Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES最新文献

{"title":"Exclusion criteria and methodological limitations in HALP score studies.","authors":"Tuba Betül Ümit","doi":"10.14744/tjtes.2025.21882","DOIUrl":"https://doi.org/10.14744/tjtes.2025.21882","url":null,"abstract":"","PeriodicalId":94263,"journal":{"name":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","volume":"31 5","pages":"493-494"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144048129","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":"Don't waste time with scoring systems to predict mortality in Fournier's Gangrene, regulate blood sugar, and defy death!","authors":"Ferdi Bolat, Muhammet Fatih Keyif, Mustafa Şit, Oğuz Çatal, Bahri Özer, Mehmet Hayri Erkol","doi":"10.14744/tjtes.2025.40921","DOIUrl":"https://doi.org/10.14744/tjtes.2025.40921","url":null,"abstract":"<p><strong>Background: </strong>Fournier's Gangrene (FG) is a rare, life-threatening necrotizing fasciitis of the perineum and genitourinary regions with high morbidity and mortality rates. Despite advancements in healthcare, FG remains a challenge due to its rapid progression and the need for aggressive intervention. This study aims to investigate the factors influencing mortality in FG patients, assess the effectiveness of laboratory parameters and scoring systems, and emphasize the role of blood glucose regulation in improving survival.</p><p><strong>Methods: </strong>This retrospective study included 36 patients diagnosed with FG at Bolu Abant İzzet Baysal University Medical Faculty Hospital between January 2014 and September 2024. Patients with incomplete data, a history of isolated perineal, gynecological, or perianal surgeries unrelated to FG, and those under 18 years of age were excluded. For all patients, Neutrophil-Lymphocyte Ratio (NLR), Platelet-Lymphocyte Ratio (PLR), Lymphocyte-Monocyte Ratio (LMR), CRP-Albumin Ratio (CAR), and Prognostic Nutritional Index (PNI), Inflammatory Prognostic Index (IPI), Systemic Inflammation Index (SII), Urology and Plastics Index (CUPI), Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC), Fournier's Gangrene Severity Index (FGSI), and Uludağ Fournier's Gangrene Severity Index (UFGSI) scores were calculated. A comparison was made between the results obtained from laboratory parameters and scoring systems and the effect of blood sugar regulation on survival. Statistical analyses were performed using SPSS 27.</p><p><strong>Results: </strong>The mean age of the patients was 64.67±13.25 years, with a male-to-female ratio of 3: 1. Diabetes Mellitus (DM) was present in 61.1% of cases and 66.7% of deceased patients. The mortality rate was 16.7%. Elevated blood glucose levels at admission were significantly associated with mortality (p=0.024). The cut-off value of 186.5 mg/dL for glucose predicted mortality with 83.3% sensitivity and specificity. Scoring systems such as LRINEC and CUPI also demonstrated predictive utility, but glucose was found to be a simpler, faster marker. Among inflammatory markers, Neutrophil-Lymphocyte Ratio (NLR) was significant (p=0.016) with a cut-off of 14.04, showing 83.3% sensitivity and 76.7% specificity.</p><p><strong>Conclusion: </strong>FG is a rapidly progressing disease requiring early diagnosis and multidisciplinary management. While scoring systems and inflammatory markers are valuable for predicting mortality, blood glucose level stands out as a simple, rapid, and effective predictor. Ensuring blood sugar regulation can significantly improve prognosis and survival in FG patients, underscoring the need for immediate attention to glucose levels in clinical practice.</p>","PeriodicalId":94263,"journal":{"name":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","volume":"31 5","pages":"472-479"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144034236","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 rare cause of appendicitis in adults: Parasitic appendicitis.","authors":"Abidin Tüzün, Cemalettin Durgun, Erkan Dalbaşı","doi":"10.14744/tjtes.2025.34237","DOIUrl":"https://doi.org/10.14744/tjtes.2025.34237","url":null,"abstract":"<p><strong>Background: </strong>Acute appendicitis (AA) is the most common indication for emergency surgery in general surgery worldwide, with peak incidence occurring in the second and fifth decades of life. The main symptoms include nausea, vomiting, and pain that typically begins around the umbilicus and migrates to the lower right quadrant. While the most frequent cause is fekaloids, intestinal parasites, tumors, and fruit seeds may also rarely contribute to the etiology of appendicitis. The aim of this study was to determine the incidence of parasitic infections in the etiology of AA, along with associated demographic and histopathological findings in adult patients who underwent appendectomy.</p><p><strong>Methods: </strong>The records of 10,658 patients over the age of 15 who underwent appendectomy between January 2011 and January 2023 were retrospectively reviewed. Based on histopathological findings, 114 patients who underwent appendectomy due to parasitic infestation were included in the study.</p><p><strong>Results: </strong>According to the pathology results, a total of 114 patients underwent appendectomy due to parasitic infestation. Of these, 53 (46.5%) were female and 61 (53.5%) were male. Histopathological examination revealed that 70 cases (61.4%) were diagnosed as acute appendicitis, 22 (19.3%) as suppurative, 15 (13.2%) as gangrenous, and seven (6.1%) as perforated appendicitis. In terms of etiology, Taenia saginata was identified in four patients (3.5%), Ascaris lumbricoides in two patients (1.8%), and Enterobius vermicularis (EV) eggs or parasites in 108 patients (94.7%).</p><p><strong>Conclusion: </strong>Parasitic infections, particularly Enterobius vermicularis, may contribute to the development of acute appendicitis, although their exact role in the pathogenesis remains unclear. In our study, Enterobius vermicularis was the most common cause of parasite-related appendicitis.</p>","PeriodicalId":94263,"journal":{"name":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","volume":"31 5","pages":"445-449"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144001069","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":"Efficacy of endoluminal vacuum therapy in managing anastomotic leakage after neoadjuvant therapy in rectal cancer patients.","authors":"Selçuk Kaya, Muhammet Kerim Çevik, Omar Alomari, Muhammed Edib Mokresh, Hasan Fehmi Kucuk","doi":"10.14744/tjtes.2025.27078","DOIUrl":"https://doi.org/10.14744/tjtes.2025.27078","url":null,"abstract":"<p><strong>Background: </strong>Anastomotic leakage is a significant complication following colorectal surgery, associated with increased morbidity and mortality. Endoluminal vacuum therapy (EVT) has emerged as a promising treatment option for managing such leaks, although stan-dardized guidelines are still lacking. This study aimed to evaluate the efficacy of EVT in managing anastomotic leakage after colorectal surgery, focusing on outcomes and contributing factors.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 25 patients who underwent EVT for anastomotic leakage between 2018 and 2022 at our institution. Data collected included patient demographics, surgical details, timing of EVT initiation, number of EVT sessions, complications, and outcomes such as leak closure and subsequent surgical interventions. Statistical analyses were performed using Python packages.</p><p><strong>Results: </strong>The study cohort had a mean age of 56.84 years, with 68% being male. All patients received neoadjuvant therapy followed by low anterior resection and diverting ileostomy; 80% underwent open surgery. EVT was initiated for postoperative anastomotic leak-age, with a mean hospital stay of 14.16 days and an average initiation time of 16.16 days post-surgery. Ileostomy closure was performed in 14 patients after endosponge therapy. The overall EVT success rate was 68%, with a mean follow-up period of 30.7 months for those who underwent ileostomy closure. No significant relationship was found between patients' age and the time to first EVT after anastomotic leakage (p=0.52). However, a significant association was observed between the timing of the first EVT and the duration of EVT termination (p=0.0003).</p><p><strong>Conclusion: </strong>EVT is a viable option for managing anastomotic leakage following colorectal surgery, demonstrating high closure rates and low associated morbidity. Early initiation of EVT appears to be crucial for optimizing treatment outcomes. Further pro-spective studies are needed to establish standardized protocols and confirm the long-term benefits of EVT in this challenging clinical context.</p>","PeriodicalId":94263,"journal":{"name":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","volume":"31 5","pages":"450-457"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144047193","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":"The observations and experience of the Surgical Disaster Response Team from Ankara Etlik City Hospital in the earthquakes of February 6, 2023 in Türkiye.","authors":"Ümit Özdemir, Emre Kaymakçı, Bilal Abbasoğlu, Ülfet Nihal Irdem Köse, Cem Koray Çataroğlu, Hüseyin Bilgehan Çevik, Abdullah Şenlikçi, Julide Ergil","doi":"10.14744/tjtes.2025.02803","DOIUrl":"https://doi.org/10.14744/tjtes.2025.02803","url":null,"abstract":"<p><strong>Background: </strong>Two major earthquakes struck southeastern Türkiye consecutively on February 6, 2023. On the same day, a Surgical Disaster Response Team was immediately formed at Ankara Etlik City Hospital and deployed to the affected region, where they worked for seven days at Hatay-Reyhanlı State Hospital. The aim of this study was to present the experiences, data, and recommendations of the Ankara Etlik City Hospital Surgical Disaster Response Team following the February 6, 2023 earthquakes.</p><p><strong>Methods: </strong>Data were collected from the individual records of the physicians in the Surgical Disaster Response Team. The physicians provided information about the units in which they worked, their roles, the procedures they performed, treatments administered, observations made, experiences encountered, and recommendations for future disaster response efforts.</p><p><strong>Results: </strong>The anesthesiologists in the team worked in the operating theatres and intensive care units. In addition to performing surgical procedures, the cardiovascular surgeon, general surgeons, and pediatric surgeon also assisted in the emergency department's red and yellow zones as needed. The orthopedic surgeons performed 96 interventions, the neurosurgeon 11, the cardiovascular surgeon five, the general surgeons four, and the pediatric surgeon four. Of the total procedures, 80% were performed by orthopedic surgeons, while the remaining 20% were carried out by specialists from other surgical branches.</p><p><strong>Conclusion: </strong>Extremity injuries are common among earthquake survivors and usually require orthopedic intervention. In a hospital where the administrative staff are also disaster victims, management should be assumed by the incoming disaster response team. A detailed disaster preparedness plan must outline which regions will provide support, including personnel, transportation, materials, and patient referrals, to specific disaster-affected areas. In addition to surgeons, the disaster response team must include emergency medicine specialists, internal medicine specialists, pediatricians, and gynecologists. The Surgical Disaster Response Team should be a fully integrated unit consisting of doctors, nurses, and auxiliary personnel.</p>","PeriodicalId":94263,"journal":{"name":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","volume":"31 4","pages":"375-380"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12000973/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056821","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":"Assessing the quality of ChatGPT's responses to commonly asked questions about trigger finger treatment.","authors":"Mehmet Can Gezer, Mehmet Armangil","doi":"10.14744/tjtes.2025.32735","DOIUrl":"https://doi.org/10.14744/tjtes.2025.32735","url":null,"abstract":"<p><strong>Background: </strong>This study aims to evaluate the accuracy and reliability of Generative Pre-trained Transformer (ChatGPT; OpenAI, San Francisco, California) in answering patient-related questions about trigger finger. This evaluation has the potential to enhance patient education prior to treatment and provides insight into the role of artificial intelligence (AI)-based systems in the patient educa-tion process.</p><p><strong>Methods: </strong>The ten most frequently asked questions regarding trigger finger were compiled from patient education websites and a literature review, then posed to ChatGPT. Two orthopedic specialists evaluated the responses using the Journal of the American Medical Association (JAMA) Benchmark criteria and the DISCERN instrument (A Tool for Judging the Quality of Written Consumer Health Information on Treatment Choices). Additionally, the readability of the responses was assessed using the Flesch-Kincaid Grade Level.</p><p><strong>Results: </strong>The DISCERN scores for ChatGPT's responses to trigger finger questions ranged from 35 to 47, with an average of 42, indicating \"moderate\" quality. While 60% of the responses were satisfactory, 40% contained deficiencies. According to the JAMA Benchmark criteria, the absence of scientific references was a significant drawback. The average readability level corresponded to the university level, making the information difficult to understand for patients with low health literacy. Improvements are needed to enhance the accessibility and comprehensibility of the content for a broader patient population.</p><p><strong>Conclusion: </strong>To the best of our knowledge, this is the first study to investigate the use of ChatGPT in the context of trigger finger. While ChatGPT shows reasonable effectiveness in providing general information on trigger finger, expert oversight is necessary before it can be relied upon as a primary source for patient education.</p>","PeriodicalId":94263,"journal":{"name":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","volume":"31 4","pages":"389-393"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12000978/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144049208","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":"Reverse shock index multiplied by simplified motor score as an indicator of clinical outcomes in patients with abdominal trauma in the emergency department: a retrospective cohort study.","authors":"Ilker Şirin, Tuğba Sanalp Menekşe, Muzaffer Akkoca","doi":"10.14744/tjtes.2025.23798","DOIUrl":"https://doi.org/10.14744/tjtes.2025.23798","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to determine the diagnostic value of the product of the reverse Shock Index (rSI) and the simplified Motor Score (sMS) (rSIsMS) as a predictor of clinical outcomes in patients with abdominal trauma.</p><p><strong>Methods: </strong>Patients who presented with abdominal trauma to the emergency department of a tertiary care hospital between 2023 and 2024 were included in the study. Using the patients' data, we calculated the Abbreviated Injury Scale (AIS), Injury Severity Score (ISS), Revised Trauma Score (RTS), and Trauma and Injury Severity Score (TRISS). Additionally, the rSIsMS and the product of the rSI and Glasgow Coma Scale (GCS) (rSIG) were calculated.</p><p><strong>Results: </strong>A total of 270 patients were included in the study. The diagnostic validity of the TRISS, rSIsMS, and rSIG, which had the highest area under the curve (AUC) values for mortality outcomes, was examined; the AUC values were 0.928, 0.908, and 0.886, respectively. The AUC values of the TRISS and rSIsMS concerning intensive care unit (ICU) needs were 0.844 and 0.852, respectively. With regard to surgical intervention needs, the AUC values of the TRISS and rSIsMS were 0.774 and 0.881, respectively. The diagnostic validity of the rSIsMS for surgical intervention needs was significantly higher than that of the TRISS (p<0.001, DeLong test). Concerning massive transfusion protocol (MTP) requirements, the AUC values of the TRISS and rSIsMS were 0.799 and 0.930, respectively. The diagnostic validity of the rSIsMS for MTP requirements was significantly higher than that of the TRISS (p<0.001, DeLong test).</p><p><strong>Conclusion: </strong>The rSIsMS is superior to other trauma scores in predicting MTP and surgical intervention needs in patients with abdominal trauma, and it performs similarly to other trauma scores in predicting mortality and ICU needs. The ease of calculation and its ability to be obtained at the bedside may further enhance the clinical utility of the rSIsMS in the emergency department.</p>","PeriodicalId":94263,"journal":{"name":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","volume":"31 4","pages":"332-340"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12000983/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144065528","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":"Factors affecting mortality in patients undergoing surgical procedures after the 2023 Türkiye earthquake.","authors":"Hatice Kaya Özdoğan, Barış Arslan, Emine Cantimur Işık, Ümit Kara, Osman Çiloğlu, Mehmet Eryılmaz, Mehmet Özdoğan","doi":"10.14744/tjtes.2025.68317","DOIUrl":"https://doi.org/10.14744/tjtes.2025.68317","url":null,"abstract":"<p><strong>Background: </strong>On February 6, 2023, two devastating earthquakes struck southeastern Türkiye and northern Syria, significantly affecting 11 provinces in Türkiye and causing widespread destruction. The aim of this study is to investigate the factors influencing mortality among patients who underwent surgical procedures at a regional tertiary care center following the earthquakes.</p><p><strong>Methods: </strong>A total of 4,622 earthquake victims were admitted to our hospital. Of these, 637 patients who required surgical interventions were included in the study. Patient records were retrospectively analyzed. Data collected included demographic characteristics, laboratory findings, types of injuries, surgical procedures performed, Acute Physiology and Chronic Health Evaluation II (APACHE II) scores, length of stay (LOS) in the intensive care unit (ICU), and mortality outcomes. Extrication time and transport time to the hospital were obtained from prehospital emergency ambulance records.</p><p><strong>Results: </strong>Among the patients, 159 had been trapped under debris and later extricated. The mean APACHE II score was 29.6 and the overall mortality rate was 3.9%. Crush syndrome and burn injuries were significant predictors of mortality. Factors associated with mortality included the use of hemodynamic support drugs, direct ICU admission upon arrival, male sex, prolonged extrication and transport times, higher APACHE II scores, elevated levels of potassium, phosphorus, creatine kinase, blood urea nitrogen, aspartate aminotransferase, alanine aminotransferase, C-reactive protein, and acidosis on admission. Extrication time demonstrated strong pre-dictive value for mortality (area under the curve [AUC]=0.895). The optimal cut-off point was identified as 21 hours, with a sensitivity of 78.9% and specificity of 86.4%.</p><p><strong>Conclusion: </strong>Extrication time from entrapment under debris is one of the most important factors predicting mortality in earthquake victims. A rescue period of 21 hours is critical for survival. Early rescue from debris and rapid transport to a medical facility are essential for improving survival outcomes in earthquake victims.</p>","PeriodicalId":94263,"journal":{"name":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","volume":"31 4","pages":"381-388"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12000980/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144049396","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":"Traumatic isolated spinous process fractures.","authors":"Muhittin Emre Altunrende, Elif Evrim Ekin","doi":"10.14744/tjtes.2025.20830","DOIUrl":"https://doi.org/10.14744/tjtes.2025.20830","url":null,"abstract":"<p><strong>Background: </strong>Isolated traumatic spinous process fractures account for a small proportion of diagnosed spinal fractures. Among spinal fractures, the cervical vertebra is the most common site of involvement, often referred to as a Clay-Shoveler's fracture. This study included patients with isolated spinous process fractures through radiologic examinations over the past five years. The study aimed to investigate the cause of trauma, the presence of spinal ligament injury, and the relationship between these fractures with age and sex.</p><p><strong>Methods: </strong>Magnetic resonance imaging (MRI) and computed tomography (CT) scans of the spine, performed for any reason over the past five years at the hospital where the study was conducted, were retrospectively reviewed and re-evaluated. Patients whose examinations were unrelated to trauma, those with imaging artifacts that interfered with evaluation, and those who had undergone spinal vertebral surgery were excluded. The etiology of fractures was classified using the International Classification of Diseases (ICD) diagnoses. Data on age, sex, cause of trauma, and spinal ligament injury were recorded.</p><p><strong>Results: </strong>A total of 44 patients (36 men and eight women) were included in the study, with a mean age of 43.1 years. Among them, 25 patients were admitted due to traffic accidents and 18 due to falls. Spinous process fractures were observed in 18, 17, and three patients in the cervical, thoracic, and lumbar regions, respectively. Multiple spinous process fractures were found in 15 patients, while six patients had fractures in both the cervical and thoracic regions (Clay-Shoveler's fracture). In 12 patients, spinal MRI with Short-TI Inversion Recovery (STIR) sequences was performed in addition to CT imaging. All patients with Clay-Shoveler's fracture fractures underwent both CT and MRI examinations. In all cases where MRI was performed, interspinous ligament damage was detected. However, no intracanal involvement or comorbid pathology was observed.</p><p><strong>Conclusion: </strong>Notably, multiple fractures may occur, particularly at the cervicothoracic junction. Although spinous process fractures associated with trauma are rarely isolated, they are usually managed with medical treatment. Therefore, the vertebrae below the initially detected fracture site should also be evaluated. Additionally, imaging studies such as MRI with STIR sequences should be performed to assess ligament damage and the neural canal, in addition to tests for evaluating bony structures.</p>","PeriodicalId":94263,"journal":{"name":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","volume":"31 4","pages":"394-398"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12000981/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144001184","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":"Clinical and radiological outcomes of surgically treated medial malleolus fractures in skeletally immature patients.","authors":"Sevan Sıvacıoğlu, Serkan Bayram, Taha Bedir Demir, Ismail Tarık Atasoy, Buğra Yoldaş, Halil Ibrahim Balcı, Mehmet Aşık","doi":"10.14744/tjtes.2025.74311","DOIUrl":"https://doi.org/10.14744/tjtes.2025.74311","url":null,"abstract":"<p><strong>Background: </strong>Medial distal tibial Salter-Harris Type 3 and Type 4 epiphyseal injuries, also known as McFarland fractures, pose significant risks due to their potential to damage the growth plate and cause long-term joint deformities. Surgical treatment is commonly performed to restore joint congruity; however, there is no clear consensus on whether surgical or conservative treatment yields better outcomes. This study aimed to evaluate the mid-term clinical and radiological outcomes of surgical treatment in patients with McFarland fractures.</p><p><strong>Methods: </strong>This retrospective study analyzed outcomes of 13 patients, aged 6-17 years, who underwent surgical treatment for McFarland fractures between 2021 and 2023 at a Level 1 Trauma Center. Surgical methods included screw fixation, K-wire fixation, and tension wire fixation. Outcome measures included radiological deformity assessments (lateral distal tibial angle [LDTA], anterior distal tibial angle [ADTA]), range of motion (ROM), Foot and Ankle Ability Measure (FAAM) scores for functional assessment, and Visual Analogue Scale (VAS) scores for pain. Comparisons were made between the operated and non-operated limbs.</p><p><strong>Results: </strong>LDTA and ADTA values showed minimal differences between the operated and non-operated limbs, indicating successful surgical realignment (p<0.05). Although slight ROM limitations were observed in the operated limb, high FAAM scores and low VAS scores reflected good functional recovery and effective pain management. Correlation analysis revealed a moderate positive correlation (r=0.45) between FAAM scores and ROM, and a weaker correlation (r=0.32) between FAAM scores and radiological alignment.</p><p><strong>Conclusion: </strong>Surgical treatment of McFarland fractures resulted in favorable clinical and radiological outcomes, with minimal limitations in ROM and significant improvements in alignment and functional recovery. However, ongoing follow-up is essential, particularly in younger patients, to monitor and manage the risk of potential growth disturbances.</p>","PeriodicalId":94263,"journal":{"name":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","volume":"31 4","pages":"399-404"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12000977/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144061680","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}