Background and objectives: In this study, the accuracy of point-of-care ultrasonography (POCUS) was compared to radiography (XR) in the diagnosis of fractures, the determination of characteristics of the fractures, and treatment selection of fractures in patients admitted to the emergency department (ED) due to trauma and suspected long bone (LB) fractures. Materials and Methods: The patients were included in the study, who were admitted to ED due to trauma, and had physical examination findings suggesting the presence of fractures in LB (humerus, radius, ulna, femur, tibia, and fibula). The patients were evaluated by two emergency physicians (EP) in ED. The first EP examined LBs with POCUS and the second EP examined them with XR. LBs were evaluated on the anterior, posterior, medial, and lateral surfaces and from the proximal joint to the distal one (shoulder, elbow, wrist, hip, knee, and ankle joint) in both longitudinal and transverse axes with POCUS. Results: A total of 205 patients with suspected LB fractures were included in the study. LB fractures were determined in 99 patients with XR and in 105 patients with POCUS. The sensitivity, specificity, positive predictive value, negative predictive value of POCUS in determining the fractures were 99%, 93%, 93%, and 99%, respectively, compared to XR. Compared to XR, POCUS was able to determine 100% of fissure type fractures (kappa (κ) value: 0.765), 83% of linear fractures (κ: 0.848), 92% of fragmented fractures(κ: 0.756), 67% of spiral fractures (κ:0.798), 75% of avulsion type fractures (κ: 0.855), and 100% of full separation type fractures (κ: 0.855). Conclusions: This study has demonstrated that POCUS has a high sensitivity in diagnosing LB fractures. POCUS has a high sensitivity in identifying fracture characteristics. POCUS can be used as an alternative imaging method to XR in the diagnosis of LB fractures and in the determination of fracture characteristics.

Joint Diseases and Related Surgery (JDRS), the official journal of the Turkish Joint Diseases Foundation, is an international, peer-reviewed, immediate open access journal. All published articles in JDRS has been free for everyone, without embargo, since 1990.

Aim: The aim of this study was to evaluate the functional results of patients with acromioclavicular joint (ACJ) dislocation and who were treated surgically with Hook plate (HP) .Patients and Methods:Patients with ACE dislocation between the years of 2016- 2018 and treated surgically with clavicle KP technique were included in the study. Of the 19 patients, 17 were male and 2 were female. 13 patients had Rockwood Type IV joint dislocation and 6 patients had Rockwood Type V joint dislocation. Functional results were evaluated with modified Constant-Murley shoulder score and standard test protocol. Descriptive statistics were used for data analysis.Results: The plate was removed at 10 months after the operation due to severe pain and limitation of movement in 1 patient. Two of the patients had plate dislocation. Other patients had no complaints. Degenerative changes were detected in direct radiography in 2 patients. The mean Modified Constant-Murley Shoulder Score of the patients was 65 (min: 26, max: 84). The mean pain score of the patients was 7. Ten (53%) patients had moderate and severe pain. Four of the patients had pain at the severity of 8, 4 of the patients had pain at the severity of 10, and 2 of the patients had pain at the severity of 12. The mean daily life activity score of the patients was 12 (min: 6-max: 20). The flexion and abduction score of the patients were lower than the external rotation and internal rotation. The mean total motion score of the patients was calculated as 27 (min: 8-max: 36).Conclusion: The HP method in the treatment of ACJ dislocation is early movement and load can be given, surgery is short and easy to apply as a method. However, it causes moderate and severe pain. This may affect functional results.

Aim:In this study, we reported the functional results and complications of patients with scapula fracture who underwent open reduction and internal fixation. Materials and Methods:The study included 16 patients with scapula fracture who were treated with open reduction and internal fixation (ARIF) between September 2015 and March 2022. Radiologic examination (AP in the scapular plane, lateral and axillary radiography) and computed tomography (CT) scans were performed in all patients. done. Fractures were classified according to the revised (AO/OTA) classification system. The patients underwent deltopectoral and posterior approaches described by Judet. Functional outcomes were measured using Constant-Murley scores. Results:Ten patients had scapular neck fracture, glenoid fossa fracture, five patients had scapular trunk fracture affecting the glenohumeral joint, and one patient had scapula process fracture. It was accompanied by clavicle shaft fracture in five patients. The mean follow-up period after injury was 42 months (6-92 months). The mean Constant-Murley score (CMS) the shoulder with scapula fracture was 93.8 (±8.93). Conclusion: Open reduction and internal fixation of displaced scapular fractures is and effective treatment option in terms of union rate and functional outcome. Keywords:Scapula fracture,Constant-Murley score,Judet approaches

Background: High-grade acromioclavicular (AC) joint separations are clinically relevant injuries in contact sports, yet data specific to recreational football players remain limited. This study evaluated clinical recovery, maintenance of vertical coracoclavicular reduction, and return-to-sport outcomes after minimally invasive acromioclavicular reconstruction (MINAR) in recreational players with acute Rockwood type IV-V AC joint separation. Methods: This single-center retrospective analysis included 49 male recreational football players who sustained acute, isolated, unilateral Rockwood type IV or V acromioclavicular (AC) joint separation during football participation between January 2015 and December 2023. All patients underwent surgery within 7 days of injury using the same MINAR construct and implant platform, and all procedures were performed by the same experienced surgical team. Postoperative rehabilitation was supervised by the institutional physiotherapy department, generally three times weekly, with progression individualized according to clinical recovery. The primary outcome was the change in Constant score from preoperative assessment to 24 months. Secondary outcomes included Taft, American Shoulder and Elbow Surgeons (ASES), and visual analog scale (VAS) pain scores; minimal clinically important difference (MCID) achievement; coracoclavicular (CC) distance; return to unrestricted match play; return to preinjury football level; and exploratory comparisons according to vertical reduction status. Coracoclavicular distance was measured independently by three blinded observers, and the mean of the three measurements was used for the radiographic analyses. Radiographic loss of vertical reduction was defined a priori as a 24-month injured-to-contralateral CCD ratio greater than 1.50. Because only five patients met this criterion, comparisons according to vertical reduction status were considered exploratory and descriptive. Results: The mean age was 35.1 ± 6.2 years, the mean body mass index was 27.9 ± 5.2 kg/m², and the mean follow-up was 48.6 ± 14.5 months. Forty-one patients had Rockwood type V injuries and eight had type IV injuries. All clinical scales improved over time (Friedman p < 0.001). The Constant score increased from 29.9 ± 6.0 preoperatively to 94.5 ± 3.8 at 24 months. Mean preoperative-to-24-month improvements were 64.6 points in Constant score, 6.11 points in Taft score, and 43.3 points in ASES score, while VAS pain decreased by 6.50 points. All 49 patients exceeded the prespecified Constant-score MCID threshold, and 47 of 49 patients (95.9%) exceeded the Taft-score MCID threshold. Return to unrestricted match play occurred in all patients at a mean of 239.9 ± 43.5 days, and 44 patients (89.8%) returned to their preinjury match level. Five patients met the radiographic criterion for loss of vertical reduction (10.2%; 95% CI, 4.4–21.8). In exploratory unadjusted comparisons, these five patients returned to unrestricted match play later than patients who maintained vertical reduction (332.4 ± 35.6 vs. 229.4 ± 29.8 days; unadjusted mean difference, 103.0 days; 95% CI, 59.5–146.5), and none returned to the preinjury football level (0/5 vs. 44/44). These sparse subgroup comparisons were interpreted descriptively. Conclusions: In this cohort of male recreational football players with acute Rockwood type IV-V acromioclavicular joint separation, MINAR reconstruction was followed by substantial improvement in shoulder function, minimal residual pain, and a high rate of return to football. Maintenance of vertical reduction and return-to-sport outcomes showed a clinically notable pattern in exploratory unadjusted analyses; however, the reduction-loss subgroup comprised only five patients, and patient-level chronology did not uniformly support a temporal pathway from reduction loss to delayed return. These findings should therefore be regarded as hypothesis-generating rather than predictive or causal.