The Both Column Fixation Corridor (BCFC) and Both Column Screws (BCS) represent innovative concepts in orthopedic surgery, yet they have not been extensively studied in the literature. This study aims to validate the BCFC as a consistent fixation pathway across genders, evaluate its axial fluoroscopic visualization, and investigate gender-specific anatomical variations for surgical planning. In this study, pelvic CT data from 400 adults (200 males, 200 females) were analyzed using Fujifilm-Synapse 3D software. In the initial step, axial fluoroscopic visualization of the corridor was simulated, and the optimal antegrade entry point (OAEP) was identified. Subsequently, virtual placement of anterior and posterior screws (aBCS, pBCS) was performed radiologically within the corridor. Measurements included screw thickness (R), length (L), distances to the spina iliaca anterior superior (SIAS-aBCS, SIAS-pBCS), and the caudo-cranial (CCT) and centro-lateral (CLT) fluoroscopic tilts required for axial visualization of the BCFC and its OAEP. Fluoroscopic axial visualization of the BCFC and identification of the OAEP were successfully achieved in all models, enabling the placement of both anterior and posterior screws across genders. Measurements revealed the following average values for female and male pelvises, respectively: aBCS thicknesses were 6.5 ± 0.8 mm and 7.9 ± 0.9 mm (p < 0.001); lengths were 131.6 ± 8.8 mm and 146.8 ± 9.9 mm (p < 0.001); pBCS thicknesses were 6.5 ± 0.8 mm and 7.5 ± 0.7 mm (p < 0.001); lengths were 132.6 ± 9.7 mm and 148.3 ± 9.6 mm (p < 0.001); caudo-cranial tilts were 42.8°± 5.4 and 39.5°± 5.2 (p < 0.001); and centro-lateral tilts were 43.1°± 4.3 and 40.0°± 5.3 (p < 0.001). SIAS-pBCS distances were 38.5 ± 6.9 mm and 40.7 ± 7.5 mm (p = 0.003), while SIAS-aBCS distances were 29.7 ± 6.9 mm and 30.2 ± 6.7 mm (p = 0.467). All parameters, except for the SIAS-aBCS distance, exhibited statistically significant gender-specific differences. The Both Column Fixation Corridor is a universally valid and consistent osseous fixation pathway present in both genders. It is suitable for the placement of two screws in pelvic and acetabular surgery, with careful consideration of gender-specific anatomical differences to optimize its application.

Determining the optimal amputation level in diabetic foot (DF) and peripheral artery disease (PAD) patients is crucial for minimizing reamputation risk while preserving functionality. The Society for Vascular Surgery Wound, Ischemia, and Foot Infection (SVS WIfI) and International Working Group on Diabetic Foot (IWGDF) scoring systems are widely used for risk stratification, but their predictive value for reamputation remains unclear. The current study aimed to evaluate the predictive utility of these scoring systems for reamputation risk in patients undergoing amputations due to DF or PAD. A retrospective cohort study was conducted on 108 patients who underwent unilateral amputations due to DF or PAD between 2016 and 2021. Patients were categorized based on WIfI and IWGDF classifications, and clinical outcomes, including reamputation rates, ICU admissions, and mortality, were analyzed using logistic regression and post hoc analyses. Reamputation occurred in 41 (38%) patients. Higher WIfI (OR: 3.85, 95% CI: 2.10-7.05, P = .001) and severe IWGDF scores (OR: 3.25, 95% CI: 1.80-5.88, P = .008) significantly correlated with increased reamputation risk. Patients with high-risk scores also exhibited higher ICU admission ( P = .03) and mortality rates ( P = .01). Male gender (OR: 3.47, 95% CI: 1.45-8.31, P = .005), diabetes (OR: 2.32, 95% CI: 1.10-4.90, P = .027), and prolonged hospitalization (OR: 1.04, 95% CI: 1.01-1.08, P = .021) were independent predictors, while above-ankle amputations were protective for reamputation (OR: 0.22, 95% CI: 0.11-0.43, P < .001). Both scoring systems are effective in predicting reamputation risk, with WIfI providing a more comprehensive risk assessment. Combining these tools may enhance decision-making and improve patient outcomes in terms of reamputation prevention, hospital stay, ICU admission, and mortality.

Functional and Radiological Comparison and Evaluation of Gustilo-Anderson Type 3 Open Tibia Fractures Treated with an Ilizarov External Fixator - Medical Journal of Bakirkoy

Objectives: In this study, we describe a novel hemiepiphysiodesis technique to prevent implant-related perichondrial ring injury in a rabbit model. Materials and methods: Proximal tibial epiphyseal plates of a total of 16 white New Zealand rabbits were used for this animal model. The subjects were divided into three equal groups as follows: Group 1 (Kirschner wire [K-wire]/cerclage), Group 2 (8-plate) right-hind legs, Group 3 (Control) left hind legs. Using anteroposterior radiography, the medial slope angle (MSA), articular line-diaphyseal angle (ALDA), and the angle between screws of 8-plate in lateral X-ray tibial slope angle (TSA) were measured. The radiographs were taken early postoperative (Day 1) and on sacrification day (Week 8). The histological evaluation of the perichondrial ring was made on a 7-mm axial section that stained with Safranin O/fast green at X10 magnification. Results: In both K-wire and 8-plate groups, the early postoperative ALDA and TSA were greater than the sacrification ALDA and TSA (p=0.028 and p<0.001, respectively). The early postoperative MSA was lower than the sacrification MSA in groups, (p<0.001). The MSA in the control group was lower than the K-wire and 8-plate groups (p<0.001 and p=0.009; respectively). The perichondrial ring thickness of the K-wire group was greater than the 8-plate group in histological evaluation (p<0.001). Conclusion: Both of the K-wire and 8-plate groups showed similar angulation effects in the proximal tibia, although histologically less damage to the perichondrial ring was observed in the K-wire group, compared to the 8-plate group.