Level IV, case series.

Background: In this study, our aim was to determine the effect of cosmetic improvement on patient satisfaction and functional scores in hallux valgus (HV) surgery. Methods: Preoperative foot photographs of 105 patients who had undergone chevron osteotomy for HV between 2016 and 2018 were taken. The patients were divided into 2 groups. Twenty-four months after surgery, the preoperative foot photographs were shown to patients in group 1 (n = 52) but not to patients in group 2 (n = 53). The groups were then compared using the visual analog scale (VAS), the American Orthopaedic Foot & Ankle Society Hallux Metatarsophalangeal-Interphalangeal (AOFAS Hallux MTP-IP), and the 36-Item Short Form Health Survey (SF-36) scores. Both groups were evaluated radiologically with preoperative and postoperative hallux valgus angles and intermetatarsal angles. Results: There was no difference between the 2 groups in terms of radiologic parameters either pre- or postoperatively, or AOFAS Hallux MTP-IP scores postoperatively. However, for group 1, the VAS was lower (0.4±0.8 vs 1.8±1.6, P = .003) and both the SF-36 physical functioning (88.3±18.1 vs 79.1±23.2, P = .017) and SF-36 mental health scores were higher (78.8±19 vs 69.2±16.3, P = .022). Conclusion: Visualizing improvement in the cosmetic appearance of the foot appears associated with patients’ perception of subjective pain and functional improvement. We recommend that preoperative foot photographs be taken and recorded. Level of Evidence: Level III, case-control study.

ÖZAmaç: Bu çalışmanın amacı halluks valgus cerrahisinde üç farklı osteotominin sesamoid rotasyonuna etkisini araştırmaktır.Yöntem: Mart 2012-Ocak 2015 arasında 108 hastanın 64'ü retrospektif olarak incelendi. Sırasıyla 26,18 ve 20 hastaya distal chevron osteotomisi, proksimal domeosteotomisi ve lapidus osteotomisi uygulandı. Hastaların yaş ortalaması 46,6 (26-62) ve takip süresi ortalama 17 ay (12-26) idi.Bulgular: Son kontrollerinde ortalama Halluks valgus açısı 18.4º , intermetatarsal açısı 7.4 º, AOFAS skoru 86.1, sesamoid rotasyonu 13,5 idi. Preoperatif ve postoperatif sesamoid rotasyon farklılıkları sesamoid pozisyonlarının çoğunu kendi başlarına düzeltebilme kabiliyetleri açısından üç farklı osteotomi karşılaştırıldığında, Lapidus osteotomisi yapılan hastalarda hem proksimal dome yapılan hastalara göre (p:0.02) hem de distal chevron yapılan hastalara göre (p:0.000) sesamoid redüksiyonu başarısı açısından anlamlı bir fark bulunmuştur. Proksimal dome yapılan hastalarla distal chevron yapılan hastalar arasında sesamoid redüksiyon başarısı açısından anlamlı bir fark bulunmamıştır (p=0.242).Sonuç: Lapidus osteotomisi uygulanan hastalarda hem sesamoid rotasyon açılarının değişimi bakımından hem de sesamoid redüksiyonu açısından diğer iki osteotomi çeşidine göre daha iyi sonuçlar bulunmuştur. Çalışmamıza göre, Lapidus prosedürünün, sesamoid redüksiyonun nüks ile ilişkili olduğu düşünüldüğünde, orta ve şiddetli halluks valguslu hastalarda daha iyi sonuçlar vereceğini düşünüyoruz. ABSTRACTAim:The aim of this study is to investigate the effect of three different osteotomies on sesamoid rotation in hallux valgus surgery.Patients and Method: 64 out of 108 patients between March 2012-January 2015 were included retrospectively. Procedure of distal chevron, proximal dome and lapidus was applied to 26,18 and 20 patients respectively. Mean age of patients was 46,6 (26-62) and mean time of follow-up was 17 months. Results:At the last follow -up of patients, the mean hallux valgus angle was 18.4º, intermetatarsal angle was 7.4 º, AOFAS score was 86.1, sesamoid rotation was 13,5. When three different osteotomies were compared in terms of preop and postop sesamoid rotation differences in terms of their ability to correct most sesamoid position within themselves, a significant difference was found in patients treated with lapidus osteotomy in terms of success of sesamoid reduction compared to both patients treated with proximal dome osteotomy (p: 0.02) and patients treated with distal chevron osteotomy (p: 0.000). There was no significant difference in the success rate of sesamoid reduction between patients with proximal dome and patients with distal chevron. (P = 0.242) Discussion: Patients treated with lapidus osteotomy; both sesamoid rotation angle changes and sesamoid reduction were found to be better than the other two osteotomy types. According to the study, we think that the lapidus procedure will give better results in patients with moderate and severe hallux valgus when sesamoid reduction is considered to be related to ...

OBJECTIVE: One of the most controversial issues in pediatric orthopedics is Developmental dysplasia of the hip (DDH). The timing of diagnosis and treatment are is the main goal to treat this condition successfully. Neglected cases that may remain undiagnosed until advancing age are still seen especially in developing countries. Delayed diagnosis and treatment with advancing age leads to more extensive surgery and cause low satisfactory rates. The aim of this study is to evaluate the effect of patients’ age on the results of single-stage treatment of Developmental Dysplasia of the Hip.MATERIAL AND METHODS: 23 patients (34 hips) treated in our hospital between 2004 and 2010 were included in the study. Single-stage treatment including open reduction, femoral shortening, and Salter’s innominate osteotomy was applied to patients whose mean age of surgery was 7.5 years. Radiological results were evaluated in terms of improvement in the acetabular index, in the acetabular angle and according to Severin’s classification, and Bucholz and Ogden’s avascular necrosis (AVN) classification at the final follow-up.RESULTS: The average follow-up period was 60 (range: 24 - 84) months. While the acetabular index was 39.7°±1.4° (range: 25°- 52°) preoperatively, it was measured as 21.8°±1.8° postoperatively. The mean amount of improvement in the acetabular angle was 17.9°±0.8°. According to Bucholz and Ogden’s classification, one patient (2.9%) had Type 1 AVN and one patient (2.9%) had Type 3 AVN. Radiologically, the success rate (85.7%) was significantly higher in children aged 8 years and younger (p = 0.008).CONCLUSIONS: According to the improvement in the acetabular index and Severin's radiological classification, successful results are obtained after a single-step treatment of DDH, which is treated in the 4-8 age range. However, the radiological results of children older than 8 years are worse than those under 8 years old.

HighlightsTibial plafond fractures carry a high risk for post-traumatic osteoarthritis.Tricortical iliac crest autologous bone grafting (TCG) avoided need for arthrodesis.TCG with internal fixation restored joint stability, congruency and alignment.TCG should be considered for whom biological restoration is feasible.