Acta orthopaedica et traumatologica turcica最新文献

{"title":"Perioperative practice variations between university and private hospitals in total knee arthroplasty: a retrospective comparative study.","authors":"Murat Köken, Danyal Gümüş, Burak Akan","doi":"10.5152/j.aott.2026.26991","DOIUrl":"10.5152/j.aott.2026.26991","url":null,"abstract":"<p><strong>Objective: </strong>Differences in healthcare delivery between university and private hospitals may influence perioperative management practices in orthopedic surgery. However, objective data comparing these settings in Türkiye remain limited. This study aimed to evaluate the differences in perioperative management practices, consultation patterns, and anesthesia strategies among patients undergoing total knee arthroplasty (TKA).</p><p><strong>Methods: </strong>In this retrospective study, 151 patients who underwent unilateral TKA between October 2018 and October 2021 were analyzed. All procedures were performed by a single surgeon at either a university hospital or a private hospital. Demographic and clinical characteristics, comorbidities, anesthesia type, consultation rates, and length of hospital stay were compared between groups. Statistical analyses were conducted using SPSS, with P < .05 considered statistically significant.</p><p><strong>Results: </strong>A total of 151 patients (mean age = 67.8 years) were included, of whom 57.6% were treated at a university hospital. Patients treated in private hospitals had a significantly higher prevalence of comorbidities than those treated in university hospitals (76.6% vs. 48.3%, P < .001). Consultation rates were higher in university hospitals (49.4% vs. 29.7%, P = .015), and consultations more frequently resulted in changes in patient management (18.4% vs. 4.7%, P = .019). General anesthesia was more commonly used in university hospitals (9.2% vs. 1.6%, P = .048), whereas spinal/epidural anesthesia predominated in private hospitals.</p><p><strong>Conclusion: </strong>Significant differences exist between university and private hospitals in perioperative management strategies, consultation practices, and anesthesia use during TKA. These findings suggest differences in institutional workflows and perioperative decision-making approaches between healthcare settings. Understanding such variations may contribute to future standardization efforts and optimization of perioperative care in orthopedic practice.   Cite this article as: Koken M, Gumus D, Akan B. Perioperative practice variations between university and private hospitals in total knee arthroplasty: a retrospective comparative study. Acta Orthop Traumatol Turc., 2026; 60(4), 0991, doi: 10.5152/j.aott.2026.26991.</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/PMC13507787/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148802905","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 effectiveness of post-lengthening plating after pediatric limb lengthening surgery: a comparative retrospective study.","authors":"Muhammed Çağatay Engin, Aziz Demirci, Abdullah Navruz, Bilal Karabak, Şuayp Benkli","doi":"10.5152/j.aott.2026.26844","DOIUrl":"10.5152/j.aott.2026.26844","url":null,"abstract":"<p><strong>Objective: </strong>The primary objective of this retrospective comparative study was to compare clinical outcomes of post-lengthening plating, also called plating after lengthening (PAL), with external fixation alone in pediatric limb lengthening.</p><p><strong>Methods: </strong>Plating after lengthening was applied to 41 limbs of 39 pediatric patients who underwent limb lengthening between 2020 and 2024. As a control group, 35 patients treated with only an external fixator during the same period were included. In both groups, the external fixator index, bone healing index, complication rates, and pain at final follow-up (assessed using a Visual Analog Scale [VAS] as a pain intensity instrument) were evaluated. For children aged <8 years, the VAS was completed by parents/guardians as proxy respondents. The success of 3-dimensional deformity correction was radiologically measured. As 2 patients in the PAL group contributed bilateral limbs, generalized estimating equations were used to account for clustering; complementary sensitivity and subgroup analyses were also performed.</p><p><strong>Results: </strong>The external fixator index was 15.1 days/cm in the PAL group and 42.3 days/cm in the control group (P < .001). Patients achieved full weight-bearing an average of 98 days after PAL, while this period was 143 days in the control group (P < .001). The rate of major complications was 4.9% in the PAL group and 20% in the control group (P = .044); however, a sensitivity analysis excluding patients with prior infection from the control group showed that this difference did not retain statistical significance (P = .117). Pain at final follow-up was significantly lower in the PAL group (Pain VAS 1.3 vs. 3.6; P < .001; 63.9% relative reduction). The deformity correction rate was 92.4% in the PAL group and 85.6% in the control group (P = .004). Findings remained robust across all sensitivity and subgroup analyses.</p><p><strong>Conclusion: </strong>Plating after lengthening appears to be a feasible option that may reduce external fixation time, accelerate bone healing, and lower residual pain at final follow-up in selected pediatric patients where intramedullary nailing is not applicable; however, longer follow-up and validated pediatric-specific patient-reported outcome measures are warranted to confirm long-term safety and outcomes.   Cite this article as: Engin M., Demirci A, Navruz A, Karabak B, Benkli Ş. The effectiveness of post-lengthening plating after pediatric limb lengthening surgery: A comparative retrospective study. Acta Orthop Traumatol Turc. 2026; 60(4), 0844 doi: 10.5152/j.aott.2026.26844.</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/PMC13507790/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148802836","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":"H3F3B gene mutation in chondroblastomas: a multicenter study.","authors":"İlkay Tosun, İsmail Yılmaz, Aslı Çakır, Cem Çomunoğlu, Kemal Türköz, Nil Çomunoğlu, Sibel Çetinkaya, Hande Nur İnceman, Gökçen Ünverengil","doi":"10.5152/j.aott.2026.25277","DOIUrl":"10.5152/j.aott.2026.25277","url":null,"abstract":"<p><strong>Objective: </strong>Chondroblastoma (CB) is a benign but locally aggressive bone tumor that may present histopathologic diagnostic challenges, particularly in atypical locations and limited biopsy specimens. Recent studies have identified recurrent mutations in the H3F3B and, less frequently, H3F3A genes, suggesting their potential diagnostic value. This study aimed to evaluate the prevalence and diagnostic utility of H3F3A and H3F3B mutations in a multicenter cohort of CB patients.</p><p><strong>Methods: </strong>Forty-three patients with histopathologically confirmed CB were included in a retrospective analysis. All cases were re-evaluated by 2 pathologists, and mutation analysis of H3F3A and H3F3B genes was performed using polymerase chain reaction-based Sanger sequencing.</p><p><strong>Results: </strong>H3F3B mutations were detected in 41 cases (95.3%), all corresponding to the Lys36Met substitution. One case (2.3%) harbored an H3F3A Gly34Trp mutation, whereas 1 case (2.3%) showed no detectable mutation. No significant histopathological differences were observed between mutation-positive and mutation-negative cases. A notable case involved a 72-year-old patient with frontal bone involvement, highlighting the diagnostic difficulty in unusual locations and older age groups.</p><p><strong>Conclusion: </strong>The findings demonstrate that H3F3B mutation analysis is an extremely sensitive and reliable molecular tool for confirming the diagnosis of CB. It is particularly valuable in challenging cases and especially in small biopsy samples where pathognomonic findings, such as chicken-wire calcification and chondroid matrix are not visible. Incorporation of molecular testing into targeted diagnostic workflows may improve diagnostic accuracy and assist in distinguishing CB from its histological mimics.   Cite this article as: Tosun I, Yilmaz I, Cakir A, et al. H3F3B gene mutation in chondroblastomas: a multicenter study. Acta Orthop Traumatol Turc.,2026; 60(4), 0277, doi: 10.5152/j.aott.2026.25277.</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/PMC13657339/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149083177","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":"Bilateral anterior cruciate ligament agenesis in a 12-year-old boy: A rare case report.","authors":"Eren Akın, Salih Kagan Kurun, Lokman Kehribar, Ahmet Emin Okutan","doi":"10.5152/j.aott.2026.25787","DOIUrl":"10.5152/j.aott.2026.25787","url":null,"abstract":"<p><p>Bilateral anterior cruciate ligament (ACL) agenesis is an exceptionally rare condition. Only a limited number of bilateral ACL agenesis cases have been reported in the literature, and these patients typically present with additional congenital anomalies or other pathologies involving the knee joint. Here, a 12-year-old male patient was reported with bilateral absence of the ACL, who had no comorbidities other than a history of casting and Achilles tenoplasty performed for pes equinovarus. The patient presented to the clinic with bilateral knee laxity and a sense of instability during daily activities. Magnetic resonance imaging of both knees revealed bilateral ACL agenesis. Unlike most previously published cases, the patient had no associated congenital anomalies or accompanying pathologies, making this case a rare example in the existing literature.   Cite this article as: Akin E, Kurun SK, Kehribar L, Okutan AE. Bilateral anterior cruciate ligament agenesis in a 12-year-old boy: A rare case report. Acta Orthop Traumatol Turc., 2026; 60(4), 0787, . doi: 10.5152/j.aott.2026.25787.</p>","PeriodicalId":93854,"journal":{"name":"Acta orthopaedica et traumatologica turcica","volume":"60 4","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13507782/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148802864","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":"Enhanced games and performance-optimized athletes: anticipating the orthopedic challenges, a narrative review.","authors":"Mani Eftekhari, Rohith Ryali, Justin Luk, Atta Taseh, Vencel Juhasz, Gergo Merkely, Soheil Ashkani-Esfahani","doi":"10.5152/j.aott.2026.25824","DOIUrl":"10.5152/j.aott.2026.25824","url":null,"abstract":"<p><p>The Enhanced Games (EG) represents a controversial shift in competitive athletics by removing anti-doping regulations and allowing the sanctioned use of performance-enhancing drugs (PEDs) in pursuit of maximum performance. This unprecedented model may fundamentally alter sports culture, competition standards, and the medical landscape in which athletes train and compete. Of particular concern are the potential consequences for orthopedic and musculoskeletal health, as PED use, particularly anabolic agents and growth factors, can both enhance and compromise musculoskeletal function. Potential benefits include increased muscle mass or bone density. However, these must be weighed against heightened risks of tendon rupture, altered joint biomechanics, delayed fracture healing, and increased susceptibility to overuse or catastrophic injuries. Given the likelihood of more extreme physical demands and higher injury rates in EG participants, proactive preparation from the orthopedic and sports medicine community is essential. This narrative review focuses on the potential influences of EG on musculoskeletal care, gathering evidence on anticipated injury patterns, surgical and rehabilitative considerations, and long-term health outcomes. The goal is to provide insight for policymakers and care providers tasked with protecting athletes who choose to compete in these environments.   Cite this article as: Eftekhari M, Ryali R, Luk J, et al. Enhanced games and performance-optimized athletes: anticipating the orthopedic challenges, a narrative review. Acta Orthop Traumatol Turc. 2026; 60(4), 0824, doi: 10.5152/j.aott.2026.25824.</p>","PeriodicalId":93854,"journal":{"name":"Acta orthopaedica et traumatologica turcica","volume":"60 4","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13507785/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148802931","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":"S1-pedicle-based triangle fixation for U-type sacral fracture: a technical note.","authors":"Caner Günerbüyük, Ali Baş, Turgut Akgül, Cemil Cihad Gedik","doi":"10.5152/j.aott.2026.25369","DOIUrl":"10.5152/j.aott.2026.25369","url":null,"abstract":"<p><p>U-type sacral fractures, accounting for 2%-5% of sacral fractures, typically result from falls. In this single-case technical note, a U-type sacral fracture from a motor vehicle crash treated with a novel fixation technique avoiding lumbosacral extension is reported. A 59-year old female with a Roy-Camille type-2 U-type sacral fracture and multiple long-bone injuries, without neurological deficit, was transferred to the university-affiliated center. Despite a severe sacral fracture, she exhibited no neurological deficits. Surgery began supine to address a distal femur fracture; then the patient was repositioned prone for sacral fixation under general anesthesia. A midline incision between S1 and S3 revealed the posterior elements. Under fluoroscopy, bilateral S1 pedicle screws were placed, followed by S3-iliac screws. Bilateral titanium rods were applied, and distraction reduced the sacral fracture. S2-iliac screws were added, functioning as iliosacral stabilization. A pre-contoured rod connected the bilateral S2 screws, and tightening achieved definitive fixation. Sagittal alignment of the sacrum was improved by nearly 10Åã, from 130Åã preoperative to 140Åã postoperative. The patient mobilized by sitting on the first postoperative day without loss of reduction. This method, suitable for U-type sacral fractures, avoids lumbopelvic fixation and fusion, but further studies are warranted. The technique described may provide an alternative to traditional lumbopelvic constructs.   Cite this article as: Günerbüyük C, Baş A, Akgül T, Gedik CC. S1-pedicle-based triangle fixation for U-type sacral fracture: a technical note. Acta Orthop Traumatol Turc. 2026; 60(4), 0369, doi: 10.5152/j.aott.2026.25369.</p>","PeriodicalId":93854,"journal":{"name":"Acta orthopaedica et traumatologica turcica","volume":"60 4","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13507784/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148802894","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":"Lower extremity and spinopelvic alignment changes after total hip arthroplasty in unilateral Crowe III-IV dysplasia: clinical and radiological outcomes.","authors":"Hakan Batuhan Kaya, Eyüp Berk Çiçek, Fatih Yıldız, İbrahim Tuncay, Nurzat Elmalı, Ayşegül Yabacı Tak, Gökçer Uzer","doi":"10.5152/j.aott.2026.25689","DOIUrl":"10.5152/j.aott.2026.25689","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate the short-term clinical and radiological outcomes of lower extremity and spinal changes following total hip arthroplasty (THA) in patients with unilateral Crowe type III and IV hip dysplasia.</p><p><strong>Methods: </strong>This prospective study included patients who have Crowe type III and IV hip dysplasia evaluated at a high-volume arthroplasty center. Demographic and surgical characteristics were documented. Clinical assessments included the Harris Hip Score (HHS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Short Form-12 (SF-12), Kujala Score, Oxford Knee Score, Oswestry Disability Index (ODI), Roland-Morris Questionnaire, American Orthopedic Foot and Ankle Society (AOFAS) Score, and Foot and Ankle Disability Index (FADI). Radiological assessments included standing anteroposterior (AP) pelvis, AP leg length, and standing/seated lumbosacral AP and lateral radiographs preoperatively and at 1-year postoperatively.</p><p><strong>Results: </strong>Thirty-three patients (mean age 52.7 Å} 11.8 years) were followed for an average of 18.3 Å} 7.0 months. Significant improvements were observed postoperatively in HHS and WOMAC scores for both ipsilateral and contralateral hips, SF-12, ODI, Roland-Morris, and ipsilateral knee WOMAC scores (all P<0.05). Radiologically, postoperative improvements included a significant reduction in leg length discrepancy (P<0.001), medial mechanical axis deviation on the ipsilateral side (P<0.001), increased joint line convergence angle and ankle joint line orientation, and spinopelvic alingment with increased sacral slope (P=0.027) and decreased lumbar lordotic angle (P<0.001).</p><p><strong>Conclusion: </strong>Unilateral high-grade hip dysplasia, when treated with total hip arthroplasty (THA), results in significant short-term improvements in clinical outcomes and lower extremity alignment. In patients with an average follow-up duration of 18.3 Å} 7.0 months, although the valgus deformity on the operated side improved, neutral alignment was not achieved. The contralateral limb remained in varus alignment. While spinopelvic parameters remained within normal limits, significant changes were observed in sacral slope and lumbar lordosis.   Cite this article as: Kaya HB, Çiçek EB, Yıldız F, et al. Lower extremity and spinopelvic alignment changes after total hip arthroplasty in unilateral Crowe III-IV dysplasia: clinical and radiological outcomes. Acta Orthop Traumatol Turc., 2026; 60(4), 0689, doi: 10.5152/j.aott.2026.25689.</p>","PeriodicalId":93854,"journal":{"name":"Acta orthopaedica et traumatologica turcica","volume":"60 4","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13507789/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148802849","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":"Is Kinesio taping beneficial in the short term after Weber Type B lateral malleolar fractures? A randomized controlled trial.","authors":"Onur Gültekin, Bekir Eray Kılınç, Ahmet Eren Şen, Candan Çetin, Yusuf Olgun, Ali Varol","doi":"10.5152/j.aott.2026.25397","DOIUrl":"10.5152/j.aott.2026.25397","url":null,"abstract":"<p><strong>Objective: </strong>Surgical treatment of Weber type B ankle fractures often requires careful postoperative rehabilitation, especially when syndesmotic injuries are present. In recent years, Kinesio taping (KT) has been used in various orthopedic conditions, though its role in fracture recovery remains debatable. This study aimed to explore whether KT might support early recovery in such cases.</p><p><strong>Methods: </strong>Thirty adult patients with isolated Weber B ankle fractures and confirmed syndesmotic injury were enrolled. They were randomly assigned to 2 groups. One received KT in addition to a conventional rehabilitation protocol; the other followed rehabilitation without taping. Pain was assessed using the Visual Analog Scale. Ankle range of motion (ROM), swelling (via tape measurement), and functional mobility through the Timed Up and Go (TUG) test were also evaluated on postoperative days 1, 7, 14, and 28. Measurement reliability was verified using intraclass correlation coefficients. Statistical comparisons involved t-tests and analysis of variance (P < .05).</p><p><strong>Results: </strong>On day 1, outcome measures were similar between groups. However, by day 7 and more evidently on day 28, the KT group showed reduced pain, improved ROM, and faster TUG performance (P < .001). Edema reduction was particularly noticeable and persisted throughout follow-up.</p><p><strong>Conclusion: </strong>Kinesio taping may serve as a beneficial adjunct during early postoperative rehabilitation following Weber B fractures. Importantly, integrating KT into standard care protocols may enrich patient-centered rehabilitation approaches due to its simplicity, safety, and noninvasive nature.   Cite this article as: Gültekin O, Kılın. BE, Şen AE, .etin C, Olğun Y, Varol A. Is Kinesio taping beneficial in the short term after Weber Type B lateral malleolar fractures? A randomized controlled trial. Acta Orthop Traumatol Turc., 2026; 60(4), 0397, doi: 10.5152/j.aott.2026.25397.</p>","PeriodicalId":93854,"journal":{"name":"Acta orthopaedica et traumatologica turcica","volume":"60 4","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148802872","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":"Off-label use of a PHILOS plate in tibiotalocalcaneal arthrodesis with variable medial cannulated screw support: a retrospective evaluation of 32 ankles.","authors":"Ahmet Yurteri, Numan Mercan, Ahmet Fevzi Kekeç, Fatih Tahak, Ahmet Yıldırım","doi":"10.5152/j.aott.2026.25553","DOIUrl":"10.5152/j.aott.2026.25553","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the clinical and radiographic outcomes of tibiotalocalcaneal (TTC) arthrodesis performed using a lateral transfibular approach with the off-label application of a Proximal Humerus Internal Locking System (PHILOS) plate and to exploratorily assess outcomes according to the use of supplemental medial cannulated screw fixation.</p><p><strong>Methods: </strong>Thirty patients (32 ankles) who underwent TTC arthrodesis between January 2019 and June 2024 and had ≥12 months of followup were retrospectively reviewed. Demographics, comorbidities, surgical indications, implant configuration, fusion rates, complications, reoperations, and patient satisfaction were analyzed. Subgroup findings regarding medial screw support were evaluated descriptively.</p><p><strong>Results: </strong>The mean follow-up duration was 37.3 ± 19.2 months, and fusion was achieved in 90.6% (29/32) of ankles. Complications occurred in 18.8% (6/32), including 3 nonunions, 2 peri-implant tibial fractures, and 1 superficial infection. Reoperation was required in 3 ankles (9.4%). Patient-reported satisfaction was \"excellent\" in 71.9%, \"good\" in 12.5%, \"fair\" in 6.3%, and \"poor\" in 9.4%.</p><p><strong>Conclusion: </strong>Tibiotalocalcaneal arthrodesis performed using the PHILOS plate with a lateral approach demonstrated acceptable fusion and complication rates in this cohort. Subgroup observations regarding supplemental medial screw fixation should be interpreted as exploratory and hypothesis generating.   Cite this article as: Yurteri A, Mercan N, Kekeç AF, Tahak F, Yıldırım A. Off-label use of a PHILOS plate in tibiotalocalcaneal arthrodesis with variable medial cannulated screw support: a retrospective evaluation of 32 ankles. Acta Orthop Traumatol Turc.2026; 60(4), 0553, doi: 10.5152/j.aott.2026.25553.</p>","PeriodicalId":93854,"journal":{"name":"Acta orthopaedica et traumatologica turcica","volume":"60 4","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13507788/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148802903","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":"Multiple Finger Reconstruction with Syndactylized Free Lateral Arm Flap.","authors":"Kubilay Erol, Can Yener, Erdem Er, Özgün Barış Güntürk","doi":"10.5152/j.aott.2026.25668","DOIUrl":"10.5152/j.aott.2026.25668","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to retrospectively evaluate the clinical and functional outcomes of multiple finger reconstructions using a syndactylized free lateral arm flap.</p><p><strong>Methods: </strong>Patients who underwent reconstruction with a syndactylized free lateral arm flap between 2013 and 2024 were retrospectively reviewed. Recorded variables included the localization of finger soft-tissue defects, associated injuries, flap dimensions, recipient vessels for anastomosis, vascular complications, and timing of flap separation. At final follow-up, finger joint range of motion was assessed using goniometry, and sensory recovery was evaluated using two-point discrimination (2PD) and Semmes-Weinstein monofilament (SWM) testing. Functional outcomes were assessed using the Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) questionnaire.</p><p><strong>Results: </strong>Fifteen patients with extensive soft-tissue defects involving 37 fingers were included. The mean flap size was 5.2 Å~ 10.7 cm. One flap was lost due to venous insufficiency. Flap separation was performed between 20 and 92 days postoperatively (mean, 58 days). Twopoint discrimination exceeded 15 mm in all patients, including those who underwent nerve coaptation. All patients demonstrated varying degrees of protective sensation on SWM testing. Elbow joint range of motion at the donor site was preserved in all cases. The mean QuickDASH score was 31.2.</p><p><strong>Conclusion: </strong>The lateral arm flap provides thin, pliable tissue with reliable vascular anatomy, allows harvesting from the same extremity, and offers the possibility of osteocutaneous reconstruction. A syndactylized free lateral arm flap represents a viable option for the reconstruction of extensive soft-tissue defects involving multiple fingers. Careful patient selection and consideration of patient compliance are critical when deciding between complex reconstruction and amputation.   Cite this article as: Erol K, Yener C, Er E, Güntürk ÖB. Multiple finger reconstruction with syndactylized free lateral arm flap. Acta Orthop Traumatol Turc., 2026; 60(2), 0668, doi: 10.5152/j.aott.2026.25668.</p>","PeriodicalId":93854,"journal":{"name":"Acta orthopaedica et traumatologica turcica","volume":"60 2","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13305763/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148341428","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}