Teoman Bekir Yeni

Background/Objectives: Postoperative wound complications remain a clinically important challenge across surgical disciplines, while the contribution of preoperative biological status and the early postoperative systemic response remain incompletely understood. This study aimed to investigate whether routinely available hematological and biochemical biomarkers measured before surgery and during the early postoperative period were associated with postoperative wound complications. Methods: This retrospective single-center study included 58 patients undergoing surgical treatment for peri-ankle fractures, a clinically relevant setting for investigating postoperative wound complications. Demographic characteristics and routine laboratory parameters obtained within 24 h before surgery and during the first 6 postoperative hours were recorded. Patients were classified according to the presence or absence of postoperative WoC. Univariate analyses, Benjamini–Hochberg false-discovery-rate (FDR) adjustment, receiver operating characteristic (ROC) curve analyses, and separate Firth penalized multivariable logistic regression models for preoperative and early postoperative parameters were performed. Results: Postoperative WoC developed in 18 patients (31.0%). In the preoperative analysis, hemoglobin, hematocrit, platelet count, sodium, chloride, and total protein differed significantly between groups. Female sex was also significantly associated with WoC. After FDR adjustment, the preoperative platelet count and total protein remained statistically significant. In the early postoperative period, hemoglobin, hematocrit, lymphocyte count, basophil count, sodium, chloride, creatinine, neutrophil-to-lymphocyte ratio (NLR), and prognostic nutritional index (PNI) differed significantly between groups. After FDR adjustment, sodium, basophil count, chloride, hemoglobin, and NLR remained statistically significant. Preoperative total protein showed the highest discriminatory performance (AUC = 0.886, 95% CI 0.797–0.976), whereas postoperative sodium demonstrated the highest early postoperative performance (AUC = 0.808, 95% CI 0.694–0.923). In the preoperative Firth model, female sex (OR = 7.209, 95% CI 1.189–57.415; p = 0.031) and higher preoperative total protein (OR = 1.399, 95% CI 1.168–1.788; p < 0.001) were associated with WoC. In the early postoperative Firth model, lower serum sodium was associated with postoperative WoC (OR = 0.477, 95% CI 0.241–0.789; p = 0.001). Conclusions: These findings indicate exploratory associations between routinely available biomarkers and postoperative wound complications. Their clinical utility remains to be established in larger prospective studies.

Background and Aims: Distal femur fractures (DFFs) are relatively rare but clinically significant injuries associated with high morbidity and mortality. With the rising prevalence of total knee arthroplasty (TKA), the proportion of periprosthetic distal femur fractures (PPDFFs) has been increasing. The incidence, classification, and clinical characteristics of DFFs, with a particular focus on PPDFFs, were aimed to be evaluated in this study. Methods: Patients admitted to our tertiary care trauma center between January 2020 and 2025 with a diagnosis of distal femur fracture were included in this retrospective descriptive study. Demographic data, mechanism of injury, fracture classification, treatment preference, surgical approach, recorded complications, and comorbidities were analyzed. Results: A total of 56 patients were evaluated, including 46 (82.1%) with native DFFs and 10 (17.9%) with PPDFFs following TKA or Total hip arthroplasty (THA) . Female predominance was significantly higher in the PPDFF group compared to native fractures (100% vs. 63%, p=0.023). All PPDFFs resulted from simple falls (100%), whereas the native group had a more diverse trauma profile (p=0.036). Fracture type, Charlson Comorbidity Index and postoperative complication rates were similar between groups (p=0.702, p=0.170, p=0.639, respectively). Conclusion: PPDFFs constituted 17.9% of all DFFs in our series, aligning with reports from tertiary referral centers. These injuries predominantly affect elderly women and are strongly associated with low-energy falls. The findings underscore the need for preventive strategies such as osteoporosis management and fall prevention, as well as for timely surgical intervention and updated epidemiological data to optimize treatment planning and improve outcomes.

The osteoarticular involvement of Brucella infection may present as arthritis, bursitis, tenosynovitis, or spondylitis. Isolated presentation of Brucella infection as bursitis is a rare occurrence. The objective of this report was to present two cases of Brucella infection presenting with isolated prepatellar bursitis as osteoarticular involvement. The initial case report concerns a 56-year-old female patient who presented with a complaint of swelling in the left knee, accompanied by minimal pain, which had been present for the previous year. The second patient was a 53-year-old male patient who presented with a complaint of painless swelling in the knee, which had first appeared two years prior and had progressively worsened. Physical examination observed swelling extending from the anterior to the lateral side of the left knee, with no erythema, warmth, or tenderness observed in both patients. Laboratory examinations revealed normal biochemical parameters, complete blood count, and erythrocyte sedimentation rate (ESR), but C-reactive protein (CRP) levels were three times higher than the cut-off value. Serological tests revealed Brucella IgG positivity. Following the investigations, surgery was planned, and through a longitudinal incision, the masses were reached and completely excised. The resected tissue’s pathological examinations revealed chronic granulomatous inflammation. In endemic regions such as the one under consideration here, Brucella bursitis should be considered in the context of isolated and suspected osteoarticular involvement, regardless of the presence of any features in the patient’s history. Clinical suspicion plays a pivotal role in the preliminary diagnosis of Brucella bursitis, guiding clinicians in the early diagnosis and effective treatment of the disease.

Background: Patients can often access the internet and social media for health information but it is not clear how much they trust and use the information retrieved.Objective: To investigate the social media and internet use rates and preferences of orthopaedic patients, to reveal to what extent they self‐treat, and to probe the affecting factors.Methods: Two thousand fifty‐eight patients admitted to an orthopaedic polyclinic were asked to fill out a survey (voluntarily) consisting of 15 items, to collect demographic data, preference for platforms and sources used, trusted sources, and the extent to which information obtained was used for self‐care.Results: The most preferred and most trusted sources of information were Google and other search engines, and physicians' personal websites (p < 0.001).Discussion: Variables such as age, gender, educational level and occupation affect the research preferences. Reliance on social media decreases with increasing educational levels (p < 0.001).Conclusion: Health information and knowledge services should work with health professionals to improve aspects of health literacy among orthopaedic patients.