Background and Objectives: The incidence of hip fractures in people of advanced ages is increasing due to our aging society. Patient positioning for the intertrochanteric fractures of the femur can be performed in various ways. The aim of this study is to clinically and radiologically compare the use of the supine hemilithotomy position, the lateral decubitus position, and the traction table when performing proximal femoral nail (PFN) surgery for femoral intertrochanteric fractures in the geriatric age group. Materials and Methods: A total of 170 elderly patients with femoral intertrochanteric fractures were included in this cross-sectional study. The patients were divided into three groups (the supine hemilithotomy group, the lateral decubitus group, and the fracture table group). For the postoperative period, complications, length of stay in the intensive care unit, and length of stay in hospital were examined, while in postoperative radiographs, tip–apex distances (TADs), collodiaphyseal angles (CDAs), and Cleveland–Bosworth quadrants were examined to evaluate the placement of the lag screw in the femoral head. The quality of fracture reduction was evaluated according to the modified Baumgaertner criteria. Results: The mean age of the patients was 77.8 ± 8.8; 57.6% of patients were female. According to the modified Baumgaertner criteria, it was determined that patients with ‘poor’ reduction quality had an approximately ten times higher risk of cut-out than those with ‘good’ reduction quality (OR = 10.111, p = 0.002, 95% confidence interval; 2.313–44.207). The operative time for patients in the fracture table group was longer than that of the other groups Additionally, the CDA in the supine hemilithotomy position group was longer. Conclusions: Although PFN surgery using the traction table is longer in terms of surgical time compared to surgery performed in the lateral decubitus position and the supine hemilitotomy position, it is advantageous in terms of better TAD and CDA values and lower complication rates.

Study Design: Randomized controlled animal experiment. Objectives: To determine and compare the efficacy of riluzole, MPS and the combination of two drugs in a rat model with acute spinal trauma, electrophysiologically and histopathologically. Methods: 59 rats were divided into 4 groups as control, riluzole (6 mg/kg, every 12 hours for 7 days), MPS (30 mg/kg, 2nd and 4th hours after injury) and riluzole + MPS. Spinal trauma was created and the subjects were followed for 7 days. Electrophysiological recordings were made via neuromonitoring. The subjects were sacrificed and histopathological examination was made. Results: For the amplitude values, mean alteration in the period from the spinal cord injury to the end of the 7th day is 15.89 ± 20.00%, 210.93 ± 199.44%, 24.75% ± 10.13% increase and 18.91 ± 30.01% decrease for the control, riluzole, riluzole + MPS and MPS groups, respectively. Although the riluzole treatment group produced the greatest increase in amplitude, it was observed that no treatment provided a significant improvement compared to the control group, in terms of latency and amplitude. It was observed that there was significantly less cavitation area in the riluzole treatment group compared to the control group ( P = .020). ( P < .05). Conclusions: Electrophysiologically, no treatment was found to provide significant improvement. Histopathologically, it was observed that riluzole provided significant neural tissue protection.

Background and objectives: The incidence of hip fractures in advanced age is increasing due to the aging society. In trochanteric region fractures of the femur, patient positioning can be performed various ways. The aim of this study is to clinically and radiologically compare the use of the supine hemilithotomy position, the lateral decubitus position, and the traction table when performing PFN surgery for femoral intertrochanteric fractures in the geriatric age group.Materials and Methods: A total of 170 older patients with femoral intertrochanteric fractures were included in this cross-sectional study. The patients were divided into three groups the supine hemilithotomy group, lateral decubitus group and fracture table. For the postoperative period, complications, length of stay in the intensive care unit, and length of stay in hospital were examined, while in postoperative radiographs, tip-apex distance (TAD), collodiaphyseal angle (CDA), and Cleveland-Bosworth quadrants were examined to evaluate the placement of the lag screw in the femoral head. Quality of fracture reduction was evaluated according to the modified Baumgaertner criteria.Results: The mean age of the patients was 77.77±8.8; 57.6% of patients were female. According to the modified Baumgaertner criteria, it was determined that patients with ‘poor’ reduction quality had an approximately ten times higher risk of cut-out than those with ‘good’ reduction quality. (OR = 10.111, p = 0.002, 95% confidence interval; 2.313-44.207). The duration of surgery of patient in the fracture table group was found to be higher than in the other groups, the CDA in the supine position group were found lower than in the other groups, and the TAD in the supine position group was found higher than in the other groups. Complications were mostly detected in patients who underwent surgery in the lateral decubitus position. (p<0,05) Conclusion: We believe that it is necessary to be familiar with all methods, since it is very difficult to choose the most appropriate method according to the surgeon’s experience, the hospital’s facilities and conditions, and the patient’s clinical status.

Introduction This study aimed to evaluate the prognostic value of a composite score integrating the neutrophil-to-lymphocyte ratio (NLR), serum albumin, and D-dimer levels for predicting 1-year mortality in geriatric patients with proximal femur fractures. Materials and methods This retrospective cohort study included 300 patients aged ≥ 65 years who were admitted with proximal femur fractures and underwent surgical treatment between November 2023 and March 2026. Demographic, clinical, and laboratory data were collected from hospital records. A composite score based on NLR, albumin, and D-dimer was calculated. An exploratory unweighted 0–3 composite score was constructed from cohort-derived ROC thresholds for NLR, albumin, and D-dimer. Logistic regression, receiver operating characteristic (ROC) curve analysis, net reclassification improvement (NRI), integrated discrimination improvement (IDI), Kaplan–Meier survival analysis, Cox regression, calibration analysis, and decision curve analysis (DCA) were performed to evaluate predictive performance. Results A total of 300 patients were analyzed, of whom 75 (25.0%) died within 1 year. Non-survivors were older and had significantly higher NLR and D-dimer levels and lower albumin levels (all p < 0.001). In mutually exclusive adjusted regression models, higher NLR and D-dimer levels, lower albumin levels, and a higher composite score were associated with 1-year mortality. In the composite-score model, each 1-point increase in score was associated with mortality after adjustment for clinical covariates (adjusted OR: 2.82, 95% CI: 1.95–4.08; p < 0.001). The composite score and its constituent biomarkers were not entered simultaneously into the same multivariable model. The composite score showed an apparent AUC of 0.86 (95% CI: 0.81–0.90), compared with AUCs of 0.74, 0.76, and 0.78 for NLR, albumin, and D-dimer, respectively. Addition of the score to the basic clinical model yielded a category-free NRI of 0.27 (95% CI: 0.14–0.40; p < 0.001) and an IDI of 0.068 (95% CI: 0.035–0.101; p < 0.001), indicating improved apparent risk separation within the derivation cohort. Kaplan–Meier and Cox regression analyses showed a stepwise increase in mortality risk across score groups (HR: 3.12 for high-risk group, p < 0.001). Calibration and decision-curve analyses suggested favorable apparent model performance and potential net benefit within the present study cohort. Conclusions In this retrospective single-center cohort, the composite score integrating NLR, albumin, and D-dimer was associated with 1-year mortality and showed promising apparent discriminatory performance. The score should be considered an exploratory prognostic tool that may complement comprehensive clinical assessment and support future risk-stratification research. Prospective multicenter studies with external validation and evaluation of clinical impact are required before its use in routine practice can be considered.