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Türk Ortopedi ve Travmatoloji Birliği Derneği ya da kalça eklemi oluşturmaktır. [8] Periprostetik eklem enfeksiyon tedavisinin modern biçimi ancak hasta merkezli yaklaşımla sağlanabilir. [9] Artroplastilerde enfeksiyon, ortopedik cerrahı zorlayan komplikasyonların başında gelir. Değişim artroplastisi, periprostetik enfeksiyon tedavisinde etkin bir yöntem olarak kullanılmaktadır. Kronik enfeksiyonun cerrahi yönetiminde, Kuzey Amerika ve Birleşik Krallık'ta, iki aşamalı değişim altın standart prosedür olarak uygulanmaktadır. Bu prosedür, ilk aşamada; enfekte implantın çıkarılması, radikal debridmanı, geçici antibiyotikli çimentonun ilk aşamada yerleştirilmesini içerir. Sonraki rekonstrüksiyon aşamasında; kalıcı protez ile çimentonun yerleştirilmesini, belirlenmiş bir periyod boyunca, altı hafta veya daha fazla sistemik antibiyotik tedavisini gerektirir. [10,11] Tek aşamalı değişim artroplastisi, ilk olarak 1981'de Bucholz tarafından, sonra da 1985'te Freeman tarafından tanımlanmış ve birçok Avrupa merkezinde umut verici sonuçlarla birlikte popülerlik kazanmıştır. [12-14] B ütün artroplastiler için enfeksiyon oranı ortalama %1,25 olarak bildirilmiştir. [1] Kalça ve diz artroplastisi sonrası periprostetik enfeksiyon oranı, nadir olarak, primer kalça artroplasti hastalarının %0,3-2,9'unda, primer diz artroplastilerinin ise %0,5-2'sinde meydana gelmektedir. [2-4] Yaşam beklentisinin ve yaşlı nüfusun fonksiyonel beklentilerinin artmasının sonucu olarak; Birleşik Devletler'de, 2030 yılında yıllık olarak, primer kalça ve diz artroplasti uygulamalarının sayısının, sırasıyla, %174 ve %673 artacağı tahmin edilmektedir. Bu nedenle, periprostetik eklem enfeksiyonları, gelecekte öngörülebilir bir ekonomik yük ve önemli bir komplikasyon olmaya devam edecektir. [5] Periprostetik eklem enfeksiyonları; total kalça artroplastisi revizyonu için üçüncü en sık (%14,8), total diz artroplastisi için ise en sık (%25,2) revizyon nedeni olarak karşımıza çıkmaktadır. [6,7] Revizyon prosedürünün esas hedefi, enfeksiyonu ortadan kaldırmak ve ağrısız, işlevsel ve stabil bir diz Periprostetik eklem enfeksiyonlarında tek aşamalı revizyon Single stage revision in the treatment of periprosthetic joint infections

Objectives In this study, we aimed to describe a new hook plate technique (HPT) and to compare our results with the conventional extension block technique (EBT) with a Kirschner wire (K-wire) for bony mallet finger treatment. Patients and methods Between April 2015 and January 2018, a total of 19 patients including 10 who were treated with EBT (7 males, 3 females; mean age: 30.1±7.3 years; range, 17 to 48 years) and nine who were treated with HPT (6 males, 3 females; mean age: 31.7±11.3 years; range, 19 to 42 years) for bony mallet finger with distal interphalangeal (DIP) joint subluxation and/or fracture fragment larger than one-third of distal phalanx (Wehbe-Schneider type 1/b, 2/a, 2/b, 3/a) joint were retrospectively analyzed. The DIP range of motion (ROM), Warren and Crawford scores, time to return to work/daily activity, operation time, the number of fluoroscopy shots, cost and complications were compared. Results No significant difference was found in the DIP ROM (p=0.708) and the Warren/Norris and Crawford scores (p=0.217 and p=0.175, respectively) between the two groups. Operation time and material cost were higher with HPT (p=0.006, p=0.001). There was no significant difference in the number of fluoroscopy shots (p=0.344). Although DIP joint motion was started at two weeks in the HPT group and at eight weeks in the EBT group, no significant difference was observed in the time of return to work and normal daily life in both groups (p=0.859). Complications were observed in two patients in the EBT group and in three patients in the HPT group. No significant difference in total complications was observed between the two groups (p=0.666). Conclusion Bony mallet finger treatment with a custom-made hook plate prepared from 1.3-mm AO plates appeared to be clinically and radiologically similar to EBT. Additionally, HPT had the advantages of allowing early ROM to DIP joint and eliminating the need for a secondary surgery such as K-wire removal. On the other hand, hardware cost with HPT was higher than EBT.

No abstract

Although diaphyseal forearm fractures in children are extremely common, the general approach is a conservative treatment (1). Despite having a high remodeling capacity, high-energy, nonreductive, and unstable fractures are treated surgically (2). Good results of open reduction and internal fixation (ORIF) with plaque have been reported in the literature (3,4). However, it has also been shown that ORIF causes complications such as soft tissue damage, infection, neurovascular damage, nonunion, malunion, and scar (5). Treatment with titanium elastic intramedullary nail (TEN) has been reported to yield better results compared with ORIF in terms of complications (6-8). This study aimed to evaluate 154 patients treated with TEN in terms of their functional status, union status, and complications. SUMMARY Diaphyseal forearm fractures in children are extremely common. They are mostly treated by conservative methods. The elastic intramedullary nail is a good solution owing to its advantages in the cases when surgery is needed. A total of 154 children with a forearm double fracture, who were surgically treated with the titanium elastic nail at the Department of Orthopedics, Erzurum Regional Training and Research Hospital between January 2010 and December 2015, were included in the study. Children aged more than 14 years with pathologic fractures, isolated radius, and isolated ulna fracture were excluded from the study. All cases were followed up for 1 year. All cases were treated first with closed reduction and casting. A surgical decision was taken for the cases that could not be reduced and had a shift in the fracture line in the follow-ups. The average union was radiologically for 5.9 weeks (4-9). Pin tract infection was observed in two cases, skin irritation in seven cases, nail migration three cases, and refracture six cases. Nerve damage, tendon rupture, malunion, nonunion, and synostosis were not observed. Perfect results were obtained in 126 (82.7%) cases, and good results were obtained in 26 (15.9%) cases in the study. Elastic intramedullary nailing is a surgical technique primarily preferred for forearm fractures in children because it is easily applicable; is associated with a small incision and no need for a secondary operation; has a low complication risk; and yields good clinical and radiological results.