Objective: The aim of this study is to compare the clinical and functional results of single-radius (SR) and multi-radius (MR) femoralcomponents in total knee arthroplasty (TKA). Methods: A total of 74 patients who underwent TKA surgery by a single surgeon between 2018 and 2021 were included in the study. The patients were then divided into 2 groups according to their femoral component design: group SR (38 patients) and group MR (36 patients). Except for gender and follow-up duration (P < .05), no significant difference was observed in age, American Society of Anesthesiologists scores, and BMI (P > .05). Knee range of motion, visual analogue scale (VAS), and combined KSS (Knee Society Score) were evaluated at the preoperative and final controls of the patients. In addition, frequency of anterior knee pain (AKP), AKP scale, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Hospital for Special Surgery (HSS) score, and the Forgotten Joint Score-12 (FJS12) were evaluated at the final follow-up. Results: There was no difference between the 2 groups in terms of postoperative range of motion (ROM), VAS, combined KSS, and HSS (P > .05). The frequency of AKP in patients with SR was found to be statistically lower than those with MR (P=.021; P < .05). The AKP scale was found to be statistically significantly lower in patients with prosthetic type MR compared to patients with SR (P=.04; P < .05). Singleradius patients had significantly better FJS-12 (P=.014; P < .05) and WOMAC scores (P=.003; P < .05). Conclusion: The results of this research showed that good clinical and functional results are obtained with TKA regardless of the femoral component design. Single-radius prostheses show better results than MR prostheses in terms of the frequency and severity of AKP. While there is no difference between femoral designs in terms of TKA-specific functional results such as KSS and HSS, the WOMAC score, which measures disease-related functions, provides better clinical results in SR designs. Additionally, SR designs show significantly better results in functional scores indicating patient satisfaction, such as FJS-12. Cite this article as: Şentürk F, Demirel M, Yenigün MY, Canbolat N, Sağlam Y, Şen C. Functional outcome comparison of single-radius and multi-radius femur inNtotal knee arthroplasty. Acta Orthop Traumatol Turc., 2025;59(3):156-163.

Background and Objectives: Courier-operated motorcycles and mopeds have become increasingly visible in urban traffic, raising concerns about injuries among both couriers and pedestrians struck by courier-operated vehicles. The study period coincided with the COVID-19 pandemic; however, this study was not designed to evaluate the effect of the pandemic on courier-related injuries. This multicenter retrospective study aimed to describe hospital-based injury patterns, injury severity, treatment requirements, complications, and mortality among selected courier-related casualties, including motorcycle couriers and pedestrians struck by courier-operated motorcycles or mopeds. Materials and Methods: This retrospective multicenter observational study included courier-related traffic casualties identified between 1 March 2020, and 1 June 2022, through nine hospitals in İstanbul and Ankara and, for fatal courier cases, linked emergency medical service and hospital records. The primary clinical cohort consisted of injured couriers and pedestrians evaluated or treated at participating hospitals. Linked prehospital and early fatal courier cases were analyzed separately for mortality-related and mechanism-specific fatality analyses. Injury severity was assessed using the New Injury Severity Score. Treatment was classified as conservative or surgical, including both fracture fixation and soft-tissue procedures. Results: A total of 857 courier-related traffic casualties were identified, including 491 couriers and 366 pedestrians. Among couriers, 111 fatal cases were verified through linked records. Clinical treatment and follow-up analyses were restricted to 380 hospital-treated surviving couriers and 366 pedestrians with available clinical records. In this selected hospital-treated courier cohort, multiple fractures, open fractures, higher injury severity scores, surgical treatment, and complications were more frequent than among pedestrians. All hospital-treated surviving couriers included in the orthopedic trauma cohort underwent surgery, reflecting the orthopedic trauma-based case-identification process, whereas most pedestrians were treated conservatively. Conclusions: Among this selected hospital-based cohort, courier casualties identified through hospital, trauma referral, emergency, forensic, and linked fatal-event records showed a more severe clinical profile than pedestrians evaluated after being struck by courier-operated motorcycles or mopeds. These findings should be interpreted as hospital-based injury-severity patterns rather than population-level estimates of accident incidence, relative injury risk, or public health burden.

Objectives: To investigate the long-term ulnar nerve function in patients with distal humerus fractures treated with open reduction and internal fixation using electromyography. Design: Retrospective cohort study. Setting: Level 1 trauma center. Patients: Fifty-two patients (20 men and 32 women) with distal humerus fractures between 2002 and 2017. Interventions: Open reduction and internal fixation with a minimum of 5 years of follow-up. Main Outcome Measurements: Nerve conduction tests for evaluation of ulnar nerve function. Secondary outcomes were modified McGowan grading system for symptoms of ulnar neuropathy. Results: The mean follow-up time was 112.7 ± 39 months after surgery. Fifteen patients (28.8%) scored in grade I, 30 (57.6%) in grade II, and 7 (13.6%) in grade III on the affected side according to McGowan grading scale. According to EMG results, 40.1% (21/52) of patients had abnormal results. There was significant differences between fracture and unaffected side regarding ulnar nerve motor wrist compound muscle action potential (CMAP) amplitude, motor below-elbow CMAP amplitude, above-elbow CMAP amplitude, above-elbow motor nerve conduction velocity, and sensory wrist amplitude. Ulnar nerve motor wrist-abductor digiti minimi latency (P = 0.01; r = 0.446) and ulnar nerve sensory conduction velocity (P < 0.001, r = −0.504) were significant correlation with McGowan grading scale. Conclusions: There were significant differences between fractured and unaffected side regarding ulnar nerve motor amplitude and sensory wrist amplitude. A mean decrease in sensory amplitude of fracture elbow was found to be 25% compared with the unaffected side in our result. Level of Evidence: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

Purpose: Tibiotalocalcaneal (TTC) arthrodesis is a well-established treatment for end-stage ankle arthritis. In patients with prior lateral malleolar fixation, the role of the fibula during arthrodesis remains controversial. While some surgeons prefer fibular preservation as an onlay graft, concerns exist regarding its biological viability after previous surgical interventions. This study aimed to compare clinical and radiological outcomes of fibular excision versus fibular onlay grafting in this specific patient population. Methods: This retrospective comparative study included patients who underwent TTC arthrodesis using retrograde intramedullary nailing following prior plate-and-screw fixation of the lateral malleolus. Patients were divided into two groups based on surgical technique: fibular excision and fibular preservation as an onlay graft. Clinical outcomes were assessed using the American Orthopaedic Foot and Ankle Society (AOFAS) score and Visual Analog Scale (VAS) for pain. Radiological evaluation included time to union. The primary outcome was postoperative pain assessed using the Visual Analog Scale (VAS), while secondary outcomes included AOFAS score, time to union, operative time, and complications. Results: A total of 37 patients were included in the final analysis. Baseline characteristics were comparable between the groups. Both techniques resulted in significant improvement in AOFAS scores, with no significant difference between groups ( p = 0.825). Postoperative VAS scores were significantly lower in the fibular excision group ( p = 0.011), and this difference was supported by a moderate effect size (Cohen’s d = 0.45), indicating clinical relevance. Time to union was similar between groups ( p = 0.945). Operative time was significantly shorter in the fibular excision group ( p < 0.001). Conclusion: In patients with prior lateral malleolar fixation, preserving the fibula as an onlay graft during TTC arthrodesis does not improve union or functional outcomes. Instead, fibular excision is associated with shorter operative time and lower postoperative pain.