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    Recurrent anterior shoulder instability: Why do the patients decide on the treatment late?
    (2021) Karsli, Burcin; Parildar, Ramazan; Tekin, Sezgin Bahadir
    Aim: Anterior shoulder instability is a condition that frequently occurs in young and active patients and reduces quality of life. In their daily practice, the authors have noticed that patients presenting to their clinic with anterior shoulder instability took longer to decide on treatment compared with reports in the literature. The aim of the present study was to investigate the reasons why patients who experience recurrent anterior shoulder instability delay treatment decisions in Turkey. Materials and Methods: A total of 49 patients, who underwent arthroscopic repairs due to anterior shoulder instability between March 2015 and January 2019, were administered a survey prepared by the authors at regular patient follow-ups. Results: Patients participating in this study experienced an average of 21.78 (range, 2–100) dislocations in the period from the first episode of dislocation to surgery. The mean time from the first dislocation to surgery was 5.5 years (range, 1–266 months). Academic degree, living area, distance from hospital, first dislocation time, first episode to surgery time, dislocation count, operation advicing time after dislocation, patient decision after dislocation, type of surgery were statistically insignificant. Conclusion: Patient responses to the survey questions indicated that delayed decisions for surgery resulted from concerns with absence from work. We believe that patients’ inclination to delay surgery due to their work and financial concerns are understandable considering existing conditions in Turkey. The high number of patients examined daily in our country may be the most important reason for incomplete information of patients.
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    Tibiotalocalcaneal nailing in ankle arthrodesis
    (2020) Karsli, Burcin; Tekin, Sezgin Bahadir
    Aim: Our objective in this study was to present the results of the patients who had retrograde tibiotalocalcaneal implants for different etiological causes. Ankle and forefoot deformities and traumatic osteoarthritis are important problems affecting the quality of life of patients. Many implants have been tried to prevent and fix these deformities. Tibiotalocalcaneal arthrodesis with retrograde intramedullary nail is one of these implants. While there are many studies in the literature on other systems, the low number of studies on intramedullary implants and low number of patients in this patient group encouraged us to undertake this study using the available data. Material and Methods: Twelve patients who had intramedullary tibiotalocalcaneal nail installation between January 2009 and May 2013 were retrospectively evaluated. In their etiologies, 33.33% of the patients (n=4) had firearm-related injuries, 33.33% had (n=4) trauma-related arthrosis, 16.67% had (n=2) diabetic neuropathy, and 16.67% had rheumatoid arthritis. Patients were evaluated based on pre- and post-operative American Orthopedic Foot and Ankle (AOFAS) scores.Results: Union was observed in all patients. The average union duration was found at 65.8 (45–124) days. Two of the patients who had arthrodesis due to firearm injuries had deep infections, and one had a superficial infection. No complications other than infections were observed. The average AOFAS pre- and post-operative scores were 48.7 (31–80) and 68.5 (40–96).Conclusion: As a result, ankle arthrodesis with intramedullary nail is a useful and efficient method for patients with severe underlying arthritis and can produce good results.