A new compression design that increases proximal locking screw bending resistance in femur compression nails.

The aim is to present our new method of compression, a compression tube instead of conventional compression screw and to investigate the difference of proximal locking screw bending resistance between compression screw application (6 mm wide contact) and compression tube (two contact points with 13 mm gap) application. We formed six groups each consisting of 10 proximal locking screws. On metal cylinder representing lesser trochanter level, we performed 3-point bending tests with compression screw and with compression tube. We determined the yield points of the screws in 3-point bending tests using an axial compression testing machine. We determined the yield point of 5 mm screws as 1963±53 N (mean±SD) with compression screw, and as 2929±140 N with compression tubes. We found 51% more locking screw bending resistance with compression tube than with compression screw (p=0,000). Therefore compression tubes instead of compression screw must be preferred at femur compression nails.

A new device to produce a standardized experimental fracture in the rat tibia.

OBJECTIVE: To develop and introduce a new device to produce a standardized closed experimental fracture in the rat tibia. METHODS: This study took place in the Research Laboratory, Medical Faculty, Dokuz Eylul University, in the year 2003. We include 20 healthy male white Wistar rats. After pinning both tibia of the rat intramedullary with the needle of a sterile injector without any incision, we tried to produce a fracture with the pendulum of the device, which was dropped in different angles in 9 rats. The tibial diaphysis of 14 rats in the main study were fractured at 60 degrees. After the fractures were confirmed radiologically, 4 tibia underwent pathological analysis to determine the degree of soft tissue damage and 24 tibia were examined in terms of histological fracture healing. RESULTS: Radiologically, this technique resulted in a transverse or short oblique bicortical fracture in the middle of the tibial diaphysis. The healing process was well adjusted with the classification of Allen. No noticeable soft tissue damage in the fracture region was demonstrated. CONCLUSION: This method of producing an easy and reproducible fracture in a standard fashion without displacement and minimal soft tissue trauma in laboratory animals with this simple apparatus make it a useful technique for bone healing studies.

A Bilateral Traumatic Hip Obturator Dislocation.

A case of a bilateral simultaneous traumatic obturator dislocation of both hip joints in an 18-year-old young man following a traffic accident is presented. We reduced the dislocated femoral heads immediately under general anesthesia followed by passive and active exercises and early full-weight bearing mobilization. After 5 years, the result was excellent.

[Multidirectional shoulder instability and open surgical procedures]. / Cokyönlü omuz instabilitesinde açik cerrahi girisim.

The principles and procedures for multidirectional instability do not substantially differ from those for anterior instability. Correct diagnosis is difficult, but it is important for a successful treatment. Conservative treatment should be attempted before surgery. Open surgical treatment using the inferior capsular shift procedure is the gold standard. It can be carried out either anteriorly or posteriorly. We prefer a laterally-based capsular shift because it facilitates capsular plication.

Reliability of threaded locking screws.

OBJECTIVE: A frequent problem for interlocking nailing that affects the treatment of the fracture is locking screw deformation. The aim of this study is to determine whether bending resistance is different between high, low, and unthreaded locking screws of interlocking femoral nails. METHODS: Ninety screws were used in this experimental study, with 10 screws used in each of 9 groups. Three-point bending tests were performed on 6 groups of 5 mm screws (titanium, stainless steel, crossed with unthreaded, low threaded, and high threaded) and the same 3 thread types of 5.5 mm stainless steel screws in a 30-mm inner diameter steel tube, imitating the level of the lesser trochanter. An axial compressor was used to determine the yield points for permanent deformation in the locking screws by way of 3-point bending tests. RESULTS: The mean yield point value of the 3-point bending tests of 5-mm low threaded stainless steel locking screws was 2071 N, 53% less than that of unthreaded screws (3169 N). The mean yield point value of 5-mm high threaded stainless steel locking screws was 556 N, 272% less than that of low threaded screws (2071 N). CONCLUSION: To avoid locking screw deformation, high threaded screws must not be used as locking screws. In cases of unreliable patients, 5-mm low threaded screws should not be used in the nailing of comminuted or oblique femur shaft fractures. All 5-mm unthreaded screws and 5.5-mm low threaded stainless steel screws can be used safely in full weight-bearing conditions of unreliable patients.

Traumatic distal ulnar artery thrombosis.

This paper is about a posttraumatic distal ulnar artery thrombosis case that has occurred after a single blunt trauma. The ulnar artery thrombosis because of chronic trauma is a frequent condition (hypothenar hammer syndrome) but an ulnar artery thrombosis because of a single direct blunt trauma is rare. Our patient who has been affected by a single blunt trauma to his hand and developed ulnar artery thrombosis has been treated by resection of the thrombosed ulnar artery segment. This report shows that a single blunt trauma can cause distal ulnar artery thrombosis in the hand and it can be treated merely by thrombosed segment resection in suitable cases.