BACKGROUND:Despite increased experience and technical developments in total knee arthroplasty (TKA), chronic postsurgical pain (CPSP) remains one of physicians’ biggest challenges. The aim of the present study was to evaluate the effectiveness of perineural injection therapy (PIT) in the management of CPSP after TKA. MATERIAL AND METHODS:A total of 60 patients who had been surgically treated with TKA because of advanced knee osteoarthritis was included in the present study. The study included 2 groups. Group A consisted of patients who received 3 rounds of PIT combined with standard postoperative TKA protocol during the same period. Group B received standard postoperative TKA protocols (rehabilitation programs, oral and intravenous analgesics). Clinical effectiveness was evaluated via Western Ontario and McMaster Universities Arthritis Index (WOMAC) and Visual Analog Scale (VAS) at baseline and 1-, 3-, and 6-month follow-ups. RESULTS:All repeated measures showed significant improvements (P<0.001) in both groups for VAS and WOMAC scores. These scores were significantly better in group A in all follow-up periods compared with group B (P<0.001). Twenty-nine patients (93.5%) in group A reported excellent or good outcomes compared with 26 patients (89.6%) in group B. CONCLUSIONS:PIT is a promising approach in CPSP with minimal cost, simple and secure injection procedures, minimal side effects, and higher clinical efficacy.

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: Pilon fractures refer to distal tibial fractures that may involve extra-articular, partial articular, or complete intra-articular components, most commonly caused by high-energy trauma. The choice between early (7 days) surgical fixation significantly impacts clinical outcomes. This study aimed to compare the effects of early vs. delayed plate fixation on fracture healing time, functional outcomes, and complication rates. Materials and Methods: This retrospective study analyzed 80 patients who underwent surgical treatment for pilon fractures between 2018 and 2023. Patients were divided into two groups: Early surgery (7 days, n=40). Additionally, patients were categorized based on the fixation method: Single plate fixation (n=40); Double plate fixation (n=40). Outcome Measures: Fracture healing time (weeks) - Defined as cortical continuity on radiographs; Functional outcomes (AOFAS score); Complication rates (infection, malunion, implant failure). Results: Shorter healing time was observed in the early surgery group (14.2 vs. 16.8 weeks, p<0.05). Better functional outcomes were recorded in the early surgery group (AOFAS score: 82.3±6.5 vs. 78.1±7.2, p<0.05). Lower infection rates were noted in the delayed surgery group (7.5% vs. 12.5%, p<0.05). Double plate fixation provided better mechanical stability but resulted in higher soft tissue complication rates. Single plate fixation preserved soft tissue integrity but had higher malunion and implant failure rates. Conclusion: Early surgery is associated with shorter healing time and better functional outcomes, but increased soft tissue complications require careful management. Delayed surgery offers a safer approach for soft tissue healing but may prolong functional recovery. While double plate fixation ensures greater stability, it may increase soft tissue morbidity, whereas single plate fixation reduces soft tissue complications but may compromise stability. A personalized surgical approach is recommended for optimal outcomes in pilon fracture management.

Background: This study aimed to determine whether the choice of reduction maneuver in patients presenting to the emergency department with nursemaid’s elbow influences the likelihood of recurrent dislocation. Additionally, the study sought to describe the epidemiological characteristics of these cases. Methods: This retrospective study included 1359 patients diagnosed with nursemaid’s elbow who presented to the Emergency Department of Malatya Training and Research Hospital from January 2015 to June 2025. Data on demographics, side affected, radiographic evaluation, reduction maneuver, and recurrence were analyzed. The chi-square test was used for statistical analysis, with p < 0.05 considered significant. Results: The median age was 2 years, with 61.2% female. Most cases (88.1%) were in the 0–3-year age group. Left-sided involvement accounted for 63.0%, right-sided involvement 37.0%. Hyperpronation was used in 68.4%, supination–flexion in 31.6%. Recurrence rate was 4.8%, higher with right elbows and supination–flexion (p < 0.05). Conclusion: Nursemaid’s elbow was more common in children under three, particularly girls, and affected the left arm. Recurrence was lower after hyperpronation than after supination–flexion. Level of Evidence: Retrospective analysis study.

Background/Aim: The management of unstable intertrochanteric fractures (ITF), which are becoming more common, is still a significant issue for public healthcare systems. As a result, successful fracture therapy is becoming a more crucial aspect of orthopedic practice. To treat older patients who have an ITF, this study compared the therapeutic outcomes and side effects of proximal femoral nail anti-rotation (PFNA) conducted in lateral decubitus and supine postures. Methods: One-hundred twenty patients between the ages of 65 and 90 who underwent PFNA surgery as a result of an unstable femoral ITF brought on by low-energy trauma were included in the study, which was conducted as a retrospective cohort study. Two groups of patients were established: (1) Group L, consisting of patients who underwent surgery in the lateral decubitus position and (2) Group S, consisting of patients who underwent surgery in the supine position. Several patient characteristics were compared: (1) demographic information, (2) length of hospital stay, (3) length of surgery, (4) intra-operative blood loss, (5) incision length, (6) number of intra-operative fluoroscopies, (7) duration of activity outside of bed, (8) duration of clinical recovery of fracture, (9) surgical complications, (10) patient outcomes, and (11) Harris hip scores (HHS). Results: Group L (60 patients) consisted of patients who underwent surgery in the lateral decubitus position, while Group S (60 patients) underwent surgery in the supine position (60 patients). The average hospital stay for patients receiving PFNA was 8.2 days for those in the supine position compared to 8.0 days for those in the lateral decubitus position. The difference between the operative times was significant (P<0.001) with 48.6 and 59.7 min in Groups L and S, respectively. Intra-operative blood losses in Groups L and S were 129.2 and 151.5 mL, respectively. Compared to Group S, Group L's mean incision length was much lower at 6 cm (as compared to 8 cm in Group S). The difference between the mean intra-operative radiation exposure times for Groups L and S was considerable at 9.38 versus 12.5 min. The mean times for fracture union and the HHS were not statistically different between the two groups after 12 weeks of treatment. Conclusion: ITFs in elderly patients can be successfully treated with PFNA in either the lateral decubitus or supine position. Surgical duration, blood loss, intra-operative X-ray exposure, and incision lengths were all reduced with PFNA performed in the lateral decubitus position. As a result, treatment of ITFs in older individuals may involve PFNA fixation in the lateral decubitus position. Particularly for people with a muscular gluteal region or obese patients, the lateral decubitus position is advised. function ready(callback){ // in case the document is already rendered if (document.readyState!='loading') callback(); // modern browsers else if (document.addEventListener) document.addEventListener('DOMContentLoaded', callback); // IE <= 8 else document.attachEvent('onreadystatechange', function(){ if (document.readyState=='complete') callback(); }); } ready(function(){ var abstract = document.getElementById("abstract"); //declare your possible strings in vars let st = innerHTML; st = st.replace(//g,""); st = st.replace(/<\/p>/g,""); st = st.replace(//g,""); st = st.replace(/<\/strong>/g,""); st = st.replace(/ /g,""); let title = "Background/Aim:"; if(st.includes(title)){ st = st.replace(title, ""+title+" "); } else{ title = "Aim:"; st = st.replace(title, ""+title+""); } let titles = ["Methods:", "Conclusion:", "Results:"]; titles.forEach((title, ndx) => { //console.log(title); st = st.replace(title, " "+title+""); }); //console.log(st); innerHTML = ''+st+''; }); Downloads Download data is not yet available. 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DOI: https://doi.org/10.1155/2013/276015 <!-- .main_entry --> Downloads PDF 228 319 Published 2023-01-04 Issue Vol. 7 No. 1 (2023): 1-5 Section Research Article How to Cite 1. Güzel İsmail, Altunkılıç T, Arı B, Saraç H. Comparing the supine and lateral positions for proximal femoral nail use in the treatment of intertrochanteric femoral fractures: Comparing supine and lateral positions for proximal femoral nail. J Surg Med [Internet]. 2023 Jan. 4 [cited 2023 Dec. 5];7(1):1-5. Available from: https://jsurgmed.com/article/view/7444 More Citation Formats ACM ACS APA ABNT Chicago Harvard IEEE MLA Turabian Vancouver Download Citation Endnote/Zotero/Mendeley (RIS) BibTeX License Copyright (c) 2023 İsmail Güzel , Tarık Altunkılıç, Bünyamin Arı, Halil Saraç This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. Citations <!-- AddThis Button BEGIN --> <!-- AddThis Button END --> #7444 <!-- .entry_details -->