Korhan Ozkan

A biomechanical comparison of proximal femoral nails and locking proximal anatomic femoral plates in femoral fracture fixation A study on synthetic bones

Background: The incidence of fractures in the trochanteric area has risen with the increasing numbers of elderly people with osteoporosis. Although dynamic hip screw fixation is the gold standard for the treatment of stable intertrochanteric femur fractures, treatment of unstable intertrochanteric femur fractures still remains controversial. Intramedullary devices such as Gamma nail or proximal femoral nail and proximal anatomic femur plates are in use for the treatment of intertrochanteric femur fractures. There are still many investigations to find the optimal implant to treat these fractures with minimum complications. For this reason, we aimed to perform a biomechanical comparison of the proximal femoral nail and the locking proximal anatomic femoral plate in the treatment of unstable intertrochanteric fractures. Materials and Methods: Twenty synthetic, third generation human femur models, obtained for this purpose, were divided into two groups of 10 bones each. Femurs were provided as a standard representation of AO/Orthopedic Trauma Associationtype 31-A2 unstable fractures. Two types of implantations were inserted: the proximal femoral intramedullary nail in the first group and the locking anatomic femoral plate in the second group. Axial load was applied to the fracture models through the femoral head using a material testing machine, and the biomechanical properties of the implant types were compared. Result: Nail and plate models were locked distally at the same level. Axial steady load with a 5 mm/m velocity was applied through the mechanical axis of femur bone models. Axial loading in the proximal femoral intramedullary nail group was 1.78-fold greater compared to the plate group. All bones that had the plate applied were fractured in the portion containing the distal locking screw. Conclusion: The proximal femoral intramedullary nail provides more stability and allows for earlier weight bearing than the locking plate when used for the treatment of unstable intertrochanteric fractures of the femur. Clinicians should be cautious for early weight bearing with locking plate for unstable intertrochanteric femur fractures.

Mid-term radiological and clinical results of incomplete triple pelvic osteotomy

Objective The aim of this study was to assess clinical and radiological results of incomplete triple pelvic osteotomy in acetabular dysplasia. Patients and methods Twenty-six hips of 24 patients (5 males, 19 females) treated with incomplete triple pelvic osteotomy by a single surgeon from February 1995 to October 2001 were retrospectively reviewed at an average follow-up time of 12 years. The mean age at the time of surgery was 21.6 years (range: 14–41). Radiological evaluation was based on the central edge angle, acetabular angle, acetabular index, acetabular head index and lateralisation. Clinical and radiological scoring was performed using the Harris scoring system, Ömeroğlu scoring system and the Tönnis criteria for osteoarthritis. Results There was significant improvements in all of the radiological parameters with 88.5% good radiological results, 96.2% excellent clinical results, no significant progression to osteoarthritis and no need for conversion to total hip arthroplasty. The rate of major complication was 11%. Retroversion was seen in 15.4% of the hips. Conclusion Our results support the use of incomplete triple pelvic osteotomy as a safe choice in the treatment of acetabular dysplasia as it offers clinical and radiological benefits and contributes to the prevention of osteoarthritis. Level of evidence Level IV, therapeutic study.

Deep peroneal nerve palsy due to osteochondroma arising from fibular head and proximal lateral tibia

Highlights • Osteochondroma are the most common benign tumors.• Disease affecting knee joint in 94% of all cases.• Clinicians should be aware of the possible tumoral lesions in drop foot etiology.

Chronic granulomatous Aspergillus synovitis: a case report.

Aspergillus can cause invasive disease of various organs especially in patients with weakened immune systems. Aspergillus synovitis and arthritis are uncommon types of involvement due to this infection. Approaches to fungal osteoarticular infections are based on only case reports. This paper presents a rare case of chronic granulomatous Aspergillus synovitis in an immunocompromised 5-year old girl who was treated for acute lymphoblastic leukemia.

An Unusual Orthopaedic Disease: Sarcoidosis—A Case Report

Sarcoidosis is an idiopathic, noncaseating granulomatous disorder with wide systemic involvement. It is encountered widely around the world and it affects both sexes, all the races in all age groups. Lungs, eyes, and skin are the organs most commonly affected. Constitutional features such as weight loss, fatigue, and myalgia are the most common symptoms. Bone involvement, which is very rare, was reported as present in 3 to 13% of effected cases, and it is most commonly seen in hands and feet, compared with long bone involvement, which is extremely rare. We hereby present a case with a diagnosis of sarcoidosis and multiple bone involvement emphasizing the importance of differential diagnosis.

Bilateral Idiopathic Carpal Tunnel Syndrome in a 4-Year-Old Girl.

Carpal tunnel syndrome (CTS), the most common entrapment neuropathy in adulthood, is rare in childhood. The symptoms may differ to those in adults, or may be misinterpreted owing to children’s difficulties in expressing themselves. Cases of idiopathic, bilateral CTS under the age of 5 are rare. A 4-year-old girl presented with pain in both hands and difficulty opening them in the morning. Bilateral severe CTS was determined at electroneuromyography (ENMG). Bilateral wrist splints were advised for both hands. Improvement in ENMG was seen at 2 weeks following conservative treatment.

Rare case of sacral mass due to chondromyxoid fibroma.

Chondromyxoid fibroma is a rare benign tumour derived from cartilage and generally seen in the metaphyseal region of long bones. It is rarely seen in the axial skeleton.1–3 Fibroma, aneurysmal bone cyst, chondroblastoma and fibrous dysplasia must be evaluated in the radiographic differential diagnosis of chondromyxoid fibroma. Being an eccentric metaphyseal location, showing sharp, sclerotic, scalloped margins and matrix calcification are its major radiographic features. In pathological evaluation, the tumour …