Background and Objectives: This study aimed to examine the ventricular repolarization (VR) disturbances of patients operated on for acute spontaneous Achilles tendon ruptures (ATRs), by comparing them with a healthy individual control group. Materials and Methods: Between June 2014 and July 2020, a total of 29 patients (28 males, 1 female; mean age: 40 ± 9.78 years; range, 21–66 years) who presented to the emergency department within the first three weeks of injury, and were diagnosed with acute spontaneous ATRs and treated with an open Krackow suture technique, were retrospectively analyzed. Fifty-two healthy individuals (47 males, 5 females; mean age: 39 ± 11.45 years; range, 21–66 years) were recruited as a control group from the cardiology outpatient clinic. Clinical data (demographic features and laboratory parameters (serum glucose, creatinine, hemoglobin, white blood cell count, and lipid profile)) and electrocardiograms (ECGs) were collected from medical records. ECGs were evaluated for heart rate and VR parameters of QRS width, QTc interval, cQTd interval, Tp-e interval, and Tp-e/QT ratio. The clinical data and these ECG parameters were compared between groups. Results: There was no statistically significant difference between groups, regarding clinical data (all p < 0.05). Among ECG parameters, heart rate, QRS width, QTc interval, and cQTd interval were similar between groups (all p < 0.05). There were two important statistically significant findings of this research: The mean Tp-e interval was longer (ATR group: 72.4 ± 24.7, control group: 58.8 ± 14.5, p: 0.01), and the Tp-e/QT ratio was higher (ATR group: 0.2 ± 0.1, control group: 0.16 ± 0.4, p: 0.027) in the ATR group. Conclusions: According to the ventricular repolarization disturbances found in this study, patients with ATR may be at a higher risk of ventricular arrhythmia than healthy people. As a result, ATR patients should be assessed for ventricular arrhythmia risk by an expert cardiologist.

Objective: We aimed to share our radiological and clinical results with a mid-term follow-up on patella fractures treated with tension band wiring (TBW). Methods: Patients surgically treated with TBW for AO type 34-A1/C1/C2/C3 patella fractures between January 2013 and June 2021 at a level 1 trauma center were included. For radiological evaluation, radiographs obtained at the routine follow-up were analyzed for complications (such as nonunion, malunion, loss of reduction, malreduction, patella baja, elongated patella, implant failure), Insall-Salvati Index (ISI), and Patellar Morphology Ratio (PMR). The Knee Injury and Osteoarthritis Score (KOOS) was utilized for functional evaluation, which includes five subscales: pain, symptoms, activities of daily living (ADL), sports/recreation, and quality of life (QOL). The clinical assessment also included the range of motion (ROM), thigh circumference (TC), and complications such as implant irritation (II). Results: This study reviewed 42 eligible patients (10 females, 32 males) with a mean age of 42.6 ± 16.1 years and a mean follow-up of 35.4 ± 24.1 months. There were 28 patients (66.7%) with at least one complication (II: 66.7%, flexion deficit: 61.9%, malunion: 40.5%, elongated patella/patella baja: 16.7%). The reoperation rate was high at 69.1% due to the high implant removal rate for II. There were statistically significant differences between injured (I) and uninjured contralateral healthy knees (UI) in terms of mean KOOS subscale scores (symptoms: I: 72.3, UI: 89.8; pain: I: 70.4, UI: 89.4; ADL : I: 72.1, UI: 90; sports: I: 61.4, UI: 84.8; QOL: I: 67.9, UI: 86.2), mean flexion degrees (I: 126.2°, UI: 135.4°), mean ISI (I: 0.9, UI: 1.0), and mean PMR (I: 1.5, UI: 1.4) (all p < 0.01). There was no difference in mean extension degrees and TC (all p > 0.05). All fractures achieved union. Conclusion: Firstly, the mid-term clinical results of patellar fractures treated with TBW were significantly worse than the contralateral healthy knee; secondly, implant irritation, knee flexion deficit, malunion, and patella baja were the significant complications, and efforts should be made to manage these problems; thirdly, patellar fractures are susceptible to developing interesting cases of the elongated patella.

Objectives: This study aims to compare the clinical results of patients rehabilitated with or without a rehabilitative knee brace (RKB) after anterior cruciate ligament (ACL) reconstruction. Patients and methods: This retrospective, comparative study was conducted at between January 2013 and December 2017. A total of 119 patients (112 males, 7 females; mean age: 32.0±8.6 years; range, 18 to 45 years) with acute ACL ruptures treated with arthroscopic ACL reconstruction and rehabilitated with (n=56) or without RKB (n=63) participated in the study. The minimum follow-up time was 24 months. The ACL quality of life (QoL) questionnaire, Lysholm Knee Scoring Scale, and Tegner Activity Level Scale were used for the evaluation of the QoL, knee function, and activity level, respectively. The time to return to sports was recorded. The side-to-side difference in the anterior translation of the tibia was measured using a KT-1000 arthrometer. Results: The mean follow-up time was 38.4±9.1 (range, 24 to 56) months. Baseline demographics and clinical characteristics were similar between groups. Regarding QoL, knee function, and activity level, no significant difference was observed between patients who used RKB and those who did not use it at the postoperative 12th month (p=0.95, p=0.56, p=0.98, respectively) and the latest follow-up (p=0.21, p=0.73, p=0.99, respectively). The mean time to return to sports (nearly 11 months for both groups) and side-to-side difference in the anterior tibial translation at the latest follow-up was also similar between groups (p=0.15 and p=0.15, respectively). There was no graft rupture during the follow-up in both groups. The complication rates were 7.9% and 7.1% for no brace and brace groups, respectively, without a statistically significant difference (p=0.87). Conclusion: According to the results of this study, there was no significant difference between the rehabilitative brace and no brace groups in clinical outcomes after ACL reconstruction.

IntroductionVenous thromboembolism (VTE), particularly pulmonary embolism (PE), is the third highest cause of death in trauma patients who survive beyond the first day. Musculoskeletal surgery is associated with several complications, some of which may be life-threatening, including deep vein thrombosis (DVT) and PE. ObjectiveThis research aims to describe risk variables for VTE after upper extremity (UE) fracture at a single institution and estimate the incidence of PE following UE fracture. MethodsThe writers accessed the database via their respective universities using the International Standard Classification (ICD) codes. The medical files of patients aged 18 and older who sought treatment at our emergency department for an injury to their UE and also sought treatment at the orthopedics and traumatology clinic between the years 2013 and 2021 were manually scanned. The patients who applied to the Chest Diseases Clinic within 30 days after the trauma and were diagnosed with PE in the ICD code scan were included in the study. ResultsUE trauma was the cause of admission to the emergency department for 3,265 patients, and 21 of those patients (0.64%) were found to have PE. Fifteen of the patients were male, and six were female. The median age was 59 years (IQR 17). There were no deaths associated with PE. One of the patients had a scaphoid fracture, seven patients had a humerus fracture, five patients had a distal radius fracture, two patients had an acromioclavicular joint injury, one patient had a shoulder dislocation, one patient had a finger fracture, four patients had wrist crush injury. Three patients had diabetes mellitus. Five patients were active smokers. JAK-2 gene V617F mutation was detected in one patient. One patient was diagnosed with prostate cancer, and one had gastric cancer. One patient had a central venous catheter. Two patients were being treated for hypothyroidism. Two patients had hypertension. ConclusionAccording to the findings of our research, the probability of developing PE in the days following of an injury to the UE was found to be 0.64%. Patients with UE injuries who are active smokers and who also have diabetes, hypertension, hypothyroidism, cancer, coagulation disorder (JAK2 gene V617F mutation), or a central venous catheter may benefit from anticoagulant prophylaxis. This is because these patients are at a higher risk of developing dangerous blood clots.