Background: Finger amputations are the most commonly encountered amputation injury in the upper extremities. It is important to avoid shortening and to preserve the length of the finger in fingertip amputations in order not to lose the functions of the hand. The aim of this study was to evaluate the results of our patients who underwent reconstruction using V-Y pulp flap and artificial nail in order to avoid donor site morbidity in fingertip defects. Methods: The results of patients who underwent reparation with V-Y flap and polyethylene nails for exposed distal phalanx and partial nail bed defect after fingertip amputation were evaluated in this retrospective study. The data of 44 patients who underwent 44 V-Y advancement flap between January 2016 and January 2021 were retrospectively analyzed. Results: A total of 44 patients, 5 female and 39 male, who were treated for fingertip amputation, with a mean follow-up period of 24.2 months (14-71) and a mean age of 34.75 (2-68) were included in the study. The mechanism of injury was guillotine-style, avulsion and crush injuries in 15 (34.1%), 11 (25%) and 18 (40.9%) patients, respectively. Among the patients, 25 (56.8%) had right hand injuries, while 19 (43.2%) had left hand injuries. The dominant hand was affected in 28 (63.6%) patients. In 5 patients, the distal phalanx was shortened to the level of the lost nail bed (shortening was maximum 5 mm). Nail formation had occurred in all patients and deformed nail structure was seen in 18 patients. Graft necrosis was seen in 2 patients. Conclusion: It is difficult for surgeons to decide on the treatment method because of the fact that there are multiple surgical techniques in the literature and the results are reported differently. Success rates are high in our technique. Each techniq.ue has its own advantages and disadvantages.

ABSTRACT Background/Aims: Different suturing techniques are performed in tendon repairs after forearm flexor tendon injury. But there is not much information about their results in the literature. The main goals of flexor tendon repairs are strong repair and early mobilization. The aim of this study was to compare the results of the modified Kessler technique alone and modified Kessler suture with a running epitenon suture technique in flexor tendon repairs in this region and to evaluate the postoperative success rates. Methods: This study was conducted between March 2017 and November 2020. The study comprised of 68 patients. Repair was performed only by the modified Kessler technique to 34 of these patients. The other 34 patients underwent reinforcement with modified Kessler suture with a running epitenon suture. Passive flexion exercises accompanied by a physiotherapist were started on the 5th day after surgery. After the 10th day, active flexion exercise was started again under the supervision of a physiotherapist. Wrist immobilization was performed for one month. The function of the tendons was evaluated according to Tang grading during 12-month follow-up of the patients. Results: Patients in the modified Kessler suture with a running epitenon suture group showed better results than those in the Modified Kessler group, for the adhesion, limitation of motion and Tang grading variables. Conclusions: Good results were obtained in most of the patients following forearm flexor tendon repair. Especially the modified Kessler suture with a running epitenon suture technique provides a stronger repair in these patients and improves outcomes by facilitating rehabilitation.

Öz Purpose:The impact on bone union of injecting bone marrow from the anterior iliac crest was examined in patients with non-unions. Materials and Methods:The present study was prepared following a retrospective study on non-union patients who applied to our clinics who accepted bone marrow injection and were followed up and monitored after the procedure. A total of 14 bones from 13 patients with long bone diaphysis and metaphysis non-union were included in the study from among patients who applied during the dates of November 2016 -December 2019. Bone marrow aspiration from the anterior iliac crest was conducted on the patients under anesthesia which was injected to the fracture line under local anesthesia and fluoroscopy. All patients were monitored on a monthly basis with frontrear and side radiography. The injection operation was conducted three times on seven patients and 2 times on a total of seven non-unions in 6 patients. Results: A total of 11 unions took place in 14 patients. A union could not be attained in three fractures. The gap was over 2 mm in fractures without union. Fracture union ratio was obtained as 79 %. The mean injection number applied on the patients was 2.5. A statistically significant correlation could not be identified between the fixation method and non-union type and union. Conclusion: Bone marrow injection is a cheap, effective, easy to use and safe surgical method for the treatment of long bone fractures with non-union.