Orthopaedics & Traumatology

The use of platelet-rich plasma (PRP) injections in the treatment of musculoskeletal disorders has become widespread in recent years. This application, which is misrepresented as stem cell therapy in the popular language, is the application of enriched platelets obtained from the patient's own blood to the problematic area.

With the development of technology in the 960s, applications using cameras in many surgical procedures for joints have become widespread rapidly, depending on the principle of "first do no harm", which is the basic rule in medicine. Of course, the branch of orthopaedics and traumatology has benefited from this simultaneously.

Arthroscopic interventions have been performed especially for patients who have a sportsman identity and have orthopaedic disorders, so that they can regain their performance before the disease and return to their lives with short-term rest.

Although these camera-assisted applications are mostly used in knee and shoulder joint disorders in orthopaedics, with the advancement of medical science, it is also applicable in elbow, wrist, hip and ankle joints.

Various treatment modalities have been applied and developed for this disease and the search for a cure is still ongoing. Despite this, disease recurrence is still the main problem. Surgical methods can be summarised as open surgery, semi-open surgery and closed surgery (primary closure, flap closure). The appropriate method is chosen according to the surgeon's preference.

Kısa tanımı omurganın eğriliğidir. Bu, sadece ön-arka planda bakıldığında yanan olan eğrilikler değik aksiyel eksen rotasyonla birlikte olan deformitedir.

Doğumdan büyüme çağının sonuna kadar herhangi bir yaşta ortaya çıkabilir. Eğriliğin belirdiği döneme göre bir sınıflandırma yapılabilir.

• İnfantil idiyopatik skolyoz; 0-5 yaş arası görülür. Erkeklerde daha sıktır.
• Juvenil idiyopatik skolyoz; 3-10 yaş arası görülür. Kız-erkek oranı eşittir. Sıklıkla ilerleyici özelliğe sahiptir.
• Adolesan skolyoz; 10 yaş ile iskelet büyümenin tamamlanması arasında görülür. Kız çocuklarında daha sıktır.

Skolyozun büyük bir kısmı henğz nedenini tam olarak bilemediğimiz idiyopatik diye adlandırlan gruptandır. Bunun yanı sıra doğumsal omurga ve kaburga anomalileri ve nöromuskuler hastalıklarda da görülür. Ülkemizde ortalma %2-4 oranında görülen skolyoz, kı çocuklarında yaklaşık 10 kat daha fazladır.

It is one of the four important ligaments that provide stability of the knee joint. It is located in the knee as the immediate posterior neighbour of the anterior cruciate ligament. Although it is generally better known because ACL injuries are more common, ACL injuries are at least as serious as ACL injuries and require treatment.

The complaints are similar to those seen in ACL injuries. Knee swelling, pain and limitation of movement are the main complaints. Patients complain of a feeling of emptying in the knee. In the chronic period, there is not as intense instability as seen in ACL injury, but some patients describe a feeling of emptiness in the knee and fear of falling, especially when going up and down stairs. Patients with such complaints of loss of stability are candidates for surgery.

The blood supply to an area inside the joint is disturbed for some unknown reason. Over time, this area detaches and breaks off and falls into the space inside the joint. This event is called osteochondritis dissecans. Although osteochondritis dissecans, which is mostly seen in young people, can occur in any joint, it occurs more frequently in the knee joint. In a small area on the surface of the joint, the articular cartilage and some bone underneath it break off. This piece that remains free in the joint cavity is called a joint mouse.

This broken piece causes pain, swelling and most importantly joint locking. Osteochondritis dissecans should be investigated in every athlete who has not reached full skeletal maturity and has knee pain. Radiological examination shows classic osteochondritis dissecans findings.

Meniscus is a tissue that exists only in the knee joint. The answer to the question of what is the function of the meniscus is to provide spring movement between the tailbone and the poplar bone. Therefore, we have 2 separate menisci in the joint part of one of our knees in the shape of the letter C, inside and outside. These menisci act as a suspension and carry the weight of the body by balancing it.

There are two types of meniscus tears. The first is meniscus tears seen in the young age group. In this case, the patient must have a 100% trauma. The rate of meniscus tear in a young person who does not have trauma (knee rotation, severe impact, etc.) is very, very low. It can be seen more frequently in football players, skiers, basketball, tennis and volleyball players.

The second group is meniscus patients over the age of 50. In this group, meniscus tears can be due to many reasons and there is no need for trauma to occur. The rate of meniscus tear may increase with the weight of the patient.

Articular cartilage can be damaged in various ways. Over the years, it wears out, first softens, then fringes and sheds, and the bone underneath is exposed. This condition, popularly known as "calcification", is called osteoarthritis or arthrosis and is the result of wear and tear that occurs with age. This widespread wear is irreversible and requires first medication and then surgical treatment.

In adults, the ability of articular cartilage to heal is almost non-existent. Unlike other tissues in the body, articular cartilage does not regenerate itself after injury. Surgical interventions are absolutely necessary to create a healing response in cartilage.

It is a method applied in limited cartilage injuries smaller than 3cm2. After the damaged area is cleaned from cartilage residues, holes extending 5 mm apart and a few mm deep are drilled into the bone. Through these holes, a way is opened for the stem cells in the bone marrow to reach the damaged area.

Talus is a bone located in the ankle and 70% of its surface is covered with cartilage. It is involved in 90% of foot and ankle movements. Although it is rarely seen, it is the second most frequently fractured bone among the ankle bones (tarsal bones).

More than half of talus fractures are caused by high-energy trauma such as falls from height or motor vehicle accidents and are usually associated with dislocation and other fractures of neighbouring bones. Protrusion fractures of the talus are seen especially in athletes.

Kienböck's disease is a disease characterised by avascular necrosis (reduction or interruption of blood flow) of the lunate (crescent-shaped), one of the two most important bones of the 8 bones forming the wrist joint.

Although the etiology is not known exactly, it is thought to be highly probable trauma-induced. It is associated with manual work. Patients often have a history of old trauma or heavy repetitive loading. It is most common in 20-40 years of age and affects the dominant hand. It is more common in men.

Clinically; It is a picture that causes progressive pain and loss of function in the wrist joint. Patients present with localised insidious pain in the wrist joint, weakness and decreased wrist range of motion. Long-term complications include severe pain, neuropathy, calcification and loss of motion in the wrist.

Dupuytren's contracture disease; Even if the cause has not been fully answered, it is a disease that is more common in people who use their hands in intensive and demanding jobs, who are exposed to intense palm trauma, and in people with systemic diseases.

There are studies reporting that Dupuytren's contracture has a close relationship with conditions such as diabetes mellitus (diabetes), smoking, chronic lung diseases, intensive work in stressful jobs, epilepsy or frequent alcohol intake.

This disease causes limitation of movement in the fingers as a result of fibrosis and contracture of the palmar fascia under the skin in the palm of the hand.

For foot health, first of all, the right shoes suitable for the shape of the foot should be selected. Shoes that are not carefully selected and that make the foot uncomfortable adversely affect foot health and can lead to many health problems, such as compression disorders, deformities of the toes, ingrown toenails, and foot fungi. For this reason, when choosing shoes, we need to choose shoes that will not affect our foot health and that our feet will be comfortable, rather than colour and model.

Hip arthritis is the most common cause of hip pain. Unrecognised and untreated hip dislocations or structural disorders in the hip joint, which are overlooked without symptoms because they do not cause much trouble, prepare the ground for hip arthritis (coxarthrosis) at an advanced age.

What is hip arthritis?

Since the hip is the part of our body that carries the most weight, it is one of the joints that wears the most over time. This wear is popularly known as hip arthritis. This disease is mostly seen in people aged 40-45 years. Hip calcification is a wear and tear disease.

Arthrosis is a non-inflammatory rheumatism of the joints. It is characterised by pain in one or many joints. In addition to pain, there may be joint stiffness, noise from the joint, limitation of movement and deformities.

Arthrosis is diagnosed by examination.

Its degree is determined by X-ray films. There are 4 degrees of arthrosis radiographically. Grade 1 is the lightest, grade 4 is the heaviest.
Blood analyses are normal.
Surgical treatment is performed in severe cases that do not respond to medication and physiotherapy.