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p of patients.Radioulnar synostosis is a rare disease which causes supination and pronation restriction as a result of osseous or fibrous connections between the radius and ulna. Radioulnar synostosis includes both congenital and post-traumatic types. L-SelenoMethionine in vitro Post-traumatic radioulnar synostosis can be seen in the proximal, middle, and distal part of the forearm, depending on the location of the trauma. Congenital proximal radioulnar synostosis occurs as a result of a separation defect between the radius and ulna in the embryonic period. In the presence of congenital proximal radioulnar synostosis, the patient should be evaluated for accompanying syndromes and possible developmental anomalies. In this report, we present a rare case of both proximal and distal radioulnar synostosis. Hypoplasia of the right pectoral muscle mass, hypoplastic appearance of the right nipple, presence of proximal and distal radioulnar synostosis in the right forearm, and accompanying symbrachydactyly suggested Poland syndrome. To the best of our knowledge this is the first case of congenital proximal and distal radioulnar synostosis with Poland syndrome.Flexor tendon entrapment (FTE) is a rare and usually lately diagnosed complication of pediatric forearm fractures. In this case report, we present a case of a neglected ring and little finger flexor digitorum profundus (FDP) entrapment after closed reduction of both bone forearm fracture and treated five years later due to late diagnosis. A 20-year-old man presented to outpatient clinic with flexion contracture of ring and little finger that occurred after both-bone forearm fracture treated with closed reduction and long arm cast five years ago. On his physical examination, flexion contracture of ring and index fingers was thought to be due to entrapment of tendons at the level of forearm and surgically released. Five years after surgical treatment for FTE, the patient had full range of motions at both fingers. He had no additional complaint. In conclusion, FTE is a rare complication after both bone forearm fractures. It should be kept in mind in the treatment of both bone forearm fractures. Surgical treatment of FTE in late cases is an effective procedure with excellent results.Although coracoid fractures are rare fractures, their treatment is critical as they form the coracoacromial arch and superior shoulder suspensory complex (SSSC), which are important structures for shoulder biomechanics. In this case series, clinical, radiological, and demographic characteristics of three male patients who received treatment due to coracoid fracture presenting with traumatic injuries were discussed. The fractures were classified according to the Ogawa and Eyres classifications, and fracture fixation was achieved surgically with the cannulated screws. All patients had a right coracoid fracture. The Constant-Murley Score and the Disabilities of the Arm, Shoulder and Hand scores the patients in the final follow-up visit at 12 months were calculated. In conclusion, good clinical and functional outcomes can be achieved by anatomical reduction and fixation through surgery for displaced coracoid fractures presenting with multiple traumatic injuries located in multiple regions of the SSSC.Quadriceps ruptures are one of the pathological conditions of the knee extensor mechanism, accounting for 3% of all tendon injuries. These injuries cause substantial disability of the extensor mechanism. Primary repair is the treatment of choice in acute presentation. In the setting of chronic conditions, the treatment becomes more challenging. Available surgical options include lengthening procedures, and reconstruction with auto graft or allografts. The traditional Scuderi and Codivilla techniques are challenging to perform in degenerative or traumatic retracted ruptures. There is no standard effective treatment in these patients, which yields the best clinical and biomechanical outcomes. An 18-year-old male patient with quadriceps re-rupture after a primary repair was managed with allograft reconstruction using suture anchors. link2 At six years of follow-up, the patient gained a full range of motion with excellent clinical outcomes. He returned to his previous work. In conclusion, quadriceps reconstruction using suture anchor and Achilles allograft combination is a feasible technique in neglected cases who present with quadriceps tendon re-rupture after primary surgical repair.A five-year-old boy with Ewing sarcoma of the proximal femur was operated at our institution with limb-sparing surgery and biological reconstruction of the proximal femur with a vascularized fibular autograft. During this procedure, the proximal femur was soaked in liquid nitrogen which was subsequently fixed to the fibular autograft, while the epiphysis of the femoral head was spared. To the best of our knowledge, this is the first report of epiphysis-sparing surgery of the proximal femur via a vascularized fibular autograft surrounded by a liquid nitrogen-treated tumor bearing bone autograft. Three years postoperatively, the patient remains disease-free, has a full weight-bearing extremity with good function, and a remodeled proximal femur with minimal deformity. There are no radiological or clinical signs indicative of femoral head osteonecrosis. In conclusion, hip-sparing biological reconstruction is a successful method of limb preservation as an alternative to tumor endoprostheses.Tuberculosis (TB) infection is a common health problem in low socioeconomic populations in developing countries. Osteoarticular TB is a disease that rarely occurs outside the vertebral column and is often diagnosed late or misdiagnosed, particularly in non-weight bearing joints. A 51-year-old female patient with Behçet's disease presented with shoulder TB following rotator cuff repair surgery, leading to joint resection as a result of recurrent infections with no reproduction in culture samples due to delayed diagnosis. Surgical excision was proposed for the treatment of draining a mass with a sinus tract opening into the joint on the anterior aspect of the right shoulder. A diagnosis was able to be reached after 13 operations, based on the presence of TB bacilli in the pathological examination of the samples. In conclusion, TB should be considered in the absence of reproduction in culture samples taken during persistent post-surgical infections.The post-traumatic impairment of blood supply of the scaphoid bones' proximal pole is the subject of controversy in the surgical techniques which would heal this fracture. In a surgery performed with a dorsal approach, the main goal is to make a strong fixation with a small incision and a good implant without disturbing the blood supply of the bone. To date, complications related to surgical treatment of scaphoid proximal pole fractures have been reported in detail. However, there is no other study which presents headless screw failure which placed for the scaphoid proximal pole fracture surgery. Although implant technologies have been developed nowadays, our case report highlights that the endurance of these implants has not been carried out in such proximal pole fractures of the scaphoid, yet. Herein, we present the explanation of a broken headless screw which was placed into the proximal pole fracture of scaphoid, avoiding to affect bone stock of the scaphoid surgical technique. We believe that this surgical technique would be helpful to manage similar difficult situations for orthopedic surgeons.A 43-year-old male patient with underlying diabetes mellitus presented with lower abdominal pain radiating to left thigh. He was hemodynamically stable, but appeared lethargic. Both iliac fossae were tender, and crepitus appreciated along the anteromedial aspect of the left thigh. The patient initially responded well to treatment and was discharged; however, he was re-admitted several months later due to recurrent collection showing the growth of Klebsiella pneumoniae in the culture and succumbed to sepsis due to deep-seated intramuscular abscess and lung empyema. link3 In conclusion, psoas abscess is a condition that can mimic various pathologies related to the lower abdomen and, therefore, clinicians should always have a high index of suspicion to prevent a missed diagnosis. Early detection may yield good outcomes, if managed with adequate surgical drainage and appropriate antibiotics.Surgical site gout is an extremely rare complication that is difficult to diagnose, particularly in patients without a history of gout. A 57-year-old male patient was admitted with no previous history of gout, complaining of surgical site gout located at the junction where flexor carpi ulnaris tendon was transferred to extensor digitorum communis tendon after 33 years of the initial surgery. The patient was presented with a progressive swelling over the last three months which was located on the dorsoulnar side of the right wrist joint. Magnetic resonance imaging revealed an iso/hypointense mass. During the excisional biopsy, retained non-absorbable suture materials were observed within the mass. Histopathological examination result was reported as a typical gout tophus. No recurrence was observed after 18 months of follow-up. In conclusion, surgical site gout may be observed at transferred tendons years after the initial surgery.Traumatic bilateral hip dislocation is a rare phenomenon. Simultaneous traumatic asymmetrical bilateral hip dislocation is even more unusual. There is no report in the literature regarding the mechanism of injury in tramcar squeezing. A 49-year-old male who had a serious tramcar accident and developed asymmetric bilateral hip dislocations (left posterior, right anterior) combined with fracture of left acetabulum and multiple injuries was admitted. Right hip dislocation was treated with manual reduction. Left hip dislocation, fracture of acetabulum and bilateral pubis, and open wound of left thigh were treated with open reduction and internal fixation. In conclusion, hip dislocation should be performed with manual reduction within 6 h. If manual reduction fails, open reduction and even internal fixation can be performed to prevent complications, such as avascular necrosis of the femoral and heterotopic ossification.

The aim of the present study was to assess the prescriptions of patients who were admitted to the orthopedics and traumatology outpatient clinic of a tertiary care hospital according to the WHO prescribing indicators.

Between January 2020 and March 2020, a total of 1,024 patients (273 males, 751 females; mean age 51.9±13.9 years; range, 19 to 103 years) were included in the study. Only patients who were prescribed drugs and 18 years of age or older were included in the study. The WHO core prescribing indicators were utilized for the assessment of rational drug use. The WHO prescribing indicators percentages between the age categories were analyzed. The average number of drugs between the age categories was also examined.

The average number of drugs per encounter was 2.9. The percentage of encounters with an antibiotic prescribed was 2.6% and with an injection prescribed was 10.7%. The percentage of drugs prescribed from essential drugs list was 33.8%. There were no prescriptions consisting generic name of drugs (0%).