ÖZAmaç: Bu çalışmada proksimal femoral çivi-antirotasyon (PFNA) veya çimentolu, kalkar destekli, bipolar hemiartroplasti uygulanan intertrokanterik femur kırıklı hastaların mortalite ve morbidite oranları değerlendirildi. Hastalar ve yöntemler: Proksimal femur kırığı nedeniyle Ocak 2008 -Ocak 2011 tarihleri arasında tedavi gören 127 hasta (42 erkek, 85 kadın; ort. yaş 79.2 yıl; dağılım 55-98 yıl) ameliyat sırasında mortalite, toplam mortalite ve mortalite oranlarının aylara göre dağılımı açısından retrospektif olarak karşılaştırıldı. Bu 127 hastadan yaşayan, en az 12 aylık takibe ulaşan, ameliyat öncesi dönemde yürüyebilen ve günlük aktivitelerini yerine getirebilen 92 hasta (28 erkek, 64 kadın; ort. yaş 80.24 yıl; dağılım 55-94 yıl) çalışmaya dahil edildi. Hastalar PFNA grubu (n=34) ve çimentolu, kalkar destekli, bipolar hemiartroplasti grubu (hemiartroplasti grubu; n=58) olmak üzere iki gruba ayrıldı. Her iki grup ameliyat süresi, ameliyat sırasında kan transfüzyonu ihtiyacı, hastanede yatış süresi, fonksiyonel sonuçlar, yaşam kalitesi, komplikasyon ve revizyon oranları ve ameliyat maliyetleri açısından karşılaştırıldı. Bulgular: Her iki gruptaki hastalarda aynı kırık tipi vardı. İki grubun kemik mineral yoğunluğu sonuçları, anestezi tipi ve riski benzerdi. İki grup arasında ameliyat sırasında mortalite, toplam mortalite ve mortalite oranlarının aylara göre dağılımı açısından anlamlı farklılık saptanmadı (p>0.05). Ortalama ameliyat süresi PFNA ve hemiartroplasti gruplarında sırasıyla 54.84 dakika (dağılım 40-110 dakika) ve 74.66 dakika (dağılım 55-120 dakika) idi. Ortalama hastanede yatış süresi PFNA ve hemiartroplasti gruplarında sırasıyla 5.91 gün (dağılım 5-12 gün) ve 9.41 gün (dağılım 6-16 gün) idi. Proksimal femoral çivi-antirotasyon grubunda ameliyat süresi ve hastanede yatış süresi daha kısa; fonksiyonel sonuçlar daha iyi idi (p<0.05). Kan transfüzyonu ihtiyacı PFNA grubunda daha az idi. Sonuç: İntertrokanterik femur kırıklarının tedavisinde hem PFNA hem çimentolu, kalkar destekli, bipolar hemiartroplasti iyi tekniklerdir. Yaşlı hastalarda ameliyat süresinin daha kısa ve tekrar ameliyat riskinin düşük olması nedeniyle internal tespit daha uygun olabilir.Anahtar sözcükler: Hemiartroplasti; kalça kırığı; intertrokanterik femur kırığı; proksimal femoral çivi-antirotasyon. ABSTRACTObjectives: This study aims to assess the mortality and morbidity rates of patients with intertrochanteric femoral fractures who were performed proximal femoral nail-antirotation (PFNA) or cemented, bipolar hemiarthroplasty with calcar replacement. Patients and methods:A total of 127 patients (42 males, 85 females; mean age 79.2 years; range 55 to 98 years) who were treated due to proximal femoral fracture between January 2008 and January 2011 were compared retrospectively in terms of intraoperative mortality, total mortality, and monthly distribution of mortality rates. Of these 127 patients, 92 (28 males, 64 females; mean age 80.24 years; range 55 to 94 years) who were alive, who achieved at least a 12-month follow-up, and could...

Background: The term massive refers to a quantitative measure of the rotator cuff tears. Irreparable rotator cuff tear is indicated by ratings that qualitatively evaluate the repairability of the tendon. These two terms should be considered separately. Methods: Between 2016 and 2022, publications in the last about 5 years were searched from Pubmed and MEDLINE online databases. The search terms (irreparable OR massive) AND (rotator cuff tear), (repairable OR massive) AND (rotator cuff tear), (massive OR retracted) AND (rotator cuff tear), (irreparable OR retracted) AND (rotator cuff tear) ”were used. For each search term, it was checked whether the title of the search term was mentioned in the title of the article, and whether the title and the content were compatible in the studies in which the searched term was mentioned in the title. Results: Of the 934 scanned articles, 69 of them were evaluated in terms of study title and material-method compatibility. 22 articles with the term “massive rotator cuff tear” in the title were identified. It was seen that in 11 of these 22 articles (50%), the title and the material method were compatible and in 11 of them (50%) the title and the content were incompatible, and the term “massive” was used instead of the term “irreparable”. Conclusions: We see that most of the studies on massive tears were actually done to emphasize irreparable tears. Since most of the massive tears are repairable, the quality feature of massive tears, which are in the group that poses a problem, as irreparable rotator cuff tear or massive irreparable rotator cuff tear should be emphasized. Keywords: Rotator cuff tears, Shoulder, Arthroscopy, Ireparable, Massive

Aim: Diagnostic arthroscopy is an invasive and an expensive method using for the diagnosis of meniscal tears. The aim of this study was to determine the value of knee magnetic resonance imaging in the diagnosis of meniscal tears and its role in the prevention of unnecessary diagnostic arthroscopy. Methods: A total of 105 patients who underwent knee magnetic resonance imaging and arthroscopy due to meniscus injury were included in the study. Fifty-nine patients were examined using a 1.5 Tesla magnetic resonance scanner and 46 were examined using a 3.0 Tesla magnetic resonance scanner. Magnetic resonance imaging findings were evaluated retrospectively in workstations by two radiologists experienced in musculoskeletal magnetic resonance imaging. Meniscal tears were reported as anterior horn tear, corpus tear or posterior horn tear. Meniscal tears were classified by using surgical classification. Each patient's magnetic resonance images were evaluated with a consensus and compared with the arthroscopic diagnosis. Results: Meniscal tears were detected in 96 out of 106 knees on arthroscopy. By using arthroscopy as the gold standard for diagnosis of meniscal tears, the sensitivity, specificity, and accuracy values of the magnetic resonance imaging evaluation were found as 85.71% (95% CI: 77.84-91.61), 93% (95% CI: 86.11-97.14) and 89.15% (95% CI: 84.17-93), respectively. These values of magnetic resonance imaging were found high in the diagnosis of meniscal tears. Conclusions: Magnetic resonance imaging is an effective imaging method in the diagnosis of meniscal tears. Although the resolution of 3.0 Tesla magnetic resonance imaging is higher, 1.5 Tesla magnetic resonance imaging is sufficient in routine meniscus tear diagnosis.