Tuncay Baran

ASSOCIATED POSTERIOR PELVIC INJURY PATTERNS IN TRANSVERSE-ORIENTED ACETABULAR FRACTURE

ABSTRACT Objective: Our study analyzed the incidence of posterior pelvic injury patterns and their influence on the surgical treatment of transverse-oriented acetabular fractures . Methods: Fifty-one transverse-oriented acetabular fracture cases admitted between 1999 and 2013 were evaluated retrospectively. Comparative studies were performed for groups organized by acetabular fracture type, degree of sacroiliac separation, and postoperative reduction quality . Results: Associated posterior pelvic injuries were found in 34 (66.7%) of the 51 patients. There were 32 sacroiliac separations in the 34 patients with associated posterior pelvic injury, and ipsilateral sacroiliac separations were more frequent in this subgroup. Measurements guided by computerized tomography showed that 16 sacroiliac separations were ≤0.5 cm (mean=0.43±0.14 cm), 10 were 0.5-1 cm (mean=0.73±0.17 cm), and the remaining 6 were >1 cm (mean=1.55±0.15 cm). In the group of 34 patients with associated posterior pelvic injury, acetabular reduction was anatomic in 19 (55.9%) patients, imperfect in 10 (29.4%) patients, and poor in 5 (14.7%) patients. For isolated acetabular fractures, reduction rates were as follows: 12 (70.6%) anatomic, 3 (17.6%) imperfect, and 2 (11.8%) poor. The rate of anatomic reduction was significantly higher when sacroiliac separation was ≤0.5 cm (p=0.027) . Conclusion: Associated posterior pelvic injuries, especially ipsilateral sacroiliac joint separation, accompany most transverse-oriented acetabular fractures and may influence the quality of acetabular reduction. Level of Evidence III, Therapeutic Studies Investigating the Results of Treatment.

Vacuum-assisted closure for skin necrosis after revision total knee arthroplasty

Although skin necrosis following total knee arthroplasty or revision total knee arthroplasty is rare, it may cause severe complications. Skin changes begin with superficial infections and may result in removal of the prosthesis. Treatment of skin necrosis is an important factor, which determines the prognosis of the prosthesis. Several techniques have been defined for sufficient closure. In this article, we present the case of a patient who was treated for skin necrosis that developed after knee revision arthroplasty, using serial debridement, convergence sutures and an intermittent vacuum‐assisted closure device (KCI Inc., San Antonio, TX).

Treatment of calcaneal fractures with closed reduction and the Endobutton-assisted technique: short-term analysis.

BACKGROUND Closed reduction and percutaneous pinning, open reduction and internal fixation, and primary arthrodesis are procedures used in the surgical treatment of calcaneal fractures. This study presents short-term clinical and radiologic results of patients with calcaneal fractures treated by closed indirect reduction with Endobutton-assisted minimally invasive osteosynthesis. METHODS Twenty-one feet of 18 patients (four women and 14 men) with calcaneal fractures were retrospectively analyzed. Böhler and Gissane angles were measured from the preoperative, postoperative, and latest follow-up lateral radiographs of the feet. American Orthopaedic Foot and Ankle Society (AOFAS) scores were used for the 6-month and latest follow-up clinical assessments. RESULTS The mean preoperative Böhler angle of 17.1° was corrected to a mean of 20.4° postoperatively. The mean value of this angle measured at the time of latest follow-up was 21.3°. The mean preoperative and postoperative Gissane angles were 116° and 117.8°, respectively. The mean value of this angle measured at the time of latest follow-up was 117.4°. The mean 6-month postoperative AOFAS score was 59.8 points. The mean AOFAS score at the time of latest follow-up (79.1 points) was significantly higher than the mean score 6 months postoperatively (P < .001). Regarding the latest follow-up AOFAS scores, four were poor, four were moderate, ten were good, and three were excellent. CONCLUSIONS With a low learning curve and satisfactory clinical outcomes, this technique can be used in acute, edematous cases with soft-tissue injuries to avoid calcaneal enlargement, infection, and soft-tissue problems.

Alveolar Rhabdomyosarcoma of the Hand: A Very Rare Case of Soft Tissue Sarcoma

Ekstremitelerin yumusak doku sarkomlari cok nadir ve oldukca kotu bir prognoza sahiptir.Rabdomyosarkomlar yumusak doku sarkomu olup, eriskin yasta nadir olarak gorulurler, dahasiklikla cocukluk ve ergenlik donemi tumorleridir. Ekstremite tutulumu rabdomyosarkomlaricin alisilmadik bolgeler olup ve genellikle kotu sonuclarla iliskilidir. Sag kalim acisindan majorfaktor tumorun cerrahi olarak tamamen cikarilmasidir.Vakamiz 22 yasinda erkek bir hastanin sol elinde cikan primer alveolar rabdomyosarkomununinkomplet tumor eksizyonu sonrasinda 5. ray amputasyon ile tedavisini anlatilmaktadir. Hastanin ameliyat sonrasi 4 yillik takiplerinde tumor dokusu saptanmamistir