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Objective: In this study, we aimed to compare the clinical and radiological results of the extensile lateral (EL) approach and sinus tarsi (ST) approach in calcaneal fracture surgery. Materyal-Metod: A total of 40 patients with Sanders II-III calcaneal fractures, including 22 patients in the EL group and 18 patients in the ST group, were included in this retrospective study. In the radiological evaluation, changes in the calcaneus Bohler and Gissane angle, length, width, and height were measured during the preoperative and postoperative period. Clinically, American Orthopedic Foot and Ankle Society (AOFAS) and the visual analog scale (VAS) were evaluated. In addition, postoperative complications were also evaluated. Results: In terms of demographic data, the results of both groups were similar. Both the length of hospital stay and the time to surgery were shorter in the ST group (p=0.019, p=0.02, respectively). There was no significant difference between the groups regarding radiological, clinical AOFAS and VAS scores. 13.6% superficial infection was seen in the EL group, and no wound problems were encountered in the ST group (p=0.102). The rate of sural nerve injury was 36.4% in the EL group and 5.6% in the ST group (p =0.003). Conclusion: Both approaches clinical and radiological outcomes were similar. However, the advantages of the ST approach were shorter hospital stays, lower rate wound infections, and sural nerve injury problems.

Abstract Introduction Anterior cruciate ligament (ACL) ruptures are common injuries that typically affect young, physically active individuals and may require surgical reconstruction. Studies have shown that the long time success of ACL reconstruction depends on the surgical technique and the postoperative rehabilitation strategy. However, there is still no consensus on the content of rehabilitation programs. Hence, additional research is required to elucidate the significance of early weight-bearing in the rehabilitation process following ACL reconstruction. The aim of this article is to examine the impact of weight-bearing on the clinical results of ACL reconstruction. Materials and methods We retrospectively reviewed patient records who had undergone arthroscopic reconstruction using a semitendinosus-gracilis tendon graft for anterior cruciate ligament rupture between January 2018 and December 2020. The study included the data of 110 patients. The patients were split into two groups: Group 1 underwent early weight-bearing, while Group 2 followed a non-weight-bearing regimen for three weeks. We assessed the patients using the anterior drawer test, Lachman test, range of motion, Lysholm knee scale, Cincinnati scale, Tegner scale, International Knee Documentation Committee (IKDC) form and clinical records. Analytical tests were conducted to compare the results. Results The complication rates did not show a significant difference between the groups. Group 1 had higher frequencies of positive anterior drawer and Lachman tests. The Lysholm and Cincinnati knee scores of patients in Group 1 were notably lower than those of patients in Group 2. Additionally, the Tegner activity scores and IKDC scores of patients in Group 1 were also meaningfully lower than those of patients in Group 2. In Group 1 patients, there was no notable relationship observed between body mass index (BMI) and the results of the anterior drawer test (ADT) or Lachman test. However, patients with a BMI of 25 or higher in Group 1 showed a decrease in postoperative IKDC scores. In Group 2 patients, no significant relationship was identified between BMI and either the ADT or the Lachman test outcome. Conclusion Based on current literature and current rehabilitation guidelines following ACL reconstruction, the decision to initiate early weight-bearing is based on a limited number of studies with low levels of evidence. In our study, we found that patients who followed a non-weight-bearing regimen for 3 weeks after surgery had better mid-term results than those who were allowed to bear weight early. It appears that further prospective studies on this topic are needed to update rehabilitation guidelines in the next.

Purpose Many factors in the etiology of anterior cruciate ligament (ACL) tears, predisposing factors related to knee morphology have also been reported. This study aimed to determine whether the Insall–Salvati (IS) index, which measures patella height, is a predisposing risk factor for ACL tears. Methods The IS index, patellar length (PL), and patellar tendon length (PTL) values of patients (study group) that underwent arthroscopic reconstruction for ACL tears obtained by preoperative magnetic resonance imaging (MRI) were compared with the index values in the preoperative MRIs of patients that underwent knee arthroscopy for reasons besides ACL tears. In addition, the anterior tibial translation (ATT) of both groups was also measured and compared on MRI images. The MRI findings of the subjects included in both study groups were arthroscopically confirmed. Results The mean ages of the study group (n = 120) and control group (n = 90) were 29.1 ± 8.2 years and 31.8 ± 9.8 years, respectively. There was a statistically significant difference between the study and control groups in terms of the PL and PTL values ( p = 0.016 and p = 0.001, respectively). The IS index was statistically significantly higher in the study group with ACL tears ( p = 0.009). The ATT was 8.61 ± 4.68 mm in the study group and 3.80 ± 1.92 mm in the control group. The ATT results of both groups were evaluated, and it was found that the study group was significantly higher than the control group ( p = 0.001) Conclusions As a result of our current study, we observed higher IS index values in patients with ACL tears than in patients without ACL tears. It should be kept in mind that patella alta, which is associated with a high IS index as one of the factors of knee morphology associated with ACL tears, may play a role in the etiology of ACL tears.

INTRODUCTION: In the present study, different femoral osteotomy levels applied in the combined surgical treatment of the patients aged over 2 years with developmental dysplasia of hip (DDH) were compared. It was aimed to determine the advantages and disadvantages of the osteotomies performed at the shaft and subtrochanteric regions of the femur and to evaluate their radiological and clinical impact on hip development. METHODS: The study included the patients aged over 2 years with DDH who were applied open reduction, Pemberton pericapsular osteotomy and femoral osteotomy. The demographic information, clinical evaluations and radiographic results of the patients were applied from the medical records. In addition, radiation exposure (the number of fluoroscopic images), operation duration and present of complications were evaluated. The hips were divided into two groups based on the level of femoral osteotomy as shaft (group 1) and subtrochanteric (group 2) groups. The Tönnis Classification System was used to assess the grade of preoperative hip dysplasia. Radiological evaluation was performed according to Severin's criteria while modified McKay's criteria was applied for clinical evaluation. Kalamachi and MacEwen's criteria were preferred for evaluation of avascular necrosis (AVN). RESULTS: Of the 46 hips, 21 hips were in the body group and 25 hips were in the subthoracanteric group. No statistically significant difference was present between the groups in terms of age, Tönnis type of hip dysplasia, preoperative acetabular index, postoperative acetabular index, preoperative collo-diaphyseal angle, postoperative collo-diaphyseal angle and derotation grade (p>0.05). The difference between the follow-up durations of the groups was statistically significant. The follow-up duration of the group 1 was shorter than the group 2. Although, clinical results in the group 1 were proportionally better than the group 2, no statistically significant difference was determined between the groups (p= 0.1264). A statistically significant difference was detected between the groups in terms of radiological results (p= 0.0008). AVN was found in none of the hips in the group 1 whereas 8 hips were detected with AVN in the group 2. The difference between the groups regarding femoral head AVN was statistically significant (p=0.0043). There was a statistically significant difference between the groups in terms of operation duration and radiation exposure (p

INTRODUCTION: One of the common reasons for admission to the emergency department is hip fractures. Mortality and morbidity rates are high in these fractures. According to many orthopedic surgeons, it is of the opinion that the radiographic image is sufficient for the treatment planning of these fractures. However, computerized tomography (CT) is sometimes needed to beter understand complex fractures. Our aim in this study is to determine whether there is a need for CT as well as radiography in determining the surgery plan in hip intertrochanteric (IT) fractures by evaluating among different observers. METHODS: Between January 2016 and January 2020, 71 patients who were operated for hip IT fractures and had both radiography and CT in automation records were evaluated by nine observers. RESULTS: The meanage of 71 patients (37 females, 34 males) was 80.8 +- 8.35 years. Observers required CT in 19.9% of the patients for treatment planning of these patients and to beter understand the fracturecon figuration. Observers found that 5.7% of the patients made changes in treatment planning after CT imaging of the fracture. DISCUSSION AND CONCLUSION: Considering beter understanding of hip biomechanics, obtaining three-dimension alimages with anatomical CT and developing implant technology, it was determined that surgeons' need for CT imaging in hip IT fractures has increased. Keywords: Hip, intertrochanteric fracture, advanced age, radiography, computed tomography.

Abstract Objective: With the rapidly increasing and diversifying elderly population of industrialized countries, the incidence of geriatric fractures is gradually increasing. The aim of this study is to evaluate the distribution of geriatric fractures according to the prevalence, age, sex, season and years. Material and Method: Analyzes of geriatric fractures in patients aged 65 and over who were admitted to our emergency department between 2015 and 2020 were performed according to the most common fracture locations (hip, distal forearm, proximal humerus and ankle). The distribution of these fractures by age, gender, seasonal characteristics and years was evaluated Results: A total of 370 cases (168 male, and 202 female patients) with an average age of 79.5years were included in the study. The most common fracturestypes in order of decreasing frequency were fractures of the hip (51.6%), distal forearm (25.1%), proximal humerus (12.4%) and ankle (10.8%). The incidence of distal forearm fractures was significantly higher in females than males (p = 0.001), but any statistically significant difference was not found between genders regarding other fractures (p> 0.05). It was observed that the incidence of hip fractures was significantly higher in the people aged 86 years and over, while the other fractures were more frequently seen in the 65-75 age group. A seasonal feature was not observed in all fractures. The highest rate of hip fractures was seen in the year 2020. There was no difference in the distribution of other types of fractures over the years Conclusion: It has been concluded that the incidence of geriatric fractures increases relatively in conditions of social isolation and does not show seasonal characteristics in our region. We are of the opinion that a good management strategy should be determined characterized with both the isolation of these patients and their early treatment and discharge in disasters as pandemics, and the incidence of geriatric fractures that can be mortal with advancing age and higher life expectancy should be very well known.

INTRODUCTION: One of the most important complications of diabetes mellitus is diabetic foot caused by peripheral circulatory disorder. Charcot neuropathic arthropathy (CN), which occurs in the advanced stage of the diabetic foot, is a chronic, progressive and difficult to treat disease METHODS: In this study, our aim is to evaluate the changes in the foot bone and foot joints of patients with CN according to the Sanders and Frykberg classification.Based on the data obtained from the automation records of our hospital, the patients' age, gender, diabetes diagnosis time and involved extremities, as well as foot radiographs were examined according to Sanders and Frykberg classification. RESULTS: The average age of 20 patients included in the study was 66.7 years, 12 males and 8 females. Type 2 with up to 5 (25%) patients according to the Sanders and Frykberg anatomical classification DISCUSSION AND CONCLUSION: The incidence of diabetes mellitus is increasing all over the world and complications due to this disease should be well known. In our study, early diagnosis of CN, is extremely important and we believe that foot amputations can be prevented with early interventions.

Use of proximal femoral nails (PFN) in the treatment of pertrochanteric fractures has become popular for the last 20 years. Also, we experince some complications during application of PFN technique in our clinical practice like many orthopaedic specialists. In this case, we encountered a fracture of the nail at the distal end during application of the PFN technique. We have detected increased femoral bowing according to the graphies performed in the postoperative period. In this case we wanted to pay attention to the possibility of encountering a fracture of the nail at the distal end due to an increased femoral bowing.

Developmental dysplasia of the hip (DDH) is a developmental pathology of the hip which may be encountered in different clinical manifestations after birth. Avascular necrosis (AVN) is the most critical complication leading to several problems in the long-term period after the treatment of DDH. It is a commonly found complication secondary to treatment and also follow-up period of the dysplastic hip joint. Development of AVN in the normal hip in treatment and follow-up process of the cases with unilateral DDH has been reported in a very limited number of studies in the literature. This paper has presented a case of AVN encountered in the normal hip by radiography performed the fifth follow-up month of the patient who previously received the treatment of unilateral DDH.