Acta orthopaedica et traumatologica turcica最新文献

{"title":"Medial patellofemoral ligament reconstruction in osteogenesis imperfecta using quadriceps tendon graft: a rare case report.","authors":"Tayfun Özel, Mehmet Ali Tokgöz","doi":"10.5152/j.aott.2026.25829","DOIUrl":"https://doi.org/10.5152/j.aott.2026.25829","url":null,"abstract":"<p><p>Osteogenesis imperfecta (OI) is a rare connective tissue disorder associated with bone fragility and ligamentous laxity, predisposing patients to recurrent patellar instability. Surgical treatment of recurrent patellar instability is challenging because standard medial patellofemoral ligament (MPFL) reconstruction techniques involving patellar tunneling may increase the risk of patellar fracture. We present a 15-year-old male patient with OI type V and recurrent patellar dislocation treated with a minimally invasive MPFL reconstruction using a pedicled quadriceps tendon graft. This patella-sparing technique was selected to reduce stress on fragile patellar bone. At the 3-year follow-up, the patient demonstrated marked clinical improvement with reduced pain and improved knee function. No patellar fracture, fixation failure, or recurrent instability was observed. This case suggests that patella-sparing MPFL reconstruction may be a safe surgical option for managing patellar instability in patients with OI.   Cite this article as: Özel T, Tokgöz MA. Medial patellofemoral ligament reconstruction in osteogenesis imperfecta using quadriceps tendon graft: A rare case report. Acta Orthop Traumatol Turc.,2026; 60(5), 0829,  doi: 10.5152/j.aott.2026.25829.</p>","PeriodicalId":93854,"journal":{"name":"Acta orthopaedica et traumatologica turcica","volume":"60 5","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149224924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Locally manufactured versus imported proximal femoral nails: inverse probability of treatment weighting: adjusted comparison of costs and complications in intertrochanteric femur fractures.","authors":"Eşref Selçuk, Oğuz Mercan, Ebrar Pakyıldız, Murat Erem, Savaş Yıldırım","doi":"10.5152/j.aott.2026.25772","DOIUrl":"https://doi.org/10.5152/j.aott.2026.25772","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To compare domestic and imported proximal femoral nails (PFNs) in the treatment of intertrochanteric femoral fractures with respect to implant cost trends and complication rates.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This retrospective cohort study included adults aged 65 years and older who underwent proximal femoral nailing for intertrochanteric femoral fractures. Fractures were identified using ICD-10 code S72.1 and AO/OTA types 31A1 and 31A2. All patients were treated between January 2019 and June 2024 at a tertiary academic trauma center. Patients with pathological fractures, prior ipsilateral hip surgery, death within 1 year, or insufficient follow-up were excluded. The primary outcomes were implant cost, reported in Turkish lira (TRY) and US dollars (USD), and complication rates. Secondary outcomes included length of hospital stay, total treatment cost, and PFN design (single- vs double-blade). Reduction quality was assessed using the Baumgaertner criteria, and the tip apex distance was measured on postoperative radiographs. In addition, data regarding the operating surgeon were recorded. Inverse probability of treatment weighting (IPTW) based on propensity scores was applied to adjust for baseline differences.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 307 patients (mean age 82.8 Å} 7.8 years; 70% women) were included and overall complication rates were 5.2%. Domestic implants were used in approximately two-thirds of cases. After IPTW adjustment, complication rates were comparable between domestic and imported PFNs (7.1% vs. 4.0%, P = .299), and most events were mechanical. From 2019 to 2021, domestic implants were cheaper in TRY but not in USD; from 2022 onward, implant costs showed an increasing trend. In 2024, when only domestic PFNs were available, the median implant cost reached its highest level ($677.28). Double-blade PFNs were more expensive than single-blade devices (P &lt; .001), whereas differences in complication rates should be interpreted cautiously due to limited covariate overlap. Length of stay showed a strong correlation with total cost (ρ = 0.41-0.47, P &lt; .001).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;After adjustment for baseline differences, implant origin was not independently associated with complication risk in geriatric patients with intertrochanteric femoral fractures; however, this finding should be interpreted cautiously given the limited number of events. Implant-related costs varied substantially over time and were mainly driven by exchange-rate volatility and market conditions. Reduction quality was the strongest determinant of complications, emphasizing that implant selection should prioritize surgical technique alongside cost and availability considerations.   Cite this article as: Selçuk E, Mercan O, Pakyildiz E, Erem M, Yildirım S. Locally manufactured versus imported proximal femoral nails: inverse probability of treatment weighting: adjusted comparison of costs and complications in int","PeriodicalId":93854,"journal":{"name":"Acta orthopaedica et traumatologica turcica","volume":"60 5","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149224891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does the lower instrumented vertebra matter? The impact of lower instrumented vertebra level on long-term health-related quality of life.","authors":"Özgür Aydın, Batuhan Göçer, Mustafa Can Koşay, Ömer Akçalı, Haluk Berk","doi":"10.5152/j.aott.2026.25762","DOIUrl":"https://doi.org/10.5152/j.aott.2026.25762","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate the relationship between the lower instrumented vertebra (LIV) level and long-term health related quality of life (HRQoL) in patients with adolescent idiopathic scoliosis (AIS) after posterior spinal fusion.</p><p><strong>Methods: </strong>This retrospective cohort study included 120 patients who underwent posterior fusion surgery for AIS between 1991 and 2019 and had clearly identifiable fusion levels with a minimum follow-up of 5 years. In 2024, all patients completed 4 patient-reported outcome instruments, including the Scoliosis Research Society-22 revised questionnaire (SRS-22r), the Turkish version of the Spinal Appearance Questionnaire (Tr-SAQ), the Oswestry Disability Index, and the EQ-5D-3L.</p><p><strong>Results: </strong>When outcomes were analyzed according to the level of the LIV, no significant differences in SRS-22r pain scores were observed among fusion levels up to L4. In contrast, patients with LIV at L5 demonstrated significantly lower SRS-22r pain scores than those fused to L2, L3, and L4 (P = .035). Likewise, EQ-Visual Analog Scale scores were significantly lower in the L5 group than in patients with fusion levels from L1 to L4 (P = .025).</p><p><strong>Conclusion: </strong>In patients undergoing fusion surgery for AIS, no significant differences in quality of life scores were observed among fusion levels up to L4. In contrast, patients with fusion extending to L5 demonstrated comparatively poorer outcomes. However, the findings regarding fusion extending to L5 are based on a small subgroup and require further validation.   Cite this article as: Aydın O, Gocer B, M, Kosay C, Akcalı O, Berk H. Does the lower instrumented vertebra matter? The impact of lower instrumented vertebra level on long-term health-related quality of life. Acta Orthop Traumatol Turc. 2026; 60(5), 0762, doi: 10.5152/j.aott.2026.25762.</p>","PeriodicalId":93854,"journal":{"name":"Acta orthopaedica et traumatologica turcica","volume":"60 5","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149225584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Semitendinosus Tendon Reconstruction for Recurrent Acromioclavicular Joint Instability Following Repeated Fixation Failure and Postoperative Trauma: A Case Report.","authors":"İbrahim Halil Dadir, Yasin Erdoğan","doi":"10.5152/j.aott.2026.26958","DOIUrl":"https://doi.org/10.5152/j.aott.2026.26958","url":null,"abstract":"<p><p>Recurrent instability following surgical treatment of Rockwood type III acromioclavicular (AC) joint injuries is uncommon but represents a challenging clinical problem, particularly after repeated fixation failure. A 67-year-old man presented with a Rockwood type III AC joint separation following a same-level fall. Initial suture-button fixation failed 45 days postoperatively. Revision hook plate fixation subsequently failed after a further traumatic event, and a third procedure involving rigid AC stabilization with dual plating also resulted in early mechanical failure. Definitive treatment was achieved using biologic reconstruction with a semitendinosus tendon autograft combined with coracoacromial ligament transfer. At 1-year follow-up, radiographs demonstrated maintained reduction of the AC joint, and the patient regained satisfactory shoulder function with full return to daily activities. This case highlights the potential role of semitendinosus tendon reconstruction as a salvage strategy following repeated fixation failure. In such complex revision settings, durable outcomes may depend not only on restoring mechanical stability but also on preserving the biological environment necessary for successful healing.   Cite this article as: Dadir İH, Erdoğan Y. Semitendinosus tendon reconstruction for recurrent acromioclavicular joint instability following repeated fixation failure and postoperative trauma: a case report. Acta Orthop Traumatol Turc. 2026; 60(5), 0958, doi: 10.5152/j.aott.2026.26958.</p>","PeriodicalId":93854,"journal":{"name":"Acta orthopaedica et traumatologica turcica","volume":"60 5","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149225080","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early Clinical Outcomes Following Patient-Specific Visual Feedback Using Intraoperatively Recorded Knee Motion After Total Knee Arthroplasty.","authors":"İsmail Güzel, Tarık Altunkılıç, Mehmet Yılmaz, Mehmet Boz, İbrahim Ulusoy, Bünyamin Arı, Aybars Kıvrak","doi":"10.5152/j.aott.2026.25329","DOIUrl":"https://doi.org/10.5152/j.aott.2026.25329","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate the association between postoperative viewing of a video demonstrating the patient's own intra-operatively recorded knee motion and early clinical outcomes following total knee arthroplasty (TKA).</p><p><strong>Methods: </strong>This retrospective study included 120 patients (47 men, 73 women; mean age, 67.0 years) who underwent primary TKA between 2020 and 2023. Patients were categorized into a video-based intervention group (n=60) and a control group (n=60) according to the time period of surgery. Patients in the intervention group viewed a postoperative video demonstrating their own intraoperatively recorded knee motion. The mean follow-up was approximately 92 days. Primary outcome measures included visual analog scale (VAS) pain scores and knee range of motion (ROM) assessed on postoperative days 45 and 90, patient satisfaction on postoperative day 90, and postopera-tive complications.</p><p><strong>Results: </strong>Patients in the video group demonstrated significantly lower VAS pain scores than the control group on postoperative day 45 (3.2 ± 1.1 vs. 4.6 ± 1.3, P=0.0002) and day 90 (1.8 ± 0.8 vs. 2.9 ± 1.1, P=0.0003). Knee ROM was significantly greater in the video group at day 45 (95.6° ± 8.3° vs. 88.3° ± 9.1°, P=0.004) and day 90 (110.3° ± 7.5° vs. 102.7° ± 8.6°, P=0.006). Patient satisfaction was significantly higher in the video group (85% vs. 65%, P=0.004), whereas postoperative complication rates were comparable between groups (6.6% vs. 8.3%, P=0.68).</p><p><strong>Conclusion: </strong>Postoperative viewing of a video demonstrating the patient's own intraoperatively recorded knee motion was associated with reduced pain, improved knee range of motion, and greater patient satisfaction during early recovery following TKA. Video-based visual feedback may be a useful adjunct to support early postoperative rehabilitation following TKA. Further prospective randomized studies are needed to better define its clinical role and permit causal inference.   Cite this article as: Güzel İ, Altunkili. T, Yılmaz M, et al. Early clinical outcomes following patient-specific visual feedback using intraoperatively recorded knee motion after total knee arthroplasty. Acta Orthop Traumatol Turc. 2026; 60(5), 0329, doi: 10.5152/j.aott.2026.25329.</p>","PeriodicalId":93854,"journal":{"name":"Acta orthopaedica et traumatologica turcica","volume":"60 5","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149225631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of subjective outcomes between single-bundle and double-bundle anterior cruciate ligament reconstruction in patients with flat lateral tibial slope.","authors":"Shang-Yu Yao, Keng-Yi Lin, Yi-Sheng Chan, Yu-Chieh Hung, Shih-Feng Hung, Yi-Jou Chen, Chih-Hao Chiu, Chin-Shan Ho, Cheng-Pang Yang","doi":"10.5152/j.aott.2026.25795","DOIUrl":"https://doi.org/10.5152/j.aott.2026.25795","url":null,"abstract":"<p><strong>Objective: </strong>A high lateral tibial slope (LTS) has been associated with an increased risk of graft failure and inferior subjective outcomes following anterior cruciate ligament reconstruction (ACLR), but the impact of a flat LTS remains unclear. This study aimed to compare long-term subjective outcomes of single-bundle (SB) and double-bundle (DB) ACLR in patients with a flat LTS to determine the more favorable approach.</p><p><strong>Methods: </strong>The study comprised 136 patients with an LTS less than 7.4 degrees who underwent SB-ACLR (64 cases) or DB-ACLR (72 cases). Lateral tibial slope was measured on preoperative magnetic resonance imaging. Patient-reported outcomes, including the University of California Los Angeles (UCLA) Activity Score, the Lysholm Knee Score, and International Knee Documentation Committee (IKDC) Score, were collected and compared between those undergoing SB- and DB-ACLR at a mean follow-up of 14.06 ± 2.98 years. Categorical and continuous variables were analyzed using chi-square and independent-samples t-tests, respectively. A P-value less than .05 was considered statistically significant.</p><p><strong>Results: </strong>The mean LTS was similar between the SB and DB groups (4.76 ± 1.48 vs. 4.23 ± 1.82, P = .06). The DB group had significantly better postoperative UCLA (9.32 ± 0.95 vs. 8.55 ± 1.99, P < .01), Lysholm (94.26 ± 5.61 vs. 88.23 ± 13.45, P < .01), and IKDC score (82.99 ± 4.55 vs. 77.67 ± 11.21, P < .01). Specifically, among male patients, no significant differences were found between SB and DB groups, though trends favored DB-ACLR.</p><p><strong>Conclusion: </strong>In patients with a flat LTS, DB-ACLR was associated with higher long-term patient-reported outcome measures than SB-ACLR; however, the clinical relevance of these differences should be interpreted with caution.   Cite this article as: Yao S, Lin K, Chan Y, et al. Comparison of subjective outcomes between single-bundle and double-bundle anterior cruciate ligament reconstruction in patients with flat lateral tibial slope. Acta Orthop Traumatol Turc., 2026; 60(5), 0795, doi: 10.5152/j.aott.2026.25795.</p>","PeriodicalId":93854,"journal":{"name":"Acta orthopaedica et traumatologica turcica","volume":"60 5","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149225573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative outcomes of timely versus delayed presentation of pediatric fractures in post-conflict Iraq: a multicenter retrospective cohort study.","authors":"Mohammed Jameel, Aiman Ali Alzubaidi, Wameth Alaa Jamel, Ban Bashar Alkurdi","doi":"10.5152/j.aott.2026.26900","DOIUrl":"10.5152/j.aott.2026.26900","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to determine the prevalence and outcomes of delayed fracture presentation in Iraq children and to identify predictors of delay, with a novel focus on the compounding effects of geography, referral pathways, and displacement status.</p><p><strong>Methods: </strong>This retrospective, multicenter cohort study was conducted at three pediatric orthopedic referral centers in Iraq (Baghdad, Najaf, Mosul) from 2019-2024. 858 children (<16 years) with acute long bone fractures were included. The primary exposure was delayed presentation (≥7 days after injury). Multivariable logistic regression was used to identify predictors. Interaction (cascade of vulnerability) and stratified analyses were performed to assess the combined effects of barriers and the modifying role of displacement status (internally displaced person [IDP] vs. non-displaced).</p><p><strong>Results: </strong>Delayed presentation occurred in 36.0% (n = 309) of children. After adjusting for confounders, including operative vs. nonoperative treatment, delay remained independently associated with significantly higher odds of malunion (AOR 3.20), nonunion (AOR 2.65), reoperation (AOR 2.45), and functional limitation (AOR 3.15). A synergistic \"cascade of vulnerability\" was observed: rural children who were referred had nearly six-fold higher odds of delay compared to urban, directly presenting children (AOR 5.9, 95% CI 4.0 8.7). Displacement status was a significant effect modifier; while rural residence strongly predicted delay in non-displaced children, this association vanished for IDPs, where referral inefficiency became the sole dominant barrier regardless of location. Among non-displaced children, both rural residence (AOR 2.7) and referral (AOR 2.1) were strong predictors. For IDPs, rural residence was no longer significant (P = .36), while referral from another facility emerged as the dominant barrier (AOR 3.4, 95% CI 1.5-7.7).</p><p><strong>Conclusion: </strong>In Iraq, delayed treatment for children's fractures is a common and serious issue strongly associated with systemic healthcare vulnerabilities and humanitarian challenges. Children in rural areas and those who are internally displaced are particularly at risk. For displaced children, difficulties navigating the healthcare system represent a more prominent risk factor than geographic distance. The findings highlight a need to strengthen the health system and provide tailored support for displaced populations to ensure all children receive timely care for fractures.   Cite this article as: Jameel M, Alzubaidi AA, Jamel WA, Alkurdi BB. Comparative outcomes of timely versus delayed presentation of pediatric fractures in post-conflict Iraq: A multicenter retrospective cohort study. Acta Orthop Traumatol Turc., 2026; 60(5), 0900, doi: 10.5152/j.aott.2026.26900.</p>","PeriodicalId":93854,"journal":{"name":"Acta orthopaedica et traumatologica turcica","volume":"60 5","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149225619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Bibliometric Analysis of Pediatric Fracture Research Published in Journals Indexed in the ULAKBİM TR Index.","authors":"Yakup Kahve, Tahsin Aydın, Utku Gürhan","doi":"10.5152/j.aott.2026.25680","DOIUrl":"https://doi.org/10.5152/j.aott.2026.25680","url":null,"abstract":"<p><strong>Objective: </strong>Pediatric fractures are among the most common traumas in childhood and constitute an important public health issue. Although bibliometric studies in this field have recently appeared in the international literature, a comprehensive national-level evaluation is lacking in Türkiye. The aim of this study is to perform a bibliometric analysis of pediatric fracture research published in journals indexed in the ULAKBİM TR Index, and to examine publication characteristics, thematic trends, and interdisciplinary collaboration patterns within this indexing system.</p><p><strong>Methods: </strong>A search was conducted in ULAKBİM TR Index database on August 15, 2025, using the keywords \"çocuk\" (child) \"pediatrik\" (pediatric), \"kırık\" (fracture), and \"fracture.\" All publications containing these terms in their title or abstract were included. Bibliographic data such as year of publication, journal, authors, institutions, keywords, and citation counts were analyzed. In addition, keyword cooccurrence networks and interdisciplinary collaboration networks were generated.</p><p><strong>Results: </strong>A total of 166 articles were evaluated. The highest number of publications appeared in Acta Orthopaedica et Traumatologica Turcica (17.5%) and Turkish Journal of Trauma and Emergency Surgery (10.2%). Institutional contributions predominantly originated from training and research hospitals affiliated with the Ministry of Health (59.6%). In keyword analysis, \"child\" (50), \"surgery\" (37), \"method\" (14), and \"radiography\" (11) were the most frequently used terms. In the interdisciplinary collaboration network, the strongest connections were observed between Orthopedics and Traumatology and Emergency Medicine, while contributions from fields such as Pediatrics, Radiology, and Public Health remained more limited.</p><p><strong>Conclusion: </strong>Pediatric fracture research published in journals indexed in the ULAKBİM TR Index suggests a gradual increase in publication activity over time, with a concentration in specific journals and institutions and a predominant focus on surgical approaches. Contributions related to rehabilitation, psychosocial effects, and long-term functional outcomes were relatively limited in the national literature.   Cite this article as: Kahve Y, Aydın T, Gürhan U. A bibliometric analysis of pediatric fracture research published in journals indexed in the ULAKBİM TR index. Acta Orthop Traumatol Turc., 2026; 60(5), 0680, doi: 10.5152/j.aott.2026.25680.</p>","PeriodicalId":93854,"journal":{"name":"Acta orthopaedica et traumatologica turcica","volume":"60 5","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149083237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reliability of the figure-of-eight method for measuring foot and ankle edema: Prospective emergency department assessment and literature review.","authors":"Seyit Mehmet Altan, Murat Yeşilaras, Necmiye Yalçın Ocak, Oğulcan Parlar","doi":"10.5152/j.aott.2026.26962","DOIUrl":"10.5152/j.aott.2026.26962","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate the inter- and intra-rater reliability of the figure-of-eight (FoE) method for measuring foot and ankle edema when performed by emergency medicine and orthopedic residents in the emergency department (ED).</p><p><strong>Methods: </strong>This prospective observational study was conducted at the ED of a tertiary hospital between November 2024 and January 2025. A total of 102 adult patients with foot or ankle trauma (51 males and 51 females) were included. The mean age was 38.1 Å} 13.1 years. Twenty residents (10 orthopedic and 10 emergency medicine residents) performed FoE measurements. Each patient underwent eight measurements, with two repeated measurements by two raters from each specialty. The primary outcome measures were inter- and intrarater reliability, assessed using intraclass correlation coefficients (ICC) with 95% confidence intervals, as well as the standard error of measurement (SEM) and minimal detectable change (MDC).</p><p><strong>Results: </strong>A total of 102 patients were analyzed. Intra-rater reliability was excellent for both emergency medicine residents (ICC = 0.987, 95% CI: 0.980-0.991, p < 0.001) and orthopedic residents (ICC = 0.984, 95% CI: 0.977-0.990, p < 0.001). Inter-rater reliability was also excellent for emergency medicine residents (ICC = 0.968, 95% CI: 0.953-0.978, p < 0.001), orthopedic residents (ICC = 0.960, 95% CI: 0.941-0.973, p < 0.001), and between both specialty groups (ICC = 0.951, 95% CI: 0.928-0.967, p < 0.001). SEM ranged from 0.57 to 1.12 cm, while MDC ranged from 1.57 to 1.75 cm for intra-rater reliability and from 2.46 to 3.10 cm for inter-rater reliability.</p><p><strong>Conclusion: </strong>The FoE method demonstrated excellent inter- and intra-rater reliability for bedside assessment of foot and ankle edema in the emergency department. These findings support its use as a simple, inexpensive, and standardized tool for reproducible clinical assessment by both orthopedic and emergency medicine residents. The method may facilitate consistent serial evaluation of patients with acute foot and ankle trauma in routine emergency practice. Further studies are warranted to evaluate its criterion validity and responsiveness.   Cite this article as: Altan SM, Yesilaras M, Ocak NY, Parlar O. Reliability of the figure-of-eight method for measuring foot and ankle edema: prospective emergency department assessment and literature review. Acta Orthop Traumatol Turc., 2026; 60(5), 0962, doi: 10.5152/j.aott.2026.26962.</p>","PeriodicalId":93854,"journal":{"name":"Acta orthopaedica et traumatologica turcica","volume":"60 5","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149225120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does Pin Removal at Three Versus Five Weeks Influence Clinical Outcomes in Gartland Type III Supracondylar Humerus Fractures? A Comparative Study.","authors":"Nazan Çevik, Yavuz Akalın, Hünkar Çağdaş Bayrak, Özgür Avcı, Hüseyin Yetkin, Mert Güneş, Alpaslan Öztürk","doi":"10.5152/j.aott.2026.26936","DOIUrl":"10.5152/j.aott.2026.26936","url":null,"abstract":"<p><strong>Objective: </strong>The optimal timing of pin removal following closed reduction and percutaneous pinning (CRPP) for pediatric Gartland type 3 supracondylar humerus fractures remains controversial. Although pins are commonly removed between the third and fifth postoperative weeks, high-level evidence comparing clinical and radiological outcomes between these time points is limited. This study aimed to evaluate whether pin removal at the third vs. the fifth postoperative week influences radiographic healing or functional outcomes.</p><p><strong>Methods: </strong>This retrospective observational study included 95 pediatric patients (aged 3-10 years) with Gartland type 3 supracondylar humerus fractures treated with CRPP between 2020 and 2025. Patients were divided into 2 groups based on the timing of pin removal: the third week (n = 42) and the fifth week (n = 53). Clinical outcomes included elbow range of motion (ROM), carrying angle difference, and the Flynn criteria at 3 and 6 months. Radiological outcomes included Baumann angle, anterior humeral line alignment, and the Radiographic Union Score for Tibia scores. Multivariable linear regression was performed to control for potential confounders. Interobserver reliability was assessed using intraclass correlation coefficients.</p><p><strong>Results: </strong>At 3 months, flexion and extension loss were modestly lower in the third-week group (P = .011, r = 0.26 and P = .031, r = 0.22, respectively). However, no significant differences were observed between groups at 6 months in terms of flexion loss, extension loss, total motion loss, carrying angle difference, or Flynn scores (all P > .05). Radiographic Union Score for Tibia scores at the time of pin removal were higher in the fifth-week group (P < .001), reflecting later radiographic assessment; however, no differences were observed at subsequent follow-ups. No cases of loss of reduction, angular deformity, or reoperation occurred in either group. Multivariable analysis demonstrated that pin removal timing was associated with early but not late motion loss.</p><p><strong>Conclusion: </strong>Pin removal at the third postoperative week did not compromise final radiological outcomes. In contrast, removal at the fifth week did not confer superior long-term functional recovery. Within the commonly practiced third-to-fifth-week interval, timing of pin removal does not appear to influence final clinical outcomes in pediatric Gartland type 3 supracondylar humerus fractures.   Cite this article as: Çevik N, Akalın Y, Bayrak HÇ, et al. Does pin removal timing influence outcomes in Gartland type 3 supracondylar humerus fractures? A comparative study of third- and fifth-week removal. Acta Orthop Traumatol Turc., 2026; 60(4), 0936, doi: 10.5152/j.aott.2026.26936.</p>","PeriodicalId":93854,"journal":{"name":"Acta orthopaedica et traumatologica turcica","volume":"60 4","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13657337/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149083147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}