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PURPOSE OF THE STUDY The aim of this study to evaluate the subjective and objective results of Extensor indicis proprius (EIP) to extensor pollicis longus (EPL) transfer with an emphasis on donor site morbidity. MATERIAL AND METHODS 17 patients (59% men, 41% women) who underwent EIP-EPL transfer were retrospectively analyzed. The mean age was 43 (9–64) years, and the mean follow-up was 72 (19–124) months. The extensor strengths were measured according to the Medical Research Council (MRC) scoring system. Nail tip-table surface distance (NTD) was measured to evaluate extension loss, and pulp-palm distance (PPD) to evaluate thumb flexion-adduction limitation. Grip and key pinch strengths were measured and corrected regarding the dominance and compared with those of the non-operated side. Quick Disability of Arm, Shoulder, and Hand (QDASH) and satisfaction scores of the patients were evaluated. RESULTS Donor site morbidity was detected in 6 patients (35%). The extension strength of the index finger was found to be significantly lower than the non-operative side (p<0.05). Thumb mean NTD and PPD values were 6.8 (0–50) and 2.9 (0–20) mm, respectively. The index finger mean NTD was 0.6 (0–10) mm. The grip strength was 86% (43%–100%) and the pinch strength was 82% (31–100%) of the expected strengths. Compared to the preoperative period, there was a significant decrease in the QDASH score (p <0.05). Postoperative QDASH scores of patients with donor site morbidity were significantly higher than those without (p <0.05). CONCLUSIONS Although patients are generally satisfied with the EIP-EPL transfer results, the permanent morbidity rate in the index finger is high. Therefore, alternatives other than EIP should be considered for transfer to EPL in individuals whose occupation requires complete and strong index finger extension. [ABSTRACT FROM AUTHOR]

PURPOSE OF THE STUDY In treatment algorithm of developmental dysplasia of the hip, posteromedial limited surgery is placed between closed reduction and medial open articular reduction. The aim of the present study was to assess the functional and radiologic results of this method. MATERIAL AND METHODS This retrospective study was performed in 37 Tönnis grade II and III dysplastic hips of 30 patients. The mean age of the patients at operation was 12.4 months. The mean follow-up time was 24.5 months. Posteromedial limited surgery was applied when sufficient stable concentric reduction was not achieved by closed technique. No pre-operative traction was applied. Postoperatively, human position hip spica cast was applied for 3 months. Outcomes were evaluated regarding modified McKay functional results, acetabular index and presences of residual acetabular dysplasia or avascular necrosis. RESULTS Thirty-six hips had satisfactory and one hip had poor functional result. The mean pre-operative acetabular index was 34.5 degrees. It improved to 27.7 and 23.1 degrees at the postoperative 6th month and the last control X-Rays. The change in acetabular index was statistically significant (p<0.05). At the last control, 3 hips had findings of residual acetabular dysplasia and 2 hips had avascular necrosis. CONCLUSIONS Posteromedial limited surgery for developmental dysplasia of the hip is indicated when closed reduction remains insufficient and medial open articular reduction remains unnecessarily invasive. This study, in line with the literature, provides evidences that this method might decrease the incidences of residual acetabular dysplasia and avascular necrosis of the femoral head. [ABSTRACT FROM AUTHOR]

Objective: Understanding the relationship between genetic structure and the molecular changes involved in endometrial cancer (EC) provides an opportunity to personalize treatments and incorporate targeted therapies., Method: We compared cytogenetic and molecular features observed in tumoral and adjacent healthy tissue endometrium samples in EC patients., Results: Non-clonal chromosome aberrations (NCCAs) frequently in patients with EC, especially in 10,15,17,22, X chromosomes and were monitored in 73.7%, clonal chromosomal alterations were observed in 26.3% of the patients. Down POLE gene expression in 42.1%, up p53gene expression in 57.9%, PTEN down-regulation in 47.3%, down ARID1A gene expression in 42.1%, PIK3CA up-regulation was observed in 68% of patients., Conclusion: The up-regulation of tumor suppressor genes in our study shows that not only these genes are involved but also different pathways and factors play a role in tumorigenesis. Furthermore, an increased number of NCCAs shows an essential role in the development of ECs.

Background: Antegrade homodigital neurovascular island flap (AHIF) is one of the methods used in fingertip amputations to cover the defect area, preserve finger length and obtain a painless and sensitive fingertip. The aim of this study was to evaluate the functional and sensory outcomes in patients who underwent AHIF for fingertip amputation and to analyze the relationship between patient satisfaction and outcome measures., Methods: Twenty patients with a mean age of 37 (18-63) years were analyzed retrospectively. The patients were evaluated in terms of hook nail development, active interphalangeal joint movements, cold intolerance, and sensory function of the flap covered area. Static two-point discrimination test and Semmes Weinstein monofilament test were performed for sensory evaluation., Results: All flaps survived completely at the end of follow-up (mean, 36 months; range 11-64 months). Five patients had cold intolerance and two had hook nails. In total, proximal interphalangeal or distal interphalangeal joint flexion contracture developed in 25 % of the patients. The mean static two-point discrimination score was 4.6 ± 1.6 (2-8) and Semmes-Weinstein monofilament test score was 3.48 ± 0.6 (2.44-4.17). Subjective satisfaction levels of the patients were found to be high and did not show a statistical relationship with the measured clinical outcome parameters (p > 0.05)., Conclusions: Since AHIF contains a solid and continuous neurovascular pedicle, the probability of necrosis and loss of sensation is low in AHIF. In addition, the graft need of the donor area is not high. Its disadvantage is the rate of restriction of joint movements., Level of Evidence: IV., Competing Interests: Declaration of competing interest The authors declare no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (Copyright © 2023 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.)

Background: The purpose of this study was to present our experience in patients who had been treated with posterior vertebral column resection (PVCR) for various spinal deformities., Methods: Thirty-seven patients who performed PVCR between 2015 and 2018 were evaluated retrospectively. The mean follow-up period was 24 months (range: 12-50 months). The demographic data of the patients, mean blood loss, amount of blood replacement, duration of operation, intensive care and hospitalization period, PVCR level, instrumentation level, amount of preoperative curvature, amount of postoperative curvature improvement, preoperative and postoperative neurological status, and complications were examined. Angular measurements were performed on X-ray., Results: The mean age of the patients was 37.5 years (range: 3-80 years). PVCR was applied to patients due to different pathologies (congenital, tumor metastasis, posttraumatic kyphosis, revision scoliosis, and infection). The mean operation time was 445.5 min (260-720) with an average blood loss of 1903 ml (400-7000 ml). It was observed that the average local kyphosis angle decreased from 67.65° to 7.42° in 26 patients who were operated for advanced deformity ( P < 0.001). When these values were compared in all 34 patients, the preoperative angle value decreased from 55.1° to 3.5° ( P < 0.001) and decreased from 70° to 0° in 13 congenital kyphosis patients., Conclusion: PVCR is an effective method for correcting severe spinal deformities and can be used to correct curvature in different patient groups., Level of Evidence: Level 3., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Journal of Craniovertebral Junction and Spine.)

The possibility that acquired traits can be transmitted across generations has been the subject of intense research in the past decades. This biological process is of major interest to many scientists and has profound implications for biology and society but has complex mechanisms and is therefore challenging to study. Because it involves factors independent from the DNA sequence, this form of heredity is classically referred to as epigenetic inheritance. Many studies have examined how life experiences and various environmental factors can cause phenotypes that are heritable and be manifested in subsequent generations. Recognizing the major importance and complexity of this research, the fourth edition of the Epigenetic Inheritance Symposium Zürich brought together experts from diverse disciplines to address current questions in the field of epigenetic inheritance and present recent findings. The symposium had sessions dedicated to epidemiological evidence and animal models, transmission mechanisms, methodologies and the far-reaching impact on society and evolution. This report summarizes the talks of speakers and describes additional activities offered during the symposium including poster sessions and an art competition on the topic of epigenetic inheritance., Competing Interests: None declared., (© The Author(s) 2024. Published by Oxford University Press.)

Background: Even in the first application of patients with early complaints of trigger finger, pinch strength of the hand may be affected. Therefore, it is difficult to assess the change of strength as a result of treatment in this problem. In this study, we aimed to evaluate the change of strength taking into account both measured and expected pinch strengths before and after A1 pulley release surgery., Methods: Thirty fingers (9 thumbs, 12 middle, 8 ring and 1 index fingers) of 26 patients (17 women, 9 men) who underwent A1 pulley release were included into this study. The mean age of the patients was 53 (16-71). Tip-to-tip finger pinch strengths were measured pre-operatively and at 3 months postoperatively. The expected strengths were calculated using the values obtained from the healthy side and taking into account the dominance effect. In the analysis, pre-operative and postoperative measured strength/expected strength ratios were compared., Results: The mean of measured pinch strength/expected pinch strength ratio was 0.91 ± 0.3 pre-operatively and 1.14 ± 0.3 postoperatively (p < 0.05)., Conclusion: With the calculation method used in this study, it was found that there was a significant increase in the tip-to-tip pinch strength after surgical A1 pulley release for the trigger finger., Level of Evidence: III (Retrospective cohort study)., Competing Interests: Declaration of competing interest The authors declare that they have no conflicts of interest., (Copyright © 2022 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.)

Venous thromboembolism (VTE) is a severe complication that can occur after major orthopedic procedures. As VTE-related morbidity and mortality are a significant concern for both medical professionals and patients, and preventative measures are typically employed. Multiple organizations, including the American College of Chest Physicians (ACCP) and the American Academy of Orthopedic Surgeons (AAOS), have developed guidelines for VTE prophylaxis specifically in patients undergoing joint replacement procedures. However, recently, the International Consensus Meeting (ICM) was convened, which brought together over 600 experts from 68 countries and 135 international societies. These experts, spanning a range of medical disciplines including orthopedic surgery, anesthesia, cardiology, hematology, vascular, and internal medicine, conducted a comprehensive review of the literature using a strict Delphi process to generate practical recommendations for VTE prophylaxis across all types of orthopedic procedures. This review article summarizes some of the recommendations of the ICM.

Ovarian torsion can be defined as the bending of the ovaries on the supporting ligament, disrupting both venous and arterial blood circulation. Insufficient blood flow causes ovarian tissue hypoxia and leads to ischemia. This study aimed to investigate whether tocilizumab has a protective effect on ischemia-reperfusion injury due to ovarian torsion in rats. Eighteen female Wistar albino rats were divided into three equal groups (Sham (SG), ischemia-reperfusion (OIR), and ischemia-reperfusion+tocilizumab (OIRT)). Degeneration, necrosis, vascular dilatation/congestion, interstitial edema, hemorrhage, and polymorphonuclear lymphocyte (PMNL) infiltration scores were significantly different between the groups (p=0.001 for all parameters). Moreover, the OIRT group had a significant improvement in these criteria compared to the OIR group (p<0.05). Additionally, there was a considerable difference between OIRT and OIR groups in the number of primordial, developing, and atretic follicles groups (p<0.05), while there was no difference in the number of corpus luteum (p=0.052). Stress markers or cytokines, such as MDA, tGSH, NF-κB, TNF-α, IL-1β, and IL-6, were significantly different between groups (p<0.05). Furthermore, a significant improvement was found in the measured variables when the OIRT group was compared with the OIR group (p<0.05). Tocilizumab may be an alternative option for treating ischemia-reperfusion injury due to ovarian torsion.

The wiring architecture of neuronal networks is assumed to be a strong determinant of their dynamical computations. An ongoing effort in neuroscience is therefore to generate comprehensive synapse-resolution connectomes alongside brain-wide activity maps. However, the structure-function relationship, i.e., how the anatomical connectome and neuronal dynamics relate to each other on a global scale, remains unsolved. Systematically, comparing graph features in the C. elegans connectome with correlations in nervous system-wide neuronal dynamics, we found that few local connectivity motifs and mostly other non-local features such as triplet motifs and input similarities can predict functional relationships between neurons. Surprisingly, quantities such as connection strength and amount of common inputs do not improve these predictions, suggesting that the network's topology is sufficient. We demonstrate that hub neurons in the connectome are key to these relevant graph features. Consistently, inhibition of multiple hub neurons specifically disrupts brain-wide correlations. Thus, we propose that a set of hub neurons and non-local connectivity features provide an anatomical substrate for global brain dynamics., Competing Interests: Declaration of interests The authors declare no competing interests., (Copyright © 2022 The Author(s). Published by Elsevier Inc. All rights reserved.)

The aim of the study was to investigate the reasons for Turkish obstetricians having self-caesarean section on maternal request (CSMR) and their attitudes and practices related to CSMR and vaginal birth after caesarean section (VBAC). The questionnaire form constructed by the authors was sent online to obstetricians working in different cities of Turkey. A total of 206 obstetricians participated and answered a self-administered questionnaire. The self-birth preferences were as follows: 17% had a vaginal delivery (VD), 61.2% had a caesarean section (CS), 4.9% had both VD and CS. Of the participants with CS, 56.3% had CSMR. The most common reason for their having self-CSMR was that it was 'safe for the baby'. The most common reason for performing CSMR with their patients was 'due to birth anxiety and phobia'. Fifty-five percent of the participants said that they first recommended VD. The most common concern related to VBAC was 'I'm afraid of legal sanctions about complications'. Although many Turkish obstetricians recommend VD to their patients, they are afraid of the complaints/trials related to unforeseen complications during VD. IMPACT STATEMENT What is already known on this subject? Caesarean section (CS) rates all over the world and in Turkey are rising. The exact frequency of CS on maternal request (CSMR) is not known, but it is estimated to be between 4% and 18%. What do the results of this study add? Although Turkish obstetricians had high self-CSMR rates, they thought that it was more correct to direct patients to vaginal delivery (VD). Obstetricians are afraid of unforeseen complications during VD and related complaints and legal trials. What are the implications of these findings for clinical practice and/or further research? Physicians expect improvements in the judgement and punishment issues related to unforeseen complications in the birth process. Besides the actual rates of CSMR need to be reported in the literature and why obstetricians perform CSMR needs to be investigated globally.

Aim of this study is to investigate whether the risk of miscarriage increases in pregnant women who had COVID-19 in first trimester. Our study included 52 patients with SARS-CoV-2 infection detected by RT-PCR and 53 patients with negative RT-PCR test in samples taken with nasopharyngeal swab in the first trimester between March 1 and December 31, 2020. Complete abortion, incomplete abortion, blighted ovum, intrauterine exitus, biochemical pregnancies were accepted as in the miscarriage group (MG). Pregnant women with COVID-19 and control group were compared in terms of demographic data, miscarriage rate and laboratory results. Patients were divided into MG and ongoing pregnancy groups (OPG) and compared in terms of the diagnosed weeks, clinical findings, laboratory results, treatments, and hospitalization. While miscarriage was observed in 15 (28.8%) of pregnant women infected with SARS-CoV-2 in the first trimester, this number was 7 (13.2%) in the control group. While the common symptoms in the MG were cough (60%), fever (53.3%), shortness of breath (53.3%), and fatigue (46.7%) (p<0.05); asymptomatic patients (51.4%) were higher in the OPG (p<0.001). Hospitalized patients were 33.3% in the MG and 8.1% in the OPG (p=0.02). According to the results of our study, the risk of miscarriage increases in pregnant women infected with SARS-CoV-2 (especially in severe infection) in the first trimester.

Background: Cyclophosphamide is a drug used in various types of cancer. It can cause oxidative and inflammatory ovarian damage and infertility. Thiamine pyrophosphate (TPP) to be investigated for its effect on cyclophosphamide-induced ovarian damage and reproductive dysfunction in the present study is the active metabolite of thiamine. It has been shown that TPP protects organs and tissues from oxidative stress and proinflammatory cytokine damage., Objectives: To investigate the effect of TPP against the ovarian damage and reproductive dysfunction caused by cyclophosphamide in rats., Material and Methods: Albino Wistar type female rats were divided into healthy control (HG), cyclophosphamide (CYC) and TPP + cyclophosphamide (TPPC) groups (for each group, n = 12). Thiamine pyrophosphate at a dose of 25 mg/kg was injected intraperitoneally (ip.) in the TPPC group, and 0.9% NaCI solution was injected ip. in the CYC and HG groups. One hour after the injection, 75 mg/kg of cyclophosphamide was administered ip. in the TPPC and CYC groups. This procedure was repeated once a day for 30 days. At the end of this period, 6 rats from each group were euthanized with a high dose of anesthetic (50 mg/kg of sodium thiopental). Biochemical and histopathological examinations were performed on the extracted ovarian tissue. The remaining animals were kept in the laboratory with mature male rats for 2 months for reproduction., Results: Thiamine pyrophosphate significantly decreased the cyclophosphamide-induced increase in the levels of the oxidant parameter malondialdehyde (MDA), proinflammatory nuclear factor kappa B (NF-κB), tumor necrosis factor alpha (TNF-α), and interleukin 1 beta (IL-1β). In addition, TPP decreased the severe histopathological damage associated with cyclophosphamide in the ovarian tissue and prevented infertility., Conclusions: Our experimental results have suggested that TPP could be beneficial in the treatment of cyclophosphamide-induced ovarian injury and infertility.

Aim: The study objective was to compare intraoperative and early postoperative outcomes among patients who underwent hysterectomy via transvaginal natural orifice transluminal endoscopic surgery (and single-port lararoscopy for presumed benign gynecologic disorders)., Methods: We retrospectively reviewed 40 patients who underwent single-port laparoscopic hysterectomy and 20 patients who underwent hysterectomy via natural orifice transluminal endoscopic surgery. Patients' age, body mass index, history of previous delivery and surgery, total operation time (from skin incision to closure), intraoperative and postoperative complications conversion to another surgical procedure, drop of hemoglobin level, postoperative pain at 1 and 18 h, average hospital stay, and clinical outcomes were analyzed., Results: Hysterectomy via transvaginal natural orifice transluminal endoscopic surgery was superior to single-port hysterectomy concerning the length of hospitalization (p < 0.001) and visual analog scale at 1 h (p = 0.024) and 18 h (p < 0.001). In transvaginal natural orifice transluminal endoscopic group, postoperative complications were lower than single-port laparoscopy group (p = 0.023). In transvaginal natural orifice transluminal endoscopy, group conversion to a standard vaginal hysterectomy occurred in two cases (10%). Four patients in the single-port laparoscopic hysterectomy group had umbilical herniation, three had port-site infections, and two patients had vaginal cuff hematoma. These patients required rehospitalization., Conclusions: Despite hysterectomy via transvaginal natural orifice transluminal surgery has not yet found its place in routine practice in gynecology departments, it could be a prominent alternative approach to other minimally invasive surgical procedures in selected patients with many advantages including lesser pain and lower complication rates compared with single-port laparoscopic hysterectomy., (© 2021 Japan Society of Obstetrics and Gynecology.)

Objectives: The values of acceleration capacity and deceleration capacity are known to capture fetal neurological development. The fetal growth restriction was found to be featured by decreased variables of phase rectified signal averaging. We have speculated that acceleration capacity and deceleration capacity could be of use in the detection of antenatal fetal distress during fetal growth restriction. The study was focused on the detection of the accuracy of acceleration capacity and deceleration capacity in diagnosing fetal distress., Material and Methods: In total, 124 pregnant women at 26-36 weeks of gestation were included in the study. The patients with appropriate to gestational age fetuses (n = 32) were enrolled in Group I. The patients with fetal growth restriction and an absence of fetal distress (n = 48) were observed in Group II. Lastly, the patients with fetal growth restriction and fetal distress (n = 44) were included in Group III. Fetal cardiosignals were obtained via non-invasive fetal electrocardiography. The maximally decreased acceleration capacity and deceleration capacity values were found in Group III., Results: A correlation was found between umbilical artery resistance index and acceleration capacity and deceleration capacity variables in all study groups. We have found that the application of phase rectified signal averaging in the antenatal period showed high sensitivity and specificity in fetal distress detection., Conclusions: Fetal acceleration capacity and deceleration capacity is a prospective option for the detection of fetal compromise during fetal growth restriction.

Purpose: Etiology could not be determined in approximately 50% of recurrent pregnancy loss cases, and it was named unexpected recurrent pregnancy loss(URPL). A body shape index(ABSI), body roundness index(BRI), and waist-to-hip ratio(WtHR) are new indexes that are superior to BMI in showing body fat distribution. We aimed to investigate the potency of ABSI, BRI, and WtHR in URPL, their superiority to BMI, and their suitability for clinical use., Methods: One hundred and thirty-eight patients between the ages of 20-40 who applied to our hospital for URPL between January 2016 and December 31, 2020 were included in our study. Weight, height, waist circumference, and hip circumference were measured, and indexes were calculated. Differences between the URPL and control groups were calculated using the IBM SPSS program., Results: There was a significant difference between the two groups for BRI, ABSI, and WtHR values, while there was no significant difference in BMI. BRI(4.4 ± 1.7vs3.9 ± 1.5), ABSI(0.08 ± 0.005 vs 0.078 ± 0.004), and WtHR(0.84 ± 0.06vs0.82 ± 0.05) values were higher in the URPL group. ROC analysis showed us that BRI, ABSI, and WtHR have a diagnostic value for URPL( P  < .05). When indexes were above the cutoff values, RPL risk increased 3.59 times in ABSI, 2.26 times in BRI, and 2.9 times in WtHR( P  < .05)., Conclusions: The relationship between obesity and URPL can be explained more clearly by using effective indexes that show body fat distribution rather than BMI. Ethics committee approval was obtained from Erzincan Binali Yildirim University in 14.01.2021. Clinical Research Ethics Committee no: 01/01., Competing Interests: Tunay Kiremitli, Sevil Kiremitli, Pasa Ulug, Kemal Dinc, Kemine Uzel and Yusuf Kemal Arslan declare that they have no conflict of interest., (© 2021 The Authors. Reproductive Medicine and Biology published by John Wiley & Sons Australia, Ltd on behalf of Japan Society for Reproductive Medicine.)

Introduction: Proximal humerus fractures (PHF) constitute the majority of the most common osteoporotic fractures. Bone density measurements can affect treatment methods and outcomes. This study was aimed to investigate the effect of osteoporosis values, measured from direct radiographs, on fracture type, surgical outcomes., Methods: 248 patients over 50 years of age who presented to Mersin City Hospital between 2017 and 2020 with proximal humeral fractures were retrospectively evaluated. The age and gender of the patients and the fracture types were evaluated according to the AO classification system from the direct radiographs obtained at the time of admission were recorded. The Tingart cortical thickness and deltoid tuberosity index (DTI) measurements were used to assess osteoporosis status in all patients. Postoperative and follow-up radiographs of 45 patients, treated with fixed-angle proximal humeral locking plate, were evaluated for radiographic results and their correlations with osteoporosis measurements were examined., Results: According to the demographic characteristics of the patients, 171 patients were female and 77 patients were male (F/M: 3/1), and mean age was 69.2 ± 11.66 (50-95). Considering the bone quality parameters in all patients, the mean Tingart value was 5.8 ± 1.6 mm and the mean DTI was 1.43 ± 0.17, where there was a correlation between the Tingart value and DTI (r = 0.810 and p < 0.001). Although there was a statistically significant relationship between the osteoporosis parameters and age and gender (p < 0.001 and p = 0.023, respectively), main AO fracture types were not related to osteoporosis (p < 0.05). In the operated group (n = 48, 19%), 19 patients (42%) showed poor outcomes, which were not associated with age and osteoporosis parameters., Conclusion: This study was concluded that osteoporosis parameters differ between genders and age groups in patients with PHF, however osteoporosis is not the main factor affecting the fracture type and surgical outcomes., Competing Interests: Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2020.)

In this issue of Cell, Wan et al. (2019) track comprehensively the development of individual neurons, along with their activity, during zebrafish spinal cord development. They find that mostly motor neurons are the founders of initially small neuronal-activity ensembles, coalescing into larger populations establishing the first motor patterns., (Copyright © 2019 Elsevier Inc. All rights reserved.)

This study presents the outcomes of patients treated with non-union of femoral neck fractures healed with valgus osteotomy, fixed with a Dynamic Hip Screw (DHS). The study retrospectively evaluated 16 patients who, between 2007 and 2014, developed pseudarthrosis following treatment for a femoral neck fracture and who were treated with DHS-osteosynthesis, after a valgus subtrochanteric osteotomy. Postoperative clinical evaluation of the patients was done? using the Harris Hip Scoring (HHS) system. Union of both the fracture and the osteotomy site was achieved in 17.2 weeks (range: 14-24 weeks) in all patients. The average Pauwels angle decreased from 72o (range 62-80) preoperatively to 26o (range 20-50) postoperatively. All fractures were Pauwels type III preoperatively and 4 type II and 12 type I postoperatively. The average HHS increased from 26 (range 18-34) preoperatively to 85 (range 68-94) postoperatively. Of the patients who were followed up for a mean duration of 3.1 years (range: 1-5 years), four had 1-cm shortening. No patient developed postoperative AVN of the femoral head. For patients with non-union after femoral neck fracture, DHS-osteosynthesis after valgus osteotomy is a method with a shorter learning curve, which can be successfully performed.

Objective: The aim of our study is to evaluate the functional outcomes and quality of life in adult ipsilateral femur and tibia fractures., Methods: 26 patients (21 male, 5 female; mean age 30 years, range: 18 to 66) treated for adult ipsilateral femur and tibia fractures were evaluated retrospectively. For femur fractures, intramedullary nails were used in 15 patients (12 antegrade, 3 retrograde), plate in 11 patients (10 locked-plate, and 1 blade-plate with a 95 degree angle). For tibia fractures, locked-plate were used in 13 patients, intramedullary nails in 9 patients, external fixator in 3 patients and multiple screws in 1 patient. According to Blake and McBryde classification, 17 fractures were type I, 9 fractures were type II (7 type 2A and 2 type 2B). The functional outcomes were evaluated by Karlström and Olerud criteria, and quality of life was evaluated by Short Form-36. The mean follow-up duration was 4.4 years (range: 1.1 to 7.3 years)., Results: The functional outcomes were excellent in 6 patients, good in 8 patients, acceptable in 6 patients and poor in 6 patients. The mean values of quality of life scales were; physical function: 64.8, physical role limitation: 60.5, pain: 68.2, general health: 63.3, vitality: 58.4, social function: 68.2, emotional role limitation: 62.7, and mental health: 65.8., Conclusion: Adult ipsilateral femur and tibia fractures are severe injuries and adversely affect the quality of life and functional outcomes. The quality of life scales should be used along with functional outcome scores in evaluating these injuries., The Translational Potential of This Article: Adult ipsilateral femur and tibia fractures cause severe morbidity. Functional outcomes and quality of life scales should be used together to evaluate these fractures. Karlström and Olerud criteria for functional outcomes and Short Form-36 scales for quality of life are suitable methods to evalute these fractures.

Background: The treatment of diaphyseal forearm fractures using open reduction and plate fixation is generally accepted as the best choice in many studies. However, periosteal stripping, haematoma evacuation may result in delayed union, nonunion and infection. Refracture after plate removal is another concern. To overcome these problems intramedullary nails (IM) with different designs have been used with various outcomes. However previous IM nails have some shortcomings such is rotational instability and interlocking difficulties. We evaluated the results of newly designed IM nail in the treatment of diaphyseal forearm fractures in adults., Materials and Methods: 32 patients who had been treated with the interlocking IM nail for forearm fractures between 2011 and 2014 were included in this study. There were 23 males and 9 females with mean age of 36 years (range 18-68 years). 22 patients (68.8%) had both bone fractures. Nine patients (28.1%) had open fractures. The remaining ten patients (31.2%) had radius or ulna fractures. Grace and Eversmann rating system was used to assess functional evaluation. Patient reported outcomes were assessed using the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire scores., Results: Union was achieved in all patients. The mean followup was 17 months (range 13 - 28 months). According to the Grace-Eversmann criteria, 27 patients (87.5%) had excellent or good results. The mean DASH score was 14 (range 5-36). Overall complication rate was 12.5%. Superficial infection was encountered in two patients. One patient had delayed union, however fracture healed without any additional surgical procedure. One patient who had open grade 3A, comminuted proximal third radius fracture developed radioulnar synostosis., Conclusions: The new design IM interlocking forearm nail provides satisfactory functional and radiological outcomes in the treatment of adult diaphyseal forearm fractures., Competing Interests: There are no conflicts of interest.

Objective: The Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation is more effective at estimating glomerular filtration rate (GFR) than the Modification of Diet in Renal Disease (MDRD) equation, particularly in patients with mildly impaired renal function. Recent studies have demonstrated, using the Cockroft-Gault and MDRD formulas, a significant correlation between slow coronary flow (SCF) and normal to mildly impaired renal function. However, these studies had some limitations. The aim of the present study was to investigate the relationship between SCF and normal to mildly impaired renal function using the CKD-EPI equation., Methods: A total of 370 patients were included, 172 with normal coronary flow (NCF) and 198 with SCF. All participants had normal to mildly impaired renal function. Both the CKD-EPI and MDRD formulas were used to calculated estimated glomerular filtration rate (eGFR), which was compared between groups., Results: No significant difference in mean values of eGFR was found between the NCF and SCF groups (CKD-EPI: 92.9±14.7 vs 92.7±14.2, p=0.72; MDRD: 89.5±19.5 vs 88.2±17.0, p=0.70, respectively). Among patients with eGFR(MDRD) ≥90 mL/min/1.73 m2, mean eGFR levels were lower among patients with SCF (107.0±12.7 vs 102.7±10.0, p=0.02)., Conclusion: No correlation was found between SCF and normal to mildly impaired renal function.