Closed Reduction And Cannulated Screw Fixation For Pediatric Femoral Neck Fractures: A Case Series

Objective: Pediatric femoral neck fractures are uncommon injuries. Accurate early reduction and fixation is recommended to avoid serious long-term complications. The aim of this study was to analyze the clinical and radiological outcomes of 12 children with femoral neck fractures who were treated with closed reduction and cannulated screw fixation. Method: Between November 2015 and December 2019, 12 children (4 males,8 females) with an average age of 9.7 were operated by closed reduction and cannulated screw fixation for femoral neck fractures. We evaluated the medical records of all patients, including age, gender, injury mechanism, fracture type, initial displacement, postoperative reduction, follow-up roentgenograms and Ratliff’s scores. Results: The mean follow-up was 22.3 months (range 12–47 months). Six Delbett type 2, five Delbett type 3 and one Delbett type 4 fractures were operated with an avarage time to surgery of 12.5 (range: 1-75 hours). Satisfactory outcomes according to Ratliff’s criteria were obtained in 10 (%83.3) children. Coxa vara occurred in 2 cases. Any avascular necrosis was not seen during the follow-up period. Conclusion: Early closed reduction and cannulated screw fixation may be effective to avoid long-term complications in pediatric femoral neck fractures. Keywords: Femoral neck fracture, Pediatric, Closed reduction

History of Arthroscopy and Knee Surgery in Turkey

Arthroscopy is an innovative method used in the field of orthopedics to enter the joint by endoscopic method, to see, to take photos and to perform operations. Currently, arthroscopy functions in practice as diagnostic arthroscopy and arthroscopic surgery. The technological development and widespread use of arthroscopy, which is currently very advanced, has taken time. I tried to contribute to the initiation and development of arthroscopy studies in Turkey when I was working in Ege University Faculty of Medicine Orthopedics and Traumatology Clinic and in the “later period” of my professional life. Our aim is to briefly touch on the development of arthroscopy in the world and in Turkey from yesterday up to today, and also to share the information we have witnessed about arthroscopy in Turkey, emphasizing its importance especially in terms of patient and public health

Proximal Femur Metastasis Treatment With Fixation or Hip Replacement. Results of 47 Patients

Objective: Purpose of the present study was to compare patients with proximal femur metastasis with actual or impending fractures who were treated by fixation or prosthetic hip replacement. Method: Twenty-seven patients underwent fixation treatment (IM nail, DHS), and 20 patients prosthetic (endoprosthesis or total hip arthroplasty) replacement. Data were analyzed regarding patient demographics, cancer type, localization and type of metastasis, actual or impending fracture, number of bone metastasis, presence of spinal or visceral metastasis and treatment data (ASA class, length of hospital stay or surgery or survival, cement usage, adjuvant treatment, postoperative walking status). Results: Fixation group (63 years) was younger than prosthesis group (70 years) (p: 0.03). Fixation was more preferred at subtrochanteric area (p˂0.001). Cementation of the lesion was more preferred and surgery time was longer at fixation group (p: 0.01). Greater number of complications (mostly medical) were more likely to be seen in the fixation group (6 ‘1 loosening’ vs 3 ‘1 dislocation’). Conclusion: It is not still clear whether one implant is clearly superior to other one, however it was revealed again that nailing was mostly preferred for the subtrochanteric area and tended to have more complications although mostly medical and unrelated to implant placement as previously reported

Retrospective Analysis of Arthroscopic Cam Decompression. Is Hip Joint Still Preserved Although at Learning Curve?

INTRODUCTION: Hip arthroscopy is an effective treatment for femoroacetabular impingement (FAI). Purpose of the present study was to report the patient reported outcomes, hip survival retrospectively at a mean follow-up of five years. METHODS: Retrospectively collected data on 25 patients with FAI at minimum follow-up of 42 months (mean 60 months) treated with hip arthroscopy and labrum repair were analyzed. The primary outcome measures were the Hip Outcome Score (HOS) Activities of Daily Living (ADL) subscale, HOS-Sport subscale, Visual analog scale (VAS) for pain. Patient satisfaction was rated. Measurement of joint spaces and osteoarthritis (Tonnis) grading were done preoperatively and at the latest follow-up RESULTS: Pre- and postoperative mean alpha angles were 670±40 and 460±30. %76 of patients achieved minimal clinically important difference (MCID) for HOSADL and %56 of patients achieved MCID for HOSSS and all reached MCID for VAS pain score. Mean satisfaction level was 7.5±1.8 Mean preoperative Tonnis stage of the patients was 0.9±0.9 which increased to 1.1±0.8 (p: 0.046). Mean preoperative lateral joint space was 4.8±1 which decreased to 4.5±1 p<0.001. Mean middle joint space also decreased from 4.5±0.9 to 4.3±0.7 (p: 0.04). However this decrease was not statistically significant at joint space measured at foveal level (p˃0.05) (5±0.8 vs 4.9±0.7). DISCUSSION AND CONCLUSION: Mid-term results show that that after cam decompression, it is possible to say that hip joint is at least preserved and progression of hip osteoarthritis seems to be delayed. Patient functional results, pain scores are generally improved in line with the literature Keywords: hip arthroscopy, osteoarthritis, hip impingement

Coexistence of Hip Torsional Deformities in Patients With Lumbar Disc Herniation; A Case-Control Study

Objective: Coexistence of lumbar spine disorder with hip diseases is defined as Hip-Spine syndrome, there might be a relation between torsional deformities of the hip and lumbar disc disease. Purpose of the present study was to find whether hip torsional parameters (femur, acetabular anteversion) and clinical findings (hip range of motion, hip score) differ in patients with lumbar disc disease. Method: Patients with lomber disc herniation (n: 20) and control subjects (n: 20) without any lumbar spine or hip disease were enrolled in the study. Femoral anteversion (FeAv), acetabular anteversion (AA), center of edge angle (CE), degree of hip flexion, extension, Harris Hip scores (HHS) were evaluated bilaterally. Results: HHS score, degree of extension plus flexion was lower at diseased side when it is compared to the control subjects (p < 0.001). Unilaterally affected patients had lower AA than control subjects (AA: 13 ± 40 vs16 ± 20 p: 0.01). Conclusion: As there is a link between hip and spine disorders, present study aims to find whether there is a causal relation between hip torsional deviations and lumbar disc disease. Partially supporting the hypothesis, diseased side had lower degrees of acetabular anteversion compared to control subjects at unilaterally affected patients. Mechanical and /or hip torsional parameters especially the acetabular retroversion may have an etiopathogenetic role in unilateral lumbar disc disease.

The Biyography of Prof. Dr. Mehmet Tiner and His Contribution to the Turkish Orthopedic Surgery (Birth 12.08.1929 Guzelbahçe-Izmir - Died: 21 May 2003 Guzelbahçe-Izmir)

Prof. Dr. Mehmet Nurettin Tiner is one of Izmir’s first Orthopedics and Traumatology specialists and one of the values Izmir has grown. He worked at Aegean University Faculty of Medicine, Dr. Behçet Uz Children’s Hospital and Dokuz Eylul University Faculty of Medicine. Mehmet Tiner has served the society in the field of Orthopedics and Traumatology in Izmir throughout his professional life. He is one of the pioneers who have made significant contributions to the development of Orthopedics and Traumatology Department in Izmir and Turkey. Our aim is to review the life, works of Mehmet Tiner and introduce him to young generations. Mehmet Tiner born in Izmir on 12 August 1929 and he graduated from Guzelbahçe Kazim Paşa Primary School, Izmir Inönü High School (1947),Istanbul Faculty of Medicine (1957). He bacame Ortopedics and Traumatology Specialist in Aegean University in 1962. Mehmet Tiner became a Associate Professor in 1969 and a full Professor in 7 January 1975 at Aegean University Medical Faculty. He is one of the founding 12 courageous faculty members of Izmir Medical Faculty, which was affiliated to Aegean University and established on March 1, 1978. Izmir Faculty of Medicine took its place within the structure of Dokuz Eylul University, which was established on 20 July 1982. Prof. Dr. Mehmet Tiner is founder of DEUTF Orthopedics and Traumatology Department on March 1, 1978 and he contributed to the many medical doctors education and graduation also have contributed to the education of Orthopedics and Traumatology Specialist in Turkey, is one of our pioneering doctors. Prof. Dr. Mehmet Tiner is married to Mrs. Hilmiye Oya from İstanbul and his son Dr. Mustafa Tiner is an Orthopedics and Traumatology specialist like himself. Professor Mehmet Nurettin Tiner, who retired from Dokuz Eylul Universtiy Faculty of Medicine on August 12, 1996, passed away on May 21, 2003 in Guzelbahçe, İzmir.

Peroperative Complications and Postoperative Alignment Problems in Patients with Primary Total Hip Replacement

INTRODUCTION: The application of hip joint arthroplasty in hip joint degenerative diseases improves joint pain. The lower elastic modulus of titanium alloy prostheses in hip prostheses than stainless steel elastic modulus ensures higher bone "bone ingrowing" in titanium alloy prostheses. However, malaligment applications during surgery shorten the life of the prosthesis. The aim of this study is to investigate post-operative alignment and to examine perioperative complications in patients undergoing total hip prosthesis. METHODS: In this study, 122 patients who underwent total hip arthroplasty for degenerative hip joint disease and elderly collum femoris fractures between 2013-2017 were evaluated. Perioperative complications in total hip prostheses and early complications of prosthesis alignment in retrospective early follow-up. RESULTS: 78 of these patients were female, 44 of them were male, the mean age was 66 years (42-87), the mean follow-up period was 27 months (6-48). Intraoperatively, femoral calcar fractures developed in 2 patients while 1.5% femoral component was placed. Malaligment was placed at an average of 6 degrees (3-9 degrees) in 9% valgus position in 11 patients. Intraoperative blood loss was observed on average 855 ml (460-1250 ml) DISCUSSION AND CONCLUSION: The results of the implants produced in our country show similar clinical and radiological results with the results stated in the literature. It is considered to be advantageous in terms of both the contribution to the country's economy and the contribution to the patient's health and being easily available.

Development of Hip Surgery and Hip Preservation Surgery in Turkey Their Place in Orthopedics and Traumatology

Femoro-acetabular impingement and acetabular dysplasia are thought to relate to development of hip osteoarthritis. Decribed treatment modalities are reported to enhance functional results of the patients and prevent development of hip osteoarthritis at mid to longterm studies. At the present review, we tried to summarize the history of Turkish orthopedics and hip surgery and evolution of most recent treatment modality ‘hip arthroscopy’ both worlwide and at Turkey.