Kaya Memisoglu

Treatment of fixed thoracolumbar kyphosis in immature achondroplastic patient: posterior column resection combined with segmental pedicle screw fixation and posterolateral fusion

A 13-year-old male achondroplastic dwarf with fixed thoracolumbar kyphosis was treated by segmental pedicle screw fixation, posterolateral fusion combined with one stage two level posterior column resection. Preoperative and postoperative kyphosis angles were 97 and 32°, respectively. Combination of segmental pedicle instrumentation with posterior column resection is a treatment option even in immature achondroplastic patients.

Tuberculous tenosynovitis of the anterior tibial and extensor hallucis longus tendons: case report.

In 1992, the World Health Organization estimated that one-third of the world’s population was infected with Mycobacterium tuberculosis.31 The incidence is highest in third world citizens of the Western Pacific region, Southeast Asia, and Africa. Even in the countries where tuberculosis is endemic, clinicians often miss the diagnosis of extrapulmonary tuberculosis. The purpose of this paper is to emphasize the importance of considering tuberculosis in the diagnosis of soft-tissue lesions of the foot.

Bone marrow edema seen in MRI of osteoarthritic knees is a microfracture.

We hypothesize that the bone marrow edema seen in MRI images of osteoarthritic joints are a result of microfractures. These microfractures caused intermittent pain of the osteoarthritis knees. Varus malalignment of the knee with osteoporosis leads loading on the medial compartment, and high pressure on the lateral compartment for valgus malalignment.

Chronic post-traumatic radial head dislocation associated with dissociation of distal radio-ulnar joint: a case report

We present an unusual case of an isolated interosseous membrane disruption of the forearm without any fracture pattern. Dislocation of both radial head and distal radio-ulnar joint was presented. Open reduction of the radial head with radial neck shortening osteotomy was performed.

A Minimally Invasive Technique for the Reduction of Calcaneal Fractures Using the Endobutton

Calcaneal fractures are very common injuries, and closed reduction-percutaneous pinning, open reduction-internal fixation, and primary arthrodesis are the procedures used in the surgical treatment of these injuries. The aim of surgical treatment is to restore the normal biomechanics of the Achilles tendon and rearfoot by anatomic reduction of the articular surfaces. Minimization of the soft tissue complications commonly associated with the open treatment of calcaneal fractures can be achieved using indirect closed reduction and Kirschner wire or screw-assisted minimally invasive percutaneous osteosynthesis methods. In the present report, we describe a technique for the treatment of calcaneal fractures associated with soft tissues that are at risk of complications and present the cases of 3 patients treated with indirect, minimally invasive reduction of comminuted calcaneal fractures with the Endobutton(®) fixation device. From our experience with this method, we believe it will be useful in cases of acute calcaneal fracture with pronounced soft tissue injury localized to the hindfoot.

Double imaging for the diagnostic work-up of alveolar soft part sarcoma with Tc-99m MIBI

The authors report a case of alveolar soft-part sarcoma with lung metastases demonstrated by “double imaging” with Tc-99m HDP and Tc-99m BIBI. The tumor originated in the soft tissue with direct invasion to the right scapula, which was hypoactive on bone scan and hyperactive on Tc-99m MIBI images. A focus of dense accumulation of Tc-99m MIBI in the lungs, suggesting metastasis was also demonstrated.

Arthroscopic fixation with intra-articular button for tibial intercondylar eminence fractures in skeletally immature patients.

The aim of this study was to describe our experiences with arthroscopy-guided intra-articular button fixation in the treatment of displaced tibial eminence fractures in skeletally immature children. Eleven adolescent patients with an average age of 12.2 years were treated arthroscopically between January 2005 and February 2007. At follow-up evaluation at 69 months, we did not find any instability. Only minimal differences were found in the functional outcomes (Lysholm and International Knee Documentation Committee scores: 95.7 and 94.3, respectively). None of the patients had a leg-length discrepancy defined at the time of the final follow-up. The advantages of this technique are as follows: (a) it is a simple and reliable arthroscopic technique with a direct view, (b) the fixation is stable, (c) there is no need to remove the implant, (d) minimal physeal interruption in a pediatric skeletally immature population, and (e) no additional arthroscopic portal.

Internal Splinting: A New Technique for Achilles Tendon Repair

Open surgical repairs of Achilles tendon ruptures may result in local wound healing problems. Various minimally invasive and percutaneous approaches have been defined to overcome this problem and they are being used with increasing frequency. We are describing a new technique called “internal splinting” that enables a strong repair and maintains the local healing tissue at the site of injury. We applied this technique to both mid-substance and distal Achilles tendon ruptures, and we combined the best features of both open and percutaneous techniques, including the use of larger diameter suture typically reserved for open tendon repair. We preserved the healing tissue, the paratenon, and the skin as in the percutaneous methods. We evaluated the first 24 patients and found that this technique is safe and the results are satisfactory.

An unusual presentation of brucellar septic arthritis involving the knee joint with extraarticular hardware: A case report

Brucellosis is a zoonotic infection with a wide spectrum of clinical presentations. We present a rare case of brucellosis with osteoarticular involvement complicated by a femoral intramedullary nail protruding the suprapatellar pouch. Although Brucella melitensis is a rare cause of brucellar septic arthritis, it should not be excluded from the list of suspected organisms in endemic areas for the disease.

The relation between botulinum toxin-A and fracture healing. comment on Hao et al.: short-term muscle atrophy caused by botulinum toxin-A local injection impairs fracture healing in the rat femur.

Dear Editors: We read with great interest the article by Hao et al. We congratulate them for their excellent study. Despite thousands of previous studies, fracture healing is one of the most interesting hallmarks at orthopedics. Fracture healing occurs as a result of complex cellular and biochemical processes in which the periosteum, surrounding soft tissues, and medulla play an active role in addition to bony tissue. Hao et al. aimed to investigate whether local muscle atrophy and dysfunction affect fracture healing in a rat femur fracture model by using Botulinum toxin-A (BTX-A). They concluded that; biomechanical testing indicated that the femurs of the BTX-A-treated side exhibited inferior mechanical properties compared with the control side. The inferior outcome following BTX-A injection, compared with saline injection, in terms of callus resistance may be the consequence of unexpected load and mechanical unsteadiness caused by muscle atrophy and dysfunction. In contrary to the current study Aydin et al. reported statistically significant increase in union, spongious bone formation, and bone marrow organization scores as well as elastic modulus value of BTX-A injected sides. They concluded that BTX-A administration increases the healing power in a relatively fixated fracture and decreases the callus diameter as if rigid fixation had been performed. The main difference between the studies of Hao et al. and Aydin et al. was the shape and the mechanism of the fracture. Aydin et al. aimed to protect the vessels and periosteoum by using standard closed fracture in all rats while Hao et al. performed open fracture (osteotomy). Do authors have any comment on the effect of vascularity and soft tissue damage as well as the continuity of periosteum on fracture healing in BTX-A injected side.