Background and Objectives: The aim of this study was to investigate the relationship between the position of the humeral head relative to the glenoid and the occurrence of iatrogenic surgical neck fractures of the humerus during anterior glenohumeral dislocation reductions. Materials and Methods: Patients with first-time anterior shoulder dislocations without generalized joint hyperlaxity were included. The humeral head displacement ratio was calculated as the distance between the medial border of the humeral head and the anterior glenoid rim divided by the diameter of the humeral head. Demographic data, concomitant tuberculum majus fractures, and the deltoid tuberosity index were recorded. Patients were divided into three groups: Group 1 (iatrogenic fracture development during closed reduction (CR)), Group 2 (failed CR), and Group 3 (successful reduction without iatrogenic fracture). Complicated dislocations were included in Groups 1 and 2, while uncomplicated dislocations were those in Group 3. Results: The study included 89 patients with a mean age of 46.44 ± 19.02 years (64 males, 25 females). Concomitant tuberculum majus fractures occurred in 37 (41.6%) cases. Iatrogenic surgical neck fractures occurred in 10 patients (Group 1), and CR was unsuccessful in 8 patients (Group 2), totaling 18 cases of complicated dislocations. Reduction without iatrogenic fracture was achieved in 71 cases (Group 3). The mean humeral head displacement ratio was higher in the complex dislocation group (92.91 ± 15.34 vs. 75.01 ± 13.80; p < 0.001). Complicated dislocations were more frequent in patients with tuberculum majus fractures (p = 0.031). Subgroup analysis showed higher humeral head displacement ratios in Groups 1 and 2 compared to Group 3 (p = 0.010 and p = 0.06, respectively). Tuberculum majus fractures were more frequent in Group 1 compared to Group 3 (p = 0.013), with no significant difference between Groups 2 and 3. Conclusions: In patients experiencing first-time traumatic anterior shoulder dislocations, a greater medial displacement of the humeral head relative to the glenoid rim significantly increases the risk of iatrogenic humeral fractures and the likelihood of unsuccessful closed reduction attempts.

Pediatric supracondylar humerus fractures (SCHFs) are among the most common childhood injuries, often requiring surgical fixation. Closed reduction with pe

Background/Objectives: Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy and various surgical techniques are used for its treatment. Extended open carpal tunnel release (EOCTR) has been proposed for improved nerve decompression. This study compares the clinical and functional outcomes of open carpal tunnel release (OCTR) and EOCTR in severe CTS, hypothesizing superior functional outcomes and lower pain levels with EOCTR. Methods: This retrospective study included 53 patients (45 females, 8 males) with severe CTS confirmed by electromyography. Patients underwent either OCTR (n = 28) or EOCTR (n = 25) between January 2020 and February 2023. The EOCTR techinque involved additional neurolysis of the recurrent motor branch and palmar cutaneous branch of the median nerve. Functional outcomes were assessed using the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire, the Boston Carpal Tunnel Syndrome Questionnaire (BCTQ), the Visual Analog Scale (VAS) for pain, and hand strength measurements. Complications and recovery parameters were also analyzed. Results: EOCTR resulted in significantly lower postoperative VAS scores (3.31 vs. 3.78, p < 0.001), DASH scores (16.54 vs. 20.68, p < 0.001), and BCTQ symptom scores (1.87 vs. 2.01, p < 0.001). No significant differences were found in grip strength (p = 0.52) or pinch strength (tip-to-tip: p = 0.54, lateral: p = 0.061, 3-point: p = 0.17). No major complications occurred, and pillar pain was similar in both groups (p = 0.82), resolving with conservative treatment. Conclusions: EOCTR with additional palmar cutaneous branch of the median nerve neurolysis may provide better short-term functional outcomes and lower pain levels compared to OCTR in severe CTS. Further prospective studies are needed to validate the long-term benefits and safety of this surgical approach.

OBJECTIVE: The aim of this study was to evaluate the effect of concomitant Lafosse Type II subscapularis (SSC) tears on the clinical and functional outcomes in patients with medium-sized supraspinatus (SS) tears.MATERIAL AND METHODS: Between January 1, 2023, and January 1, 2025, a total of 41 patients (20 females and 21 males) who underwent arthroscopic rotator cuff repair and met the inclusion criteria were retrospectively reviewed. The SSC (+) group included patients with Lafosse Type II SSC tears who underwent repair, whereas the SSC (–) group included patients with arthroscopically confirmed intact SSC tendons. All patients were evaluated preoperatively and at the final follow-up using the Visual Analog Scale (VAS), American Shoulder and Elbow Surgeons (ASES) score, Disabilities of the Arm, Shoulder and Hand (DASH) score, and Subjective Shoulder Value (SSV).RESULTS: The mean age of the patients was 55.65 ± 9.35 years, with the mean follow-up of 13.05 ± 4.74 months. The right shoulder was most commonly affected (70.7%), and 80.5% of tears occurred on the dominant side. There were no significant differences between the groups in terms of preoperative VAS, ASES, DASH, and SSV scores (p=0.883, p=0.547, p=0.799, p=0.718). Postoperatively, both groups demonstrated significant improvement in all clinical scores, but no statistically significant differences were observed between the SSC (+) and SSC (–) groups (p=0.211, p=0.076, p=0.327, p=0.072). No cases of pseudo paralysis were observed preoperatively, and no severe motion loss leading to functional restriction was seen during postoperative follow-up.CONCLUSIONS: In medium-sized SS tears accompanied by Lafosse Type II SSC tear, short-term clinical and functional outcomes after repair are similar to the outcomes in patients with isolated SS tears.

Aim: Videos related to avascular necrosis of the femoral head are no exception, and so the aim of this study is to evaluate the educational quality of YouTube videos on this topic. Material and Method: A standardized video search was performed on YouTube using the terms “avascular necrosis of the hip”, “osteonecrosis of the hip” and “avascular necrosis of the femoral head”. The top 50 videos were then analyzed, and the characteristics and content of the videos were recorded. The Journal of American Medical Association criteria, The DISCERN score, The Global Quality Score and the new YouTube ‘Avascular Necrosis of the Femoral Head Score” were all used to assess the reliability and accuracy of the videos. Results: The median video duration of the 50 videos was 10.85±19.17 minutes. The median number of views was 10,866 (range 221 to 278,174). According to the video content, 60% of the videos contained information about the disease, 10% were about patient experience, and the remaining 30% related to surgical technique or approach. Physicians were the primary uploader on YouTube for this topic. The rate of low-quality videos was determined as following according to the different evaluative systems: 68% according to the newly defined YouTube Avascular Necrosis of the Femoral Head Score, 60% according to the DISCERN score, and 56% according to The Global Quality Score. The Journal of the American Medical Association, The Global Quality Score, and DISCERN score were significantly correlated with video duration, while the New YouTube Avascular Necrosis of the Femoral Head Score was significantly correlated with video duration, time since upload, number of views, and like rate. Conclusion: Most of the popular YouTube videos about avascular necrosis are of a low quality.

Aim: This study aimed to evaluate the clinical and radiological results of interphalangeal joint injuries treated with the pin-and-rubber method and to determine the effectiveness of this treatment method. Material and Method: Patients aged 18 years or older who presented with injuries of the interphalangeal joints of the hand and were treated with the pin-and-rubber method were included in the study. Patients with open fractures, multiple finger injuries, or those who underwent open surgery were excluded. Total of 32 interphalangeal joint injuries were evaluated retrospectively. Eight of those patients declined to participate in the study and the final analysis included 24 fingers of a total of 24 patients. Age, sex, injured finger, type of injury, and time until treatment were recorded for all patients. Union was evaluated based on joint radiographs from patients final follow-up appointments. For the evaluation of functional results, joint range of motion was measured with a finger goniometer and Disabilities of the Arm, Shoulder, and Hand Questionnaire (DASH) and visual analog scale (VAS) scores were evaluated. Results: The median age of the analyzed patients was 30 (18-69) years. The most frequent mechanism of injury was fall (52.4%) and the most frequent injured finger was the fourth. The median follow-up duration for these patients was 25 (16.25-31.75) months. The median DASH score was 4.16 (0.00-7.50) and the median VAS score was 4 (0.00-8.00). The median range of motion of the proximal interphalangeal joint was 90° (80.00-98.75°), while that of the distal interphalangeal joint was 55° (36.25-80.00°). Union was achieved in all cases. Condylar fractures were observed in two patients over the course of follow-up. Conclusion: The treatment of interphalangeal joint fractures or fracture dislocations by the pin-and-rubber method was confirmed to be an easily applicable and effective treatment method that does not cause a significant loss range of motion.