Mustafa Yalın

Background: Total hip arthroplasty (THA) is a complex intervention for patients with Crowe 3–4 high hip dislocations (HHD). The impact of age on outcomes in this patient group remains unclear. Aim: The current study evaluates short- to mid-term outcomes of THA in patients younger and older than 60 years, focusing on complication rates, clinical outcomes, and implant survival. Methods: A retrospective cohort study was conducted on 77 patients with HHD (Crowe 3–4) who underwent cementless THA. Patients were stratified into 2 age groups: n = 43) and ⩾60 years ( n = 34). Outcomes assessed included Harris Hip Score (HHS), complications, and revision-free survival. Kaplan-Meier and Cox proportional hazards analyses were employed. Results: Older patients had significantly higher complication rates (20.6% vs. 4.7%, p = 0.045), primarily due to deep vein thrombosis (DVT) (11.8% vs. none, p = 0.045). However, complication rates were comparable between unilateral (14.9%) and staged bilateral THA (16.7%, p = 0.789). Cox regression identified ASA Class 3 as an independent predictor of complications (HR 1.89, p = 0.043), while age and procedure type were not significant. Functional outcomes, including HHS and SF-36 scores, improved significantly in both groups without age-related differences. Kaplan-Meier survival analysis showed similar revision-free survival rates between age groups at 2 years (95.3% vs. 91.2%) and 3 years (92.1% vs. 88.5%, p = 0.287). Conclusions: Age does not independently predict revision or inferior functional outcomes following THA in HHD. Higher complication rates in older patients are primarily attributed to comorbidities. Appropriate perioperative management ensures comparable long-term outcomes regardless of age, emphasing the importance of addressing comorbidities over chronological age in candidate selection for THA.

Age-related differences after fasciotomy for earthquake-related acute compartment syndrome (ACS) remain incompletely defined. This study compared pediatric

Aim: This study aims to perform a bibliometric analysis of Lapidus-related research to identify trends, key contributors, and emerging innovations in the field.Material and Methods: Data were extracted from the Web of Science Core Collection database, focusing on publications containing the keyword "Lapidus" in orthopaedic journals up to December 2024. Bibliometric tools such as VOSviewer were used to analyze publication trends, collaboration networks, and keyword co-occurrence. Metrics like citation counts, influential authors, and institutional contributions were evaluated to uncover the academic landscape of Lapidus-related research.Results: A total of 310 articles from 35 countries were included, with the United States leading in publications and citations. The Journal of Foot & Ankle Surgery was identified as the most productive journal. Key contributors, including Coughlin, Dayton, and Hyer, were highlighted for their significant impact, particularly in advancing the modified Lapidus procedure. Keywords such as "hallux valgus," "modified Lapidus," and "bunion" were the most frequent, with a noticeable rise in studies focusing on multiplanar corrections and modern fixation techniques since 2020.Conclusion: This bibliometric analysis underscores the growing prominence of the modified Lapidus procedure, driven by technological advancements and improved surgical outcomes. The findings reveal notable gaps in global collaboration, emphasizing the need for international partnerships. This study provides a comprehensive overview of current trends, offering a foundation for future clinical research and innovation in hallux valgus correction.

Objective: This study aimed to compare clinical outcomes and total treatment costs of 3 fixation strategies—isolated dorsal plating, dorsal plating with a single lag screw, and dorsal plating with dual lag screws—in patients undergoing first metatarsophalangeal (MTP) joint arthrodesis for advanced hallux rigidus. Methods: This retrospective study included 99 patients who underwent primary first MTP joint arthrodesis between 2019 and 2024. Patients were categorized into Group 1 (dorsal plate only; n = 27), Group 2 (plate + 1 lag screw; n = 42), and Group 3 (plate + 2 lag screws; n = 30). Demographic variables, radiographic union, revision rates, functional outcomes (American Orthopaedic Foot and Ankle Society [AOFAS], Visual Analog Scale [VAS], Foot Function Index [FFI]), and total 12-month treatment costs were evaluated. The primary outcome measures were union rate, time to union, revision surgery, functional scores, and cumulative cost. Results: Group 1 demonstrated significantly lower union rates compared with Groups 2 and 3 (88.9% vs. 100% for both; P = .027) and a longer mean time to union (75 days vs. 65.8 and 62 days, respectively; P = .001). Revision surgery was required only in Group 1 (11.1%). The AOFAS scores were significantly higher in the screw-augmented groups (P = .013), while VAS and FFI scores showed no between-group differences. Cost analysis identified Group 2 as the most cost-effective strategy (9500 ± 1100 TL ≈ $310 ± 36), compared with Group 1 (11 200 ± 1400 TL ≈ $365 ± 46, P = .021) and Group 3 (11 600 ± 1300 TL ≈ $378 ± 42, P = .038). Conclusion: Single lag-screw augmentation of dorsal plate fixation provides superior union, fewer revisions, improved functional scores, and the lowest overall 12-month cost. These findings support dorsal plating with a single lag screw as a practical, value-based fixation strategy for advanced hallux rigidus, offering optimal clinical and economic outcomes. Cite this article as: Kazez M, Batur ÖC, Önce G, Kürüm H, Kaya O, Yalın M. Single lag-screw–augmented dorsal plating yields superior union and lower costs in first metatarsophalangeal arthrodesis. Acta Orthop Traumatol Turc., 2026; 60(2), 0417, doi: 10.5152/j.aott.2025.25417.

The aims of this study are twofold: (1) to investigate how intensive care unit (ICU) admission rates differ among heart failure (HF) subtypes [HF with pres

Background: Carpal tunnel release (CTR) is a common procedure for carpal tunnel syndrome (CTS), with WALANT (Wide-Awake Local Anesthesia No Tourniquet) and Axillary Brachial Plexus Block (ABPB) as two primary anesthesia options. This study compares their effects on pain, functional recovery, grip strength, and sleep quality. Methods: A prospective observational study with quasi-randomization was conducted on 62 patients undergoing CTR under WALANT or ABPB. Outcomes included operative time, Visual Analog Scale (VAS) for pain, grip strength, and Pittsburgh Sleep Quality Index (PSQI). Patients were followed up at 1 week, 3 weeks, and 3 months postoperatively. Results: WALANT significantly reduced operative time compared to ABPB (mean: 20.8 ± 4.1 min vs. 41.5 ± 9.4 min; mean difference: 20.7 min; 95% CI: 16.3–25.1; p = 0.001; d = 2.45). It was also associated with significantly lower pain scores at both 3 weeks and 3 months. At 3 weeks, VAS scores were 0.7 ± 0.8 (WALANT) vs. 2.5 ± 2.1 (ABPB) (mean difference: 1.8; 95% CI: 0.6–2.9; p = 0.003; d = 1.00), and at 3 months, 0.3 ± 0.4 vs. 2.3 ± 1.4, respectively (mean difference: 2.0; 95% CI: 1.1–2.9; p = 0.003; d = 1.15). Early postoperative pain scores (1st hour and 1st day) were also lower in the WALANT group; however, these differences did not reach statistical significance. Grip strength recovery at 3 months showed no significant difference between groups in both thumb pinch and finger pinch measurements ( p > 0.05). Similarly, sleep quality improvements assessed by PSQI did not significantly differ between groups at 3 months (WALANT: 5.7 ± 1.6 vs. ABPB: 5.9 ± 1.3; p = 0.868). Conclusion: WALANT is a time-efficient and effective anesthesia method for CTR, offering prolonged pain relief without compromising functional recovery, grip strength, or sleep quality.

Aim: This study aimed to evaluate the accuracy, readability, and safety of ChatGPT‐4.0's responses to frequently asked questions (FAQs) related to orthopaedic trauma and to examine whether readability is associated with the quality and reliability of content.Methods: Ten common patient questions related to orthopaedic emergencies were submitted to ChatGPT‐4.0. Each response was assessed independently by three orthopaedic trauma surgeons using a 4‐point ordinal scale for accuracy, clinical appropriateness, and safety. Readability was calculated using the Flesch‐Kincaid Grade Level (FKGL). Inter‐rater agreement was analysed using intraclass correlation coefficients (ICC). The presence of disclaimers was also recorded.Results: ChatGPT‐4.0's responses had a mean FKGL score of 10.5, indicating high school‐level readability. Stratified analysis showed comparable readability scores across response quality categories: excellent (10.0), poor (9.8), and dangerous (10.1), suggesting that readability does not predict content reliability. Accuracy and safety scores varied considerably among responses, with the highest inter‐rater agreement in clinical appropriateness (ICC = 0.81) and the lowest in safety assessments (ICC = 0.68). Notably, nine out of 10 responses included a disclaimer indicating the nonprofessional nature of the content, with one omission observed in a high‐risk clinical scenario.Conclusion: Although ChatGPT‐4.0 provides generally readable responses to orthopaedic trauma questions, readability does not reliably distinguish between accurate and potentially harmful information. These findings highlight the need for expert review when using AI‐generated content in clinical communication.

The current study aimed to examine the short- and long-term relationship between complications and radiologic and functional outcomes in surgically treated patients with Delbet type II and type III paediatric femoral neck fractures (PFNFs). We examined the medical records of PFNFs from 2006 to 2013. Retrospective analysis examined patient demographics, fracture types, surgical procedures, complications, and follow-up outcomes. We used Ratliff’s method for early radiological and clinical assessment of patients in the second postoperative year. At the final follow-up, Tönnis criteria and the Harris hip score were used to evaluate late findings in adulthood. Over an average follow-up of 157.2 months, we evaluated 26 patients, with an average age of 10.7 years. Early complications included coxa breva (34.6%) and limb length discrepancy (LLD) (30.8%); late complications included osteoarthritis (OA) (23.1%) and LLD (23.1%). During the early follow-up period, avascular necrosis (AVN) was observed in 6 individuals, accounting for 23.1% of the cases. There were no cases of nonunion or infection detected in any of the patients. AVN correlated with non-anatomic reduction, poor Ratliff classification (early), lower Harris hip scores (late), and OA (late) (p < 0.05). Non-anatomic reduction was significantly correlated with all three main complications (p < 0.05). Anatomical reduction significantly influences early and late complications following PFNF surgery. Therefore, we strongly affirm that prioritising anatomical reduction is more important than any other criterion mentioned in the literature. The AVN predicts OA and poor long-term outcomes. Coxa breva and LLD did not correlate with poor clinical outcomes or the onset of OA.

Aim: The purpose of the current study was to investigate the postoperative pattern of sleep quality and to evaluate the correlation between sleep quality and clinical scores in patients following arthroscopic surgery for chronic persistent lateral epicondylitis (ASCPLE). Methods: The current study included consecutive patients seeking lateral epicondylitis (LE) treatment at four orthopaedic outpatient clinics between 2020 and 2022 who failed to improve with conservative treatments and consented to ASCPLE. The current study evaluated patient demographics, the Pittsburgh Sleep Quality Index (PSQI), and patient-rated outcomes measures (PROMs) like the Disability of the Arm, Shoulder, and Hand (DASH) score and the Patient-rated Tennis Elbow Evaluation (PRTEE) score before and after ASCPLE surgery, with follow-up assessments at three weeks, three months, and six months. Results: The study involved 28 patients aged 32-47 years. Statistically significant decreases were observed in the PSQI and DASH values at postoperative 3rd week, 3rd month, and 6th month compared to preoperative values (p