Acta orthopaedica et traumatologica turcica最新文献

{"title":"An Unexpected Journey: Migration of a Scoliosis Rod to the Groin.","authors":"Bedirhan Albayrak, Furkan Tabur, Furkan Erdoğan, Hüseyin Sina Coşkun","doi":"10.5152/j.aott.2026.261011","DOIUrl":"10.5152/j.aott.2026.261011","url":null,"abstract":"<p><p>Rod migration is a rare but potentially serious late complication of spinal instrumentation. A case of long-distance rod migration to the groin following anterior lumbar fusion for adolescent idiopathic scoliosis is presented. A 43-year-old female, who had undergone selective anterior lumbar fusion 20 years earlier, presented with progressive lumbar pain. Initial radiographs demonstrated screw loosening and rod dislodgment. Before the planned revision surgery, the patient re-presented with pain localized to the hip and groin. Imaging revealed distal migration of the rod toward the anterior aspect of the hip joint. The patient underwent surgical removal of the migrated rod via an anterior hip (Smith-Petersen) approach. Intraoperatively, the rod was identified adjacent to the femoral nerve and was carefully removed without neurovascular injury. Postoperatively, symptoms improved, and staged treatment consisting of removal of the remaining instrumentation followed by correction of the residual deformity was planned. Rod migration is frequently associated with pseudoarthrosis, inadequate biological fusion, and persistent segmental motion. These factors may facilitate progressive implant migration along anatomical pathways such as the psoas muscle. Clinical presentation is typically nonspecific, leading to potential diagnostic delays. This case highlights the importance of considering implant-related complications in patients with atypical pain and a history of spinal instrumentation. Early recognition is essential to prevent implant progression and potentially serious neurovascular complications.   Cite this article as: Albayrak B, Tabur F, Erdoğan F, H, Coşkun S. An unexpected journey: migration of a scoliosis rod to the groin. Acta Orthop Traumatol Turc. 2026; 60(4), 01011, doi: 10.5152/j.aott.2026.261011.</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/PMC13657343/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149083211","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}

{"title":"Preoperative patient expectations and postoperative satisfaction following singlelevel unilateral biportal endoscopic lumbar discectomy: Are higher expectations associated with lower satisfaction?","authors":"Yusuf Bayram, Muhammed Enes Karataş, İbrahim Uzunlu, Yunus Emre Bulum","doi":"10.5152/j.aott.2026.25799","DOIUrl":"10.5152/j.aott.2026.25799","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;Unilateral biportal endoscopy (UBE) has gained prominence in the surgical treatment of lumbar disc herniation (LDH) because of its minimally invasive profile. How preoperative patient expectations align with postoperative satisfaction after UBE remains insufficiently characterized. The aim was to evaluate the relationship between preoperative expectations and 6-month postoperative satisfaction after single-level UBE discectomy, while also assessing perioperative safety and patient-reported outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Retrospective, single-center cohort of consecutive adults undergoing single-level UBE discectomy (September 2022-January 2024) performed by a single surgeon. Preoperative expectations were captured with an 8-item Likert-type survey (scaled 0-100). Outcomes at 6 months included visual analog scale (VAS) (back/leg), Oswestry Disability Index (ODI), a single-item satisfaction score (0-100), and patient acceptable symptom state (PASS) derived by anchor-based receiver operating characteristic (ROC) analysis for ODI; a sensitivity analysis tested the fixed threshold ODI ≤25. Group comparisons used ANOVA/Kruskal-Wallis with Tukey post-hoc as appropriate. Associations were examined using Pearson correlation and restricted multivariable regression models adjusted for clinically prespecified covariates.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;During the study period, 102 patients were screened; 73 were eligible after exclusions (n = 29). Six-month outcome data were available for 68/73 patients (5 lost to follow-up/incomplete records). The analyzed cohort had a mean age of 44.7 } 9.8 years and 55.9% were male. Perioperative metrics reflected a favorable minimally invasive profile (operative time 96.8 } 11.7 minutes; estimated blood loss 56.3 } 24.1 mL; length of stay 1.8 Å} 0.9 days; complications 5.9%, no reoperations). Pain and disability improved substantially from baseline to 6 months (VAS 7.6 } 1.1 to 1.9 } 0.8; Δ = -5.7 } 1.3; P &lt; .001; ODI 56.3 } 8.7 to 17.5 } 6.1; Δ = -38.8 } 9.2; P &lt; .001). The mean expectation rating score was 76.5 } 14.8 and satisfaction 82.1 } 12.4. Higher preoperative expectations correlated with lower satisfaction (r = -0.37; P = .02). Satisfaction differed across expectation strata (P &lt; .01), with the highest scores in the moderate group and lowest scores in the high group; post-hoc significance was observed for moderate versus high expectations (Tukey, P = .004). Patient acceptable symptom state analysis identified a cohort-specific ODI threshold with high discriminative ability; overall PASS rates were high and did not differ across expectation groups. In multivariable models, higher expectations were independently associated with lower satisfaction but not with change in VAS/ODI or achievement of PASS.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Single-level UBE discectomy yields robust improvements in pain and function with low morbidity. Higher preoperative expectation scores were","PeriodicalId":93854,"journal":{"name":"Acta orthopaedica et traumatologica turcica","volume":"60 4","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13657336/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149083156","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}

{"title":"Chondroblastoma: the relationship between local invasiveness, recurrence, and histopathological features.","authors":"Mine İlayda Şengör Aygün, Cem Çomunoğlu, Berkay Doğan, Müjdat Adaş, Rahime Tanrıtanır","doi":"10.5152/j.aott.2026.25407","DOIUrl":"10.5152/j.aott.2026.25407","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to assess the histopathological and clinical characteristics of chondroblastomas (CBs), with particular emphasis on the correlation between local invasion and mitotic activity, cytological atypia, and recurrence.</p><p><strong>Methods: </strong>A retrospective analysis was performed on 26 cases of CB diagnosed between 2016 and 2024 and pathologically evaluated at a tertiary oncology center, with surgical procedures performed across 2 tertiary oncology referral centers. Clinical, radiological, and histopathological data were reviewed. For comparative analysis, tumors were grouped as non-infiltrative (confined to the bone) or infiltrative (showing invasion of the bone cortex and/or extracortical connective tissues). Tumors were assessed for cytological atypia, mitotic index, matrix production, calcification, aneurysmal bone cyst formation, and invasion pattern. Immunohistochemical staining for S100, DOG1, and Ki-67 was conducted. Statistical analyses included t-tests, Mann-Whitney U, chi-square, and correlation analyses.</p><p><strong>Results: </strong>The mean age at diagnosis was 17.7 years, with a male-to-female ratio of 1.36 : 1. The femur was identified as the most common site. Invasion beyond the bone cortex was observed in 16 patients (61.5%), including 4 instances of soft tissue involvement. Invasive tumors showed significant association with moderate cytological atypia (P = .022), higher mitotic index (P = .023), and lower extremity location (P = .02). A positive correlation was identified between mitotic index and both atypia (P = .001) and tumor invasiveness. Recurrence occurred in four patients (15.4%), all presenting invasive tumors. No metastases were reported during the mean follow-up period of 38.9 months.</p><p><strong>Conclusion: </strong>Although CB typically manifests benign behavior, a subset of these tumors demonstrates locally aggressive characteristics, such as cortical and soft tissue invasion. Elevated mitotic activity and moderate cytological atypia may serve as histopathological markers for local aggressiveness.   Cite this article as: Aygün MİŞ, .omunoğlu C, Doğan B, Adaş M, Tanrıtanır R. Chondroblastoma: the relationship between local invasiveness, recurrence, and histopathological features. Acta Orthop Traumatol Turc., 2026; 60(4), 0407, doi: 10.5152/j.aott.2026.25407.</p>","PeriodicalId":93854,"journal":{"name":"Acta orthopaedica et traumatologica turcica","volume":"60 4","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13657338/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149083133","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}

{"title":"The gait stability characteristics of individuals with chronic ankle instability.","authors":"Huiqiang Chen, Qingyang Kang, Mengyu Yao, Degao Li, Fangzheng Lin, Ji Qi, Yongjin Li, Dingkun Lin, Xiaolong Zeng, Yansong Xiao","doi":"10.5152/j.aott.2026.25567","DOIUrl":"10.5152/j.aott.2026.25567","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this study was to investigate gait stability characteristics in patients with chronic ankle instability (CAI) by analyzing six degrees of freedom (6DOF) kinematic alterations in comparison with healthy controls.</p><p><strong>Methods: </strong>A cross-sectional study was conducted to evaluate 6DOF ankle kinematics in individuals with CAI and healthy controls using a dual fluoroscopic imaging system during treadmill walking. Three representative gait cycles were selected for each participant, normalized to 0-100% of the gait cycle, and averaged for analysis. Time-series kinematic differences were assessed using Statistical Parametric Mapping (SPM1D) with one-way ANOVA and post-hoc tests, while discrete variables were compared between groups with Bonferroniadjusted significance.</p><p><strong>Results: </strong>Compared with the control group, the contralateral limbs demonstrated greater distal displacement during 44-55% of the gait cycle (2.7-3.8 mm, p<0.001), whereas the CAI limbs exhibited reduced plantarflexion during 68-75% of the gait cycle (5.1-7.3, p<0.001). Additionally, the range of motion (ROM) for abduction-adduction (2.5Åã, p<0.05) and internal-external rotation (2.4, p<0.05) on the CAI sides was smaller compared with the contralateral sides. Both the CAI and contralateral limbs showed a decrease in medial-lateral displacement in the coronal plane relative to the control group (3.1mm, p<.05).</p><p><strong>Conclusion: </strong>This study demostrated that individuals with CAI exhibit distinct gait strategies compared to healthy controls, characterized by a reduction in plantarflexion in the CAI sides, an increase in distal displacement in the contralateral sides, and an overall decrease in the ROM on the CAI sides.   Cite this article as: Chen H, Kang Q, Yao M, et al. The gait stability characteristics of individuals with chronic ankle instability. Acta Orthop Traumatol Turc., 2026; 60(4), 0567, doi: 10.5152/j.aott.2026.25567.</p>","PeriodicalId":93854,"journal":{"name":"Acta orthopaedica et traumatologica turcica","volume":"60 4","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13657344/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149083246","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}

{"title":"miR-655-3p is a highly accurate diagnostic biomarker for primary osteoarthritis and alleviates joint inflammation by targeting TLR4.","authors":"Ruye Li, Chao Chen, Deming Chen","doi":"10.5152/j.aott.2026.25803","DOIUrl":"10.5152/j.aott.2026.25803","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate the potential of miR-655-3p as a diagnostic biomarker for primary osteoarthritis (OA) and to investigate its intrinsic molecular mechanisms as a means of addressing the lack of sensitive early diagnostic biomarkers and targeted anti-inflammatory therapies for this prevalent degenerative joint disorder.</p><p><strong>Methods: </strong>Quantitative real-time polymerase chain reaction was performed to measure (1) miR-655-3p levels in the serum of 93 primary OA patients and 60 non-OA controls, (2) miR-655-3p levels in the synovial fluid of OA patients, and (3) messenger RNA (mRNA) expression of TLR4, RelA, TNF-α, and IL-6 in the IL-1β-induced OA chondrocyte model. Enzyme-linked immunosorbent assay measured the secretion of IL-6 and TNF-α. Receiver operating characteristic curve (ROC) analysis assessed its diagnostic value in multiple clinical scenarios. Cell function assays investigated cell viability and apoptosis. Target genes were predicted via 3 databases, and the interaction between miR-655-3p and TLR4 was verified by dual-luciferase reporter assay and Western blot. Rescue experiments were performed to confirm the mechanistic specificity.</p><p><strong>Results: </strong>miR-655-3p was downregulated by 44.8% in OA serum (P < .001) and 46.7% in IL-1β-induced chondrocytes (P < .001). ROC curve analysis showed an overall area under the curve (AUC) of 0.9518 (95% CI: 0.920-0.983), with consistent high accuracy in distinguishing OA from healthy controls (AUC = 0.9509), meniscus injury patients (AUC = 0.9425), and mild OA from controls (AUC = 0.9306). Serum miR- 655-3p levels were negatively correlated with OA severity (American Academy of Orthopaedic Surgeons score, P = .010) and inflammatory factor levels (TNF-α, IL-6, both P < .001). Dual-luciferase assay confirmed TLR4 as a direct target of miR-655-3p; miR 655-3p overexpression reduced TLR4 protein expression by 48.7%, while inhibition increased it by 52.8%. TLR4 overexpression completely reversed the antiinflammatory and anti-apoptotic effects of miR-655-3p in OA chondrocytes.</p><p><strong>Conclusion: </strong>miR-655-3p is a highly accurate diagnostic biomarker for primary OA, and upregulating miR-655-3p may provide a novel clinical treatment direction by targeting TLR4 to alleviate joint inflammation.   Cite this article as: Li R, Chen C, Chen D. MiR-655-3p is a highly accurate diagnostic biomarker for primary osteoarthritis and alleviates joint inflammation by targeting TLR4. Acta Orthop Traumatol Turc., 2026; 60(4), 0803, doi: 10.5152/j.aott.2026.25803.</p>","PeriodicalId":93854,"journal":{"name":"Acta orthopaedica et traumatologica turcica","volume":"60 4","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13657335/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149083137","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}

{"title":"Facet tropism is not associated with lumbar spondylolysis: a computed tomography-based three-dimensional morphometric case-control study.","authors":"Muhammed Enes Karataş, Mehmet Akif Çaçan, İsmail Türkten, Kadriye Betül Pençe, Bayram Ufuk Şakul","doi":"10.5152/j.aott.2026.261005","DOIUrl":"10.5152/j.aott.2026.261005","url":null,"abstract":"<p><strong>Objective: </strong>Facet tropism has been proposed as a morphologic modifier of posterior element loading, but prior evidence in lumbar spondylolysis is inconsistent and often based on 2D measurements. This study aimed to evaluate whether facet tropism differs between patients with lumbar spondylolysis and controls using a CT-based three-dimensional (3D) morphometric workflow with vertebra-anchored reference planes.</p><p><strong>Methods: </strong>This retrospective case-control study included 39 individuals: 19 with CT-confirmed lumbar spondylolysis and 20 controls (age and sex comparable). Vertebrae L1-L5 were segmented, 3D surface models were generated, and best-fit planes were computed for each superior and inferior facet surface bilaterally. Facet orientation was quantified relative to sagittal, frontal, and transverse planes. Facet tropism (FT) was defined as the absolute right-left difference in facet angles for the same level and facet type; FT presence was descriptively defined as >5, while hypothesis testing used continuous FT values. Group comparisons were performed across L1-L5 and for prespecified lowerlumbar segment metrics (L4-L5 facet-plane mismatch and L5v intra-vertebral mismatch).</p><p><strong>Results: </strong>Spondylolysis involved L5 in 18/19 patients (4 unilateral, 14 bilateral) and L4 in 1/19. Across L1-L5, facet tropism (FT) did not differ between groups for either superior or inferior facets in any plane (all p > .05). The greatest numerical difference was observed for L5 inferior FT on the sagittal plane (controls 10.38 } 9.40 vs. patients 7.51 } 10.93), but this comparison did not reach statistical significance (p = .092). Lower-lumbar segment-focused mismatch measures also showed no between-group differences (all p > .05). Frontal-plane and sagittal-plane angles showed strong positive correlations in both groups (controls: r = 0.811-0.998; patients: r = 0.851-0.995; all p < .05), whereas transverse-plane parameters showed no meaningful associations.</p><p><strong>Conclusion: </strong>Using CT-based 3D morphometry, no statistically significant association between facet tropism and lumbar spondylolysis was demonstrated in the present study population, and facet tropism did not discriminate cases from controls across lumbar levels or lowerlumbar segmental mismatch metrics. In this cohort, which was predominantly characterized by L5 involvement and frequent bilateral defects, side-to-side facet asymmetry did not appear to represent a major independent morphologic marker when measured with a standardized 3D framework.   Cite this article as: Karatas ME, .a.an MA, Türkten İ, Pen.e KB, Şakul BU. Facet tropism is not associated with lumbar spondylolysis: a computed tomography- based three-dimensional morphometric case-control study. Acta Orthop Traumatol Turc., 2026; 60(4), 1005, doi: 10.5152/j.aott.2026.261005.</p>","PeriodicalId":93854,"journal":{"name":"Acta orthopaedica et traumatologica turcica","volume":"60 4","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13657332/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149083169","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}

{"title":"Combined anterior latissimus dorsi and teres major transfer and superior capsular reconstruction using autogenous biceps tendon for anterosuperior irreparable rotator cuff tears: technical note.","authors":"Chang Hee Baek, Bo Taek Kim, Jung Gon Kim, Chaemoon Lim","doi":"10.5152/j.aott.2026.25643","DOIUrl":"10.5152/j.aott.2026.25643","url":null,"abstract":"<p><p>This technical note describes the surgical technique of combining anterior latissimus dorsi and teres major (LDTM) tendon transfer with biceps superior capsular reconstruction (SCR) for the treatment of anterosuperior irreparable rotator cuff tears (AIRCTs). Anterosuperior irreparable rotator cuff tears, characterized by irreparable tears in the subscapularis and supraspinatus tendons, can lead to significant shoulder dysfunction. The described procedure aims to restore glenohumeral stability, prevent humeral head migration, and optimize shoulder mechanics. The LDTM tendon transfer replicates the function of the subscapularis, while the biceps SCR helps prevent superior humeral head migration. This technical note provides a comprehensive, reproducible, and effective surgical approach for managing AIRCTs.   Cite this article as: Baek CH, Kim BT, Kim JG, Lim C. Combined anterior latissimus dorsi and teres major transfer and superior capsular reconstruction using autogenous biceps tendon for anterosuperior irreparable rotator cuff tears: technical note. Acta Orthop Traumatol Turc., 2026; 60(3), 0643, doi: 10.5152/j.aott.2026.25643.</p>","PeriodicalId":93854,"journal":{"name":"Acta orthopaedica et traumatologica turcica","volume":"60 4","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13657342/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149083144","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}

{"title":"Does the level of the supracondylar humerus fractures affect the stability of pinning configurations? A biomechanical study.","authors":"Mehmet Kaymakoğlu, Rafik Ramazanov, Zirvecan Güneş, Taha Aksoy, Güney Yılmaz","doi":"10.5152/j.aott.2026.25352","DOIUrl":"10.5152/j.aott.2026.25352","url":null,"abstract":"<p><strong>Objective: </strong>Supracondylar humerus fractures (SHFs) are prevalent injuries in pediatric orthopedics and often necessitate surgical management to restore elbow function and prevent long-term complications. The study aimed to evaluate the biomechanical effects of different fracture levels relative to the olecranon fossa and the efficacy of different pin configurations.</p><p><strong>Methods: </strong>Synthetic humerus bone models were used to standardize the fracture patterns and simulate surgical interventions. Pin configurations, including lateral divergent and cross-pin configurations, were applied using 3D-printed custom guides. Bending and torsional tests were conducted to assess biomechanical stability, with stiffness values calculated for each fixation method. Statistical analysis was performed to compare outcomes between the groups.</p><p><strong>Results: </strong>Distinct biomechanical responses to bending and torsional loads at various fracture levels and fixation configurations were observed. Lower-level fractures demonstrated greater stability in bending forces (low cross bending-high cross bending, P = .025; low divergent bending-high divergent bending, P = .004), with cross-pin fixation providing advantages in torsional forces compared with lateral divergent pinning (low divergent torsion-high divergent torsion, P = .001). Conversely, no significant biomechanical superiority was observed in higher-level fractures. Statistical analysis highlighted significant differences in maximum forces and stiffness values between the fixation groups, indicating the selection of optimal fixation strategies based on fracture characteristics.</p><p><strong>Conclusion: </strong>Results showed that distal SHFs were biomechanically more stable under bending forces, with cross-pin fixation providing an advantage in torsional forces for lower-level fractures. However, no significant biomechanical superiority was found for high fractures. These findings contribute to the understanding of fracture fixation strategies and highlight the importance of tailored approaches based on the fracture level. Further clinical studies are warranted to validate these biomechanical findings and to assess their impact on patient outcomes.   Cite this article as: Kaymakoğlu M, Ramazanov R, Güneş Z, Aksoy T, Yılmaz G. Does the level of the supracondylar humerus fractures affect the stability of pinning configurations? A biomechanical study. Acta Orthop Traumatol Turc. 2026; 60(4), 0352, doi: 10.5152/j.aott.2026.25352.</p>","PeriodicalId":93854,"journal":{"name":"Acta orthopaedica et traumatologica turcica","volume":"60 4","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13657334/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149083155","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}

{"title":"Minimally Invasive Management of Peri-implant Fractures in Intramedullary Limb Lengthening: A Technical Note.","authors":"Raffi Armağan, Yusuf Sülek, Muharrem Kanar, Osman Tuğrul Eren","doi":"10.5152/j.aott.2026.25503","DOIUrl":"10.5152/j.aott.2026.25503","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to describe a novel minimally invasive surgical technique for the management of intraoperative and postoperative fractures occurring at the tip of intramedullary lengthening nails without altering the original treatment plan.</p><p><strong>Methods: </strong>This technical note describes a surgical technique applied in two representative cases of peri-implant fractures encountered during intramedullary limb lengthening procedures between 2011 and 2017. The technique involves bypassing the fracture line by utilizing the residual elongation capacity of the nail, followed by stabilization with a percutaneously applied locking compression plate (LC-DCP) and cable system. Key technical steps, intraoperative considerations, and postoperative management are outlined.</p><p><strong>Results: </strong>The described technique enabled successful stabilization of both intraoperative femoral and postoperative tibial fractures without implant exchange or alteration of the treatment plan. The planned lengthening goals were achieved, fracture healing was confirmed radiographically, and both patients regained pain-free ambulation with satisfactory functional outcomes. No major complications or alignment problems requiring additional intervention were observed.</p><p><strong>Conclusion: </strong>This technique provides a practical, reproducible, and minimally invasive solution for managing peri-implant fractures associated with intramedullary lengthening nails. By preserving the existing implant and avoiding additional surgical procedures, it may reduce treatment complexity, cost, and morbidity while maintaining satisfactory clinical outcomes.   Cite this article as: Armağan R, Sülek Y, Kanar M, Eren OT. Minimally invasive management of peri-implant fractures in intramedullary limb lengthening: A technical note. Acta Orthop Traumatol Turc. 2026; 60(4), 0503, doi: 10.5152/j.aott.2026.25503.</p>","PeriodicalId":93854,"journal":{"name":"Acta orthopaedica et traumatologica turcica","volume":"60 4","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13657333/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149083215","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}

{"title":"Investigation of the effects of acrylamide on tendon healing in rats.","authors":"Mahmut Burak Şahin, Seyran Kılınç, Rasim Hamutoğlu, Celal Kaloğlu","doi":"10.5152/j.aott.2026.25781","DOIUrl":"10.5152/j.aott.2026.25781","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate the effect of acrylamide (AA), a compound formed in heat-processed foods, on tendon healing.</p><p><strong>Methods: </strong>Sixty-four female Wistar albino rats were randomly assigned to 8 groups. A transverse incision was made 0.5 cm proximal to the calcaneal insertion of the right Achilles tendon and repaired using the modified Kessler technique. Experimental groups received AA via gastric gavage, while the controls received saline. Groups 1-4 were sacrificed on day 15, and Groups 5-8 on day 30. Tendons were examined immunohistochemically, histopathologically, morphometrically, and biomechanically.</p><p><strong>Results: </strong>No significant differences in maximum tensile load were found between control and experimental groups on days 15 and 30 (P > .05). Capsule formation was observed at incision sites in both periods, thicker in the 30-day group. Compared with controls, experimental groups showed reduced cellularity and increased collagen fibers. Type 1 and 3 collagen density around the repair site was higher in the AA groups; however, it decreased at day 30 relative to day 15. Notably, chondroblast-like cells with euchromatic nuclei appeared between collagen fibers in the 30-day AA group. MMP-2 and MMP-9 expression were markedly reduced in both tendinocytes and collagen fibers, while MMP-7 showed minimal collagen staining and reduced tendinocyte expression in AA-treated animals.</p><p><strong>Conclusion: </strong>Acrylamide exposure did not significantly affect tensile strength at either 15 or 30 days; however, early destructive effects on tendon tissue were evident, which did not progress by day 30. These findings suggest that consuming AA-containing foods after tendon injury may adversely affect early healing. Further research is needed to clarify the mechanisms involved.   Cite this article as: Şahin MB, Kılın. S, Hamutoğlu R, Kaloğlu C. Investigation of the effects of acrylamide on tendon healing in rats. Acta Orthop Traumatol Turc.,2026; 60(4), 0781, doi: 10.5152/j.aott.2026.25781.</p>","PeriodicalId":93854,"journal":{"name":"Acta orthopaedica et traumatologica turcica","volume":"60 4","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13507783/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148802917","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}