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

{"title":"The problem-solving role of the 'wait and repeat CT' approach in the diagnosis and treatment of acute abdomen.","authors":"Esra Akçiçek, Ahmet Gürkan Erdemir, Ilkay Sedakat Idilman, Mehmet Ruhi Onur, Erhan Akpınar, Bülent Erbil","doi":"10.14744/tjtes.2025.26793","DOIUrl":"10.14744/tjtes.2025.26793","url":null,"abstract":"<p><strong>Background: </strong>This study aims to assess the diagnostic value and problem-solving utility of follow-up abdominopelvic computed tomography (CT) scans performed within 10 days of the initial presentation for acute non-traumatic abdominal symptoms in the emergency department.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on patients who presented with acute abdominal symptoms to the emergency department between January 1, 2013 and May 30, 2023, and underwent abdominopelvic CT scans in the acute setting. Among this cohort, 149 patients had repeat abdominopelvic CT scans during the same admission and were classified into five groups based on findings: Group A (no change in diagnosis), Group B (confirmation of suspected initial diagnosis), Group C (disease progression), Group D (disease regression), and Group E (new diagnosis).</p><p><strong>Results: </strong>The mean age of the cohort was 51.5+-18 years (range: 19-92). The average interval between initial and repeat CT scans was 40.9+-59.05 hours (range: 0.5-238). The number of patients in each group was as follows: Group A (n=21), Group B (n=60), Group C (n=32), Group D (n=25), and Group E (n=11). Partial bowel obstruction was the most common finding (27%, 41/149), with 72% (18/25) of Group D showing regression on follow-up CT. The \"wait and follow-up\" approach significantly guided management decisions for partial bowel obstruction (p<0.01).</p><p><strong>Conclusion: </strong>This study emphasizes the importance of the \"wait and repeat CT\" strategy in enhancing diagnostic accuracy and guiding clinical management for patients with acute non-traumatic abdominal complaints. Follow-up CT scans were particularly effective in identifying conditions such as partial bowel obstruction.</p>","PeriodicalId":94263,"journal":{"name":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","volume":"31 9","pages":"847-853"},"PeriodicalIF":1.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12460630/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145002367","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":"Predictive value of disability scoring systems for return-to-work outcomes in hand and forearm injuries.","authors":"Nilay Cankurt Ayar, Mustafa Selçuk Ayar, Berna Aydin, Ahmet Turla","doi":"10.14744/tjtes.2025.61475","DOIUrl":"10.14744/tjtes.2025.61475","url":null,"abstract":"<p><strong>Background: </strong>Predicting return-to-work (RTW) outcomes following upper extremity trauma is crucial for optimizing patient care, guiding rehabilitation, and reducing the socioeconomic burden. Although several disability scoring systems have been proposed to assess injury severity, their ability to estimate RTW status and duration remains underexplored. This study aimed to evaluate the predictive value of the Modified Hand Injury Severity Score (MHISS), Upper Extremity Disability Rate (UEDR), and Total Body Disability Rate (TBDR) for RTW outcomes in patients with hand, wrist, and forearm injuries.</p><p><strong>Methods: </strong>A retrospective cross-sectional study was conducted on 69 patients who presented to the Forensic Medicine Department of Ondokuz Mayıs University between 2020 and 2024. Eligible participants were adults with documented hand, wrist, or forearm injuries and complete treatment records, including MHISS scoring. Demographic data, injury characteristics, and disability rates (UEDR, TBDR) were collected. Statistical analyses included Spearman correlation, receiver operating characteristic (ROC) analysis, and logistic regression to assess associations between scoring systems and RTW status and duration.</p><p><strong>Results: </strong>The median MHISS score was 20.0, with corresponding UEDR and TBDR values of 3.0% and 2.0%, respectively. Occupational injuries, observed in 37.7% of cases, were associated with significantly higher disability scores (p<0.05). ROC analysis demonstrated strong predictive ability for MHISS (area under the curve [AUC]: 0.886), UEDR (AUC: 0.903), and TBDR (AUC: 0.897) in identifying RTW status. While MHISS effectively predicted RTW status, it did not correlate with RTW duration (p=0.082). In contrast, UEDR and TBDR showed weak but statistically significant correlations with RTW duration (r=0.295 and r=0.296, respectively). Multivariate logistic regression did not identify any independent predictors of RTW.</p><p><strong>Conclusion: </strong>Disability scoring systems such as MHISS, UEDR, and TBDR are useful tools for predicting whether patients will return to work following hand and forearm injuries. However, their ability to estimate the duration of work absence is limited. Future research should integrate psychosocial, occupational, and rehabilitation-related variables to develop more comprehensive models for RTW prognosis.</p>","PeriodicalId":94263,"journal":{"name":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","volume":"31 9","pages":"900-906"},"PeriodicalIF":1.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12460626/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145002370","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":"Prognostic value of lactate-enhanced quick sequential organ failure assessment (qSOFA) versus standard qSOFA in predicting mortality among sepsis patients in the emergency department: A retrospective cohort study.","authors":"Veysi Siber, Ahmet Burak Erdem","doi":"10.14744/tjtes.2025.55728","DOIUrl":"10.14744/tjtes.2025.55728","url":null,"abstract":"<p><strong>Background: </strong>The quick Sequential Organ Failure Assessment (qSOFA) score is widely used for bedside risk stratification in sepsis patients. However, its limited sensitivity may hinder early identification. The lactate-enhanced qSOFA (LqSOFA), which incorporates serum lactate levels into the qSOFA score, may improve prognostic accuracy. This study aimed to evaluate the diagnostic performance of LqSOFA in predicting early (24-hour) and late (30-day) mortality, as well as intensive care unit (ICU) admission, among patients with sepsis.</p><p><strong>Methods: </strong>This retrospective descriptive study included patients aged ≥18 years who were diagnosed with sepsis based on Sepsis-3 criteria and admitted to the emergency department (ED) of a tertiary-care teaching hospital between July 1, 2024 and December 31, 2024. Patients were identified through ICD-10 (International Classification of Diseases, 10th Revision) codes, and diagnoses were clinically confirmed. qSOFA and LqSOFA scores were calculated using initial vital signs and venous lactate levels. The primary outcomes were 24-hour and 30-day mortality; ICU admission was assessed as a secondary outcome. Statistical analyses were conducted using SPSS v27 and Jamovi v2.5.7. The diagnostic performance of the scores was evaluated using receiver operating characteristic (ROC) curve analysis. Area under the curve (AUC), sensitivity, specificity, and predictive values were calculated, and AUC comparisons were performed using the DeLong test (p<0.05 considered significant).</p><p><strong>Results: </strong>A total of 236 patients were included (median age: 75 years; 53% male). The 24-hour and 30-day mortality rates were 20.3% and 36.4%, respectively. LqSOFA demonstrated significantly higher diagnostic accuracy than qSOFA for predicting 24-hour mortality (AUC: 0.709 vs. 0.673; p<0.05). Although LqSOFA also showed a higher AUC for 30-day mortality, the difference was not statistically significant. Nevertheless, LqSOFA exhibited superior specificity and positive predictive value. For ICU admission, LqSOFA demonstrated greater sensitivity than qSOFA (79% vs. 57%).</p><p><strong>Conclusion: </strong>LqSOFA outperforms qSOFA in predicting mortality and ICU admission among sepsis patients in the emergency department. Given its simplicity, objectivity, and ease of implementation, LqSOFA may serve as a practical tool to support clinical decision-making in emergency settings.</p>","PeriodicalId":94263,"journal":{"name":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","volume":"31 9","pages":"891-899"},"PeriodicalIF":1.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12460629/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145002334","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":"Comparison of hematoma block and dexmedetomidine for reduction of distal radius fractures in the emergency department: a prospective randomized controlled study.","authors":"Emin Fatih Vişneci, Demet Acar, Ebubekir Eravşar, Betül Kozanhan, Osman Lütfi Demirci, Mehmet Gül","doi":"10.14744/tjtes.2025.80876","DOIUrl":"10.14744/tjtes.2025.80876","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to compare the effects of hematoma block (HB) and dexmedetomidine administration on pain control, reduction quality, and physician satisfaction during the reduction of distal radius fractures (DRFs) in the emergency department (ED).</p><p><strong>Methods: </strong>A total of 60 patients presenting to the ED with DRFs were enrolled. Patients were randomly assigned to two groups: one received HB, while the other underwent conscious sedation with dexmedetomidine. Pain levels were assessed using the Visual Analog Scale (VAS) at three time points: before the procedure, 10 minutes after administration of the intervention, and post-reduction. Physician satisfaction during reduction was measured using the 5-point Likert Satisfaction Scale (LSS). Post-reduction quality was evaluated on control radiographs using the Sarmiento criteria.</p><p><strong>Results: </strong>Among the patients included in the study, 28 were female, 19 were male, and 13 were children (<12 years). The mean age was 32.97+-20.48 years in the dexmedetomidine group (DG) and 35.25+-18.92 years in the hematoma block group (HBG), with no statistically significant difference between the groups (t=-0.448, p=0.65). There was no significant difference in physician satisfaction during reduction between the two groups according to LSS results (χ²=2.296, p=0.512). Pre-procedure VAS scores were comparable between the two groups (t=-0.148, p=0.883). However, VAS scores 10 minutes after the intervention were significantly lower in the DG compared to the HBG (p=0.009, t=-2.773). Post-reduction quality based on the Sarmiento criteria showed no significant difference between the groups (χ²=0.64, p=0.89). No adverse effects related to either method were observed in any of the patients.</p><p><strong>Conclusion: </strong>Dexmedetomidine provides faster and more effective pain management than HB for DRF reduction in the ED. Given its minimal systemic side effects, dexmedetomidine may represent a viable alternative for procedural sedation and analgesia (PSA) in fracture reductions requiring sedation in the ED.</p>","PeriodicalId":94263,"journal":{"name":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","volume":"31 9","pages":"913-919"},"PeriodicalIF":1.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12460639/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145002354","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":"Outcome of cervical cases operated with posterior cervical pedicle screw placement: a single-center retrospective study.","authors":"Ali Borekci, Pinar Kuru Bektasoglu, Erhan Çelikoğlu","doi":"10.14744/tjtes.2025.83686","DOIUrl":"10.14744/tjtes.2025.83686","url":null,"abstract":"<p><strong>Background: </strong>Cervical pedicle screws offer biomechanical advantages over other stabilization systems. However, their placement carries a relatively high risk of vascular or neurological injury due to individual differences and the complex structure of the cervical spine. Therefore, understanding patient-specific anatomy is crucial for the safe and accurate placement of pedicle screws. In this study, we present our single-center case series over a seven-year period involving cervical pedicle screw placement in subaxial cases.</p><p><strong>Methods: </strong>We retrospectively analyzed patients who underwent cervical subaxial pedicle screw placement between 2017 and 2024. A freehand surgical technique was employed, using a mini-laminotomy approach to ensure safe screw placement. During the procedure, the medial, superior, and inferior borders of the pedicle were palpated.</p><p><strong>Results: </strong>A total of 70 cases were analyzed retrospectively. Fifty patients were male, and 20 were female. The patients ranged in age from 20 to 89 years (median age: 64 years). Fifty-seven patients (81.5%) had cervical stenosis as the surgical indication. Of the remaining cases, 11 patients had fractures and two had tumors. Among the 468 pedicle screws placed, 434 were graded as 0-1. The correct placement rate was 92.7%. Thirty-four screws were malpositioned (grade 2-3), representing a rate of 7.3%.</p><p><strong>Conclusion: </strong>In our case series, the accuracy of cervical subaxial pedicle screw placement was high. We believe that achieving this level of accuracy requires a strong understanding of anatomy, three-dimensional spatial awareness, and surgical experience.</p>","PeriodicalId":94263,"journal":{"name":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","volume":"31 8","pages":"798-803"},"PeriodicalIF":1.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12363150/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144791141","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":"Dorsoradial vs. circular cast for distal radius fractures: a retrospective comparative cohort study.","authors":"Oğuzhan Gökalp, Gökhan Ilyas","doi":"10.14744/tjtes.2025.80448","DOIUrl":"10.14744/tjtes.2025.80448","url":null,"abstract":"<p><strong>Background: </strong>Non-articular dorsally angulated distal radius fractures (DRFs) are often managed conservatively, yet the optimal cast design remains debated. Dorsoradial (DR) casting leaves the ulnar border open, potentially better accommodating swelling and reducing early cast-related interventions.</p><p><strong>Methods: </strong>A single-center retrospective cohort study included adults with AO-23-A2/A3 DRFs treated between May 2019 and May 2023. Patients received either a DR cast (n=88) or a conventional circular cast (CC) (n=122) for a standard five-week immobilization. Primary outcomes included functional (Patient-Rated Wrist Evaluation, PRWE) and clinical (Gartland-Werley, GW) scores, along with radiographic alignment (volar tilt, radial inclination, radial height) at a median follow-up of 118.5 weeks. Secondary outcomes were early cast revisions (release or reinforcement) and complications. Statistical tests included Mann-Whitney U, χ²/Fisher, with Bonferroni-adjusted α=0.017.</p><p><strong>Results: </strong>Baseline characteristics were similar across groups: mean age 60±11 years, 87% female, comparable AO subtype distribution, and osteoporosis status. Early revision: DR 22.7% vs. CC 36.1% (absolute risk reduction 13% points; odds ratio: 0.51, p=0.038), primarily due to fewer cast releases for swelling/pain (12.5% vs. 32.8%, p=0.001). Function: PRWE scores were 34±18 (DR) vs. 36±18 (CC), p=0.435; GW scores were good-excellent in 79.5% vs. 77.8%, p=0.508. Radiographic outcomes: final volar tilt and radial height were similar (both p>0.08). DR casts better preserved radial inclination (median change 0°, p=0.057) compared to CC casts, which lost 1.3° (-6%, p<0.001); however, the net 1.2° intergroup difference is below the 5° minimal clinically important difference (MCID) and is clinically negligible. No cases of compartment syndrome or acute carpal tunnel occurred.</p><p><strong>Conclusion: </strong>Dorsoradial casting delivers functional and radiographic outcomes equivalent to circular casting while reducing early revision rates by one-fifth. By lowering unplanned cast adjustments and follow-up visits, the DR technique represents a pragmatic alternative for centers with limited monitoring capacity treating dorsally angulated extra-articular DRFs.</p>","PeriodicalId":94263,"journal":{"name":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","volume":"31 8","pages":"789-797"},"PeriodicalIF":1.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12363139/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144791161","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":"Scientific response to the 2023 Kahramanmaraş earthquake: A bibliometric study.","authors":"Muhammed Salih Süer, Ender Ergüder, Serkan Demir, Şener Balas","doi":"10.14744/tjtes.2025.30820","DOIUrl":"10.14744/tjtes.2025.30820","url":null,"abstract":"<p><strong>Background: </strong>On February 6, 2023, Türkiye experienced two devastating earthquakes with epicenters in Pazarcık and Elbistan, measuring 7.7 and 7.6 on the Richter scale. These earthquakes resulted in over 50,000 deaths and widespread destruction of infrastructure. The disaster triggered a large-scale humanitarian crisis, presenting significant medical and psychological challenges. Understanding the scientific response to such events is crucial for enhancing future disaster preparedness and management.</p><p><strong>Methods: </strong>A systematic search was conducted in the Web of Science database using the terms \"Kahramanmaraş earthquake,\" \"Pazarcık earthquake,\" \"Elbistan earthquake,\" and \"Türkiye earthquake 2023.\" The search covered literature published from February 6, 2023 onward, and focused on medical publications. A total of 371 articles were initially identified; after excluding geological, engineering, and social science studies, 350 articles were included. Bibliometric analysis was performed using the Bibliometrix package in R Studio and visualized with Biblioshiny. Key indicators analyzed included publication volume, citation count, author collaboration, and thematic clustering.</p><p><strong>Results: </strong>The analysis identified 350 articles published in 173 journals, with contributions from 1,739 authors. The average number of co-authors per document was 6.03, indicating a high level of collaboration. However, only 5.429% of the studies involved international authors. The annual growth rate of publications was -11.11%, suggesting a projected decline in research activity. The most cited article was Emergency Medicine Association of Turkey Disaster Committee Summary of Field Observations of February 6th Kahramanmaraş Earthquakes, which emphasized the challenges faced in emergency response. Psychological studies were more numerous; however, publications related to emergency response and trauma care received higher citation counts. Keyword analysis revealed a focus on trauma care, post-traumatic stress disorder (PTSD), surgical management, and public health. Notable clinical advancements included the SAFE-QUAKE (Seismic Activity Forecasting and Evaluation-QUAKE) scoring system for predicting dialysis needs and the Mangled Extremity Severity Score (MESS) for amputation triage.</p><p><strong>Conclusion: </strong>The research response to the Kahramanmaraş earthquakes followed a clear progression: an early focus on emergency response and public health, followed by injury and surgical management, and a later emphasis on psychological recovery. Despite a strong domestic research effort, low international collaboration hindered broader knowledge exchange. Sustained funding, enhanced global partnerships, and integrated mental health and trauma care strategies are essential for improving future disaster preparedness and healthcare system resilience.</p>","PeriodicalId":94263,"journal":{"name":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","volume":"31 8","pages":"766-775"},"PeriodicalIF":1.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12363148/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144791163","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":"Mortality prediction in geriatric patients with multiple trauma presenting by ambulance.","authors":"Aynur Yurtseven, Afşin Emre Kayıpmaz","doi":"10.14744/tjtes.2025.42574","DOIUrl":"10.14744/tjtes.2025.42574","url":null,"abstract":"<p><strong>Background: </strong>The Modified 5-Factor Frailty Index (mFI-5) has been shown to predict complications following treatment in geriatric patients. However, few studies have compared the mFI-5 with other trauma scoring systems in cases involving multiple injuries. This study aimed to evaluate the Relationship Between mFI-5, Injury Severity Score (ISS), and Geriatric Trauma Outcome Score (GTOS) and their association with mortality in geriatric trauma patients.</p><p><strong>Methods: </strong>This retrospective cohort study included patients aged 65 and older who were admitted to the emergency trauma unit of a tertiary care hospital. Data collected included laboratory parameters, imaging results, blood transfusion requirements, hospitalization status, intensive care unit admission, surgical intervention, ISS, GTOS, mFI-5 scores, and mortality outcomes.</p><p><strong>Results: </strong>A total of 241 patients were included, with a mean age of 78.12 (±8.34) years. Falls were the most common cause of trauma (n=142, 58.9%). Thoracic injuries were the most frequently observed (n=86, 53.7%). Patients who died within the first 24 hours of admission had significantly higher ISS (14.1 vs. 26.33), GTOS (119.02 vs. 157.33), and mFI-5 (2.53 vs. 3.33) scores (p=0.001, p=0.001, and p=0.017, respectively). Similar trends were noted for one-month and three-month mortality (p=0.001 for all).</p><p><strong>Conclusion: </strong>Scoring systems are essential for early mortality prediction in geriatric trauma patients. ISS, GTOS, and mFI-5 scores have shown similar effectiveness in predicting comorbidities, intensive care unit admission, and mortality in geriatric trauma patients. ISS involves a complex calculation, while GTOS, although specifically designed for geriatric patients, requires additional computations based on the ISS. In contrast, mFI-5 may be more practical in emergency settings because it is easy to calculate.</p>","PeriodicalId":94263,"journal":{"name":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","volume":"31 8","pages":"739-746"},"PeriodicalIF":1.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12363138/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144791140","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":"Endoscopic management of cystic stump leaks: Insights from a tertiary care center.","authors":"Fırat Aslan, Halil Alper Bozkurt, Serhat Binici, Abdullah Hilmi Yılmaz","doi":"10.14744/tjtes.2025.63221","DOIUrl":"10.14744/tjtes.2025.63221","url":null,"abstract":"<p><strong>Background: </strong>Cystic stump leakage is the most common cause of bile leakage following cholecystectomy, representing a significant postoperative complication that requires prompt intervention. Currently, endoscopic treatment is the preferred management approach. This study aims to identify factors influencing the success of endoscopic therapy for cystic stump leaks by analyzing cases treated at our institution.</p><p><strong>Methods: </strong>Thirty-seven patients who underwent endoscopic retrograde cholangiopancreatography (ERCP) for cystic stump leakage were included in this study. Patient demographics, associated complications, and length of hospital stay were analyzed.</p><p><strong>Results: </strong>All patients showed clinical improvement, with a mean hospital stay of 5.1 days. The presence of comorbidities, emergency surgery, or conversion to open surgery did not significantly impact treatment efficacy. Post-procedure, percutaneous drainage was required in 10 patients (27%). Procedure-related pancreatitis was noted in one patient (2.7%). Statistical analysis revealed that both the need for percutaneous drainage and the length of hospital stay were significantly lower in patients who had pre-existing drains (p<0.03). Additionally, early ERCP was associated with a significantly shorter hospital stay (p<0.01).</p><p><strong>Conclusion: </strong>Stent placement via ERCP is a safe and effective strategy for managing cystic stump leaks. Early ERCP intervention following cystic stump leak detection is recommended. Furthermore, percutaneous drainage may be necessary in patients who do not respond adequately to initial treatment.</p>","PeriodicalId":94263,"journal":{"name":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","volume":"31 8","pages":"722-728"},"PeriodicalIF":1.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12363144/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144791136","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":"Extension Block Kirschner Wire Fixation for Acute Bony Mallet Finger: A Retrospective Analysis.","authors":"Sevan Sıvacıoğlu, Fatih Şentürk, Muhammet Buğra Tellioğlu, Süleyman Altun, Bülent Kılıç","doi":"10.14744/tjtes.2025.73885","DOIUrl":"https://doi.org/10.14744/tjtes.2025.73885","url":null,"abstract":"<p><strong>Background: </strong>Bony mallet finger is a common injury of the distal phalanx that often requires surgical fixation when fracture displacement disrupts joint congruity. Extension-block Kirschner wire fixation, originally described by Ishiguro, is a minimally invasive method with high reported success rates. This study aimed to evaluate the clinical and radiological outcomes of patients with acute bony mallet finger treated with the extension-block technique using Kirschner wires.</p><p><strong>Methods: </strong>A retrospective review was conducted on 76 patients treated surgically between October 2020 and December 2023. Radiographic union, extension lag, Crawford classification scores, and complications were analysed. Fractures were also categorised according to the Wehbé and Schneider classification. Statistical analyses included the Shapiro-Wilk test, Wilcoxon signed-rank test, and Chi-square or Fisher's exact tests as appropriate.</p><p><strong>Results: </strong>The mean patient age was 34.4 ± 11.6 years. The median injury-to-surgery interval was 3 days, and the median follow-up duration was 18.5 months. Union was achieved in 97% of cases. The median preoperative DIP joint extension lag improved significantly from 8.8° (IQR 5.8-14.2) to 2.1° (IQR 0-4.8) at final follow-up (p < 0.001, r = 0.72). According to the Crawford classification, 80.2% of patients achieved excellent results, 13.2% good, 1.3% satisfactory, and 5.3% poor outcomes. Complications were limited to two non-unions and one malunion (3.9%).</p><p><strong>Conclusion: </strong>Extension-block Kirschner wire fixation provides excellent functional and radiographic outcomes in the treatment of acute bony mallet finger when performed early. The technique is safe, effective, and minimally invasive, with low complication rates and high union success.</p>","PeriodicalId":94263,"journal":{"name":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","volume":"31 8","pages":"804-808"},"PeriodicalIF":1.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144818950","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}