Neglected malleolus fracture cases, among other conditions in which arthrodesis is inevitable, usually present with pseudoarthrosis of the malleolus and impaired ligament balancing. The study aimed to summarize the clinical data results of neglected malleolus fractures accompanied by ankle instability. The retrospective study was conducted at Adana City Training and Research Hospital. The files of the patients diagnosed with nonunion malleolus fractures admitted between January 1, 2018, and July 30, 2023, were analyzed. In addition to the demographics, the type of malleolus fracture, the technique used in arthrodesis surgery, use of graft, union status, presence of early and late complications, visual analog scale (VAS), and Maryland Foot Score (MFS) scores at preoperative, 3-, 6-, and 12-month postoperative visits were recorded. There was a total of 11 files available for analysis. The mean age of the cases was 70.55 ± 5.03, ranging between 65 and 82. The records showed that the patients ignored the need for surgical treatment for an average of 10.64 ± 3.5 months. In terms of the technique, 4 were treated using the Ilizarov only, 3 with the intramedullary nails, 3 with plates and screws, and the remaining Ilizarov and plate. The average duration of the union was 6.27 ± 2.99 months. The mean VAS scores for preoperative, postoperative 3rd, postoperative 6th, and postoperative 12th months were 7.55 ± 0.78, 5.55 ± 2.31, 3.45 ± 2.27, and 2.45 ± 1.44, respectively. The mean Maryland Foot Scores (MFS) for preoperative, postoperative 3rd, postoperative 6th, and postoperative 12th months were 21.82 ± 6.85, 51.27 ± 15.39, 61.18 ± 20.21, and 70.82 ± 5.27, respectively. This study has shown that no matter how difficult the case, if the appropriate implant and basic arthrodesis principles are followed, the union can be achieved, albeit late, in cases with osteoarthritis due to neglected ankle malleolus fracture. Especially in the presence of infection, it should be kept in mind that union may be delayed compared to the regular arthrodesis recovery duration, requiring the team performing the surgery to be familiar with the Ilizarov technique.

Aim: The aim of this study was to compare the three most commonly used fixation methods for the fractured trochanter major fragment in patients undergoing uncemented bipolar hemiarthroplasty for unstable intertrochanteric fractures. Methods: The medical records of 231 acute hip fracture cases aged 65 years and older with AO classification 31/A2.2 and 31/A2.3 who underwent unilateral primary cementless bipolar hemiarthroplasty at Adana Şehir Training and Research Hospital between January 2021 and January 2023 were retrospectively analyzed. The files were classified into three groups based on the fixation technique used in the operation. Results: There were 231 files, with a mean age of 82.3±7.9. The majority (55.8%) were classified as ASA III. The analysis resulted in no significant differences between the groups in terms of age, number of days between the day of the injury and the day of the surgery, fixation failure, nonunion, number of revision surgeries, hospitalization duration, and HHS recorded at the third and sixth-month follow-up visits. Among the 73 males and 158 females, the ratio of the side in which the fracture occurred showed no difference (p=0.854). The female rate was significantly higher in group 3 compared to other groups (p=0.003). Regarding union success, cases in group 1 had significantly lower trochanter major union rates (p

Aim: The open reduction-plate method is frequently used in the surgical treatment of mid-distal humeral fractures. However, the radial nerve is always a major problem. In our study, we tried to present a surgical procedure that would eliminate this problem. For this reason, patients who were operated on for humeral mid-distal fractures in our hospital were investigated. Methods: We compared the elastic nail-supported external fixator after closed reduction with plate-screw osteosynthesis after open reduction. Group 1 (16) was divided into elastic nail supported external fixator, Group 2 (39) plate screw osteosynthesis. Groups were analyzed retrospectively. Results: While there was no delayed union and no neurological complications in group 1, three patients in group 2 had pseudoarthrosis and two patients had iatrogenic radial nerve deficit. Conclusion: There was no significant difference in union times and complication rates. However, in the method we defined; operative time, length of hospital stay were statistically significantly lower. We have also demonstrated further advantages of the technique we have described. These; protection of fracture hematoma, no incision scar, no plaster fixation, early rehabilitation, ease of removal of implants. Its disadvantage is that the fixator stays on the patient for about three months. We think that the method will become widespread when the advantages and disadvantages of this technique are evaluated by surgeons. A monolateral external fixator supported by an elastic nail can be used safely, successfully, and easily for the treatment of mid–distal humerus fractures that do not involve the joint.

Introduction: Earthquakes cause a high rate of limb crush injuries complicated by acute compartment syndrome (ACS), leading to numerous fatalities. Following the 2023 earthquakes in Türkiye, we aimed to characterize the timing, anatomical distribution, accompanying procedures, and short-term outcomes of fasciotomies performed for acute compartment syndrome at a tertiary referral center. Methods: We conducted a retrospective cohort study at Adana City Training and Research Hospital during the first week following the earthquake. Patients with extremity crush injury were included; those undergoing fasciotomy for suspected or confirmed ACS constituted the fasciotomy cohort. Demographic, clinical, procedural, and mortality data were extracted from medical records. Comparative analyses assessed age, timing, fracture association, and co-procedures between fasciotomy and non-fasciotomy groups. Results: Among 473 patients with extremity crush injury, 327 (69.1%) underwent fasciotomy. Fasciotomies clustered within the first 48 hours and predominantly involved the lower limb (68.5%), especially the cruris. Compared with non-fasciotomy patients, the fasciotomy cohort was younger (p < 0.001), underwent surgery sooner after the earthquake (p < 0.001), and was less likely to have fractures (p < 0.001). Sixteen fasciotomy patients died in-hospital, with mortality influenced by systemic complications rather than limb management alone. Conclusions: Fasciotomy represented a substantial portion of the orthopedic workload in the first week following the earthquakes, with a front-loaded distribution, primarily involving procedures in the lower limb, concentrated within the first 48 hours. These data emphasize the need for early staffing surge, instrument and dressing preparedness, structured wound-care pathways, and integration for crush syndrome.

Background and Objectives: Pediatric both-bone forearm fractures are commonly treated nonoperatively, yet early loss of reduction remains a clinically important problem. Childhood obesity may be associated with reduced early radiographic stability after closed reduction and casting. Materials and Methods: A retrospective single-center cohort study was performed, including children aged 3 to 13 years who presented between 2020 and 2023 with acute both-bone forearm fractures involving the radius and ulna. Patients were categorized as normal weight (BMI 5th–84th percentile) or obese (≥95th percentile); overweight children (85th–94th percentile) were excluded. Fracture morphology and level, initial management (operative vs. conservative), and early loss of reduction were recorded. Multivariable logistic regression was conducted within the conservative cohort to identify independent factors associated with loss of reduction. Results: A total of 895 patients were included (normal weight n = 633; obese n = 262). Obese children had a higher proportion of complete fractures than normal-weight children (82.4% vs. 61.9%, p < 0.001) and underwent operative management more frequently at index presentation (33.6% vs. 13.1%, p < 0.001). Among conservatively treated patients (n = 724), early loss of reduction occurred in 36 cases and was more common in obese than normal-weight children (13.2% vs. 2.4%, p < 0.001). In multivariable analysis, obesity was independently associated with loss of reduction (aOR 5.98; 95% CI 2.89–12.38; p < 0.001). Conclusions: In children aged 3 to 13 years with both-bone forearm fractures treated with casting, obesity was independently associated with early loss of reduction. Weight status may serve as a practical clinical risk marker to support counseling and closer early radiographic surveillance during nonoperative care.