Rib anomalies are rare congenital anomalies that do not usually cause additional symptoms, can be seen together with some other developmental defects, and whose frequency varies according to ...ethnicity and age in the society. Congenital anomalies of the ribs include short rib, pseudoarthrosis of the first rib, intrathoracic rib, pelvic rib, cervical rib, forked rib, rib fusion, and rib bridging. In this study, the coexistence of the right cervical rib and the left rudimentary 1st thoracic rib was presented in a 56-year-old female case.
In this study, it was aimed to investigate the general distribution and characteristics of hydatid cyst (HC) cases in society by a single-center comprehensive study. Three thousand ninety consecutive ...patients who were followed up and treated for HC in our hospital between January 2001 and December 2020 were analyzed retrospectively. It was determined that HC was seen more in males than females (54.84% and 45.16%, respectively) in childhood and more in females than males in adulthood (59.89% and 40.11%, respectively,
P
< 0.001). Regarding the living areas, 82.01% of the cases were living in the rural area and 17.99% in the city center (
P
< 0.001). It was observed that the cases increased significantly in the second ten years (72.36%) compared to the first 10 years (27.64%) (
P
< 0.001). At least one of the liver or lungs was involved in 95.08% of the cases. The liver was involved in 80.23% of the cases (66.87% in children, 84.94% in adults,
P
< 0.001) and the lung in 22.91% (38.59% in children, 17.38% in adults,
P
< 0.001). Other regions’ involvement percentages were as follows: spleen 2.36%, musculoskeletal system 1.59%, kidneys 1.13%, intracranial region 0.91% (2.61% in children, 0.31% in adults,
P
< 0.001), omentum 0.91%, mediastinum 0.61%, cardiac region 0.58%, pelvic cavity 0.58%, diaphragm 0.55%, pancreas 0.13%, retroperitoneal area 0.13%, ovarian region 0.13%, uterine wall 0.06%, thyroid glands 0.03%, and nasal cavity 0.03%. HC ratio has increased in recent years. Liver involvement is more common in adults than children. Lung and intracranial involvement are more common in children than in adults.
Mortality rates after hip fractures increase by up to 30% with age. This study investigated the contribution of various parameters to prognosis and mortality.
Our study prospectively examined ...patients with hip fracture aged 65 years and over who applied to the Atatürk University Medical Faculty Hospital Orthopedics Service in 2020-2021.
The 120 patients included in the study had a mean age of 79.71±7.27 years, and 51.7% were female. Twenty patients (16.7%) died within the first 30 days after a hip fracture. They had a significantly lower median Lawton-Brody instrumental activities of daily living (IADL) scale score (p=0.045) and a higher rate of malnutrition according to the Mini Nutritional Assessment (MNA) score (p=0.016). Additionally, these patients with 30-day mortality had a significantly lower rate of surgical treatment (p=0.027) and a longer time from injury to surgery (p=0.014). The time to surgery was a significant independent risk factor for 30-day mortality, with each 1-hour delay increasing the odds of mortality by 1.066 (odds ratio OR=1.066; 95% confidence interval CI, 1.001-1.013; p=0.013). In addition, the presence of malnutrition was another independent risk factor that increased the odds of mortality by 4.166 times (OR=4.166; 95% CI, 1.285-13.427; p=0.017).
We recommend placing more importance on supportive treatment in patients presenting with hip fractures, especially in those with malnutrition; performing surgical intervention as early as possible; and more closely following up with patients with the aforementioned risk factors.
Purpose:
Computerized tomography (CT) imaging is increasingly being used to evaluate patients with ankle trauma. However, conventional CT (C CT) has a significantly higher radiation dose (RD) than ...plain radiography. This study aimed to evaluate the diagnostic accuracy and reliability of ultra-low-dose CT (ULDCT) protocol for ankle fractures.
Methods:
Ninety-eight consecutive patients who had ankle CT for suspected ankle fracture were included in our prospective study. C CT and ULDCT protocols were simultaneously performed on these 98 patients. Two observers independently evaluated ULDCT and C CT images. The effective RD of the ULDCT and C CT groups was calculated.
Results:
The interobserver agreement was 1 (perfect). ULDCT and C CT group images showed no significant difference in image quality. The effective RD of the ULDCT was significantly lower than the C CT (p < 0.001).
Conclusions:
By evaluating the results of this study, ULDCT proved to be a reliable diagnostic imaging method for fractures of the ankle. The satisfactory diagnostic image quality of the ULDCT protocol provides promising results.
Level of Evidence:
Level II/lesser quality RCT or prospective comparative study
Open reduction (OR) alone and OR plus Pemberton periacetabular osteotomy (PPO) techniques are commonly used in the treatment of developmental dysplasia of the hip at walking age. However, discussions ...on the timing of acetabular osteotomy are still ongoing. The aim of the present study was to compare the results of patients who underwent Ferguson OR (FOR group) and OR plus PPO group.
Between 2008 and 2017, we performed surgery on the hips, which we thought were used for closed reduction but could not be reduced as closed, or that the reduction was not stable. Patient follow-up was ≥12 months. The study included 75 hips of 57 patients of which 20 (26.7%) patients with FOR and 55 (73.3%) patients with PPO. Preoperative and postoperative acetabular indices (AIs), additional surgical intervention rates, and avascular necrosis (AVN) rates were compared. The Kalamchi-McEwen classification system was used to evaluate AVN.
The average age of the patients was 12.38 (9-14) months. The mean follow-up period was 38.95 (12-140) months. AVN developed in 21 (24%) hips (6 (8%) type 1, 13 (17.3%) type 2, and 2 (2.7%) type 3). AVN developed in 7 (35%) hips in the FOR group and 14 (25.5%) hips in the PPO group. No statistically significant difference was found between the two groups (p=0.416). Revision surgery was performed in 2 (3.7%) cases of the PPO group and 6 (31.5%) cases of the FOR group. Statistically, the PPO group had less revision surgery (p=0.004). The PPO group had an AI of 13.33° (5°-27°) that was significantly lower (p<0.001) than that of 27.98° (18.39°) of the FOR group.
Ferguson and Pemberton techniques are current and effective in the treatment of patients with developmental hip dysplasia at walking age. There was no significant difference between the two groups when examined from the point of view of AVN, but the results of PPO surgery were found to be better with respect to AI and revision surgery.
Infraclavicular brachial plexus nerve block is a commonly performed anesthesiology technique in the upper extremity. Local anesthetics may be administered at different temperatures for both neuraxial ...and peripheral nerve blocks. We aimed to evaluate the effects of the temperature of the local anesthetic at the time of administration on the onset and duration of sensory and motor blocks in infraclavicular brachial plexus nerve block.
A total of 80 patients undergoing elective upper extremity surgery were randomly assigned to one of the following groups using a computer-based randomization software; low temperature (4 °C) (Group L, n = 26), room temperature (25 °C) (Group R, n = 27) and warmed (37 °C) (Group W, n = 27). A 1:1 mixture of 2% lidocaine and 0.5% bupivacaine was used as local anesthetic. Infraclavicular brachial plexus nerve block was performed under ultrasound guidance in all patients preoperatively. The onset and duration of sensory and motor blocks were recorded.
Each group had different onset of motor (p < 0.001) and sensory (p < 0.001) blocks. The duration of motor block was similar between groups (p = 221). However, a significant difference was found in the duration of sensory block between group L (399.1 ± 40.8 min) and group R (379.6 ± 27.6 min) (p = 0.043). There was no complication related to nerve block procedure.
The administration of the local anesthetic at lower temperatures may prolong the onset of both motor and sensory blocks in infraclavicular brachial plexus nerve block.
Introduction:
Tibial slope angles (TSAs) have been identified as potential risk factors of anterior cruciate ligament (ACL) injury in the literature. A higher body mass index (BMI) might increase the ...risk of ACL tear because of greater axial compressive force. The aim of this study was to determine the relationship of these factors and the combined effect of BMI and TSA in determination of risk potential for ACL injury.
Methods:
The preoperative magnetic resonance (MR) images of 81 ACL-injured male knees and of 68 male individuals with no ACL injuries were evaluated by 2 radiologists to measure the TSA. The Mann-Whitney U-test was performed to indicate the significant difference in height, weight, and BMI values. The independent samples t-test was used to determine the differences between ACL-injured and non-injured groups regarding TSA values. Odds ratios were calculated by logistic regression tests, and receiver operating characteristics (ROC) curves revealed the area under the receiver operating characteristics curve (AUC) values to compare the relationships of these parameters with ACL injury.
Results:
Body mass index, lateral tibial slope (LTS), and medial tibial slope (MTS) were predictive of ACL risk injury. Body mass index alone had the greatest effect among these parameters, and there were no statistically significant differences in coronal tibial slope values between the ACL-ruptured and control groups. The greatest AUC was observed for the combination of BMI, MTS, and LTS.
Conclusions:
Body mass index, LTS, and MTS angles were associated with ACL injury risk and BMI + MTS + LTS together revealed the greatest effect on ACL injury.
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