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    Assessment of Calcaneal Morphology and Radiological Parameters in Haglund's Syndrome
    (Galenos Publ House, 2022) Buyukdogan, Kadir; Aslan, Lercan; Kaymaz, Burak; Yilmaz, Onur; Ayik, Gokhan; Mermerkaya, Musa Ugur
    Objective: To compare the radiological parameters of the normal population with the patients with Haglund's syndrome (HS) and to seek a correlation between pain scores and radiological parameters in patients with HS.Methods: Thirty-one patients surgically treated for HS (Haglund group) and 36 healthy subjects free of hindfoot pathology seen in consultation for any other foot pathologies (control group) were included in the study. Demographic data of the patients were acquired, and radiological measurements such as; Fowler Philip Angle (FPA), lateral talus-first metatarsal angle (LTFMA), and Calcaneal pitch angle (CPA) were recorded. The visual analog scale (VAS) and the American Orthopaedic Foot & Ankle Society (AOFAS) scores of the patients in the Haglund group were assessed.Results: Mean CPA, FPA, and LTFMA in the Haglund group were 23.88 +/- 4.6, 58.16 +/- 5.7, and 4.92 +/- 1.88, respectively, and the same recordings in the control group were 21.16 +/- 4.81, 59.1 +/- 4.3, and 4.25 +/- 2.57, respectively. CPA differences between Haglund and control groups were statistically significant (p=0.021). The average values of the VAS and AOFAS scores of the patients in the Haglund group were 8.45 +/- 1.06 and 47.4 +/- 7.58, respectively. There was no correlation between the scores and the radiological measurements of patients in the Haglund group.Conclusion: Radiological assessments are widely debated. Many studies support our results that measurements defined for the morphology of calcaneus are not associated with the Haglund's disease severity. Increase in the CPA is found to be related to HS. This may be explained by the extension of the calcaneus to irritate the Achilles tendon and cause heel pain.
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    Neutrophil to lymphocyte ratio may be a predictive marker of poor prognosis in Legg-Calve-Perthes disease
    (Sage Publications Ltd, 2016) Kaymaz, Burak; Buyukdogan, Kadir; Kaymaz, Nazan; Komorcu, Erkam; Golge, Umut Hatay; Goksel, Ferdi; Aksoy, Mehmet Cemalettin
    Legg-Calve-Perthes disease (LCPD) is the idiopathic avascular necrosis of the femoral head in childhood. The pathologic changes seen in the femoral head are likely a result of vascular factors. Blood neutrophil to lymphocyte (N/L) ratio is a simple marker of subclinical inflammation. This study aims to to analyse the predictive ability of N/L ratio for the prognosis in LCPD patients. Methods: Patients who had been diagnosed as LCPD from 2008 to 2014 were investigated retrospectively and 40 LCPD patients (33 male and 7 female) and 25 healthy age and sex-matched children (controls) were included in the study. LCPD patients were divided into 2 groups according to expected prognosis (good prognosis expected Herring A and B patients as Group I and poor prognosis expected Herring B-C and C patients as Group II) and healthy children (control) were included in Group III. All the patients' hematological markers were analysed. Results: Mean age was 7.1 +/- 2.0 years in group I (4.9-12 years), 8.3 +/- 2.2 years (4-12.5 years) in group II and 7.8 +/- 1.3 years (6-12 years) in group III. Mean values for Groups I, II and III for neutrophil to lymphocyte (N/L) ratio were 1.13 +/- 0.65, 1.75 +/- 0.95, 1.08 +/- 0.37, respectively. The mean neutrophil to lymphocyte (N/L) ratio of Group II was higher than the other 2 groups (p = 0.003). Conclusions: N/L ratio may give us information about the natural course of LCPD and may be used as independent predictor of prognosis in patients with LCPD.