IoT-Enabled Electronic Nose System for Beef Quality Monitoring and Spoilage Detection.

Food spoilage is a major concern in the food industry, especially for highly perishable foods such as beef. In this paper, we present a versatile Internet of Things (IoT)-enabled electronic nose system to monitor food quality by evaluating the concentrations of volatile organic compounds (VOCs). The IoT system consists mainly of an electronic nose, temperature/humidity sensors, and an ESP32-S3 microcontroller to send the sensors' data to the server. The electronic nose consists of a carbon dioxide gas sensor, an ammonia gas sensor, and an ethylene gas sensor. This paper's primary focus is to use the system for identifying beef spoilage. Hence, the system performance was examined on four beef samples stored at different temperatures: two at 4 °C and two at 21 °C. Microbial population quantifications of aerobic bacteria, Lactic Acid Bacteria (LAB), and Pseudomonas spp., in addition to pH measurements, were conducted to evaluate the beef quality during a period of 7 days to identify the VOCs concentrations that are associated with raw beef spoilage. The spoilage concentrations that were identified using the carbon dioxide, ammonia, and ethylene sensors were 552 ppm-4751 ppm, 6 ppm-8 ppm, and 18.4 ppm-21.1 ppm, respectively, as determined using a 500 mL gas sensing chamber. Statistical analysis was conducted to correlate the bacterial growth with the VOCs production, where it was found that aerobic bacteria and Pseudomonas spp. are responsible for most of the VOCs production in raw beef.

Lumbopelvic Fixation with Bridged Distal Iliac Screws for Vertically Unstable Sacral Fractures.

Purpose: The purpose of this study is to evaluate preliminary outcomes of vertically unstable sacral fractures treated by lumbopelvic fixation (LPF) augmented transiliac bridged screws. Methods: From April 2017 to December 2019, fifteen consecutive patients with vertically unstable sacral fractures who had undergone LPF augmented transiliac bridged screws were enrolled. The radiological assessment included standard lumbopelvic x-rays and pelvic computed tomography (CT) to evaluate the lumbosacral angle (LSA), sacral kyphosis angle (SKA), lumbar lordosis angles (LLA) and Matta's reduction criterias (MRC). Clinical and neurologic impairment outcomes were evaluated by the Majeed grading scale (MGS) and Gibbons criterias, respectively. Results: All patients were followed for an average of 18 months (range, 14-25). All sacral fractures eventually healed and implant failure did not occur in any patient, though there were two patients with a loss of reduction (< 5 mm) during the follow-up period. According to the MRC, the results were excellent on 14 sides, good on five sides, and fair on one side. The MGS mean score was 82 points (range, 49-98 points); the results were excellent in nine cases, good in four cases, and fair in two cases. There was no statistically significant difference in SKA and LLA in preoperative and postoperative final controls. The preoperative and postoperative LSA were 72 ± 13.9 and 44.1 ± 11.3, respectively, and a statistically significant improvement was observed (p = 0.01). Conclusion: In vertically unstable sacrum fractures, we believe that LPF augmented with transiliac bridging technique may expedite the reduction of vertical sacrum fracture and offers a reinforced fixation choice.

Ozone gas applied through nebulization as adjuvant treatment for lung respiratory diseases due to COVID-19 infections: a prospective randomized trial.

The objective of this study was to provide lung disinfection by nebulizing ozone gas with distilled water and olive oil for patients who have clinical symptoms due to coronavirus disease 2019 (COVID-19). The study attempted to reduce the viral load of COVID-19 in the lungs of patients, to provide a faster response to medical treatment. Between August 2020 and September 2020, 30 patients who met the study criteria were prospectively evaluated. There were 2 groups with 15 patients in each group: patients in control group were not treated with ozone and only received standard COVID-19 treatment; patients in ozone group received lung disinfection technique with ozone and standard COVID-19 treatment. A statistically significant difference was found in the length of stay in hospital, change in C-reactive protein, polymerase chain reaction results after 5 days, and computed tomography scores between two groups. There was no statistically significant difference in D-dimer, urea, lactate dehydrogenase, lymphocyte, leukocyte, and platelet between two groups. According to the data, we think that the lung disinfection technique applied with ozone inhalation reduces the rate of pneumonia in COVID-19 patients and makes the patients respond faster to the treatment and become negative according to the polymerase chain reaction tests. The study was approved by the Ethical Committee of the Istanbul Medipol University Clinical Trials (approval No. 0011) on July 2, 2020.

Predictive Factors and Amputation Level for Reamputation in Patients With Diabetic Foot: A Retrospective Case-Control Study.

The aim of this study was to assess the rate and level of reamputation in patients who had a previous amputation from diabetic foot. We retrospectively analyzed patients who underwent amputation and reamputation due to diabetic foot in our clinic between 2011 and 2019. Fifty-nine were evaluated as the healed group after the first amputation and 55 were evaluated as the reamputation group. Given 55 patients who needed reamputation: there were 13 finger or ray, 23 transmetatarsal or syme, 18 transtibial, and 1 transfemoral in the first operation. We found the reamputation rate was 65.4% in distal amputations. When serum parameters were examined before the first amputation in each group, there was no statistically significant difference in white blood cells, neutrophils, lymphocytes, platelets, sedimentation, C-reactive protein, total protein, hematocrit, urea, creatinine, and HgA1c values. There was, however, a significant difference between groups in albumin levels. When comorbidities were assessed for smoking, hypertension, duration of diabetes, and number of debridements after the first surgery, a significant difference between groups was found. When peripheral artery disease and chronic renal failure were examined, no significant difference was observed. In our study, it was observed that the rate of reamputation was higher in distal level amputations for diabetic foot patients. Accordingly, albumin values, smoking, hypertension, duration of diabetes, number of debridements after surgery, were seen as risk factors for reamputation patients.

Retrospective observational study of intramuscular oxygen-ozone therapy for the treatment of neck pain: cervical paravertebral injection.

Neck pain is one of the major pathologies responsible for loss of labor. Many conservative treatment methods for neck pain have been described. The purpose of this study was to obtain pain scores for patients undergoing paravertebral ozone-oxygen (O3/O2) injections for neck pain caused by cervical disc disease. Over the last 6 months of 2018, 72 patients who undergoing intramuscular O3/O2 injections to treat neck pain were examined retrospectively in this multicenter study. Patients were injected with 30 mL of 20 µg/mL O3/O2 gas (into the paravertebral space). Subjects were treated once a week for 6 weeks. The visual analog scale pain scores and Japanese Orthopedic Association scores were obtained before (pre-injection) and after treatment (i.e., at 2 and 6 months). Significant improvements were observed in visual analog scale and Japanese Orthopedic Association scores at both 2 and 6 months versus the pre-injection scores. There was no significant difference in the visual analog scale or Japanese Orthopedic Association scores between 2 and 6 months. Paravertebral O3/O2 injection is a reliable and effective treatment of neck pain caused by cervical disc disease. The study was approved by Umraniye Education and Research Hospital, University of Health Sciences, Turkey (Reference Number: 00102187854) on September 25, 2019.

Clinical and radiological results of kyphectomy and sliding growing rod surgery technique performed in children with myelomeningocele.

BACKGROUND: The aim of this study was to present clinical and radiological results of myelomeningocele (MMC) patients treated with the sliding growing rod (SGR) technique after kyphectomy. METHODS: Between 2016 and 2019, 30 patients (21 males and nine females) who underwent the SGR technique with kyphectomy and posterior instrumentation due to MMC were retrospectively reviewed. Patients' pre- and postoperative kyphosis, scoliosis, correction rates, bleeding during surgery, blood supply during and after surgery, operation time, instrumentation levels, number of vertebrae removed, MMC onset levels, hospital stay, annual lengthening amounts, and complications were evaluated. RESULTS: The mean patient age was 6.9 (4-10) years. Mean preoperative kyphosis was 115° (87-166°), mean early postoperative kyphosis was 3.9° (20-10°), and final follow-up postoperative kyphosis was 5.1° (22-8°). In nine patients presenting with scoliosis, scoliosis was evaluated as 60.2° (115-35°) preoperative, as 12.9° (32-0°) early postoperative, and 15.7° (34-0°) in the final measurement. The kyphotic deformity correction rate was 96.5%, and the scoliotic deformity correction rate was 74.9%. A statistically significant difference was seen between pre- and early postoperative values in kyphosis and scoliosis measurements (p < 0.05). The annual prolongation of the patients was calculated as averages of 0.72 and 0.77 cm/year between T1-T12 and T1-S1, respectively. CONCLUSION: Kyphectomy performed during the early MMC period patients appears to be an excellent method for facilitating rehabilitation and daily care of these patients. It appears that the SGR technique, which provides lung volume protection and lengthening with kyphectomy, is a safe and reliable method in patients. LEVEL OF EVIDENCE: Level 4.

A new approach for spinal deformity patients with meningomyelocele: reverse Y incision.

We report a new surgical incision for spinal deformity in patients who had undergone meningomyelocele closure surgery. Six patients underwent kifectomy using an inverse Y incision. They all had multiple prior operations in the lumbar region due to dural meningomyeloceles. Four of the patients were girls. The primary indication for the reverse Y incision was a T12 and above posterior fusion defect and a large lumbar posterior fusion defect. These patients included four with kyphoscoliosis, one with lordoscoliosis, and one with lumbar kyphosis. The median age of the patients was 5.52 at the time of operation. The median follow up time was 17.3 months. Under appropriate indication, the reverse Y approach offers a reliable and successful solution for surgery.

Assessment of the Quality and Reliability of the Information on Rotator Cuff Repair on YouTube.

INTRODUCTION: YouTube® has become a common health information source for patients. Recent studies have determined that videos on YouTube® contain misleading and inappropriate information for different medical conditions. The aim of the present study was to assess the quality and reliability of videos pertaining to rotator cuff (RC) repair surgery. HYPOTHESIS: YouTube® users prefer watching videos with high educational quality which are provided by physicians. MATERIAL AND METHODS: A search was performed using keywords "rotator cuff surgery" and "rotator cuff repair" on YouTube® and the first 100 videos for each keyword were analyzed. Video source, time since upload, duration, and number of views, likes, and dislikes were recorded. Video popularity was reported using the video power index (VPI) and view ratio. Video educational quality was measured using the recognized DISCERN, the Journal of the American Medical Association (JAMA) score and a novel RC-specific score (RCSS). RESULTS: Among the 200 videos identified, 67 were included. The mean duration was 7.7minutes and the mean number of the views was 147,430. Videos uploaded by a physician had significantly higher DISCERN, JAMA, and RCSS (p<0.001). While the main video source was physicians (48%), the most popular videos were uploaded by patients and commercial websites, according to the VPI and view ratios. The number of likes, view ratios, and VPI were negatively correlated with each score. There were negative correlations between duration and VPI scores, and positive correlations with DISCERN, JAMA score, and RCSS. Animated videos showed significantly lower results for all quality scores (p<0.05), while their VPI was significantly higher (p<0.01). DISCUSSION: Online information on RC repair surgery provided by YouTube® was low quality, despite being mostly uploaded by physicians and having relatively higher quality scores. YouTube® users prefer watching low quality videos which were provided by patients and commercial websites. LEVEL OF EVIDENCE: IV, Case series.

Comparison of three different approaches for anterior knee pain after tibia intramedullary nailing.

PURPOSE: The aim of this study was to compare anterior knee pain and functional outcomes in patients who underwent intramedullary tibial nailing using transpatellar, medial parapatellar or suprapatellar nail entry methods. METHODS: We retrospectively reviewed patients who underwent tibial fracture repair in our clinic between January 2010 and March 2017. After applying the exclusion criteria, 58 patients were included in the study. Patients were divided into 3 groups based on the nailing approach: medial parapatellar, transpatellar or suprapatellar. Age, body mass index, follow-up duration, Kujala Score, Lysholm Knee Score, anterior knee pain, length of hospitalization and surgical duration were assessed. RESULTS: Of the 58 patients studied, 21 underwent a transpatellar (TP) approach, 16 a medial parapatellar (MP) approach, and 21 a suprapatellar (SP) approach. The mean Kujala Score of patients who had the TP approach was 80 ± 7.15 (72-93) and the average Lysholm Knee Score was 80.23 ± 8.74 (70-95). There was no statistically significant difference between Kujala Scores (p = 0.38) or Lysholm Knee Scores (p 0.06) among the groups; similarly, no statistically significant difference was found among the three groups in terms of anterior knee pain, length of hospitalization or surgical duration (p > 0.05). CONCLUSION: The suprapatellar tibia nailing method is as safe and reliable as transpatellar and medial parapatellar methods in terms of effect on postoperative anterior knee pain and functional outcomes. LEVEL OF EVIDENCE: Level 3 case-control study.

Radius and ulna locking intramedullary nails are safe and reliable after adolescent forearm fractures: a case-controlled study in adolescents.

The aim of this study is to compare the radiological and functional results of newly designed radius and ulna intramedullary nails (IMNs) with those of titanium elastic nails (TENs) for forearm fractures in adolescents requiring surgery. Patients aged between 10 and 17 years who underwent surgery for forearm fractures between January 2011 and January 2018 were retrospectively evaluated. Of the 45 patients who met the study criteria, 18 patients received IMNs and 27 patients received TENs. The clinical results were evaluated according to the Price criteria. The mean age, mean follow-up period, fracture type, postoperative period, length of hospital stay, surgical reduction type, union time, implant diameter and radiological findings were evaluated. No differences were found between the groups in terms of mean age, mean follow-up time, type of fracture, length of hospitalization, reduction quality, complications or union time (P > 0.05). Significant differences were observed in implant diameter, angulation on early radiological examination and the formation of large bone calluses (P < 0.05). According to the Price criteria, among the patients who received IMNs, 16 patients had excellent results, while two patients had good results, and among the patients who received TENs, 20 patients had excellent results, while seven patients had good results. According to our study, radius and ulna locked intramedullary nailing treatments for adolescent forearm fractures are as safe and reliable as TEN treatment.

Transforaminal Lumbar Interbody Fusion For Lumbar Degenerative Disease: Patient Selection And Perspectives.

Most adults will experience low back pain during their lifetime, with most of these instances resolving or improving without sequelae in a few weeks. For the small number of patients with severe, recalcitrant pain, lumbar fusion may be required, particularly when concomitant leg pain or deformity is present. Lumbar interbody fusion surgery is the usual treatment for degenerative lumbar disease, but it requires a long recovery period. Many surgical techniques have been described in the literature for spondylolisthesis. The main objective is to create interbody fusion, decompression of normal structures and a stable vertebrae. TLIF surgical techniques has a long learning curve. Comorbidities of the patient may make surgery more difficult. Methods such as transforaminal lumbar interbody fusion (TLIF), posterior lumbar interbody fusion, anterior lumbar interbody fusion and lateral lumbar interbody fusion are also available for interbody fusion in the literatüre. The aim of this review is to show which patients are more suitable for TLIF surgery and to discuss the advantages and disadvantages of TLIF surgery over other techniques.

The Effect of Paravertebral Ozone Injection in the Treatment of Low Back Pain.

AIM: Paravertebral ozone injection is a new treatment method described in the literature for low back pain. The aim of this study was to compare the pre- and post-treatment pain scores of patients undergoing paravertebral ozone/oxygen (O3 /O2 ) injections for low back pain. METHODS: From September 2018 to December 2018, 122 patients who underwent paravertebral ozone injections due to low back pain were examined retrospectively; 62 patients who met the study criteria were included. The patients were injected with 15 µg/mL (50 mL) O3 /O2 gas in the paravertebral space. The subjects were treated every 7 days for 6 total session. The VAS and Oswestry Disability Index (ODI) scores were assessed before treatment and after treatment (first and third months). The patients' body mass indexes (BMIs) were measured before the injections. RESULTS: There were 12 male patients and 50 female patients. The mean age was 51.9 (range 25 to 71) years. The mean duration of pain was 9.1 (3 to 24) months. Significant improvements were observed in the statistical comparison of VAS and ODI scores between the pre-injection and first month controls (P < 0.000). There was no significant difference in the statistical comparison of VAS and ODI scores between the first and third months (P < 0.05). There was no statistically significant difference between BMI and pain scores (P > 0.213). CONCLUSION: Paravertebral O3 /O2 gas is a reliable and effective treatment for the treatment of lumbar disc herniation, radicular pain, and mechanical back pain due to low back pain.

The incidence of biphalangeal fifth toe: Comparison of normal population and patients with foot deformity.

BACKGROUND: Pedal biphalangism, which was also defined as symphalangism, is seen at a frequency that cannot be ignored; however, no study can be found in the literature evaluating biphalangism in normal population in comparison to those who have foot disorders. The aim of this study was to evaluate the incidence of the pedal fifth toe symphalangism in normal population and in patients with foot deformity including hallux valgus, pes planus, pes cavus, and pes equinovarus. We hypothesized that pedal fifth toe symphalangism may be a predisposing factor or an accompanying structural variation for foot deformity. MATERIALS: Patients admitted to the emergency department of our center in October and November 2016 were defined as the control group, and patients with the diagnosis of hallux valgus, pes planus, pes cavus, and pes equinovarus treated between 2011 and 2016 in our department were defined as the foot deformity group. Individuals who had anteroposterior, oblique, and lateral radiographs of foot were included in the study. RESULTS: One thousand and four patients participated in the cross-sectional observational study. Biphalangeal fifth toe was found in 328 of 1004 (32.7%) patients. In foot deformity group ( n = 672), 222 patients (33%) had biphalangeal fifth toe. In the control group, 106 (31.9%) of the 332 patients had biphalangeal fifth toe. There was no statistically significant difference in the incidence of biphalangeal fifth toe between the two groups ( p = 0.72). CONCLUSIONS: According to the results of this study, biphalangeal fifth toe is a common pedal anatomical variant seen approximately in one-third of the population who have either foot deformity or not. This information may be valuable for podiatrist undertaking the conservative or surgical treatment of fifth toe-related disorders.

Osteosarcopenia increases hip fracture risk: A case-controlled study in the elderly.

BACKGROUND: The aim of this study was to determine the relationship between bone mineral density (BMD), gluteus maximus muscle volume, and hip fracture type in patients with hip trauma. METHODS: A total of 134 patients were included in the study; 76 were in the study group [mean age 71.89 (65-80)] (hip fracture group), and 58 were in the control group [mean age 71.27 (65-80)] (hip trauma without fracture). The fracture type, femoral head diameter (FHD), and body mass index (BMI) were assessed. Fracture type was evaluated according to AO/OTA classification. The total gluteus maximus volume t (GMV) was evaluated via computed tomography (CT). RESULTS: In both groups, there were significant positive correlations between BMD and tGMV/FHD, tGMV/BMI, and tGMV. When comparing the groups regarding total muscle volume, the muscle volume in the control group was significantly higher. CONCLUSION: According to this study, GMV have an impact on bone mineral density. The risk of hip fracture should not be assessed by only examining bone density in patients over 65 years of age. The clinical relevance is that increasing the gluteal muscle volume above cut-off value in elderly individuals may help to reduce hip fracture risk.

Comparison of Four Different Posterior Screw Fixation Techniques for the Treatment of Thoracolumbar Junction Fractures.

OBJECTIVE: The purpose of this study was to compare clinical and radiologic outcomes of patients who underwent short-segment posterior instrumentation with screw augmentation at the fracture level and long-segment instrumentation for thoracolumbar junction fractures. METHODS: Sixty-three patients were retrospectively evaluated by being divided into the following 4 groups: Groups A, B, C, and D included patients who had undergone 4-level instrumentation without insertion of screws at the fracture level, 3-level instrumentation by insertion of screws at the fracture level, 4-level instrumentation by insertion of screws at the fracture level, and 5-level instrumentation by insertion of screws at the fracture level, respectively. RESULTS: No significant difference was observed in preoperative local kyphosis angle (LKA) (P > 0.05), whereas there was a significant decrease in early postoperative LKA in Group C compared with the other groups (P < 0.05). However, there was no significant difference of LKA in the 4 groups measured on radiographs obtained at the final follow-up (P > 0.05). Anterior corpus height loss, Cobb angle of the fractured vertebra, and sagittal index, measured pre- and postoperatively and at the final follow-up, showed no significant difference (P > 0.05). There was no statistically significant difference between clinical scores of the 4 groups (P > 0.05). CONCLUSIONS: Short-segment posterior instrumentation with screw augmentation at the fracture level provides at least as much mechanical stability as long-segment instrumentation. Moreover, there is no difference between short-segment instrumentation with screw augmentation at the fracture level and long-segment instrumentation in terms of clinical outcomes.

Is intact fibula a disadvantage in treatment of tibial diaphysis fracture with intramedullary nailing?

BACKGROUND: The aim of this study was to compare solitary tibial diaphysis fractures and tibial diaphysis fractures associated with fibula fracture treated with the intramedullary nailing method. METHODS: Records of 254 patients diagnosed with tibial diaphysis fracture and treated with intramedullary nailing between 2010 and 2013 were examined and 30 patients were included in the study. Group 1 comprised patients with solitary tibial diaphysis fracture, and Group 2 was made up of patients with tibial diaphysis fractures associated with fibula fracture. Patients in both groups were compared in terms of time to surgery, duration of surgical tourniquet, time to union, and varus, valgus, recurvatum, and antecurvatum deformities of the tibia at final follow-up. RESULTS: No statistically significant difference was found between the 2 groups in time to surgery, duration of surgical tourniquet, time to union, or varus, valgus, recurvatum, and antecurvatum deformities. CONCLUSION: Results indicated that intact fibula in tibial diaphysis fracture treated with intramedullary nailing was not a disadvantage; it did not affect rate of union or lead to loss of reduction, non-union, or malunion.

Comparison of Salter osteotomy and Tonnis lateral acetabuloplasty with simultaneous open reduction for the treatment of developmental dysplasia of the hip: midterm results.

The aim of this study was to compare the midterm clinical and radiological outcomes of the Salter osteotomy (SO) and Tonnis lateral acetabuloplasty (TLA) with concomitant open reduction for the treatment of developmental dysplasia of the hip. Twenty-five hips of 20 patients who underwent SO with open reduction and 26 hips of 23 patients who underwent TLA with open reduction were evaluated retrospectively. The average age of the patients at the time of the operation was 35.6 months in the SO and 36.6 months in the TLA group, without a statistically significant difference (P=0.836). The average follow-up times in the SO and TLA groups were 59.9 and 54.8 months, respectively (P=0.397). Preoperative (40.6° in the SO vs. 42.2° in the TLA, P=0.451) and last follow-up acetabular index (12° in the SO vs. 14° in the TLA, P=0.227) and center-edge angle measurements (30° in the SO vs. 26° in the TLA, P=0.069) did not show a statistically significant difference between the SO and TLA groups; however, early postoperative acetabular index improvement was better in the TLA group than in the SO group (21.2° in the SO vs. 17.2° in the TLA, P=0.014). According to the Severin grading system, both groups showed a similar number of good outcomes without a statistically significant difference (P=0.936). Clinical assessment on the basis of McKay's criteria showed similar good and excellent outcomes (P=0.936). Both osteotomy techniques showed similar satisfactory outcomes for the treatment of DDH in patients older than 18 months of age.

Prospective comparative study of two methods for fixation after distal femur corrective osteotomy for valgus deformity; retrograde intramedullary nailing versus less invasive stabilization system plating.

INTRODUCTION: The aim of this study was to compare the radiological and functional results of two different methods of fixation for the correction of femoral valgus deformities. METHODS: Patients who had undergone osteotomy and correction of a valgus deformity from 2007 to 2013 were prospectively followed. Thirty three patients (20 females, 13 males) with 39 lower limbs were included in the study. Seventeen lower limbs were treated with retrograde intramedullary nailing (IMN) and 22 with less invasive stabilization system plating. Standing orthoroentgenograms of the lower limbs were taken pre-operatively and at the final follow-up. mLDFA, aLDFA, mechanical axis deviation (MAD) were measured in this orthoroentgenograms. Knee osteoarthritis outcome score (KOOS) and knee range of motion were used pre-operatively and at the final follow-up as part of the evaluation of the clinical results. All patients duration of surgery, length of hospital stay were assessed. Operations were performed by two orthopedic surgeons. The choice of correction method for each patient was determined by the surgeon. Pre-operative and post-operative values were simultaneously measured by two additional orthopedic surgeons. RESULTS: The mean age of the patients was 26.2 years (18.0-51.0) in the plating group and 29.3 years (18.0-55.0) in the nailing group. Patients in the plating and nailing groups were followed up for 24.0 (12.0-60.0) and 27.8 (12.0-60.0) months. All patients were followed for a minimum of 12 months. No significant differences were observed between the groups in terms of age, sex, or duration of follow-up (p > 0.05) Comparison of the pre- and post-operative mLDFA, aLDFA, MAD, length of hospital stay, and duration of surgery between the plating group and nailing group, no significant difference was observed between the groups (p > 0.05). However, patients treated with retrograde IMN had significantly better post-operative results in terms of the KOOS and range of motion of the knee according to plating group (p < 0.05). CONCLUSION: Retrograde IMN does not provide a radiological advantage over the LISS plating technique for valgus deformity but retrograde IMN and correction offered better functional results in cases of femoral valgus deformity than did the LISS plating method.

Results of surgical treatment in metacarpal shaft fractures using low profile mini plates.

BACKGROUND: Metacarpal fractures are among the most common fractures of the hand. They may lead to loss of function if treated improperly. These injuries can be treated conservatively. However, if significant shortening, rotational deformity and angulation occur, surgical treatment is required. In this article, results of metacarpal fractures treated with open reduction and internal fixation with mini plates were presented. METHODS: We retrospectively reviewed the clinical and radiologic records of twenty-nine consecutive patients with 37 metacarpal fractures treated by open reduction and internal fixation with low profile mini plate fixation between 2006 and 2013. Surgical treatment with dorsal approach was planned for cases with unacceptable shortening, rotational deformity, and angulation. Early active motion was begun in all cases postoperatively. Patients were permitted to use their hands in daily activities four weeks after surgery. For objective assessment, total range of joint motion was measured. Rotational deformity of the fingers was assessed. Grip strength and quick DASH scores were compared with the uninjured side. Metacarpal shortening was evaluated radiologically, and angulation was measured. RESULTS: Mean age was 35.1 years (19-61 years) and mean follow-up period was 32 months (6-39 months). While mean operation time was 8.48 days (2-23 days), mean shortening was 7.58 (2-30) mm. In cases with radiologically documented union, mean angulation in the posteroanterior plane was 8.13 (0-42) degrees preoperatively and 3.55 (0-28) degrees postoperatively. In lateral X-rays, mean angulation was 8.22 (0-39) degrees preoperatively and 3.66 (0-28) degrees postoperatively. Mean quick DASH score was 3.6 (0-11.4). Mean grip strength measurements by Jamar hand dynamometer were 41.05 (±8.3) kg for fractured hands, 44.7 (±9) kg for normal hands. No significant relationship was found between normal hand and fracture hand by Mann-Whitney U test. CONCLUSION: As in general fracture treatment principles, goals in metacarpal fracture treatment are obtaining an anatomical and stable reduction, fracture union and beginning early movement to avoid loss of function. Open reduction and low profile titanium plate application in metacarpal fractures is the choice of treatment in suitable cases as it meets the above mentioned treatment principles.