Journal of Multidisciplinary Orthopaedic Surgery
The Journal of Multidisciplinary Orthopaedic Surgery (JMOS) fundamentally values all research that upholds scientific and ethical standards, aiming to publish your work without unnecessary barriers. While mainstream peer-reviewed journals remain the traditional cornerstone of scientific research, they frequently overlook or reject supplementary materials and unconventional content due to strict editorial boundaries—despite their potential to captivate readers. At JMOS, we believe every aspect of your research holds inherent value, and we provide an accessible platform to showcase your work within the scientific literature. JMOS is a peer-reviewed, open-access journal covering all aspects of multidisciplinary clinical and basic research, involving collaboration between clinicians and scientists from different disciplines. The journal aims to publish scientific studies focused on the latest developments in the field, especially in Orthopaedics and Traumatology, as well as other scientific branches related to musculoskeletal problems. The Journal of Multidisciplinary Orthopaedic Surgery covers the following types of studies: • Original research articles • Biomechanical studies • Experimental studies • Review articles • Case reports • Surgical techniques • Brief reports • Clinical images • Educational articles • Letters to the editor The journal also accepts scientifically written, up-to-date, high-quality, original, and evidence-based medical articles—including those concerning musculoskeletal disorders—from disciplines such as Plastic and Reconstructive Surgery, Geriatrics, Neurosurgery, Osteopathic Medicine, Emergency Medicine, General Surgery, Physical Medicine and Rehabilitation, Radiology, Trauma, and Sports Medicine. JMOS is published three times a year, in April, August, and December. It is a peer-reviewed journal that provides open access to scientific studies. Published issues and the full texts of the articles can be accessed free of charge. The journal does not charge any Article Processing Charges (APCs) or submission fees for the publication of articles.
Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution (CC BY-NC) 4.0 License that allows others to share the work with an acknowledgment of the work’s authorship and initial publication in this journal.
Giant Baker's cyst associated with pigmented villonodular synovitis: surgical management of a rare case
Section: Case Reports Keywords: Baker’s cyst, pigmented villonodular synovitis, knee pain, surgical excision, arthroscopic synovectomy This case report presents a rare instance of pigmented villonodular synovitis in conjunction with a large Baker's cyst. A 48-year-old female patient presented with progressive pain, swelling and limited range of motion in the right knee. Magnetic resonance imaging revealed a giant Baker's cyst measuring approximately 11.5 × 8 cm. This was consistent with the presence of multiple lobulated and septated cystic structures. The largest of these measured 7.5 × 5 cm and was located in the popliteal fossa. Proliferative synovial changes suggestive of pigmented villonodular synovitis were also noted in the synovium. Following the failure of conservative treatment, the cyst was excised via a posterior approach and an arthroscopic synovectomy was performed simultaneously. Pathological examination confirmed the diagnoses of a Baker's cyst and pigmented villonodular synovitis. There were no complications postoperatively, and the patient achieved a full range of motion in her knee and was able to resume her daily activities without pain. This case highlights the importance of considering pigmented villonodular synovitis in the diagnostic process for large, complicated Baker's cysts, and demonstrates that surgical excision combined with arthroscopic synovectomy is an effective, safe treatment approach.
Copyright (c) 2026 Erdoğan Suna (Author) https://creativecommons.org/licenses/by-nc/4.0
Isolated lesser trochanter avulsion fracture in an adolescent footballer: successful conservative management
Section: Case Reports Keywords: Lesser trochanter, avulsion fracture, iliopsoas muscle, conservative treatment, adolescent athlete, football player A lesser trochanter avulsion fracture is an injury that typically occurs in young athletes due to sudden muscle contractions and high-load mechanical stress. These fractures result from the abrupt contraction of the iliopsoas muscle and share similar characteristics with apophyseal injuries. Although rare, they hold clinical significance due to uncertainties in the treatment process and the presence of various treatment options. This case report discusses the conservative treatment process of an adolescent football player who sustained a lesser trochanter avulsion fracture while playing football. The patient presented with complaints of acute hip and groin pain. Diagnostic evaluations confirmed the presence of an avulsion fracture. During the conservative treatment process, the patient was regularly monitored for four months, and by the 18th week, a complete clinical resolution was achieved. These treatment results support the effectiveness of conservative treatment methods for isolated lesser trochanter fractures. However, in some cases, surgical intervention may be necessary, and it is important to personalize the treatment process for each patient. This case report demonstrates that a conservative approach to the treatment of lesser trochanter avulsion fractures can yield successful results, while also emphasizing that each patient's condition is unique, and the treatment plan should be tailored accordingly.
Copyright (c) 2026 Buğra Can, Şükrü Demir (Author) https://creativecommons.org/licenses/by-nc/4.0
Evaluation and management of clavicle fractures in the juvenile population: a retrospective analysis of 456 patients
Section: Research Articles Keywords: Clavicle fractures, conservative treatment, juvenile, preschool child, pseudoarthrosis, malunion Background: Pediatric clavicle fractures in the juvenile population are common injuries that typically heal successfully with nonoperative treatment. Despite this favorable natural history, many centers continue to schedule routine outpatient follow-up visits and obtain repeated radiographs after the initial orthopedic consultation, although the true clinical value of these practices remains uncertain. Methods: We retrospectively reviewed 456 children aged 3–10 years who presented with clavicle fractures. Fracture location, displacement pattern, periosteal integrity, treatment modality, union status, and radiographic remodeling were recorded, along with demographic variables. The primary outcome measure was any change in clinical management following the initial orthopedic consultation. Patients with polytrauma, pathologic fractures, or those lost to follow-up were excluded; the analysis focused on isolated clavicle fractures in this age group. Results: The majority of fractures were located at the midshaft (93.0%). Nonoperative management predominated: Velpeau bandages were used in 63.2% of patients and figure-of-eight bandages in 36.4%. Surgical treatment was required in only two patients (0.4%), both due to an increased risk of skin compromise. Complete fracture union was observed in 453 of 456 patients (99.3%); two refractures subsequently achieved union, and one case demonstrated radiographic findings consistent with clavicular pseudoarthrosis. In asymptomatic patients, follow-up visits and repeat radiographs did not lead to any change in management, and no neurovascular complications were identified. Conclusions: In juvenile patients with isolated and uncomplicated clavicle fractures—including completely displaced patterns—routine clinical follow-up and serial radiographic evaluations after the initial assessment may be unnecessary. A selective follow-up strategy based on clinical findings could reduce radiation exposure and healthcare utilization without compromising patient outcomes.
Copyright (c) 2026 Mustafa İştahlı (Author) https://creativecommons.org/licenses/by-nc/4.0
Parrot's pseudoparalysis: a case of congenital syphilis
Section: Case Reports Keywords: Congenital syphilis, Parrot's pseudoparalysis, pathological fracture, bone diseases, syphilitic periostitis Congenital syphilis is a systemic disease caused by the transplacental transmission of Treponema pallidum, which can severely affect the skeletal system during infancy. Bone involvement is typically characterized by diffuse periostitis and osteochondritis, resulting in an acquired flaccid extremity secondary to severe bone pain, a condition known as ”Parrot’s pseudoparalysis.” This article presents the diagnostic and therapeutic journey of a 2.5-month-old male patient who presented with left arm immobility and a clavicle fracture. Due to the complexity of his clinical and laboratory findings, he was initially misdiagnosed with mechanical trauma and later evaluated for macrophage activation syndrome (MAS). Following referral to our center due to persistent acute-phase reactant elevation and limb immobility, radiological evaluation revealed diffuse periosteal reactions, intramedullary lytic-sclerotic areas in the long bones, and a pathological fracture of the left clavicle. Guided by these specific skeletal findings, serological tests were performed, which returned positive for VDRL and Treponema pallidum-specific antibodies, confirming the diagnosis of early congenital syphilis. After a 14-day course of intravenous aqueous crystalline penicillin G, a dramatic improvement in clinical findings and inflammatory markers was observed, with complete resolution of the pseudoparalysis. Although relatively rare today, congenital syphilis must be retained in the differential diagnosis of infants presenting with unexplained localized edema, pathological fractures, and pseudoparalysis.
Copyright (c) 2026 Beyzanur Avcı Yalçın (Author) https://creativecommons.org/licenses/by-nc/4.0
A neglected Bosworth fracture-dislocation complicated by diabetic neuropathy: a case report
Section: Case Reports Keywords: Bosworth fracture, ankle dislocation, diabetic neuropathy, Charcot neuroarthropathy, neglected fracture, ankle arthrodesis The Bosworth fracture-dislocation is an exceedingly rare and complex ankle injury characterized by the entrapment of the proximal fibular fragment behind the posterior tibial tubercle. Due to its anatomical configuration, this injury is typically irreducible by closed means and poses a significant diagnostic challenge. We present a unique case of a neglected Bosworth fracture in a 62-year-old female who presented three months after the initial trauma. Upon her delayed presentation, clinical examination revealed a fixed external rotation and equinus deformity of the right ankle, while radiographic and computed tomography (CT) evaluations confirmed a chronic Bosworth fracture-dislocation. A key feature of this case was the patient’s newly diagnosed uncontrolled diabetes mellitus and associated severe peripheral neuropathy. It is highly probable that the loss of protective sensation masked the typical pain response, allowing the patient to intermittently bear weight and leading to a neglected clinical picture consistent with early Charcot neuroarthropathy. Given the chronic nature of the dislocation and the significant joint destruction, anatomical open reduction and internal fixation were no longer feasible. Instead, a salvage procedure consisting of fibular repositioning and ankle arthrodesis with an intramedullary nail was performed to provide skeletal stability and prevent further complications such as ulceration or limb loss. This case highlights how comorbidities like diabetic neuropathy can alter injury perception, leading to delayed treatment and the necessity for more radical surgical interventions like arthrodesis.
Copyright (c) 2026 Hasan Safa Doğan (Author) https://creativecommons.org/licenses/by-nc/4.0
From heel to hip: medial buttressing for quadrilateral plate fractures of the acetabulum with a locking calcaneal plate
Section: Research Articles Keywords: Quadrilateral plate, calcaneus plate, acetabulum fractures, quadrilateral surface, spring plate, medial buttressing Background: Complex acetabular fractures involving the quadrilateral plate (QLP) present significant surgical challenges due to poor bone quality, the inherent thinness of the QLP, and the proximity of significant neurovascular structures. While modern anatomical plates exist, their high cost and limited accessibility remain barriers. This study evaluates a novel, cost-effective surgical technique using a locked titanium calcaneus plate combined with a suprapectineal reconstruction plate for medial buttressing. Methods: A total of 60 patients treated for acetabular fractures between 2016 and 2025 were reviewed. Ten patients specifically underwent medial buttressing for QLP fractures. Among these, five patients received a locked titanium calcaneus plate fixed to a suprapectineal reconstruction plate. Clinical and demographic data, fracture classifications (Letournel and Judet), and postoperative reduction quality (measured via CT scans) were analyzed. Reduction was categorized as anatomical (< 2 mm) or non-anatomical (≥ 2 mm). Results: The mean age was 39.5 ± 16.1 years. Posterior wall fractures were the most common elementary pattern (60.6%), while anterior column with posterior hemitransverse fractures predominated the complex group (37%). Postoperative CT scans showed anatomical reduction in 83.3% of the total cohort. The mean follow-up was 11.5 months. The surgical approach was predominantly Kocher-Langenbeck (60%), followed by the modified Stoppa (30%) and ilioinguinal (10%) approaches. Conclusion: Combining a locked titanium calcaneus plate with a suprapectineal reconstruction plate is a viable and effective alternative for stabilizing complex QLP fractures. This technique provides stable medial support using widely available implants, making it a good option in clinical settings where patient-specific or modern anatomical plates are unavailable.
Copyright (c) 2026 Kemal Somdaş, Süleyman Yalçın, Fırat Ozan (Author) https://creativecommons.org/licenses/by-nc/4.0
Section: Clinical Image Keywords: Femur fracture, high-energy trauma, open fracture, management, complication This study presents the multidisciplinary management of a Winquist-Hansen Type 4 femoral shaft fracture and a Gustilo-Anderson Type IIIA open fracture consistent with high-energy trauma.
Copyright (c) 2025 Yusuf Cennet (Author) https://creativecommons.org/licenses/by-nc/4.0
Arthrodesis of the first metatarsophalangeal joint by locking plate in patients with hallux rigidus
Section: Research Articles Keywords: Hallux rigidus, metatarsophalangeal arthrodesis, fusion, plate fixation Background: The aim of this study was to evaluate the clinical and radiological results of first metatarsophalangeal (MTP) joint arthrodesis surgery performed with a plate in patients diagnosed with hallux rigidus (HR). Methods: Nineteen patients who underwent first MTP joint arthrodesis with a diagnosis of HR between 2018 and 2024 were retrospectively analyzed. Patient gender, surgical site, complication status, preoperative and postoperative hallux valgus angles (HVA), union and follow-up times, and staging according to the Coughlin-Shurnas classification were evaluated. Statistical analysis was performed using the Wilcoxon test, with p < 0.05 considered significant. Results: A total of 19 patients (15 females, 4 males) were included in the study. The mean age was 55.3 ± 8.1 years, and the follow-up period was 9.16 ± 1.95 months. Hallux rigidus was detected as stage 2 in one patient and stage 3 in 18 patients. The preoperative HVA decreased from 18.9° ± 5.4 to 14.6° ± 6.1 postoperatively; the difference was not statistically significant (p = 0.129). Complications occurred in six patients (31.6%). The mean time to union was 8.39 ± 2.4 weeks, and one patient experienced nonunion. Conclusion: We consider arthrodesis using plates as an appropriate surgical technique in the treatment of HR due to its high union rate.
Copyright (c) 2025 Fettah Deniz, Serhat Bozkurt, Mustafa İştahlı, Hüseyin Örgü (Author) https://creativecommons.org/licenses/by-nc/4.0
Barber’s disease: a rare case of interdigital pilonidal sinus
Section: Case Reports Keywords: Barber’s disease, interdigital pilonidal sinus, hand web space disease, interdigital hair pocket disease, occupational disease, hand infection Barber's disease is caused by short hairs penetrating the interdigital spaces of the hands. The chronic inflammatory reaction causes fistulas, sinuses, and cysts. We present a patient with an interdigital pilonidal sinus in the third interdigital space of the right hand.
Copyright (c) 2025 Mustafa İştahlı, Hüseyin Yetkin (Author) https://creativecommons.org/licenses/by-nc/4.0
Three-dimensional printed custom-made scapular implant reconstruction after total scapulectomy for malignant tumor: a case report
Section: Case Reports Keywords: Total scapulectomy, Ewing’s sarcoma, 3D-printed implants, custom-made implant, scapula Although rare in childhood, cancer remains a significant cause of death in children. Even though hematological cancers such as leukemia and lymphoma are more common in children, sarcomas with bone and soft tissue involvement should not be overlooked. This study presents the diagnosis, treatment, and limb-sparing reconstruction of scapular Ewing’s sarcoma detected in a 9-year-old female patient who presented to our outpatient clinic with a mass and pain on the left side of her back, along with a brief review of the literature.
Copyright (c) 2025 Ali Pakırdaşı, Sabri Batın, Kaan Gürbüz, Fırat Ozan (Author) https://creativecommons.org/licenses/by-nc/4.0
Obesity associated low back pain and knee osteoarthritis: a cross-sectional hospital-based study
Section: Research Articles Keywords: Obesity, body mass index, low back pain, knee osteoarthritis, cross-sectional study Background: Obesity is associated with an increased risk of diseases, including low back pain and knee osteoarthritis. Methods: This was a cross-sectional study that was conducted at the surgical outpatient department (SOPD) of the Usmanu Danfodiyo University Teaching Hospital (UDUTH), Sokoto, from October to December 2024. Data collection was conducted through a self-administered questionnaire and a face-to-face interview, following the random selection of patients. Data comprises demographics and variables such as height, weight, Body Mass Index (BMI), presence or absence of low back pain (LBP), and presence or absence of knee osteoarthritis (KOA). The BMI was obtained from the patient’s weight and height, and it was categorised into either normal (< 29.9kg/m2) or obese (> 30kg/m2). Results: The mean age of presentation was 46.49±14.23, and the most frequent age range was 40-59 years (48.2%). The male-to-female ratio was 1:1.02. The majority of the study subjects 78 (46.4%) were unemployed, with 61 (73.5%) being female. There were 73 (43.4%) obese subjects and 95 (56.5%) non-obese subjects. Those who presented with LBP were 75 (44.6%), KOA were 71 (42.3%), and those with both LBP and KOA were 30 (17.9%). Presence of obesity was statistically significant for females (p = 0.002; OR = 2.67), those with LBP (p = 0.007; OR = 2.299), KOA (p = 0.0001; OR = 3.43), and for the presence of both LBP and KOA (p = 0.001; OR = 3.86). Conclusions: The study findings are consistent with a high prevalence of low back pain and knee osteoarthritis among the obese subjects. Weight reduction improves symptoms and reduces the risk of complications.
Copyright (c) 2025 Altine Aliyu Nuradeen, Abdullahi Galadima Bello, Lukman Olalekan Ajiboye, Abdulazeez Mukhtar, Ariyibi Liad Abimbola, Khadijat Lawal, Okezie Chukwuebuka, Auwal Ibrahim, Nuhu Mustapha (Author) https://creativecommons.org/licenses/by-nc/4.0
Section: Clinical Image Keywords: Osteopoikilosis, spotted bones, melorheostosis, Leri's disease, Buschke-Ollendorff syndrome Osteopoikilosis is a rare, benign sclerosing bone dysplasia characterized by multiple, symmetric, well-defined sclerotic lesions primarily located in the epiphyseal and metaphyseal regions of long bones, pelvis, and hands. Although usually asymptomatic and incidentally discovered, its radiographic appearance may mimic osteoblastic metastases, leading to diagnostic confusion. Accurate recognition of imaging features is essential to avoid unnecessary invasive procedures and to provide appropriate patient reassurance.
Copyright (c) 2025 Süleyman Yalçın (Author) https://creativecommons.org/licenses/by-nc/4.0
An unusual case in total knee replacement surgery: alkaptonuric ochronosis
Section: Case Reports Keywords: Alkaptonuria, ochronosis, total knee arthroplasty, degenerative joint disease, surgery Alkaptonuria is a rare autosomal recessive metabolic disorder caused by homogentisic acid oxidase deficiency, leading to the accumulation of homogentisic acid and ochronotic pigmentation in connective tissues. Although it typically presents with dark urine and arthropathy in later life, it often remains undiagnosed until advanced degenerative changes occur. We report a 54-year-old male patient who underwent total knee arthroplasty due to advanced degenerative arthritis. Intraoperatively, unexpected black pigmentation of the articular cartilage and surrounding connective tissues was observed. The patient had no previous diagnosis of alkaptonuria and was managed with postoperative metabolic evaluation, dietary advice, and follow-up. Ochronosis may remain undetected until late adulthood and can be encountered incidentally during orthopedic procedures. Awareness of this rare entity is crucial for orthopedic surgeons to ensure accurate intraoperative assessment and appropriate postoperative management.
Copyright (c) 2025 Ahmet Yesevi Sarıaslan, Muhammed Ali Demir, Oğuz Temizyürek (Author) https://creativecommons.org/licenses/by-nc/4.0
Mid-term results of the posteromedial release in the treatment of relapse clubfoot
Section: Research Articles Keywords: Clubfoot, talipes equinovarus, recurrent, relaps, posteromedial release, Turco method Background: Clubfoot (CF) is one of the most common musculoskeletal deformities in newborns, with an incidence of 1–2 per 1,000 live births. While the Ponseti method is the gold standard for initial management and achieves over 90% initial correction rates, relapse remains a significant challenge, particularly in severe cases or in instances of poor compliance with orthotic use. Recurrent CF may require surgical intervention when conservative measures fail. Posteromedial release (PMR) is a well-established surgical technique designed to correct all components of the deformity in a single stage. Methods: This retrospective study included 16 patients (20 feet) with relapsed idiopathic CF who were treated with PMR after unsuccessful conservative or previous surgical treatment. All surgeries were performed by the same surgeon using Turco’s posteromedial approach. Clinical evaluation was conducted using the Pirani Score (PS) before and after surgery. Radiographic parameters including anteroposterior talocalcaneal angle (ATCA), lateral talocalcaneal angle (LTCA), and anteroposterior talo-first metatarsal angle (ATMA) were measured preoperatively and at final follow-up. Results: The mean patient age was 4.5 years, with a mean follow-up of 2.7 years. The mean PS improved significantly from 4.13 to 0.89 (p = 0.001). Radiological outcomes also showed significant improvement: ATCA increased from 21° to 23° (p = 0.047), LTCA from 20° to 30° (p = 0.002), and ATMA decreased from 45° to 11° (p = 0.001). In addition to PMR, the surgical procedures performed on the patients were as follows: cuboid decancellation, medial column lengthening, lateral cuneiform transfer of the tibialis anterior tendon, split tibialis posterior tendon transfer to the proneus brevis tendon, and multiple metatarsal osteotomies. Conclusions: PMR is a safe and effective surgical option for the treatment of relapsed congenital clubfoot when conservative methods fail. It allows for satisfactory mid-term correction both clinically and radiologically, with low complication rates and durable outcomes.
Copyright (c) 2025 Süleyman Yalçın, Kemal Somdaş, Fırat Ozan (Author) https://creativecommons.org/licenses/by-nc/4.0
Necessity of osteosynthesis in elderly patients with osteoporotic proximal femur fractures
Section: Clinical Image Keywords: Elderly patient, osteoporosis, proximal femur fractures, arthroplasty, proximal femoral nail, Girdlestone procedure Necessity of osteosynthesis in elderly patients with osteoporotic proximal femur fractures
Copyright (c) 2025 Hasan Safa Doğan, Fettah Deniz, Serhat Bozkurt (Author) https://creativecommons.org/licenses/by-nc/4.0
Demographic and clinical profiles of elementary versus associated acetabular fractures: insights from a single-center study
Section: Research Articles Keywords: Acetabular fracture, demographic data, elementary acetabular fractures, associated acetabular fractures, intensive care Background: Acetabular fractures present a complex spectrum of injuries, often categorized as simple (elementary) or associated (complex) based on the Judet and Letournel classification. Understanding whether this morphological distinction correlates with demographic or perioperative clinical parameters remains an area of active investigation. Methods: This retrospective study included 51 patients who underwent surgical treatment for acetabular fractures at our institution. Patients were grouped as elementary or complex based on fracture type. Demographic data, injury mechanism, operative time, hemoglobin change, transfusion requirements, intensive care unit (ICU) admission, hospital stay duration, and presence of concomitant injuries were recorded and compared between groups. Results: Of the 51 patients, 31 (60.8%) had elementary fractures and 20 (39.2%) had complex fractures. The mean age, injury mechanism, operative time, hemoglobin change, transfusion needs, and presence of concomitant injuries did not significantly differ between the two groups (p < 0.05). However, patients with complex fractures had a significantly longer hospital stay and higher ICU admission rates (p < 0.05). Concomitant injuries were observed in 56.9% of all patients, with similar distribution across fracture types. Conclusions: While elementary and complex acetabular fractures share similar demographic and perioperative profiles in terms of trauma mechanism, age, and operative parameters, complex fractures are associated with increased postoperative care requirements, including longer hospitalizations and greater ICU utilization. These findings suggest that fracture morphology itself may influence early postoperative outcomes independently of classic trauma severity indicators.
Copyright (c) 2025 Muhammed Ali Demir, Ahmet Yesevi Sarıaslan (Author) https://creativecommons.org/licenses/by-nc/4.0
Search trends of orthopedic terms in Turkey: a five-year time series analysis based on Google Trends
Section: Research Articles Keywords: Orthopedic terms, orthopedic health, Google Trends, digital information seeking Background: This study aimed to analyze digital search trends related to ten commonly used orthopedic terms in Turkey using Google Trends data. The objective was to investigate temporal variations and seasonal patterns in public interest regarding orthopedic health topics. Methods: Weekly search data from the Turkish region between May 2020 and May 2025 were obtained via Google Trends. The analyzed terms included meniscus, scoliosis, trigger finger, anterior cruciate ligament, hallux valgus, knee arthroplasty, hip arthroplasty, heel spur, carpal tunnel syndrome and tendinitis. Using the Python programming language, time series analyses were conducted to identify seasonal trends and peak search weeks. Results: The terms scoliosis and heel spur demonstrated the highest search popularity. Notably, scoliosis-related searches peaked during the summer months, while heel spur queries increased during the autumn. An upward trend in searches for sports related terms such as meniscus was observed during late summer and early fall. Conversely, search volumes for knee and hip arthroplasty, conditions typically associated with older age groups, remained relatively low, potentially reflecting lower digital health literacy among the elderly. Trigger finger was identified as the term with the lowest overall search popularity. Conclusions: Digital search behaviors related to orthopedic terms in Turkey exhibit temporal variation and seasonal patterns. These findings may inform the timing and strategic planning of public health awareness campaigns. Digital data sources such as Google Trends may serve as effective tools in health communication and digital epidemiology.
Copyright (c) 2025 Ömer Levent Karadamar, Mustafa Kara, Tarık Özdin, Ali Aydilek, Anıl Özgür (Author) https://creativecommons.org/licenses/by-nc/4.0
Bent intramedullary femoral nail: a rare injury following high-energy trauma
Section: Case Reports Keywords: High-energy trauma, bent, femoral fracture, intramedullary nail, deformation, peri-implant fracture High-energy trauma may result in catastrophic orthopedic injuries, particularly in patients with existing long bone implants. Peri-implant fractures pose unique mechanical and biological challenges, especially when implant integrity is compromised. We report a rare case of a young adult with a previously healed femoral shaft fracture treated with an antegrade intramedullary nail. Following a motor vehicle accident, the implant experienced severe axial deformation, with associated new fractures at the midshaft and distal femur. Despite undergoing emergency interventions, the patient succumbed due to multisystem trauma. This case illustrates a rare mechanical failure where the intramedullary nail’s structural limits were exceeded. Radiological and biomechanical analysis provides insights into the forces involved and the potential need for implant redesign in high-risk trauma settings.
Copyright (c) 2025 Abdurrahman Buğrahan Kişioğlu, Mustafa İştahlı, Zafer Karagöz (Author) https://creativecommons.org/licenses/by-nc/4.0
Catastrophic complication after total knee arthroplasty
Section: Case Reports Keywords: Catastrophic failure, complication, revision total knee arthroplasty, infection, amputation Infection is a significant complication in total knee arthroplasty (TKA) applications and has serious morbidity. Considering the difficulties in diagnosis and treatment of infections that develop after TKA, and the cost to patient health and national economies, preventing infection development would be a more rational approach. For this purpose, the patient’s risk factors should be determined and these risk factors should be optimized adequately and meticulously in the preoperative period. When an infection develops after TKA, the correct diagnosis should be made without delay and the most appropriate treatment method should be determined and applied to the patient. In determining the appropriate treatment approach; the patient’s age, the duration of symptom onset, concomitant diseases, bone quality, the status of the soft tissue cover and the type of microorganism should be taken into consideration. In this article, we present two cases, a 75-year-old woman and a 95-year-old woman, who underwent amputation due to infection after TKA. Transfemoral amputation was performed due to infection that developed after two-stage revision.
Copyright (c) 2025 Mustafa İştahlı, Ahmet Yesevi Sarıaslan, Oğuzhan Karaman, Hasan Onur Arık, Hüseyin Taşkoparan (Author) https://creativecommons.org/licenses/by-nc/4.0
Section: Editorial Dear Colleagues, We are most pleased to present you the first issue of our international and peer-reviewed journal that has just started its publication life. First of all, I would like to thank the editorial team of our journal and all the authors who contributed to our first issue. Considering the latest point that cumulative science has brought humanity to, we are happy to include in our journal any important findings, evidence-based information and experiences that may contribute to science on musculoskeletal system problems. See you in the next issue. Sincerely, Editor-in-Chief Fırat Ozan, MD, Prof,
Copyright (c) 2025 Fırat Ozan (Author) https://creativecommons.org/licenses/by-nc/4.0
Surgical treatment of trigger finger in adults
Section: Research Articles Keywords: Trigger finger, Tenosynovitis, hand surgery, open surgery, A1 pulley Background: Trigger finger (TF) is a common stenosing tenosynovitis characterized by painful catching or locking of the flexor tendon of the finger. In this study, we evaluated the results of patients diagnosed with TF who underwent A1 pulley release through open incision. Methods: Between January 2024 and April 2025, 211 patients (161 females, 50 males; mean age 59.4 ± 11.05 years; range, 18-86 years) with a diagnosis of TF who underwent open A1 pulley release were included in the study. Results: Involvement was on the right in 124 (58.7%) hands and on the left in 87 (41.2%) hands. The thumb was affected in 62 (50%), second finger in 9 (7.2%), third finger in 22 (17.7%), fourth finger in 28 (22.6%), and fifth finger in 3 (2.4%) of those with right hand involvement. In the left hand, 56 (64.4%) involved the thumb, 2 (2.3%) the second finger, 15 (17.2%) the third finger, 11 (12.6%) the fourth finger, and 3 (3.4%) the fifth finger. The mean follow-up period was 7.8 ± 4.9 (range, 1-16) months. Postoperative recurrence rates were as no recurrence in 206 (97.6%) patients and recurrence in 5 (2.4%) patients. Conclusions: The open release method we applied in the surgical treatment of TF is an effective and reliable method in that all anatomical structures, especially the A1 pulley, are visible, reducing the development of neurovascular complications and allowing the A1 pulley to be completely loosened.
Copyright (c) 2025 Tarık Özdin, Oğuzhan Deprem, Zafer Karagöz, Hüseyin Yetkin (Author) https://creativecommons.org/licenses/by-nc/4.0
Mid-term clinical outcomes of posterior spinal instrumentation surgery in thoracolumbar and lumbar curvatures of adolescent idiopathic scoliosis patients
Section: Research Articles Keywords: Adolescent idiopathic scoliosis, posterior spinal instrumentation, thoracolumbar curve, lumbar curve, SRS-24, Cobb angle Background: The aim of this study is to evaluate the mid-term surgical, clinical, and radiological outcomes of posterior spinal instrumentation (PSI) in patients diagnosed with adolescent idiopathic scoliosis (AIS) presenting thoracolumbar and lumbar curvatures. Methods: This retrospective study included 43 AIS patients who underwent posterior spinal fusion between 2020 and 2022 at two different centers. Patients with syndromic scoliosis or incomplete data were excluded. All procedures were performed by the same surgical team using a posterior approach under general anesthesia. A minimum of 10 and a maximum of 15 levels were instrumented from T2 to S1. In addition to standard instrumentation, vertebral column resection (VCR), pedicle subtraction osteotomy (PSO), and ponte osteotomies were applied in selected cases. Demographic data, operative parameters (duration, blood loss, transfusion), hospital stay, radiological outcomes (Cobb angle, T1 tilt, lowest instrumented vertebra [LIV] angle), pulmonary function test results (FVC, FEV1), and scoliosis research society 24-item questionnaire (SRS-24) were collected and analyzed. Results: The mean age of the patients was 14.83 ± 2.12 years, and the average follow-up period was 15 ± 7.74 months. The mean preoperative Cobb angle was 48.93°, which improved to 2.88° postoperatively. Postoperative improvements were also observed in T1 tilt and LIV angles. Pulmonary function tests revealed increased FVC and FEV1 values after surgery. The mean SRS-24 score was 96 ± 19, reflecting high patient satisfaction and functional recovery. Postoperative complications included cerebrospinal fluid leakage in three patients (treated successfully with epidural blood patch), pleural injury in one patient (repaired intraoperatively), and two cases of surgical site infection (managed with antibiotics, debridement, and hyperbaric oxygen therapy). No major neurological complications were recorded. Conclusions: Posterior spinal instrumentation is an effective and safe surgical technique for correcting spinal deformity and improving respiratory function in AIS patients with thoracolumbar and lumbar curves. The low complication rates and high SRS-24 scores observed in this study align with existing literature and highlight the reliability of PSI when performed with proper indication and planning. Early diagnosis and timely surgical intervention are crucial for achieving optimal outcomes in this patient population.
Copyright (c) 2025 Sabri Batın, Muhammed Ali Demir, Emre Bal (Author) https://creativecommons.org/licenses/by-nc/4.0
A rare disease to be considered in forefoot pain: Morton’s neuroma
Section: Case Reports Keywords: morton neuroma, intermetatarsal ligament, interdigital nerve, surgery, foot Morton's neuroma, one of the causes of severe forefoot pain, is not a true nerve-based tumoral pathology, contrary to what is expected. Diagnosis can be made with comprehensive anamnesis, detailed physical examination and descriptive radiological examinations. Various conservative and surgical treatment options are available. In this case report, a rare Morton's neuroma case is presented.
Copyright (c) 2025 Ali Pakirdasi (Author) https://creativecommons.org/licenses/by-nc/4.0
Closed subtalar dislocation: Long-term results
Section: Case Reports Keywords: talus, subtalar dislocation, avascular necrosis, foot injuries, joint dislocations Talus dislocation is a rare injury that occurs as a result of high-energy trauma and is generally associated with open-type fractures. Due to the talus’s extensive articular surface and limited vascular perforation area, the risk of avascular necrosis following trauma is considerably high. In this study, a case of closed medial talus dislocation resulting from a fall down the stairs is presented. The patient was immobilized with a short leg cast for two weeks after closed reduction and was followed up for three years. At the end of the follow-up period, no avascular necrosis was detected in the talus, and ankle movements were found to be normal.
Copyright (c) 2025 Süleyman Yalçın, MD, Kemal Somdaş, MD (Author) https://creativecommons.org/licenses/by-nc/4.0
The role of C-reactive protein to procalcitonin ratio in detecting early periprosthetic joint infections after total joint arthroplasty
Section: Research Articles Keywords: periprosthetic joint infection, total knee arthroplasty, C-reactive protein, procalcitonin, biomarker, early diagnosis Background: Periprosthetic joint infection (PJI) is a severe complication following total joint arthroplasty (TJA), leading to significant morbidity and mortality. Early diagnosis is crucial for effective treatment. The C-reactive protein / procalcitonin (CRP / PCT) ratio has emerged as a potential biomarker for the early detection of PJIs. This study aims to evaluate the utility of the CRP / PCT ratio in diagnosing early-stage PJIs following total knee arthroplasty (TKA). Methods: A prospective cross-sectional study was conducted on 51 patients who underwent unilateral primary TKA between April 2021 and August 2021. Patients were classified into three groups: (1) those who developed an infection within the first month (acute phase), (2) those who developed an infection within the first year, and (3) those without infection. Inflammatory markers, including CRP, PCT, erythrocyte sedimentation rate (ESR), and white blood cell (WBC) count, were recorded at multiple postoperative time points. The CRP / PCT ratio was calculated and analyzed for its diagnostic performance. Results: Patients in Groups 1 and 2 exhibited significantly higher CRP and PCT levels compared to Group 3. The CRP / PCT ratio was notably elevated in infected patients, particularly on postoperative days 3 and 28 (p < 0.05). Additionally, ESR levels remained elevated at 6 and 12 months in infected patients. These findings suggest that the CRP / PCT ratio may serve as an early indicator of PJI and offer superior diagnostic accuracy compared to each biomarker alone. Conclusions: The CRP / PCT ratio appears to be a promising biomarker for the early detection of PJI following TKA. Monitoring this ratio may facilitate timely intervention and potentially reduce morbidity associated with delayed diagnosis. Further studies with larger sample sizes are needed to validate these findings and optimize diagnostic protocols.
Copyright (c) 2025 Mehmet Ekici, Muhammed Ali Demir, Sait Dalyan (Author) https://creativecommons.org/licenses/by-nc/4.0