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Objectives: Although numerous surgical techniques and fixation methods have been described for the treatment of hallux rigidus (HR) with arthrodesis, consensus on the gold standard treatment has not been reached. The aim of this study is to retrospectively compare the clinical and radiological outcomes of compression screw fixation and plate fixation in the treatment of HR with arthrodesis. Methods: Patients who underwent arthrodesis surgery due to HR between January 2021 and December 2023 at a single center were retrospectively reviewed. Patients who met the inclusion criteria were divided into two groups: those who underwent arthrodesis with plate fixation (PLATE) and those who underwent arthrodesis with compression screw fixation (SCREW). Demographic data including age, gender, affected side, operative time, hallux valgus angle (HVA), dorsiflexion angle, AOFAS scores, and implant irritation data were compared among patients with at least 3 months of follow-up. Results: It was observed that all patients included in the study had successful bone union without any complications. There were no significant differences between the two groups in terms of age, gender, affected side, preoperative HVA, and preoperative AOFAS scores (P= 0.970, P= 0.426, P= 0.694, P= 0.216, and P= 0.905, respectively). The mean operation time and postoperative AOFAS score were lower in the PLATE group compared to the SCREW group (P=0.006 and P=0.004, respectively). However, in the SCREW group, the dorsiflexion angle and the rate of implant irritation were lower compared to the PLATE group (P=0.016 and P=0.01, respectively). Conclusions: In the surgical treatment of HR, both plate fixation arthrodesis and compression screw arthrodesis are reliable surgical techniques. While plate fixation arthrodesis is a faster and more practical method, arthrodesis with a compression screw results in fewer complaints related to the implant and provides a more functional recovery. [ABSTRACT FROM AUTHOR]

Whether the lateral ankle ligaments contribute to syndesmotic stability is still controversial and has been the subject of frequent research recently. In our study, we tried to elucidate this situation using the finite element analysis method. Intact model and thirteen different injury models were created to simulate injuries of the lateral ankle ligaments (ATFL, CFL, PTFL), injuries of the syndesmotic ligaments (AITFL, IOL, PITFL) and their combined injuries. The models were compared in terms of LFT, PFT and EFR. It was observed that 0.537 mm LFT, 0.626 mm PFT and 1.25° EFR occurred in the intact model (M#1), 0.539 mm LFT, 0.761 mm PFT and 2.31° EFR occurred in the isolated ATFL injury (M#2), 0.547 mm LFT, 0.791 mm PFT and 2.50° EFR occurred in the isolated AITFL injury (M#8). The LFT, PFT and EFR amounts were higher in the both M#2 and M#8 compared to the M#1. LFT, PFT and EFR amounts in M#2 and M#8 were found to be extremely close. In terms of LFT and PFT, when we compare models with (LFT: 0.650 mm, PFT: 1.104) and without (LFT: 0.457 mm, PFT: 1.150) IOL injury, it is seen that the amount of LFT increases and the amount of PFT decreases with IOL injury. We also observed that injuries to the CFL, PTFL and PITFL did not cause significant changes in fibular translations and PFT and EFR values show an almost linear correlation. Our results suggest that ATFL injury plays a crucial role in syndesmotic stability. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study is to retrospectively compare the outcomes of two different third-generation intramedullary nails, PFNA (Proximal Femoral Nail Antirotation) and Intertan, used in unstable trochanteric fractures in the geriatric population. Materials and Methods: Our study included 85 patients aged 65 and older who underwent surgery for unstable intertrochanteric fractures at a single center between September 2021 and September 2023. Patients were divided into two groups based on the type of proximal femoral nail (PFN) used: the PFNA group and the Intertan group. These two groups were compared in terms of age, gender, operation duration, length of hospital stay, Harris hip scores, union rates, reoperation rates, and radiological parameters (reduction quality, Tip Apex Distance (TAD), Parker index (PI), collodiaphyseal angle (CDA)). Results: There were no significant differences between the groups in terms of age, gender, length of hospital stay, Harris hip scores, reoperation rates, and radiological parameters (reduction quality, TAD, PI, CDA). However, the union rate was significantly higher in the Intertan group compared to the PFNA group (p=0.008). Additionally, the operation duration was significantly shorter in the PFNA group compared to the Intertan group (p=0.03). Conclusion: In unstable trochanteric fractures, while PFNA nails may be more practical with appropriate reduction and implant positioning, Intertan nails provide a more rigid fixation and stabilization, resulting in higher union rates and lower risk of implant failure, making them implants that can be used safely. [ABSTRACT FROM AUTHOR]

Background and objectives: We aimed to determine the effects of vanillic acid (VA) on fracture healing radiologically, histologically, immunohistochemically, and biomechanically using a rat femur open fracture injury model. Methods: 32 male Wistar-Albino rats were used and divided into two groups: the study group (VA) and the control group. From the time they were operated on until they were sacrificed, the rats in the study group were given 100 mg/kg/day VA by oral gavage. After sacrification, the femurs were analyzed. Results: It was observed that the Huo histological scoring was significantly higher in the VA group (p = 0.001), and the ratio of the amount of callus tissue compared to intact bone tissue was significantly higher. While no significant difference was observed in immunohistochemical H-scores in Coll antibody staining (p = 1.000), a borderline significant difference in favor of VA was observed in Colili antibody staining (p = 0.078). In biomechanical analysis, failure load (N), total energy (J), maximum stress (MPa), and stiffness (N/mm) measurements were significantly higher in the VA group (p = 0.040, p = 0.021, p = 0.015, and p = 0.035, respectively). Conclusion: It has been observed that VA, with its antioxidative properties, increases fracture healing in rats, in which an open fracture model was created. We are hopeful that such an antioxidant, which is common in nature, will increase fracture healing. Since this study is the first to examine the effect of VA on fracture healing, further studies are needed. [ABSTRACT FROM AUTHOR]

Purpose: The objective of this study is to evaluate the influence of patient positioning on intraoperative outcomes, specifically intraoperative time, fracture reduction, and implant location, in individuals with trochanteric femur fractures undergoing intramedullary nailing. The study compares two patient positions: the lateral decubitus position (LDP group) and the utilization of a traction table (TT group). Materials and Methods: A total of 82 patients with trochanteric femur fractures, who underwent surgery were included. The patients were divided into LDP and TT groups. Various parameters, including age, gender, fracture details, setup time, operation time, anesthesia time, fluoroscopy time, tip-apex distance (TAD), collodiaphyseal angle (CDA), reduction quality, and implant position, were analyzed. Result: Surgical time in the LD group was 33.90 ± 6.05 minutes, whereas in the TT group, it was 33.00 ± 6.64 minutes. Anesthesia time was 50.55 ± 7.46 minutes in the LD group and 55.26 ± 12.49 minutes in the TT group. Fluoroscopy time in the LD group was 45.20 ± 7.18 seconds, while in the TT group, it was 46.23 ± 4.50 seconds. Lateral decubitus position resulted in shorter setup and anesthesia times compared to the traction table. Conclusion: Intramedullary nailing in the lateral decubitus position is a viable and practical choice for fracture reduction, with the potential to decrease morbidity and mortality rates especially in elderly patients. [ABSTRACT FROM AUTHOR]

The basic surgical treatment for avascular necrosis of the femur head is core decompression. In this report we discuss a case where the patient developed compartment syndrome after core decompression surgery with history of anticoagulant use. A 49-year-old man, who was using Coumadin 5 mg once daily due to aortic valve replacement and atrial fibrillation, had undergone core decompression surgery done due to stage 2 femur head avascular necrosis (AVN). He later developed isolated anterior thigh compartment syndrome for which fasciotomy was performed. Every surgical intervention to the extremities of patients with anticoagulant treatment should be considered high risk for compartment syndrome, even if appropriate precautions are taken. It is necessary to clinically observe for a sufficient duration to be able to identify symptoms.