Mehmet Nuri Konya

Clinical and radiographic outcomes after femoral varus derotation osteotomy for Legg-Calvé-Perthes disease at 25 years follow-up: what are the determinants of outcome in the long term?

Objective The main purposes of the present study were to analyse the long-term clinical and radiographic results of femoral varus derotation osteotomy performed in a group of patients with the diagnosis of Legg-Calvé-Perthes (LCP) disease and to compare the effects of age, lateral pillar classification, radiographic stage according to Waldenströms classification, and the amount of varisation obtained on long-term results. Design The study group consisted of 21 hips. The mean postoperative follow-up time was 25.1 years. The effect of age at the time of surgery, preoperative lateral pillar classification, Waldenströms classification, and the amount of varisation on Merle dAubigne score, Stulberg class, and presence of degenerative arthritis of the hip joint were assessed at the final follow-up. Results Better clinical and radiographic outcomes were detected in patients operated younger than 10 years. The hips with lateral pillar group C involvement preoperatively were found to be significantly associated with worse clinical scores, worse radiographic outcome, and higher rate of degenerative arthritis. The overall rate of the hips with good radiologic outcome was 52.4%. 7 hips had degenerative arthritis at the final follow-up. Conclusions Femoral varus derotation osteotomy revealed a congruent joint in half of the operated hips and arthritis-free hip joint in 2/3 at 25 years follow-up. Age at the time of surgery and preoperative lateral pillar classification were the main determinants of the radiographic outcome whereas the factors significantly correlated with progression to degenerative arthritis were determined preoperative lateral pillar classification and Stulberg group at maturity.

A rare case of 3C disease: Ritscher-Schinzel syndrome presenting with recurrent talipes equinovarus.

Highlights • Talipes equinovarus can concurrently be seen with several diseases but it can rarely manifest as a component of any syndrome.• Ritscher–Schinzel syndrome, or cranio-cerebello-cardiac syndrome, is rarely seen and has autosomal recessive inheritance.• A comprehensive literature review did not show any reports about concurrent hip dysplasia and clubfoot with this Ritscher–Schinzel syndrome.• So we report this case to raise some awareness that persistent PEV, in some cases, could be a feature of this rare genetical disorder, Ritscher–Schinzel syndrome.

Open reduction and pinning for the treatment of Gartland extension type III supracondylar humeral fractures in children

In this study, we aim to evaluate the clinical and radiological results of children who were treated with four different surgical approaches. In our clinics between February 2004 and November 2012, the children who underwent surgical treatment for supracondylar humeral fractures and whose data were available with regular follow-up of at least 1xa0year were included in the study. Clinical outcomes were evaluated for 54 patients with Gartland type 3 extension supracondylar fractures. Functional and cosmetic results of the patients were determined according to the Flynn criteria. Mean age of the patients was 4.9 (between 2 and 14) among which 26 of them were girls and 28 were boys. Mean operation time was 45 (35–85) min. Average length of hospital stay (LHS) was 2.9 (1–7) days. Average duration of splints was 3.5 (2–6) weeks, while the average removal period of the wires was 4.6 (3–8) weeks. Mean consolidation time was 4.6xa0weeks (3–8). Mean follow-up was 14.36xa0months. In our study, we performed 54 patients functional and cosmetic results. While 48 of the patients had satisfying results (excellent, good, or fair), six of them had unsatisfactory (poor) results. The results of this study suggest that clinical results with surgical treatment of Gartland type 3 extension fractures were satisfactory. However, the delay in the surgical treatment may cause a number of complications.

The use of a proximal femoral nail as a hip prosthesis: A biomechanical analysis of a newly designed implant

Complication rates of hip fractures after proximal femoral nail are not rare. In such fractures, treatment invariably comprises the extraction of proximal femoral nail and the introduction of a different hip prosthesis. To solve this problem, we aimed to develop a new implant, the modular nail prosthesis, which combines an intramedullary nail with a hip prosthesis. The aim of this study was to determine the effect of stress load distribution on the stem using finite element analysis under laboratory conditions. For this, the shortest stem of 175u2009mm was chosen. In addition, six proximal femoral nail–hip prosthesis combinations were produced and tested with a biomechanical test device and passed 2300-N load bearing. According to the test results, our newly developed modular nail prosthesis can be converted to hip prosthesis securely.

A Rare Condition Presented with Small Hand: Silver Russell Syndrome [SRS] Case Report and Brief Literature Review

Silver-Russell syndrome [SRS] is a rare condition that etiology is not completely understood and characterized by phenotypic changes. The genetic causes of SRS are complex, often results from the abnormal regulation of certain genes that control growth. Research has focused on genes located in particular regions of chromosome 7 and chromosome 11. In the etiology, there can be deletion of the short arm of chromosome 18 and genetic disorders, such as Turner mosaicism [1,2]. Here, we aim to provide our patients admitted to our clinic with hand hypoplasia.

Post-traumatic Median Nerve Neuroma in Wrist. A Case Report and brief review of Literature

Introduction: Distal median nerve masses may be developed post-traumatic or non-traumatic. In this paper, we aim to present a 52 year old female case with a postraumatic neuroma of the median nerve in the left wrist. Case Series: A 52-year-old female patient had accidental incised wound over her left wrist which was primarily sutured. She presented 6 months later with unrelieved pain and growing swelling at the wrist. USG showed solid mass of size 2x3 cms. Intraoperatively the mass was seen to arise from medial nerve and careful excision was done protecting the nerve. At one year follow up the patient is relived of her symptoms with no sensorimotor deficit. Conclusion: Post traumatic neuroma present as unrelieved pain and progressive swelling. A high index of suspicion should be kept in cases of wound that are primarily sutured over an area with superficial nerves. Careful excision of the lesion is very effective in relieving patients symptoms