Background and Objectives: Adolescent idiopathic scoliosis (AIS) may influence pelvic orientation and lower-limb alignment; however, data on coronal lower-limb alignment after completion of spinal treatment remain limited. This study aimed to evaluate lower-limb radiographic alignment in AIS patients after spinal treatment and to determine whether these parameters differ according to main curve location. Materials and Methods: In this retrospective study, 70 AIS patients treated surgically (n = 52) or with brace therapy (n = 18) between 2010 and 2020 were analyzed. Patients were grouped according to main curve location as thoracic (n = 28), lumbar (n = 21), or thoracolumbar (n = 21). Pre-treatment standing full-spine radiographs were used to assess Cobb angle, coronal balance, and pelvic coronal obliquity angle (PCOA). After completion of spinal treatment, full-length weight-bearing lower-limb radiographs were evaluated for femoral and tibial lengths, mechanical axis deviation (MAD), femoral neck–shaft angle (NSA), anatomical lateral distal femoral angle (aLDFA), and mechanical lateral distal femoral angle (mLDFA). Additional treatment-stratified, treatment-adjusted, and threshold-based analyses were performed. Results: PCOA, coronal balance, bilateral MAD, right aLDFA, and right mLDFA differed significantly among the three curve-location groups. The lumbar group demonstrated more negative MAD values than the thoracic group, indicating a tendency toward valgus alignment (right MAD: −5.88 ± 8.8 mm vs. 3.65 ± 7.9 mm, p = 0.004; left MAD: −3.5 ± 7.5 mm vs. 3.75 ± 7.0 mm, p = 0.005). After adjustment for treatment modality, age, and main Cobb angle, curve location remained significantly associated with right MAD, left MAD, right aLDFA, and right mLDFA. However, the proportion of patients with clinically relevant malalignment, defined as MAD exceeding ±10 mm in at least one limb, did not differ significantly among the groups. Conclusions: AIS patients show subtle but measurable differences in coronal lower-limb alignment after completion of spinal treatment. Lumbar and thoracolumbar curves are associated with greater pelvic obliquity and a tendency toward more valgus mechanical-axis alignment, whereas limb lengths and NSA remain comparable among curve-location groups. These findings appear to represent mainly radiographic or biomechanical variations rather than overt clinically relevant deformity in most patients.

The purpose of this study is to evaluate and compare the clinical and radiological parametres of the distal Chevron and Lindgren-Turan osteotomy. It is hypothesized that functional and clinical scores would be similar in mid to long term results of these techniques. This study was planned retrospectively and patients who underwent distal Chevron and Lingren-Turan osteotomy due to hallux valgus(HV) between February 2013 and December 2022 were reviewed from the hospital archives. During the study period, a total of 550 patients were operated due to HV. 146 patients met the inclusion criterias and were taken in the final analysis (89 who underwent the chevron osteotomy and 57 underwent the Lingren-Turan osteotomy). Radiological and clinical outcomes were evaulated at the last follow up. A total of 146 patients operated due to hallux valgus were (89 who underwent the chevron osteotomy and 57 underwent the Lingren-Turan osteotomy) were included in the present study. No statistically significant difference was observed between the groups (p > 0,05) in terms of demographic characteristics. In both groups, the HVA, IMA scores decreased and the AOFAS scores increased significantly postoperatively. The mean AOFAS scores improved significantly from preoperatively to postoperatively: from 67,96 to 85,9 in group 1, from 69,5 to 89,8 in group 2. The shortening of the first metatarsals and the amount of lateral displacement were found to be significant in both groups (p < 0,001), both lateral displacement and metatarsal shortening were found to be higher in the Turan group. In conclusion, evidence from this study has revealed that Chevron and Lindgren-Turan osteotomies are both effective and satisfactory procedures with similar mid to long term clinical and radiological results.

Background: An increased prevalence of benign lesions has been associated with the increased use of radiological tools in orthopedic practice. Purpose: To investigate the inter-observer reliability of the radiographic detection of lesions on the proximal humerus between different observers. Material and Methods: X-ray radiological examinations of 17,243 patients were performed by an orthopedic surgeon to assess the presence of proximal humeral bone lesions. After this initial screening, 201 patients with lesions were identified and these 201 scans were assessed by three different physicians: an orthopedic oncologist, an orthopedic surgeon, and a musculoskeletal radiologist. Of the 201 patients with lesions, 80 had magnetic resonance imaging in addition to X-rays and were assessed. The diagnosis of the lesions was determined by each participant according to their radiological appearance to assess inter-observer reliability. Results: The prevalence of proximal humeral lesions was determined by the orthopedic surgeon to be 1.165% (201 of 17,243 patients). In 201 patients with a lesion, the mean age was 48 ± 17 years (range = 18–91 years). According to the assessments of the orthopedic oncologist, orthopedic surgeon, and musculoskeletal radiologist, the most common bone lesion identified was enostosis, with prevalence percentages of 53.7%, 59.7%, and 64.7%, respectively. A noteworthy consensus exists in the collective diagnosis of bone lesions among the three investigators, demonstrated by a substantial agreement with Fleiss’ κ at 0.74 ( P < 0.001). Conclusion: There was remarkable agreement between the three investigators on the collective diagnosis of bone lesions. Enostosis was the most common bone lesion at the proximal humerus in our series.

Pauwels type III femoral neck fractures are characterized by steep, vertically oriented fracture lines and are biomechanically unstable due to high shear and varus forces. While sliding hip screws (SHS) and cannulated screw (CS) constructs are commonly used, no consensus exists regarding the optimal fixation method for these challenging fractures. The diamond-shaped (rhomboid) configuration, incorporating four cannulated screws placed in both superior-inferior and anterior-posterior axes, has been proposed as a potential alternative, but remains insufficiently studied. In this biomechanical study, 24 synthetic femur models with standardized Pauwels type III osteotomies were randomly assigned to three fixation groups (n = 8): inverted triangle cannulated screws (ICS), SHS with an anti-rotational screw (SHS + AS), and diamond-shaped cannulated screws (DCS). All models underwent static, dynamic (cyclic), and failure load testing using an Instron biomechanical testing system. Displacement at the fracture site was evaluated using a digital image correlation (DIC) method. The DCS group demonstrated the highest mean failure load and superior stiffness in both static and post-cyclic testing. Additionally, shear displacement was significantly lower in the DCS group during static loading compared to the SHS + AS group (p < 0.05). No significant differences were found between ICS and SHS + AS groups in most parameters. The diamond-shaped cannulated screw configuration exhibited promising biomechanical performance in Pauwels type III fractures, offering enhanced resistance to shear forces. Considering the minimally invasive nature of CS fixation, this configuration may serve as a viable alternative to conventional methods. Further studies are needed to validate these findings in cadaveric and clinical settings.