Although, osteochondroma is the most common bone tumor, metacarpal involvement is quite uncommon ... more Although, osteochondroma is the most common bone tumor, metacarpal involvement is quite uncommon and usually accompanies multiple hereditary exostoses. Herein, we described a patient with solitary ostechondroma of the fourth metacarpal bone, and discussed the differential diagnosis of bony spurs that can be seen in hand.
Background and objectives: The purpose of this retrospective study was to compare the clinical an... more Background and objectives: The purpose of this retrospective study was to compare the clinical and radiological outcomes of patients who underwent biplane chevron medial malleolar osteotomy (MMO) for osteochondral lesions of the talus (OLT), fixed with either magnesium (Mg) or titanium (Ti) screws. Materials and Methods: A total of 22 patients (12 male, 10 female) with a mean age of 40.6±12.5 years (range, 18-56 years) who underwent MMO for OLT treatment were included in this retrospective study. Of the 22 patients, MMO was fixed with bioabsorbable Mg screws (Alloy: MgYREZr) in 11 patients, and in the remaining 11 patients (one bilateral) MMO were fixed with Ti screws. All patients were followed up for at least one year with a mean of 20.7±8.9 months (range, 12–49 months). The American Orthopedic Foot and Ankle Society (AOFAS) scale and the visual analog scale (VAS) were used to evaluate the clinical results. Union of the osteotomy, postoperative displaceme...
Although fractures of the midfoot are common, cuneiform fractures are rarely seen. These fracture... more Although fractures of the midfoot are common, cuneiform fractures are rarely seen. These fractures are frequently associated with other fractures of the midfoot such as Lisfranc fracture-dislocations. However, isolated cuneiform fractures are extremely rare, with few cases reported in the relevant literature. Herein, the authors report 2 cases of isolated medial cuneiform fractures. One of the patients was treated with headless screw fixation due to displacement in fracture configuration, and the other was treated conservatively. Fractures were united without any complication in both patients. In this report, the authors discuss the mechanism of injury, diagnostic challenges, and treatment options of isolated medial cuneiform fractures. Level of Evidence: Therapeutic, Level IV
Os paracuneiforme is an extremely rare accessory ossicle located at the medial aspect of the medi... more Os paracuneiforme is an extremely rare accessory ossicle located at the medial aspect of the medial cuneiform bone. Although foot pain secondary to accessory ossicles is well known, symptomatic os paracuneiforme that requires surgical excision is rarely reported in the current literature. Herein, a 12-year-old boy with symptomatic os paracuneiforme is presented, and its clinical and imaging findings as well as the treatment are discussed.
The purpose of this study is to compare the efficacy of autologous blood (ABI) versus corticoidst... more The purpose of this study is to compare the efficacy of autologous blood (ABI) versus corticoidsteroid (CS) injections for the treatment of lateral epicondylitis (LE). Eighty patients were randomly allocated into two treatment groups either autologous blood or methylprednisolone acetate injections. Patients were evaluated using visual analogue scale (VAS), patient rated tennis elbow evaluation (PRTEE) and hand grip strength (HGS) measurements. The CS injection group showed a significant decrease in pain compared with ABI regarding VAS in Day 15 (p=0.0001) and this temporary superior results continued till the Day 30 (p=0.0001). At the Day 90 and Day 180 VAS score returned towards preinjection state in CS group, however, VAS score in ABI continued to decline and became superior compared to CS group (p=0.0001, p=0.0001). Similarly, PRTEE score was statistically superior in CS injection group at Day 15 (p=0.0001) and Day 30 (p=0.001), but at Day 90 ABI group showed statistically bett...
Objective. The purpose of this retrospective study was to compare the clinical and radiological r... more Objective. The purpose of this retrospective study was to compare the clinical and radiological results of magnesium versus titanium screw fixation for modified distal chevron osteotomy in hallux valgus (HV).Materials and Methods.A total of 31 patients who underwent modified distal chevron osteotomy for HV deformity between 2014 and 2017 were reviewed retrospectively. Headless magnesium (Mg) compression screw fixation was applied in 16 patients (17 feet) and headless titanium (Ti) compression screw in 15 patients (17 feet). Patients were followed up for at least 12 months with a mean of 19.0 ± 6.8 months in the Mg screw group and 16.2 ± 6.19 in the Ti screw group, respectively (p: 0.234). Clinical results were evaluated using the American Orthopedic Foot and Ankle Society Hallux metatarsophalangeal-interphalangeal (AOFAS-MTP-IP) scale and a visual analogue scale (VAS). The hallux valgus angle (HVA) and intermetatarsal angle (IMA) were measured before and after surgery. Time to osteo...
Archives of orthopaedic and trauma surgery, Jan 25, 2018
The purpose of this retrospective study was to evaluate the outcome of medial malleolar fractures... more The purpose of this retrospective study was to evaluate the outcome of medial malleolar fractures treated with magnesium (MgYREZr) bioabsorbable compression screw fixation. Eleven patients with a medial malleolar fracture (either isolated or accompanied by bimalleolar or trimalleolar ankle fractures) who were treated with magnesium bioabsorbable compression screws between 2015 and 2016 in our hospital were retrospectively evaluated. Patients were monitored with a mean follow-up of 17.3 ± 4.1 months (range 12-24 months). The mechanism of injury was ground level falls in all patients. All fractures were classified as closed fractures. American Orthopedic Foot and Ankle Society's (AOFAS) scale and the visual analog scale (VAS) were used to evaluate the clinical results during the final follow-up. Bone union and a possible loss of reduction were assessed with serial radiographs. Potential complications including revision surgery and infection were recorded and reported. There were 1...
The purpose of this study was to investigate the interobserver and intraobserver reliabilities of... more The purpose of this study was to investigate the interobserver and intraobserver reliabilities of four different radiographic grading scale of osteoarthritis (OA) of the knee joint, namely, Kellgren–Lawrence (KL), Ahlback, Brandt, and OA Research Society International (OARSI). One consultant orthopaedic surgeon and one rheumatologist who were familiar with these OA grading scales participated in the study. Radiological assessments were performed in random order by each observer on two separate occasions, at least 2 weeks apart. K-statistics were used to establish a relative level of agreement between the observers for the two readings and between separate readings by the same observer. A total of 140 patients (53 males and 87 females) with a mean age of 61.2 years (range, 50–72 years) were included in the study. Intraobserver reliability for KL was substantial for observer A (κ: 0.753) and moderate for observer B (κ: 0.573). Interobserver reliability for KL was moderate for both obs...
Journal of Emergency Medicine, Trauma and Acute Care, 2016
Biphalangeal toe is a normal anatomic variant where distal and middle phalanges fuse to each othe... more Biphalangeal toe is a normal anatomic variant where distal and middle phalanges fuse to each other. In the context of trauma, biphalangeal toes may pose a diagnostic challenge and fractures may be interpreted as normal which can lead to misdiagnosis and under treatment. Here, we present a rare case of fracture through a biphalangeal fifth toe with delayed diagnosis. This variation should be kept in mind during the evaluation of a patient with foot trauma and assessment of foot radiographs, particularly in the emergency department where the majority of initial cases are presented.
Avulsion fractures of the anterior inferior tibiofibular ligament from its tibial attachment, Til... more Avulsion fractures of the anterior inferior tibiofibular ligament from its tibial attachment, Tillaux fractures, are usually seen in adolescents during the interval of the distal tibial epiphyseal closure. However, this pattern of fracture is rare in adult patients, because the ligaments will usually fail before the bone fails. Avulsion fracture of the posterior inferior tibiofibular ligament from its tibial attachment, Volkmann fracture, is the posterolateral counterpart of a similar injury. In the present study, the cases of 2 adult patients with simultaneous Tillaux and Volkmann fractures are reported and the mechanism of injury, diagnosis, and treatment discussed. This fracture pattern is extremely rare and, to the best of our knowledge, has not been previously reported.
Accessory ossicles of the foot and ankle are normal variants of bone development that usually rem... more Accessory ossicles of the foot and ankle are normal variants of bone development that usually remain asymptomatic. However, they may be involved in various disorders and become a source of pain such as in fractures, dislocations, degenerative changes, osteonecrosis, osteoarthritis, osteochondral lesions, avascular necrosis, and irritation or impingement of adjacent soft tissues. Hence, during the assessment of the situations above, knowledge about these little-known ossicles could be very important to reach the correct diagnosis. Recent studies in the literature have mostly focused on the most frequent 9-12 accessory bones. In this review, 24 types of accessory ossicle are described. These ossicles are accessory navicular bone, os peroneum, os trigonum, os intermetatarseum, os vesalianum. os subfibulare, os subtibiale, os calcaneus secundarius, os calcanei accessorium, os supratalare, os sustentaculi, os talotibiale, os tali accessorium, talus secundarius, os subcalcis, os cuboideum...
Irritant contact dermatitis due to synthetic undercast padding is rare complication of plaster ca... more Irritant contact dermatitis due to synthetic undercast padding is rare complication of plaster cast treatment which is underreported in orthopedic literature. Pruritis was the main symptom a few days following the application of the cast in our patient. However, the symptoms were underestimated by the treating physician. Severe irritant contact dermatitis can occur against the polyester undercast padding and should be kept in mind in patients whom complaining of pruritis under the treatment of casting. INTRODUCTION The danger of severe irritant contact dermatitis after the application of casts is not generally appreciated. Because of its apparent rarity, we decided to report the following case of severe irritant contact dermatitis due to synthetic undercast padding in a patient under fracture treatment.
The purpose of this retrospective study is to report the clinical and radiological outcome of tot... more The purpose of this retrospective study is to report the clinical and radiological outcome of total hip arthroplasty in patients with previous hip arthrodesis. We retrospectively reviewed 28 (40 hips) prospectively followed patients in whom ankylosed hips were converted to total hip arthroplasty (THA) between 2010 and 2014 in our institution. The average age at the time of the conversion operation was 40.8 ± 9.8 years (range 24-62). The ankylosis had lasted 20.4 ± 13.0 years (range 3-56) before conversion surgery. The etiology of the ankylosis was septic arthritis in 10 (25%), post-traumatic hip osteoarthritis in 8 (20%), developmental hip dysplasia in 6 (15%), rheumatoid arthritis in 6 (15%), primary osteoarthritis in 5 (12.5%) and ankylosing spondylitis in 5 (12.5%) hips. The indications for arthroplasty were intractable low back pain in 14 (50%), hip pain in 24 (85.7%), and ipsilateral knee pain in 19 (67.8%) patients. Harris Hip Score (HHS) was used to rate the clinical results before and after the surgery. Radiographic evaluations included component malposition and loosening. All complications during the study period were recorded. The mean follow-up period was 39.9 ± 10.6 months (range 24-60). The mean preoperative HHS was 33.3 ± 8.6 (range 18-50) and the mean HHS at the final follow-up was 74.9 ± 8.6 (range 52-97). There was a statistically significant increase in HHS (p = 0.0001). HHS was excellent in 1, good in 6, fair in 14 and poor in 7 patients. Increase in HHS was lower than 20 points in one patient (18 points), and one patient required two-staged exchange procedure due to deep infection. Thus, according to our success criteria (increase in HHS more than 20 points, radiographically stable implant, and no further surgical reconstruction), 92.8% (26/28) of patients had benefit from the surgery. Trendelenburg sign was positive in 12 hips. There was limb length inequality in 11 patients (mean 0.5 cm, range 1-3 cm). No patients had heterotopic ossification, sciatic nerve palsy or dislocation. There were five intra-operative fractures of the greater trochanter that were treated with cable wiring. One patient had trochanteric avulsion injury and was treated with trochanteric grip and cables. One patient (2.5%) had deep infection one year after the conversion THA and was treated with two-staged exchange procedure. Conversion hip arthroplasty is an effective treatment method which provides functional recovery and patient satisfaction. However, a proper surgical technique and planning is necessary to minimize the complications.
To compare the efficacy of autologous blood injection versus corticosteroid injection for lateral... more To compare the efficacy of autologous blood injection versus corticosteroid injection for lateral epicondylitis. 21 men and 59 women (mean age, 45.2 years) presenting with lateral epicondylitis were randomised to receive either autologous blood injection (2 ml of autologous venous blood mixed with 1 ml of 2% prilocaine hydrochloride) or corticosteroid injection (1 ml of 40 mg methylprednisolone acetate mixed with 1 ml of 2% prilocaine hydrochloride) given by a single physician. Patients were assessed before (day 0) and after (days 15, 30, and 90) treatment for elbow pain (using a visual analogue scale [VAS]), function (using the patient-rated tennis elbow evaluation [PRTEE] questionnaire), and grip strength (using a hydraulic hand dynamometer). Patients were followed up at 6 months by telephone to assess elbow pain using the VAS. No complications (infection, skin atrophy, neurovascular damage, or tendon rupture) were noted. 10 patients reported increased pain for up to 2 days after ...
Although, osteochondroma is the most common bone tumor, metacarpal involvement is quite uncommon ... more Although, osteochondroma is the most common bone tumor, metacarpal involvement is quite uncommon and usually accompanies multiple hereditary exostoses. Herein, we described a patient with solitary ostechondroma of the fourth metacarpal bone, and discussed the differential diagnosis of bony spurs that can be seen in hand.
Background and objectives: The purpose of this retrospective study was to compare the clinical an... more Background and objectives: The purpose of this retrospective study was to compare the clinical and radiological outcomes of patients who underwent biplane chevron medial malleolar osteotomy (MMO) for osteochondral lesions of the talus (OLT), fixed with either magnesium (Mg) or titanium (Ti) screws. Materials and Methods: A total of 22 patients (12 male, 10 female) with a mean age of 40.6±12.5 years (range, 18-56 years) who underwent MMO for OLT treatment were included in this retrospective study. Of the 22 patients, MMO was fixed with bioabsorbable Mg screws (Alloy: MgYREZr) in 11 patients, and in the remaining 11 patients (one bilateral) MMO were fixed with Ti screws. All patients were followed up for at least one year with a mean of 20.7±8.9 months (range, 12–49 months). The American Orthopedic Foot and Ankle Society (AOFAS) scale and the visual analog scale (VAS) were used to evaluate the clinical results. Union of the osteotomy, postoperative displaceme...
Although fractures of the midfoot are common, cuneiform fractures are rarely seen. These fracture... more Although fractures of the midfoot are common, cuneiform fractures are rarely seen. These fractures are frequently associated with other fractures of the midfoot such as Lisfranc fracture-dislocations. However, isolated cuneiform fractures are extremely rare, with few cases reported in the relevant literature. Herein, the authors report 2 cases of isolated medial cuneiform fractures. One of the patients was treated with headless screw fixation due to displacement in fracture configuration, and the other was treated conservatively. Fractures were united without any complication in both patients. In this report, the authors discuss the mechanism of injury, diagnostic challenges, and treatment options of isolated medial cuneiform fractures. Level of Evidence: Therapeutic, Level IV
Os paracuneiforme is an extremely rare accessory ossicle located at the medial aspect of the medi... more Os paracuneiforme is an extremely rare accessory ossicle located at the medial aspect of the medial cuneiform bone. Although foot pain secondary to accessory ossicles is well known, symptomatic os paracuneiforme that requires surgical excision is rarely reported in the current literature. Herein, a 12-year-old boy with symptomatic os paracuneiforme is presented, and its clinical and imaging findings as well as the treatment are discussed.
The purpose of this study is to compare the efficacy of autologous blood (ABI) versus corticoidst... more The purpose of this study is to compare the efficacy of autologous blood (ABI) versus corticoidsteroid (CS) injections for the treatment of lateral epicondylitis (LE). Eighty patients were randomly allocated into two treatment groups either autologous blood or methylprednisolone acetate injections. Patients were evaluated using visual analogue scale (VAS), patient rated tennis elbow evaluation (PRTEE) and hand grip strength (HGS) measurements. The CS injection group showed a significant decrease in pain compared with ABI regarding VAS in Day 15 (p=0.0001) and this temporary superior results continued till the Day 30 (p=0.0001). At the Day 90 and Day 180 VAS score returned towards preinjection state in CS group, however, VAS score in ABI continued to decline and became superior compared to CS group (p=0.0001, p=0.0001). Similarly, PRTEE score was statistically superior in CS injection group at Day 15 (p=0.0001) and Day 30 (p=0.001), but at Day 90 ABI group showed statistically bett...
Objective. The purpose of this retrospective study was to compare the clinical and radiological r... more Objective. The purpose of this retrospective study was to compare the clinical and radiological results of magnesium versus titanium screw fixation for modified distal chevron osteotomy in hallux valgus (HV).Materials and Methods.A total of 31 patients who underwent modified distal chevron osteotomy for HV deformity between 2014 and 2017 were reviewed retrospectively. Headless magnesium (Mg) compression screw fixation was applied in 16 patients (17 feet) and headless titanium (Ti) compression screw in 15 patients (17 feet). Patients were followed up for at least 12 months with a mean of 19.0 ± 6.8 months in the Mg screw group and 16.2 ± 6.19 in the Ti screw group, respectively (p: 0.234). Clinical results were evaluated using the American Orthopedic Foot and Ankle Society Hallux metatarsophalangeal-interphalangeal (AOFAS-MTP-IP) scale and a visual analogue scale (VAS). The hallux valgus angle (HVA) and intermetatarsal angle (IMA) were measured before and after surgery. Time to osteo...
Archives of orthopaedic and trauma surgery, Jan 25, 2018
The purpose of this retrospective study was to evaluate the outcome of medial malleolar fractures... more The purpose of this retrospective study was to evaluate the outcome of medial malleolar fractures treated with magnesium (MgYREZr) bioabsorbable compression screw fixation. Eleven patients with a medial malleolar fracture (either isolated or accompanied by bimalleolar or trimalleolar ankle fractures) who were treated with magnesium bioabsorbable compression screws between 2015 and 2016 in our hospital were retrospectively evaluated. Patients were monitored with a mean follow-up of 17.3 ± 4.1 months (range 12-24 months). The mechanism of injury was ground level falls in all patients. All fractures were classified as closed fractures. American Orthopedic Foot and Ankle Society's (AOFAS) scale and the visual analog scale (VAS) were used to evaluate the clinical results during the final follow-up. Bone union and a possible loss of reduction were assessed with serial radiographs. Potential complications including revision surgery and infection were recorded and reported. There were 1...
The purpose of this study was to investigate the interobserver and intraobserver reliabilities of... more The purpose of this study was to investigate the interobserver and intraobserver reliabilities of four different radiographic grading scale of osteoarthritis (OA) of the knee joint, namely, Kellgren–Lawrence (KL), Ahlback, Brandt, and OA Research Society International (OARSI). One consultant orthopaedic surgeon and one rheumatologist who were familiar with these OA grading scales participated in the study. Radiological assessments were performed in random order by each observer on two separate occasions, at least 2 weeks apart. K-statistics were used to establish a relative level of agreement between the observers for the two readings and between separate readings by the same observer. A total of 140 patients (53 males and 87 females) with a mean age of 61.2 years (range, 50–72 years) were included in the study. Intraobserver reliability for KL was substantial for observer A (κ: 0.753) and moderate for observer B (κ: 0.573). Interobserver reliability for KL was moderate for both obs...
Journal of Emergency Medicine, Trauma and Acute Care, 2016
Biphalangeal toe is a normal anatomic variant where distal and middle phalanges fuse to each othe... more Biphalangeal toe is a normal anatomic variant where distal and middle phalanges fuse to each other. In the context of trauma, biphalangeal toes may pose a diagnostic challenge and fractures may be interpreted as normal which can lead to misdiagnosis and under treatment. Here, we present a rare case of fracture through a biphalangeal fifth toe with delayed diagnosis. This variation should be kept in mind during the evaluation of a patient with foot trauma and assessment of foot radiographs, particularly in the emergency department where the majority of initial cases are presented.
Avulsion fractures of the anterior inferior tibiofibular ligament from its tibial attachment, Til... more Avulsion fractures of the anterior inferior tibiofibular ligament from its tibial attachment, Tillaux fractures, are usually seen in adolescents during the interval of the distal tibial epiphyseal closure. However, this pattern of fracture is rare in adult patients, because the ligaments will usually fail before the bone fails. Avulsion fracture of the posterior inferior tibiofibular ligament from its tibial attachment, Volkmann fracture, is the posterolateral counterpart of a similar injury. In the present study, the cases of 2 adult patients with simultaneous Tillaux and Volkmann fractures are reported and the mechanism of injury, diagnosis, and treatment discussed. This fracture pattern is extremely rare and, to the best of our knowledge, has not been previously reported.
Accessory ossicles of the foot and ankle are normal variants of bone development that usually rem... more Accessory ossicles of the foot and ankle are normal variants of bone development that usually remain asymptomatic. However, they may be involved in various disorders and become a source of pain such as in fractures, dislocations, degenerative changes, osteonecrosis, osteoarthritis, osteochondral lesions, avascular necrosis, and irritation or impingement of adjacent soft tissues. Hence, during the assessment of the situations above, knowledge about these little-known ossicles could be very important to reach the correct diagnosis. Recent studies in the literature have mostly focused on the most frequent 9-12 accessory bones. In this review, 24 types of accessory ossicle are described. These ossicles are accessory navicular bone, os peroneum, os trigonum, os intermetatarseum, os vesalianum. os subfibulare, os subtibiale, os calcaneus secundarius, os calcanei accessorium, os supratalare, os sustentaculi, os talotibiale, os tali accessorium, talus secundarius, os subcalcis, os cuboideum...
Irritant contact dermatitis due to synthetic undercast padding is rare complication of plaster ca... more Irritant contact dermatitis due to synthetic undercast padding is rare complication of plaster cast treatment which is underreported in orthopedic literature. Pruritis was the main symptom a few days following the application of the cast in our patient. However, the symptoms were underestimated by the treating physician. Severe irritant contact dermatitis can occur against the polyester undercast padding and should be kept in mind in patients whom complaining of pruritis under the treatment of casting. INTRODUCTION The danger of severe irritant contact dermatitis after the application of casts is not generally appreciated. Because of its apparent rarity, we decided to report the following case of severe irritant contact dermatitis due to synthetic undercast padding in a patient under fracture treatment.
The purpose of this retrospective study is to report the clinical and radiological outcome of tot... more The purpose of this retrospective study is to report the clinical and radiological outcome of total hip arthroplasty in patients with previous hip arthrodesis. We retrospectively reviewed 28 (40 hips) prospectively followed patients in whom ankylosed hips were converted to total hip arthroplasty (THA) between 2010 and 2014 in our institution. The average age at the time of the conversion operation was 40.8 ± 9.8 years (range 24-62). The ankylosis had lasted 20.4 ± 13.0 years (range 3-56) before conversion surgery. The etiology of the ankylosis was septic arthritis in 10 (25%), post-traumatic hip osteoarthritis in 8 (20%), developmental hip dysplasia in 6 (15%), rheumatoid arthritis in 6 (15%), primary osteoarthritis in 5 (12.5%) and ankylosing spondylitis in 5 (12.5%) hips. The indications for arthroplasty were intractable low back pain in 14 (50%), hip pain in 24 (85.7%), and ipsilateral knee pain in 19 (67.8%) patients. Harris Hip Score (HHS) was used to rate the clinical results before and after the surgery. Radiographic evaluations included component malposition and loosening. All complications during the study period were recorded. The mean follow-up period was 39.9 ± 10.6 months (range 24-60). The mean preoperative HHS was 33.3 ± 8.6 (range 18-50) and the mean HHS at the final follow-up was 74.9 ± 8.6 (range 52-97). There was a statistically significant increase in HHS (p = 0.0001). HHS was excellent in 1, good in 6, fair in 14 and poor in 7 patients. Increase in HHS was lower than 20 points in one patient (18 points), and one patient required two-staged exchange procedure due to deep infection. Thus, according to our success criteria (increase in HHS more than 20 points, radiographically stable implant, and no further surgical reconstruction), 92.8% (26/28) of patients had benefit from the surgery. Trendelenburg sign was positive in 12 hips. There was limb length inequality in 11 patients (mean 0.5 cm, range 1-3 cm). No patients had heterotopic ossification, sciatic nerve palsy or dislocation. There were five intra-operative fractures of the greater trochanter that were treated with cable wiring. One patient had trochanteric avulsion injury and was treated with trochanteric grip and cables. One patient (2.5%) had deep infection one year after the conversion THA and was treated with two-staged exchange procedure. Conversion hip arthroplasty is an effective treatment method which provides functional recovery and patient satisfaction. However, a proper surgical technique and planning is necessary to minimize the complications.
To compare the efficacy of autologous blood injection versus corticosteroid injection for lateral... more To compare the efficacy of autologous blood injection versus corticosteroid injection for lateral epicondylitis. 21 men and 59 women (mean age, 45.2 years) presenting with lateral epicondylitis were randomised to receive either autologous blood injection (2 ml of autologous venous blood mixed with 1 ml of 2% prilocaine hydrochloride) or corticosteroid injection (1 ml of 40 mg methylprednisolone acetate mixed with 1 ml of 2% prilocaine hydrochloride) given by a single physician. Patients were assessed before (day 0) and after (days 15, 30, and 90) treatment for elbow pain (using a visual analogue scale [VAS]), function (using the patient-rated tennis elbow evaluation [PRTEE] questionnaire), and grip strength (using a hydraulic hand dynamometer). Patients were followed up at 6 months by telephone to assess elbow pain using the VAS. No complications (infection, skin atrophy, neurovascular damage, or tendon rupture) were noted. 10 patients reported increased pain for up to 2 days after ...
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