Şahan Güven - Academia.edu (original) (raw)

Papers by Şahan Güven

International Journal of Academic Medicine and Pharmacy

Supracondylar humerus fractures are the most common elbow injuries in children. Closed reduction ... more Supracondylar humerus fractures are the most common elbow injuries in children. Closed reduction percutaneous fixation is the preferred method in the treatment of pediatric supracondylar humeral fractures. The optimal pin configuration is still a matter of debate. As the most commonly used fixation method, medial-lateral cross pinning provides better stability biomechanically but there is an increased risk of ulnar nerve injury. We also used the modified Dorgan method (lateral cross pin) to minimize the risk of ulnar nerve injury and to obtain fixation with similar biomechanical stability. In this study, we compared the results of standard medial-lateral pinning and the modified Dorgan method in the treatment of Gartland type 3 supracondylar fractures. We retrospectively analyzed 54 patients (32 males, 22 females) with pediatric supracondylar humerus fractures who were treated at the Ankara City Hospital Orthopedics and Traumatology Clinic between 2019 and 2021 years. In clinical and functional evaluation, we evaluated joint range of motion, carrying angle, complications, Baumann angle and Flynn criteria. The mean age of the patients was 6.3 years. The most common injuries were falling while playing (64.81%), then fall from a bicycle (16.66%), traffic accidents (12.96%) and fall from a height (5.55%). The mean follow-up was 30.68 weeks (24-48 weeks). There was no ulnar or radial nerve injury or major reduction loss in any postoperative patient. Superficial pin tract infection was seen in only two cases, which resolved with simple medical interventions. According to Flynn functional criteria, the result for group 1 was excellent in 80.0% and good in 20.0% and the result for group 2 was excellent in 83.33% and good in 16.67%. There was no significant difference between the groups in terms of clinical and functional outcomes, neurovascular injury, union time. It is well known that poor sleep quality is related with depression and anxiety.

Joint Diseases and Related Surgery

Earthquakes are devastating natural disasters that cause many deaths and injuries in a short time... more Earthquakes are devastating natural disasters that cause many deaths and injuries in a short time. Earthquakes were responsible for an estimated 1.87 million deaths in the 20 th century. [1] Previous studies have examined injury profiles and analyzed the effects of earthquakes on intracranial hemorrhage, fractures, dislocations and crush injuries, and these pathologies are the leading causes of earthquake-Objectives: The aim of this study was to evaluate the benefits of our triage system in acceleration of intervention for the musculoskeletal injuries and clinical follow-ups of trauma patients admitted to our center after the Kahramanmaras earthquake. Patients and methods: Between February 6 th , 2023 and February 20 th , 2023, a total of 439 patients (207 males, 232 females; mean age: 37.1±19.1 years; range, 1 to 94 years) with earthquake-related musculoskeletal injuries after the Kahramanmaras earthquake were retrospectively analyzed. Data including age, sex, referral city information, removal time from the rubbles, physical examination findings, clinical photos, fasciotomy and amputation stumps and levels, and X-ray images and computed tomography images of all patients were shared and archived in the WhatsApp (Meta Platforms, Inc. ® ATTN/CA, USA) group called 'Earthquake' created by orthopedic surgeons. To complete the patient interventions as soon as possible and to ensure order, the patients were distributed with the teams in order through this group by the consultant orthopedic surgeon. The treatments were applied and recorded according to the skin and soft tissue conditions, and fractures of the patients. All treatments were carried out with a multidisciplinary approach. Results: Of the patients, 16.2% were children. Lower limb injuries constituted 59.07% of musculoskeletal injuries. Upper limb, pelvic, and spinal cord injuries were observed in 21.9%, 12.7%, and 6.25%, respectively. Conservative treatment was applied to 183 (41.68%) patients. The most common surgical intervention was debridement (n=136, 53.1%). External fixation was applied in the first stage to 21 (8.2%) patients with open fractures. The mean removal time from the rubbles was 32.1±29.38 h. A total of 118 limb fasciotomy operations were applied to the patients. Fifty limb amputations were performed in 40 patients at the last follow-up due to vascular insufficiency and infection. Conclusion: Based on our study results, we believe that a triage system using a good communication and organization strategy is beneficial to prevent treatment delay and possible adverse events in future disasters.

Cureus, 2021

Background and objective Unicondylar knee replacement (UKR) is one of the most frequently perform... more Background and objective Unicondylar knee replacement (UKR) is one of the most frequently performed arthroplastic operations worldwide. Migration and subsidence regarding the tibial component of UKR is a well-known phenomenon. In this study, we aimed to analyze whether plain radiographs are a reliable means to measure the true coronal and sagittal alignment of the UKR's tibial component. Methods Patients undergoing a UKR procedure at our center between December 2020 and March 2011 were eligible for this study. Inclusion criteria were as follows: the presence of well-aligned standard and reproducible anteroposterior and lateral X-rays taken one week before or after a low-radiation artifact-reduced CT scan. Sixty-six knees were included in the study. Coronal and sagittal alignment of the tibial component was measured in a standard manner by two observers on both X-rays and CT scans. A correlation analysis was performed, and the margin of error was established. Results Intra-observer reliability was high among the two observers whether for X-ray or CT scan measurements [intraclass correlation coefficient (ICC): >0.900]. On the other hand, coronal plane measurements had lower inter-observer ICC values on both X-rays and CT scans while reliability on the sagittal plane was higher. There was a high correlation between radiographic measurements on X-rays and CT scans on both planes. Conclusion Even though the measurements on plain radiographs were slightly different from the ones obtained from CT scans, the correlation between them was very strong. Caution should be exercised when measuring the coronal alignment of the tibial implant on X-rays since it is more frequently affected by rotational misalignment.

International Journal of Academic Medicine and Pharmacy

Supracondylar humerus fractures are the most common elbow injuries in children. Closed reduction ... more Supracondylar humerus fractures are the most common elbow injuries in children. Closed reduction percutaneous fixation is the preferred method in the treatment of pediatric supracondylar humeral fractures. The optimal pin configuration is still a matter of debate. As the most commonly used fixation method, medial-lateral cross pinning provides better stability biomechanically but there is an increased risk of ulnar nerve injury. We also used the modified Dorgan method (lateral cross pin) to minimize the risk of ulnar nerve injury and to obtain fixation with similar biomechanical stability. In this study, we compared the results of standard medial-lateral pinning and the modified Dorgan method in the treatment of Gartland type 3 supracondylar fractures. We retrospectively analyzed 54 patients (32 males, 22 females) with pediatric supracondylar humerus fractures who were treated at the Ankara City Hospital Orthopedics and Traumatology Clinic between 2019 and 2021 years. In clinical and functional evaluation, we evaluated joint range of motion, carrying angle, complications, Baumann angle and Flynn criteria. The mean age of the patients was 6.3 years. The most common injuries were falling while playing (64.81%), then fall from a bicycle (16.66%), traffic accidents (12.96%) and fall from a height (5.55%). The mean follow-up was 30.68 weeks (24-48 weeks). There was no ulnar or radial nerve injury or major reduction loss in any postoperative patient. Superficial pin tract infection was seen in only two cases, which resolved with simple medical interventions. According to Flynn functional criteria, the result for group 1 was excellent in 80.0% and good in 20.0% and the result for group 2 was excellent in 83.33% and good in 16.67%. There was no significant difference between the groups in terms of clinical and functional outcomes, neurovascular injury, union time. It is well known that poor sleep quality is related with depression and anxiety.

Joint Diseases and Related Surgery

Earthquakes are devastating natural disasters that cause many deaths and injuries in a short time... more Earthquakes are devastating natural disasters that cause many deaths and injuries in a short time. Earthquakes were responsible for an estimated 1.87 million deaths in the 20 th century. [1] Previous studies have examined injury profiles and analyzed the effects of earthquakes on intracranial hemorrhage, fractures, dislocations and crush injuries, and these pathologies are the leading causes of earthquake-Objectives: The aim of this study was to evaluate the benefits of our triage system in acceleration of intervention for the musculoskeletal injuries and clinical follow-ups of trauma patients admitted to our center after the Kahramanmaras earthquake. Patients and methods: Between February 6 th , 2023 and February 20 th , 2023, a total of 439 patients (207 males, 232 females; mean age: 37.1±19.1 years; range, 1 to 94 years) with earthquake-related musculoskeletal injuries after the Kahramanmaras earthquake were retrospectively analyzed. Data including age, sex, referral city information, removal time from the rubbles, physical examination findings, clinical photos, fasciotomy and amputation stumps and levels, and X-ray images and computed tomography images of all patients were shared and archived in the WhatsApp (Meta Platforms, Inc. ® ATTN/CA, USA) group called 'Earthquake' created by orthopedic surgeons. To complete the patient interventions as soon as possible and to ensure order, the patients were distributed with the teams in order through this group by the consultant orthopedic surgeon. The treatments were applied and recorded according to the skin and soft tissue conditions, and fractures of the patients. All treatments were carried out with a multidisciplinary approach. Results: Of the patients, 16.2% were children. Lower limb injuries constituted 59.07% of musculoskeletal injuries. Upper limb, pelvic, and spinal cord injuries were observed in 21.9%, 12.7%, and 6.25%, respectively. Conservative treatment was applied to 183 (41.68%) patients. The most common surgical intervention was debridement (n=136, 53.1%). External fixation was applied in the first stage to 21 (8.2%) patients with open fractures. The mean removal time from the rubbles was 32.1±29.38 h. A total of 118 limb fasciotomy operations were applied to the patients. Fifty limb amputations were performed in 40 patients at the last follow-up due to vascular insufficiency and infection. Conclusion: Based on our study results, we believe that a triage system using a good communication and organization strategy is beneficial to prevent treatment delay and possible adverse events in future disasters.

Cureus, 2021

Background and objective Unicondylar knee replacement (UKR) is one of the most frequently perform... more Background and objective Unicondylar knee replacement (UKR) is one of the most frequently performed arthroplastic operations worldwide. Migration and subsidence regarding the tibial component of UKR is a well-known phenomenon. In this study, we aimed to analyze whether plain radiographs are a reliable means to measure the true coronal and sagittal alignment of the UKR's tibial component. Methods Patients undergoing a UKR procedure at our center between December 2020 and March 2011 were eligible for this study. Inclusion criteria were as follows: the presence of well-aligned standard and reproducible anteroposterior and lateral X-rays taken one week before or after a low-radiation artifact-reduced CT scan. Sixty-six knees were included in the study. Coronal and sagittal alignment of the tibial component was measured in a standard manner by two observers on both X-rays and CT scans. A correlation analysis was performed, and the margin of error was established. Results Intra-observer reliability was high among the two observers whether for X-ray or CT scan measurements [intraclass correlation coefficient (ICC): >0.900]. On the other hand, coronal plane measurements had lower inter-observer ICC values on both X-rays and CT scans while reliability on the sagittal plane was higher. There was a high correlation between radiographic measurements on X-rays and CT scans on both planes. Conclusion Even though the measurements on plain radiographs were slightly different from the ones obtained from CT scans, the correlation between them was very strong. Caution should be exercised when measuring the coronal alignment of the tibial implant on X-rays since it is more frequently affected by rotational misalignment.