İnsanlığın tarihi kadar eski olan el sanatları geleneği, insanoğlunun ihtiyaçları doğrultusunda giderek zenginleşmiştir. Meslek sahibi insanlar, farklı zamanlarda el emeği ürünler ortaya koymuşlar ve ...zaruri ihtiyaçların giderilmesini sağlamışlardır. Fakat günümüzde meydana gelen gelişim ve bunun beraberinde ortaya çıkan değişim, toplumların kültürüne de yansımıştır. Özellikle değişen teknoloji, yaşam biçimleri ve ihtiyaçlar söz konusu mesleklerin geleceğini de etkilemiştir. Bu etki ise geleneksel meslekler açısından iyi yönde olmamıştır. Geleneksel kültürün bir parçası olan el sanatları, değişimin de etkisiyle günümüzde işlevini yitirmeye başlamıştır. El sanatlarına duyulan ihtiyaç giderek azalmış, hazır ürüne rağbet artmıştır. Bu alanlarda çalışacak eleman bulunamamaya başlamıştır. Dolayısıyla eski ustaların sahip olduğu meslekî bilgi ve tecrübe yeni kuşaklara aktarılamamıştır. Bu nedenle de el sanatlarıyla uğraşacak çıraklar yetiştirilememiştir. En nihayetinde ilgili mesleklerin unutulup gitmesi durumu ortaya çıkmıştır.
Bu çalışmada, kökleri çok eskilere giden ve sosyal, kültürel ve ekonomik açıdan önem taşıyan geleneksel mesleklerden semerciliğin tarihi seyri Muğla şehri özelinde incelenmiştir. Nitekim Muğla, tarihî Arasta’sı, Yağcılar Hanı, Saburhane Semti, Saatli Kule’si ile geleneksel olanı muhafaza etme gayretinde olan bir şehirdir. Geleneksel kent dokusu izlerinin günümüzde de yaşatılmaya çalışıldığı bir yerleşim yeri olma özelliğini taşımaktadır. Aynı zamanda, el sanatları alanında da önemli bir potansiyele sahiptir. Arşiv belgeleri ve diğer yazılı kaynaklardan hareketle bu el sanatlarına dair bilgilere ulaşılabilmektedir. Ayrıca sözlü tarih yöntemi de kullanılarak birtakım bilgiler elde edilebilmektedir. Nitekim Muğla şehir merkezinde semercilik mesleğini icra etmiş olan son ustaların yanında çalışmış iki kaynak kişi tespit edilerek onların bilgilerinden istifade edilmiştir. En nihayetinde, Muğla şehir merkezinde unutulmuş geleneksel bir meslek olan semerciliğe dair yazılı kaynaklardan ve mesleği icra edenlerin gözlemlerinden, deneyimlerinden yararlanılması yoluyla kültürel mirasa dikkat çekmek ve daha sonra bu alanda yapılacak çalışmalara referans oluşturmak hedeflenmiştir.
The tradition of handicrafts, which is as old as the history of humanity, has gradually become richer in line with the needs of human beings. Professional people produced handmade products at different times and ensured that essential needs were met. However, today's development and the accompanying change have also been reflected in the culture of societies. Especially changing technology, lifestyles and needs have also affected the future of these professions. This effect was not good for traditional professions. Handicrafts, which are a part of traditional culture, have begun to lose their function with the effect of change. The need for handicrafts has gradually decreased, and the demand for ready-made products has increased. The shortage of personnel to work in these areas has begun. Therefore, the professional knowledge and experience of the old masters could not be transferred to the new generations. For this reason, apprentices to deal with handicrafts could not be trained. Eventually, the situation of forgetting related professions has emerged.
In this study, the historical course of saddle making, which is one of the traditional professions that has very old roots and is important in terms of social, cultural and economic aspects, has been examined in the city of Muğla. As a matter of fact, Muğla is a city that strives to preserve the traditional with its historical Arasta, Yağcılar Han, Saburhane District and Saatli Kule. It has the characteristic of being a settlement where traces of traditional urban texture are tried to be kept alive today. At the same time, it has an important potential in the field of handicrafts. Based on archival documents and other written sources, information about these handicrafts can be reached. In addition, some information can be obtained by using the oral history method. As a matter of fact, two source people who worked with the last masters who have practiced the saddlebag business in the city center of Muğla have been identified and their knowledge has been benefited from. Ultimately, it is aimed to draw attention to the cultural heritage by benefiting from the written sources about saddle-making, a forgotten traditional profession in the city center of Muğla, and from the observations and experiences of those who practice the profession, and to create a reference for the studies to be done in this field later on.
Little is known of the scale of avoidable injuries presenting to medical services on a national level in the UK. This study aimed to assess the type and incidence of preventable wrist and hand ...injuries (as defined by the core research team) at a national level in the UK. 28 UK hospitals undertook a service evaluation of all hand trauma cases presenting to their units over a 2 week period in early 2021 identifying demographical and aetiological information about injuries sustained. 1909 patients were included (184 children) with a median age of 40 (IQR 25-59) years. The commonest five types of injury were fractures of the wrist; single phalangeal or metacarpal fractures; fingertip injuries; and infection, with the most common mechanisms being mechanical falls and manual labour. This is the first extensive survey of preventable hand injuries in the UK, identifying a need for further work into prevention to reduce healthcare burden and cost. 50% of injuries presenting to hand surgeons are preventable, with the most common injuries being single fractures of the wrist, phalanx and metacarpal. Few preventable injuries were related to alcohol or narcotic intoxication. Further research is needed to identify how to initiate injury prevention measures for hand injuries, particularly focussed towards hand fracture prevention.
The treatment of the extremely uncommon avascular necrosis of the capitate with a medial femoral condyle corticocancellous free flap has been described previously by one group reporting on outcomes ...in a paediatric patient. However, no literature to-date has detailed results of this procedure in an adult. We illustrate the case of a 53-year-old man who sustained capitate avascular necrosis and tendon rupture of traumatic aetiology. He was managed by resection of the necrotic segment, followed by inset of the medial femoral condyle free flap with the novel applications of indocyanine green to ensure adequate perfusion and intramedullary cannulated screw fixation of the capitate. Tendon transfer was also performed in the same operative sitting. At 9 months postoperatively, the patient displayed full range of motion of the wrist without any pain, and the imaging demonstrated union. This microsurgical approach may be performed in adult patients with favourable postoperative outcomes.
Abstract
Background
End-stage wrist arthritis has traditionally been treated with a total wrist fusion. There is a recent trend toward motion preserving surgery in the form of total wrist ...replacement.
Questions
Is there a functional benefit to performing a total wrist replacement instead of a total wrist fusion in patients with end-stage wrist arthritis? Is there any difference in secondary outcome measures including pain, grip strength, and range of motion? Does the risk of adverse events and treatment failure differ between the two techniques?
Methods
A systematic literature search was performed to identify studies reporting either total wrist arthrodesis or arthroplasty for end-stage wrist arthritis. Studies were systematically screened and assessed for risk of bias and quality. Data were extracted and reviewed.
Results
A total of 43 studies were included in the review: 17 on arthrodesis, 24 on arthroplasty, and 2 matched cohort studies. This represented 669 index arthrodesis operations in 603 patients, and 1,371 index arthroplasty operations in 1,295 patients. A significant improvement in functional outcome was seen with both interventions. Similar improvements were seen in pain scores, and modest improvements were seen in grip strength. Range of motion following arthroplasty improved to a functional level in two studies. Complication rates were higher after arthroplasty (range: 0.2–9.5%) than those after arthrodesis (range: 0.1–6.1%;
p
= 0.06). Fourth-generation implants (range 0.1–2.9%) performed better than earlier designs (range: 0.2–8.1%;
p
= 0.002). Implant revision rates ranged from 3.5 to 52.6%. Fourth-generation prostheses survival rates were 78% at 15 years (Universal 2), 86% at 10 years (Motec), 90% at 9 years (Re-Motion), and 95% at 8 years (Maestro).
Conclusion
The newer fourth-generation wrist implants appear to be performing better than earlier designs. Both wrist arthrodesis and wrist arthroplasty improve function, pain, and grip strength. The risk of complication following wrist replacements is higher than that after total wrist arthrodesis.
Abstract This case report describes the successful use of a novel “conservative hip replacement” in conditions precluding the use of a standard total hip arthroplasty in a 70-year-old man. The ...femoral canal was occluded because of previous surgery for a bone tumor in the subtrochanteric region. The patient continues to do well at 4 years with minimal discomfort. At this interval, the Oxford Hip Score was 35. This conservative hip replacement has been developed to preserve bone stock and produce more physiologic loading of the proximal femur. Its design has been produced, using plain radiographs and computed tomography, to maximize “fit and fill” of the femur. The neck supports standard modular heads, allowing the use of any bearing surface. The prosthesis has been rigorously laboratory tested.
Abstract Objectives The aim of this study was to assess the impact on practice of vena cava filter insertion guidelines (Eastern Association for the Surgery of Trauma: practice management ...guidelines). Design The study was performed at a level 1 trauma centre with data from the ‘Trauma Audit and Research Network’ cross-referenced to hospital data. Results A total of 1138 specific ‘high-risk’ major trauma patients were identified over a 6-year period. The mean age was 46 years (18–102) and the male to female ratio was 3.3:1. The average Injury Severity Score was 23.6 (4–75). The overall DVT rate was 2.6% and the PE rate was 1.8%. A retrievable IVC filter was inserted in 42 cases (3.8%). The filter retrieval rate was 23.8% at a mean of 68.5 days (4–107). Only one complication was reported of a breakthrough PE despite filter. Applying the EAST guidelines to this cohort would have suggested filter insertion in 279 (24.6%) cases. The kappa concordance value between observed practice and the ‘EAST filter group’ was 0.103 (poor). The PE rate in the ‘EAST filter group’ was 2.2% vs 1.6% in the ‘no filter group’ (p = 0.601, no statistical difference) and the observed odds ratio was 0.814 (95% CI 0.413, 1.602). Conclusion The EAST guidelines are useful but may be overestimating the need for filter insertion.
Purpose
This study assesses whether sterile surgical helmet systems (SSHS) provide surgeons with additional protection from aerosol pathogens alongside their traditional role protecting against ...splash. There has been debate on whether to use such systems in reopening elective orthopaedic surgery during the current COVID-19 pandemic environment.
Methods
Thirty-five participants were enrolled in a double-blinded randomised controlled study investigating efficacy of the Stryker Flyte Surgical Helmet (Stryker Corporation, Kalamazoo, MI, USA) as protection against respiratory droplets. Wearing the SSHS in a fit testing hood, subjects were randomised to nebulised saccharin solution or placebo. Twenty were allocated to the saccharin group with 15 to placebo. Positive sweet taste represented a failure of the test. Taste tests were performed with the helmet fan turned on and off.
Results
SSHS did not prevent saccharin taste (
p
< 0.0001). Within the saccharin cohort, 40% recorded a positive taste with the fan on and 100% with the fan off. There was a statistically significant difference in mean time-to-taste saccharin (
p
= 0.049) comparing fan on (123.5 s) vs. off (62.6 s).
Conclusions
SSHS do not protect against aerosol particulate and therefore are not efficacious in protection against COVID-19. The fan system employed may even increase risk to the surgeon by drawing in particulates as well as delay recognition of intraoperative cues, such as exhaust from diathermy, that point to respirator mask leak.
This study assesses the efficacy of distal periarterial sympathectomy in treating chronic digital ischemia by evaluating clinical outcomes of surgery.
A systematic literature review of distal ...sympathectomy for chronic digital ischemia was conducted. Data extracted included study design, patient statistics, aetiology, follow-up duration, sympathectomy level, and surgical outcomes.
21 studies were analysed, containing a total of 337 patients, 324 hands, and 398 digits. Patient age ranged from 23.2 to 56.6 years. Causes of ischemia included Scleroderma, Raynaud's disease, atherosclerosis/Buerger's disease, systemic lupus erythematosus/discoid lupus, undifferentiated rheumatic disorder/mixed connective tissue disease, CREST syndrome, trauma and unknown diagnoses. Common digital artery sympathectomy was mostly performed. Follow-up spanned 12-120 months.
Distal sympathectomy led to reduced pain in 94.7 % patients. Complete resolution of ulceration was seen in 73 % patients. Subsequent amputation was required in 28 % patients. Other complications were reported in 24.1 % patients.
This study indicates that distal periarterial sympathectomy may effectively treat chronic digital ischemia, offering pain relief and resolution of digital ulceration. However, risks of complications and amputation persist. Further research is required to inform patient selection and establish the optimal technique and extent of distal sympathectomy surgery, before it can be considered a valid treatment option.
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