with literature data. 34 knees of 33 patients who underwent revision knee arthroplasty operation between January 2008 and January 2012 and were sufficiently followed-up were included into this study. Single-stage revision knee arthroplasty was performed for 25 knees for aseptic reasons, and two-stage revision knee arthroplasty was performed for 9 knees for septic reasons. For all patients, alpha, beta, gamma, sigma and total valgus angles were measured in pre-and post-operative anteroposterior (AP) X-rays and lateral X-rays based on American Knee Society radiological assessment form. For all patients, pre-and post-operative American Knee Society knee score and functional score was assessed. As laboratory work-up, all patients’ pre-and post-operative erythrocyte sedimentation rate, C-reactive protein, white blood cells values were compared. The patients’ mean knee score and functional score was detected to be 34.7 (4-57) and 33.5 (5-55), respectively, and to be 78.2 (62-90) and 73.8 (50-90) after revision. In pre-operative assessments performed based on Knee Society radiographic assessment form, mean alpha angle was found to be 95.3 (77-103), mean beta angle to be 84.8 (71-100), mean gamma angle to be 5.8 (0-30), mean sigma angle to be 83.3 (49-97), and mean total valgus angle to be 0.1 (-13-12). In post-operative assessments, mean alpha angle was found to be 94.7 (90-99), mean beta angle to be 88.4 (84-92), mean gamma angle to be 3.7 (0-10), mean sigma angle to be 88.1 (85-92), and mean total valgus angle to be 3.1 (-1-8). We think that when revision knee arthroplasty operation is performed for proper indication and according to the surgical technique, it is a highly effective and preferable method in decreasing the pain severity and improving the life quality of the patients. © 2018, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.

Aim: Lower limb amputations (LLA) are considered as a serious psychosocial condition. The causes of amputation in young persons are generally trauma, work accidents, or tumors, while in geriatric patients, it is mostly vascular problems. The aim of this study is to determine the causes and levels of LLA of geriatric patients in a tertiary care center.Materials and Methods: In order to conduct this study, information was obtained from the automation records of geriatric patients who underwent LLA in our clinic between the years 2014 and 2017. We divided our patients into three groups according to their ages. Group 1 consisted of those patients in the age group of 65-74 years, Group 2: 75-84 years, and Group 3: 84-95 years. We also classified our patients according to amputation causes and levels.We classified the patients as above-knee, transtibial, metatarsal, and toe amputation according to the level of lower extremity amputation.Results: Of the 96 patients included in the study, 70 were male (72.9%), and 26 (27.1%) were female. Group 1 consisted of 45 patients, group 2had 38 patients, and group 3 had 13 patients. It was observed that the most common cause of LLA was diabetic foot ulcers (65 patients), followed by ischemic foot as a cause of LLA in 25 patients. Moreover,4 patients were amputated due to a tumor, while amputation was performed in 2 patients as a result of a crush injury. It was observed that metatarsal and toe amputation was the most common amputation type according to amputation levels. (26 patients)Conclusion: As a result of our study, the most common cause of LLA in Geriatric patients was diabetic foot ulcers. Considering that lower extremity amputations cause severe morbidity and mortality in geriatric patients, it is crucial to identify these patients with preventive medicine practices.

PEV is one of the most common deformities in the foot. The incidence of PEV varies between communities and many theories about its etiology have been proposed. In this study, we aimed to share our experience with the incidence and etiology of PEV in the neonatal intensive care unit of a tertiary hospital. 3658 patients who were followed up in a tertiary neonatal intensive care unit from 2014 to 2017 were included in the study. Data on the number and etiology of newborns with PEV deformity were obtained from the automation records of our hospital. PEV deformity was diagnosed in 32 (0.87%) of 3658 babies treated in the neonatal intensive care unit over a period of 3 years. Of these 32 patients, 18 (56.25%) were bilateral, and 14 (43.75%) unilateral PEV. Two (6.25%) of our patients had a positive family history. While 23(71.87%)) of our patients were delivered by cesarean, 9 (28,1%) of our patients were born normally. Considering birth weights, the number of babies born under 2500 grams was 7 (21.8%), and the number of babies born above 2500 grams was 25 (78.1%). Considering the data we obtained at the end of the study, the incidence of PEV was lower than in the literature. In fact, our hypothesis before starting the study was that the incidence of PEV was higher in the neonatal intensive care unit. Although the frequency of PEV is known to vary between populations, the etiology of PEV is not fully known. We believe that future studies (such as genetic studies) will be more beneficial to science than classical knowledge about PEV etiology. [Med-Science 2020; 9(3.000): 556-9]

Kalca eklem cikiklari tum eklem cikiklarinin yaklasik %5’ini olusturmaktadir. En sik posterior kalca eklem cikigi gorulmektedir. Anterior kalca eklemi cikiklari nadir gorulur. Bu yazida, is kazasi sonrasi gelisen ve ameliyathanede sedasyon altinda kapali redukte edilen anterior obturator kalca eklem cikigi olgusu sunulmaktadir. Hastanin 1 yillik takibi sonunda radyografik olarak femur basi avaskuler nekrozu tespit edilmedi. Fizik muayenesinde kalca eklem hareketleri olagan bulundu. Anahtar Kelimeler: Kalca cikigi, kapali reduksiyon, avaskuler nekroz

The aim of this study was to compare the outcomes of intertrochanteric femur fractures treated with proximal femoral nail (PFN) and bipolar hemiarthroplasty (BPH) in elderly patients.A total of one hundred and forty-three patients with intertrochanteric femur fractures treated surgically between January 2008 and January 2012 were included into the study. Patient demographics, type of fracture according to Association for Osteosynthesis/Association for the Study of Internal Fixation (AO/ASIF) classification, and the American Society of Anesthesiologists (ASA) classification system scores; type of surgical procedure (BPH or PFN), operative details, complications and follow-up scores (Harris Hip Score [HHS]; Mean Mobility Score [MMS]) were recorded.The preoperative characteristics of the patients in both PFN and BPH groups were similar. BPH had higher operation times, blood loss in operation and mortality rates (p0.005). Reoperation times were higher in PFN group (p0.005). There were no differences with regard to the HHS and the reduction in MMS at the last follow-up with a 30.4 (10.9) months follow-up (p0.05).Although both PFN and BPH had satisfactory outcomes in surgically treated patients with intertrochanteric femur fractures, we recommend intertrochanteric femur fractures in the elderly tobe treated with PFN; which is an effective and appropriate treatment modality with less surgery related trauma and lower mortality rates.

Synovial hemangiomas are rare benign tumors of vascular origin. A 23-year-old boy presented with knee pain and swelling. The boy had developed symptoms 18-months earlier. He was diagnosed with synovial hemangioma based on magnetic resonnance imaging examination and histopathologic findings of the arthroscopic biopsy tissue. We present the magnetic resonance imaging and histopathologic findings of synovial hemangioma of the knee.

Amac: Klinigimizde gestasyonel trofoblastik hastalik nedeniyle tedavi edilen hastalarin risk faktorleri, tanisi, yonetimini arastirmayi amacladik. Gerec ve Yontem: Kliniginize Ocak 2010- Agustos 2013 yillari arasinda molar gebelik tanisi almis hastalar taranarak hastalarin yasi, gravide, parite ve abortus bilgileri kaydedildi. Hastalarin sikayeti, muayene, ultrason bulgulari, β HCG ve tam kan sayimi degerleri, hastaligin tedavisi, patoloji sonuclari, hastalarda gelisen komplikasyonlar, takipte β HCG degerleri kayit edildi. Bulgular: Klinigimizde molar gebelik hizi 1000 dogumda 8 olarak bulundu. Hastalarin ortalama yasi 28±4,5 olup ortalama gestasyonel yas 8±3,2 haftaydi. Hastalarin en sik gelis sikâyeti vajinal kanama (n=23, %57,5), amenore (n=10,%25) , karin agrisi (n=6, %15) idi. β HCG degerleri 191 ile 125200 arasinda degismekteydi. Hastalarin 26 (65%) sinda ultrason bulgusu molar gebelik lehine yorumlanmisti. Patoloji sonuclari 26 (%65) hastada parsiyel mol, 13 (%32.5) hastada komplet mol ve 1 (%2.5) hastada koryokarsinom gelmistir. Hastalik ve komplikasyonlarina ait olum olgusuna rastlanmamistir. Sonuc: Klinigimizde molar gebelik hizi 1000 dogumda 8 olup en sik gelis sikâyeti vajinal kanamadir