Study DesignEighty-four patients who had been treated for degenerative spinal diseases between January 2006 and June 2009 were reviewed retrospectively.PurposeWe aimed to compare the clinical and radiologic findings of manual workers who underwent posterolateral fusion (PLF) or posterior interbody fusion (PLIF) involving fusion of 3 or more levels of the spine.Overview of LiteraturePrevious studies have concluded that there is no significant difference between the clinical outcome of PLF and PLIF techniques.MethodsAfter standard decompression, 42 patients underwent PLF and the other 42 patients underwent PLIF. Radiologic findings, Oswestry disability index (ODI) scores, and visual analogue scale (VAS) scores were assessed preoperatively and at 6-month intervals postoperatively and return to work times/rates were assessed for 48 months.ResultsPatients who underwent PLF had significantly shorter surgical time and less blood loss. According to the 48-month clinical results, ODI and VAS scores were reduced significantly in the two groups, but the PLIF group showed better results than the PLF group at the last follow-up. Return to work rate was 63% in the PLF group and 87% in the PLIF group. Union rates were found to be 81% and 89%, respectively, after 24 months (p=0.154).ConclusionsPLIF is a preferable technique with respect to stability and correction, but the result does not depend on only the fusion rates. Discectomy and fusion mass localization should be considered for achieving clinical success with the fusion technique. Before performing PLIF, the association of the long operative time and high blood loss with mortality and morbidity should be taken into consideration, particularly in the elderly and disabled patients.

The treatment of tendon diseases increasing as the result of longer life expectancy and further taking place of re-creative activities in life maintains its importance in orthopedic surgery. Significant data's have been obtained with numerous conducted studies and many developed surgical methods in this field, however the ongoing challenges and some complications are still lasting today. Therefore, a number of studies were conducted in order to obtain the ideal tendon repair method and are still conducted. For reaching the desired goal of all of these studies, to have a good knowledge about the biological and biomechanical structure of the tendon, the healing stages, and the factors aff ecting the repair mechanisms and healing has an undeniable place. In this review it has been aimed to help the researchers by reviewing the studies about tendon repair and healing in the literature. Keywords: Tendon healing, Tendon repair, Tendon surgery, bFGF, PRP, Hyaluronic acid, Growth factors, Gliding mechanism, Suture techniques Tendon İyileşmesi ve Tamirinde Güncel Yaklaşımların Gözden Geçirilmesi ÖzetYaşam süresinin uzaması ve rekreatif aktivitelerin yaşamda daha fazla yer alması sonucunda artan tendon hastalıklarının tedavisi ortopedik cerrahideki önemini korumaktadır. Bu alanda yapılan çok sayıda çalışmalar ve geliştirilen birçok cerrahi metotlarla önemli kazanımlar elde edilmiş olmasına karşın öteden beri devam eden zorluklar ve komplikasyonların bir kısmı günümüzde de hala devam etmektedir. Dolayısı ile ideal tendon tamir metodu elde etmek için çok sayıda çalışma yapılmış ve yapılmaktadır. Bütün bu çalışmaların istenen hedefe ulaşabilmesinde, tendonun biyolojik ve biyomekanik yapısının, iyileşme evrelerinin, tamir mekanizmaları ve iyileşmesini etkileyen faktörlerin iyi bilinmesi yadsınamaz bir gerçektir. Bu çalışma, tendon tamiri ve iyileşmesi konusunda son yıllarda yapılan çalışmalar ve klasik bilgilerin harmanlanarak güncel yaklaşımların aktarılması amacıyla rapor edilmiştir.

Medial clavicle fractures are not common and may be associated with injuries to the adjacent vital structures. This study consists of the case of a 15-year-old boy who had a preexistingventriculoperitoneal shunt and a displaced medial clavicle fracture. In the study, we performed a successful surgical treatment using a distal radius locking plate. The mechanism of the injury and treatment options are discussed in relation to the literature in the field.

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ÖzetAmaç: Çocuklarda tibia şaft kırıkları çoğunlukla konservatif olarak tedavi edilmekle birlikte çoklu uzun kemik kırığı veya eşlik eden organ yaralanması olan ya da okul çağında olan tibia şaft kırıklı hastalarda cerrahi tedavi düşünülmelidir. Bu yazıda ender çivisi ile tibia şaft kırığı tedavi edilmiş hastalar sunulmuştur. Gereç ve Yöntem: Hepsi çocuk olan 9'u erkek 12 hastanın 13 kırığına genel anestezi altında 2 adet 3,5 mm'lik uygun boyda tibia ender çivisi uygulandı. Ameliyat sonrası 2 hafta uzun bacak atel kullanıldı. Hastaların okula gitmelerine 10 günden sonra izin verildi. Hastalar takip grafileri ve muayeneleri ile kırığın tipi, kaynama süresi, kısalık-uzunluk farkı, rotasyon, eklem hareket kısıtlılığı, refraktür, Flynn kriterlerine göre klinik sonuç ve enfeksiyon açısından değerlendirildi. Bulgular: Hastaların yaş ortalaması 8,6 yıl (4-15) idi. Kırık tipi bütün hastalarda Winquist tip 2 ve 3 idi. Takip süresi ortalama 20 ay (14-40)idi. Hastaların 3 ünde mevcut olan açık kırığın ikisi tip 1, biri ise tip 2 idi. Hastalarda tedavi edilen tibialarda uzunluk ve kısalık farkı ortalama 7 mm (2-21), rotasyon farkı ortalama 4 derece (2-8), varusvalgus açılanması ortalama 5 derece (2-10) idi. Hiç bir hastada refraktür gelişmedi. Flynn kriterlerine göre 5 kırıkta mükemmel, 7 kırıkta iyi ve 1 kırıkta kötü sonuç alındı. Sonuç: Erken okula dönüş imkanı, tespit sonrası refraktür riskinin düşüklüğü ve fiyat avantajı sebebiyle çocuklarda 4 yaş üzeri tibia şaft kırıklarının cerrahi tedavisinde Ender çivisi öncelikle düşünülmelidir. AbstractAim: Although tibial shaft fractures in children are mostly treated conservatively. Surgical treatment should be considered in patients in school age with the tibial shaft fracture or with multiple long-bone fracture or who have organ injury. The patients treated their tibia shaft fractures with Ender nail are presented in this article. Material ans Method: Two tibia Ender nails been 3.5 mm in appropriate length were performed under general anesthesia to the 13 fractures of 12 patients, all of whom were children and 9 out of whom were men. Long-leg splint was used for 2 weeks after the surgery. The patients were allowed to go to school after 10 days. Patients were evaluated according to Flynn criteria in terms of the clinical outcome and infection with their follow-up X-rays and examination and the type of the fracture, duration of the union, shortening-length difference, rotation, limitation of the joint motion, refracture. Results: The mean age of the patients was 8,6 years (4-15). The type of the fracture was Winquist type 2 and 3 in all of the patients. The mean duration of the follow-up was 20 months (14-40). Two of the existing-open fractures were type 1 and one of them was type 2 in three patients. In the difference of the length and shortening in treated tibias in patients was an average of 7 mm (2-21), the difference of the rotation was 4 degrees (2-8), and the angulation of varus-valgus was an average of 5 degrees (2-10). None of the patients developed refractures. A perfe...