Impact of presence of ossific nucleus on results of closed reduction in treatment of developmental dysplasia of the hip (302 hips).

Closed reduction is an effective treatment method for developmental dysplasia of the hip (DDH). Still, there are certain controversial issues regarding the timing of the treatment. In this study, we investigated the results of closed reduction and Outcomes of 302 hips of 218 patients treated with closed reduction have been analyzed retrospectively. One hundred fifty-two hips that had ossific nucleus [ossific nucleus (+)] during reduction have been compared with 150 hips that had no ossific nucleus [ossific nucleus (-)] during reduction. Also, the patients have been divided into two groups, the patients treated with closed reduction before the sixth month and the patients treated with closed reduction after the sixth month. Groups have been compared between themselves in terms of avascular necrosis (AVN) and redislocation. Seventy-seven of the 112 hips treated with closed reduction in the first six months were ossific nucleus (-), and AVN has been noted in 5 (6%) patients. However, although no AVN has been seen in any of the 35 ossific nucleus (+) hips, no statistically significant difference has been found between two groups. Seventy-three of the 190 hips treated with closed reduction after the sixth month were ossific nucleus (-), and AVN has been seen in 13 (17%) of these hips. AVN has been seen in 9 (7%) of the 117 ossific nucleus (+) hips. The AVN ratio was found significantly lower in the ossific nucleus (+) hips (P < 0.034). Although the presence of ossific nucleus does not provide extra protection against AVN in before the sixth month, the presence of ossific nucleus is protective against AVN after the sixth month.

Is Ebselen A Therapeutic Target in Fracture Healing?

OBJECTIVE: We investigated the effect of ebselen on fracture healing in an experimental fracture model. MATERIALS AND METHODS: We divided rats into two groups, 6 rats in each: the experimental femur fracture control group and the ebselen treatment group with an experimental femur fracture. In the experimental femur fracture control group, we created only experimental femur fracture. In the ebselen treatment group, we administered ebselen treatment with creating an experimental femur fracture. We administered ebselen intraperitoneally at 5 mg/kg once daily for 1 month after the 1st day of experimental femur fracture in the ebselen treatment group. We evaluated the recovery status of fractured femurs at the end of 1st month with radiographic, histopathological, and immunohistochemical methods. RESULTS: According to the radiographic fracture healing scores, ebselen treatment increased the extent of new bone formation and fracture cartilage callus significantly compared to the control group. According to the histopathological recovery scores, ebselen treatment significantly improved healing scores compared to the control group. Ebselen treatment increased the expression scores of bone healing markers in the ebselen treatment group, such as vascular endothelial growth factor and osteocalcin, compared to the control group. CONCLUSION: We demonstrated that ebselen treatment increases the formation of new bone in the femur in an experimentally created femoral fracture model. Ebselen has been shown to improve the bone fracture healing in a radiological and histopathological manner, and more detailed studies are needed.

Relations of Body Mass Index, body fat, and power of various muscles to sport injuries.

The aim of the present study was to estimate associations of Body Mass Index, body fat, and muscle power on sport injuries. In injured and noninjured athletes during a sport season of four months, the differences in Body Mass Index, the percent body fat, and back, leg, and right- and left-hand muscle strength were examined. The subjects were 329 men and 127 women attending classes in the departments of Physical Training and Sport of Atatürk University (Erzurum, Erzincan, and Agri in Turkey). Body Mass Index was higher in injured athletes than in noninjured ones, but there was no difference in percent body fat between injured and noninjured athletes. The back and leg muscle power were higher for noninjured athletes than for injured ones. The right- and left-hand power was higher for injured athletes in some sports. Because the back and leg muscles function in control of equilibrium, the power of these muscles may be important for control related to avoidance of sport injuries.

[Old unreduced traumatic patellar dislocation]. / Yerine konmamiseski travmatik patella çikigi.

The old unreduced traumatic patellar dislocation is very rare and the results of the treatment are not always satisfactory. We report a 11 year-old boy with an unreduced patellar dislocation and a healed ipsilateral femoral fracture. The dislocation was reduced by an operative procedure. A long leg cast was applied for 6 weeks then the knee exercises were started. One year after surgery, he still has satisfactory results. This case suggests that if the dislocation is not of long duration and degenerative changes are absent in the patella and the knee joint, open reduction may be helpful in the treatment of old unreduced traumatic patellar dislocations. .

Failure analysis of the cement mantle in total hip arthroplasty with an efficient probabilistic method.

Accurate prediction of long-term behaviour of cemented hip implants is very important not only for patient comfort but also for elimination of any revision operation due to failure of implants. Therefore, a more realistic computer model was generated and then used for both deterministic and probabilistic analyses of the hip implant in this study. The deterministic failure analysis was carried out for the most common failure states of the cement mantle. On the other hand, most of the design parameters of the cemented hip are inherently uncertain quantities. Therefore, the probabilistic failure analysis was also carried out considering the fatigue failure of the cement mantle since it is the most critical failure state. However, the probabilistic analysis generally requires large amount of time; thus, a response surface method proposed in this study was used to reduce the computation time for the analysis of the cemented hip implant. The results demonstrate that using an efficient probabilistic approach can significantly reduce the computation time for the failure probability of the cement from several hours to minutes. The results also show that even the deterministic failure analyses do not indicate any failure of the cement mantle with high safety factors, the probabilistic analysis predicts the failure probability of the cement mantle as 8%, which must be considered during the evaluation of the success of the cemented hip implants.

Antioxidant profile in patients with complex regional pain syndrome type I.

OBJECTIVE: Complex regional pain syndrome (CRPS) type I is one of the most important problems with regard to physical medicine and rehabilitation. CRPS may cause not only higher therapeutic costs but also greater work time loss. The mechanism and pathogenesis of CRPS still remains unknown. Some findings indicating oxidative stress have been reported. This study was carried out to determine the role of oxidative stress in patients with CRPS. MATERIALS AND METHODS: Twenty patients (13 women and seven men) with CRPS and 20 age- and sex-matched healthy controls were enrolled in this study. Complex regional pain syndrome was diagnosed according to the modified International Association for the Study of Pain (IASP) criteria. We evaluated demographic, clinical and laboratory characteristics of the patients. Antioxidant enzymatic activities consisting of serum superoxide dismutase (SOD), glutathion peroxidase (GPX) and glutathione S-transferase (GST) activities were measured using appropriate methods and compared with healthy controls. RESULTS: The mean age of the patients was 39.5 years and the mean duration of symptoms was 5.5 months. Complex regional pain syndrome devoleped after a traumatic event in 90% of patients. In 10% of patients there were no traumatic events. SOD, GPX and GST levels were significantly higher in patients with CRPS than healthy controls (P = 0.012, P = 0.036 and P = 0.016, respectively). CONCLUSION: Our findings suggest a possible role of oxidative stress in the pathogenesis of CRPS.

Comparison of Open Bankart Repair versus Modified Bristow Operation for the Treatment of Traumatic Recurrent Anterior Dislocation and Capsular Laxity of the Shoulder.

OBJECTIVE: The purpose of this study was to compare the results of open Bankart repair versus those of modified Bristow operation in patients with recurrent anterior dislocations of the shoulder, the last of which was caused by a minor trauma. MATERIALS AND METHODS: This study included 38 patients (34 (89.5%) male and 4 (10.5%) female) who presented recurrent dislocation of the shoulders with capsular laxity and who underwent an open Bankart repair or a modified Bristow operation. The mean age of the patients was 29.6 years (range, 17-60 years). The mean follow-up period was 5.5 years (range, 35 months to 9 years). A total of 25 patients (65.8%) underwent an open Bankart repair, whereas 13 (34.2%) underwent a modified Bristow operation. The treatment results were assessed using the Rowe score for instability. RESULTS: Of the 38 shoulders assessed, 24 (63.1%) were right shoulders and 14 (36.9%) were left shoulders. Furthermore, 26 (68.4%) were the dominant shoulders of the patients, and 12 (31.6%) were the non-dominant shoulders. The mean time from the first dislocation was 3.8 years (range, 10 months to 11 years). The age at which the first shoulder dislocation occurred was 20 years or younger in 7 cases (18.4%), 21-30 years in 22 cases (57.9%), 31-40 years in 6 cases (15.8%) and 41 or older in 3 cases (7.9%). The patients had experienced 4-10 recurrent dislocations in 15 cases (39.5%), 10-20 recurrent dislocations in 10 cases (26.3%) and 20 or more recurrent dislocations in 13 cases (34.2%). The mean Rowe score was 85.6 following open Bankart repair and 81.9 following modified Bristow. No significant difference was observed between these good and excellent Rowe scores following the open Bankart repair and the modified Bristow operation (p>0.05). CONCLUSION: Proper patient selection for the open Bankart repair and the modified Bristow operation is crucial. When the proper patients have been selected for these procedures, both produce satisfactory results for the treatment of patients with capsular laxities.