Does rotational deformity cause poor outcomes after pediatric supracondylar humerus fractures?

BACKGROUND: We aimed to show the effect of rotational deformity on the development of cubitus varus deformity (CVD) com-plication after supracondylar humerus fracture surgery. METHODS: Patients with Gartland type II, and more severe fractures treated with Closed reduction and percutaneous pinning alone were included in the study. Rotational deformity was assessed with the formula described by Henderson et al. Patients with rotational deformity >10° were included in Group 1, and patients with deformity <10° in Group 2. In terms of CVD development, patients were evaluated with the Baumann angle measurements made on the carrying angle and final follow-up radiographs. Patients who developed CVD were divided into two groups: Group A included patients who developed CVD and Group B included patients who did not develop CVD. The cosmetic and functional results were evaluated using Flynn criteria. RESULTS: Eighty-eight patients who met the inclusion criteria were enrolled in the study, 32 were female and 56 were male. The mean age at the time of surgery was 6.0±2.8 years and the mean follow-up time was 5.1±2.5 years. Based on measurements, Group 1 had 13 patients and Group 2 had 75 patients. Only four of the 88 had developed CVD. Three of these patients had a rotational deformity of ≥20°. The mean age of patients in group A was 2.1 years and the mean carrying angle was 5.7°±1.5° varus (P<0.001). According to the Flynn cosmetic criteria, Group A and Group 1 had significantly worse outcomes (P<0.001). CONCLUSION: In conclusion, fixation of the distal fragment in rotation may be associated with CVD and intraoperative assessment is of great value to avoid long-term deformity and cosmetic degradation.

Arthroscopic Treatment of Femoral Condyle Chondral Lesions: Microfracture Versus Liquid Bioscaffold.

Purpose: This study aims to compare the microfracture (MF) technique with the bioscaffold solution application (BST-CarGel) in treating femoral chondral lesions. Methods: Thirty-eight patients ages 18-45 with isolated single femoral condyle full-thickness (ICRS grade 3-4) chondral lesions were included in the study. Patients were divided into two groups as MF applied (Group I = 21) and bioscaffold combined with MF (Group II = 17). The visual analog scale (VAS), Western-Ontario, and McMaster Osteoarthritis Index (WOMAC) were used in clinical evaluation. The location, size, and depth of lesions were evaluated with preoperative magnetic resonance imaging (MRI). Magnetic resonance observation of cartilage repair tissue (MOCART) score was used for postoperative evaluation. Results: The mean age was 32.5 (range 19-44) years. Mean follow-up was 14.9 months (range 12-24). Lesion size was 3 cm2 in group I and 2.9 cm2 in group II. There were no differences between groups regarding demographic characteristics but BMI (Body Mass Index) was lower in group II which was significant. The duration of surgery was longer in group II (p < 0.001). Postoperative statistical significant improvements were found in WOMAC and VAS scores in groups, but there was no statistical difference. Although there was no significant radiological difference in the group II according to the MOCART score, higher scores were obtained compared to group I. Conclusion: No difference was found, clinical and radiological, in terms of short-term outcomes. MF is a method to be applied as a primary treatment with its cost-effective, simple and short surgery technique, and effective clinical results up to 4 cm2. Level of Evidence: Level III: retrospective comparative study.

A 22-Month old with a Neglected Monteggia Injury: A Case Report and Review of the Literature.

Introduction: A pediatric Monteggia injury, when the diagnosis is missed or neglected, is still a challenging problem for the treating orthopedic surgeon. In this case report, we report our treatment method for a neglected Monteggia injury in a 22-month-old child. Case Presentation: A 22-month-old female patient had a history of significant trauma 8 months earlier, but no referral was made to any health institution during this period. The patient presented with swelling in the right elbow and what the family described as an occasional click noise during elbow movements. There was a 1/3 proximal plastic deformation of the ulna on radiographs, with anterior bowing concomitant with an anterior dislocation of the radial head. The patient was evaluated with a diagnosis of neglected type I Monteggia lesion. Conservative follow-up was carried out by applying closed reduction of the radiocapitellar joint under sedation. However, the conservative treatment method failed after 1 week of follow-up. For definitive treatment, closed radiocapitellar reduction and ulnar osteotomy (intramedullary Kirschner wire and oblique Kirschner wires) were applied. At the end of 3 months, the patient had full open range of motion in all directions without pain. Conclusion: This case report is noteworthy due to the patient's young age and the ulnar fixation method applied. It also shows that in the presence of ulnar bowing, maintenance of radiocapitellar reduction with only closed reduction without ulnar osteotomy could not be achieved.

Reliability of Fossae Lumbales Laterales and Pelvic Incidence for Estimating Transsacral Corridors Assessed Using Reconstruction Computed Tomography.

Background: The present study aimed to evaluate the effect of fossae lumbales laterales and pelvic incidence (PI) on transsacral corridors. Methods: Patients who underwent pelvic computed tomography (CT) during routine therapy in a single center between 2015 and 2020 were retrospectively reviewed. The patients' age and sex were documented during CT examination. Measurements were performed for both the upper and second sacral segments. Height and weight of the patients were determined using appropriate tools and body mass index (BMI) was calculated. Transsacral corridors were identified in true coronal and true sagittal planes and their width was determined as the maximum gap measured so that no screws could come out of the transacral corridors. PI was measured. Results: Our study included 244 (57%) male and 184 (43%) female patients, who had a mean age of 49.3 ± 14.15 years (range, 18-89 years) and a mean BMI of 26.57 ± 2.38 kg/m2. No statistically significant correlation was found between the detection of the dimple sign in physical examination and the presence of an adequate corridor. The PI was statistically significantly higher in the patients with dimples (p < 0.001). PI of the female patients was higher than that of the male patients (p = 0.026). The correlation between PI and the existence of adequate corridors for S1 and S2 screws was not statistically significant (p = 0.858 and p = 0.129, respectively). On the relationship between the presence of adequate S1 and S2 corridors where transsacral screws could be sent, an inverse relationship was detected: if the S1 transsacral corridor was adequate, the S2 corridor was inadequate or vice versa. Conclusions: We could not obtain meaningful results on the use of the dimples of Venus or PI instead of CT to evaluate the adequacy of transverse corridors. Nevertheless, we confirmed that an increased PI was associated with the presence of dimples of Venus.

Comparison of Open Versus Arthroscopic Repair for Subscapularis Tendon Tears With or Without Concomitant Supraspinatus Tendon Tears.

Background: The literature comparing open and arthroscopic repair of subscapularis tendon (ST) tears is insufficient. Purpose: To compare the clinical results of open versus arthroscopic repair of ST tears with or without concomitant supraspinatus tears. Study Design: Retrospective cohort study. Methods: We retrospectively evaluated 70 patients treated for isolated ST tears and ST tears with concomitant supraspinatus tendon tears at a single center between 2011 and 2019. Patients were divided into 2 groups: those who underwent open ST repairs (group O) and those with an arthroscopic ST repair (group A). Range of motion (ROM), liftoff and belly-press tests, and Constant-Murley (CM) scores were included in the pre- and postoperative functional evaluations. The minimal clinically important difference was calculated using the anchor-based method for changes in CM score. Tear size was evaluated according to the Lafosse classification. The categorical data were assessed using the Pearson chi-square, Fisher exact, and Fisher-Freeman-Halton tests. The parametric and nonparametric data were evaluated using the Student t test and Mann-Whitney U test, respectively. The dependent groups (for nonnormally distributed data) were evaluated using the Wilcoxon signed rank test. Results: Group O included 34 patients, and group A included 36 patients. The mean age was 62.9 years, and the mean follow-up period was 66.7 months. Even though group O exhibited a significantly better preoperative CM score (53.7 ± 4.6 vs 48.9 ± 6.8 [mean ± SD]; P = .001), group A had a significantly better postoperative CM score (88.7 ± 4.7 vs 84.6 ± 2.9; P < .001). Our measurements revealed a minimal clinically important difference of 11.5 points for the CM score. Group A had significantly greater postoperative ROM in abduction (153° vs 143.9°; P = .005) and forward elevation (159.1° vs 149.7°; P = .005), as well as significantly greater postoperative improvement in positive belly-press test results (P = .028). Complications occurred in 4 patients in group O and in 1 patient in group A. Conclusion: The study findings indicated that arthroscopic ST repair was more advantageous than open repair in terms of ROM and functional outcomes.

Percutaneous Grafting and Screw Fixation in Patients with Scaphoid Nonunion.

Objective The aim of the present study was to analyze the clinical and radiological results of patients with type-V cystic scaphoid nonunion who were treated with percutaneous grafting and screw. Methods A total of 11 patients were treated with a percutaneous bone graft with screw fixation. The criteria for inclusion in the study were a type-V scaphoid nonunion and age > 18 years old. Those with humpback deformity, arthritis, ligament damage determined on magnetic resonance imaging, or avascular necrosis (AVN) in the nonunion fragment were excluded from the study. Results The mean follow-up time was 36 months (range: 15-53 months). At the final follow-up examination, the mean visual analogue scale score was 1.06 (range: 0-2.3). Postoperatively, the mean extension was 61.6° (44-80°), flexion 66° (60-80°), radial deviation 12° (7-20°), and ulnar deviation 25° (20-34°). The mean grip strength of the operated hand was found to be 94%, compared with the healthy side. The results obtained in the Mayo Modified Wrist Score were poor in 2 patients, good in 2 and excellent in 7 (64%). With the exception of 2 patients, union was obtained radiologically in 9 patients, with a mean of 12.6 weeks (range, 8-16 weeks). Conclusion Percutaneous grafting and screw fixation cannot replace open surgery in cases with deformity, shortening, humpbacking, or in long term nonunions; however, it is a reliable and effective treatment method in selected cases, such as Slade & Dodds type-V cystic nonunion.

Mean Platelet Volume to Platelet Count Ratio as a Predictor of Mortality in Unstable Pertrochanteric Fracture Treated with Short Proximal Femoral Anterograde Nail.

Introduction: The relationship between mean platelet volume (MPV) and platelet count (PC, MPV/PC) has been studied in detail in various diseases. The aim of this study was to investigate the effect of the MPV/PC ratio in estimating the risk of postoperative mortality in unstable pertrochanteric fractures. In addition, serum biomarkers such as the neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), and platelet-to-lymphocyte ratio (PLR) will be compared with the MPV/PC ratio in predicting mortality. Materials and Methods: We retrospectively reviewed the records of eligible adult patients with a pertrochanteric fracture who admitted to the Department of Orthopedics and Traumatology between January 2011 and December 2019. The MPV/PC ratio was estimated as the MPV value divided by the PC at admission, postoperative day 2, and postoperative day 5 of the surgery. The clinical outcome was 30-day mortality and overall mortality. Results: We included 447 patients who received unstable pertrochanteric fracture surgery. In multivariate Cox proportional hazard models, higher MPV/PC ratios on admission were significant risk factors for 30-day mortality. In the ROC analysis, MPV/platelet ratio ≥ 0.048 at admission was critical for 30-day mortality (sensitivity 0.636, specificity 0.659, p < 0.001). Discussion: The MPV/PC ratio alone predicted 30-day mortality in patients with pertrochanteric fracture. Further prospective and multicenter clinical trials supporting our findings and aiming to uncover the reason for the change in blood parameters will help to reduce mortality in unstable pertrochanteric fractures.

Can C-reactive protein-based biomarkers be used as predictive of 30-day mortality in elderly hip fractures?A retrospective study.

BACKGROUND: C-reactive protein-to-lymphocyte ratio (CLR), C-reactive protein/albumin (CRP/ALB), and CRP are prognostic factors for outcome and survival in oncology and digestive surgery. CLR has not been studied for the prediction of mortality in hip fracture. The aim of this study is to investigate whether there is an association between pre-operative CLR, CRP/ALB, and CRP levels in patients with hip fracture and patient survival. METHODS: The medical reports of the patients who underwent surgery with a diagnosis of hip fracture in our hospital between January 2016 and December 2019 were retrospectively reviewed. The patients were divided into two groups (Group E: Those who died within 1 month and Group S: Those who died after the 1st month or those who survived). A total of 19 parameters, namely, included ' blood parameters including hemoglobin, C-reactive protein, albumin, lymphocytes, neutrophils, monocytes, platelets, PLR, NLR, LMR, CLR CRP/ALB ratios, gender, American Society of Anesthesiologists, Charlson Comorbidity Index, delirium, infections, repeated surgeries, and type of anesthesia were evaluated preoperatively and on the post-operative 2nd and 5th days and 1 month. RESULTS: A total of 165 patients with the mean age of 83.09±8.52 years who met the inclusion criteria were studied. The pre-op-erative means of CRP, neutrophil count, CLR ratio, and CRP/ALB ratio were statistically significantly higher in Group E than in Group S (p=0.016, p=0.023, p=0.035, and p=0.044, respectively). The univariate regression analysis showed that age, pre-operative Hb level, CRP, and CRP/ALB ratio were significant predictors of the 1-month mortality (ß=-0.335, p=0.049; ß=0.411, p=0.028; ß=3.632, p=0.007; and ß=-3.280, p=0.008; respectively). When we performed the ROC curve analysis, the CRP/ALB ratio had the highest AUC, with the highest sensitivity and specificity. The cutoff value of CRP/ALB ratio was found to be 12.42. CONCLUSION: We found that the pre-operative CRP/ALB ratio is an important parameter for predicting the first 30-day mortality in elderly patients with intertrochanteric femur fractures. For this reason, we recommend that CRP and albumin be checked in prepa-ration for routine pre-operative anesthesia.

Percutaneous Grafting and Screw Fixation in Patients with Scaphoid Nonunion / Enxerto percutâneo e fixação de parafusos em pacientes com não consolidação do escafoide

Abstract Objective The aim of the present study was to analyze the clinical and radiological results of patients with type-V cystic scaphoid nonunion who were treated with percutaneous grafting and screw. Methods A total of 11 patients were treated with a percutaneous bone graft with screw fixation. The criteria for inclusion in the study were a type-V scaphoid nonunion and age > 18 years old. Those with humpback deformity, arthritis, ligament damage determined on magnetic resonance imaging, or avascular necrosis (AVN) in the nonunion fragment were excluded from the study. Results The mean follow-up time was 36 months (range: 15-53 months). At the final follow-up examination, the mean visual analogue scale score was 1.06 (range: 0-2.3). Postoperatively, the mean extension was 61.6° (44-80°), flexion 66° (60-80°), radial deviation 12° (7-20°), and ulnar deviation 25° (20-34°). The mean grip strength of the operated hand was found to be 94%, compared with the healthy side. The results obtained in the Mayo Modified Wrist Score were poor in 2 patients, good in 2 and excellent in 7 (64%). With the exception of 2 patients, union was obtained radiologically in 9 patients, with a mean of 12.6 weeks (range, 8-16 weeks). Conclusion Percutaneous grafting and screw fixation cannot replace open surgery in cases with deformity, shortening, humpbacking, or in long term nonunions; however, it is a reliable and effective treatment method in selected cases, such as Slade & Dodds type-V cystic nonunion.

Resumo Objetivo O objetivo do presente estudo foi analisar os resultados clínicos e radiológicos de pacientes com não consolidação do escafoide que foram tratados com enxerto percutâneo e parafuso. Métodos Um total de 11 pacientes foram tratados com enxerto ósseo percutâneo com fixação de parafuso. Os critérios de inclusão no estudo foram não consolidação do escafoide do tipo 5 e idade > 18 anos. Foram excluídos do estudo aqueles com deformidade corcunda, artrite, dano ligamentar determinado por ressonância magné- tica ou necrose avascular (NAV) no fragmento de não consolidação. Resultados O tempo médio de seguimento foi de 36 meses (intervalo: 15-53 meses). No exame final de seguimento, o escore médio de escala visual analógica foi de 1,06 (intervalo: 0-2,3). No pós-operatório, a extensão média foi de 61,6° (44-80°), flexão 66° (60-80°), desvio radial 12° (7--20°) e desvio ulnar 25° (20-34°). A força média de aderência da mão operada foi de 94% em comparação com o lado saudável. Os resultados obtidos no Mayo Modified Wrist Score foram ruins em 2 pacientes, bons em 2 e excelentes em 7 (64%). Com exceção de 2 pacientes, a consolidação foi confirmada radiologicamente em 9 pacientes com média de 12,6 semanas (intervalo: 8-16 semanas). Conclusão Enxerto percutâneoe fixação de parafusos não podem substituir a cirurgia aberta em casos de deformidade, encurtamento ou acorcundamento ou em não consolidação a longo prazo; no entanto, é um método de tratamento confiável e eficaz em casos selecionados, tais como a não consolidação do tipo V de Slade e Dodds.

Endoscopic versus open in situ decompression for the management of cubital tunnel syndrome.

OBJECTIVE: This study aimed to compare the results of endoscopic in situ decompression (EISD) versus open in situ decompression (OISD) in the management of cubital tunnel syndrome (CUTS). METHODS: In this retrospective study, 32 patients who underwent either OISD or EISD for the treatment of CUTS between 2012 and 2019 were identified and divided into one of the two groups: Group I consisted of 13 patients undergoing EISD and group II consisted of 19 patients receiving OISD. Patients were queried regarding the presence of preoperative and postoperative paresthesia. Electromyography (EMG) was performed on all patients preoperatively and at the final control. Preoperative and postoperative pain with palpation were evaluated over the cubital tunnel. The Dellon classification was used for preoperative evaluation of patient symptoms, and the Bishop classification was used for postoperative evaluation. Hand grip strength was measured with a dynamometer. At the preoperative and postoperative final follow-up, the palmar, key, and tip pinches were measured with a pinchmeter. The surgical incision length was measured with a ruler at the end of the operation in all patients. The operation duration was recorded as the time interval between the beginning of the incision and the end of the tourniquet. RESULTS: The overall mean age was 43.8 (range; 22 to 66) years. Nine patients were female, and 23 patients were male. No Dellon I patients were present in either group. Overall, 68.75% of the patients were Dellon II and 31.25% were Dellon III. According to the Bishop score, excellent and good results were obtained in 84.6% of the patients in Group I and 73.7% of the patients in Group II. The final follow-up examination found continued paraesthesia in 6 (18.75%) patients. Comparison of the improvement in the postoperative NCV value showed a statistically significantly superior improvement in Group I compared to Group II. The postoperative palmar pinch and tip pinch tests results were statistically significantly better in group I than in group II. CONCLUSION: Although EISD had better results clinically, no statistically significant difference was found between the two techniques in terms of Bishop scores and complications. Examination of the electrophysiological results suggested a better outcome in patients who underwent EISD. LEVEL OF EVIDENCE: Level III, Therapeutic Study.

Early Results of Kinesio Taping and Steroid Injections in Elbow Lateral Epicondylitis: A Randomized, Controlled Study.

Background and objectives: This study prospectively compares early results of Kinesio tape (KT) as an alternative method for the treatment of lateral epicondylitis with those of corticosteroid injection and the rest-and-medication group (RMG). Materials and methods: Among the fifty patients (53 elbows), KT was applied to 20 patients (21 elbows), and corticosteroid injection (CSI) was applied to 15 patients (17 elbows). Fifteen patients were included in the RMG. Patients in the RMG were informed about their condition, and necessary warnings were given. No oral or topical treatments were recommended. If needed, paracetamol or nonsteroidal anti-inflammatory drugs (NSAIDs) were prescribed. Patients were classified according to the Nirschl scores and evaluated with visual analog scale (VAS); Quick Disability of Arm, Shoulder and Hand (QDASH); and the Turkish version of the Patient Related Elbow Evaluation (PREE-T). Results: Improvements in all scores were statistically significant in all groups at the end of the second week. At the end of the fourth week, there was also a statistically significant improvement in all three groups, but these improvements were not as high as they were in the first 2 weeks. There was a slight deterioration in the functional scores in the RMG and CSI groups, while the improvement in the KT group continued. In the KT group, the average QDASH score was 18.1 (4.5-35), the VAS score was 2 (1-3), the VAS score in resisted wrist extension was 4 (2-5) and the Nirschl score was 2 (1-3) at the fourth week. The KT group had significant superiority in these parameters over the RMG (p = 0.035, p = 0.035, p = 0.029, p = 0.035, respectively). However, there was no significant difference between the KT, the RMG and the CSI groups at the fourth week. Conclusions: CSI, KT and rest-and-medication treatments were all effective in terms of pain reduction and functional scores at the end of week 2, and the only treatment that continued to be effective in the final week was KT.

Cast immobilization versus volar locking plate fixation of AO type C distal radial fractures in patients aged 60 years and older.

OBJECTIVE: The aim of this study was to evaluate the efficacy of conservative treatment (cast immobilization) for complex intra-articular distal radius fractures (AO type C) in elderly patients and to determine whether or not the application of a volar locking plate (VLP) is necessary. METHODS: A retrospective study on patients treated at two different clinics was conducted between 2014 and 2016. A total of 49 elderly patients ≥60 years old were treated either operatively with volar locking plate fixation (n = 25; 7 males and 18 females; mean age: 66.6 ± 7.4 years) or conservatively with cast immobilisation (n = 24; 7 males and 17 females; mean age: 68.9 ± 8.7 years) for complex intra-articular distal fractures. Clinical, functional and radiological evaluations were conducted at the final follow-up examinations of the patients. RESULTS: There was no statistically significant difference between the two groups of patients with respect to the follow-up periods, gender, age and fracture type (p > 0.05). At the end of mean follow-up time of 16 months the grip strength (p = 0.03), radial tilt (p = 0.06), radial inclination (p = 0.01), radial height (p = 0.01) and articular step-off (p = 0.02) were significantly better in the volar locking plate group, while there was no significant difference between the functional results (based on the Quick Disabilities of the Arm, Shoulder and Hand score) (p = 0.8) and range of motion. The grip strength was significantly higher in the VLP group when compared to the cast group (p = 0.03). CONCLUSION: The results of this study suggest that the locking plate fixation for the complex intra-articular distal radius fractures provides better results for the grip strength and radiographic parameters than cast immobilization in patients ≥60 years old, while no difference was found between the clinical and functional results. LEVEL OF EVIDENCE: Level III, Therapeutic Study.

Linburg-Comstock: Is Overuse an Etiological Factor?

BACKGROUND: Linburg-Comstock anomaly is typically defined as a tenosynovial interconnection between flexor pollicis longus and flexor digitorum profundus tendon of the second finger. There are several studies stating that the current anomaly is congenital or acquired. The aim of this study is to reveal whether overuse, which is mostly reported as an acquired etiologic factor, effective in development of the current anomaly. METHODS: Three hundred thirteen medical secretaries who work with computer keyboard at least 6 hours a day were defined as study group. Three hundred twenty-three volunteers without jobs who necessitate continuous and repetitive hand and finger activities were defined as control group. All individuals were examined by an orthopaedic surgeon. Additionally, cases with Linburg-Comstock anomaly were evaluated in respect of forearm pain and subjective findings of carpal tunnel syndrome. RESULTS: Linburg-Comstock anomaly was determined in 27.8% cases of medical secretary group and in 32.2% of healthy control group. In medical secretaries with Linburg-Comstock anomaly, 25.3% had forearm pain and 5.7% had findings of carpal tunnel syndrome. In control group with Linburg-Comstock anomaly, 21.2% had forearm pain and 13.5% had findings of carpal tunnel syndrome. No relationship was found between overuse of the hand and Linburg-Comstock anomaly and the symptoms accompanying the anomaly. CONCLUSIONS: The current study reveals that overuse is not an etiologic factor in Linburg-Comstock anomaly existence and related symptoms. We think that the current anomaly develops on congenital basis rather than acquired factors.

HISTORIQUE: En général, le syndrome de Linburg-Comstock désigne une interconnexion ténosynoviale entre le tendon long fléchisseur et le tendon fléchisseur profond de l'index. Selon plusieurs études, cette anomalie est congénitale ou acquise. La présente étude visait à déterminer si la surutilisation, surtout considérée comme un facteur étiologique acquis, contribue à l'apparition de cette anomalie. MÉTHODOLOGIE: Les chercheurs ont sélectionné un groupe d'étude composé de 313 secrétaires médicales qui saisissaient des données au moins six heures par jour. Le groupe témoin était formé de 323 volontaires n'occupant pas un emploi exigeant des activités répétitives et continues des mains et des doigts. Un chirurgien orthopédique les a tous examinés. De plus, les chercheurs ont évalué les syndromes de Linburg-Comstock en fonction de la douleur de l'avant-bras et des observations subjectives de syndrome du canal carpien. RÉSULTATS: Les chercheurs ont constaté la présence d'un syndrome de Linburg-Comstock chez 27,8 % des secrétaires médicales et 32,2 % des sujets du groupe témoin. Chez les secrétaires médicales atteintes de ce syndrome, 25,3 % souffraient de douleurs à l'avant-bras et 5,7 % présentaient des constatations de syndrome du canal carpien. Quant aux sujets du groupe témoin ayant l'anomalie, 21,2 % souffraient de douleurs à l'avant-bras et 13,5 % présentaient des constatations de syndrome du canal carpien. Les chercheurs n'ont remarqué aucun lien entre la surutilisation de la main, le syndrome de Linburg-Comstock et les symptômes connexes. CONCLUSIONS: La présente étude révèle que la surutilisation n'est pas un facteur étiologique du syndrome de Linburg-Comstock et des symptômes connexes. Les auteurs croient qu'il s'agit d'une anomalie congénitale et d'un problème non acquis.

[Who is responsible for the postoperative nerve injury? Anesthesia? Orthopedics? Trauma?]. / Ameliyat sonrasi sinir hasarinda sorumlu kim? Anestezi? Ortopedi? Travma?

In the pathogenesis of peripheral nerve injury, mechanical as well as vascular pressure, and chemical reasons play a role. In the applications of peripheral nerve block, there can be mechanical injury due to the type of needle and intrafascicular injections. In humerus fractures, nerve injury can be seen due to the surgical retractions and close proximity of the nerves with the bone. In addition, trauma may be the reason for posttraumatic nerve injury. In this presentation, we discussed the causes of postoperative nerve damage, which is seen after the operation of the distal humerus fracture.