OBJECTIVE: This study retrospectively compared the clinical and radiological outcomes of patients with bilateral developmental dysplasia of the hip who underwent either a single-stage operation (using a Salter innominate osteotomy for one hip and a Pemberton pericapsular osteotomy for the other hip) or a two-stage procedure comprising consecutive operations. METHODS: Extensive pre- and postoperative clinical, surgical and radiological examinations were undertaken. RESULTS: A total of 63 patients received the single-stage operation (group A), and 55 patients received consecutive operations (group B). There were no significant between-group differences in acetabular index or centre-edge angle correction. Group A had significantly reduced anaesthetic exposure, duration of hospitalization, blood transfusion volume, antibiotic costs and hospitalization costs. Group A also had a lower rate of surgical complications and avascular necrosis than group B. CONCLUSIONS: The single-stage surgical procedure was more economical and allowed more rapid recovery than two consecutive operations. The surgical and anaesthesia team must be highly proficient in order to perform single-stage operations successfully.

Objective In this experimental study, PRF (Platelet Rich Fibrin), HA (Hyaluronic Acid) gel and ADCON® Gel were compared in terms of preventing epidural fibrosis. Methods Twenty-eight Sprague–Dawley rats (mean weight, 400–450 g) were divided into 4 groups. L3-L4 laminectomy was performed in each group. Following laminectomy, Adcon® Gel, HA gel and PRF were applied onto the surgery site locally in Group 1, 2 and 3, respectively. Group 4 was maintained as control without any local application. After five weeks, L3-L4 vertebrae were removed totally and taken to histopathological evaluation for epidural fibrosis, acute inflammatory cell density, chronic inflammatory cell density, hemorrhage, angiogenesis and new bone formation. Results Acute inflammation cell density, angiogenesis, and new bone formation levels were comparable among the study groups (p > 0.05). However, new bone formation was higher in the PRF group. Epidural fibrosis and chronic inflammatory cell density were significantly lower in the PRF group (p < 0.05). Conclusion We concluded that PRF contributed to hemostasis and prevented epidural fibrosis. ER -

Objective: This study aims to present a review about complications of surgical treatment of Developmental Dysplasia of the Hip and comparing the kinds and ratios of two osteotomy technique (Salter Innominate Osteotomy and Pemberton Pericapsular Osteotomy). Materials and Methods: Fifty-seven patients of 126 that had bilateral developmental dysplasia of the hip are the case series that had undewent to Salter Innominate Osteotomy for one hip and Pemberton Pericapsular Osteotomy for other hip by one surgeon in one stage. Results: Avascular Necrosis ratio was 19.29% on hips with Salter Innominate Osteotomy, and 8.77% on hips with Pemberton Pericapsular Osteotomy. Salter Innominate Osteotomy made lower limb discrepency with 0.47 cm mean in all patients. There were 17 general complications on hips with Salter Innominate Osteotomy (SIO) (14.91%) and 9 general complications on hip with Pemberton Pericapsular Osteotomy (PPO) (7.89%). As looking for general complications, SIO/PPO ratio were 1.8 (17/9). Conclusion: By the comparing two osteotomy technique for complication ratios, SIO had two-fold of complications than PPO. SIO had 65% more complications as to PPO.

The coexisting of three deformities as hallux valgus, flatfoot, and the calcaneal spur is an undefined medical condition, and it may be called triad of foot deformities (TFD) as a definition for a new disease entity. A customized 3D insole prototype was created by postprocessing of MRI data, and printed by 3D printer technology for the purpose of providing effective and innovative treatment for TFD. A 42 years-old female was clinically examined for TFD findings. All radiological measurements were made on the weightbearing anteroposterior and lateral X-rays. The patient underwent the pedogram (RSscan International, footscan©). MRI images were taken for the purpose of 3D scanning that was used for producing the 3D splint for TFD. AOFAS (American Orthopedic Foot and Ankle Society scores) and FHSQ (Foot Health Status Questionnaire) were used for clinical follow-up. MRI images of the patient were imported to Mimics software in order to create a 3D model using image processing. Thus, Patient-Specific 3D customized silicone orthotic insole that was based on 3D printing technology was produced. The one-simple test was used to compare the results of AOFAS and FHSQ scores. The measurements of radiological measurements were given. On the clinical follow-up, AOFAS was FHSQ scores were obtained. There was a significant difference in terms of AOFAS and FHSQ scores (p ≤ 0.05). As a result of our study; our 3D customized insole was produced at the price of approximately 1/3 of the total cost of three standard medical products. The coexisting of these three deformities may be called triad of foot deformities (TFD). The 3D printer technology enables us to access a customized, personalized conservative treatment option for TFD. The conservative treatment of TFD is possible by a single orthotic insole.