Acta Orthopaedica Et Traumatologica Turcica[JOURNAL]
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200 papers
Reduced ankle strength and dorsiflexion joint motion after surgical treatment of Myerson type b Lisfranc injuries: A controlled study.
Demirel M, Karaçam Mİ, Ayan MO … +3 more , Şahinkaya T, Utlu DK, Polat G
Acta Orthop Traumatol Turc · 2025 Dec · PMID 41578769 · Full text
OBJECTIVE: This study aimed to evaluate whether sagittal plane range of motion (ROM) and isokinetic muscle strength of the ankle are affected following surgical treatment of patients with Myerson type B Lisfranc injuries...
OBJECTIVE: This study aimed to evaluate whether sagittal plane range of motion (ROM) and isokinetic muscle strength of the ankle are affected following surgical treatment of patients with Myerson type B Lisfranc injuries. METHODS: This retrospective controlled study included 14 patients who underwent open reduction and internal fixation for Myersontype B Lisfranc injuries and 14 age- and sex-matched healthy controls. Ankle dorsiflexion and plantarflexion ROM were measured, and isokinetic strength was assessed bilaterally at 30°/s and 120°/s. Clinical outcomes were evaluated using the American Orthopaedic Foot and Ankle Society (AOFAS) Midfoot Score and the Foot and Ankle Outcome Score (FAOS). Radiographic assessments were performed at final follow-up. RESULTS: At a mean follow-up of 77 months, the mean FAOS was 83.5 ± 15.6. According to the AOFAS classification, 21% of patients were rated as excellent, 43% good, 14% fair, and 21% unsatisfactory. Dorsiflexion ROM was significantly lower on the affected side compared to both the contralateral limb (5.57° ± 3.94 vs. 18.36° ± 3.08, P = .003) and the control group (22.57° ± 4.22, P < .001). While plantarflexion ROM did not significantly differ, isokinetic strength was significantly reduced in most parameters, particularly in dorsiflexion. CONCLUSION: Patients with surgically treated Myerson type B Lisfranc injuries exhibit persistent deficits in ankle dorsiflexion ROM and in isokinetic strength and endurance of both dorsiflexion and plantarflexion, despite favorable clinical scores and radiographic outcomes. These findings highlight the importance of incorporating objective functional assessments in the long-term follow-up of these patients. Cite this article as: Demirel M, Karaçam Mİ, Ayan MO, Şahinkaya T, Utlu DK, Polat G. Reduced ankle strength and dorsiflexion joint motion after surgical treatment of Myerson type B Lisfranc injuries: A controlled study. Acta Orthop Traumatol Turc., 2025;59(6):405-414.
Precision, Personalization, and Progress: A New Era in Foot and Ankle Surgery.
Ashkani-Esfahani S, Aslan L
Acta Orthop Traumatol Turc · 2025 Dec · PMID 41578767 · Publisher ↗
Cite this article as: Ashkani-Esfahani S, Aslan L. AOTT special issue Editorial. Acta Orthop Traumatol Turc., 2025;59(6):337-339.
Cite this article as: Ashkani-Esfahani S, Aslan L. AOTT special issue Editorial. Acta Orthop Traumatol Turc., 2025;59(6):337-339.
The effect of arch supports on foot alignment in patients with metatarsalgia based on weight-bearing computed tomography and radiographic parameters.
Taseh A, Ghandour S, Karaismailoglu B … +3 more , Toy K, Ashkani-Esfahani S, Landsman A
Acta Orthop Traumatol Turc · 2025 Nov · PMID 41578761 · Full text
OBJECTIVE: Arch support insoles are among the first-line conservative treatments for patients with metatarsalgia. This study aims to exam ine the clinical effect, along with the associated radiologic changes in foot alig...
OBJECTIVE: Arch support insoles are among the first-line conservative treatments for patients with metatarsalgia. This study aims to exam ine the clinical effect, along with the associated radiologic changes in foot alignment, among metatarsalgia patients with and without the use of arch support insoles. METHODS: In this clinical trial, 14 patients with metatarsalgia aged 18 to 65 years were recruited. Pain intensity was obtained at the first visit and after 4, 8, and 12 weeks. All participants underwent bilateral weight-bearing computed tomography (WBCT) and weight-bearing (WB) radiographs of their feet while standing barefoot and on non-custom-made insoles. Several linear and angular radiological measure ments were conducted and compared between the barefoot and insole conditions. Interobserver reliability was calculated (intraclass correlation coefficient [ICC]), and the groups were compared using P < .05 as the statistical significance threshold. RESULTS: A total of 14 patients, consisting of 6 females and 8 males, participated in the study. Patient Reported Outcomes Measurement Information System Pain Intensity scores showed significant improvement starting from the 8th week (P = .04). Weight-bearing radio graphic measurements showed significant decreases in the M2-M3 and M2-M5 tangent angles (P = .04 and .03, respectively). Similarly, the M4-M5 intermetatarsal angle decreased when wearing insoles (P = .01). There were no significant changes in the WBCT measurements. CONCLUSION: Arch support insoles significantly improved pain in patients with metatarsalgia. This symptomatic relief coincides with immediate radiologic changes, mainly in the forefoot area. Future prospective studies with larger populations are suggested to investigate the effects of these insoles on metatarsalgia with various foot types. Cite this article as: Taseh A, Ghandour S, Karaismailoglu B, Toy K, Ashkani-Esfahani S, Landsman A. The effect of arch supports on foot alignment in patients with metatarsalgia based on weight-bearing computed tomography and radiographic parameters. Acta Orthop Traumatol Turc., 2025;59(6):374-378.
Plantar fascia avulsion fracture of the calcaneus in adolescence: a rare case report.
Sağlam S, Yücel MO
Acta Orthop Traumatol Turc · 2025 Sep · PMID 40996211 · Full text
This case report describes a rare avulsion fracture of the calcaneus involving the plantar fascia insertion in an adolescent patient following a sports-related injury. The patient presented with acute heel pain, and imag...
This case report describes a rare avulsion fracture of the calcaneus involving the plantar fascia insertion in an adolescent patient following a sports-related injury. The patient presented with acute heel pain, and imaging confirmed a significant avulsion at the plantar fascia's calcaneal attachment. Unlike the more common Achilles tendon-related avulsion injuries, this case illustrates a less frequently recognized injury pattern in the pediatric population. Management was conservative, consisting of rest, immobilization, and a structured rehabilitation program. The patient achieved full recovery, returning to normal activities without residual symptoms. This case underscores the importance of considering plantar fascia avulsion fractures in adolescent patients with heel pain, particularly in the context of athletic trauma.
Limb preservation with radical muscle debridement in crush-related compartment syndrome: a case report from an earthquake survivor.
Kaplan GO, Yıldızdal S, Nasır S
Acta Orthop Traumatol Turc · 2025 Sep · PMID 40996148 · Full text
The role of fasciotomy in the treatment of lower extremity crush injuries remains controversial. Late fasciotomy wounds are known to be associated with sepsis and amputation. This report presents the results of a limb-sa...
The role of fasciotomy in the treatment of lower extremity crush injuries remains controversial. Late fasciotomy wounds are known to be associated with sepsis and amputation. This report presents the results of a limb-saving treatment procedure for a patient with crushinduced leg compartment syndrome who had undergone fasciotomy before admission. A 36-year-old male patient, trapped under rubble for 37 hours, presented with purulent-necrotic drainage from the fasciotomy site of his right leg. Two radical muscle debridements were performed to excise all necrotic muscles. No signs of sepsis developed postoperatively, and renal function normalized with the aid of hemodialysis. At the 1-year follow-up, the patient was able to walk with the assistance of a walker. Semmes-Weinstein monofilament testing showed a positive response to a 4.31-mm monofilament over the plantar aspect of the first metatarsal head; however, no sensation was detected in the dorsal aspect of the foot. This case highlights that radical muscle debridement may be considered a limb-preserving surgical option in patients with crush-induced leg compartment syndrome, as it can prevent sepsis, improve renal and metabolic function, and potentially obviate the need for amputation.
Amputation surgery is associated with a higher risk of malpractice in cases of traumatic amputation: retrospective analyses of extremity amputation malpractice litigation.
Çevik FE, Bayram S, Söylemez F … +2 more , Beşkoç C, Aslıyüksek H
Acta Orthop Traumatol Turc · 2025 Sep · PMID 40996133 · Full text
Objective: This study aims to undertake a comprehensive review of malpractice litigation cases involving limb amputation surgery, with a subsequent evaluation of the cases accepted as malpractice. Methods: The retrospect...
Objective: This study aims to undertake a comprehensive review of malpractice litigation cases involving limb amputation surgery, with a subsequent evaluation of the cases accepted as malpractice. Methods: The retrospective, descriptive study evaluated cases of alleged medical malpractice involving extremity amputations sent to the Medical Council. When medical error decisions were made by the board, the full range of allegations was subjected to evaluation, including issues related to consent, diagnosis, and treatment errors. A review was conducted of all closed legal cases pertaining to medical malpractice in the field of extremity amputation. A comprehensive dataset was collated, encompassing detailed information on each case. This included age, sex, and the anatomical location of the amputation (lower or upper extremity). Additionally, the amputation mechanism, the duration of hospitalization, and the time interval between surgery and the initiation of legal proceedings were investigated. Results: The study encompassed 290 medical litigations with a mean age of 39.6 ± 20 years. Of the participants, 213 (73.4%) were male, and 77 (26.6%) were female. Amputation surgery was conducted on the lower extremity in 191 patients (65.9%), the upper extremity in 97 patients (33.4%), and both upper and lower extremities in 2 patients (0.7%). The reasons for amputation surgery were classified as secondary to disease in 143 patients (49.3%) and traumatic injury in 147 patients (50.7%). Fifty-nine cases were accepted as medical malpractice. No significant di!erences were found between cases with and without medical malpractice, or among age groups, genders, extremities, lengths of hospital stays, levels of amputation, whether cases were secondary to trauma or disease. Conclusion: It is evident that there is a higher prevalence of malpractice in cases of traumatic injury; therefore, clinicians should exercise greater caution and diligence in the management of these cases. Level of Evidence: Level IV, Prognostic study.
A bibliometric analysis of Turkish orthopedics and traumatology in high-impact global literature over a decade (2014-2023).
Korkmaz T, Afacan MY, Elibollar C … +3 more , Cıbıkcı AOG, Karaismailoğlu B, Seker A
Acta Orthop Traumatol Turc · 2025 Sep · PMID 40996114 · Full text
Objective: This study aimed to assess the contributions and global impact of Turkish orthopedics and traumatology research published in high-impact international journals over the past decade (2014-2023). By examining ar...
Objective: This study aimed to assess the contributions and global impact of Turkish orthopedics and traumatology research published in high-impact international journals over the past decade (2014-2023). By examining article types, citation metrics, journal impact factors, and author a!liations, the aim was to highlight publication trends, strengths, and areas needing improvement within Turkish orthopedic research. Methods: Using the Web of Science database, keywords were searched under journal categories including "Orthopedics," "Orthopedics, Rehabilitation and Sports Medicine," and "Sports Sciences." Articles from the top 40 orthopedic journals indexed in Science Citation Index Expanded were identified and selected based on their 2022 impact factors. Articles published between January 2014 and December 2023 with first authors a!liated with a Turkish institution were included. Citation density was calculated by dividing the total number of citations by the number of years since publication. Data extracted included publication type, citation count, citation density, research methodology, author a!liations, and institutional contributions. Results: Out of 70 279 articles published globally, 425 orthopedic articles with Turkish first authorship were identified in the selected journals. Most articles were clinical (88.7%), with the most frequent article types being case presentations (31.3%), retrospective cohort studies (17.9%), and laboratory research (11.3%). The least common types were expert opinions, epidemiological studies, and meta-analyses. The majority of articles appeared in Spine Journal (34.6%) and Knee Surgery, Sports Traumatology, Arthroscopy (27.3%), with no articles published in the highest-ranked journal (British Journal of Sports Medicine). Spine surgery was the leading subfield (29.9%), followed by sports, shoulder, and elbow surgery (22.6%) and reconstructive surgery (16%). Orthopedic specialists comprised 56% of first authors, with multicenter studies representing 65.4% of the articles. Public institutions accounted for 80.1% of published articles, while private institutions contributed 19.9%. A total of 356 articles were cited 8349 times, with a median citation number of 9 per article. Mean citation density was highest in meta-analysis (8.5 citation/year), epidemiological studies (8.3 citation/year), and randomized controlled trials (7.8 citation/ year), while lowest in case presentations (0.3 citation/year), expert opinions (0.4 citation/year), and laboratory research (2.2 citation/year). Conclusion: Turkish orthopedic research has maintained a significant presence in top orthopedic journals, mostly through clinical studies, especially in spinal and sports injury subfields. Despite high publication volume, citation impact remains relatively lower. Future e"orts should encourage higher-impact study designs, international collaborations, and standardized research evaluations to enhance the global influence of Turkish orthopedic literature. Level of Evidence: N/A.
A nationwide survey of orthopedic residency training in Türkiye: Theoretical education, surgical exposure, faculty engagement, and mentorship influence on resident competence.
Kalem M, Dursun Savran M, Özgencil B … +2 more , Özbek EA, Şahin E
Acta Orthop Traumatol Turc · 2025 Aug · PMID 40996100 · Full text
Objective: This study aimed to evaluate orthopedic residency training in Türkiye by analyzing the structure of clinical education, levels of faculty engagement, availability of mentorship, and residents' self-perceived c...
Objective: This study aimed to evaluate orthopedic residency training in Türkiye by analyzing the structure of clinical education, levels of faculty engagement, availability of mentorship, and residents' self-perceived competence. It further examined the influence of mentorship and faculty involvement on surgical training, academic career interest, and subspecialty decisions. Methods: A cross-sectional survey was conducted among orthopedic residents across Türkiye between February 6-18, 2025. A total of 849 residents participated, covering all provinces with orthopedic training centers. Data on institutional characteristics, educational methods, surgical exposure, mentorship, and residents' self-assessed competencies were collected using an online questionnaire. The mean age of participants was 29.1 years (range: 23-35), and 95.2% were male. The mean residency year was 2.7. The primary outcomes included surgical exposure, self-assessed competence, academic interest, and mentorship impact. Results: Among participants, 8.13% reported no theoretical education, with peer-based learning (52.1%) being the dominant method. Faculty-led instruction was limited (24.6%). A mentor figure was present in 68.8% and was significantly associated with higher selfassessed competence in theoretical knowledge, surgical skills, and complication management (P < .0001). Mentored residents had greater academic interest (41.1% vs. 33.2%, P=.011) and clearer subspecialty goals (27.9% vs. 18.9%, P=.017). Only 45.7% of the fifth-year residents rated themselves as highly competent. Higher monthly operating room days and case volumes were significantly correlated with greater self-perceived competence (P=.0001). Conclusion: This study reveals substantial disparities in surgical training, faculty engagement, and mentorship across orthopedic residency programs in Türkiye. Structured mentorship initiatives, improved surgical exposure, and faculty-driven education are essential to enhance residents' professional development and preparedness for independent practice.
Button-related finger injuries in textile workers: the hidden danger of the industry.
Şakçı MŞ, Karahan M
Acta Orthop Traumatol Turc · 2025 Sep · PMID 40996027 · Full text
Objective: This study aimed to evaluate button-related injuries, which are increasingly common in the textile and apparel manufacturing sector, to contribute to diagnosis and treatment and to raise awareness among employ...
Objective: This study aimed to evaluate button-related injuries, which are increasingly common in the textile and apparel manufacturing sector, to contribute to diagnosis and treatment and to raise awareness among employers and workers. Methods: This retrospective study included 23 patients with button-related injuries. The study evaluated patient demographics, the department they presented to, the level of hand injury, accompanying pathologies (osseous, neurological, vascular, and tendinous injuries), tetanus immunization status, occupational health and safety training status, awareness of workplace physicians, prior awareness of such injuries, history of occupational accidents, and long-term outcomes. Statistical analyses were performed using SPSS v21. Descriptive data were summarized as frequency (%) or mean ± SD, and the Shapiro-Wilk test was used to assess normality. Results: Among the 23 patients (14 males, 9 females), 16 sustained injuries to the distal phalanx and pulp level, while 7 had injuries at the middle phalanx level. At presentation, 4 patients exhibited hypoesthesia on the a!ected side of the finger, and 9 patients had reduced blood flow. Two patients had accompanying phalanx fractures. No tendinous pathologies were observed in any of the patients. All patients underwent surgical intervention. Seven patients developed nail deformities in the follow-up. Conclusion: Timely intervention and appropriate treatment after an injury are crucial for limb salvage and functionality. In long-term follow-ups, most patients healed without major complications; however, some the patients developed nail deformities. Level of Evidence: Level IV, Therapeutic Study.
Computed tomography-guided radiofrequency ablation in the treatment of intra-articular proximal femoral osteoid osteoma.
Çakır MS, Ercan CC, Karagülle M … +3 more , Aycan OE, Polat B, Acunas B
Acta Orthop Traumatol Turc · 2025 Aug · PMID 40996025 · Full text
Objective: The present study aimed to evaluate the clinical success of computed tomography (CT)-guided radiofrequency ablation (RFA) in the treatment of proximal femoral located intra-articular osteoid osteoma (IAOO). Me...
Objective: The present study aimed to evaluate the clinical success of computed tomography (CT)-guided radiofrequency ablation (RFA) in the treatment of proximal femoral located intra-articular osteoid osteoma (IAOO). Methods: This retrospective study included consecutive patients with clinical and CT imaging features suggestive of IAOO who were treated using a standardized CT-guided RFA technique between January 2020 and September 2024. The clinical, demographic, and radiological characteristics of the patients were documented. The e!cacy and results of the RFA treatment were evaluated. Results: Based on the inclusion criteria, 20 patients were included in the study. The mean follow-up period was 29.2 months (range: 6-48 months). The median procedure time was 43 minutes. No immediate or late major or minor complications were recorded. Technical success was achieved in 100% of the cases. In 3 of 20 patients, pain symptoms recurred within the first month, so RFA was performed again, and full clinical success was achieved. The preoperative mean Visual Analogue Scale (VAS) score was 7.4 (range: 5-10). The postoperative first month mean VAS score was 1.2 (range: 0-2). Conclusion: Computed tomography-guided RFA is a highly safe and e"ective technique that can be considered as the first choice for treating symptoms associated with proximal femoral IAOO. Performing all manipulations under CT guidance at all stages of the procedure, accessing the nidus through extra-articular normal bone, and centralizing the nidus with the RFA probe facilitates the safety of the technique and prevents damage to the articular cartilage. Ü Level of Evidence: Level IV, Therapeutic Study.
Spinopelvic assessment in preoperative planning of total hip arthroplasty: a comparative cohort analysis.
Çetin O, Öztürk A, Avci Ö … +3 more , Kaya AÖ, Çevik N, Akalin Y
Acta Orthop Traumatol Turc · 2025 Aug · PMID 40995981 · Full text
Objective: This study aimed to evaluate the utility of preoperative spinopelvic analysis in reducing dislocation risk and to assess changes in spinopelvic mobility following total hip arthroplasty (THA). Methods: This co...
Objective: This study aimed to evaluate the utility of preoperative spinopelvic analysis in reducing dislocation risk and to assess changes in spinopelvic mobility following total hip arthroplasty (THA). Methods: This cohort was assessed between 2018 and 2021, including 123 patients (123 hips) who underwent THA via the posterolateral approach. Group 1 (63 hips, 61 patients) underwent spinopelvic analysis with standing and sitting radiographs preoperatively and at 1- and 2-year follow-up, while Group 2 (62 hips, 62 patients) did not. Patients with Crowe type III-IV dysplasia, neurological or cognitive disorders, or acute trauma were excluded. Sacral slope (SS), spinopelvic tilt (sPT), and pelvic femoral angle were assessed. Intergroup comparisons were performed to evaluate the dislocation rates and changes in spinopelvic mobility. Results: One dislocation occurred in Group 1 and 3 in Group 2. In Group 1, significant changes were observed in sitting SS (preoperative to year 1: P < .001; year 2: P=.003) and sitting sPT (year 1: P=.004; year 2: P=.043), while standing measurements remained stable (SS: P=.762-.470; sPT: P=.683-.600). Mean sitting hip flexion also increased significantly (P < .001). Among 26 patients with hypermobility, 18 demonstrated normalization at 1 year, and 2 additional patients normalized at 2 years. In 1 patient with hypomobility, adjustment of acetabular anteversion based on spinopelvic findings successfully prevented dislocation. Conclusion: Preoperative spinopelvic analysis enabled the identification of mobility abnormalities and allowed for targeted surgical adjustments that may reduce dislocation risk. Notably, dislocations could potentially have been avoided with prior spinopelvic evaluation, underscoring its clinical relevance in preoperative planning. Postoperatively, SS increased exclusively in the sitting position, while remaining unchanged in standing position, reinforcing the necessity of seated imaging for comprehensive assessment. Level of Evidence: Level II, Cohort Study.
MRI-based evaluation of tibial tunnel proximity to the anterior horn of the lateral meniscus in remnant-preserving anterior cruciate ligament reconstruction.
Bombaci H, Marasli MK, Akinci O … +1 more , Ozogul M
Acta Orthop Traumatol Turc · 2025 Aug · PMID 40995966 · Full text
Objective: This study aims to evaluate the proximity between the anterior horn of the lateral meniscus (AHLM) and the tibial tunnel on postoperative magnetic resonance imaging (MRI) in patients who underwent remnant-pres...
Objective: This study aims to evaluate the proximity between the anterior horn of the lateral meniscus (AHLM) and the tibial tunnel on postoperative magnetic resonance imaging (MRI) in patients who underwent remnant-preserving anterior cruciate ligament reconstruction (RP-ACLR), in order to assess the potential risk of AHLM injury. Methods: Eighty patients who underwent RP-ACLR between 2014 and 2020 were retrospectively analysed using postoperative MRIs. A 4-layer hamstring graft was used in all cases, and the mean diameter of the tibial tunnel was 8.17 ± 0.67 mm (range: 7-10 mm). The nearest distances between the AHLM and the tibial tunnel were measured in the coronal and axial planes on postoperative MRIs. Pearson and Spearman correlation tests were used for the correlation analyses. Calculations were made for the intraclass and interclass correlation coe!cients (ICC). Results: In the axial plane, the tibial tunnel was tangential to the AHLM in 4 patients (5%) and in the coronal plane in 3 patients (3.8%), with the nearest distance measured as 0 mm. No contour irregularity of the lateral meniscus was observed in any patient; meniscal morphology and signal characteristics were preserved, and no complex tears, deformations, or extrusions were detected on MRI. Statistical analyses demonstrated excellent intraobserver (ICC: 0.97-0.98) and interobserver (ICC: 0.99) reliability of the measurement method. Additionally, no statistically significant correlation was found between the measured distances and Lysholm scores. Conclusion: This study demonstrated that, although the tibial tunnel in RP-ACLR is in close proximity to the AHLM, injury to the AHLM can be avoided by carefully adjusting the trajectory of the guide wire to ensure it exits through the centre of the remnant tissue. Level of Evidence: Level IV, Therapeutic Study.
Impact of single-leg versus double-leg weight-bearing radiographs on surgical decision-making in knee osteoarthritis.
Bozduman Ö, Köker Y, Ozturk M … +2 more , Tuncay İ, Akan B
Acta Orthop Traumatol Turc · 2025 Aug · PMID 40995887 · Full text
Objective: This study aimed to evaluate how single-leg weight-bearing and double-leg weight-bearing radiographs a!ect knee osteoarthritis assessment and treatment planning. Methods: Fifty orthopedic physicians were asked...
Objective: This study aimed to evaluate how single-leg weight-bearing and double-leg weight-bearing radiographs a!ect knee osteoarthritis assessment and treatment planning. Methods: Fifty orthopedic physicians were asked to assess the knee radiographs of 10 female patients (mean age: 68 ± 6.6 years) presenting with knee pain. The radiographs were obtained in both double-leg and single-leg weight-bearing positions. Physicians were asked to determine the appropriate treatment plan (conservative management, unicondylar knee replacement, or total knee replacement). If they opted for surgical intervention, they were further asked to specify which prosthetic material they required to be available during surgery (a unicondylar knee prosthesis, both unicondylar and total knee prostheses, a total knee prosthesis, both total and revision knee prostheses). Treatment plans based on double-leg and single-leg weight-bearing radiographs were compared. Results: Conservative management was more frequently selected based on double-leg weight-bearing radiographs (P < .001). In contrast, the requirement for additional surgical materials was significantly higher for single-leg weight-bearing radiographs (P < .001). Specifically, 53.6% of physicians preferred having both total and revision knee prostheses available based on double-leg weight-bearing images, compared to 64.2% for single-leg images. Moreover, 31.2% of physicians upstaged their treatment plans after reviewing single-leg radiographs. Additionally, 13% of physicians opted for a total knee prosthesis based on double-leg weight-bearing images, whereas this proportion increased to 29% with single-leg weight-bearing images. Conclusion: Single-leg weight-bearing radiographs prompted more invasive treatment decisions, highlighting their clinical utility in detecting pathology that may influence surgical planning. Level of Evidence: Level IV, Diagnostic Study.
Physiotherapists' preparedness for a national hip screening program in children with cerebral palsy: a survey study.
Kozlu S, Bayhan Aİ, Akpınar E … +1 more , Özyalvaç ON
Acta Orthop Traumatol Turc · 2025 Sep · PMID 40995886 · Full text
Objective: Cerebral palsy (CP) is a prevalent neurological disorder a!ecting 2-3 per 1000 live births globally. A common orthopedic consequence in CP is hip dislocation, with an incidence ranging from 15% to 30%. This st...
Objective: Cerebral palsy (CP) is a prevalent neurological disorder a!ecting 2-3 per 1000 live births globally. A common orthopedic consequence in CP is hip dislocation, with an incidence ranging from 15% to 30%. This study aimed to assess physiotherapists' (PTs) awareness and knowledge of hip dislocation in CP and identify knowledge gaps in this field. Methods: A cross-sectional survey was administered to PT working in healthcare institutions across Türkiye. The online anonymous survey, hosted on Google Forms, received responses from 128 PTs. It included questions related to the diagnosis, treatment approaches, and clinical experience concerning hip dislocation/subluxation. The survey consisted of 3 types of questions: demographic questions, yes/no knowledge questions, and opinion-suggestion questions. Results: The majority of PTs participating in this study work with pediatric patients. Physiotherapists had basic knowledge about hip dislocation although we observed significant gaps in areas related to routine screening programs and advanced treatment modalities. PTs incorrectly answered 3 out of 8 knowledge-based questions. The majority emphasized the importance of early diagnosis and treatment and expressed a need for more education and awareness programs. Conclusion: Physiotherapist provided important opinion-suggestion insights. The findings indicate a need for improved education and training for PT concerning hip dislocation in children with CP. We believe that the most appropriate screening method for Türkiye is to establish a screening program with a multidisciplinary structure formed between pediatric orthopedists, physical medicine and rehabilitation specialists (PM&R), PT, and family physicians (FPs). Level of Evidence: N/A.
Simultaneous arthroscopic treatment of adhesive capsulitis and rotator cuff tear: a retrospective analysis of clinical outcomes.
Sıvacıoğlu S, Tunalı O, Çetin O … +1 more , Atalar AC
Acta Orthop Traumatol Turc · 2025 Sep · PMID 40995665 · Full text
Objective: This study aimed to evaluate the clinical and functional outcomes of patients who underwent simultaneous arthroscopic capsular release for adhesive capsulitis and rotator cu! repair. Methods: A retrospective a...
Objective: This study aimed to evaluate the clinical and functional outcomes of patients who underwent simultaneous arthroscopic capsular release for adhesive capsulitis and rotator cu! repair. Methods: A retrospective analysis was performed on patients treated between 2014 and 2023 who underwent arthroscopic global capsular release combined with rotator cu! repair. Preoperative and postoperative outcomes, including range of motion (ROM), Visual Analogue Scale (VAS) scores, and Constant scores, were assessed with a minimum follow-up of six months. Results: Among 69 patients undergoing capsular release, 29 patients (20 females, 9 males; mean age: 56 years) received concurrent rotator cu! repair. The mean follow-up period was 14 months. Most tears involved the supraspinatus (25 full-thickness, 4 partial bursal-side). Complications were minimal, with only two diabetic patients displaying persistent ROM limitations and there were no re-tear in followup period. Statistically significant di!erences seen in ROM, VAS and Constant scores, VAS decreased from 7.1 to 1.2, Constant score improved from 37.5 to 72.3 (P < .05). Conclusion: Simultaneous arthroscopic management of adhesive capsulitis and rotator cu! tears provides favorable clinical and functional outcomes with lower complication rates compared to current literature, supporting its value as an e!ective treatment option. However, the limited sample size and relatively short follow-up should be considered when interpreting these results. Level of Evidence: Level IV, Therapeutic study.
Measuring shoulder abduction strength using 2 different dynamometers: comprehensive intrarater and interrater reliability and validity.
Atli E, Topaloglu M, Hosbay Z … +1 more , Ozdincler AR
Acta Orthop Traumatol Turc · 2025 Aug · PMID 40995070 · Full text
Objective: The purpose of this study is to investigate the intrarater and interrater reliability of handheld dynamometer (HHD) measurements in assessing isometric muscle strength of the shoulder abductors and to compare...
Objective: The purpose of this study is to investigate the intrarater and interrater reliability of handheld dynamometer (HHD) measurements in assessing isometric muscle strength of the shoulder abductors and to compare these results with those obtained using a fixed dynamometer (FD). Methods: The study involved 25 voluntary participants, all over the age of 18, asymptomatic (with no injuries in the upper extremity), and not engaged in overhead sports. The participants were evaluated twice by 2 di!erent testers who were experienced in orthopedic rehabilitation, at 90 degrees of shoulder abduction in the scapular plane. On the first measurement day, Tester 1 performed measurements using both HHD and FD, while on the second measurement day, both testers used only the HHD. A 3- to 7-day interval separated the 2 measurement sessions. Paired-samples t-tests were used to evaluate the systematic bias between the testers. Spearman's rank correlation coe"cient, intraclass correlation coe"cient, standard error of measurement, and minimal detectable change were calculated. The statistical significance level was accepted as P < .05. Results: Data from 22 participants (15 women, 7 men; mean age: 23.00 ± 3.19 years) were analyzed, as 3 individuals did not attend the final assessment. A strong correlation (r=0.772) was found between Tester 1's HHD measurements and FD, while a similarly strong correlation (r=0.748) was observed for Tester 2's HHD measurements. Excellent intrarater reliability (intraclass correlation coe"cient [ICC]=0.941) was found between Tester 1's measurements, and excellent interrater reliability (ICC=0.889) was found between testers. Conclusion: Handheld dynamometer has demonstrated excellent interrater and intrarater reliability and high validity for assessing shoulder abductor muscle strength in research and clinical use. Since the muscle strength of testers using the HHD may influence the results, the FD may be a more appropriate option when the study population is stronger than the testers. Studies involving di!erent clinical populations and testers with varying experience levels are needed to improve the relevance of the results. Level of Evidence: Level III, Diagnostic Study.
Impact of anticoagulation therapy on surgical timing, hospital stay, and postoperative outcomes in proximal femur fracture patients.
Masionis P, Derkintyte D, Bogdzevic EF … +2 more , Bobina R, Satkauskas I
Acta Orthop Traumatol Turc · 2025 Sep · PMID 40994363 · Full text
Objective: This study aimed to evaluate the association between preoperative anticoagulant use and time to surgery, hospital length of stay, and 30-day postoperative complications in elderly patients with proximal femur...
Objective: This study aimed to evaluate the association between preoperative anticoagulant use and time to surgery, hospital length of stay, and 30-day postoperative complications in elderly patients with proximal femur fractures. Methods: This study included 572 patients with low-energy proximal femur fractures who required surgical treatment. Patients were categorized into two groups based on anticoagulation therapy use. The following data was collected and compered between the groups: time from hospitalization to surgery, hospital length of stay, percent changes in hemoglobin and other post-operative complications: death, cardiac complications, sepsis, deep venous thrombosis, pneumonia, urinary tract infection, surgical site infection, pressure ulcers, acute kidney injury and delirium. Multivariate regression analysis was performed to analyze possible confounders. Results: The median age of study participants was 83 years. 78.2% being female. Anticoagulation therapy was used by 19.9% of patients, predominantly non-vitamin K oral anticoagulants. Patients receiving anticoagulants experienced significantly longer hospital stays (median 9 vs. 7 days; P < .05) and surgical delays (median 3 vs. 2 days; P < .0001) compared to those without anticoagulation. Complication rates and hemoglobin level changes did not di!er significantly among the groups (P > .05). Multivariate analysis identified age, time to surgery, and hospital length of stay as independent predictors of 30-day postoperative complications, with age and hospital stay also significantly associated with 30-day mortality. Conclusion: Anticoagulation therapy did not directly increase 30-day postoperative complications or mortality but was associated with surgical delays and prolonged hospital stays, which negatively impacted outcomes. Delayed surgery and extended hospitalization emerged as key risk factors. These findings underscore the clinical importance of minimizing surgical delays in anticoagulated patients to improve postoperative outcomes. Level of Evidence: Level II, Prognostic study.
Comparative effects of cyclooxygenase-2 selective and nonselective nonsteroidal anti-inflammatory drugs and acetaminophen on rotator cuff tendon-bone healing in a rat model.
Bektaş E, Çelebi ME, Kurtulmuş T … +1 more , Yılmaz F
Acta Orthop Traumatol Turc · 2025 Aug · PMID 40994320 · Full text
Objective: This study aimed to investigate and compare the e!ects of naproxen (a nonselective nonsteroidal anti-inflammatory drug [NSAID]), celecoxib (a cyclooxygenase (COX)-2 selective NSAID), and acetaminophen (an anal...
Objective: This study aimed to investigate and compare the e!ects of naproxen (a nonselective nonsteroidal anti-inflammatory drug [NSAID]), celecoxib (a cyclooxygenase (COX)-2 selective NSAID), and acetaminophen (an analgesic with minimal anti-inflammatory activity) on tendon and tendon-bone healing following surgically induced supraspinatus tendon repair in a rat model. Methods: In this experimental study, 56 adult male Wistar Albino rats (mean weight, 300 g) were randomized into 4 groups (n=14 per group): control (1% methylcellulose vehicle), naproxen, celecoxib, and acetaminophen. A standardized full-thickness tear of the supraspinatus tendon was surgically created, and repair was performed using transosseous suture fixation through a humeral bone tunnel. Postoperative treatments were administered via oral gavage for 14 days. Tendon healing was assessed at 28 days through histological evaluation using modified Bonar scoring (n=6 per group) and biomechanical testing via uniaxial tensile assays (n=8 per group). Primary outcome measures included Bonar scores, maximum tensile strength, displacement, and sti!ness. Results: The acetaminophen and control groups demonstrated superior maximum strength and sti!ness compared to the NSAID-treated groups; however, these di!erences did not achieve statistical significance (maximum strength: P=.28; sti!ness: P=.40). Histological analyses revealed significantly enhanced tendon-bone healing in the acetaminophen and control groups relative to the celecoxib and naproxen groups (P=.01). Conclusion: The early postoperative administration of COX-2 selective and nonselective NSAIDs may compromise early tendon-bone healing compared to acetaminophen. Although biomechanical di!erences were not statistically significant at 28 days, histological findings underscore the potential impact of analgesic selection on early postoperative tendon healing. Level of Evidence: N/A.
Upholding ethical standards in submissions and peer review.
Berk H
Acta Orthop Traumatol Turc · 2025 Sep · PMID 40994114 · Full text
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Iatrogenic injury to the descending branch of the lateral circumflex femoral artery during intertrochanteric fracture fixation: a case report of guide pin-related vascular complication.
Cho HM, Heo H, Jung MC
Acta Orthop Traumatol Turc · 2025 Jul · PMID 40728093 · Full text
Vascular injuries associated with femoral intertrochanteric fractures are rare but can result in serious complications. A case of iatrogenic injury to the descending branch of the lateral circumflex femoral artery in a p...
Vascular injuries associated with femoral intertrochanteric fractures are rare but can result in serious complications. A case of iatrogenic injury to the descending branch of the lateral circumflex femoral artery in a patient who underwent surgical fixation of an intertro-chanteric femoral fracture is presented. The injury possibly occurred during the creation of the entry point for nail insertion using a guide pin. Clinical symptoms emerged 10 days postoperatively and were successfully managed with percutaneous embolization, without major complications. This case highlights that pseudoaneurysms can develop as a result of guide pin use during hip nailing procedures. Surgeons can avoid this complication by obtaining lateral and anteroposterior views of the hip. Level of Evidence: IV, Case Report.
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