Sever’s disease is among the most common causes of foot pain in childhood.The etiology of Sever’s disease is still under debate.The objective of this prospective study is to investigate the relationship between Sever’s disease and attention deficit hyperactivity disorder(ADHD). The study was prospectively conducted for 1 year between 2023–2024.Of 238 children admitted to our clinic with foot pain, 88 children diagnosed with Sever’s disease were included in the study.A control group including 90 individuals was employed.Patients diagnosed with Sever’s disease in the orthopedics outpatient clinic and healthy control group were evaluated by a pediatric psychiatrist in terms of ADHD based on the DSM-4 diagnostic criteria. Fifty-seven patients were male, and 31 were female.While 45 male patients were diagnosed with ADHD, 12 of them did not have ADHD.While 17 female patients were diagnosed with ADHD, 14 did not have ADHD. ADHD was detected in 12 (13.3%) of 90 patients in the control group, comprising 9 boys and 3 girls. The prevalence of ADHD in the Sever’s disease cohort was 62 (70.5%) out of 88, significantly higher than the control group’s 12 (13.3%) out of 90 patients (p < 0.01). The high number of the patients diagnosed with ADHD among the Sever’s patients who were not engaged in sports was found to be statistically significant(p < 0.01).The diagnosis of ADHD was found to be statistically more significant in boys with Sever’s disease compared to girls(p < 0.018). Children with Sever’s disease can be the candidates for attention deficit hyperactivity disorder.It is thought that evaluating children, especially male children, diagnosed with calcaneal apophysitis within the framework of attention deficit hyperactivity disorder will be valuable.

This study aimed to assess the treatment process of open, unstable tuft fractures occurring in toddlers and preschool-aged children treated using a 25-gauge hypodermic needle in the emergency department, and the cosmetic and functional results achieved by this treatment. This retrospective cohort study included a total of 72 patients. Children aged two to six years were included in the study. Van Beek classification was used for the evaluation of nail bed injuries. Cosmetic results were evaluated on the basis of Zook classification whereas functional results were evaluated according to the Buck-Gramko score simplified by Nietosvaara et al. The patient population consisted of 52 men and 20 women. The mean age was 4 ± 1.33 years. The operating time was 19.17 ± 3.66 minutes and the time to union was 46.68 ± 4.84 days. While excellent and good functional results were obtained in 65 (90.2%) of the patients, excellent and very good cosmetic results were obtained in 51 (70.8%) patients. Unless there is an accompanying extremity fracture, unstable pediatric tuft fractures can be successfully fixed with a hypodermic needle in the emergency department. Gentle and precise repair of the nail bed may provide cosmetically and functionally satisfactory results.

Background: Tibial distal diaphyseal–metaphyseal junction (DDMJ) fractures are rare in children and pose therapeutic challenges due to their morphology and risk of displacement. This study compared the clinical, radiological, and economic outcomes of elastic stable intramedullary nailing (ESIN), plate fixation, and Kirschner wire (K-wire) fixation. Methods: A retrospective review was conducted on 64 patients (6–15 years) treated between 2014 and 2023. Patients were grouped according to fixation method. Demographic, operative, radiographic, functional (AOFAS), complication, and cost data were analyzed. Results: The K-wire group, plate group, and ESIN group consisted of 27, 19, and 18 patients, respectively. The mean follow-up duration was 18.03 ± 6.87 months. Of the patients, 38 were male and 26 were female. Concomitant fibula fractures were present in 43 patients and were not present in 21 patients. AOFAS scores were highest in the plate group at the 4th month, while they were similar in all groups in the subsequent follow-ups. The costliest method was plate (2517.64 ± 104.83 $) (p = 0.001). Conclusions: All three fixation methods provided satisfactory long-term outcomes. Plate fixation offers faster early recovery but at higher cost and risk of soft-tissue complications; ESIN balances stability and invasiveness; K-wire is economical but less stable. Treatment choice should be individualized according to fracture pattern, patient factors, and resource availability.

Background/Aim: Clubfoot is the most common congenital foot deformity. Although the etiology and pathoanatomy of clubfoot are not fully understood, dysplasia is present in all musculoskeletal structures below the knee at varying rates. The aim of any treatment regimen is to obtain a pain-free, properly positioned foot that has functional use. The objective of this investigation was to evaluate difficulties in the follow-up and treatment of patients with clubfoot treated in our clinic after the 2023 Kahramanmaras earthquake. Methods: Data from patients with clubfoot treated with the Ponseti method at the Orthopedics and Traumatology Outpatient Clinic of Gaziantep Metropolitan Municipality Inayet Topcuoglu Hospital in Turkey between December 2022 and July 2023 were obtained from the hospital's electronic registry system. Patient demographics, the number of plaster casts made before the earthquake, the total number of plaster casts made, time delays in treatment due to the earthquake, and costs were all analyzed. The Dimeglio score was used for the morphological classification of clubfoot. We analyzed patient data from three time periods: the time of the initial treatment, the period before the earthquake, and the period after the earthquake. Results: The study included 31 feet (16 left and 15 right) of 20 patients (11 males, 9 females). The mean age of the cohort was 3.5 months (standard deviation: 1.6 months). The median and minimum/maximum Dimeglio scores were 11 (9, 13), 6 (4, 8), and 9 (7, 11) at first admission, before the earthquake, and after the earthquake, respectively (P<0.001). The number of casts before the earthquake was 4.32 (0.32), and the total number of casts was 9.39 (1.38). The average time delay until retreatment after the earthquake was 12 weeks (range: 8–15 weeks). There was a significant positive correlation between the duration of the delay and the Dimeglio score measured after the earthquake (r=0.392, P=0.029). The additional cost per patient due to the delay was calculated to be 8290.8 ± 5033.761 TRY (308.78 ± 187.43 USD). Conclusion: The 2023 Kahramanmaras earthquake had a significant impact on the management of clubfoot and other elective procedures. Dealing with the consequences of an unprecedented natural disaster is certainly challenging. However, by adopting carefully designed protocols and therapeutic approaches that are based on the unique characteristics of an illness, we can successfully alleviate the repercussions of such events. '+st+' Department of Orthopaedics and Traumatology Ricco AI, Richards BS, Herring JA, Disorders of the Foot. In: Herring JA, editor. Tachdjian’s Pediatric Orthopaedics. Philadelphia PA: Saunders; 2013. p.761–883. Ošt’ádal M, Lišková J, Hadraba D, Eckhardt A. 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