The aim of this study was to evaluate the clinical and radiological results of patients with acute type III Rockwood acromioclavicular joint (ACJ) dislocation treated surgically by employing tension band wiring. The study included 24 patients with traumatic type III ACJ dislocations according to the Rockwood classification. The clinical and radiological outcomes of patients were assessed at the final follow-up visit. Implant failure and reduction loss were assessed using radiographs, whereas the Constant-Murley scoring system was used to assess the patients clinically. The mean follow-up period was 3.5 ± 1.3 years (range: 1-6 years). The mean age of the patients was 41.8 ± 11.7 years (range: 19-64 years) and the mean length of hospital stay was 2.3 days (range: 1-6 days). The fixation material was removed postoperatively at an average of 7.2 ± 9.9 months (range: 3-40 months). At the end of the follow-up period, the mean Constant-Murley score was 72.5 ± 12.8 (range: 50-90). The ACJ reduction was stable in 13 (54.2%) patients. Residual subluxation was detected in 11 (45.8%) patients. Distal clavicular osteolysis was noted in six (25%) patients. Acromioclavicular osteoarthritis was detected in five (20.8%) operated shoulders on follow-up radiographs. During the follow-up, Kirschner-wire migration and breakage occurred in four (16.6%) and seven (29.1%) patients, respectively. This study showed that surgical treatment with the tension band wiring method provided functionally satisfactory results even if complications developed because of the presence of implants. Independent of age, we can recommend it as the primary treatment method for patients who do not have very high expectations regarding their shoulder function. Additionally, we think that reducing the duration of implant retention will reduce the incidence of complications.

Aim: This study aimed to compare the effects of the Winograd and modified Winograd methods for nail bed suturing on clinical outcomes in patients with nail ingrown. Methods: In total, 45 patients who underwent surgery for ingrown toenails between December 2019 and December 2020 were randomised retrospectively. In this study, different methods applied by the authors were studied, and the methods applied by each author were divided into two separate groups. All patients had partial germinal matrix and nail bed excisions. Thirty (53.6%) of the nails were dressed in gauze, leaving the excised area of ​​the nail unsutured (group 1). Then, the remaining 26 nails (group 2) were sutured with the mattress suturing technique to ensure that the skin was under the nail. Clinical outcomes, visual analogue scale (VAS) scores, and verbal satisfaction status were statistically evaluated. Results: In our study, 56 nails of 45 patients were evaluated retrospectively. The patients were followed up for an average of 13 (10­19) months. The mean age was 27.13 (15-­48) years. In total, 31 (68.9%) of the patients were men, and 14 (31.1%) were women. The incidence of postoperative bleeding and granulation tissue development decreased in the sutured group. In group 1, the development of hypertrophic granulation tissue after surgery had a significantly negative impact on VAS score and recovery time. In the sutured group, patients returned to work or performed activities of daily living for a shorter period. Approximately 95% of patients were satisfied or extremely satisfied. Conclusion: Partial matrix excision using the appropriate suturing technique is associated with a fast recovery, low recurrence rate, high patient satisfaction, and earlier return to work activities of daily life among patients treated for ingrown toenails.

Diabetes mellitus (DM) is a major global health problem, and its incidence is growing. Depending on this increase, the number of diabetes-related complications will also rise. This study aimed to determine the risk factors associated with major and minor amputations resulting from diabetes. Patients diagnosed with diabetic foot complications (n = 371) and hospitalized between January 2019 and March 2020 were retrospectively evaluated using information obtained from the database of Diabetic Foot Wound Clinic. Examination of the data identified 165 patients for inclusion in the study, who were stratified into major amputation (group 1, n = 32), minor amputation (group 2, n = 66) and non-amputation (group 3, n = 67) groups. Of the 32 patients who underwent major amputations, 84% had a below-knee amputation, 13% had an above-knee amputation and 3% had knee disarticulation. At the same time, 73% of 66 patients who underwent minor amputation had a single-finger amputation, 17% had a multiple-finger amputation, 8% had a transmetatarsal amputation, and 2% had Lisfranc amputation. Laboratory results showed high acute phase protein and low albumin (ALB) levels in patients from group 1 (p < 0.05). Although Staphylococcus aureus was found to be the most common infectious agent, Gram-negative pathogens were dominant (p < 0.05). Also, there was a significant cost difference between the groups (p < 0.05). Furthermore, those aged over 65 had a high Wagner score, high Charlson Comorbidity Index (CCI), long diabetic foot ulcer (DFU) duration, and high white blood cell (WBC) count, all of which were risk factors for major amputation (p < 0.05). This study demonstrated an increased Wagner staging and incidence of peripheral neuropathy (PN) and peripheral arterial disease (PAD) in major amputation patients. In addition, the rate of distal vessel involvement was high in major amputation patients, with elevated acute phase proteins and low ALB levels crucial in laboratory findings.

Background and Objectives: This study aimed to evaluate the factors influencing early postoperative mortality in patients undergoing cementless hemiarthroplasty for proximal femoral fractures. Materials and Methods: The medical records of 227 patients treated between January 2019 and December 2020 were retrospectively reviewed. Patients were divided into two groups: survivors (Group 1, n = 160) and non-survivors (Group 2, n = 67). The variables assessed included demographic data, neutrophil-to-lymphocyte ratio, surgical duration, hospital stay, American Society of Anesthesiologists (ASA) score, cardiac ejection fraction (EF), Charlson Comorbidity Index (CCI), osteoporosis status, and hemoglobin and albumin levels. Clinical evaluation was performed using the Harris Hip Score. Binary logistic regression was used to analyze risk factors; receiver operating characteristic (ROC) analysis was applied to determine cutoff values. Results: The mean follow-up duration was 14.03 ± 10 months. The mean ages were 80 ± 7.68 yr in Group 1 and 83.99 ± 7.42 yr in Group 2. Statistically significant differences were found between groups regarding ASA scores, intensive care unit (ICU) admission rates, and osteoporosis status (p < 0.001). Preoperative and postoperative albumin levels were also significantly different (p < 0.001). The 1-year and 6-month mortality rates were 39.6% and 29.5%, respectively. Univariate analysis identified age, EF, ASA score, preoperative and postoperative albumin levels, CCI, ICU admission, and ICU stay duration as mortality-related factors. Multivariate binary logistic regression analysis revealed that low postoperative albumin levels may have a significant effect on mortality at 1, 3, and 6 months. ROC analysis showed a significant albumin cutoff value of 2.95 g/dL. Conclusions: Higher postoperative albumin levels were inversely associated with early mortality following hemiarthroplasty in elderly patients. Perioperative monitoring of albumin levels may help improve outcomes, particularly in individuals with severe comorbidities.

Objective: The cementing technique employed in total knee arthroplasty (TKA) significantly influences the penetration of cement into the bone, ultimately affecting the stability of the joint. This study aimed to assess the impact of tourniquet usage on tibial cement penetration, operative time, bleeding, and functional outcomes following TKA. Materials and Methods: A retrospective evaluation was conducted on 103 patients who had undergone TKA and had a minimum follow-up period of 2 years. The patients were categorized into three groups: Group 1 utilized a tourniquet throughout the entire surgery, Group 2 released the tourniquet immediately after prosthesis implantation, just before cement hardening, and Group 3 did not employ a tourniquet at any stage of the procedure. Tibial cement penetration was assessed via X-ray examination, following the Knee Society Scoring System criteria. Operative time, bleeding levels, and Lysholm and Oxford scores were compared among the groups. Statistical analysis was performed using SPSS version 22.0 software. Results: In Group 1, bone penetration of cement was significantly higher than in both Group 2 and Group 3, except for zone 1 in the anterior-posterior (AP) view (p < 0.017). Group 3 exhibited significantly less bleeding compared to the other groups (p < 0.017). There was no significant difference in terms of bleeding between Group 1 and Group 2. The operation time was significantly shorter in Group 1 compared to the other groups (p < 0.017). The mean cement penetration depth across all groups was measured at 2.44 ± 0.27 mm. Bleeding volume and operation time did not have a significant effect on mean cement penetration (p > 0.05). Additionally, there were no significant differences observed between the groups in terms of the Lysholm and Oxford functional test results (p > 0.017). Conclusions: The use of a tourniquet was found to increase cement penetration and reduce operation time; however, it did not have a significant impact on reducing bleeding. Based on our findings, we recommend considering a shorter tourniquet time and implementing effective bleeding control measures to mitigate potential complications associated with tourniquet usage.