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Item Hindfoot Valgus following Interlocking Nail Treatment for Tibial Diaphysis Fractures: Can the Fibula Be Neglected?(HINDAWI LTD, 2014-01-01) Uzun, Metin; Kara, Adnan; Adas, Mujdat; Karslioglu, Bulent; Bulbul, Murat; Beksac, BurakPurpose. We evaluated whether intramedullary nail fixation for tibial diaphysis fractures with concomitant fibula fractures (except at the distal one-third level) managed conservatively with an associated fibula fracture resulted in ankle deformity and assessed the impact of the ankle deformity on lower extremity function. Methods. Sixty middle one-third tibial shaft fractures with associated fibular fractures, except the distal one-third level, were included in this study. All tibial shaft fractures were anatomically reduced and fixed with interlocking intramedullary nails. Fibular fractures were managed conservatively. Hindfoot alignment was assessed clinically. Tibia and fibular lengths were compared to contralateral measurements using radiographs. Functional results were evaluated using the Knee Injury and Osteoarthritis Outcome Score (KOOS) and the Foot and Ankle Disability Index Score (FADI). Results. Anatomic union, defined as equal length in operative and contralateral tibias, was achieved in 60 fractures (100\%). Fibular shortening was identified in 42 fractures (68\%). Mean fibular shortening was 1.2 cm (range, 0.5-2 cm). Clinical exams showed increased hindfoot valgus in 42 fractures (68\%). The mean KOOS was 88.4, and the mean FADI score was 90. Conclusion. Fibular fractures in the middle or proximal one-third may need to be stabilized at the time of tibial intramedullary nail fixation to prevent development of hindfoot valgus due to fibular shortening.Item Minimal invasive fixation of distal tibial fractures does not result in rotational malalignment: A report of 24 cases with CT imaging(TURKISH ASSOC TRAUMA EMERGENCY SURGERY, 2017-01-01) Sonmez, Mehmet Mesut; Gulabi, Deniz; Ugurlar, Meric; Uzun, Metin; Sarban, Sezgin; Seker, AliBACKGROUND: Tibial torsion is rotation of the proximal versus the distal articular axis in the transverse plane. This study used computed tomography (CT) to examine rotational malalignment in the crus following use of minimally invasive plate osteosynthesis (MIPO) technique in distal tibial fractures and evaluated effect of rotational difference on clinical outcomes and VAS scores. METHODS: Analysis of 24 patients who were operated on for closed distal tibial fracture with MIPO technique between 2010 and 2012 was conducted. Malrotation was defined as rotational difference > 10 degrees. Operated knees were evaluated with 0.5-mm, fine-cut, 3-dimensional CT scan performed in cooperation with radiology department. Side-to-side difference in tibial torsion angle > 10 degrees was considered significant degree of malrotation. All patients were assessed clinically (visual analogue scale {[}VAS] and American Orthopaedic Foot and Ankle Society {[}AOFAS] scores) and radiologically at final visit. RESULTS: Mean follow-up period was 20.00 +/- 9.46 months (range: 18-51 months). Mean VAS score was 2.58 +/- 0.83 (range: 1-4) and mean AOFAS score was 87.50 +/- 4.05 (range: 78-93). Mean tibial rotation angle was 31.54 +/- 6.00 degrees (range: 18-45 degrees) on healthy side and 32.00 +/- 6.24 degrees (range: 10-43 degrees) on the operated side. No statistically significant difference was determined (p > 0.05). CONCLUSION: Use of intraoperative fluoroscopy, cable technique, and uninjured extremity as reference, can reduce incidence of rotational malalignment of distal tibial fractures treated with MIPO.Item Medical photography: principles for orthopedics(BIOMED CENTRAL LTD, 2014-01-01) Uzun, Metin; Bulbul, Murat; Toker, Serdar; Beksac, Burak; Kara, AdnanBackground: Medical photography is used clinically for patient evaluation, treatment decisions, and scientific documentation. Although standards for medical photography exist in many branches of medicine, we have not encountered such criteria in publications in the area of orthopedics. Purpose: This study aims to (1) assess the quality of medical images used in an orthopedic publication and (2) to propose standards for medical photography in this area. Methods: Clinical photographs were reviewed from all issues of a journal published between the years 2008 and 2012. A quality of clinical images was developed based on the criteria published for the specialties of dermatology and cosmetic surgery. All images were reviewed on the appropriateness of background, patient preparation, and technique. Results: In this study, only 44.9\% of clinical images in an orthopedic publication adhered to the proposed conventions. Conclusions: Standards have not been established for medical photography in orthopedics as in other specialty areas. Our results suggest that photographic clinical information in orthopedic publications may be limited by inadequate presentation. We propose that formal conventions for clinical images should be established.Item Assessment of the Quality and Reliability of the Information on Rotator Cuff Repair on YouTube(ELSEVIER MASSON, CORP OFF, 2020-01-01) Celik, Haluk; Polat, Omer; Ozcan, Cagri; Camur, Savas; Kilinc, Bekir Eray; Uzun, MetinIntroduction: YouTube has become a common health information source for patients. Recent studies have determined that videos on YouTube contain misleading and inappropriate information for different medical conditions. The aim of the present study was to assess the quality and reliability of videos pertaining to rotator cuff (RC) repair surgery. Hypothesis: YouTube users prefer watching videos with high educational quality which are provided by physicians. Material and methods: A search was performed using keywords ``rotator cuff surgery{''} and ``rotator cuff repair{''} on YouTube and the first 100 videos for each keyword were analyzed. Video source, time since upload, duration, and number of views, likes, and dislikes were recorded. Video popularity was reported using the video power index (VPI) and view ratio. Video educational quality was measured using the recognized DISCERN, the Journal of the American Medical Association (JAMA) score and a novel RC-specific score (RCSS). Results: Among the 200 videos identified, 67 were included. The mean duration was 7.7 minutes and the mean number of the views was 147,430. Videos uploaded by a physician had significantly higher DISCERN, JAMA, and RCSS (p < 0.001). While the main video source was physicians (48\%), the most popular videos were uploaded by patients and commercial websites, according to the VPI and view ratios. The number of likes, view ratios, and VPI were negatively correlated with each score. There were negative correlations between duration and VPI scores, and positive correlations with DISCERN, JAMA score, and RCSS. Animated videos showed significantly lower results for all quality scores (p <0.05), while their VPI was significantly higher (p < 0.01). Discussion: Online information on RC repair surgery provided by YouTube was low quality, despite being mostly uploaded by physicians and having relatively higher quality scores. YouTube users prefer watching low quality videos which were provided by patients and commercial websites. (C) 2019 Elsevier Masson SAS. All rights reserved.Item Comparison of magnesium versus titanium screw fixation for biplane chevron medial malleolar osteotomy in the treatment of osteochondral lesions of the talus(SPRINGERNATURE, 2020-01-01) Uzun, MetinItem Letter to the editor `Intramedullary percutaneous fixation of metacarpal fractures: screw versus connected K-wires'(SPRINGERNATURE, 2022-01-01) Uzun, MetinItem Letter to the editor `Augmented compression in exchange nailing for femoral and tibia non-unions accelerates time to radiographic union'(SPRINGERNATURE, 2022-01-01) Uzun, Metin