Lower extremity deformities of patients with arthrogryposis multiplex congenita present a wide spectrum of severity and deformity combinations. Treatment goals range from merely ensuring comfortable seating and shoe wear, to fully independent and active ambulation, but the overarching intention is to help realize the patient's greatest potential for independence and function. Treatment of hip and knee contractures and dislocations has become more interventional, whereas treatment of foot deformities has paradoxically become much less surgical. This article synopsizes the treatment strategies presented in September 2014 in Saint Petersburg, Russia at the second international symposium on arthrogryposis.

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The aim of this study was to report the results of early open reduction of hip dislocations in infants with arthrogryposis multiplex congenita. Seven patients who were under 6 months of age at the time of hip reduction, with a mean follow-up period of 47.5±11.3 months after surgery, were included in this study. Four of seven patients (six of 13 hips) required additional hip surgeries during their follow-up. The short-term results of early open reduction of hips were not promising as most of the patients required additional hip surgeries.

ÖZAmaç: Bu çalışmada total diz artroplastisi (TDA) hastalarında eklem içi tranekzamik asit (TA) uygulamasının drenlerdeki kan miktarına, kan transfüzyonu miktarına, hastanede kalış süresine ve toplam maliyete etkisi değerlendirildi. Hastalar ve yöntemler: Çalışmaya TDA cerrahisi uygulanan toplam 118 hasta dahil edildi (24 erkek, 94 kadın; ort. yaş 67.0; dağılım 52-81 yıl). Hastalar eklem kapsülünün kapatılmasının ardından eklem içi 2 g TA uygulanan 58 hasta (TA grubu; 10 erkek, 48 kadın ort. yaş 65.6; dağılım 55-80 yıl) ve herhangi bir eklem içi enjeksiyon uygulanmayan 60 hasta (TA'sız grup; 14 erkek, 46 kadın; ort. yaş 68.3; dağılım 52-81 yıl) olarak iki gruba ayrıldı. Her hastanın ameliyat öncesi ve sonrası hemoglobin düzeyleri arasındaki maksimum farklılık, drenlerdeki kan miktarı, kan transfüzyonu miktarı, hastanede kalış süresi ve maliyeti kaydedildi. Bulgular: Ameliyat öncesi ve sonrası hemoglobin düzeylerindeki ortalama farklılık TA'sız grupta daha yüksek idi (1.7 g/dL'ye karşın 2.6 g/dL, p<0.05). Drenlerdeki ortalama kan miktarları (327.5 mL'ye karşın 800.0 mL, p<0.05), kan transfüzyonu miktarları (0 üniteye karşın 10 ünite, p<0.05), ortalama hastanede kalış süreleri (4.03 güne karşın 4.53 gün, p<0.05) ve hastane maliyetleri (1.935,26 Amerika Birleşik Devletleri dolarına karşın 1.959,64 Amerika Birleşik Devletleri doları, p<0.05) TA grubunda daha düşük idi. Sonuç: Primer TDA sırasında eklem içi TA uygulaması kan kaybını ve kan transfüzyonu gereksinimini azaltırken ameliyat sonrası hastanede kalış sürelerini kısaltıp toplam hastane maliyetlerini anlamlı şekilde azaltabilmektedir.Anahtar sözcükler: Kan kaybı; hastane maliyeti; total diz artroplastisi; tranekzamik asit. ABSTRACT Objectives:This study aims to evaluate the effect of intraarticular tranexamic acid (TA) administration on the amount of blood in the drains, the amount of blood transfusion, length of hospital stay, and the total cost in total knee arthroplasty (TKA) patients. Patients and methods:The study included a total of 118 patients (24 males, 94 females; mean age 67.0 years, range 52 to 81 years) who underwent primary unilateral TKA surgery. Patients were divided into two groups as 58 patients who were performed intra-articular injection of 2 g TA after closure of articular capsule (TA group; 10 males, 48 females, mean age 65.6 years; range 55 to 80 years) and 60 patients who were not performed any intra-articular injection (non-TA group; 14 males, 46 females; mean age 68.3 years; range 52 to 81 years). The maximum difference between pre-and postoperative hemoglobin levels, the amount of blood in the drains, the amount of blood transfusion, length of hospital stay, and cost of each patient were recorded. Results: The mean difference between pre-and postoperative hemoglobin levels were higher in the non-TA group (1.7 g/dL vs 2.6 g/dL, p<0.05). The mean amounts of blood in drains (327.5 mL vs 800.0 mL, p<0.05), the amounts of blood transfusions (0 units vs 10 units, p<0.05), the mean lengths of hospital stay (4.03 days vs 4.53 days, p<0.05), ...

The role of the platelet-to-lymphocyte ratio and neutrophil-to-lymphocyte ratio in the prediction of length and cost of hospital stay in patients with infected diabetic foot ulcers: A retrospective comparative study