Eklem Hastaliklari Ve Cerrahisi-Joint Diseases and Related Surgery最新文献

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The positive impact of platelet-derived growth factor on the repair of full-thickness defects of articular cartilage. 血小板源性生长因子对关节软骨全层缺损修复的积极影响。
IF 1.6 4区 医学
Eklem Hastaliklari Ve Cerrahisi-Joint Diseases and Related Surgery Pub Date : 2019-08-01 DOI: 10.5606/ehc.2019.64018
Sezgin Sarban, Hasan Tabur, Z Füsun Baba, U Erdem Işıkan
{"title":"The positive impact of platelet-derived growth factor on the repair of full-thickness defects of articular cartilage.","authors":"Sezgin Sarban,&nbsp;Hasan Tabur,&nbsp;Z Füsun Baba,&nbsp;U Erdem Işıkan","doi":"10.5606/ehc.2019.64018","DOIUrl":"https://doi.org/10.5606/ehc.2019.64018","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to investigate the potential use and histological effects of the local administration of platelet-derived growth factor (PDGF) in the repair of full-thickness osteochondral defects in articular cartilage in an animal model.</p><p><strong>Materials and methods: </strong>Twenty-four adolescent 18-week-old New Zealand White rabbits with an average weight of 2500 g (range, 1600 g to 3200 g) were used in the study. The rabbits were randomly divided into three groups (n=8) as the control group (group A) and two experimental groups (groups B and C). Defects of cylindrical full-thickness (3.5 mm wide, 4 mm deep) were created in the weight-bearing area of the right knee medial femoral condyles. In group A, the defect was left empty. In group B, the defect was filled with a collagen sponge. In group C, the defect was filled with a collagen sponge impregnated with PDGF. All rabbits were followed-up for 12 weeks. Right knee medial femoral condyles were used for macroscopic and histological analyses.</p><p><strong>Results: </strong>At macroscopic level, the repair tissue was similar to normal adjacent cartilage at 12 weeks in group C. The surface of the repair tissue in group C was smoother and more regular compared to groups A and B. The total histological score of defects in group C was statistically significantly superior compared to groups A and B (p<0.05). Matrix staining and immunostaining of collagen type 2 were stronger in group C compared to the other groups, indicating the presence of a tissue similar to a normal cartilage.</p><p><strong>Conclusion: </strong>Platelet-derived growth factor can induce repair in full-thickness defects of articular cartilage in an animal model. Thus, this study demonstrates the potential use of PDGF for full-thickness osteochondral defects.</p>","PeriodicalId":50551,"journal":{"name":"Eklem Hastaliklari Ve Cerrahisi-Joint Diseases and Related Surgery","volume":"30 2","pages":"91-6"},"PeriodicalIF":1.6,"publicationDate":"2019-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37414007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 4
Biochemical markers decrease and increase disproportionally in A1 pulley tissue of type 2 diabetic trigger finger patients. 2型糖尿病扳机指患者A1滑轮组织生化指标呈不成比例的升高和降低。
IF 1.6 4区 医学
Eklem Hastaliklari Ve Cerrahisi-Joint Diseases and Related Surgery Pub Date : 2019-08-01 DOI: 10.5606/ehc.2019.66112
Nazmi Bülent Alp, Gökhan Akdağ, Gülsüm Karduz, Kübra Vardar, Uğur Aksu
{"title":"Biochemical markers decrease and increase disproportionally in A1 pulley tissue of type 2 diabetic trigger finger patients.","authors":"Nazmi Bülent Alp,&nbsp;Gökhan Akdağ,&nbsp;Gülsüm Karduz,&nbsp;Kübra Vardar,&nbsp;Uğur Aksu","doi":"10.5606/ehc.2019.66112","DOIUrl":"https://doi.org/10.5606/ehc.2019.66112","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to detect the levels of some biochemical markers in A1 pulley tissue of type 2 diabetic trigger finger patients to enlighten the mechanisms leading to cellular complications.</p><p><strong>Patients and methods: </strong>The study included 35 trigger finger patients (5 males, 30 females; mean age 53.9±9.15 years; range, 37 to 71 years). We measured total thiol (total-SH) levels to determine the status of the non-enzymatic antioxidant defense system and advanced oxidation protein product (AOPP) levels to determine levels of oxidative protein modification in pulley tissues of trigger finger patients with or without diabetes. Extracellular matrix degradation was assessed by measuring levels of sialic acid (SA) in the pulley tissue.</p><p><strong>Results: </strong>Total-SH values for the groups with and without diabetes were 22.7±1.6 vs. 38.9±5.2 nmol/mg protein, respectively, while AOPP values were 472.5±131.6 vs.175.6±9.9 mmol/g protein, respectively. The SA levels of diabetic and nondiabetic patients were 0.4±0.0 vs. 0.63±0.1 nmol/mg protein, respectively.</p><p><strong>Conclusion: </strong>Our results revealed that tissue SA levels and tissue SH levels decreased and AOPP levels increased disproportionally in the A1 pulley tissue of diabetic patients, which may indicate the role of oxidative protein damage and extracellular matrix changes in diabetic trigger finger etiology.</p>","PeriodicalId":50551,"journal":{"name":"Eklem Hastaliklari Ve Cerrahisi-Joint Diseases and Related Surgery","volume":"30 2","pages":"117-23"},"PeriodicalIF":1.6,"publicationDate":"2019-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37133821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Modified percutaneous fixation for displaced intra-articular calcaneal fractures. 改良经皮内固定治疗移位的跟骨关节内骨折。
IF 1.6 4区 医学
Eklem Hastaliklari Ve Cerrahisi-Joint Diseases and Related Surgery Pub Date : 2019-08-01 DOI: 10.5606/ehc.2019.66386
Emre Baca, Alican Koluman
{"title":"Modified percutaneous fixation for displaced intra-articular calcaneal fractures.","authors":"Emre Baca,&nbsp;Alican Koluman","doi":"10.5606/ehc.2019.66386","DOIUrl":"https://doi.org/10.5606/ehc.2019.66386","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to review the results of surgically treated displaced intra-articular calcaneal fractures with a fast, less complicated, and modified percutaneous technique.</p><p><strong>Patients and methods: </strong>This retrospective study included 114 patients (86 males, 28 females; mean age 39 years; range, 16 to 66 years) admitted to our clinic for calcaneal fractures between May 2012 and June 2016 and operated using closed reduction and percutaneous fixation with two crossed Schanz pins. Trauma type, additional injuries, medical comorbidities, pre- and postoperative period, duration of operation, time to bone healing, complications, postoperative functional and radiological results were evaluated.</p><p><strong>Results: </strong>The increase in the postoperative Bohler's angle measurements was statistically significant compared to preoperative values (p=0.001; p<0.01). According to Sanders classification, seven feet (5.3%) were type II, 76 feet (57.57%) were type III, and 49 feet (37.12%) were type IV. The mean American Orthopaedic Foot and Ankle Society (AOFAS) score was 80.4 (range, 47 to 92). According to Sanders classification, the mean AOFAS scores were 81.25 for type II, 81.88 for type III, and 80.19 for type IV. Mean duration of operation was 8±1.5 minutes.</p><p><strong>Conclusion: </strong>Modified percutaneous fixation can give good results, even when open reduction is contraindicated. Maintaining the alignment and elevating the depressed intra-articular fragment may be sufficient for good mid-term results without anatomic reduction.</p>","PeriodicalId":50551,"journal":{"name":"Eklem Hastaliklari Ve Cerrahisi-Joint Diseases and Related Surgery","volume":"30 2","pages":"168-74"},"PeriodicalIF":1.6,"publicationDate":"2019-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37147356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 11
Suprapatellar approach for fractures of the tibia: Does the fracture level matter? 髌骨上入路治疗胫骨骨折:骨折水平重要吗?
IF 1.6 4区 医学
Eklem Hastaliklari Ve Cerrahisi-Joint Diseases and Related Surgery Pub Date : 2019-04-01 DOI: 10.5606/ehc.2019.63487
Özgür Çiçekli, Alauddin Kochai, Erhan Şükür, Ali Murat Başak, Alper Kurtoğlu, Mehmet Türker
{"title":"Suprapatellar approach for fractures of the tibia: Does the fracture level matter?","authors":"Özgür Çiçekli,&nbsp;Alauddin Kochai,&nbsp;Erhan Şükür,&nbsp;Ali Murat Başak,&nbsp;Alper Kurtoğlu,&nbsp;Mehmet Türker","doi":"10.5606/ehc.2019.63487","DOIUrl":"https://doi.org/10.5606/ehc.2019.63487","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to evaluate proximal, shaft, and distal tibial fractures treated with suprapatellar (SP) tibial intramedullary nailing (IMN) in terms of alignment, healing, and patellofemoral (PF) pain.</p><p><strong>Patients and methods: </strong>The study included 58 patients (41 males, 17 females; mean age 42.9 years; range, 18 to 75 years) treated via the SP approach in semiextention. Suprapatellar IMN surgeries were performed by two surgeons. After a minimum of 12 months of follow-up, patients' genders, ages, limb sides, fracture types, and classifications were recorded. Fracture reduction accuracy, angulation, PF arthritis, healing time, complications, and nonunions were analyzed. Anterior knee pain, visual analog scale (VAS), and Lysholm knee scoring scale were used as clinical measurements.</p><p><strong>Results: </strong>Seventeen fractures were in the proximal third, while 22 were in the middle third and 19 were in the distal third of the tibia. The mean healing time was 7.14 months (range, 4 to 13 months); differences in healing time between fracture locations were not statistically significant (p=0.83). The mean follow-up duration was 19.83 months (range, 12 to 30 months); there were no statistically significant differences in follow-up times in terms of fracture sites (p=0.51). The VAS score for the knee was 0 in 49 patients (84.5%) and <3 in nine patients (15.5%). The Lysholm score differences between the fracture location groups were not statistically significant (p=0.33).</p><p><strong>Conclusion: </strong>Suprapatellar tibial IMN can be applicable to extra-articular tibial fractures in all locations. Providing easy anatomic reduction in semiextention, convenient fluoroscopic imaging, safety for the PF joint, acceptable anterior knee pain, and satisfactory functional outcomes render SP approach more feasible.</p>","PeriodicalId":50551,"journal":{"name":"Eklem Hastaliklari Ve Cerrahisi-Joint Diseases and Related Surgery","volume":"30 1","pages":"10-6"},"PeriodicalIF":1.6,"publicationDate":"2019-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37069061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 6
Selective arterial embolization as neoadjuvant treatment in hip pseudotumors. 选择性动脉栓塞作为髋关节假性肿瘤的新辅助治疗。
IF 1.6 4区 医学
Eklem Hastaliklari Ve Cerrahisi-Joint Diseases and Related Surgery Pub Date : 2019-04-01 DOI: 10.5606/ehc.2019.65011
Mehmet Ali Tokgöz, Andrea Sambri, Giuseppe Rossi, Giuseppe Bianchi, Davide Maria Donati
{"title":"Selective arterial embolization as neoadjuvant treatment in hip pseudotumors.","authors":"Mehmet Ali Tokgöz,&nbsp;Andrea Sambri,&nbsp;Giuseppe Rossi,&nbsp;Giuseppe Bianchi,&nbsp;Davide Maria Donati","doi":"10.5606/ehc.2019.65011","DOIUrl":"https://doi.org/10.5606/ehc.2019.65011","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to investigate the significance of selective arterial embolization (SAE) as neoadjuvant for the treatment of pseudotumor (PT) associated with hip arthroplasty and present our case series including all the known bearing techniques.</p><p><strong>Patients and methods: </strong>This retrospective study included 16 patients (9 males, 7 females; mean age 75.5 years; range, 55 to 87 years) affected by hip PT. Seven patients were treated only surgically without any adjuvant treatment (group A), while nine patients were performed preoperative SAE (group B). Pseudotumors were grouped according to magnetic resonance imaging and computed tomography (CT) classifications. Durations of all operations and number of blood units given intra- and postoperatively were recorded.</p><p><strong>Results: </strong>Although embolization did not change the amount of intraoperative bleeding (p=0.619), a common vascular network leading to PT was observed in all patients in angiography. Group A's mean duration of operation was shorter than group B (p=0.03); however, this condition was attributed to larger and more complex lesions of patients who underwent embolization. According to CT classification, blood loss was more and duration of operation was longer in severe stages (p=0.046 and p=0.035, respectively).</p><p><strong>Conclusion: </strong>Successful demonstration of vascular network in patients with PT strengthens the idea that SAE technique may be used particularly in severe cases according to CT classification. Our findings suggest that PT may develop in all commonly used bearings.</p>","PeriodicalId":50551,"journal":{"name":"Eklem Hastaliklari Ve Cerrahisi-Joint Diseases and Related Surgery","volume":"30 1","pages":"17-23"},"PeriodicalIF":1.6,"publicationDate":"2019-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37067898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Wear pattern on the bottom of tennis shoe after surgical repair of acute Achilles tendon rupture: 22-year follow-up. 急性跟腱断裂手术修复后网球鞋底磨损模式:22年随访。
IF 1.6 4区 医学
Eklem Hastaliklari Ve Cerrahisi-Joint Diseases and Related Surgery Pub Date : 2019-04-01 DOI: 10.5606/ehc.2019.002
O Şahap Atik
{"title":"Wear pattern on the bottom of tennis shoe after surgical repair of acute Achilles tendon rupture: 22-year follow-up.","authors":"O Şahap Atik","doi":"10.5606/ehc.2019.002","DOIUrl":"https://doi.org/10.5606/ehc.2019.002","url":null,"abstract":"<p><p>In this article, we report a 67-year-old male patient who had a different wear pattern on the bottom of his tennis shoe after surgical repair of acute Achilles tendon rupture with 22-year follow-up. The wear pattern was well-matched with dynamic pedobarography. In left shoe with less total contact area and higher pressure values, there was more wear compared to right shoe.</p>","PeriodicalId":50551,"journal":{"name":"Eklem Hastaliklari Ve Cerrahisi-Joint Diseases and Related Surgery","volume":"30 1","pages":"65-7"},"PeriodicalIF":1.6,"publicationDate":"2019-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37067905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
Are peripheral nerve blocks effective in pain control of pediatric orthopedic tumor surgery? 周围神经阻滞在小儿骨科肿瘤手术疼痛控制中有效吗?
IF 1.6 4区 医学
Eklem Hastaliklari Ve Cerrahisi-Joint Diseases and Related Surgery Pub Date : 2019-04-01 DOI: 10.5606/ehc.2019.62395
Güldeniz Argun, Göze Çayırlı, Güray Toğral, Murat Arıkan, Süheyla Ünver
{"title":"Are peripheral nerve blocks effective in pain control of pediatric orthopedic tumor surgery?","authors":"Güldeniz Argun,&nbsp;Göze Çayırlı,&nbsp;Güray Toğral,&nbsp;Murat Arıkan,&nbsp;Süheyla Ünver","doi":"10.5606/ehc.2019.62395","DOIUrl":"https://doi.org/10.5606/ehc.2019.62395","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to evaluate the efficacy of ultrasound (US)-guided peripheral nerve blocks in postoperative analgesia after pediatric orthopedic tumor surgery.</p><p><strong>Patients and methods: </strong>This retrospective study included 108 children (64 boys, 44 girls, mean age 10.23 years; range, 2 to 18 years) who were performed orthopedic tumor surgery under general anesthesia. The children were divided into two groups as those who were performed nerve block for postoperative pain control (group 1, n=54) and those who were performed intravenous analgesic (group 2, n=54). In group 1, nerve blocks were performed with bupivacaine 0.25%. In group 2, intraoperative acetaminophen 15 mg/kg was performed intravenously. Postoperative visual analog scale (VAS) scores, time to pain onset, nausea, vomiting, total analgesic consumption in 24 hours, and complications were recorded at first, second, sixth and 24th hours.</p><p><strong>Results: </strong>Visual analog scale scores were higher in group 2 than group 1 at first, second, and sixth hours, but were not different at 24th hour. Mean time to pain onset was 10.2 hours in group 1 and 1.8 hours in group 2 (p<0.05). Mean time to pain onset and VAS values at first, second, sixth and 24th hours did not differ between nerve block types. Nausea and vomiting rates were not different between groups 1 and 2 (18.51% and 16.66%, respectively; p=0.4). Total analgesic consumption in 24 hours was higher in group 2 compared to group 1 (1.7 and 0.07 mg/kg, respectively; p<0.05).</p><p><strong>Conclusion: </strong>Pain-free periods extending up to 10 hours provided by US-guided peripheral nerve blocks may help recovery while reducing postoperative analgesic use and their side effects.</p>","PeriodicalId":50551,"journal":{"name":"Eklem Hastaliklari Ve Cerrahisi-Joint Diseases and Related Surgery","volume":"30 1","pages":"46-52"},"PeriodicalIF":1.6,"publicationDate":"2019-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37067902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 4
Surgical management of primary malignant proximal fibular tumors: Functional and clinical outcomes of 23 patients. 原发性腓骨近端恶性肿瘤的手术治疗:23例患者的功能和临床结果。
IF 1.6 4区 医学
Eklem Hastaliklari Ve Cerrahisi-Joint Diseases and Related Surgery Pub Date : 2019-04-01 DOI: 10.5606/ehc.2019.62888
İsmail Burak Atalay, Selçuk Yılmaz, İzzet Korkmaz, Mehmet Fatih Ekşioğlu, Bedii Şafak Güngör
{"title":"Surgical management of primary malignant proximal fibular tumors: Functional and clinical outcomes of 23 patients.","authors":"İsmail Burak Atalay,&nbsp;Selçuk Yılmaz,&nbsp;İzzet Korkmaz,&nbsp;Mehmet Fatih Ekşioğlu,&nbsp;Bedii Şafak Güngör","doi":"10.5606/ehc.2019.62888","DOIUrl":"https://doi.org/10.5606/ehc.2019.62888","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to evaluate the clinical characteristics and treatment outcomes of patients with primary malignant tumors located in the proximal fibula.</p><p><strong>Patients and methods: </strong>This retrospective study included 23 patients (15 males, 8 females; mean age 22.1 years; range, 9 to 63 years) with primary malignant tumors located in the proximal fibula between May 2007 and May 2017. The anamnesis or medical history, physical examination, plain chest radiography, lung computed tomography, direct radiograph, and magnetic resonance imaging of the affected extremity and routine laboratory tests of all patients were evaluated.</p><p><strong>Results: </strong>Of the patients, 11 were diagnosed with osteosarcoma (47.8%), nine with Ewing's sarcoma (39.1%), two with chondrosarcoma (8.7%), and one was diagnosed with synovial sarcoma (4.3%). Pain and palpable mass were the most common symptoms. Six patients had lung metastases at the time of diagnosis. Of the patients, eight were performed Malawer type 1 resection (34.8%), nine type 2 resection (39.1%), four above knee amputation (17.4%), and two proximal tibia tumor resection prosthesis (8.6%). Mean follow-up duration was 36 months (range, 12 to 119 months). Local recurrence developed in three patients. Mean Musculoskeletal Tumor Society (MSTS) score of all patients was 62.</p><p><strong>Conclusion: </strong>Surgical treatment of primary malignant tumors of the proximal fibula is problematic. In appropriate indications, Malawer type 1 resection should be the treatment of choice due to lower local recurrence rates and higher MSTS scores.</p>","PeriodicalId":50551,"journal":{"name":"Eklem Hastaliklari Ve Cerrahisi-Joint Diseases and Related Surgery","volume":"30 1","pages":"24-31"},"PeriodicalIF":1.6,"publicationDate":"2019-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37067899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 3
A new method for the assessment of reduction tension during open reduction in patients with developmental dysplasia of the hip. 一种评估髋关节发育不良患者切开复位时复位张力的新方法。
IF 1.6 4区 医学
Eklem Hastaliklari Ve Cerrahisi-Joint Diseases and Related Surgery Pub Date : 2019-04-01 DOI: 10.5606/ehc.2019.61744
Oktay Adanır, Serdar Yüksel, Ozan Beytemur
{"title":"A new method for the assessment of reduction tension during open reduction in patients with developmental dysplasia of the hip.","authors":"Oktay Adanır,&nbsp;Serdar Yüksel,&nbsp;Ozan Beytemur","doi":"10.5606/ehc.2019.61744","DOIUrl":"https://doi.org/10.5606/ehc.2019.61744","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to describe our standardized method for evaluating the tension of reduction around the hip joint during open reduction in patients with developmental dysplasia of the hip (DDH).</p><p><strong>Patients and methods: </strong>We retrospectively evaluated 67 pediatric patients (8 males, 59 females; mean age 21.9±11.1 months; range, 9 to 67 months) who were performed open reduction or open reduction with concomitant pelvic and/or femoral osteotomy for DDH at our clinic between January 2009 and March 2014. The amount of distraction between femoral head and acetabulum was measured to evaluate the tension of reduction during surgery. Factors associated with avascular necrosis (AVN) such as age at reduction, presence of concomitant pelvic and/or femoral shortening osteotomy, and severity of dislocation were determined.</p><p><strong>Results: </strong>Statistically significant association was found between the presence of femoral osteotomy, severity of dislocation, and amount of distraction and AVN. The incidence of AVN was 38.8% (10 grade I, 12 grade II, 3 grade III, and one grade IV AVN). Cut-off value for the amount of distraction to prevent the development of AVN was calculated as 4 mm.</p><p><strong>Conclusion: </strong>According to our study findings, we advise using our technique for the evaluation of the tension of reduction around the hip joint and performing tension free reduction in the treatment of DDH to minimize the risk of AVN development.</p>","PeriodicalId":50551,"journal":{"name":"Eklem Hastaliklari Ve Cerrahisi-Joint Diseases and Related Surgery","volume":"30 1","pages":"38-45"},"PeriodicalIF":1.6,"publicationDate":"2019-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37067901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 5
Effectiveness of abduction orthosis for the treatment of acetabular dysplasia. 外展矫形器治疗髋臼发育不良的疗效观察。
IF 1.6 4区 医学
Eklem Hastaliklari Ve Cerrahisi-Joint Diseases and Related Surgery Pub Date : 2019-04-01 DOI: 10.5606/ehc.2019.63718
Güney Yılmaz, Sancar Bakırcıoğlu, Rıza Mert Çetik
{"title":"Effectiveness of abduction orthosis for the treatment of acetabular dysplasia.","authors":"Güney Yılmaz,&nbsp;Sancar Bakırcıoğlu,&nbsp;Rıza Mert Çetik","doi":"10.5606/ehc.2019.63718","DOIUrl":"https://doi.org/10.5606/ehc.2019.63718","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to evaluate the effectiveness of full-time bracing in residual acetabular dysplasia (RAD) and the effect of previous Pavlik harness usage on the results of treatment with abduction orthosis.</p><p><strong>Patients and methods: </strong>We retrospectively reviewed 80 patients (9 males, 71 females; mean age 6±0.8 months; range, 5 to 7 months) with developmental dysplasia of the hip (119 dysplastic hips) treated with hip abduction orthosis. Patients with an acetabular index (AI) measurement of 30° and over who used full-time hip abduction brace for six months were included in the study. Acetabular index values were measured at the initiation, third, and sixth months of treatment and the effectiveness of abduction orthosis was evaluated. The patients were analyzed for the effect of prior Pavlik harness application on abduction orthosis treatment.</p><p><strong>Results: </strong>Mean AI value of the dysplastic hips (n=119) was 33.4°±2.6°, which decreased to 28.5°±2.6° after treatment (p<0.001). The AI improvement in the first three-month period was significantly faster than the second three-month period (2.9°±1.9° vs. 1.9°±1°; p=0.013). No difference was observed in AI development between patients with or without prior Pavlik treatment (p=0.1). In patients with unilateral dysplasia, dysplastic hips improved significantly faster than normal hips (p<0.001). As a result of a mean follow-up duration of 20.2±9.8 months from the onset of brace treatment, 32 (32%) hips were grouped as normal, 49 (48%) as mildly dysplastic, and 22 (20%) as severely dysplastic based on Tönnis criteria.</p><p><strong>Conclusion: </strong>Hip abduction orthosis may be used in patients with RAD between 6 to 12 months of age. Acetabular index improvement was faster in the first three months of brace treatment. Dysplastic hips improved faster than normal hips, and prior Pavlik harness treatment did not alter the effectiveness of orthosis.</p>","PeriodicalId":50551,"journal":{"name":"Eklem Hastaliklari Ve Cerrahisi-Joint Diseases and Related Surgery","volume":"30 1","pages":"32-7"},"PeriodicalIF":1.6,"publicationDate":"2019-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37067900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 4
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