Hayati Durmaz

Strength of different meniscus suturing techniques

Abstract We measured and compared the primary stabilities of five different meniscal suturing techniques. The techniques tested were horizontal mattress, vertical mattress, knot-end, vertical, and vertical loop. Twenty bovine medial menisci were cut to simulate peripheral longitudinal tears and repaired with one of the five suture techniques. Then the two parts of the meniscus were pulled using the Instron Tensometer until failure occurred. Knot-end techniques gave inferior results (mean ultimate failure strength 64 ± 5 N) compared with the other techniques. Vertical mattress failed at 130 ± 3 N, vertical loop at 128 ± 4.5 N, horizontal mattress at 98 ± 5 N and vertical suturing at 136 ± 2.7 N. This study shows the superior mechanical characteristic of the vertical suturing technique.

Tuberculosis tenosynovitis with multiple rice bodies of the flexor tendons in the wrist: A case report

Highlights • Therefore, although a rare diagnosis, tuberculosis of the tendon sheath should be kept in mind in developing countries. The reason is that the presentation and lab findings of tendon sheath tuberculosis are non-specific, making it hard to differentiate from other causes for this condition. For example a wrist tuberculosis may present with carpal tunnel symptoms. While MR sequences, especially T2, may give hints of tuberculosis, these can be easily misinterpreted as pigmented villonodular synovitis.• All these may cause a delay in diagnosis. In order to prevent any delay in diagnostic evaluation, all steps should be taken carefully.• Wide debridements to alleviate the symptoms of wrist tuberculosis is not enough a treatment. It is true that wide debridements quickly lessens the symptoms; however, the actual treatment of the condition is antituberculosis treatment directed at the causative organism. Antituberculosis medications are needed to decrease recurrence levels and avoid complications.

Concomitant rhomboid-shaped tibiae and fibulae, finger-like projections, and orthopedic management in a new variant of nievergelt syndrome: A case report

Highlights • The rare Nievergelt syndrome (NS) is the most severe form of mesomelic dysplasia and is characterized by disproportionate shortness of the limbs.• The primary phenotypic characteristics include a rhomboid-shaped tibia and overgrown fibula with bony protuberances and skin dimples.• These finger-like projections and concomitant rhomboid-shaped tibiae and fibulae should be kept in mind for the NS.• The limb lengthening and deformity corrections using an external fixator could be considered in the orthopedic treatment of the NS.• A preoperative evaluation of the vascular status could prevent several postoperative complications.

Conservative management equally effective to new suture anchor technique for acute mallet finger deformity: A prospective randomized clinical trial

Study Design: Prospective randomized controlled trial. Purpose of the Study: This study was designed to compare our new suture anchor technique with conservative management in acute Wehbe‐Schneider type I A‐B and II A‐B mallet fingers. Methods: Twenty nine patients who presented to our clinic between 2013 and 2015 were randomized for surgical or conservative treatment. Wehbe‐Schneider subtype C fractures were excluded. Fourteen were treated with surgery, and 15 were treated with conservative treatment. Primary outcomes were visual analog scale score, active distal interphalangeal (DIP) joint flexion, return to work, extension deficit and DIP joint degeneration. Follow‐up time was 12 months. Results: The mean visual analog scale was 2.0, and return to work was on average in 63.2 days in the surgical group and 1.47 and 53.7 days in the conservative group. Extension deficit was 8.1° in the surgical group and 6.1° in the conservative group. The mean DIP flexion at final follow‐up was 54.5° (40–65) in the surgery group and 58.3° (45–70) in the conservative group. DIP joint degeneration was observed with X‐rays in 4 patients in surgical group, and none of the patients in the conservative group had DIP degeneration at 1 year after treatment. Conclusions: The therapeutic effectiveness of suture anchor technique was not statistically different from conservative treatment. Subluxation seen after fixation treatment with suture anchors may be due to inadequate anchor fixation. DIP joint degeneration was seen significantly more in the surgical group. Our study suggests that the new suture anchor technique is not superior to conservative treatment. Level of Evidence: Ib.

Chronic acquired radial head dislocations associated with ulnar bowing in children. Report of three cases

The most common cause of chronic radial head dislocations is Monteggia lesions. Although acute, Monteggia fractures in children are easy to treat; complex reconstruction techniques may be required to reduce and stabilize chronic radial head dislocations. Early, accurate diagnosis and appropriate treatment remain the key factors for successful results in Monteggia or equivalent lesions in children.RésuméLa cause la plus commune des luxations chroniques de la tête radiale sont les lésions de Monteggia. Bien qu’il soit facile de traiter les fractures fraîches de Monteggia chez les enfants, des techniques complexes de reconstruction peuvent être exigées pour réduire et stabiliser des luxations chroniques de la tête radiale. Le diagnostic précoce et précis et le traitement approprié demeurent les facteurs principaux de succès dans les fractures de Monteggia ou dans les lésions équivalentes chez les enfants.