Introduction: To compare surgical and conservative management of midshaft clavicle fractures according with scapulothoracic joint angle change, considering clinical, functional, and radiological outcomes. Methods: A total of 95 midshaft clavicle fracture patients aged between 18-70 years with a minimum follow-up duration of 12 months were included in this study. Patients were treated either conservatively (Group I) or surgically (Group 2). Plane deformities, scapulothoracic joint angle, shortness and isokinetic muscle strength were measured. Shoulder Pain, Disability Index (SPADI) and Short Form-3 6 (SF36) were assessed. Results: Scapulothoracic joint angles were higher in the conservative treatment group than in surgery group (p=0.036). Consequently, winged scapula was seen more commonly in the conservative treatment group than in the surgery group (p=0.001). Surgical treatment was associated with significantly better SF-36 physical scores and with SPADI pain and disability scores. However, the two groups did not differ in terms of isokinetic muscle strength. Negative anteroposterior plane deformity (p<0.001) and negative axial plane deformity (p=0.004) were more frequent in the conserva- tive treatment group. Clavicle shortness was more common in the conservative treatment group. Conclusions: According to our findings scapulothoracic joint angle changes were seen in the conservative treatment group more than in the surgery group. Consequently, winged scapula was seen more commonly in the conservative treatment group than in the surgery group (p=0.001). Level of Evidence III; Retrospective comparative study.

Aim: The current study aimed to evaluate the late-term results of patients operated for lumbar spine fractures in our clinic. Material and Method: 134 patients from January 2012 to January 2020 were treated with “short-segment pedicle instrumentation” for lumbar fractures in our neurosurgery department. Patients with a burst fracture of a single lumbar vertebra were included. The final sample consisted of 67 patients who were followed up over the years with radiographs before and after surgery and CT scans at the final follow-up. Results: The results showed that 60% of the patients were rated as Denis P1, 35% as P2, and 5% as P3. Screw breakage was observed in seven patients, and 67 patients underwent revision surgery. Furthermore, the fractured vertebral body’s height was improved at the final follow-up stage, and an increase was witnessed from the preoperative figure of 16.4 mm to 25.8 at the final follow-up. At the final follow-up, the average Cobb angle was -11.6° preoperatively, and 6.3° after the operation and the correction loss was 12.1° which was severe in the middle part of the vertebra. By the final follow-up, disc spaces were narrowed below and above the fractured vertebra, and no correlation was found between clinical outcomes and adjacent disc degeneration. Conclusion: We concluded that short-segment pedicle instrumentation produced satisfactory long-term results for lumbar fractures. To achieve adequate outcomes, correct management of complications and evaluation of various factors must be focused on.

This study aimed to investigate how the presence of neuropathic pain related to partial rotator cuff tears affects the short-term results of subacromial injection and suprascapular nerve blockade therapy in patients with chronic shoulder pain. In this prospective observational study, shoulder pain via verbal numeric pain rating (VNPR, 0–10) and functional status through simple shoulder test (SST) were evaluated before and second week after procedure. After dividing as neuropathic pain and non-neuropathic pain groups, pre-procedural and follow-up scores concerning pain intensity, functional status, and whether there were those of patients with minimal clinically important change (MCIC) in areas of pain and function were evaluated. Between the groups including 140 patients, while there was no statistical difference in baseline pain intensity and functional status (P = .14,.11, respectively), outcomes of those without neuropathic pain were favored at the follow-up (P = .02,.01, respectively). Given baseline pain scores, the reduction (%) was significantly lower in neuropathic pain group (P = .03). There was no significant difference in patients with MCIC in pain intensity and functional status between the groups (P = .08,.59, respectively). An improvement was determined in pain intensity and functional status at the follow-up in both groups (P < .001). The improvement in pain intensity and functional status is poorer in patients with partial rotator cuff rupture-related neuropathic pain than in those without neuropathic pain. However neuropathic pain has no negative effect on the response to treatment.

Purpose: This study was planned to compare the quadriceps muscle strength, knee joint proprioception, and quadriceps force sense between individuals with total knee arthroplasty (TKA) and healthy controls and investigate the relationship between quadriceps muscle strength, knee joint proprioception, and quadriceps force sense in individuals with TKA, in which joint proprioception is mostly provided by extra-articular proprioceptors. Methods: Forty-six individuals (mean age: 67, 80.4% female) who had undergone TKA surgery at least four months before and 46 age-matched healthy controls (mean age: 63, 73.9% female) were included in this study. Quadriceps muscle strength was assessed by maximal isometric contraction test, knee joint position sense (active and passive) with repositioning error test, and quadriceps force sense with force sensitivity test. An isokinetic dynamometer was used in all assessments. Results: In the total knee arthroplasty group, quadriceps strength (p

Joint Diseases and Related Surgery (JDRS), the official journal of the Turkish Joint Diseases Foundation, is an international, peer-reviewed, immediate open access journal. All published articles in JDRS has been free for everyone, without embargo, since 1990.

Purpose: This study aims to evaluate the incidence and follow-up outcomes of Developmental Hip Dysplasia (DDH) in infants admitted to City Hospital using the Graf classification. Furthermore, it aims to investigate the prevalence of DDH in Central Anatolia and assess the effectiveness of current screening and treatment protocols for detecting and managing DDH in infants. Materials and methods: A total of 10.650 infants underwent screening for DDH using the Graf USG method as part of the National DDH screening program at City Hospital between August 2020 and September 2022. Infants born at term (38 weeks and above) and screened between 30-90 days of birth were included, while premature infants were excluded. Hips were classified according to the Graf method into types 1 (normal), 2 (immature), 2A (+), 2A (-), 2B, 2C, D, 3, and 4, based on alpha angles. Results: The study examined the USG results of 8,695 term infants (52.5% male and 47.5% female) between 2020 and 2022. The mean gestational age of participants at the time of the initial USG examination was approximately 7.94±2.07 weeks. Graf type 1 was more prevalent in males (97-96.5%), while Graf type 2 was more common in females (7.2-7.8%). Radiologists tended to recommend a re-examination after one month for type 2a Graf hips (84.49-82.02%), whereas orthopedic consultation was advised for type 2B, 2C, and type 3 hips. The vast majority of infants (93.6%) underwent only one USG screening. Pelvic X-ray was requested for 15.9% of patients, and additional USGs were requested for 5.7% of patients. Pavlik treatment was applied to 4.2% of patients who did not return to normal, Frejka pillow treatment was applied to 1.5% Interestingly, none of the patients who maintained regular USG monitoring and treatment required surgical intervention involving osteotomy. Conclusion: USG is an early diagnostic method for DDH, which allows for simple treatment options and the prevention of complications. It is a simple, inexpensive, and non-invasive method. Our study supports that regular USG screenings in infants eliminate the need for surgical procedures requiring osteotomy. However, the proportion of individuals who failed to adhere to their follow-up appointments despite receiving abnormal results remains elevated, underscoring the necessity for implementing diverse strategies aimed at augmenting parental awareness in this context.