BACKGROUND Hallux valgus(HV)is a common foot deformity that manifests with increasing age,especially in women.The associated foot pain causes impaired gait and decreases quality of life.Moderate and severe HV is a def...BACKGROUND Hallux valgus(HV)is a common foot deformity that manifests with increasing age,especially in women.The associated foot pain causes impaired gait and decreases quality of life.Moderate and severe HV is a deformity that is charac-terized by the involvement of lesser rays and requires complex surgical treatment.In this study,we attempted to develop a procedure for this condition.AIM To analyse the treatment results of patients who underwent simultaneous surgical correction of all parts of a static forefoot deformity.METHODS We conducted a prospective clinical trial between 2016 and 2021 in which 30 feet with moderate or severe HV associated with Tailor’s bunion and metatarsalgia were surgically treated via a new method involving surgical correction of all associated problems.This method included a modified Lapidus procedure,M2M3 tarsometatarsal arthrodesis,intermetatarsal fusion of the M4 and M5 bases,and the use of an original external fixation apparatus to enhance correction power.Preoperative,postoperative,and final follow-up radiographic data and American Orthopaedic Foot and Ankle Society(AOFAS)scores were compared,and P values<0.05 were considered to indicate statistical significance.RESULTS The study included 28 females(93.3%)and 2 males feet(6.7%),20(66.7%)of whom had a moderate degree of HV and 10(33.3%)of whom had severe deformity.M2 and M3 metatarsalgia was observed in 21 feet,and 9 feet experienced pain only at M2.The mean follow-up duration was 11 months.All patients had good correction of the HV angle[preoperative median,36.5 degrees,interquartile range(IQR):30-45;postoperative median,10 degrees,IQR:8.8-10;follow-up median,11.5 degrees,IQR:10-14;P<0.01].At follow-up,metatarsalgia was resolved in most patients(30 vs 5).There was a clinically negligible decrease in the corrected angles at the final follow-up,and the overall AOFAS score was significantly better(median,65 points,IQR:53.8-70;vs 80 points,IQR:75-85;P<0.01).CONCLUSION The developed method showed good sustainability of correction power in a small sample of patients at the one-year follow-up.Randomized clinical trials with larger samples,as well as long-term outcome assessments,are needed in the future.展开更多
Introduction: Traumatic Brain Injury (TBI) is a major public health problem causing significant morbidity and mortality in young adults. This study aimed to describe the epidemiological, diagnostic, therapeutic, and e...Introduction: Traumatic Brain Injury (TBI) is a major public health problem causing significant morbidity and mortality in young adults. This study aimed to describe the epidemiological, diagnostic, therapeutic, and evolutionary aspects of TBI. Materials and Methods: This was a prospective, descriptive study conducted from 1 April 2022 to 31 March 2023 on patients admitted to and treated for cranioencephalic trauma in the General Surgery department of Kara Regional Hospital. Results: Eighty-three (83) patients with cranioencephalic trauma were managed out of 773 patients admitted to the department during the study period. The mean age was 34 ± 14.98 years and the sex ratio was 3.6 in favour of men. Motorbike taxi drivers were the social group most affected (n = 33, 40%). The causes of trauma were dominated by public road accidents (n = 80;96%). TBI was mild (n = 40;48%), moderate (n = 35;42%) and severe (n = 8;10%). Cerebral CT scans were performed in 19 patients (23%). Cerebral contusion (n = 4) was the most frequent cerebral lesion. Six patients (7%) with severe head injuries were transferred to Kara University Hospital. Six deaths (7%) occurred in patients with severe head injuries. The main sequelae were intermittent headaches in all patients reviewed, and memory problems (6%). Conclusion: Traumatic brain injuries are common at Kara Regional Hospital. Severe cranial trauma is less frequent but leads to death because of financial difficulties and limited technical facilities.展开更多
BACKGROUND The usefulness of a mandatory joint aspiration before re-implantation in patients with a cement spacer already in place is unclear.AIM To evaluate the role of culturing synovial fluid obtained by joint aspi...BACKGROUND The usefulness of a mandatory joint aspiration before re-implantation in patients with a cement spacer already in place is unclear.AIM To evaluate the role of culturing synovial fluid obtained by joint aspiration before re-implantation in patients who underwent a two-stage septic revision.METHODS A retrospective observational study was conducted,including patients that underwent a two-stage septic revision(hip or knee)from 2010 to 2017.After the first stage revision and according to intraoperative culture results,all patients were treated with an antibiotic protocol for 6-8 wk.Following 2 wk without antibiotics,a culture of synovial fluid was obtained.The results of these cultures were recorded and compared with cultures obtained during re-implantation surgery.RESULTS Forty-one patients(20 hip and 21 knee spacers)were included in the final analysis.In 39 cases,the culture of synovial fluid was negative,while in the remaining 2 cases(knee spacers)no analysis was possible due to dry tap.In 5 of the patients,two or more intraoperative cultures taken during the re-implantation surgery were positive.CONCLUSION We found no evidence to support mandatory joint aspiration before re-implantation in patients with a cement spacer in place.展开更多
To the Editor:Osteosynthesis is considered as a standard management for the non-displaced femoral neck fracture in elderly patients,^([1])but some of the patients would suffer from avascular necrosis or non-union afte...To the Editor:Osteosynthesis is considered as a standard management for the non-displaced femoral neck fracture in elderly patients,^([1])but some of the patients would suffer from avascular necrosis or non-union after osteosynthesis.It has been demonstrated that the outcome of the salvage procedure after primary avascular necrosis is not reliable.^([2])Therefore,the preoperative detection of the risk factors should be of great significance.The Garden classification system has been the most commonly used to distinguish the severity of femoral neck fracture,but it is mainly focused on the displacement in the coronal plane.Since the integrity of posterior cortex has been demonstrated as an important role in the outcomes of displaced femoral neck fractures,^([3])it is reasonable to investigate the effect of posterior cortex on the non-displaced pattern.Recently,we compared the outcomes after osteosynthesis for nondisplaced femoral neck fractures with and without posterior cortex complete fracture.展开更多
文摘BACKGROUND Hallux valgus(HV)is a common foot deformity that manifests with increasing age,especially in women.The associated foot pain causes impaired gait and decreases quality of life.Moderate and severe HV is a deformity that is charac-terized by the involvement of lesser rays and requires complex surgical treatment.In this study,we attempted to develop a procedure for this condition.AIM To analyse the treatment results of patients who underwent simultaneous surgical correction of all parts of a static forefoot deformity.METHODS We conducted a prospective clinical trial between 2016 and 2021 in which 30 feet with moderate or severe HV associated with Tailor’s bunion and metatarsalgia were surgically treated via a new method involving surgical correction of all associated problems.This method included a modified Lapidus procedure,M2M3 tarsometatarsal arthrodesis,intermetatarsal fusion of the M4 and M5 bases,and the use of an original external fixation apparatus to enhance correction power.Preoperative,postoperative,and final follow-up radiographic data and American Orthopaedic Foot and Ankle Society(AOFAS)scores were compared,and P values<0.05 were considered to indicate statistical significance.RESULTS The study included 28 females(93.3%)and 2 males feet(6.7%),20(66.7%)of whom had a moderate degree of HV and 10(33.3%)of whom had severe deformity.M2 and M3 metatarsalgia was observed in 21 feet,and 9 feet experienced pain only at M2.The mean follow-up duration was 11 months.All patients had good correction of the HV angle[preoperative median,36.5 degrees,interquartile range(IQR):30-45;postoperative median,10 degrees,IQR:8.8-10;follow-up median,11.5 degrees,IQR:10-14;P<0.01].At follow-up,metatarsalgia was resolved in most patients(30 vs 5).There was a clinically negligible decrease in the corrected angles at the final follow-up,and the overall AOFAS score was significantly better(median,65 points,IQR:53.8-70;vs 80 points,IQR:75-85;P<0.01).CONCLUSION The developed method showed good sustainability of correction power in a small sample of patients at the one-year follow-up.Randomized clinical trials with larger samples,as well as long-term outcome assessments,are needed in the future.
文摘Introduction: Traumatic Brain Injury (TBI) is a major public health problem causing significant morbidity and mortality in young adults. This study aimed to describe the epidemiological, diagnostic, therapeutic, and evolutionary aspects of TBI. Materials and Methods: This was a prospective, descriptive study conducted from 1 April 2022 to 31 March 2023 on patients admitted to and treated for cranioencephalic trauma in the General Surgery department of Kara Regional Hospital. Results: Eighty-three (83) patients with cranioencephalic trauma were managed out of 773 patients admitted to the department during the study period. The mean age was 34 ± 14.98 years and the sex ratio was 3.6 in favour of men. Motorbike taxi drivers were the social group most affected (n = 33, 40%). The causes of trauma were dominated by public road accidents (n = 80;96%). TBI was mild (n = 40;48%), moderate (n = 35;42%) and severe (n = 8;10%). Cerebral CT scans were performed in 19 patients (23%). Cerebral contusion (n = 4) was the most frequent cerebral lesion. Six patients (7%) with severe head injuries were transferred to Kara University Hospital. Six deaths (7%) occurred in patients with severe head injuries. The main sequelae were intermittent headaches in all patients reviewed, and memory problems (6%). Conclusion: Traumatic brain injuries are common at Kara Regional Hospital. Severe cranial trauma is less frequent but leads to death because of financial difficulties and limited technical facilities.
文摘BACKGROUND The usefulness of a mandatory joint aspiration before re-implantation in patients with a cement spacer already in place is unclear.AIM To evaluate the role of culturing synovial fluid obtained by joint aspiration before re-implantation in patients who underwent a two-stage septic revision.METHODS A retrospective observational study was conducted,including patients that underwent a two-stage septic revision(hip or knee)from 2010 to 2017.After the first stage revision and according to intraoperative culture results,all patients were treated with an antibiotic protocol for 6-8 wk.Following 2 wk without antibiotics,a culture of synovial fluid was obtained.The results of these cultures were recorded and compared with cultures obtained during re-implantation surgery.RESULTS Forty-one patients(20 hip and 21 knee spacers)were included in the final analysis.In 39 cases,the culture of synovial fluid was negative,while in the remaining 2 cases(knee spacers)no analysis was possible due to dry tap.In 5 of the patients,two or more intraoperative cultures taken during the re-implantation surgery were positive.CONCLUSION We found no evidence to support mandatory joint aspiration before re-implantation in patients with a cement spacer in place.
基金funded by grants from the National Natural Science Foundation of China(No.82072445)National Natural Science Foundation Cultivation Programme of Beijing Jishuitan Hospital(No.ZR-202309).
文摘To the Editor:Osteosynthesis is considered as a standard management for the non-displaced femoral neck fracture in elderly patients,^([1])but some of the patients would suffer from avascular necrosis or non-union after osteosynthesis.It has been demonstrated that the outcome of the salvage procedure after primary avascular necrosis is not reliable.^([2])Therefore,the preoperative detection of the risk factors should be of great significance.The Garden classification system has been the most commonly used to distinguish the severity of femoral neck fracture,but it is mainly focused on the displacement in the coronal plane.Since the integrity of posterior cortex has been demonstrated as an important role in the outcomes of displaced femoral neck fractures,^([3])it is reasonable to investigate the effect of posterior cortex on the non-displaced pattern.Recently,we compared the outcomes after osteosynthesis for nondisplaced femoral neck fractures with and without posterior cortex complete fracture.
