Background: Extensor carpi ulnaris tendinopathy (ECU) can be one cause of ulnar side wrist pain and it is more prominent in pronation-supination movements against resistance. In supination, flexion, and ulnar deviation within the ulnar groove, the tendon is tense and becomes predisposed to subluxation or dislocation. Snapping occurs during this dislocation and relocation. As a result of this friction between the tendon sheath and ulnar groove, tendinopathy and pain occur. ECU tendon is an important structure that contributes to the dynamic stability of wrist therefore resulting degeneration contributes disruption of distal radioulnar joint and causes wrist instability.Methods: Participants without active wrist complaints who presented to the outpatient clinic between 2019 and 2020 were included. Provocation test was performed and participants with snapping were evaluated with ultrasound to determine subluxation or dislocation. Participants asked to indicate approximately how much time they spent daily on the phone, computer and game console. The distribution of data was evaluated with the Kolmogorov-Smirnov test. Quantitative data that were not normally distributed were evaluated using the Mann-Whitney U test, and Student’s t-test was used for normally distributed data. The Chi-square test was used to compare categorical variables. For all tests,p < 0.05 was considered statistically significant.Results: Four hundred and fifteen women and 340 men were included in the study. Fifty of the 755 participants (6.6 %) had snapping. 22 of the 755 participants (2.9 %) had dislocation or subluxation on ultrasound. Three (13.6 %) participants had dislocation and 19 (%86.4) participants had subluxation on ultrasound. All 50 of the participants with snapping had significant repetitive trauma and sports activities. It was determined that 21 of the 22 participants who were found to have subluxation or dislocation by ultrasound had more than two hours of hobby activity and significantly more participants had more than two hours of activity compared to the group without subluxation or dislocation.Conclusions: This study with a large number of participants will contribute to the literature in terms of evaluating the contribution of technological devices, such as computers, smartphones, and consoles to chronic wrist pain and the prevalence of ECU snapping in the asymptomatic population.Trial registration: Date of Approval; 19.02.2019, Approval Number; 19-KAEK-045.

Background: The literature comparing open and arthroscopic repair of subscapularis tendon (ST) tears is insufficient. Purpose: To compare the clinical results of open versus arthroscopic repair of ST tears with or without concomitant supraspinatus tears. Study Design: Retrospective cohort study. Methods: We retrospectively evaluated 70 patients treated for isolated ST tears and ST tears with concomitant supraspinatus tendon tears at a single center between 2011 and 2019. Patients were divided into 2 groups: those who underwent open ST repairs (group O) and those with an arthroscopic ST repair (group A). Range of motion (ROM), liftoff and belly-press tests, and Constant-Murley (CM) scores were included in the pre- and postoperative functional evaluations. The minimal clinically important difference was calculated using the anchor-based method for changes in CM score. Tear size was evaluated according to the Lafosse classification. The categorical data were assessed using the Pearson chi-square, Fisher exact, and Fisher-Freeman-Halton tests. The parametric and nonparametric data were evaluated using the Student t test and Mann-Whitney U test, respectively. The dependent groups (for nonnormally distributed data) were evaluated using the Wilcoxon signed rank test. Results: Group O included 34 patients, and group A included 36 patients. The mean age was 62.9 years, and the mean follow-up period was 66.7 months. Even though group O exhibited a significantly better preoperative CM score (53.7 ± 4.6 vs 48.9 ± 6.8 [mean ± SD]; P = .001), group A had a significantly better postoperative CM score (88.7 ± 4.7 vs 84.6 ± 2.9; P < .001). Our measurements revealed a minimal clinically important difference of 11.5 points for the CM score. Group A had significantly greater postoperative ROM in abduction (153° vs 143.9°; P = .005) and forward elevation (159.1° vs 149.7°; P = .005), as well as significantly greater postoperative improvement in positive belly-press test results ( P = .028). Complications occurred in 4 patients in group O and in 1 patient in group A. Conclusion: The study findings indicated that arthroscopic ST repair was more advantageous than open repair in terms of ROM and functional outcomes.

Background and objectives: This study prospectively compares early results of Kinesio tape (KT) as an alternative method for the treatment of lateral epicondylitis with those of corticosteroid injection and the rest-and-medication group (RMG). Materials and methods: Among the fifty patients (53 elbows), KT was applied to 20 patients (21 elbows), and corticosteroid injection (CSI) was applied to 15 patients (17 elbows). Fifteen patients were included in the RMG. Patients in the RMG were informed about their condition, and necessary warnings were given. No oral or topical treatments were recommended. If needed, paracetamol or nonsteroidal anti-inflammatory drugs (NSAIDs) were prescribed. Patients were classified according to the Nirschl scores and evaluated with visual analog scale (VAS); Quick Disability of Arm, Shoulder and Hand (QDASH); and the Turkish version of the Patient Related Elbow Evaluation (PREE-T). Results: Improvements in all scores were statistically significant in all groups at the end of the second week. At the end of the fourth week, there was also a statistically significant improvement in all three groups, but these improvements were not as high as they were in the first 2 weeks. There was a slight deterioration in the functional scores in the RMG and CSI groups, while the improvement in the KT group continued. In the KT group, the average QDASH score was 18.1 (4.5–35), the VAS score was 2 (1–3), the VAS score in resisted wrist extension was 4 (2–5) and the Nirschl score was 2 (1–3) at the fourth week. The KT group had significant superiority in these parameters over the RMG (p = 0.035, p = 0.035, p = 0.029, p = 0.035, respectively). However, there was no significant difference between the KT, the RMG and the CSI groups at the fourth week. Conclusions: CSI, KT and rest-and-medication treatments were all effective in terms of pain reduction and functional scores at the end of week 2, and the only treatment that continued to be effective in the final week was KT.

Introduction Our aim was to evaluate different treatment methods including conservative treatment (CT), locking-plate osteosynthesis (OS) and hemiarthroplasty (HA) in three- and four-part humeral fractures in patients older than 50 years. Methods Forty-seven patients that have at least one year of follow-up were divided into three groups: 18 patients treated with OS, 14 patients treated conservatively and 15 patients treated with HA. For further evaluation, constant shoulder score, disabilities of the arm, shoulder and hand score (DASH), American Shoulder and Elbow Society (ASES) score had been used. Shoulder range of motion was also assessed. Results OS and CT groups had better scores than HA group. In OS group, average Constant score was 71.6 +/- 16.2, DASH score was 12.1 (5.2-24.2) and ASES score was 77.5 (50.8-96.6). In CT group, average Constant score was 69.6 +/- 19.2, DASH score was 16.4 (12.5-36.7) and ASES score was 76.6 (45.4-87.9). DASH scores (p = 0.032), Constant scores (p = 0.001), forward elevation (p < 0.001), abduction (p < 0.001), internal (p = 0.022) and external rotation (p = 0.048) were significantly improved in OS and CT groups than HA group. Conclusions HA should not be considered a priority in surgical planning in Neer three-part and four-part proximal humerus fractures. CT is superior for patients with additional morbidity and advanced age. But in patients who are younger and can tolerate the surgical procedure, the priority should he OS.

Objective: This study aimed to compare the medium- to long-term results of mosaicplasty and autologous matrix-induced chondrogenesis (AMIC) in treating osteochondral defects of the talus (OCD). Methods: Fifty patients treated for talus OCD were evaluated between 2010 and 2020. Patients were divided into 2 groups: patients who underwent mosaicplasty (Group I) and those who underwent AMIC (Group II). The OCD was graded according to the Berndt-Hardy and Hepple classification systems. The size of the OCD area, the number of osteochondral plugs, and the size of the collagen matrix were determined from the surgical data. The effects of patients aged below and above 45, defect areas smaller or larger than 1.5 cm2 , and gender on functional outcomes were analyzed in both groups. Range of motion (ROM), The American Orthopaedic Foot & Ankle Society score (AOFAS), the Freiburg ankle Index score (FAI), the Tegner activity scale, and the visual analog scale (VAS) were used for the functional evaluations. Results: Group I included 28 patients, and group II included 22 patients. The mean age was 41.6 years; the mean follow-up period was 69.9 months. In the final examination of the patients, both methods could provide significant improvement in all functional scores (P < .001). Although it was not statistically significant, group II had better functional values. The size of the defect area independently negatively affected the preoperative AOFAS (P=.001 and P=.011, respectively) and FAI (P=.001 and P=.008, respectively) scores. Besides that, age and gender did not affect the results (P > .05). Conclusion: Both methods can provide successful results; however, the AMIC method can achieve better results than mosaicplasty in similarly sized defects without causing additional morbidity. Cite this article as: Gedikbas M, Ozturk T, Asci M, Erpala F, Sobay U, Güneş T. Comparison of autologous matrix-induced chondrogenesis and mosaicplasty in the treatment of osteochondral defects of the talus. Acta Orthop Traumatol Turc., 2024;58(5):301-307.