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Factors Associated with Pelvic Fractures in Polytrauma Patients with Orthopaedic Injuries - Archives of Basic and Clinical Research

Aims: This study evaluated healthcare professionals’ perceptions, clinical practices, and referral patterns regarding bariatric surgery in overweight or obese patients with musculoskeletal pain, and identified factors associated with referral decision-making.Methods: A cross-sectional survey was completed by 603 healthcare professionals from multiple specialties. The questionnaire assessed clinical exposure to obese patients with musculoskeletal pain, body-mass index (BMI) assessment practices, weight-loss recommendations, attitudes toward bariatric surgery, referral criteria, and factors influencing referral decisions and referral center selection.Results: Overall, 405 participants (67.2%) reported that at least one-quarter of their patients with musculoskeletal pain were overweight or obese. Although 422 (70.0%) consistently recommended weight loss and 463 (76.8%) considered weight reduction highly effective for symptom relief, only 68 (11.3%) routinely assessed BMI. Bariatric surgery was regarded as moderately or highly effective by 515 participants (85.4%), and 572 (94.9%) believed it could reduce the need for orthopaedic surgery. The most common indication for bariatric surgery referral was obesity refractory to conservative treatment (67.4%). Referral criteria differed significantly according to age (p=0.034), specialty (p

Background/Objectives: Rapid weight loss following sleeve gastrectomy substantially reduces mechanical loading across the lower extremities, yet its effects on patellar height remain unknown. This study investigated early postoperative radiographic changes in patellar height following sleeve gastrectomy and evaluated whether these changes were associated with the magnitude of weight loss or body mass index (BMI) reduction. Methods: This retrospective observational study was conducted at a specialized high-volume bariatric surgery center in Kocaeli, Türkiye. Standardized bilateral knee radiographs were obtained preoperatively and at the routine fourth postoperative month in patients undergoing primary sleeve gastrectomy. Patellar height was assessed using the Insall–Salvati (IS), Blackburne–Peel (BP), and Caton–Deschamps (CD) indices. Results: A total of 155 consecutive patients were included. Body weight and BMI decreased significantly by the fourth postoperative month (both p < 0.001). The IS index remained unchanged (1.13 [IQR, 0.25] vs. 1.11 [IQR, 0.22]; p = 0.314), whereas the BP index decreased from 0.94 [IQR, 0.26] to 0.90 [IQR, 0.23] (p = 0.004), and the CD index decreased from 1.06 [IQR, 0.20] to 1.04 [IQR, 0.32] (p = 0.039). Although absolute postoperative BP values demonstrated weak associations with baseline and postoperative body weight and BMI, the magnitude of postoperative changes (Δ values) was not independently associated with the extent of weight loss or BMI reduction. In contrast, baseline patellar height independently predicted postoperative radiographic adaptation. Conclusions: Rapid postoperative weight loss following sleeve gastrectomy was associated with early radiographic changes in patellar height. Although these changes were statistically significant, they were modest in magnitude and appeared to be influenced predominantly by baseline patellar anatomy, which independently predicted postoperative radiographic adaptation, rather than by the extent of weight loss.

Aims: To evaluate the perceptions of overweight and obese patients attending an outpatient clinic regarding the use of Artificial Intelligence (AI) for health-related issues, their trust in AI-generated information on obesity-related musculoskeletal complaints, and their attitudes toward receiving exercise and nutrition recommendations from AI. Methods: This cross-sectional, anonymous survey included 514 overweight and obese patients attending outpatient clinics. The questionnaire consisted of demographic questions and six items related to AI. Associations between demographic characteristics and survey responses were analyzed.Results: Overall, 49.4% of participants reported having used AI for health-related purposes at least occasionally. The most common response regarding trust in AI-generated health information was "I'm not sure" (59.3%). Participants were significantly more willing to receive nutrition recommendations than exercise recommendations from AI. Nearly half of the participants (49.4%) believed that physicians would continue to play an essential role in healthcare despite advances in AI. AI use, perceived usefulness of AI, and trust in AI were significantly associated with both age and educational level (all p

Background/Objectives: While bariatric surgery is known to improve plantar pressure distribution and reduce foot-related symptoms, its impact on radiographic forefoot alignment parameters, such as the intermetatarsal angle (IMA) and hallux valgus angle (HVA), remains unclear, highlighting the need for further investigation. The aim of this study was to quantitatively evaluate changes of HVA and IMA in patients undergoing bariatric surgery and to determine whether weight loss-induced reductions in mechanical load are associated with differential changes of the forefoot. Methods: Weight-bearing anteroposterior foot radiographs of 102 patients who underwent laparoscopic sleeve gastrectomy were obtained preoperatively and at 6 months postoperatively. HVA and IMA were measured using standardized digital techniques. Changes in angular parameters were analyzed in relation to body mass index reduction. Results: Intra-observer reliability was excellent for all angular measurements (ICC: 0.987–0.999, p < 0.001). Radiographic evaluation demonstrated no significant change in HVA (p = 0.147), whereas IMA showed a significant decrease postoperatively (p < 0.001). No significant change was observed in HVA distribution (p = 0.341), and although the proportion of patients within the normal IMA range increased, this did not reach statistical significance (p = 0.091). Correlation analysis revealed significant associations of postoperative angles with age and body weight parameters (p < 0.05), while no significant relationship was found between changes in body weight or BMI and angular measurements (p > 0.05). Conclusions: Sleeve gastrectomy significantly improves biomechanically driven aspects of forefoot alignment (decrease in IMA), while structural deformities (HVA) remain unchanged in the short-term. These findings highlight that obesity-related forefoot pathology is predominantly linked to altered load distribution rather than fixed structural deformity, suggesting that radiographic parameters reflecting biomechanical loading are more sensitive to weight loss.

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.