Background: The study was planned to analyze the internal and external anatomical findings of cardiac injuries and the presence of accompanying pulmonary injuries in intentionally inflicted thoracic injuries to swine models. Methods: We inflicted a penetrating heart injury in six Suis domesticus female swine models. Two cardiac injuries, one on the left paratracheal of 4th intercostal space and the other on the right side were inflicted on each model by the same researcher using a 20 cm long scalpel. All animals were then sacrificed for morphological evaluation. Results: After strikes to the left 4th intercostal space, external evaluation showed that 50% of the subjects suffered a single laceration and that 33% suffered multiple lacerations. Internal evaluation showed additional intracardiac injuries in all five subjects. However, the subject that suffered a single laceration on the outer surface of the heart had multiple internal injuries while another subject that had multiple outer lacerations had only one intracardiac injury. Only three subjects suffered cardiac injuries and only two out of those three with pulmonary injuries after right 4th intercostal intrusions. Conclusions: This experiment has shown that external evaluation of the heart tissue may not alone be sufficient to determine the extent of cardiac injuries and accompanying pulmonary injuries caused by penetrating thoracic injuries.

AMAÇ: Bu çalýþmanýn amacý, travmatik yaralarda enfeksiyon geliþiminin önlenmesinde oral antibiyotiklerin etkinliðini incelemektir.
GEREÇ VE YÖNTEM: Kýrk adet Wistar albino rat sekizerli beþ gruba ayrýldý. Ratlarýn sýrtýnda ezik yara modeli oluþturulduktan sonra, yaralar basit sütür ile kapatýldý. Staphylococcus aureus ATCC 29213 suþlarý enfeksiyon oluþturulmak için kullanýldý. Kontrol grubu dýþýndakilere oral gavaj ile beþ gün sefaleksin, amoksisilin-klavulanat, klaritromisin ve levofloksasini içeren antibiyotikler verildi. Yaralar, son tedavi verildikten sonra 18. saatinde kalitatif ve kantitatif olarak deðerlendirildi.
BULGULAR: Kantitatif deðerlendirmede amoksisilin-klavulanat, klaritromisin, sefaleksin, levofloksasin ile tedavi edilen gruplarda enfeksiyon tespit edilmedi. Guruplar arasýnda yaralardaki bakteri sayýsý açýsýndan anlamlý fark bulunmadý. Kantitatif inflamasyon bulgularýna göre deðerlendirildiðinde, medikasyon uygulanan dört grubun hiçbirinde hiperemi ve püy belirlenmedi. Endürasyon açýsýndan gruplar arasýnda anlamlý fark bulunmadý.
SONUÇ: Ratlarda Staphylococcus aureus ile oluþturduðumuz enfekte travmatik ezik yara modelinde; oral proflaktik antibiyotiklerin yara enfeksiyonunu önlemede etkin olduðu bulunmuþtur.

BACKGROUND: The objective of this study is to examine the effectiveness of oral antibiotics in the prevention of infection development in traumatic wounds.
METHODS: Forty Wistar albino rats were divided into five groups of eight animals. After the crushed wound model was made on the back of the rats, wounds were closed with a simple suture and Staphylococcus aureus ATCC 29213 strain was used to create infection. All rats apart from the controls were given oral gavage with antibiotics including cephalexin, amoxicillin-clavulanate, clarithromycin or levofloxacin for five days. Wounds were evaluated qualitatively and quantitatively on fifth day approximately 18 hours after the last treatment.
RESULTS: In the quantitative evaluation, no infection was observed in the treatment groups with amoxicillin-clavulanate, clarithromycin, cephalexin or levofloxacin. There was no significant difference on the numbers of bacteria found in the wounds among the groups. In terms of quantitative inflammation findings, no hyperemia or pus was detected in the groups that were given medication. Also no statistically significant difference was found among the groups in terms of induration.
CONCLUSIONS: Oral prophylactic antibiotics have been found to be effective in the prevention of wound infection in the traumatic crushed wound model infected with Staphylococcus aureus in rats.

Introduction: Traumatic brain injury is one of the major concerns of global public health, because it is the main cause of morbidity and mortality among young people. This study aimed at investigating possible association between the parameters of arterial blood gas (ABG) and outcome of patients with severe head trauma.
Methods: In this prospective study, 70 patients with severe head trauma were studied in Urmia Imam Khomeini hospital in a 18 month period of time. The parameters of ABG were documented within the first hours of admission and their correlation was investigated with Glasgow Coma Scale (GCS) and Glasgow Outcome Score (GOS). These parameters also were compared between expired and discharged patients.
Results: Seventy patients with severe head trauma including 60 males (85.7%) and 10 females (14.3%) with a mean age of 34.34±14.82 (range: 18-76) years were studied. The mortality rate during hospitalization was 38.6% (n=27). There was no significant correlation between the parameters of ABG and GCS score and GOS scores. There was no significant difference between the survivors and nonsurvivors in terms of mean value of ABG parameters.
Conclusion: ABG at the time of admission is not a significant predictor of outcome in patients with severe head trauma.

Amaç: Bu çalýþmanýn amacý yeni bir travma skorlama sistemi olan GAP skorunun Acil Servis (AS)’e baþ vuran major travma hastalarýnda mortalite tahmin gücünü deðerlendirmektir.
Yöntemler: Uludað Üniversitesi Týp Fakültesi Hastanesi AS’ ine baþvuran ≥18 yaþ majör travmalý 100 hasta çalýþmaya alýndý. Hasta verileri prospektif olarak deðerlendirilerek hastalarýn RTS, ISS, TRISS, MGAP ve GAP skorlarý hesaplandý.
Bulgular: Hastane içi mortaliteyi öngörmede, ISS, TRISS, MGAP ve GAP arasýnda pozitif yönde anlamlý bir korelasyon saptandý(p<0.0001). Travma skorlama sistemlerinin sýrasýyla kýsa dönem(24 saat) ve uzun dönem(4 hafta) mortalite tahmin oranlarý ROC analizinde Eðri Altýndaki Alan(EAA)- Area Under Curve(AUC); RTS için 0.727- 0.680, ISS için 0.863-0.816, TRISS için 0.945-0,911 MGAP için 0.970-0.938, GAP için 0.910-0.904 olarak bulundu. Hesaplanan travma skorlarýnýn hepsinin mortalite tahmin gücü anlamlý olarak bulundu(p<0.001). GAP’ýn hem AS’ de, hem de hastane içi mortaliteyi öngörmede istatistiksel olarak anlamlý bir þekilde(p=0.0001) seçici ve duyarlý olduðu belirlendi.
Sonuç: Bu sonuçlarla GAP skorunun travma hastalarýnda, hem sahada ve hem de baþvuru anýnda AS’ de kolayca hesaplanabilecek ve hastanýn mortalitesini öngörerek AS doktoruna fikir verebilecek bir skorlama sistemi olduðunu düþünmekteyiz.

Introduction: The purpose of the study is to detect the mortality predictive power of new Glasgow Coma Scale, Age, and Arterial Pressure(GAP) scoring system in major trauma patients admitted to the Emergency Department(ED).
Methods: A total of 100 major trauma patients admitted to Uludað University Faculty of Medicine ED who 18 years of age or were over were included in the study. In this prospective study, RTS, ISS, TRISS, MGAP and GAP scores of the patients were calculated.
Results: A significant positive correlation was established between ISS, TRISS, MGAP, and GAP in predicting in-hospital mortality(p<0.0001). Short-term(24 hour) and long-term(4-week) mortality prediction rates and Area Under Curve(AUC) in ROC analysis were 0.727- 0.680 for RTS, 0.863-0.816 for ISS, 0.945-0,911 for TRISS, 0.970-0.938 for MGAP, and 0.910-0.904 for GAP. All calculated trauma scoring systems revealed a significant mortality prediction power(p<0.001). GAP score was found statistically and significantly selective and sensitive in predicting both in-ED and in-hospital mortality(p=0.0001).
Conclusion: In major trauma patients, GAP score is an easily calculable system both in the field and at the time of admission in the EDs by providing emergency physicians with future decision-making schemes by means of mortality prediction of the patients.

Background
The harmful effects of smoking have been well documented in the medical literature for decades. To further the support of smoking cessation, we investigate the effect of smoking on a less studied population, the trauma patient.

Methods
All trauma patients admitted to the surgical ICU at the LAC+USC medical center between January 2007 and December 2011 were included. Patients were stratified into 2 groups - current smokers and non-smokers. Demographics, admission vitals, comorbidities, operative interventions, injury severity indices and APACHE II scores were documented. Univariate and multivariate modeling was performed. Outcomes studied were mortality, duration of mechanical ventilation and length of hospitalization.

Results
A total of 1754 patients were available for analysis, 118 (6.7%) patients were current smokers. The mean age was 41.4±20.4, 81.0% male and 73.5% suffered blunt trauma. Smokers had a higher incidence of congestive heart failure (4.2% vs. 0.9%, p=0.007) and alcoholism (20.3% vs. 5.9%, p<0.001) but had a significantly lower APACHE II score. After multivariate regression analysis, there was no significant mortality difference. Patients who smoked spent more days mechanically ventilated (Beta Coefficient: 4.96 [1.37, 8.55, p=0.007]).

Conclusion
Smoking is associated with worse outcome in the critically ill trauma patient. On average, smokers spent 5 days longer requiring mechanical ventilation than nonsmokers.

Amaç: Güneydoðu Anadolu Bölgesi’nde yaþayan Geriatrik hastalarda açýk göz yaralanmasýnýn etiyolojik faktörleri ve prognozu etkileyen faktörleri irdelemek.
Gereç-yöntem: 2008-2012 yýllarý arasýnda kliniðimizde açýk göz yaralanmasý nedeni ile opere edilen ve takibi yapýlan 65 yaþ ve üstü 45 olgu retrospektif olarak deðerlendirildi. Dosya bilgilerinden olgularýn yaþý, cinsiyeti, travmanýn oluþ nedeni ve þekli, görme derecesi, travmanýn oluþ zamaný ile cerrahi arasýnda geçen süre deðerlendirildi.
Bulgular: Hastalarýn ortalama yaþý 70.4±8.2 (65-90) yýl idi. Olgularýn %75.6 (34)’sý erkek ve %24.4 (11)’ü kadýn idi. Travmanýn oluþ þekli en sýk olarak odun çarpmasý ve ikinci sýklýkta býçak deðmesi olarak tespit edildi. Korneaskleral penetrasyon en sýk olarak izlendi. Görme keskinlikleri müracaat anýnda 2.26±0.65 logMAR ölçüldü. Travmaya en sýk eþlik eden komplikasyon iris prolapsusu ve hifema olarak izlendi. Ýlk görme keskinliði ile nihai görme keskinliði arasýnda korelasyon izlendi.
Sonuç: Geriatrik olgularda oküler penetran yaralanmalar daha az görülmekle beraber yara yeri iyileþmesi zorluðu ve deðiþen skleral rijidite nedeniyle daha kötü prognozlu olabileceði düþünüldü. Nihai görme keskinliðini etkileyen en önemli faktörün hastanýn müracaat anýndaki görme keskinliði olduðu görüldü.

Purpose: The purpose of this study was to evaluate the etiologic and prognostic factors of open eye injuries in geriatric patients in the Southeastern Region of Anatolia.
Materials: Forty-five geriatric patients who underwent surgery for an open eye injury in our clinic between the years of 2008-2012 were evaluated retrospectively. Age, gender, cause and the mechanism of the trauma, visual acuity (VA), and the time between the trauma and the surgery were obtained from files and evaluated.
Result: The mean age of the patients was 70.4±8.2(65-90) years. Thirty-four of the cases were male and 11 were female. The most frequent mechanism of trauma was a wood strike, while the second most common one was injury with a knife. Corneoscleral penetration was the most frequently observed trauma. The mean VA of the patients was 2.26±0.65 at admission, and was 1.53±0.99logMAR at the final evaluation. The most frequent complications of trauma were iris prolapse and hyphema. There was a significant correlation between the first and final VA.
Conclusion: Penetrating ocular injuries are seen less frequently among geriatric patients, and their prognosis may be worse due to less-efficient wound site healing and differences in scleral rigidity. The most important factor affecting the final VA measurement was the VA of the patient at admission.

Bu çalýþmada travmalý olgularda anatomik ve fizyolojik skorlama sistemleri (TRISS, RTS, ISS, NISS) birbiriyle karþýlaþtýrýlarak, mortalite ve morbiditeyi hangi travma skorunun en doðru ve güvenilir bir þekilde tahmin ettiðinin araþtýrýlmasý amaçlandý.
Çalýþmamýz, üniversite hastanesi acil servisi’ne 8 aylýk dönemde travma nedeniyle baþvuran 633 hastanýn kesitsel olarak incelenmesi yöntemiyle yapýldý. Çalýþmaya 16 yaþ ve üzerindeki künt ve penetran travmalý (trafik kazasý, ateþli silah yaralanmasý, delici-kesici alet yaralanmasý gibi) hastalar dahil edildi.
Hastalarýn geliþ anýndaki travma skorlarý (ISS, NISS, RTS, TRISS) hesaplandý. Mortalite tahmini için ortalama travma skoru hesaplandý ve p deðeri tümü için eþit bulundu(p = 0.001).Travma skorlarý yoðun bakým ünitesinde yatýþ süresi için analiz edildiðinde, NISS, RTS ve TRISS skorlama deðerleri anlamlý (p=0.048, p=0.048 and p=0.017 sýrasýyla), ISS skorlamasý anlamlý deðildi (p = 0.257). Sadece TRISS skorlama sisteminin yoðun bakým ünitesi hastalarýnda mekanik ventilasyonda kalma süresini tahmin etmede iyi bir belirleyici olduðu bulundu(p = 0.01).
Sonuç olarak hastaneye yatýþ gereksinimini ve yoðunbakýmda yatýþ gereksinimini anatomik skorlama sistemleri olan NISS ve ISS’nin; yoðunba kýmda yatýþ süresi ve mekanik ventilatörle ilgili süreci ise anatomofizyolojik skor olan TRISS’ýn daha iyi öngördüðünü tesbit ettik.

In this study, we compared the anatomical and physiological scoring systems (TRISS, RTS, ISS, and NISS) to each other, to find out the most accurate and reliable trauma score for the risk classification of morbidity and mortality among the trauma patients.
This is a cross-sectional study, which included 633 patients who admitted to our University Hospital Emergency Department during an 8-month period due to trauma. All blunt and penetrating trauma (traffic accident, assault, etc.) patients above sixteen years were included.
Arrival time trauma scores (ISS, NISS, RTS, and TRISS) of the patients were calculated. Mean trauma score for the mortality prediction was calculated and the p value was equal for all (p=0.001). Trauma scores were also analyzed for the hospitalization time in intensive care unit. While NISS, RTS and TRISS values were significiant (p=0.048, p=0.048 and p=0.017 respectively), ISS value was not significiant (p=0.257) for predicting the intensive care unit hospitalization time. Only TRISS was a good predictor for the mechanically ventilation time in intensive care unit patients (p=0.01).
In conclusion, we determined that the anatomical trauma scores (NISS, ISS) predicted the hospitalization and intensive care unit necessities better, whereas TRISS, an anatomo-physiological trauma score, defined the intensive care unit hospitalization and mechanically ventilation time better.

Background: The purpose of the present study was to retrospectively analyze the patients’ data presented with Fournier’s gangrene, to compare obtained data with the literature and to investigate the role of ‘Trauma’ in the etiopathogenesis.
Methods: A retrospective study was conducted on 126 patients with Fournier’s gangrene that consulted to our department.
Results: There were 76 male and 4 female patients. The mean age of the patients was 53.5±13.6 years. The most common presentation of patients was swelling (n=74). The scrotum has been shown to be the most commonly affected area in the patients (n=75). Diabetes mellitus was the leading predisposing factor and trauma was the leading responsible cause for Fournier’s gangrene. Escherichia coli was the most frequently identified microorganism (n=43, 53.75%). Primary closure was the most common technique used for all patients. Three patients exhibited a mortal course due to sepsis and multi-organ failure.
Conclusion: Fournier’s gangrene still has a high mortality rate. Rapid and correct diagnosis of the disease can avoid inappropriate or delayed treatment and even death of the patient. The healthcare professionals should be aware that any trauma in the perineal region could lead to Fournier’s gangrene.
Keywords: Fournier’s gangrene; trauma; reconstruction.

Amaç: Bu çalýþmada ayak bileði burkulmasý olan gebelerde tanýya ulaþmada ve tedavide güvenli, standart bir yol göstermeyi ve uyguladýðýmýz cerrahi tedavinin sonuçlarýný deðerlendirmeyi amaçladýk.
Gereç ve Yöntem: Kasým 2005- Ocak 2013 tarihleri arasýnda ayak bileði burkulmasý þikayeti ile baþvurup Ortopedi Ve Travmatoloji Kliniði’ ne konsülte edilen 96 gebe retrospektif olarak deðerlendirildi. Ottawa Ayak Bileði Kriterleri(OABK) kullanýlarak hastalarda görüntüleme yöntemi gereði olup olmadýðý belirlendi. Radyolojik inceleme olarak yüzeyel usg, direkt grafi(0,6 mGy’ yi geçmeyecek dozda sadece mortis grafisi), mrg(sadece T1 ve STIR) ve ameliyathanede 0,8 mGy/s dozunda, 0,4 ms’ lik tek çekimler þeklinde floroskopi kullanýldý. Cerrahi tedavi uygulanan hastalar gebeliklerinin akýbeti, cerrahinin sonuçlarý ve AOFAS Skoru ile deðerlendirildi
Bulgular: 96 hastanýn 44’ ü (%45,8) bir görüntüleme yöntemine baþvurma gereði duyulmadan konservatif yöntemlerle tedavi edildi. Geri kalan 52 hastanýn 17’ sinde(%17,7) usg, 24’ ünde(%25) mrg, 4’ünde(%4,1) direkt grafi ve 7’ sinde(%7,2) usg+mrg ile tanýya ulaþýldý. Bu tür hastalarda izlenebilecek bir taný ve tedavi algoritmasý oluþturuldu. Ameliyat sonrasý hastalarýn hiçbirinde gebeliðin sonlandýrýlmasý gereði duyulmadý ve cerrahi tedavinin gebelikleri üzerinde yol açtýðý bir komplikasyona rastlanmadý. Cerrahi tedavi uygulanan hastalarýn ortalama AOFAS Skoru 83(65-100) bulundu.
Sonuç: Gebelikte ayak bileði burkulmalarýna yaklaþýmda literatürde standardizasyon yoktur. Çalýþmamýzda uyguladýðýmýz taný ve tedavi algoritmasý bu açýdan faydalý olabilir. Cerrahi tedavide, dikkatli hazýrlýk ve teknik ile iyi sonuçlar alýnmaktadýr

Background: The aim of this study is to suggest a safe management method for diagnosing and treating of ankle disorders in pregnant patients.
Methods: Between November 2005-January 2013, 96 pregnant patients with ankle disorder who were consultated to department of orthopedics and traumatology, were evaluated retrospectively. The Ottawa ankle rules were used for the need of radiologic evaluation. Radiological procedures: Surface USG, X-ray (0,6 mGy, mortise view), MRI (T1 and STIR) and fluoroscopy with 0,8 mGy/s doses 0,4 ms one shot views in surgery room. The results of operated patients were evaluated with AOFAS scoring system.
Results: 44 (%45,8) patients were treated with conservative methods and there was no need for radiological evaluation. USG was used for 17 (%17,7), MRI for 24 (%25), X-ray for 4 (%4,1) and both USG and MRI for 7 (%7,2) patients for diagnosing. An algorithm was composed for diagnosing and treating pregnant patients with ankle disorders. There were no complications of radiological and surgical procedures over pregnancy. The AOFAS score was 83 (65-100) in operated patients.
Conclusion: There is no standard management method for diagnosing and treating pregnant patients with ankle disorders. The algorithm we present may be useful. Good results can be obtained with a appropriate preparation and surgical technique.

Amaç: Bu çalýþmada; pediatrik hastalarda gözlenen sýcak süt yanýklarýnýn incelenmesi ve elde edilen verilerin literatürle karþýlaþtýrýlmasý amaçlanmýþtýr.
Gereç ve Yöntem: Erciyes Üniversitesi Týp Fakültesi Yanýk Ünitesi’nde hospitalize edilmiþ 159 pediatrik hasta üzerinde 14 yýllýk geriye dönük bir çalýþma yapýlmýþtýr.
Bulgular: Hastalarýn 81’i erkek ve 79’u kýz olup erkek: kýz oraný 1.03: 1’di. Hastalarýn yaþ ortalamasý 2.7±1.6’ydý. Hastalarýn %59.7’si imersiyon, %40.3’ü ise sütün üzerine dökülmesi/sýçramasý sonucu yaralanmýþtý. Hastalarýn ortalama yanýk yüzey alaný %18.6±10.8’di. Hastalarýn %22’sinde orta derecede yanýk travmasý varken; %78’inde ciddi yanýk travmasý mevcuttu. Hastalarýn %49’unun tedavisi debritman ve otoderi grefti ile gerçekleþtirildi. Yanýk ünitemizde ayný dönem içerisinde hospitalize edilmiþ 542 sýcak su yanýklý hastanýn mortalite oraný %1.5 iken, 159 sýcak süt yanýklý hastanýn mortalite oraný ise %5.6’ydý.
Sonuç: Sýcak süt yanýklarýnýn, su, kahve ve çay gibi içeriðinde yað olmayan sýcak sývýlar nedeniyle meydana gelen yanýklarýndan ayrý olarak deðerlendirilmesi gerekmektedir. Sütün sahip olduðu yüksek yað içeriði nedeniyle kazanmýþ olduðu fiziksel ve kimyasal özellikler dokularda daha fazla tahribata neden olmakta ve bu nedenle mortalite ve morbidite oranlarý daha fazla olmaktadýr.

Backround: The aim of this study was to investigate the hot milk burns among the pediatric patients and to compare our experiences with similar studies in the literature.
Methods: A 14-year retrospective study was conducted on 159 pediatric patients with hot milk burn who hospitalized at the Burn Unit of Erciyes University Medical Faculty.
Results: There were 81 male and 78 female patients with a male to female ratio of 1.03: 1. The mean age of the patients was 2.7±1.6 years. The initial injury was immersion in 59.7% of the patients and spillage in 40.3%. The mean burned body surface area of the patients was 18.6±10.8%. Twenty-two percent of the patients had moderate and 78% had major burn trauma. Forty-nine percent of the patients received burn wound debridement and reconstruction with autoskin grafts. Our burn unit’s mortality rate was 1.5% among 542 pediatric patients with hot water and 5.6% among 159 pediatric patients with hot milk burn during the same period respectively.
Conclusion: Hot milk burns should be considered as separately from other hot liquid burns which do not contain fat such as water, tea and coffee. Physical and chemical properties of milk because of its high content of fat give rise to more tissue destruction, increased morbidity and mortality.

Klavikula kýrýklarýnýn tedavisinde kabul gören yaklaþým konservatif yöntemler olmakla beraber deplase ve parçalý kýrýklarda cerrahi tedavi önerilmektedir. Cerrahi tedavide ise açýk repozisyon ve plak vida uygulamalarý yaygýn olarak kullanýlmaktadýr. Çalýþmamýzda Edinburg tip2b klavikula diafiz kýrýðý olan,açýk repozisyon ve anatomik kilitli klavikula plaðý ile tedavi edilmiþ olan 31 hastanýn radyolojik ve klinik sonuçlarý retrospektif olarak deðerlendirildi.. Çalýþmaya alýnan 31 hastanýn 32 klavikula cisim kýrýðýnýn 17'si sað ve 15'i sol taraf idi. Olgularýn 24'ü erkek, 7'si kadýn ve ortalama yaþ 28 (15-62) yýl idi. Hastalarýn ortalama takip süreleri 12,3 (6-36) ay ve kaynama 15,2 (12-20) hafta idi. Tip 2 b2 kýrýðý olan hastalardan üç tanesinde kaynama süresi 12 haftadan uzun idi. Hastalarýn kaynama sonrasýndaki Constant skorlamasý 92 (85-98) ve DASH deðerleri 9 (2-20) olarak belirlendi. 32 klavikula kýrýðýnýn üç (%9)'ünde implant baðlý sorun belirlendi.
Klavikula cisim kýrýklarýnýn cerrahi tedavisinde anatomik kilitli klavikula plaklarý ile fonksiyonel ve radyolojik olarak baþarýlý sonuçlar alýnabilmektedir.

Although conservative measures are the general choice of treatment for clavicle fractures; surgery is advised for displaced and multifragmentary fractures. Open reduction and osteosynthesis with plate-screw combination are used widely as surgical treatment options. In our study, there were 21 patients with Edinburgh Type IIB clavicle middiaphysal fractures treated surgically with locked anatomical clavicle plate. Among those 31 patients and 32 clavicle middiaphysal fracture, Seventeen clavicle fracture were right-side and fifteen were left side. 24 of them were males, 7 of them were females and the mean age was 28 (15-62) years. The mean follow up period was 12,3 (6-36) months and healing time 15,2 (12-20) weeks. 3 patients with type IIB fracture had a healing time longer than 12 weeks. As the result of healing patients’ mean Constant score was 92 (85-98) and DASH score 9 (2-20). There has been a problem due to the implant detected in 3 (9%) patients.
Succesfull funtional and radiographic results can be achieved as a result of the surgical treatment of the clavicle middiaphysal fractures wih locked anatomical plates.

Ergotamine toxicity is an important and rare condition including tachycardia, arterial spasm which occurring as a result of accidental overdosing or drug interactions. We assessed the consequences of delayed diagnosis of peripheral arterial vasoconstriction occurring after simultaneous macrolide use by a 35-year-old woman using an ergot-derived drug for migraine. Diagnosis of ergotamine intoxication begins with suspicion. Interventional radiologists and surgeons should be aware of this acute dangerous condition.

Radiofrequency ablation (RFA) has been established as the mainstay therapy for hepatocellular carcinoma (HCC) in patients deemed unsuitable for surgical resection. However, delayed diaphragmatic hernia can occur as a result of this procedure. There have been only seven other cases reported on this complication in the literature. Considering the recent growth in the popularity of the procedure, it is predictable that the incidence of the diaphragmatic hernia, due to RFA, will definitely increase. This case report is therefore vitally important as it increases clinical awareness of this currently rare complication, which could lead to improved survival rates in these patients. This case concerns an 81-year-old Asian man with a past medical history of cirrhosis and HCC (segment IV and VIII) who presented with a delayed, right diaphragmatic hernia and strangulated ileus 18 months after his original RFA procedure. It is important to implement extra measures to limit the risk of diaphragmatic, thermal injuries when RFA is performed. In particular, gastroenterologists, surgeons and accident and emergency staff should all be aware of this complication proceed with rapid diagnosis and management when patients, who previously underwent RFA, present with acute abdominal pain.

INTRODUCTION: Sacral fractures are generally accompanied pelvic ring fractures. They rarely develop in isolated form. However, sacroiliac dislocation without sacral fracture is extremely rare.
METHOD: One sacroiliac dislocation without sacral fracture was operated. Lumbopelvic stabilization was applied using iliac wing plates. The case was evaluated according to demographic data and VAS, ASIA and Oswestry scales.
CONCLUSION: Considering the role of the sacrum, which transmits the load of the entire spine to pelvis, for ensuring the mechanic stability of the spine, meticulous care must be given when evaluating the patients with sacral and pelvic fractures. Very serious spinopelvic instability is present in sacroiliac dislocations even without sacral fractures. Caudal migration of the sacrum together with the cranial migration of the iliac wings can cause serious pelvic imbalance and difficulties in walking and maintaining the standing position. Aggressive stabilization and fusion are required, and these must be performed in the early period.

In this case report, we would like to present a 36-year-old male patient injured in a street fight without any disease previously known, who was accepted to our Intensive Care Unit with the preliminary diagnoses of minimal cerebral contusion and aspiration pneumonia however by the physical examination, clinical and laboratory findings, was diagnosed as thyroid storm due to trauma.
In the current literature, only a few cases reported showing thyroid storm induced by trauma and we would like to present the clinical features and management of this life threatening endocrinological emergency.

Cardiac tamponade (CT) is a clinical entity characterized by hemodynamic insufficiency resulting from increased intrapericardial pressure due to accumulation of contents such as serous fluid, blood, and pus. CT is a treatable cause of cardiogenic shock which can be fatal unless diagnosed promptly. Dyspnea, chest pain, hypotension, tachycardia, pulsus paradoxus, raised jugular venous pressure, muffled heart sounds, decreased electrocardiographic voltage and enlarged cardiac silhouette on chest X-ray are the major clinical signs in CT. Idiopathic or viral pericardititis, iatrogenic trauma during percutaneous coronary interventions or CABG, external trauma, malignancies, acute or chronic kidney disease, collagen vascular diseases, tuberculosis, radiation on chest wall, hypothyroidism and aortic dissection are the etiologic factors. Herein we present a case of surgically treated CT which was diagnosed in the third day of ingestion of a sewing needle.