Altintas, F. | Gurbuz, H. | Erdemli, B. | Atilla, B. | Ustaoglu, R.G. | Ozic, U. | Kinik, H.

Article | 2008 | Acta Orthopaedica et Traumatologica Turcica42 ( 5 ) , pp.322 - 327

Objectives: We investigated risk factors for venous thromboembolism (VTE), prophylaxis measures employed, and incidence of symptomatic deep venous thrombosis (DVT) and pulmonary embolism (PE) in patients undergoing major orthopaedic surgery (MOS). Methods: An open, multicenter, prospective, observational study was conducted in 21 medical centers, comprising 899 patients. Of these, 316 patients (35.2%) underwent total hip arthroplasty (THA), 328 patients (36.5%) underwent total knee arthroplasty (TKA), and 255 patients (28.4%) underwent surgery for hip fractures (HF). Pharmacologic prophylaxis was employed in all the patients. Result . . .s: Risk factors for VTE were seen in 73.2% of the patents, the most common being obesity (72%) and prolonged immobilization (36.3%). Low-molecular-weight heparin (91.1%) and fondaparinux (8.9%) were used for prophylaxis, which was short-term in 273 patients (30.4%) and long-term in 626 patients (69.6%). Mechanical prophylaxis was performed with compression stockings in 610 patients (67.9%) and by intermittent pneumatic compression in 67 patients (7.5%). During three-months of follow-up, symptomatic DVT and PE were seen in eight (0.9%) and four patients (0.4%), respectively. Mortality occurred in 10 patients (1.1%). Complications of major and minor bleeding were seen in eight (0.9%) and 40 (4.5%) patients, respectively. Conclusion: Effective VTE prophylaxis is associated with low risk of clinically apparent DVT and PE in MOS. © 2008 Turkish Association of Orthopaedics and Traumatology Daha fazlası Daha az

Beyzadeoğlu, Tahsin | Torun, Gamze Köse | Ekici, Işın D. | Bekler, Halil | Yılmaz, Cemil

Article | 2012 | Acta Orthopaedica et Traumatologica Turcica46 ( 3 ) , pp.201 - 207

Amaç: Çalışmamızın amacı bupivakain, levobupivakain ve tramadolün eklem kıkırdağı ve kondrositler üzerindeki etkisini in vivo ve in vitro olarak deneysel sıçan modelinde araştırmaktı. Çalışma planı: 250-300 g ağırlığında 30 adet Sprague Dawley cinsi sıçan randomize olarak 3 gruba ayrıldı. Bupivakain (Grup 1), levobupivakain (Grup 2) ve tramadol (Grup 3) sağ dizlerine, %0.9 serum fizyolojik ise sol dizlerine enjekte edildi. Her gruptan sıçanların 5’inin yaşamı 48. saatte, 5’inki ise 10. günde sonlandırıldı. Örnekler fikse ve dekalsifiye edilerek, hematoksilen&eosin ve toluidin mavisi ile boyandı. Tüm örnekler ICRS osteoartrit ve kıkı . . .rdak histopatolojik sınıflama sistemine göre değerlendirildi. Sıçanların eklem kıkırdak hücreleri kültür edilip hücre kültür kaplarına ekildi. Ekilmiş kıkırdak hücre örnekleri (104 hücre/ml) %0.5’lik üç farklı (sırasıyla bupivakain, levobupivakain ve tramadol) anestezik ajan içinde inkübe edildi. Örneklerdeki hücre sayısını ölçmek için, CellTiter 96 Nonradioactivity Cell Proliferation (MTS) assay kullanıldı. Bulgular: Levobupivakain enjekte edilen grupta, 10. gün yaşamları sonlandırılan sıçanlarda, 48. saatte sonlandırılanlara kıyasla istatistiksel olarak belirgin yüksek OARSI derecesi, OA evresi ve skorları bulundu. (p Objective: The aim of this study was to evaluate the effects of both in vivo and in vitro bupivacaine, levobupivacaine and tramadol on articular cartilage and chondrocytes in experimental rat models. Methods: Thirty mature Sprague Dawley rats weighing 230-300 g were randomized into 3 groups. Bupivacaine (Group 1), levobupivacaine (Group 2) and tramadol (Group 3) were injected into the right knee joints and a physiological 0.9% saline into the left. From each group, 5 rats were executed 48 hours following drug administration after 5 and 10 days. The specimens were fixed, decalcified and stained with hematoxylin & eosin and toluidine blue. All samples were histopathologically evaluated according to the recommendation of ICRS’ osteoarthritis and cartilage histopathology grading and staging system. Articular cartilage cells of the rats were cultured and seeded into cell culture flasks. Cartilage cell seeded samples (104 cells/ml) were incubated in three different anesthetic agents (0.5%); bupivacaine, levobupivacaine, and tramadol, respectively. CellTiter 96® Non-Radioactive Cell Proliferation (MTS) assay was used to determine the cell density on the samples. Results: Statistically significant higher OARSI grades and OA stage and scores were detected when comparing the group injected with levobupivacaine and executed after 10 days with the levobupivacaine injected group killed after 48 hours ( Daha fazlası Daha az

Kızılcık, Nurcan | Özler, Turhan | Menda, Ferdi | Uluçay, Çagatay | Köner, Ozge | Altıntaş, Faik

Article | 2017 | Acta Orthopaedica et Traumatologica Turcica51 ( 2 ) , pp.104 - 109

Objective: The aim of this study was to compared the effectiveness of intraarticular levobupivacain withlevobupivacain and magnesium sulfate.Methods: In this prospective randomized double blinded study, 96 patients (67 male, 29 female; agerange: 18e65 years) with ASA (American Society of Anesthesiologist) score I and II, who had undergonearthroscopic meniscectomy operation, were divided to 3 groups that had postoperative analgesia withintra-articular saline injection (control group), levobupivacain injection (L group) or levobupivacain andmagnesium sulfate injection (LM group). Patients were compared with postoperative VAS (Visual A . . .nalogScore) score during rest and activity, opioid analgesic need, non-opioid analgesic need and othermedication needs.Results: Postoperative VAS scores during rest and activation at early postoperative period were signiŞcantly lower at LM group when compared with L group and lower than control group at all time periods.Opioid analgesic need, non-opioid analgesic need and other medication needs for non-pain symptomswere lower at LM group when compared with L and control groups at all time periods.Conclusion: Intraarticular magnesium sulfate plus Levobupivacain injection is a safe and effectivemethod for post operative pain management after arthroscopic meniscectomy.Keywords: Intra-articular injection, Magnesium sulfate, Levobupivacain, Postoperative analgesia, Chondrocyte apoptosis, Pain management, Arthroscopic menisectomyLevel of Evidence: Level I, Therapeutic study© 2017 Turkish Association of Orthopaedics and Traumatology. Publishing services by Elsevier B.V. This isan open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/) Daha fazlası Daha az

Özler, Turhan | Uluçay, Çağatay | Önal, Ayberk | Altıntaş, Faik

Other | 2015 | Acta Orthopaedica et Traumatologica Turcica49 ( 3 ) , pp.255 - 259

Objective: Prevention of deep venous thrombosis (DVT) and associated pulmonary embolism following major orthopedic surgeries is challenging, and there is an increased interest in developing new treatment strategies. We compared 2 switch-therapy modalitiesenoxaparin to rivaroxaban and enoxaparin to dabigatranand enoxaparin monotherapy for preventing DVT after total knee arthroplasty (TKA) and total hip arthroplasty (THA). Methods: This was a prospective, non-blinded, randomized controlled study. We selected 180 eligible patients out of 247 patients undergoing TKA or THA. During the preoperative checkup, patients were randomized to re . . .ceive either enoxaparin (enoxaparin group) or switch-therapy regimens, comprising enoxaparin during hospitalization and rivaroxaban (rivaroxaban group) or dabigatran (dabigatran group) during the outpatient period. All patients were evaluated for DVT using Doppler ultrasonography (USG) 6 weeks postoperatively. The primary efficacy outcome was the prevention of symptomatic or Doppler ultrasonography (USG)-proven DVT, whereas the primary safety outcome was the incidence of bleeding during the DVT-prophylaxis period. Results: Doppler USG at 6 weeks after surgery revealed no signs of DVT in any patient. During the hospitalization period, only 2 major bleeding events were reported (1 [1.6%] in the enoxaparin group and 1 [1.6%] in the dabigatran group). No major bleeding events were reported during the outpatient follow-up period in any group. Differences among the 3 groups regarding bleeding events were not statistically significant (p>0.05). Conclusion: When using switch-therapy modalities, clinicians can take advantage of the safety of enoxaparin during the hospitalization period and ease of use of new oral anticoagulant drugs during the outpatient period Daha fazlası Daha az

Atay, Evren Fehmi | Güven, Melih | Altıntaş, Faik | Kadıoğlu, Barış | Ceviz, Emrah | İpek, Serdar

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

Amaç: Bu çal›flmada kalça ve diz artroplastisinde ameliyat sonras› uygulanan ototransfüzyon yönteminin allojenik kan transfüzyonu ihtiyac›n› önlemedeki etkinliinin deerlendirilmesi amaçlanm›flt›r. Çal›flma plan›: Total kalça ve diz artroplastisi uygulanm›fl 74 hasta (77 artroplasti giriflimi) ça- l›flma ve kontrol gruplar›na randomize edilerek prospektif olarak deerlendirildi. Diz grubunda (39 hasta; 30 kad›n, 9 erkek; ortalama yafl 66.6) standart yaklafl›mla turnike kontrolünde çimen- tolu, kalça grubundaysa (35 hasta; 24 kad›n, 11 erkek; ortalama yafl 59.3) posterolateral yakla- fl›mla çimentosuz artroplasti uyguland›. Hiçbir hast . . .aya ameliyat öncesinde ve s›ras›nda allojenik kan transfüzyonu yap›lmad›. Çal›flma gruplar›ndaki hastalarda ameliyat sonras› 4. saatte cerrahi sahada biriken kan ototransfüzyon seti ile transfüze edildi. Kalça ve diz çal›flma gruplar›nda or- talama ototransfüzyon miktarlar› s›ras›yla 413 mL ve 480 mL idi. Banka kan› transfüzyonu; he- moglobin 8 gr/dL’nin, hematokrit ise %25’in alt›nda olduu ve klinik olarak anemi bulgular›n›n efllik ettii hastalarda uyguland›. Sonuçlar: Çal›flma ve kontrol gruplar› aras›nda ameliyat öncesi ve sonras› hemoglobin-hematok- rit deerlerinde istatistiksel anlaml› fark yoktu. Diz hastalar›nda çal›flma grubunda 1 (%5), kon- trol grubunda 8 (%38) (p0.01); kalça hastalar›nda ise çal›flma grubunda 9 (%53), kontrol gru- bunda 15 (%79) hastada (p0.044) banka kan› transfüzyonu yap›ld›. Çal›flma gruplar›nda alloje- nik transfüzyon miktar› kontrol gruplar›na göre anlaml› olarak düflüktü (diz grubu p0.008, kal- ça grubu p0.048). Ç›kar›mlar: Diz ve kalça artroplastisinde ototransfüzyon yöntemiyle diz artroplastisinde daha belirgin olmak üzere allojenik kan transfüzyonu ihtiyac› ve transfüzyon miktar› azalmaktad›r Daha fazlası Daha az

Beyzadeoğlu, Tahsin | Gökçe, Alper | Bekler, Halil

Article | 2007 | Acta Orthopaedica et Traumatologica Turcica41 ( 3 ) , pp.220 - 224

Amaç: Plantar fasiitis tedavisinde gece ateli kullanımının etkinliği ve tedavi sonuçları değerlendirildi. Çalışma planı: Çalışmaya plantar fasiitis tanısı konan 44 hasta (53 ayak) alındı. Yakınmaların süresi ortalama 7.25.9 haftaydı (dağılım 1-24 hafta). On iki ayakta eşlik eden kalkaneal çıkıntı vardı. Tüm hastalara klasik konservatif tedavi uygulandı ve bu tedaviye ek olarak, uyurken ayak bileğini 5 dorsifleksiyonda tutan gece atelini sekiz hafta kullanmaları önerildi. Yirmi beş hasta (14 kadın, 11 erkek; 31 ayak) sadece konservatif tedaviyi sürdürdü. On dokuz hasta (12 kadın, 7 erkek; 22 ayak) ise gece ateli uygulamasını kabul et . . .ti. Değerlendirme, hastaların ilk başvurularında ve ikinci ay sonunda, AOFAS ayak bileği-arka ayak değerlendirme skalası ve görsel analog skala (GAS) ile yapıldı. Ortalama izlem süresi atel kullanmayan grupta 32.7 ay (dağılım 13-53 ay), atel kullanan grupta 33.8 ay (dağılım 12-54 ay) idi. Sonuçlar: Tedavi öncesindeki ayak bileği-arka ayak değerlendirme skoru ve GAS skoru açısından iki grup arasında anlamlı farklılık yokken, ikinci ayda, atel kullanan hastalarda her iki skordaki düzelmenin anlamlı derecede daha fazla olduğu görüldü (sırasıyla, p0.01 ve p0.001). Takip süresi sonunda atel kullanmayan grupta dokuz ayakta (%29), atel kullanan grupta üç ayakta (%13.6) yakınmaların tekrarladığı görüldü. Tüm hastalar değerlendirildiğinde, kalkaneal çıkıntı, iki taraflı tutulum ve vücut kütle indeksi ile memnuniyet oranları ve nüks arasında; kalkaneal çıkıntı ile vücut kütle indeksi arasında anlamlı ilişki bulunmadı. Başvurudaki yakınma süresi ile nüks arasındaki ilişki ise anlamlıydı (r0.326, p0.031). Çıkarımlar: Plantar fasiitis nedeniyle ilk kez tedavi gören hastalarda, diğer konservatif yöntemlere eklenen gece ateli kullanımı erken dönemde topuk ağrısının gerilemesini sağlamasına karşın, iki yıldan uzun takipte yakınmaların tekrarlaması üzerinde belirgin bir etki sağlamamıştır. Objectives: We evaluated the effectiveness and results of night splint applications for the treatment of plantar fasciitis. Methods: The study included 44 patients (53 feet) with plantar fasciitis. The mean symptom duration was 7.2±5.9 weeks (range 1 to 24 weeks). Calcaneal spurs were detected in 12 feet. All the patients received classic conservative treatment and all were recommended to use a night splint that kept the ankle in 5-degree of dorsiflexion for eight weeks. Twenty-five patients (14 females, 11 males; 31 feet) did not accept to use a night splint, whereas 19 patients (12 females, 7 males; 22 feet) did. Evaluations were made with the AOFAS ankle-hindfoot rating scale and a visual analog scale (VAS) before and after two months of treatment. The mean follow-up periods were 33.8 months (range 12 to 54 months) and 32.7 months (range 13 to 53 months) for those who completed treatment with and without the use of a night splint, respectively. Results: Although there were no significant differences between the two groups with regard to the initial AOFAS and VAS scores, patients using a night splint exhibited significantly higher improvements in both scores at the end of the second month (p0.01 and p0.001, respectively). Heel pain recurred in three feet (13.6%) and in nine feet (29%) with and without night splint applications, respectively. Overall, the presence of a calcaneal spur, bilateral involvement, and body mass index were not correlated with patient satisfaction and recurrences. There was no correlation between the presence of a calcaneal spur and body mass index. However, symptom duration till treatment showed a significant correlation with recurrences (r0.326, p0.031). Conclusion: Patients without previous treatments for plantar fasciitis obtain significant relief of heel pain in the short term with the use of a night splint incorporated into conservative methods; however, this application does not have a significant effect on prevention of recurrences after a two-year follow-up Daha fazlası Daha az

Altıntaş, Faik | Gürbüz, Hakan | Erdemli, Bülent | Atilla, Bülent | Ustaoğlu, Recep Gür | Öziç, Uğur | Kınık, Hakan

Article | 2008 | Acta Orthopaedica et Traumatologica Turcica42 ( 5 ) , pp.322 - 327

Amaç: Ülkemizde majör ortopedik cerrahi (MOC) için farmakolojik profilaksi uygulanan hastalarda venöz tromboembolizm (VTE) risk faktörleri, kullanılan profilaksi yöntemleri ve klinik bulgu veren derin ven trombozu (DVT) ve pulmoner emboli (PE) sıklığı araştırıldı. Çalışma planı: Prospektif, çokmerkezli, açık, müdahalesiz bir gözlem çalışması planlanarak, 21 merkezden 899 hasta çalışmaya alındı. Olguların 316’sında (%35.2) total kalça protezi (TKP), 328’inde (%36.5) total diz protezi (TDP), 255’inde (%28.4) kalça kırığı (KK) cerrahisi uygulandı. Tüm hastalarda farmakolojik DVT profilaksisine başvuruldu. Sonuçlar: Olguların %73.2’sind . . .e VTE risk faktörleri vardı. En sık görülen risk faktörleri obezite (%72) ve uzamış immobilizasyon (%36.3) idi. Profilaksi için olguların %91.1’inde düşük molekül ağırlıklı heparin, %8.9’unda fondaparinuks kullanıldı. Olguların 273’üne (%30.4) kısa dönem, 626’sına (%69.6) uzun dönem profilaksi uygulandı. Mekanik profilaksi 610 olguda (%67.9) elastik çorap ile, 67 olguda (%7.5) aralıklı hava basınç cihazı ile uygulandı. Üç aylık takip sonucunda sekiz olguda (%0.9) klinik bulgu veren DVT, dört olguda (%0.4) PE gelişti. Mortalite 10 olguda (%1.1) görüldü. Kanama komplikasyonu sekiz olguda (%0.9) majör, 40 olguda (%4.5) minör idi. Çıkarımlar: Etkin VTE profilaksi yapıldığında MOC’de klinik bulgu veren DVT ve PE oranları düşük olmaktadır. Objectives: We investigated risk factors for venous thromboembolism (VTE), prophylaxis measures employed, and incidence of symptomatic deep venous thrombosis (DVT) and pulmonary embolism (PE) in patients undergoing major orthopaedic surgery (MOS). Methods: An open, multicenter, prospective, observational study was conducted in 21 medical centers, comprising 899 patients. Of these, 316 patients (35.2%) underwent total hip arthroplasty (THA), 328 patients (36.5%) underwent total knee arthroplasty (TKA), and 255 patients (28.4%) underwent surgery for hip fractures (HF). Pharmacologic prophylaxis was employed in all the patients. Results: Risk factors for VTE were seen in 73.2% of the patents, the most common being obesity (72%) and prolonged immobilization (36.3%). Low-molecular-weight heparin (91.1%) and fondaparinux (8.9%) were used for prophylaxis, which was short-term in 273 patients (30.4%) and long-term in 626 patients (69.6%). Mechanical prophylaxis was performed with compression stockings in 610 patients (67.9%) and by intermittent pneumatic compression in 67 patients (7.5%). During three-months of follow-up, symptomatic DVT and PE were seen in eight (0.9%) and four patients (0.4%), respectively. Mortality occurred in 10 patients (1.1%). Complications of major and minor bleeding were seen in eight (0.9%) and 40 (4.5%) patients, respectively. Conclusion: Effective VTE prophylaxis is associated with low risk of clinically apparent DVT and PE in MOS Daha fazlası Daha az

Akman, B. | Şaylı, U. | Güven, M. | Altıntaş, F.

Letter | 2018 | Acta Orthopaedica et Traumatologica Turcica52 ( 4 ) , pp.326 - 327

[No abstract available]

Özkul, Fatih | Barkana, Duygun Erol | Badıllı, Şule Demirbaş | İnal, Serap

Article | 2012 | Acta Orthopaedica et Traumatologica Turcica46 ( 5 ) , pp.332 - 338

Amaç: Bu pilot çal›flman›n amac› dirsek fleksiyonunun proprioseptif duyusunu robot yard›ml› rehabi- litasyon sistemi RehabRoby ile deerlendirmek ve RehabRoby’yi fizyoterapide kullan›labilecek bir ro- bot sistemi olarak deerlendirmekti. Çal›flma plan›: Çal›flmaya fizyoterapi (FZT) veya elektrik ve elektronik mühendislii (EEM) eitimi gören 20 gönüllü (her grupta 5 kad›n ve 5 erkek) al›nd›. RehabRoby’ye yerlefltirilen deneklerden aktif ve sonra rahatl›kla tolere edilebilen bir dirence karfl›, s›ras›yla gözler aç›k ve kapal› olarak dirsek flek- siyonu yapmalar› ve belirlenmifl hedef aç›lar›n› (20o, 45o ve 90o) bulmalar› istendi. Denekle . . .rin hareket aç›s›, her hedef aç›da uygulanan tork ve hedef aç›ya ulafl›rken ortaya ç›kan hareket hatas› (uyum hata- s›) mutlak veriler olarak kaydedildi. Ayn› zamanda deneklerin sosyo-demografik ve fiziksel özellikleri de incelendi. Bulgular: Gözler aç›k 45o dirsek fleksiyonunu bulmada FZT örencilerinin yapt›› uyum hatas› EEM örencilerine göre daha az bulundu. Gözler kapal› 20o dirençli dirsek fleksiyonu ile tork aras›nda ne- gatif bir korelasyon kaydedildi (p0.05). Ayn› zamanda, kad›n olman›n ve biceps brachii kas› kuvveti- nin gözler kapal› 20o aktif dirsek fleksiyonunda hatan›n az olmas› üzerinde belirleyici faktörler olduu saptand›. Görüfl olmaks›z›n 45o’deki uyum hatas› FZT grubunda (-0.31) EEM grubuna göre (0.77) da- ha düflüktü Ayr›ca, biceps brachii kas› kuvvetinin ise 20o’deki hareketin propriyosepsiyon duyusu üze- rinde etkin bir rol oynad›› sonucuna var›ld›. Ç›kar›mlar: Bu pilot çal›flman›n sonucunda propriyosepsiyon duyusunun deerlendirilmesinde Re- habRoby’nin kullan›labilir bir sistem olduu sonucuna var›ld› ve RehabRoby robotik sisteminin, ge- çerlilik çal›flmalar› yap›ld›ktan sonra, gelecekte hastalarda proprioseptif duyuyu deerlendirme, tan›la- ma ve gelifltirme amaçl› kullan›labilecei düflünüldü Daha fazlası Daha az

Özler, Turhan | Güven, Melih | Önal, Ayberk | Uluçay, Çağatay | Beyzadeoğlu, Tahsin | Altıntaş, Faik

Article | 2014 | Acta Orthopaedica et Traumatologica Turcica48 ( 3 ) , pp.249 - 252

Amaç:Bu çalışmada tanısı atlanmış izole posterior malleol kırıklı hastaların yaralanma mekanizması ve klinik ve radyolojik sonuçlar açısından değerlendirilmesi amaçlandı. Çalışma planı: Atlanmış izole posterior malleol kırığı olan 7 hasta (5 erkek, 2 kadın, ortalama yaş 32 (23-40)) çalışmaya alındı. Ayak bileği burkulması nedeniyle acil servise başvuran ve standart ayak bilek grafileri ile kırık saptanmayan bu 7 hastada şikayetlerin devam etmesi nedeniyle 3. haftada çekilen ayak bileği MR görüntülemesi ile izole posterior malleol kırığı tanısı koyuldu. Hastalar 3 hafta boyunca yük kısıtlaması ve ayak bilekliği ile tedavi edildiler. . . .Kırık kaynamasının ve olası dejeneratif değişikliklerin değerlendirilmesinde ayak bileğinin ön-arka, yan ve 50 dış rotasyonda çekilen grafileri kullanıldı. Bütün hastalar 1 yıl takip edildi. Bulgular: Altıncı hafta sonunda 7 hastanın 6’sında kırık kaynaması görüldü. Bir hastanın ise 6. ayda hala kırığı kaynamamıştı. Hastaların ortalama AOFAS ayak bileği ardayak skorları tedavi öncesi ve tedavi sonrası 3. ayda sırası ile 20 (11-31) ve 86 (43-96) idi. Birinci yıl takiplerinde hiçbir hastada dejeneratif değişiklik veya instabilite saptanmadı. Çıkarımlar: Ayak bileği arkasında ağrı yakınması olan ve plantar fleksiyon ve/veya aksiyel kompresyon mekanizması ile ayak bileği burkulması tarif eden hastalarda izole posterior malleol kırığı akla getirilmelidir. Tanıda 50 dış rotasyonda çekilen yan grafi kırığın saptanmasına yardımcı olabilir. Objective:The aim of this study was to evaluate the injury mechanism and clinical and radiological results of the patients with isolated posterior malleolar fracture. Methods: Seven patients (5 male, 2 female; mean age: 32 years; range: 23-40) with a missed isolated posterior malleolar fracture were included in the study. All patients had initially been examined for an ankle sprain in the emergency room, where the initial plain radiographs did not show any abnormality. Due to the long lasting symptoms all patients underwent an MRI scan by the 3rd week which revealed a posterior malleolar fracture. Patients were treated with an ankle brace for 3 weeks. All patients were followed up for 1 year. Bone healing and degenerative changes were evaluated with plain Radiographs, including a 50° external rotation lateral. Clinical outcome was evaluated with American Orthopedic Foot and Ankle Society ankle hindfoot scale. Results: Fracture healing was seen in 6 of the 7 patients by the 6th week. There was no radiographic healing by 6th month in the remaining patient. Mean AOFAS ankle hindfoot scores at the beginning of the treatment and at 3rd month were 20 (11-31) and 86 (43-96), respectively. There was no instability or degenerative changes at one-year follow-up. Conclusion: Isolated posterior malleolar fracture should be kept in mind in patients who present with pain at the posterior part of the ankle following a forced plantar flexion and/or axial compression injury. A 50° external rotation lateral radiograph can be useful in detecting the fracture Daha fazlası Daha az

Servet, Erkan | Bekler, Halil | Kılınçoğlu, Volkan | Özler, Turhan | Özkut, Afşar

Other | 2016 | Acta Orthopaedica et Traumatologica Turcica50 ( 2 ) , pp.234 - 241

Objective: Epineural scar formation is one of the most significant negative factors affecting surgical repair after peripheral nerve injury. The scar tissue mechanically hinders axonal regeneration and causes adhesions between nerves and surrounding tissues. A hemostatic agent Ankaferd Blood Stopper (ABS; İmmun Gıda İlaç Kozmetik San. ve Tic. Ltd. Şti., Istanbul, Turkey) has not been previously used. Decreasing the postoperative bleeding and adhesions between nerve and surrounding tissues will prevent the formation of scar tissue, as well as corresponding compressive neuropathy and/or deceleration of axonal regeneration. The . . .purpose of this experimental study was to investigate the effects of bleeding on nerve healing and scar tissue after repair of peripheral nerve injuries.Methods: The right sciatic nerve of 30 Sprague-Dawley male rats (weighing 260-330 g) was cut 1.5 cm proximal to the trifurcation and repaired primarily with 8/0 sutures using epineural technique. The rats were then divided into 3 groups. Saline was applied in Group 1 (n10), ABS in Group 2 (n10), and heparin in Group 3 (n10) for 5 minutes to the repair site and surrounding tissues. In each group, electrophysiological measurements were performed with electromyography (EMG) at postoperative week 12. Magnetic resonance diffusion tensor imaging was used at week 12. Macroscopical and histopathological evaluations were conducted after sacrificing the rats at week 24 with total excision of the repaired sciatic nerves and surrounding tissues.Results: The ABS and saline groups showed better healing than the heparin group. The ABS and saline groups were better in the histopathologic evaluations, but there was no statistically significant difference between the 2 groups.Conclusion: Statistically significant differences were not found between the 3 groups. Significant results may be obtained with larger studie Daha fazlası Daha az

Uluçay, C. | Özler, T. | Güven, M. | Akman, B. | Kocadal, A.O. | Altintaş, F.

Article | 2013 | Acta Orthopaedica et Traumatologica Turcica47 ( 5 ) , pp.330 - 333

Objective: We aimed to find out the distribution of etiological factors in patients who had total hip replacement for coxarthrosis. Methods: The medical records of the 965 hips of 886 patients operated with total hip replacement between 2001 and 2012 in two separate arthroplasty clinics were analyzed by two separate senior surgeons. Each patient's pre- and postoperative X-rays and demographic data such as gender, age, side and probable etiologic factors were noted. Results: Six hundred and eighty-four patients were women and 202 were men. The mean age were 62.7±14.3 (range: 16 to 91) in women, 58.8±17.1 (range: 25 to 91) in men. 52. . . .1% of the surgeries were performed on the right side, 39% on the left, and 8.9% bilaterally. In women 36.2% of the cases were primary coxarthrosis, while the etiology was developmental dysplasia of the hip (DDH) in 43.5% of the cases, avascular necrosis in 10%, romatoid diseases in 7%, slipped capital femoral epiphysis in 5%, posttraumatic coxarthrosis in 3.9%, pathologic coxarthrosis in 1.9%, and Perthes sequel in 1.7%. In men, 24.4% of the cases were primary coxarthrosis, while the etiology was avascular necrosis in 21% of the cases, DDH in 17.6%, posttraumatic coxarthrosis in 16.8%, romatoid diseases in 10.9%, Perthes sequel in 4.2%, slipped capital femoral epiphysis in 2.5%, and pathologic coxarthrosis in 2.5%. The most common etiologic factor was DDH with a rate of 37.1%. Conclusion: Despite the heterogeneity of our study population, our results may reflect the distribution of coxarthrosis etiologies in Turkey. Developmental dysplasia of the hip appears to be the most frequent cause of coxarthrosis among the patients undergoing total hip replacement. © 2013 Turkish Association of Orthopaedics and Traumatology Daha fazlası Daha az