Background: Total hip arthroplasty (THA) in adult patients with developmental dysplasia of the hip (DDH) presents unique surgical challenges due to altered hip anatomy and biomechanics. One of the most critical factors influencing surgical success is correcting femoral anteversion. This study evaluates the effects of different anteversion corrections (increased, unchanged, and decreased) during THA on clinical outcomes in adult Crowe type 3-4 DDH patients. Methods: A retrospective analysis was conducted on 130 patients who underwent THA with anteversion correction between 2008 and 2017 at a tertiary university hospital. Patients were divided into three groups: Group 1 (increased anteversion), Group 2 (unchanged anteversion), and Group 3 (decreased anteversion). Clinical outcomes were assessed using AOFAS and Lysholm scores, Q-angle measurements, and physical examinations, while radiological evaluations were performed to determine implant stability and complications. Results: Postoperative assessments show that increased anteversion is associated with higher rates of instability, knee dysfunction, and pain. Group 1 had significantly lower AOFAS scores (p < 0.001) and fell due to rotational deformity (25.6%). Group 2 exhibited the best clinical outcomes, with the lowest rates of instability and the highest functional scores. Group 3 had moderate functional improvements but a higher dislocation rate (17.1%) than Group 2. Conclusions: Our findings suggest that excessive changes in femoral anteversion during THA, remarkably increasing it, may negatively impact clinical outcomes by causing instability and pain. Preserving the anteversion angle as much as possible is the most favorable approach for optimizing functional recovery and implant stability. Further large-scale, long-term studies are required to confirm these findings and refine surgical strategies for DDH patients undergoing THA.

This study investigates the automated detection of enchondromas, benign cartilage tumors, from x‐ray images using deep learning techniques. Enchondromas pose diagnostic challenges due to their potential for malignant transformation and overlapping radiographic features with other conditions. Leveraging a data set comprising 1645 x‐ray images from 1173 patients, a deep‐learning model implemented with Detectron2 achieved an accuracy of 0.9899 in detecting enchondromas. The study employed rigorous validation processes and compared its findings with the existing literature, highlighting the superior performance of the deep learning approach. Results indicate the potential of machine learning in improving diagnostic accuracy and reducing healthcare costs associated with advanced imaging modalities. The study underscores the significance of early and accurate detection of enchondromas for effective patient management and suggests avenues for further research in musculoskeletal tumor detection.

Background and Objectives: The primary objective of surgeons treating bone and soft tissue sarcomas (STS) is to achieve optimal local tumor control, ensuring a tumor-free margin and preventing local recurrence. However, the impact of surgical resection margin status on extremity STSs remains an area that requires further exploration. Therefore, this study aims to investigate the effects of surgical resection margin status on both local recurrence and overall survival rates. Materials and Methods: One hundred and eighty-five patients who underwent surgical resection with a diagnosis of soft tissue sarcoma were studied. The study recorded patient demographics, tumor characteristics, surgical margin distance (in millimeters), and disease-related outcomes. Results: The minimum follow-up period was 24 months (24–168). The mean time to local recurrence after resection was 103.2 months (95% CI 91.73 to 114.64). The mean local recurrence-free survival was found to be 7.23 months in patients with positive surgical margins, 87.42 months in patients with ≤1 mm, and 139.80 months in patients with >1 mm (p < 0.001). Patients with surgical margins ≤1 mm were more likely to have local recurrence than patients with >1 mm (0.41 [0.21–0.81], p = 0.010). The mean overall survival was 106.72 months (95% CI 95.98 to 117.46). Positive surgical margins were associated with decreased overall survival (3.58 [1.46–8.80], p = 0.005). There was a statistically significant difference between the histologic grade in terms of local recurrence (4.50 [95% CI 2.57 to 7.88]; p < 0.001) and overall survival (3.12 [95% CI 1.52 to 6.41]; p = 0.002). Conclusions: Achieving a negative surgical margin distance of more than 1 mm appears to be correlated with a reduced risk of local recurrence. Positive surgical margins are a risk factor that detrimentally impacts overall patient survival. However, determining the appropriate margin distance for all patients poses a significant challenge.

Background and Objective: Tenosynovial giant cell tumors (TGCTs) are benign but potentially aggressive soft-tissue tumors, most commonly affecting the hand and frequently associated with local recurrence despite surgical treatment. While positive surgical margins are recognized as the strongest predictor of recurrence, the preoperative identification of factors influencing margin status remains underexplored. This study analyzed the risk factors associated with surgical margin positivity and local recurrence in patients treated for localized hand TGCTs, contributing to more accurate preoperative risk stratification. Materials and Methods: A retrospective analysis was conducted on 44 patients diagnosed with localized TGCTs of the hand and treated surgically at a tertiary regional hospital between 2009 and 2023. Demographic characteristics, tumor size and location, anatomical relationships (bone, joint, and neurovascular proximity), Al Qattan classification, and surgical outcomes were recorded. Binary logistic regression was used to evaluate the impact of these variables on surgical margin status and recurrence. Postoperative satisfaction was assessed using a four-choice questionnaire. Results: The mean patient age was 47.5 years, with 68.2% being female. The most common tumor site was the second finger (31.8%), and 20.5% of patients had positive surgical margins. Recurrence occurred in four patients (9.1%). Bone invasion, interphalangeal joint proximity, neurovascular involvement, and Al Qattan type 2 tumors were statistically significant risk factors for both surgical margin positivity and recurrence. Lesions with periosteal involvement, however, did not significantly impact recurrence risk. Among patients with positive margins, 44.4% developed recurrence. Conclusions: Complete surgical excision with clean margins remains the cornerstone of TGCT management. This study uniquely identifies preoperative predictors of margin positivity—key contributors to recurrence—highlighting the importance of meticulous surgical planning in high-risk cases. Close postoperative follow-up is essential, particularly for patients with positive margins, to detect and manage recurrence promptly.

The terrible triad of the elbow consists of radial head fracture and coronoid process fracture in addition to posterior dislocation of the elbow. It indicates high-risk complications such as instability, malunion, nonunion, and proximal radioulnar synostosis. We describe a rare case that was admitted to the emergency service with a terrible triad of the elbow with additional capitellum fracture, lateral collateral ligament (LCL) injury, and ipsilateral humeral shaft fracture. We treated the patient urgently by performing osteosynthesis of the humeral shaft fracture, radial head fracture, coronoid fracture, capitellum fractures, and repair of the LCL rupture. The terrible triad of the elbow also can be accompanied by adjacent column fractures, including the humeral shaft. In such complex cases, preoperative planning should be done well, and the entire anatomy should be demonstrated with additional imaging. Optimal treatment of all the fractured bones and ligaments is critical for early rehabilitation. The main aim of surgery is to acquire desired results by starting an early rehabilitation, including joint movement.

Our study aims to investigate the factors associated with survival in patients with skeletal metastases of renal cell carcinoma and to outline the principles of managing patients with skeletal metastases using a multidisciplinary approach. We retrospectively reviewed 42 patients with clear cell metastatic renal cell carcinoma (mRCC) and bone metastases treated between 2005 and 2022. Demographics, tumor characteristics, metastasis patterns, surgical interventions, and systemic treatments were recorded. Survival outcomes were analyzed using the Kaplan-Meier method and the Cox proportional hazards model. Factors such as MSKCC and IMDC risk scores, the number and location of metastases, and treatment modalities were evaluated for their prognostic impact. Forty-two patients with a mean age of 58.4 years and a mean follow-up period of 28.4 months were included in the study. The 1-, 2-, and 5-year overall survival (OS) rates were 73.7%, 44.2%, and 13.7%, respectively. Solitary metastases (5-year OS 80%) and complete metastasectomy (5-year OS 20.1%) were associated with significantly improved survival. Diffuse metastases (HR 22.8; p = 0.006) and oligometastases (HR 7.7; p = 0.044) were associated with higher mortality compared to solitary lesions. Neither MSKCC nor IMDC scores were independently predictive of OS in multivariate analysis. Systemic therapies, including tyrosine kinase inhibitors (TKIs), mTOR inhibitors, antiresorptive agents, and radiotherapy, did not significantly impact survival outcomes. This study emphasizes that metastatic burden and achieving complete metastasectomy are the most critical factors for prolonged survival in metastatic renal cell carcinoma (mRCC) with bone involvement. Systemic therapies alone provide limited benefit, highlighting the need for individualized, multidisciplinary treatment strategies. Prospective studies are warranted to refine prognostic models and optimize care for this challenging patient group.