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Few studies have investigated the reliability of Reimers' hip migration percentage (RMP) in children with cerebral palsy (CP). Most studies on the topic reflected rating results of physician with a similar level of experience from the same expertise. This study aimed to determine the effect of clinician's experience and expertise on the intra-and inter-observer reliability of RMP.In this retrospective observational study, hip radiographs of children with CP were identified. 5 observers with different degrees of working experience from 3 different clinical fields, including orthopedics, radiology, and physical medicine and rehabilitation, performed all RMP measurements. All measurements were repeated 6 weeks later by the same observers. Inter- and intra-observer reliability for RMP measurements were assessed using Intraclass Correlation Coeficient (ICC), calculated from 2 sets of repeated measurements on a subset of 50 hips, with a 6 week apart for each observer.Fifty hip radiographs of 25 children with CP (10 females and 15 males; mean age: 6 years; age range: 2-8 years) were examined in the current study. No significant differences existed in intra-and inter-observer measurements. Excellent intra-observer reliability was observed between the 2 separate measurements for each observer, with a mean ICC of 0.976 (range: 0.956-0.989; P

Objectives: In intraarticular distal humerus fractures, internal fixation with double plates is the gold standard treatment. However the optimal plate configuration is not clear in the literature. The aim of this study was to compare the biomechanical stability of the parallel and the orthogonal anatomical locking plating systems in intraarticular distal humerus fractures in artificial humerus models. Methods: Intraarticular distal humerus fracture (AO13-C2) with 5 mm metaphyseal defect was created in sixteen artificial humeral models. Models were fixed with either orthogonal or parallel plating systems with locking screws (Acumed elbow plating systems). Both systems were tested for their stiffness with loads in axial compression, varus, valgus, anterior and posterior bending. Then plastic deformation after cyclic loading in posterior bending and load to failure in posterior bending were tested. The failure mechanisms of all the samples were observed. Results: Stiffness values in every direction were not significantly different among the orthogonal and the parallel plating groups. There was no statistical difference between the two groups in plastic deformation values (0.31 mm-0.29 mm) and load to failure tests in posterior bending (372.4 N-379.7 N). In the orthogonal plating system most of the failures occurred due to the proximal shaft fracture, whereas in the parallel plating system failure occurred due to the shift of the most distal screw in proximal fragment. Conclusion: Our study showed that both plating systems had similar biomechanical stabilities when anatomic plates with distal locking screws were used in intraarticular distal humerus fractures in artificial humerus models. (C) 2016 Turkish Association of Orthopaedics and Traumatology., NA

The purpose of this study was to determine the comparative effectiveness of the use of single fluoroscopy versus double fluoroscopy during intramedullary nailing in the oblique position for intertrochanteric femur fractures in terms of surgery and radiation time.Fifty-two patients (20 men, 32 women; average age: 78.2 years; range: 69-88 years) were included in the study. While double fluoroscopy was used for 25 patients, single fluoroscopy was used for the remaining 27 patients. Data of the preparation time between anesthesia and surgery, surgery time, radiation time, bleeding volume, postoperative collodiaphyseal angle between the fractures and intact parts, and the tip-apex distance (TAD) were compared.The surgery time in the double and single fluoroscopy groups averaged 34.48±8.92 minutes and 50.37±16.63 minutes, respectively (p0.01). The radiation time was 42.72±16.00 seconds for the double-fluoroscopy group and 68.22±21.53 seconds for the single-fluoroscopy group (p0.01). The surgical preparation time, bleeding volume, collodiaphyseal angle and TAD distance did not vary significantly between groups (p0.05).The use of double fluoroscopy in the oblique position in the surgical treatment of intertrochanteric femur fractures reduced the surgical time and the anesthesia time for patients, as well as the exposure to radiation, thereby also reducing the risk of complications.

Only a few randomised, controlled studies have compared different non-operative methods of treatment of mid-shaft fractures of the clavicle.In this prospective, randomised controlled study of 60 participants (mean age 31.6 years; 15 to 75) we compared the broad arm sling with the figure of eight bandage for the treatment of mid-shaft clavicle fractures. Our outcome measures were pain, Constant and American Shoulder and Elbow Surgeons scores and radiological union.The mean visual analogue scale (VAS) pain score on the first day after treatment was significantly higher (VAS 1 6.8; 4 to 9) in the figure of eight bandage group than the broad arm sling group (VAS 1 5.6; 3 to 8, p = 0.034). A mean shortening of 9 mm (3 to 17) was measured in the figure of eight bandage group, versus 7.5 mm (0 to 24) in the broad arm sling group (p = 0.30).The application of the figure of eight bandage is more difficult than of the broad arm sling, and patients experience more pain during the first day when treated with this option. We suggest the broad arm sling is preferable because of the reduction of early pain and ease of application.Cite this article: Bone Joint J 2015;97-B:1562–5.

[No abstract available]

Purpose Salvage or amputation for grade 3C open fracture of tibia is not well responded question universally because of surgical innovations, cultural believes, difficulties in estimate the outcome, coasts, and different results in the literature. The aim of this study was to evaluate the surgical outcomes of Gustilo grade 3C open tibia fractures with at least two years follow-up in non-military adults. Methods Twenty-two non-military patients with a mean age of 31.1 were operated with grade 3c open fractures at tibia level in last 10 years in our clinic. We evaluated them retrospectively and asked about their daily life, pain, and if present, about the wish for secondary amputation. We also asked if they would prefer a first day amputation rather than their present status. Results Mean operation time after the injury was 13 h. Seven patients had nerve injury. Mean operation number was 3.5. Eight patients (%36) (all due to circulatory problem) had to have amputation. All patients treated with temporary unilateral external fixation than converted to circular external fixators when soft tissue healing was completed. Two patients were reoperated because of deformity. Four patients needed revision surgery because of non-union. At long term follow, we had osteomyelitis in one patient. Conclusions Scoring systems and the ischemic time are not the only predictors of amputation. The decision of the treatment mode should be made by the patient and the care team after discussing the options and outcomes rather than relying on a scoring system.

Tibial hemimelia is a rare disorder characterized by the absence or hypoplasia of the tibia with associated rigidity. The aim of this study was to retrospectively evaluate the affectivity of reconstructive surgeries including centralization of the knee-ankle joints and lengthening with Ilizarov principles, as well as physical and functional results of amputation and reconstruction.This is an IRB-approved retrospective review of all patients diagnosed with tibial hemimelia who required surgery at a single institution between 1998 and 2011. Charts were analyzed for clinical and radiographical findings. At final follow-up, patients underwent physical and radiographic examination. Patients and their parents were asked to complete the SF-10™ health survey (QualityMetric Inc., Lincoln, RI, USA).Twenty-one patients (12 male, 9 female) with 30 affected extremities were included. Mean age was 4.8±3.1 years at initial surgery. Knee level disarticulation was performed in 6 extremities of 4 patients. One patient with type III underwent transtibial amputation. Mean number of surgeries for each patient was 6.4±3.3, and mean duration of external fixator and casting was 17±6 months. Mean lengthening was 4.9±1.3 cm, and mean limb length discrepancy was 3.1±1.7 cm at 5.8±3.7 years at follow-up. SF-10™ scores were similar in disarticulated and reconstructed patients (p=0.63). All scores were significantly higher when disarticulation was performed in cases of knee instability (p0.01).When stability of the knee joint is present, treatment modality should be chosen according to the existence of the proximal tibia. Amputation should be preferred in cases of knee joint instability.

Objective: Tibial hemimelia is a rare disorder characterized by the absence or hypoplasia of the tibia with associated rigidity. The aim of this study was to retrospectively evaluate the affectivity of reconstructive surgeries including centralization of the knee-ankle joints and lengthening with Ilizarov principles, as well as physical and functional results of amputation and reconstruction. Methods: This is an IRB-approved retrospective review of all patients diagnosed with tibial hemimelia who required surgery at a single institution between 1998 and 2011. Charts were analyzed for clinical and radiographical findings. At final follow-up, patients underwent physical and radiographic examination. Patients and their parents were asked to complete the SF-10™ health survey (QualityMetric Inc., Lincoln, RI, USA). Results: Twenty-one patients (12 male, 9 female) with 30 affected extremities were included. Mean age was 4.8±3.1 years at initial surgery. Knee level disarticulation was performed in 6 extremities of 4 patients. One patient with type III underwent transtibial amputation. Mean number of surgeries for each patient was 6.4±3.3, and mean duration of external fixator and casting was 17±6 months. Mean lengthening was 4.9±1.3 cm, and mean limb length discrepancy was 3.1±1.7 cm at 5.8±3.7 years at follow-up. SF-10™ scores were similar in disarticulated and reconstructed patients (p=0.63). All scores were significantly higher when disarticulation was performed in cases of knee instability (p

BACKGROUND: Although pediatric pelvis fractures are relatively uncommon, long-term consequences and associated life-treating injuries often have a substantial impact for the rest of a child's life. The prognosis of pediatric pelvic fractures is better than that of the adults because of their greater elasticity, healing capacity and re-modelling. Fractures through the physis may lead to growth disturbance and/or acetabular dysplasia. Non-union is rare and mal-union is usually well-tolerated. The purpose of this study was to evaluate the results of a single trauma center and review the literature approach to pediatric pelvic fractures. METHODS: Medical records were analyzed for diagnosis, the mechanism of injury, additional injuries, treatment methods, and complications. The types of fractures were classified according to Torode and Zieg classification. Patients were called back and seen at the clinic as a last follow up visit. RESULTS: Twenty eight skeletally immature patients, under the age of 12, were treated for pelvic fracture from 1997 to 2012. Mean age was 6.8±2.4 years. Three children with an unstable pelvic ring injury required pelvic external fixation. One patient died due to pelvic hemorrhage postoperatively. Mean follow up was 5.3±3.6 years. CONCLUSION: Pediatric pelvic fractures are rare but life-threating injuries. Overall good or excellent long-term results can be expected in most cases with appropriate timing and treatment. Language: en

The purpose of this study was to report a less seen age-group (90) of hip fractures and to assess the predictors of functional loss, complications and mortality.Thirty-two patients at a mean age of 92.8 (±2.7) were treated in a single institution and reported at a mean follow-up of 2.02 (±1.35) years.Mortality was similar between proximal femoral nailing (PFN) and bipolar cemented hemiarthroplasty (BCH) in first year (p = 0.17) but significantly high in following years in BCH (p = 0.035) and patients with cardiac disease (p = 0.054).Hip fractures are challenging in extremely old patients and associated with increased mortality and disability.

This study aimed to compare the efficacy of two treatment modalities for periprosthetic supracondylar fractures. The results of intramedullary nailing in 7 patients and locked plating in 9 patients were reviewed retrospectively. Mean follow-up was 4.3 years (range : 1 to 13 years). One patient died on the first postoperative day. Union of the fracture was achieved in the other 15 patients, after a mean time of 3.86 months: 3.9 months (range: 3 to 6 months) in the locked plate group and 3.86 months (range : 3 to 5 months) in the intramedullary nail group (p = 0.96). Mean Knee Society Score was 78 points (range : 68 to 84 points) and mean total knee range of motion was 82 degrees (range 70 degrees to 90 degrees) with no significant differences between groups. Sagittal and coronal plane measurements were similar both in the early postoperative period and at the last follow-up. The two treatment modalities had similar results with a high success rate.

ÖZET Yüksel Lisans Tezi İç Anadolu'da Yayılış Gösteren Microtus türlerinin Morfolojik ve Biyometrik özelliklerinin İncelenmesi Derya YAVUZ SAĞLAM Ankara Üniversitesi Fen Bilimleri Ensititüsü Biyoloji Ana Bilim Dalı Danışman: Prof. Dr. Nuri YİĞİT İç Anadolu'dan 19 farklı lokaliteden yakalanan 329 Microtus örneği incelendi ve Microtus socialis, Microtus lydius, Microtus rossiaemeridionalis, Microtus dogramacii ve Microtus anatolicus olmak üzere 5 türün yayılış yaptığı saptandı. Bu türlerden M. socialis içinde iki farklı renk formu saptandı. Beş türün biyometrik karakterleri kullanılarak yapılan Khi-kare testinde; analiz edilen 19 karakter ölçüsü ve ağırlıkta istatistik olarak önemli bir farklılık bulunmadı. Ancak Khi kare test sonuçlarının tersine, 5 türün iç ve dış karakter ölçülerinin ikili gruplar halinde t- testi ile yapılan karşılaştırmasında önemli farklılıklar saptandı. Bu bulgulara göre; Microtus alt cinsine dahil edilen M. rossieameridionalis, Sümeriomys alt cinsi türleri olan M. socialis, M. dogramacii ve M. anatolicus biyometrik olarak önemli farklılıklar göstermektedir. Sümeriomys alt cinsi içinde de M. lydius diğer türlerden biyometrik olarak oldukça farklıdır. Bu alt cins içinde en fazla benzerlik M. socialis ve M. dogramacii arasında saptanmıştır. Ayrıca biyometrik karakterlerle oluşturulan UPGMA kümesinde, M. lydius 'un en farklılaşmış tür, M. socialis ve M. anatolicus1 un ise birbirine en yakın tür olduğu saptandı. 2004, 67 sayfa ANAHTAR KELİMELER: Microtus, morfoloji, Biyometri, İç Anadolu ABSTRACT Master Thesis Investigations of Morphologic and Bioraetric Characteristics of Microtus species Distributed in Central Anatolia Derya YAVUZ SA?LAM Ankara University Graduate School of Natural and Applied Sciences Department of Biyology Supervisor: Prof. Dr. Nuri Yİ?İT Three hundred twenty nine Microtus specimens from 19 different localities were examined, and it was determined that Microtus socialis, Microtus lydius, Microtus rossiaemeridionalis, Microtus dogramacii and Microtus anatoliscus are distributed in Central Anatolia.Two different color patterns were determined in M. socialis. According to Khi square test performed by biometric charatersitics of five species, there was no statistical difference (p>0,05) among weight and measurements of five species. In contrast to Khi square test results, external and cranial measurements of five species were analyzed by t- test as pair- wise groups and it was determined significant differences among species. According to these results, M. rossieameridionalis belongs to subgenus Sumeriomys showed important biometric differences than M. socialis, M. lydius, M. dogramacii, M. anatolicus which are the members of the subgenus Microtus. M. lydius was loud to be the most biometrically diverged species among other species of subgenus Microtus. The highest similarity was found between M. socialis and M. dogramacii in Sumeriomys subgenus. According to UPGMA cluster performed by biometric charactersitics except for weights, M. lydius appeared to be the most diverged species. But M. socialis and M. anatolicus established a clade with high similarity. 2004, 67 pages KEY WORDS: Microtus spp, morphology, biometry, Central Anatolia 11 78