Beyzadeoglu, T. | Köse, G.T. | Ekici, I.D. | Bekler, H. | Yilmaz, C.

Erratum | 2012 | Acta Orthopaedica et Traumatologica Turcica46 ( 4 )

[No abstract available]

Parmaksızoğlu, Fatih | Beyzadeoğlu, Tahsin

Article | 2004 | Acta Orthopaedica et Traumatologica Turcica38 ( 1 ) , pp.60 - 66

Amaç: El parmaklarının travmatik amputasyonlarmda kallus distraksiyonu ile falangeal uzatma uyguladığımız olguların sonuçları değerlendirildi. Çalışma planı: El parmaklarında travmatik amputasyon olan 13 erkek hastanın (ort. yaş 27.7; dağılım 12-43) 16 falanksı kallus distraksiyonu yöntemi ile uzatıldı. Uzatma tek taraflı dinamik eksternal fiksäsyon cihazı ile l mm/gün şeklinde uygulandı. Ortalama izlem süresi 42 ay (dağılım 12-80 ay) idi. Sonuçlar: Başparmaklarda ortalama 24 mm (dağılım 18-26 mm), diğer parmaklarda 21 mm (dağılım 18-26 mm) uzama sağlandı. Başparmaklarda oluşan yeni parmak boyu ile birinci web derinliği ve açıklığı . . .yeterli hale geldi ve elin uc-uc, uc-yan ve kaba kavramalarında fonksiyonel açıdan artış görüldü. Başparmak gücü, fleksör pollisis longusun katkısı ortadan kalktığı için, sağlam tarafın %65'ine karşılık gelecek şekilde, ortalama 7 kilogram (dağılım 5-9 kg) olarak ölçüldü. Diğer parmaklardaki uzama elin kullanım fonksiyonunu artırdı. İyileşme indeksi (l cm uzama için geçen ay sayısı), başparmaklarda ortalama 1.7 ay/cm (dağılım 1.6-2.1 ay/cm), diğer parmaklarda 1.6 ay/cm (dağılım 1.4-1.9 ay/cm) bulundu. Dört parmakta çivi dibi enfeksiyonu görüldü. Çıkarımlar: Başparmak distal falanks kayıplarında, baş parmak kısalığının yol açtığı fonksiyonel sorunların giderilmesinde, proksimal falanksa yapılan uzatma osteotomisi etkin bir rekonstrüksiyon yöntemidir. Diğer parmaklarda ise, ray rezeksiyon veya ray rezeksiyon ve transpozisyon yöntemini kabul etmeyen hastalarda uygulanabilir bir yöntemdir Objectives: We evaluated the results of lengthening of the phalanges by callus distraction in traumatic amputations of the fingers. Methods: We treated traumatic amputations of 16 fingers of 13 male patients (mean age 27.7 years; range 12 to 43 years) by callotasis of the phalanges. Callus distraction was performed with a rate of 1 mm/day using a unilateral dynamic external fixation device. The mean follow-up period was 42 months (range 12 to 80 months). Results: The mean lengthening was 24 mm (range 18 to 26 mm) and 21 mm (range 18 to 26 mm) for the thumbs and the other fingers, respectively. The achieved thumb length provided adequate depth and width of the first web space and enabled functional improvement in the ability of gripping, and pulp-to-pulp and pulp-to-side pinching, hi the absence of flexor pollicis longus, the mean strength of the thumbs was 7 kg (range 5 to 9 kg), amounting to 65% of the normal side. Lengthening of the other fingers resulted in improved functioning of the hand. The mean healing index (number of months per centimetre of lengthening) was 1.7 months/cm (range 1.6 to 2.1 months/cm) and 1.6 months/cm (range 1.4 to 1.9 months/cm) in the thumbs and the other fingers, respectively. Pin tract infections were observed in four phalanges. Conclusion: Callotasis of the proximal phalanx of the thumb is an effective reconstruction method to compensate for the loss of distal phalanx and to alleviate functional problems due to shortness. It may also be applied to the phalanges of the other fingers in patients who.,who do not accept ray resection with or without transposition Daha fazlası Daha az

Sever, C. | Uygur, F. | Külahçi, Y. | Torun Köse, G. | Urhan, M. | Küçükodaci, Z. | Çayci, T.

Article | 2010 | Acta Orthopaedica et Traumatologica Turcica44 ( 5 ) , pp.403 - 409

Objectives: This experimental study aimed to create a prefabricated vascularized bone graft using the interconnected porous coralline hydroxyapatite ceramic by combining vascular bundle implantation, mesenchymal stem cells, and hyperbaric oxygen therapy (HBOT) administration in a rat model. Methods: Forty-five male Sprague-Dawley rats were divided into three groups, each containing 15 rats. The hydroxyapatite ceramics were vascularized by the superficial inferior epigastric artery and vein in all groups. These vessels passed through the hole of the hydroxyapatite blocks. In Group 2, mesenchymal stem cells were administered into the . . .hydroxyapatite. In Group 3, both mesenchymal stem cells and HBOT were administered. The presence and density of any new bone formation and neovascularization were evaluated by radiography, microangiography, scintigraphy, biochemical analysis, and histomorphometry. Results: Neovascularization and bone formation were significantly greater in Group 3, in which both mesenchymal stem cells and HBOT were applied, than the other groups. Conclusion: HBOT enhances neovascularization and osteogenesis, thus HBOT can provide optimal and faster prefabrication of a vascularized bone graft. © 2010 Turkish Association of Orthopaedics and Traumatology Daha fazlası Daha az

Özkul, F. | Erol Barkana, D. | Badilli Demirbaş, Ş. | Inal, S.

Article | 2012 | Acta Orthopaedica et Traumatologica Turcica46 ( 05.06.2020 ) , pp.332 - 338

Objective: The aim of this study was to evaluate the proprioceptive sense of elbow flexion through a robot-assisted rehabilitation system, RehabRoby, and to understand the usability of RehabRoby as a robotic system in physiotherapy. Methods: The study included 20 volunteer, healthy students studying either physiotherapy (PT) (5 females and 5 males) or electrical and electronics engineering (EEE) (5 females and 5 males). Using the RehabRoby, they were asked to flex their elbow joints in pronation actively and then against a comfortable resistance to the target angles (20°, 45° and 90°), with eyes open and closed. Angle of movement an . . .d applied torque for each target angle and error of movement with respect to the target angle (error of matching) were recorded as absolute values. Participants' socio-demographic and physical features were also evaluated. Results: Physiotherapy students had less matching error at 45° with eyes opened than EEE students. A negative correlation was found between resistive elbow flexion and applied torque while eyes closed at 20° ( Daha fazlası Daha az

Bekler, Halil İbrahim | Rosenwasser, Melvin P. | Akılına, Yelena | Bulut, Güven

Other | 2010 | Acta Orthopaedica et Traumatologica Turcica44 ( 2 ) , pp.157 - 161

Amaç: Otolog ven greftleri periferik arter köprüleme (bypass) işlemlerinde kullanılmaktadır. Greftin aniden arteryel kan basıncına maruz kalması, ven duvar basıncında artışa yol açarak greftte aşırı gerilmeye ve akımda değişikliklere neden olur. Vendeki aşırı gerilmeye sıklıkla anastomozda sızıntı, trombüs oluşumu ve akım kaybı eşlik eder. Bu çalışmada, sıçan modelinde arter köprülemede kullanılan ven greftlerine eriyebilir kolajen örtü uygulamasının grefti koruyucu etkisi araştırıldı. Çalışma planı: Çalışmada, ağırlıkları 250-350 gr arasında değişen, Sprague-Dawley cinsi 22 dişi sıçan kullanıldı. Sıçanlar çalışma (n15) ve kontrol ( . . .n7) grupları olarak rastgele iki gruba ayrıldı. Tüm sıçanlarda, sol femoral venden 10 mm’lik bir segment greft olarak alınarak sağ femoral arter kesisi ven greftiyle onarıldı. Kontrol grubunda başka bir işlem uygulanmadı. Çalışma grubunda onarım tamamlandıktan sonra, ven grefti uygun uzunlukta bir kolajen örtü (Neurawrap Nerve Protector) ile sarıldı ve ven grefti etrafında bir tüp oluşturacak şekilde dikildi. İşlem sonunda kanama yoğunluğu ve süresi ile damar açıklığı kaydedildi. Proksimal ve distal arter segmentleri Doppler ultrasonografi ile incelendi. Tüm gözlem ve ölçümler ameliyattan 1 ve 2 saat sonra tekrarlandı. İkinci saatin sonunda tüm sıçanlar kurban edilerek, arteryel bölümleri ile birlikte ven greftleri histolojik çalışma için çıkarıldı. Sonuçlar: Kontrol grubunda, damar klemplerinin çıkarılmasından sonra tüm ven greftlerinde ani şişme gözlendi. Bu gruptaki tüm deneklerde, anastomoz hattında 1-3 dakika süren kanamayı greftlerin balonlaşması izledi. Çalışma grubunda ise hiçbir ven greftinde şişme ve balonlaşma görülmedi. Bu grupta 11 örnekte herhangi bir kanama görülmezken, diğer dördünde kanama zamanı 1 dakikanın altındaydı. Kontrol grubunda, iki saat sonra yedi greftin sadece biri açıktı, biri daha 3. dakikada tıkandı. Çalışma grubunda ise greftlerin tümü açıktı, hiç tromboz gelişmedi. Doppler incelemede ortalama kan akım hızı kontrol grubunda 0. saatte proksimal arterde 0.930.33 cm/sn, distal arterde 0.730.44 cm/sn ölçüldü. Çalışma grubunda, proksimal ve distal arter kan akımı hızları 0, 1 ve 2 saat sonunda sırasıyla 0.450.27 ve 0.460.22 cm/sn, 0.400.22 ve 0.620.40 cm/sn, 0.550.22 ve 0.640.37 cm/sn idi. Çıkarımlar: Ven greftlerinde aşırı gerilmenin dışarıdan örtü desteğiyle önlenmesi, anastomoz sızıntısını azaltır, intimal mediayı korur, akımın devamını sağlar, tromboz oluşumunu azaltır ve greftin açık kalmasını sağlar. Objectives: Autologous interpositional vein grafts are used in peripheral arterial bypass procedures. Sudden exposure of vein grafts to arterial blood pressure is associated with increased wall tension leading to overdistension of the graft and changes in flow patterns. Overdistension of vein grafts often results in anastomotic leaks, thrombosis, and loss of patency. This study was designed to evaluate the use of a biodegradable collagen cover as a means of preventing overdistension of venous bypass grafts in a rat model. Methods: Twenty-two Sprague-Dawley female rats weighing 250-350 g were randomly assigned to two groups: study group (n 15) and control group (n7). In all the rats, a 10-mm segment of the left femoral vein was harvested and used as a graft in repair of a right femoral artery injury. Following this procedure, control rats remained untreated. After completion of the femoral artery repair in the study group, the graft was wrapped with a collagen cover of appropriate length (NeuraWrap Nerve Protector) and sutured to form a tube around the vein graft. At the end of the procedure, the intensity and duration of bleeding, and vessel patency were recorded and the proximal and distal arterial segments were examined by Doppler ultrasonography. All observations and measurements were repeated at 1 and 2 hours after surgery. After the second hour, all the rats were sacrificed and vein graft samples with the arterial portions were removed for histological study. Results: After removal of the vascular clamps of the control group, a sudden distension was observed in all the vein grafts. In this group, bleeding at the anastomosis site lasted for 1 to 3 minutes and was followed by ballooning of the grafts. In the study group, however, none of the samples exhibited distension and ballooning. There was no bleeding in 11 samples at all, and bleeding time was less than one minute in the remaining four samples. In the control group, only one graft was patent at two hours, one of the grafts was occluded after only three minutes. In the study group, all the grafts were patent and no thrombosis was noted. The mean blood flow velocity of the control group measured at 0 hour by Doppler ultrasonography was 0.93±0.33 cm/sec in the proximal artery, and 0.73±0.44 cm/sec in the distal artery. The mean blood flow velocities in the proximal and distal arteries of the study group were as follows, respectively: at 0 hour: 0.45±0.27 and 0.46±0.22 cm/sec; at 1 hour: 0.40±0.22 and 0.62±0.40 cm/sec; and at 2 hours: 0.55±0.22 and 0.64±0.37 cm/sec. Conclusion: Prevention of overdistension of vein grafts with the use of an external cover decreases anastomotic leaks, protects the intimal media, maintains blood flow, reduces the incidence of thrombosis, and thus provides a higher patency rate Daha fazlası Daha az

Bekler, H. | Bulut, G. | Usta, M. | Gokce, A. | Okyar, F. | Beyzadeoglu, T.

Article | 2008 | Acta Orthopaedica et Traumatologica Turcica42 ( 2 ) , pp.125 - 129

Objectives: This experimental study was designed to find new ways of improving stabilization of fractures in osteoporotic elderly patients through alterations made in the configuration and geometry of locked screw-plate fixation used in the conventional plate technique. Methods: Four screw configurations with varying angulations were used for plate-bone construction. Forty iron plates of high quality (100×35×3 mm) were divided into four groups and two screw holes, 3 mm in diameter, were drilled on each plate at a distance of 15 mm. In group A, the holes were drilled so that the screws would be vertically sent to the bone interface. . . .In the remaining groups, the holes were drilled for convergent (group B, 15°) and divergent (group C, 15°; group D, 30°) screw orientation. Screw-plate fixation was tested in a modified osteoporotic bone (Osteoporotic Generic Bone, Synbone) on an Instron materials testing system with an axial pullout force of 0.1 mm/sec. Failure loads were read from load-displacement curves and the type of failure was noted. Results: Screws placed in divergent orientations showed the highest axial pull-out strength (group C, 83.3 N/mm; group D, 80.8 N/mm), followed by convergent placement (72N/mm) and vertical placement (66.7 N/ mm). The type of failure was breakage of the bone sample in divergent configurations, and screw pull-out in convergent and vertical configurations. Conclusion: Divergent constructs may be a promising alternative to conventional screw placement in treating osteoporotic fractures. ©2008 Turkish Association of Orthopaedics and Traumatology Daha fazlası Daha az

Çakmak, Selami | Mahiroğulları, Mahir | Keklikçi, Kenan | Sarı, Enes | Erdik, Baran | Rodop, Osman

Article | 2013 | Acta Orthopaedica et Traumatologica Turcica47 ( 3 ) , pp.162 - 172

Amaç: Bu makale ile bilateral, bifosfonatla ilişkili, düşük enerjili femur cisim kırığı olan hastaların demografik özelliklerinin değerlendirilmesi amaçlandı. Çalışma planı: Ocak 2008 ila Ocak 2012 tarihleri arasında düşük enerjili femur cisim kırığı olan hastaların kayıtları incelenerek bifosfonatla ilişkili olabilecek olgular saptandı. Postmenopozal osteoporoz tanısı olan, en az 5 yıl süreyle bifosfonat kullanan ve kırıkları öncesinde prodromal ağrısı olan hastalar çalışmaya alındı. Bulgular: Çalışmaya alınma kriterlerine uyan 5 kadın hasta saptandı. Hastaların hepsinde bilateral, düşük enerjili, ardışık femur cisim kırığı vardı. . . .Kırık yapıları benzerdi ve atipik (lateral kortekste kalınlaşmanın olduğu transvers-kısa oblik kırıklar) idi. Ortalama bifosfonat tedavi süresi 8.6 yıl idi. Ortalama hasta yaşı 76.2 olarak saptandı. Üç hastanın ortalama kırık kaynama süresi 20-28 hafta idi. Diğer iki hastada gecikmiş kaynama veya kaynamama nedeniyle revizyon yapıldı. Çıkarımlar: Uzun süre (5 yıldan daha uzun) bifosfonat kullanılması, kemik remodelizasyonunun baskılanması ile yakın ilişkili olan artmış kırılganlık nedeniyle yetmezlik kırıklarına yol açabilir. Bifosfonatlar ile atipik düşük enerjili femur cisim kırıkları arasında nedensel bir ilişki henüz gösterilememiş olmakla birlikte bifosfonatların optimal kullanım süresi ve uzun dönem güvenilirliği konusunda endişelerimiz bulunmaktadır. Objective: The aim of this study was to evaluate the demographic characteristics of patients with bilateral bisphosphonate-related low-energy femoral shaft fractures. Methods: The clinical registry was reviewed for patients with bisphosphonate-related low-energy fractures localized at femoral shaft between January 2008 and January 2012. Patients with a diagnosis of postmenopausal osteoporosis, bisphosphonate usage of at least 5 years and prodromal pain prior to fracture were included the study. Results: Five women met the inclusion criteria. All patients had bilateral low-energy sequential femoral shaft fractures. Fracture patterns were similar and atypical (transverse-short oblique fractures with lateral cortical thickening). Mean period of bisphosphonate treatment was 8.6 years. Mean patient age was 76.2 years. Union time of three patients was between 20 and 28 weeks. The remaining two fractures were revised for delayed union or nonunion. Conclusion: Long-term (over 5 years) use of bisphosphonates may cause insufficiency fractures due to increased fragility and brittleness which have a close relationship with depressed bone remodeling. While there is still no causal relationship between bisphosphonates and atypical, low-energy femoral shaft fractures, we have some concerns about the optimal usage time and long-term safety of bisphosphonate drug Daha fazlası Daha az

Birinci, Tansu | Demirbas, Sule Badıllı

Article | 2017 | Acta Orthopaedica et Traumatologica Turcica51 ( 3 ) , pp.233 - 237

Objective: The aim of this study was to analyze the relationship between the medial longitudinal archmobility and static and dynamic balance.Methods: A total of 50 subjects (25 female, and 25 male; Mean age: 22.2 1.3 years; BMI: 22.8 3.8 kg/m2) were included in this study. The relative arch deformity (RAD) was calculated with both 10% and 90%weight bearing (WB). Static balance was evaluated with Single Leg Stance Test and dynamic balance withTechnoBody PK 200WL computerized balance device. Subjects were evaluated for goniometric measurements of lower extremity joints, leg dominance and leg-length discrepancy.Results: Bipedal dynamic . . . balance was correlated with both feet length at 10% WB and 90% WB. Therewas a correlation between the dynamic balance on dominant foot and RAD value on the aspect ofMedium Speed (r¼ 0.32, p ¼ 0.02), Perimeter Length (r ¼ 0.32, p ¼ 0.02) and AnteriorePosteriorSway (r¼ 0.36, p ¼ 0.01). Static balance was unaffected by RAD value when the visual system waseliminated.Conclusion: Our results suggest that decrease of arch mobility on the dominant foot is associated withposterior sway by causing knee or hip strategy and preventing ankle strategy even in small perturbations.The rate of deviation from the equilibrium point and the degree of total swaying increase when arch mobility decreases Daha fazlası Daha az

Bekler, Halil | Bulut, Güven | Usta, Metin | Gökçe, Alper | Okyar, Fethi | Beyzadeoğlu, Tahsin

Article | 2008 | Acta Orthopaedica et Traumatologica Turcica42 ( 2 ) , pp.125 - 129

Amaç: Bu deneysel çalışmada, konvansiyonel kilitli plak yönteminden farklı olarak, vidaların konfigürasyon ve geometrilerinde yapılan değişikliklerle yaşlı osteoporotik hastalarda stabilizasyonun dayanıklılığını artırmanın yolları arandı. Çalışma planı: Farklı vidalama açılarına sahip dört plakkemik konfigürasyonu oluşturuldu. Yüksek kaliteli 40 adet demir plak (100x35x3 mm) dört gruba ayrıldıktan sonra, her birine 15 mm aralıkla ve 3 mm çapında iki adet delik açıldı. Grup A’da delikler vidaların paralel (0) gönderileceği şekilde, grup B’de vidaların eksenleri bir noktada birleşecek şekilde (konverjan 15), grup C ve D’de ise vida ek . . .senleri birbirinden uzaklaşacak şekilde (diverjan, sırasıyla 15 ve 30) açıldı. Vida testi için, modifiye osteoporotik kemik (Osteoporotic Generic Bone, Synbone) modellerine tespit edilmiş plaklar Instron materyal test cihazına yerleştirilerek 0.1 mm/ sn hızında aksiyel sıyrılma uygulandı. Her örnek için dayanma gücünü aşan yük seviyeleri yük-yer değiştirme eğrilerinden okundu ve yetersizlik tipi kaydedildi. Sonuçlar: En yüksek sıyrılma direncini diverjan düzenekler (grup C’de 83.3 N/mm; grup D’de 80.8 N/mm) gösterdi. Ortalama sıyrılma direnci konverjan düzenekte 72 N/mm, klasik paralel düzenekte 66.7 N/mm bulundu. Yetersizlik tipi diverjan düzeneklerde kemik kırılması iken, konverjan ve paralel düzeneklerde vida sıyrılması şeklindeydi. Çıkarımlar: Osteoporozlu hastalardaki kemik kırıklarının tedavisinde diverjan düzenekler, klasik vida yerleşiminin yerini alabilecek bir seçenek olabilir. Objectives: This experimental study was designed to find new ways of improving stabilization of fractures in osteoporotic elderly patients through alterations made in the configuration and geometry of locked screw-plate fixation used in the conventional plate technique. Methods: Four screw configurations with varying angulations were used for plate-bone construction. Forty iron plates of high quality (100x35x3 mm) were divided into four groups and two screw holes, 3 mm in diameter, were drilled on each plate at a distance of 15 mm. In group A, the holes were drilled so that the screws would be vertically sent to the bone interface. In the remaining groups, the holes were drilled for convergent (group B, 15°) and divergent (group C, 15°; group D, 30°) screw orientation. Screw-plate fixation was tested in a modified osteoporotic bone (Osteoporotic Generic Bone, Synbone) on an Instron materials testing system with an axial pullout force of 0.1 mm/sec. Failure loads were read from load-displacement curves and the type of failure was noted. Results: Screws placed in divergent orientations showed the highest axial pull-out strength (group C, 83.3 N/mm; group D, 80.8 N/mm), followed by convergent placement (72 N/mm) and vertical placement (66.7 N/mm). The type of failure was breakage of the bone sample in divergent configurations, and screw pull-out in convergent and vertical configurations. Conclusion: Divergent constructs may be a promising alternative to conventional screw placement in treating osteoporotic fractures Daha fazlası Daha az

Bekler, Halil | Beyzadeoğlu, Tahsin | Gökçe, Alper

Article | 2007 | Acta Orthopaedica et Traumatologica Turcica41 ( 5 ) , pp.387 - 392

Amaç: Düşük ayak deformitesi nedeniyle posterior tibial tendon (PTT) transferi uygulanan hastalar değerlendirildi. Çalışma planı: Düşük ayak deformitesi saptanan sekiz hastada (2 kadın, 6 erkek; ort. yaş 40; dağılım 15-75 yıl) PTT ayak dorsaline nakledildi. Üç hastada sol, beş hastada sağ alt ekstremitede tutulum vardı. Etyoloji altı hastada travmatik peroneal sinir yaralanması, iki hastada ise kalça ve bel cerrahisinin yol açtığı daha yüksek seviyeli sinir yaralanmalarıydı. Klinik sonuçları değerlendirirken, ilk olarak hastaların tedavi sonucuyla ilgili düşünceleri sorgulandı; daha sonra hastalar Yeap ve ark. tarafından PTT transfe . . .rlerinden sonra önerilen Stanmore değerlendirme skalasına göre incelendi. Ortalama takip süresi 39 ay (dağılım 8-78 ay) idi. Sonuçlar: Stanmore skalasına göre üç hastada mükemmel, iki hastada iyi, iki hastada orta, bir hastada kötü sonuç alındı. Dört hasta durumunu mükemmel, üçü iyi, biri ise kötü olarak değerlendirdi. Kötü sonuç alınan olguda, politravma sekelli femur kırığı, asetabulum posterior kırıklı çıkığı, L3 kompresyon kırığı öyküsüyle birlikte, siyatik sinirde de en az iki seviyeli hasar vardı. Orta sonuç alınan iki hastanın birinde ameliyat sonrası yetersiz bakım nedeniyle, ayak dorsalinde transfer bölgesinde derin yangı gelişti. Kullanılmış olan dikişli ankor, bir bölüm kemik debridmanıyla birlikte çıkarıldı. Diğer hastada ise doğuştan olan spondilolistezis zemininde gelişen ve füzyon ameliyatını takiben ilerleyen ciddi paraparezi vardı. Çıkarımlar: Düşük ayak deformitesi tedavisinde PTT transferi, paraparezili ambulatuvar hastalarda dahi başarıyla uygulanabilen bir tekniktir. Bu hastalarda anterior tibial tendonun da işleme eklenmesi yararlı olabilir. Objectives: We evaluated tibialis posterior tendon (TPT) transfers in patients with drop foot deformity. Methods: Eight patients with drop foot deformity (2 females, 6 males; mean age 40 years; range 15 to 75 years) underwent TPT transfer to the dorsum of the foot. The deformity was on the left in three patients and on the right in five patients. Etiology was traumatic peroneal nerve injuries in six patients, and upper-level nerve injuries after hip and lumbar surgery in two patients. For clinical evaluation, the patients were questioned about the results of treatment, and the Stanmore evaluation scale was applied, which is recommended by Yeap et al. for TPT transfers. The mean follow-up period was 39 months (range 8 to 78 months). Results: According to the Stanmore scale, the results were excellent in three patients, good in two patients, fair in two patients, and poor in one patient. Subjectively, four patients defined their condition as excellent, three as good, and one as poor. One poor result was associated with polytrauma sequelae including a femoral fracture, posterior acetabular fracture-dislocation, and L3 compression fracture, accompanied by at least a two-level injury to the sciatic nerve. Of two patients with a fair result, one patient developed deep infection at the dorsum of the foot due to inadequate postoperative care and required removal of the suture anchor with partial bone debridement. The other patient had severe paraparesis associated with congenital spondylolisthesis, which aggravated following spinal fusion surgery. Conclusion: We conclude that TPT transfer is a successful technique for the treatment of drop foot even in ambulatory patients with paraparesis. Addition of tibialis anterior tendon transfer may be useful in these patients Daha fazlası Daha az

Atay, E.F. | Güven, M. | Altintaş, F. | Kadioglu, B. | Ceviz, E. | Ipek, S.

Article | 2010 | Acta Orthopaedica et Traumatologica Turcica44 ( 4 ) , pp.306 - 312

Objectives: We aimed to evaluate the effectiveness of postoperative autotransfusion method on prevention of the need of allogeneic blood transfusion in hip and knee arthroplasty. Methods: Seventy-four patients who underwent 77 hip and knee arthroplasty operations were randomized into control and study groups, and evaluated prospectively. In the knee group (39 patients; 30 females, 9 males; mean age 66.6 years), cemented, cruciate retaining, and bicompartmental arthroplasty was performed under tourniquet control; whereas in the hip group (35 patients; 24 females, 11 males; mean age 59.3 years) cementless arthroplasty with posterolate . . .ral approach was performed. None of the patients received preoperative and intraoperative allogeneic blood transfusion. The collected blood in the surgical area was transfused with autotransfusion system to the patients in the study groups at the end of the fourth hour postoperatively. The mean amounts of autotransfused blood in hip and knee groups were 413 mL and 480 mL, respectively. Allogeneic blood transfusion was applied to the patients with hemoglobin level below 8 g/dL, hematocrit level below 25%, and clinical symptoms of anemia. Results: Preoperative and postoperative hemoglobin-hematocrit levels did not differ significantly between study and control groups. Allogeneic blood transfusion was applied to one patient (5%) in study and 8 patients (38%) in control groups during knee arthroplasty (p=0.01); whereas 9 patients (53%) in study and 15 patients (79%) in control groups received allogeneic blood transfusion during hip arthroplasty (p=0.044). The amount of allogeneic blood transfusion in study groups was significantly lower than that in control groups (p=0.008 for knee arthroplasty, p=0.048 for hip arthroplasty). Conclusion: The need and amount of allogeneic transfusion were reduced with postoperative autotransfusion in both knee and hip arthroplasty groups with greater extent in knee arthroplasty. © 2010 Turkish Association of Orthopaedics and Traumatology Daha fazlası Daha az

İnan, Muharrem | Altıntaş, Faik | Duru, İlay

Article | 2009 | Acta Orthopaedica et Traumatologica Turcica43 ( 2 ) , pp.106 - 112

Rotasyonel deformiteler beyin felçli çocuklarda yaygın olarak görülen, içe dönük ve dışa dönük yürümeyi içeren alt ekstremite anormallikleridir. İçe dönük yürüme üç tür deformitenin birinden kaynaklanır: artmış femoral anteversiyon, internal tibial torsiyon ve metatarsus varus; daha nadir görülen dışa dönük yürüme ise femoral retroversiyon ve eksternal tibial torsiyondan kaynaklanır. Dikkatli fizik ve radyografik inceleme ile doğru tanı konmalıdır. Rotational deformities are common lower extremity abnormalities in children with cerebral palsy, which include intoeing and outtoeing. Intoeing is caused by one of the three types of defo . . .rmity: increased femoral anteversion, internal tibial torsion, and metatarsus varus, while outtoeing, the less common form, is caused by femoral retroversion and external tibial torsion. An accurate diagnosis should be made with careful physical and radiographic examination Daha fazlası Daha az