Background: Acetabular fractures present a complex spectrum of injuries, often categorized as simple (elementary) or associated (complex) based on the Judet and Letournel classification. Understanding whether this morphological distinction correlates with demographic or perioperative clinical parameters remains an area of active investigation. Methods: This retrospective study included 51 patients who underwent surgical treatment for acetabular fractures at our institution. Patients were grouped as elementary or complex based on fracture type. Demographic data, injury mechanism, operative time, hemoglobin change, transfusion requirements, intensive care unit (ICU) admission, hospital stay duration, and presence of concomitant injuries were recorded and compared between groups. Results: Of the 51 patients, 31 (60.8%) had elementary fractures and 20 (39.2%) had complex fractures. The mean age, injury mechanism, operative time, hemoglobin change, transfusion needs, and presence of concomitant injuries did not significantly differ between the two groups (p < 0.05). However, patients with complex fractures had a significantly longer hospital stay and higher ICU admission rates (p < 0.05). Concomitant injuries were observed in 56.9% of all patients, with similar distribution across fracture types. Conclusions: While elementary and complex acetabular fractures share similar demographic and perioperative profiles in terms of trauma mechanism, age, and operative parameters, complex fractures are associated with increased postoperative care requirements, including longer hospitalizations and greater ICU utilization. These findings suggest that fracture morphology itself may influence early postoperative outcomes independently of classic trauma severity indicators.

Alkaptonuria is a rare autosomal recessive metabolic disorder caused by homogentisic acid oxidase deficiency, leading to the accumulation of homogentisic acid and ochronotic pigmentation in connective tissues. Although it typically presents with dark urine and arthropathy in later life, it often remains undiagnosed until advanced degenerative changes occur. We report a 54-year-old male patient who underwent total knee arthroplasty due to advanced degenerative arthritis. Intraoperatively, unexpected black pigmentation of the articular cartilage and surrounding connective tissues was observed. The patient had no previous diagnosis of alkaptonuria and was managed with postoperative metabolic evaluation, dietary advice, and follow-up. Ochronosis may remain undetected until late adulthood and can be encountered incidentally during orthopedic procedures. Awareness of this rare entity is crucial for orthopedic surgeons to ensure accurate intraoperative assessment and appropriate postoperative management.

Amaç: Bu çalışma, acil şartlarında değerlendirilen femur boyun kırığı hastalarında femur başı histopatolojik inceleme gerekliliğini ve erken dönemde yapılan ameliyatların klinik sonuçlarını araştırmayı amaçladı. Gereç ve Yöntemler: Etik kurul onayı sonrası 01.01.2019–31.12.2023 arasında tek merkezde 1450 femur boyun kırığı olgusu retrospektif incelendi. Radyografide patolojik şüphe saptanan olgular BT/MR ile değerlendirildi ve yaklaşık 20 uzman hekimin katılımıyla şüpheli bulunan 293 hastadan, bilinen kanser öyküsü olan 52’si ve patolojik örnek gönderilmeyen 9’u dışlandı; 65 yaş üstü, düşük enerjili travmalı 232 hasta analize alındı. Cerrahi, patoloji sonucu beklenmeden uygun artroplasti ile gerçekleştirildi; femur baş-boyun örnekleri rutin histopatolojiye gönderildi ve gerektiğinde immünohistokimya ile moleküler testler uygulandı. Bulgular: Ortalama yaşı 82,11 (64–99) olan 232 hastanın 11’inde (%4,7) patolojik kırık saptandı; bu olguların tamamında geriye dönük sorgulamada kırık öncesi kalça ağrısı, kilo kaybı ve halsizlik vardı. On hastaya hemiartroplasti uygulandı; bir olguda metastaz progresyonuna bağlı 6. ayda implant yetmezliği gelişerek tümör rezeksiyon protezi ile revizyon yapıldı, dış merkezde total kalça protezi uygulanan bir olguda ise asetabular gevşeme ve litik alanlar nedeniyle sementli asetabular ring ile revizyon sonrası prostat kanseri metastazı tanısı kondu. İzlemde 49 hasta (%21,1) eksitus oldu ve patolojik kırık saptanan 11 hastadan 1’i bu gruptaydı. Sonuç: Kırık öncesi kasık/kalça ağrısı, hızlı kilo kaybı, halsizlik ve ailevi/kişisel kanser öyküsü gibi klinik ipuçları ile radyolojik şüpheli bulguların birlikte olduğu hastalarda seçici histopatolojik inceleme hastalık yönetimi açısından değer taşırken, histopatolojik inceleme düşük tanısal getiriyle gereksiz maliyet artışına yol açabilir.

Background: Work-related hand injuries constitute a major public health concern and a significant cause of occupational morbidity and lost productivity, particularly in highly industrialized regions. This study aimed to evaluate the epidemiological characteristics of patients presenting with occupational hand injuries in Kayseri, Türkiye. Methods: A retrospective cohort study was conducted, evaluating 586 patients with work-related hand injuries between January 2024 and December 2024. Inclusion criteria comprised isolated hand injuries resulting from occupational accidents and documented patient consent. Demographic parameters, injury mechanisms, affected anatomical zones, and treatment modalities were systematically analyzed. Results: The patient cohort was predominantly male (91.9%), with a mean age of 31 years. The machinery sector accounted for the highest incidence of trauma (30.7%). High-energy crush injuries inflicted by press machines were the predominant mechanism of injury (62.0%). Topographically, the index finger (second digit) was the most frequently injured. While 71% of patients were treated and discharged directly from the emergency department, 29% required formal hospital admission. Anatomical analysis revealed that among the individual tendons lacerated, 57.8% involved the extensor zones and 42.2% involved the flexor zones. Furthermore, left-hand digital injuries (54%) were significantly more prevalent than right-hand injuries. Conclusion: Occupational hand injuries disproportionately afflict young male industrial workers and are primarily driven by high-energy mechanisms, resulting in trauma that ranges from superficial lacerations to devastating amputations.

Animal bites, particularly from domestic cats, represent a significant public health concern, accounting for a substantial number of emergency room visits annually. However, osteomyelitis of the metacarpal bone following a cat bite is a rare and underreported complication which presents unique diagnostic and therapeutic challenges. A 35-year-old male patient developed metacarpal osteomyelitis following a housecat bite, despite receiving early empirical antibiotic therapy. Unlike conventional osteomyelitis, cat bite-related osteomyelitis can progress insidiously due to rapid wound closure, creating an anaerobic environment that fosters deep-seated infection. This case underscores the importance of early radiological evaluation, aggressive surgical debridement, and prolonged targeted antibiotic therapy in managing such infections. In conclusion, the report highlights the need for heightened clinical suspicion and tailored management strategies to prevent delayed diagnosis and complications in similar cases.

This retrospective study aimed to compare the effects of hemiarthroplasty and proximal femoral nail on one-year mortality in patients over 65 years of age with femoral intertrochanteric fractures. A total of 307 patients treated for femoral intertrochanteric fracture between January 1, 2019, and December 31, 2021, were evaluated and divided into two groups: hemiarthroplasty (Group 1) and proximal femoral nail (Group 2). Data collected included demographic information, pre- and postoperative hemoglobin and albumin levels, neutrophil-to-lymphocyte ratios, presence of osteoporosis, duration of surgery, length of hospital stay, postoperative intensive care unit requirement, presence of additional trauma, American Society of Anesthesiologists scores, cardiac ejection fraction values, and comorbidities assessed using the Modified Charlson Comorbidity Index. Receiver operating characteristic analysis was used to determine cut-off values for factors significantly affecting mortality. The mean age of the patients was 81.38 ± 8.014 years, with a mean follow-up of 14.48 ± 9.69 months (range = 1–36). The overall one-year mortality rate was 39.1% (n = 120): 41.9% in Group 1 and 32.6% in Group 2. Univariate regression analysis showed that age, sex, American Society of Anesthesiologists scores, ejection fraction, pre- and postoperative albumin levels, Modified Charlson Comorbidity Index, and intensive care unit stay duration significantly affected mortality. Multiple logistic regression identified male sex as a risk factor in Group 1 and intensive care unit admission in Group 2. This study demonstrates that, irrespective of the implant type, patients' existing chronic illnesses and metabolic conditions must be carefully assessed.