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    Ankle Joint Injuries Accompanying Fifth Metatarsal Base Fractures
    (Amer Podiatric Med Assoc, 2021) Turgut, Ali; Uzakgider, Meliksah; Altun, Ozan; Egeli, Ercument; Erku, Serkan; Kalenderer, Onder
    Background: Fifth metatarsal base fractures are the most commonly seen fractures of the foot. Ankle sprains occur with inversion and plantarflexion mechanisms, similar to most fifth metatarsal base fractures. We sought to investigate the possible ankle injuries that accompany fifth metatarsal base fractures. Methods: A hospital's digital database was searched for the International Classification of Diseases, Tenth Revision codes for metatarsal bone fractures (codes S92.30 and S92.35) between January 2015 and January 2018. Thirty-nine patients with fifth metatarsal base fracture who underwent ankle magnetic resonance imaging (MRI) within 14 days of injury were included in the study. The MRI findings were evaluated, and comparisons were performed according to fracture zone, sex, and age. Results: The most common MRI finding was talocrural joint effusion, which was observed in 28 patients (71.8%). Bone marrow edema was observed in 16 patients (41.0%). Chondral injury at the medial dome of talus was observed in three patients (7.7%). Grade 1 ligament sprain was observed in six patients (15.4%): two in the lateral ligament and four in the deltoid ligament. Conclusions: Although most fifth metatarsal base fractures and ankle sprains occur as a result of a common mechanism, physical examination findings and patients' complaints are very important. Routine MRI should be unnecessary for most patients. If a patient with a fifth metatarsal base fracture has complaints about the ankle joint, one should be aware of bone marrow edema, which was observed in 41.0% of the study population.
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    Indirect impact of the COVID-19 pandemic on diabetes-related lower extremity amputations: A regional study
    (Turkish Joint Diseases Foundation, 2022) Ergisi, Yilmaz; Ozdemir, Erdi; Altun, Ozan; Tikman, Mesut; Korkmazer, Selcuk; Yalcin, Muhammed Nadir
    Objectives: This study aims to evaluate the indirect impact of the novel coronavirus disease 2019 (COVID-19) pandemic on diabetes-related lower extremity amputations. Patients and methods: Patients who underwent lower limb amputation due to complications of diabetes between August 2019 and February 2020 (control group) and August 2020 and February 2021 (pandemic group) were retrospectively reviewed. None of the patients had a previous COVID-19 infection. Patients' amputation level and latest diabetes follow-up date until amputation were recorded. Results: A total of 19 feet of 19 patients (14 males, 5 females; mean age: 70.0 +/- 10.5 years; range, 53 to 91 years) in the control group and 18 feet of 18 patients (12 males, 6 females; mean age: 70.4 +/- 11.3 years; range, 54 to 91 years) were included. There was no statistically significant difference in amputation levels between the two groups (p=0.959). The mean time elapsed from the last diabetes control in the control and the pandemic group was 5.9 +/- 12.8 months and 8.2 +/- 9.8 months, respectively (p=0.038). A total of eight (42.1%) patients in the control group and seven (38.9%) patients in the pandemic group did not have a follow-up for diabetes in the last year prior to amputation (p=0.842). Conclusion: Although the COVID-19 pandemic seems to cause a delay in the routine medical care of patients with diabetes, it appears not to have an indirect effect on the lower extremity amputation level and incidence. Patients' adherence may be the major determinant in amputation surgery.
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    The role of wrist circumference (regional obesity versus local swelling) in conservatively treated distal radius fractures: a single center experience
    (2023) Özdemir, Erdi; Altun, Ozan; Ergısı, Yılmaz; Dasar, Uygar; Yalçın, Muhammed Nadir
    Aim: Regional obesity around the wrist due to local excessive fat or local swelling due to edema has not been studied as a risk factor to predict the possibility of reduction loss during conservative treatment of distal radius fractures. We aimed to investigate the impact of wrist circumference on reduction loss risk in conservatively treated distal radius fractures. Material and Methods: Patients with distal radius fractures who were conservatively in our institution between January 2021 and December 2021 are retrospectively reviewed. Patients’ demographics, wrist circumference, radiographic parameters were obtained from hospital registry notes. Wrist circumference was measured with an unstretchable tape positioned on a line passing from lister tubercle of the distal radius and distal ulna. The difference in the wrist circumferences between the injured and uninjured extremities represented local swelling. The association of these factors with reduction loss was evaluated. Results: A total of 73 consecutive patients (19 male, 54 female) with a mean age of 61.1 ± 12.9 were included. There were 18 reduction losses. There was no association with reduction loss between injured and uninjured wrist circumferences (p>0.05). However, local swelling, initial displacement at dorsal angulation and radial inclination, presence of dorsal comminution, and accompanying ulnar styloid fracture were associated with reduction loss (p<0.05). Local swelling had an odd ratio of 6.661 (1.848 – 24.006, p= 0.004). Conclusion: Excessive local swelling is found to be a risk factor to predict reduction loss in conservative treatment of distal radius fractures while regional obesity is not.
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    What is the importance of distal nail diameter in the treatment of intertrochanteric femur fractures?
    (Turkish Joint Diseases Foundation, 2022) Ergisi, Yilmaz; oezdemir, Erdi; Korkmazer, Selcuk; Kekec, Halil; Altun, Ozan; Yalcin, Nadir
    Objectives: The aim of this study was to investigate the effect of distal nail diameter in the treatment of geriatric intertrochanteric femur fractures (ITFFs).Patients and methods: Between January 2017 and January 2021, a total of 91 patients (34 males, 57 females; mean age: 80.6 +/- 7.8 years; range, 65 to 96 years) who had osteosynthesis due to an ITFF with a short cephalomedullary nail (CMN) were retrospectively analyzed. The patients were divided into two groups: Group 1 (n=18) included patients with a distal nail diameter of <= 10 mm and Group 2 (n=73) included patients with a distal nail diameter of >10 mm. Patients' age, sex, fracture type according to AO classification, intramedullary femoral canal diameter, canal fit ratio, operation duration, reduction quality, the distal diameter of the CMN, and complications were evaluated.Results: There was no statistically significant difference between Group 1 and Group 2 in terms of the mean age, sex, fracture type, mean intramedullary canal diameter, reduction quality, and implant failure (p>0.05). The mean operation duration was significantly shorter in Group 2 (112.9 +/- 39.9 min) compared to Group 1 (128.8 +/- 36.4 min) (p=0.048). A total of three intraoperative peri-implant fractures occurred which included one 9 mm nail, one 12 mm nail, and one 14 mm nail.Conclusion: Our study results suggest that there is no advantage of using a >10-mm CMN in the treatment of geriatric ITFFs in terms of reducing the implant failure rate. However, the utility of a >10-mm CMN can reduce the operation duration.