Background: This study aimed to assess important criteria, including osteoporosis, fracture type, implant position within the bone, fracture reduction, and radiographic union, in patients with intertrochanteric femoral fractures treated with proximal femoral nail (PFN) fixation and to show their effect on clinical outcomes. Methods: PFN fixation was applied in 73 patients (41 females, 32 males; mean age: 64.5 ± 6.2). The T score, fracture type according to the AO Foundation and Orthopedic Trauma Association (AO/OTA), implant-related complications (IRCs), Harris hip score (HHS), Jensen social function (JSF) score, and Parker-Palmer mobility score (PPMS), postoperative reduction classification, screw position according to the Cleveland zone, Radiographic Union Scale for the Hip (RUSH) score, and tip-apex distance (TAD) were recorded. Results: Most screws were in central-central (n = 42) and inferior-central (n = 11) positions. IRCs were seen mostly in cases of screws placed in peripheral zones (n = 10) and were not observed in almost any patient with a TAD ≤ 25 mm (n = 52) (p < 0.001). Most of the patients with acceptable or good fracture reduction did not have IRCs (n = 11 and 50, respectively) (p < 0.001). Half of type 3A1 (n = 13) and most type 3A2 (n = 20) fractures showed radiographic union at 3 months, and most type 3A3 (n = 9) fractures showed radiographic union at 5 months (p < 0.05). At 12 months, type 3A2 fractures had the highest HHS (79.2 ± 5.3) and PPMS (3.9 ± 1.5), while type 3A3 fractures had the lowest HHS (70.3 ± 4.6) and PPMS (0.6 ± 2.8) (p < 0.05). At 12 and 24 months, type 3A3 fractures had higher JSF scores (2.8 ± 0.4 and 3.5 ± 0.5, respectively); at 3 months, type 3A1 fractures had higher JSF scores (3.1 ± 0.3) (p < 0.05). The radiographic bone union time was prolonged in patients with a T score ≤ -2.5 standard deviation (SD) (p < 0.05). The HHS and PPMS increased while the RUSH score, considered as the radiographic union, was going towards the 4th month and decreased after the 4th month (p < 0.05). Conclusions: Considering the criteria (osteoporosis, fracture type, implant position within the bone, fracture reduction, and radiographic union) examined in this study, satisfactory results can be obtained with PFN fixation in the treatment of patients with intertrochanteric femoral fractures.

Purpose: To compare the correction angles determined by the Miniaci and Dugdale techniques in patients treated with medial open wedge high tibial osteotomy (MOWHTO) and show their impact on clinical outcomes.Methods: Seventy‐four patients constituted the study group. The correction angles in Group 1 were measured using the Miniaci technique, and those in Group 2 were measured using the Dugdale technique. The clinical evaluations included the Tinetti Gait and Balance Assessment (TGBA), the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) scores, and the Visual Analogue Scale (VAS). The effect of the correction angle on the patient's clinical outcomes was evaluated. Measurement techniques were also changed between groups for comparison.Results: Seventy‐four patients (62 females, 12 males) with a mean age of 53.7 ± 4.9 years were followed up for a mean of 67.4 ± 5.5 months. The TGBA, WOMAC, and VAS scores were improved at the last follow‐up compared to the preoperative scores (p < 0.05). The preoperative TGBA and WOMAC scores were not significantly different between the two groups, but the last follow‐up TGBA and WOMAC scores in Group 2 were worse than those in Group 1 (p < 0.05). When measuring techniques were changed, the preoperative correction angle (PCA) value and the last follow‐up correction angle (LFCA) value were lower in Group 1 measured with the Dugdale technique but higher in Group 2 measured with the Miniaci technique (p < 0.05).Conclusion: Since the correction angle values measured with the Miniaci technique in MOWHTO are higher than those measured with the Dugdale technique; the functional results are better.Level of evidence: Retrospective cohort study, III.

This study aims to collect data, which is a risk factor on bone fractures in children. The study group consisted of 1020 children (n=282; 28% girls and n=738; 72% boys, with a mean age of 8.3 years) with a bone fracture. The age, gender, the month and the time of the day the fracture was sustained, mechanism of injury, feature of the fracture, the presence of coexisting injuries, and the method of treatment were recorded. Boys had approximately three times more fractures than girls. The fractures were found to be more prevalent in upper extremities (76.6%) and on its left side (56.0%), and the most commonly fractured bone was isolated radius (n=304; 32.1%); most frequently distal radius). The most prevalent lower-extremity fractures were to the femur (n=92; 31.7%). It was found that fractures occurred most frequently between the ages 3 and 6 (23.6%), and fractures in boys were most common among 13 to 15-year-old patients (n=216; 23.9%), whereas girls aged 3–6 years suffered the most fractures (n=103; 30.8%). The fractures were more common in spring (n=384; 31.0%) and summer (n=365; 29.5%). The time slot bone fractures occurred the most was from 12:00 pm to 5:00 pm (n=824; 66.6%). The most common reasons for fractures were outdoor falls (n=705; 57.0%), and indoor falls (n=239; 19.3%), respectively. Bone fractures co-occurred with head trauma the most (n=30; 42.3%). Fifty-nine patients (5.8%) had epiphysis fracture. 51 patients (5.0%) had open fractures. Five hundred ninety-two patients (58.0%) were given outpatient treatment. Child bone fractures are most frequently seen in the left upper extremity in 10–15-year-old boys, occurring as a result of outdoor falls in the afternoon in the spring and summer months. Bones located in the wrist, hand, and elbow have been found to be much more vulnerable to fractures. Many of the fractures were treated by conservative methods. Creating a safe environment for children is the most effective method of injury control. Necessary arrangements should be made for the safety of children in the environment and at home. Continuing education and legal regulations play an active role in injury control.

Amaç: Osteoartrit (OA), 65 yaş üstü her 3 kişiden 1'ini etkileyen ve kadınlarda erkeklere göre daha sıklıkla görülen artritin en yaygın şeklidir. OA düşük dereceli bir inflamatuar hastalık olarak bilinmekte olup platelet indekslerinin hastalık tahmininde ve hastalık evresini belirlemede kullanılabilirliğini araştırmayı amaçladık. Materyal ve Metot: Çalışmamıza hastanemiz ortopedi polikliniğine başvuran 100 sağlıklı ve 174 OA tanısı alan toplam 274 birey dahil edilmiştir. Çalışmaya bireylerin yaş, cinsiyet, platelet indeks değerleri [platelet sayısı, mean platelet volüme (MPV), platelet dağılım genişliği (PDW) ve platelekrit (PCT)], en çok etkilenen diz veya kalça ekleminin Kellgren-Lawrence (KL) derecelendirmesi ve Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) skoru dahil edildi. Bulgular: KL derecelendirmesi arttıkça kadın hasta yüzdesi ve yaş ortalaması arttığı, platelet indekslerinden platelet sayısı ve MPV’nin KL derecelendirmesi arttıkça azaldığı bulunmuştur. Hastaların KL derecelendirmesine göre WOMAC skoru karşılaştırmasında ise KL derecelendirme derecesi arttıkça WOMAC skorunun da arttığı belirlenmiştir. Hasta ve kontrol grupları arasında platelet indexlerinin ROC curve analizinde ise eğri altında kalan alan (EAA) PLT, MPV, PCT, MPV/PLT, MPV/PDW, PDW/PCT, PDW/PLT değerleri için sırasıyla 0,654; 0,676; 0,546; 0,601; 0,607; 0,554 ve 0,621 şeklinde saptanmış ve cutt off değerleri ise youden indexi ile hesaplanmış olup sırasıyla platelet için 264,50; MPV için 8,35; PCT için 0,22; MPV/PLT için MPV/PLT için 0,033; MPV/PDW için 0,57 ve PDW/PLT için 0,05 olarak belirlenmişti. Sonuç: Düşük dereceli bir sistemik inflamasyon durumu olan OA' nın artmış platelet sayıları ve artmış MPV seviyeleri ile ilişkili olduğu ve OA grubunda hastalık derecesi ile platelet sayısı ve MPV ‘nin azaldığı bulunmuştur.

This study aimed to compare the effects of microfracture (MF) versus intra-articular hyaluronic acid (HA) + oral glucosamine and chondroitin sulfate (GC) in addition to MF in patients with osteoarthritic knees who underwent medial open wedge high tibial osteotomy (MOWHTO) after an average follow-up of five years. The study was designed retrospectively and included patients who underwent MOWHTO due to gonarthrosis, the MF method performed on these patients, and HA + GC treatments applied in addition to MF. Three groups consisting of 79 patients were formed: only HTO (Group 1), HTO + MF (Group 2), and HTO + MF + HA + GC (Group 3). The groups were compared using knee injury and osteoarthritis outcome score (KOOS), visual analog scale (VAS) for pain, and range of motion (ROM). The associations between the degree of correction and function and pain were evaluated. Additionally, the KOOS subparameters were compared between the groups. There were significant improvements in the postoperative KOOS and VAS scores in all three groups (p < 0.05). However, the ROM did not improve in Group 1. There was no significant difference in the postoperative KOOS, VAS, or ROM values ​​between Groups 2 and 3, but these values ​​were significantly better in Groups 2 and 3 than in Group 1 (p < 0.05). When the degree of correction increased, there were no significant positive changes in the postoperative KOOS or VAS score in Group 1, unlike in the other two groups (p < 0.05). In corrections of ≥ 10°, while there was no significant difference in the postoperative KOOS or VAS score ​​between Groups 2 and 3, these parameters significantly improved in these two groups compared to Group 1 (p < 0.05). Among the KOOS subparameters, pain and activities of daily living scores ​​were greater in Groups 2 and 3 than in Group 1 (p < 0.05). In MOWHTO, MF is a sufficient treatment method that improves the patient’s clinical condition without requiring additional treatments such as HA and GC. III, retrospective cohort study.