Background: The aim of this study was to compare the outcomes of unstable intertrochanteric femur fractures treated with cementless calcar-replacement bipolar hemiarthroplasty (CRH) and proximal femoral nail (PFN) in elderly patients. Methods: All consecutive unstable intertrochanteric fractures treated with cementless CRH or PFN at our institution between January 2015 and January 2019 were reviewed retrospectively. The primary outcome measures were postoperative complications, reoperation rate, and hip function. The secondary outcome measures were intraoperative blood loss, transfusion rate, surgical time, hospital stay, and two-year mortality. Results: Ninety-four patients in the hemiarthroplasty group and 77 patients in the PFN group were included for analysis. There were no significant differences between the two groups regarding the complications, ASA score, and reoperation rate. Significant differences were found between hemiarthroplasty and PFN group in comparison of the average length of hospital stay (P < 0.05), time from hospitalization to operation (P < 0.05), intraoperative blood loss (P < 0.001), transfusion rate (P < 0.001), operation time (P < 0.001), Harris Hip Score (HHS; P < 0.001), and two-year mortality (P < 0.05). Conclusion: Both hemiarthroplasty and PFN produce satisfactory results in surgically treated unstable intertrochanteric femur fractures in the elderly. Both groups are associated with their own complications, but in the PFN group, better functional results, less surgery-related trauma, and lower mortality rates are the main advantages.

Objective: The aim of this prospective study was to evaluate the radiological and laboratory parameters of patients diagnosed with COVID-19 who underwent surgery for a lower extremity fracture in our COVID-19 care units in terms of DVT.Patients and Methods: Patients who were operated on due to lower extremity fracture between 10 March and 1 May and diagnosed with COVID-19 were evaluated prospectively. Patients’ age, gender, affected side, fracture location, fracture type, COVID-19 radiological or clinical symptoms and Doppler USG and biochemical markers screening for DVT were evaluated.Results: Thirty patients, ages 39-88, were included in the study. Preoperative D-dimer value of the patients was mean 5.9 mg / L. In all the patients, the D-dimer level was above the normal range. The mean troponin value was 0.025 ng / mL preoperatively. The troponin value was found to be normal in 8 patients and above the normal value in 22 patients. On physical examination, DVT findings were present in 1 patient and DVT was detected in 2 patients on doppler ultrasound.Conclusion: It can be recommended that extra attention should be given to vascular complications in COVID-19 positive trauma patients, as both the effect of trauma itself increases hypercoagulability and COVID-19 disease seems to have the potential to increase hypercoagulability.

Objectives: One of the most common reasons for shoulder instability is recurrent shoulder instability. Arthroscopic repair is an option in the surgical treatment of Bankart lesions, and it is indicated if certain criteria are met. Recent evidence suggests that neurobehavioral traits may predispose individuals to orthopedic injuries. Therefore, we aimed to investigate the correlation between psychiatric parameters and recurrent dislocations in patients treated with arthroscopic Bankart repair. Methods: A total of 83 patients were included in the study, including 42 patients who underwent arthroscopic Bankart surgery due to recurrent shoulder dislocation (RSD) and 41 demographically matched healthy volunteers. The evaluated functional data included parameters such as Constant shoulder score and Rowe score for instability. Psychiatric parameters such as attention deficit hyperactivity disorder (ADHD), the Baratt impulsiveness Scale (BIS-11) and the Depression Anxiety and Stress Scale (DASS-21) were also evaluated. Results: The mean Constant shoulder score was 86.07 ± 12.07 (excellent) and the mean Rowe instability score was 81.26 ± 18.23 (good). The following psychiatric parameters were significantly greater in the patient group than in the control group. Conclusions: RSD patients were found to have significantly higher postoperative ADHD, BIS-11 and DASS-21 scores. Existing ADHD and impulsivity may represent behavioral traits associated with RSD. Higher DASS-21 scores in patients are associated with depression. We recommend that routine psychiatric evaluation for ADHD and impulsivity should be considered in the management of patients with RSD to improve outcomes and prevent recurrence.

Aim: Distal radius fractures are one of the most common fractures in the elderly population. In this study, we aimed to evaluate the changes in radiological parameters in patients treated conservatively for distal radius fractures according to fracture types and age groups.Methods: Patients who received conservative treatment for distal radius fractures between 10 January 2015 and January 2019 were retrospectively screened. Fractures of the patients were divided according to the Arbeitsgemeinschaft für Osteosynthesefragen (AO) classification, and the patients were divided into two groups as under 75 years old and over 75 years old. Ulnar variance, radial inclination, and volar tilt values of the patients after fracture reduction and at the end of the treatment were examined and compared with each other.Results: Wrist radiographs of 232 patients were evaluated in the study. According to the AO classification, 151 patients had type A (A2:144, A3:7), 46 patients had type B (B1:6, B2:33, B3:7), and 35 patients had type C (C1:21, C2:10, C3:4) fractures. While there were 134 patients in the group under 75 years old, there were 98 patients in the patient group over 75 years old. Radiological parameters (except volar tilt in AO type C fractures) were found to be impaired according to the initial evaluation after treatment, regardless of the fracture type and age.Conclusion: It should be kept in mind that patients treated conservatively for distal radius fractures may impair the reduction quality of the patients, the accepted radiological parameters may deteriorate. In elderly patients, the deterioration in these parameters was independent of gender, the presence of ulnar fractures, and fracture classification.