Background and Objectives: The aim of this study was to compare the short- and long-term effectiveness of ultrasound-guided percutaneous release (CTR-US) and mini-open surgery in the treatment of carpal tunnel syndrome (CTS). Materials and Methods: A retrospective analysis was conducted on 172 patients who underwent surgical treatment for CTS between 2015 and 2020. The patients were divided into two groups: those who underwent CTR-US (Group A, n = 66) and those treated with mini-open surgery (Group B, n = 106). All patients were evaluated using the Boston Carpal Tunnel Questionnaire (BCTQ) and the Quick Disabilities of the Arm, Shoulder, and Hand (QDASH) scores before surgery and at 3 months, 6 months, 1 year, 2 years, and 5 years postoperatively. Electrophysiological and ultrasound findings were also compared. Statistical analyses were performed using t-tests, Mann–Whitney U tests, and Chi-square tests, with significance set at p < 0.05. Results: A total of 172 patients who met the study criteria were included. Among the participants, 112 were women and 60 were men. The mean age was calculated as 61 years for female patients and 54 years for male patients. No significant differences were found between the groups in terms of age, gender, laterality, and disease duration. Both groups demonstrated significant improvements in BCTQ and QDASH scores at all postoperative time points compared to preoperative scores (p < 0.001). The CTR-US group showed advantages in shorter treatment duration (p < 0.001), lower cost (p < 0.05), and faster recovery time. Electrophysiological evaluations revealed faster improvements in distal motor latency (DML) and sensory conduction velocity (SCV) in the CTR-US group (p < 0.05). Ultrasound assessments indicated that both methods achieved effective release of the transverse carpal ligament. No significant differences were observed between the groups in long-term questionnaire scores. Conclusion: CTR-US offers advantages such as shorter treatment duration, lower cost, and faster recovery due to its minimally invasive nature. Consistent with the literature, CTR-US provided faster recovery and improved patient comfort. However, mini-open surgery remains a reliable alternative with long-term symptom control and low complication rates. Our study found that both methods are effective, but CTR-US stands out for its esthetic and functional advantages.
Background/Objectives: Recurrent hip dislocations are a rare occurrence in pediatric patients. As there are few cases of voluntary habitual dislocation documented in the literature, there is a paucity of information available regarding its pathogenesis, risk factors, and classification. The prognosis for these patients is generally good. A long-term follow-up duration of two years was conducted to evaluate outcomes. Statistical analysis was performed to assess the impact of family structure and treatment approaches on outcomes. Methods: From January 2010 to December 2022, patients with voluntary habitual hip dislocation were retrospectively identified through the hospital information system. Data regarding demographic characteristics, clinical findings, and treatment outcomes were analyzed. A total of 13 patients (14 hips) met the inclusion criteria. Conservative treatment methods, including orthosis and family therapy, were applied. Statistical analysis was performed to assess the impact of family structure and treatment approaches on outcomes. Results: The mean age at diagnosis was 48.7 months, with 77% of cases being female. Posterior dislocation was observed in all cases, and no underlying bone pathology was detected on imaging. The prognosis for these patients is generally good. At the one-year follow-up, 85% of patients achieved a complete resolution of dislocations, increasing to 100% by the two-year follow-up. Patients from larger families demonstrated significantly slower recovery rates at the first- and sixth-month evaluations (p = 0.033 and p = 0.048, respectively), but outcomes were comparable by one year. A unique aspect of this study is the emphasis on family dynamics, which significantly influenced treatment adherence and recovery. Statistical analysis was performed to assess the impact of family structure and treatment approaches on outcomes. Conclusions: Voluntary habitual hip dislocation is a rare condition with good long-term outcomes under conservative management. This study highlights the importance of addressing family dynamics in the treatment plan, especially in larger families, where attention and psychological factors may play a significant role in delayed recovery.
27 October 2026 in European Journal of Orthopaedic Surgery & Traumatology
Background: Chronic insertional Achilles tendinopathy (CIAT) is a type of tendinopathy resistant to conventional conservative treatments. The efficacy of extracorporeal shock wave therapy (ESWT) remains controversial. This study aims to evaluate the effects of ESWT on pain management and functional improvement in CIAT patients and compare it with physical and medical treatments Methods: In this retrospective study, 372 patients diagnosed with CIAT between 2019 and 2023 were evaluated. The patients were divided into two groups: those who received only physical/medical therapy (Group 1) and those who underwent a combination of ESWT and physical/medical therapy (Group 2). Clinical outcomes were assessed using the American Orthopedic Foot and Ankle Society (AOFAS) score and the Visual Analog Scale (VAS) scores. The severity of the disease was determined through magnetic resonance imaging (MRI). Group comparisons were conducted using the independent samples t-test and Fisher’s exact test, while changes over time were assessed with repeated measures ANOVA. Correlation analyses were evaluated using Pearson and Spearman correlation coefficients. Results: Significant improvement in AOFAS and VAS scores was observed in both groups by the third month (p < 0.01). However, at 6 and 12 months, ESWT did not demonstrate superiority over physical/medical treatment. Correlation analysis showed a positive relationship between baseline AOFAS scores and functional improvement, while higher initial VAS scores correlated with greater post-treatment pain reduction. Cardiovascular risk factors negatively impacted both functional recovery and pain reduction (p < 0.05). Although patient satisfaction was higher in the ESWT group, the difference was not statistically significant. Conclusions: ESWT may provide short-term pain relief and functional improvement in CIAT but does not offer a long-term advantage over physical/medical treatment. The placebo effect may contribute to early positive outcomes. These findings do not support ESWT as a routine treatment for CIAT.
This study aimed to compare the effects of early (48 hours) intramedullary nailing on fracture union time and complication rates in patients with isolated tibial shaft fractures. A total of 68 patients who underwent intramedullary nailing for isolated tibial shaft fractures were retrospectively included in the study. Patients were divided into two groups based on the timing of surgery: early surgery group (n=34) and delayed surgery group (n=34). Demographic data, AO classification, time to union, and complication rates were compared between the groups. The mean time to union was significantly shorter in the early surgery group (15.2 ± 3.4 weeks) compared to the delayed group (17.6 ± 4.1 weeks) (p=0.011). There was no statistically significant difference between the groups in terms of complication rates, including superficial/deep infections, nonunion, and implant failure (p>0.05). Fracture types according to the AO classification were evenly distributed between the groups. Early intramedullary nailing significantly shortens the union time in isolated tibial shaft fractures. However, surgical timing does not appear to have a significant effect on complication rates. Therefore, the decision on surgical timing should be individualized based on patient characteristics and soft tissue condition.