Triple pelvic osteotomy for the treatment of symptomatic acetabular dysplasia in adolescents and adults : A review of 42 hips.

We treated 42 hips with symptomatic acetabular dysplasia using triple pelvic osteotomy. The mean age of the patients was 20.7 years (12-47). The median follow-up was 50.3 months. The average Harris hip score improved from 74 to 92 points. Significant improvement from the preoperative to the latest follow-up evaluation was seen radiologically with reference to the center-edge angle, the anterior center-edge angle, the acetabular index and the femoral head extrusion index. Shenton's line was intact in 9 hips before the operation and it was intact in 40 hips at the latest follow-up. The cross-over sign was present in 15 hips before the operation and it was present in one hip after the operation. The results of this study demonstrated that triple pelvic osteotomy provides improved radiographic results and good symptomatic relief in acetabular dysplasia.

Ischemia-modified albumin and flap viability.

Monitoring flap viability in the postoperative period is important for the prediction of partial or total flap failure. Many alternative methods such as laser Doppler flowmetry, photoplethysmography, infrared spectroscopy, fluorescein injection, evaluation of flap color, turgor, temperature and capillary reflow have been used for this purpose. Although these methods are valuable in the determination of flap condition, they are not sufficient prognostic markers for flaps. In this study, we investigated the relationship between serum ischemia-modified albumin (IMA) values and flap viability. In 20 Wistar rats, caudal-based 9 x 3 cm dorsal flaps were prepared. IMA values were measured before the flap elevation as well as 6 h and 1 week after the surgical procedure. Seven days after the operation, the viable flap areas were calculated. The relationship between changes in the IMA level during the study and viable flap area measurements was investigated. There was no statistically significant correlation between serum IMA level alterations during the preoperative to postoperative 6th hour period and necrotic flap area measurements. This lack of correlation was also present between the change in IMA levels during the preoperative to postoperative 7th day period and necrotic flap area measurements. In conclusion, serum IMA levels do not predict rat skin flap viability.

Performance of simple calculated osteoporosis risk estimation in a sample of women with suspected osteoporosis in the Turkish population.

The aim of this study was to evaluate the performance of the simple calculated osteoporosis risk estimation (SCORE) in a random sample of postmenopausal women. We collected data on 177 consecutive patients aged over 45 years. Bone mineral density (BMD) measurements were taken at the hip and lumbar spine. The test performance cut-off value was evaluated according to scores of 5, 6, 7, 8 and age distribution. When all groups were evaluated, SCORE 6 sensitivity (Sn), specificity (Sp), positive predictive value (PPV) and negative predictive value (NPV) were 86.7, 59.1, 63, 82.5%, respectively. In the age ranged 45-49, we determined SCORE 6 results of Sn 85, Sp 100%. The test was able to identify women not requiring detailed densitometric investigation in this age group to a high level of accuracy. At SCORE 6 receiver operating characteristic (ROC) analysis, the area under the curve (AUC) was 0.6. We determined that the SCORE questionnaire performance in estimating those women with low BMD in the Turkish population was limited. However, since it is a simple, economical and practical pre-test, a SCORE 6 cut-off value can be used together with the physician's clinical analysis in sending patients with suspected low BMD for dual energy X-ray absorptiometry (DEXA) measurement.

Initial fixation strength of interference nail fixation for anterior cruciate ligament reconstruction with patellar tendon graft (experimental study).

The objective of this study was to evaluate initial fixation strength of a new interference nail fixation in anterior cruciate ligament reconstruction using bone-patellar tendon-bone graft. Human cadaver knees were used. Fixation strengths ranged from 500 N to 600 N (mean 550 N). This corresponds to loads in the graft during aggressive rehabilitation. No slippage occurred at fixation site of specimens. Most of the failures appeared from the femoral side with tendon ruptures. With respect to primary fixation strength, interference nail fixation is a reasonable alternative for anterior cruciate ligament reconstruction with bone-patellar tendon-bone graft.