Objective: The aim of this study was to analyze the relationship between mortality and possible risk factors in elderly patients surgically treated with hemiarthroplasty for hip fracture and to determine mortality rates and yearly survival outcome in a selected cohort. Methods: A total of 92 patients (51 men (55.4%) and 41 women (44.6%); mean age: 76.47 years) who underwent hemiarthroplasty for hip fracture were included into the study. The following data associated with risk factors were recorded for 92 patients: age, gender, pre-fracture activities of daily living (ADL), type of fracture, American Society of Anesthesiologists (ASA) score, therapeutic procedure, type of anesthesia, length of time after fracture until operation, postoperative mobility, and duration of hospitalization. A multivariate logistic regression test was used to evaluate the correlation between the risk factors and first- and second-year mortality rates. Third-year mortality rate after surgery was analyzed and compared with the general mortality rate in a similar population of the same age group living in the same city. Results: The mortality rate was 18.5% (17 patients) after the first-year follow-up and 25% (23 patients) after the second year. The mortality risk after hip fracture was found to be 11.7 times greater than the similar age group population in the third year. In addition, there was a significant relationship between a low (dependent) preoperative ADL score, advanced age (>80 years), male gender, high ASA score and poor ability to walk (unable to walk), and first- and second-year mortalities (p0.05). Conclusion: Advanced age, male gender, a high ASA score, a dependent preoperative ADL score, and a postoperative inability to walk were determined to be the most important risk factors affecting mortality in elderly patients with hip fracture. The mortality risk was 11.7 times greater than that of a population with similar characteristics. Level of Evidence: Level IV, Therapeutic study Cite this article as: Aslan A, Atay T, Aydoğan NH. Risk factors for mortality and survival rates in elderly patients undergoing hemiarthroplasty for hip fracture. Acta Orthop Traumatol Turc 2020; 54(2): 138-43.

Diabetic foot is challenging progressive disease which requires multisystemic control. Neuropathy, arteriopathy, and cellular responses should treated collaboratively. Despite all medical advances, diabetic foot can highly resulted with amputation and also re‐amputation can be required because of failed wound healing. In this study, we aimed to investigate the relation between blood parameters and amputation events. Diabetic 323 patients include to the study who referred to orthopaedic clinic for amputation. Amputation levels (amputation levels phalanx, metatarsal, lisfranc, syme, below knee, knee‐disarticulation, above‐knee amputation) and re‐amputations recorded and compared with routine blood parameters. Re‐amputation was observed at 69 patients. The significant difference detected between lower albumin, higher HbA1c, higher CRP levels (P < 0.05) in regards to gross amputation levels, and increased wound depth. Furthermore, lower albumin levels and higher levels of WBC, HbA1c, CRP, and Creatinine were detected in re‐amputation levels. Especially, HbA1c, CRP, and Creatinine levels were found as upper bound of reference line for re‐amputation. The statistically optimal HbA1c cutoff point for diabetes was ≥7.05%, with a sensitivity of 86% and a specificity of 59%. In according to our results, simple blood parameters can be useful for observing the progress of amputation in diabetic foot. Particularly, lower albumin, and higher HbA1c, CRP, and Creatinine levels detected as related with poor prognosis. Besides, screening of HbA1c level seems to be highly sensitive for detecting of re‐amputation possibility.

The Q scores of scientific journals are an analytical tool that determines the ranking of journals based on their own scientific group and impact factor. It shows the rankings of the journal within its own group and it is a useful guide for researchers in the selection of the journal, however it should be used with caution in academic career advancement. Quartile scores may vary according to the scientific categories. The Q scores of a journal briefly show the 25% quantile resulting from quartered the number of journals in the area where the journal is placed. The first quartile has the top 25% of the journals and gets the Q1 score and the last quartile gets Q4 score. And so, the second 25% slice takes Q2 score and the third 25% slice takes Q3 score.

Osteopetrosis is a rare hereditary disease which is characterized by increased bone density. Bone resorption is insufficient or fails due to the osteoclast defect in osteopetrosis. Half of the patients are asymptomatic and diagnosed incidentally or based on the presence of fracture. Adult onset osteopetrosis usually presents with hip and proximal femoral fractures. Internal fixation can be performed; however, technical challenges may be experienced due to increased bone density. As in other fractures, nonunion or varus malunion of these fractures may occur. Although rare, osteopetrosis may complicate treatment of fractures in such patients. In this study, we aimed to present two new cases of ADO type II with an osteopetrotic femoral fracture along with the clinical and radiological findings in the light of a comprehensive literature review. Orthopaedics surgeons should be aware of intraoperative technical difficulties and possible postoperative complications during the follow-up period. Investigation would be beneficial for the diagnosis of osteopetrosis such the patient with fractures who has minor trauma history and increased bone density in radiography.

Objectives: We evaluated the efficacy of viscosupplementation with low- or high-molecular-weight hyaluronic acid (HA) preparations following arthroscopic debridement (AD) in patients with osteoarthritis of the knee.\r\nMethods: The study included 45 patients (19 men, 26 women; mean age 53 years; range 41 to 66 years) with Kellgren-Lawrence grade 2-3 osteoarthritis of the knee. Following AD, the patients were randomized to three groups to receive three intra-articular injections of 2 ml hylan G-F 20 (Synvisc, n=16), five intra-articular injections of 2 ml sodium hyaluronate (Hyalgan, n=14), and no injections (controls, n=15). Injections were administered at one-week intervals. All the patients were evaluated with pain, stiffness, and functional capacity scores of the WOMAC (Western Ontario and McMaster Universities) osteoarthritis index before and 6 and 12 months after AD. \r\nResults: Two patients and three patients complained of transient pain in Synvisc and Hyalgan groups, respectively. WOMAC scores showed significant decreases in all the groups at 6 and 12 months. There were no significant differences between the three groups with respect to improvement in WOMAC scores at 6 months. However, compared to the control group, differences between pre- and posttreatment scores at 12 months were significantly greater in the Synvisc (p=0.004) and Hyalgan (p=0.003) groups, with no significant difference between the two HA groups (p>0.05).\r\nConclusion: Our findings show that AD is beneficial in osteoarthritis of the knee in patients with appropriate indications, viscosupplementation increases the efficacy of treatment, and that low- and high-molecular-weight HA preparations have similar efficacy. Özet Amaç: Diz osteoartriti tanısıyla artroskopik debridman (AD) sonrasında düşük veya yüksek molekül ağırlıklı hiyalüronik asit (HA) enjeksiyonu uygulanan hastalarda viskosuplementasyonun etkinliği değerlendirildi.\r\nÇalışma planı: Çalışmaya, Kellgren-Lawrence ölçütlerine göre evre 2 veya 3 diz osteoartriti tanısı konan 45 hasta (19 erkek, 26 kadın; ort. yaş 53; dağılım 41-66) alındı. Hastalar AD sonrasında §rastgele üç gruba ayrıldı. Synvisc grubuna (n=16) 2 ml Hylan G-F 20 birer hafta arayla üç kez, Hyalgan grubuna (n=14) 2 ml sodyum hiyalüronat birer hafta arayla beş kez eklem içine uygulandı. Kontrol grubuna (n=15) ise enjeksiyon uygulaması yapılmadı. Tüm hastalar ameliyat öncesinde ve ameliyat sonrası 6. ve 12. aylarda ağrı, eklem sertliği ve fiziksel fonksiyon açısından WOMAC (Western Ontario and McMaster Universities) osteoartrit indeksi ile değerlendirildi. \r\nSonuçlar: Synvisc grubunda iki, Hyalgan grubunda üç hastada enjeksiyon sırasında geçici ağrı görüldü. Ameliyat öncesi ile karşılaştırıldığında, ameliyat sonrası 6. ay ve 12. ay WOMAC skorları tüm gruplarda düşüş gösterdi. Altıncı ayda WOMAC skorlarındaki düzelme açısından gruplar arasında fark saptanmazken, 12. ayda elde edilen düzelme farkı hem Synvisc hem de Hyalgan gruplarında kontrol grubuna göre anlamlı derecede fazlaydı (sırasıyla p=0.004 ve p=0.003); ancak, Synvisc ve Hyalgan grupları arasında bu açıdan fark yoktu (p>0.05).\r\nÇıkarımlar: Bulgularımız, gonartrozlu olgularda uygun endikasyonlarda AD’nin yararlı olduğunu, sonrasındaki viskosuplementasyon uygulaması ile tedavi etkinliğinin arttığını ve etkinlik açısından yüksek ve düşük molekül ağırlıklı HA preparatları arasında fark olmadığını göstermektedir.