Objectives: This study aimed to assess the patient demographics and emergency response adaptation in a primary-level state hospital following the 6 February Türkiye earthquakes. Materials and methods: The study was conducted at the XXX Hospital, which remained largely unaffected by the earthquakes. The hospital faced challenges in providing medical care due to the loss of staff, damaged infrastructure, and limited resources. A volunteer orthopedic surgery team, along with other medical professionals, provided treatment to the earthquake victims. The patient data was collected from the conventional record book of the operating room. Results: From 6 to 12 February 2023, a total of 111 surgeries were performed at the hospital, with 92 (%83) being earthquake-related. Orthopaedic surgeons operated on most of the patients. The most common surgeries included fasciotomies, amputations, and fracture fixations. The surgeries were performed in a time-sensitive manner, with immediate life- and extremity-saving procedures prioritized. The hospital's infrastructure challenges and the lack of digital recording systems hampered the data collection process. Conclusion: The study highlighted the challenges faced by the XXX Hospital in providing emergency medical care following the earthquakes. Despite the chaotic conditions and limited resources, the medical professionals worked tirelessly to ensure continuous care for the earthquake victims. The demographic analysis revealed a predominance of young patients, and the most common surgeries were related to compartment syndromes and extremity injuries. The findings emphasize the importance of preparedness, robust infrastructure, and efficient patient recording systems in facilitating effective emergency response and healthcare delivery during and after natural disasters. Lessons learned from this study can contribute to the development of future action plans to improve emergency medical care in earthquake-prone regions.

SUMMARY OBJECTIVE: Venous thromboembolism prophylaxis remains a complex and controversial issue in orthopedic practice, with persistent variability in recommendations even among experts. With the growing use of online platforms and artificial intelligence, the aim of this study was to evaluate the quality and clinical adequacy of artificial intelligence-generated recommendations regarding venous thromboembolism. METHODS: Thirty-three guideline-based questions derived from International Consensus Meeting, National Institute for Health and Care Excellence, American College of Chest Physicians, and American Academy of Orthopaedic Surgeons recommendations were independently submitted to ChatGPT (Generative Pre-trained Transformer [GPT]-4.0) by two orthopedic surgeons, resulting in 66 generated responses for analysis. Responses were assessed using the DISCERN instrument, Journal of the American Medical Association benchmark criteria, and a novel clinically oriented scale, the Thromboembolism Digital Knowledge Level. Inter-rater reliability was evaluated using intraclass correlation coefficients. RESULTS: According to DISCERN, 62.1% of responses were classified as good quality, whereas Thromboembolism Digital Knowledge Level evaluation demonstrated that only 45.45% of responses were clinically adequate, with no responses classified as excellent. The same responses were systematically categorized into higher quality levels by DISCERN compared to Thromboembolism Digital Knowledge Level. All scoring systems demonstrated excellent inter-rater reliability (Intraclass Correlation Coefficient range: 0.897–0.961). Although differences between scoring systems were statistically significant, the effect size was moderate (r=0.39). Strong correlations were observed between evaluators across all scales (p<0.001). CONCLUSION: ChatGPT-generated responses demonstrated good structural quality but limited clinical adequacy for thromboembolic prophylaxis after arthroplasty. These findings suggest that artificial intelligence systems should be used cautiously and may not be sufficient as standalone clinical decision-support tools.

Background: The Rockwood classification is the most widely used radiographic framework for grading acromioclavicular (AC) joint dislocations. However, native anatomical variation may be associated with differences in the radiographic appearance of AC joint dislocations. Purpose: To evaluate the association between the acromioclavicular joint coronal orientation angle (AJCO) and Rockwood grade and to characterize the relationship between native coronal orientation and radiographic grade. Methods: This retrospective observational radiographic study included 198 adults with acute AC joint dislocations classified as Rockwood II, III, or V on standardized bilateral Zanca radiographs. AJCO was measured on the contralateral, uninjured side as the angle between the AC joint orientation line and a vertical reference. Two blinded orthopedic surgeons performed measurements independently, with reliability assessed using intraclass correlation coefficients. AJCO was compared across Rockwood groups, its monotonic association with grade was evaluated using Spearman correlation, and exploratory receiver operating characteristic analysis was performed for the tested binary contrast. Results: AJCO differed significantly across Rockwood injury grades, decreasing progressively from type II to type V injuries (median [IQR]: type II, 18.3° [14.6–26.0°]; type III, 15.3° [12.0–21.3°]; type V, 14.0° [8.6–18.0°]; p < 0.001). Consistent with this finding, AJCO demonstrated an inverse weak-to-moderate association with Rockwood grade (Spearman ρ = −0.338, 95% CI −0.453 to −0.214; p < 0.001). AJCO showed limited ability to discriminate higher-grade injuries (Rockwood ≥ III), with an AUC of 0.694 (95% CI, 0.612–0.777; p < 0.001), characterized by high specificity but low sensitivity at the optimal threshold. Furthermore, lower AJCO values remained significantly associated with higher Rockwood grades after adjustment for age and sex (OR = 0.899 per degree increase, 95% CI, 0.864–0.935; p < 0.001). Conclusions: Lower AJCO values were associated with higher Rockwood grades in this cohort, but the magnitude of association and discriminatory performance were limited. These findings support AJCO as a morphology-related contextual variable associated with Rockwood grade rather than as a stand-alone diagnostic or treatment-guiding measure.