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    Functional results of patients with femoral intertrochanteric fractures who underwent surgery of proximal femoral nail or bipolar hemiarthroplasty: A comparative study
    (2023) Ayık, Ömer; Aygün, Ümit
    Aim: In this study, the functional results of patients with femoral intertrochanteric fractures who underwent surgery were compared with their clinical features in terms of proximal femoral nail ( PFN ) and bipolar hemiarthroplasty ( BPH ). Materials and Methods: PFN (Group 1) was implanted in 40 of 89 patients (44 female, 45 male) aged between 51-80 (mean 68,16 ± 6,78) whereas BPH (Group 2) was used with 49 patients. Age, gender, fracture mechanism, additional disease, Body mass index (BMI), Albumin level, Hemoglobin (Hb) decrease level, T-score, American Society of Anesthesiologists (ASA) classification, type of anesthesia, surgery type, operation time, hospital stay and full weight-bearing time, the scores of Harris Hip Function (HHS), the social function of Jensen (JSF), Parker-Palmer mobility (PPMS) in preoperative and postoperative periods, and postoperative complications were all recorded. Results: In group 1; patients were younger, operation time was 46.78 ± 5.29 minutes and hospital stay was 2.48±0.75 days, which were shorter compared with group 2. For group 1, most surgery types were closed, T-score was -2.49±0.59 and better, the time of full weight-bearing was 3.48±0.78 months, Hb decrease was 1.17±0.37 and less, and Albumin level was 3.11±0.4 g/dL and higher compared to group 2 (p<0.05). HHS was better in the BPH group at the sixth month (p<0.05). In group 1, the 12th, and 24th months scores of JSF were better, PPMS was higher in all evaluations (p<0.05). Operation time, ASA, T-score, and albumin levels correlate with functional scores, while BMI and Hb did not. Conclusion: Many factors are important for progressing patients with intertrochanteric femur fractures toward a functional level. Considering these parameters in patients with femoral intertrochanteric fracture, PFN or BPH can both be used for treatment according to the surgeon's preference.
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    Isolated dorsal dislocation of the 5th carpometacarpal joint; a missed injury
    (EMERGENCY MEDICINE PHYSICIANS ASSOC TURKEY, 2022) Aygün, Ümit; Yazıcı, Alikemal
    5th carpometacarpal (CMC) joint dislocations of the wrist region are very rare and easily overlooked injuries. In this type of injury, which causes serious functional problems in the hand if not treated appropriately, closed methods are generally used in the treatment. In this study, we present a case with fracture-dislocation of the 5th CMC joint. Fracture-dislocation of the 5th CMC joint of a 25-year-old patient who was admitted to the emergency department due to wrist pain was not noticed. The diagnosis was made during the follow-up of the patient, and the joint was reduced with closed method and fixed with a K wire. No serious problems were encountered in the patient's controls. Undiagnosed 5th CMC joint dislocation disrupts the transverse and longitudinal arches of the hand, so the patient has a weak and painful gripping function. Radiological findings may be unclear on anterior-posterior and lateral views, and additional images may be obtained if in doubt.
  • Küçük Resim
    Öğe
    Prognostic factors between the proximal femoral nail and bipolar hemiarthroplasty in femoral intertrochanteric fractures
    (MediHealth Academy Yayıncılık, 22 Ekim 2022) Aygün, Ümit; Ayık, Ömer
    Aim: In the treatment of intertrochanteric femur fractures, proximal femoral nail (PFN), and bipolar hemiarthroplasty (BPH) are widely used. This study aimed to compare these two types of implants depending on risk factors regarding patients. Material and Method: PFN (Group 1) was applied to 40 of the 89 patients (44 female, 45 male) aged between 51-80 (mean 68.16±6.78) and BPH (Group 2) was applied to 49 of them. Age, gender, fracture side, fracture mechanism, additional disease, Body mass index (BMI), Albumin level, Hemoglobin (Hb) decrease level, T-score, American Society of Anesthesiologists (ASA) classification, type of anesthesia, surgery type, operation time, hospital stay and full weight-bearing time, Harris Hip Score (HHS) in preoperative and postoperative periods, classification of intertrochanter fracture according to the AO Foundation and Orthopedic Trauma Association (AO/OTA), postoperative complications were recorded. Results: Group 1 was younger with a mean age of 64.55±6.23 years compared to Group 2 (p <0.05). Most of the fractures were 3A2 type and the result of low energy (p>0.05). In group 1, operation time was 46.78±5.29 minutes and hospital stay was 2.48±0.75 days, which was shorter, most surgery types were closed, T-score was -2.49±0.59 and better, the time of full weight-bearing was 3.48±0.78 months, Hb decrease was 1.17±0.37 g/dL and less, Albumin level was 3.11±0.4 g/dL and higher (p<0.05). In Group 2, the age was the highest (72.6±5.2) and the T score was the lowest (-2.9±0.4) in the 3A2 fracture type (p<0.05). HHS was better in the BPH group at the sixth month (p<0.05), and there was no difference between the two groups at the end of one year (p>0.05). Conclusion: Prognostic markers for treatment outcomes in individuals with intertrochanteric fractures are still unknown. It is important to determine the factors that will contribute to the long-term functional results in these patients.