Evaluation of Orthopaedics and Traumatology Patients Referred From a Tertiary Hospital.

Background This study aims to determine the rate of interhospital transfer, transfer diagnoses, where they were referred, and the reasons for the transfer of patients who presented to the emergency department and requested orthopaedic and traumatology consultations and to evaluate measures that may be effective in reducing the number of referrals for a more effective health service provision as a result of this information. Material and methods In this descriptive study, 59 patients were transferred to the emergency department of our hospital between January 1, 2019, and January 1, 2022, for whom orthopaedic and traumatology consultations were requested and for whom the orthopaedic physician requested transfer (training and research hospitals, university hospitals and private hospitals), and they were retrospectively evaluated. Results The ages of the study participants ranged from 1 to 91 years, with a mean age of 39.8 ± 20.9 years. Therefore, the majority of referred patients were male and Turkish citizens aged 18-65 years; there were no forensic cases; they were evaluated in the yellow area as a result of triage; and most of the transfers were from training and research hospitals and university hospitals, which are tertiary health institutions. On categorising patients based on their transfer diagnoses, it was found that patients with subtotal amputation of the finger were the most common among the referred patients. Conclusion To reduce the number of referrals, it is recommended to increase the standards in assistant training, especially in pelvis, acetabulum, and hand surgeries. It is also recommended to optimise material supply and skilled labour distribution.

Effect of elbow carrying angle on lateral epicondylitis development.

Lateral epicondylitis is one of the most common elbow joint injuries and elbow anatomy is a risk factor. Our study aims to evaluate whether the elbow carrying angle affects the development of lateral epicondylitis by considering sex differences. Elbow radiographs of 211 people (aged 18-65 years) diagnosed with lateral epicondylitis and having anteroposterior radiographs of the elbow taken in the appropriate position in the imaging archive of our hospital between January 1, 2021 and January 1, 2022 were retrospectively analyzed. The control group comprised elbow radiographs of 113 people in the same age range. The study evaluated the age, sex, and side and elbow carrying angles of the participants in the patient and control groups. The average elbow carrying angle was calculated as 14.6 (7.8-22.1). No significant relationship was found between the lateral epicondylitis and control groups based on sex (P = .383), side (P = .634) and age (P = .189). The mean elbow carrying angle was 13.8 ±â€…3.7 in the group with lateral epicondylitis and 15.9 ±â€…3.6 in the control group and was significantly lower in the group with lateral epicondylitis (P < .05). A decrease in the elbow carrying angle namely cubitus varus, may lead to the development of lateral epicondylitis.

Does Femoral Arterial Calcification Have an Effect on Mortality in Patients Who Underwent Hemiarthroplasty Due to Hip Fracture?

AIM: We aimed to investigate the effect of femoral arterial calcification on mortality in patients who underwent hemiarthroplasty due to hip fracture. MATERIAL AND METHODS: In our study, 481 patients who were operated for hip fracture between 01.01.2015 and 01.01.2021 were evaluated retrospectively. Femoral arterial calcification on the fractured side was evaluated in the preoperative pelvic anteroposterior (AP) X-ray, and the patients were divided into two subgroups according to the presence or absence of femoral arterial calcification. The overall survival and first-month and first-year survival of the patients were evaluated. Patients' age, gender, side, fracture type, treatment method, time between fracture and operation date, presence of femoral arterial calcification and type of anesthesia (regional, general) were recorded. RESULTS: Of the 481 patients included in the study, 299 were female and 182 were male, and the mean age was calculated as 80.5. Of the patients, 187 were diagnosed with femoral neck fractures and the remaining 294 with pertrochanteric fractures. It was observed that the mortality rate in the first month after surgery was 58 (12%) for both groups, and the mortality rate in the first year was 173 (35.9%) for both groups. The overall postoperative mortality was calculated as 302 (62.7%) for both groups. Femoral arterial calcification was detected in 191 of 481 patients, and femoral arterial calcification was not observed in the remaining 290 patients. Similarly, when both groups were compared in terms of mortality in the first month after surgery, mortality in the first year and overall mortality rates, no significant difference was found between the groups (p>0.05). CONCLUSION: In our study we showed that femoral arterial calcification has no effect on mortality in acute hip fractures treated by hemiarthroplasty in people over 65 years of age.

Inverse Correlation Between Bone Mineral Density and Systemic Immune Inflammation Index in Postmenopausal Turkish Women.

AIM: In this study, the correlation between the change in bone mineral density (BMD) and the numerical value of the systemic immune inflammation index (SII) in postmenopausal Turkish women was investigated. MATERIAL AND METHODS: The study comprised patients who had undergone menopause for at least one year and whose blood samples were examined by dual-energy X-ray absorptiometry (DEXA) on the same day. A retrospective evaluation of 527 postmenopausal women was performed. Age, body mass index (BMI), BMD, t score, neutrophil-lymphocyte-platelet-monocyte counts, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), and SII (platelet count x neutrophil count/lymphocyte count) values were calculated and recorded. RESULTS: When the data were analyzed with the Statistical Package for the Social Sciences (SPSS; IBM SPSS Statistics for Windows, version 26.0. Armonk, NY: IBM Corp.), neutrophil (p<0.001), lymphocyte (p=0.004), monocytes (p=0.002), platelet distribution width (PDW) (p=0.02), procalcitonin (PCT) (p=0.04), erythrocyte sedimentation rate (ESR) (p=0.001), C-reactive protein (CRP) (p=0.001), NLR (p=0.001), PLR (p=0.004), MLR (p=0.003), and SII (p=0.001) values were found to be higher in the postmenopausal osteoporosis (PMO) group than in the normal and osteopenia groups (p<0.05). When the platelet (p=0.15), mean platelet volume (MPV) (p=0.07), and 25-OH vitamin-D (p=0.15) values were compared, no correlation was found between the groups (normal, osteopenia, and PMO) (p>0.05). CONCLUSION: This study revealed that NLR, PLR, MLR, and SII values were inversely correlated with the change in BMD in postmenopausal Turkish women. These biomarkers, which are obtained from a simple, affordable, and accessible routine blood examination, may play an effective role in the early diagnosis and prevention of PMO in the future.

Clubfoot from past to the present: A bibliometric analysis with global productivity and research trends.

Clubfoot, a common congenital abnormality, affects the lower extremities; however, the literature search revealed no bibliometric research on this subject. Thus, we aimed to holistically analyze scientific articles and reveal global productivity and trend issues. This study statistically analyzed 1417 published articles on clubfoot (1980-2021) from the Web of Science database. Bibliometric network visualization maps were created to reveal trend topics, citation analysis, and cross-country collaborations. The analysis was conducted using Spearman correlation analysis. An exponential smoothing estimator was used to predict article productivity. The United States of America (433, 30.5%), the United Kingdom (166, 11.7%), and India (107, 7.5%) are the top 3 countries contributing to the literature. The Journal of Pediatric Orthopedics (220 articles), the Journal of Pediatric Orthopedics-Part B (147 articles), and Clinical Orthopedics and Related Research (69 articles) are the top 3 most productive journals. Dobbs MB (34 articles) is the most active author, and Shriners Hospital Children (44 articles) is the most active institution. Bibliometric analysis revealed that recently studied trend topics included Pirani score, Dimeglio score, Ponseti method, Ponseti casting, tenotomy, recurrence, neglected, tendon transfer, bracing, gait, risk factors, pedobarography, complex clubfoot, and polymorphism. The most studied subjects included Ponseti technique, treatment/casting, recurrent/relapsed clubfoot, Pirani score, pediatrics/children, foot deformities, surgery, ultrasound, Achilles tendon/tenotomy, gait analysis, casting, outcomes, neglected clubfoot, and tenotomy. Research leadership was determined in the western and European countries and Canada in studies and scientific collaborations on clubfoot; its impact was remarkable in India, China, and Turkey.