Ercan Hassa - Academia.edu (original) (raw)

Papers by Ercan Hassa

PubMed, Oct 26, 2023

Determination of the acetabular morphology and orientation is important for the total hip arthrop... more Determination of the acetabular morphology and orientation is important for the total hip arthroplasty applications. In general, preoperative planning for these patients is done on true hip X-rays in orthopedics clinics. But those evaluations may not represent the acetabular architecture in detail, because of 2 dimensional images. The aim of this study is to determine the acetabular morphology of a healthy Turkish adult population sample through examination of acetabular parameters on 3-dimensional computed tomography (CT)-based images according to side and gender. A retrospective evaluation was made of acetabulum CT scans taken for various reasons in a healthy Turkish population sample. The examination parameters were defined as measurements of the acetabular anteversion angle, acetabular abduction angle, lateral center edge angle, acetabular width, acetabular depth, sagittal acetabular angle, and medial wall thickness values. The CT scans including the bone structure were examined of a total of 252 hips of 126 patients. The acetabular index was calculated as depth/width × 100. Lateral center edge angle of < 20° with medial wall thickness > 5 mm was accepted as a criterion of dysplasia of the acetabulum. Evaluation was made of the acetabular CT scans of 73 females and 53 males with a mean age of 44.64 ± 12.31 (19-68) years. A statistically significant difference was determined between the sides in respect of acetabular anteversion angle (P = .007) and between the genders in respect of acetabular depth and acetabular width (P = .001, P = .001). The prevalence of dysplasia was determined to be 1.6% for the whole study group, as 1.9% in males and 1.4% in females. In the current study sample there were parametric differences between sides and genders in terms of acetabulum morphology and orientation. Further studies of larger series will be able to provide a better representation of the Turkish population.

$Research paper thumbnail of A retrospective observational examination following the COVID-19 pandemic: Was everything necessary done in the management of hip fractures?$

PubMed, Jul 31, 2023

Objective: Hip fragility fracture-related mortality depends on several variables. The management ... more Objective: Hip fragility fracture-related mortality depends on several variables. The management of such cases during the COVID-19 pandemic is an important issue that needs to be evaluated. The aim of this study is to evaluate the management of such cases during the COVID-19 pandemic in a single trauma center in Turkey. Patients and methods: In this retrospective study, the length of stay (LoS) and 30-day mortality rates in patients with hip fragility fractures, in the ICU - clinic combined follow- ups (ICU/Clinic group) combined follow-ups and in the clinic follow-ups (Clinic Only group) were compared between pre-pandemic and pandemic period. Results: The data of 393 patients, 164 (41.7%) men and 229 (58.3%) women, with a mean age of 81.22±8.37 (45-100) years, were analyzed. The total LoS during the pandemic was determined to be shorter than the pre-pandemic period in both the patient groups that followed up in the Clinic Only and those in ICU/Clinic (p<.001, p=.007). The 30-day mortality rates of the groups were similar. Conclusions: The length of the hospital stay of hip fragility fracture patients was seen to be shorter during the COVID-19 pandemic, but this early discharge did not affect the 30-day mortality rates.

Journal of health sciences and medicine, May 31, 2023

Aim: Symptomatic calcific rotator cuff tendinopathies (CRCT) continue to be a significant health ... more Aim: Symptomatic calcific rotator cuff tendinopathies (CRCT) continue to be a significant health problem in the adult population because of intense pain and disability. Different clinical responses obtained with different treatment modalities show us the importance of determining the optimal method. The aim of this study is to compare short term pain and functional status improvements in adult patients diagnosed with CRCT and treated with oral non-steroid anti-inflammatory drugs (O-NSAID) or percutaneous steroid injections (PSI). Material and Method: A retrospective examination was made of the clinical results of adult patients diagnosed with CRCT and treated with one of the two treatment methods. Whole study group was formed of 40 patients (20 male, 20 female) with a mean age of 42.35 ± 8.28 (range, 23-57) years. The clinical responses of the patients in a period of 3 months were compared between the two treatment groups O-NSAID, PSI using the Visual Analogue Scale (VAS) and the Quick Disability of the Arm, Shoulder, and Hand Scale (Q-DASH). The angular upper limit values of the active range of motion (ROM) of the shoulder joint (anteflexion and abduction angle) of patients also were compared in the study. Results: In the PSI treatment group, in the 3rd week and 3rd month clinical evaluations, significant better responses were obtained in both the VAS and Q-DASH scores of the patients compared to O-NSAID treatment group (p=0.000, p=0.001, respectively). And significant greater shoulder anteflexion and abduction ROM upper limits were determined in the PSI treament group compared to O-NSAID treatment group at the end of the 3rd month (p=0.000, p=0.000, respectively). Conclusion: The percutaneous steroid applications in treatment of CRCT can provide more pleasing short term results than O-NSAID treatments in terms of pain reduction and functional improvement.

$Research paper thumbnail of Does the distance of the fixation points to the fracture affect healing in tibial shaft fractures treated with openable distal claw intramedullary nail?$

Journal of health sciences and medicine, Jan 12, 2023

Objective: A retrospective examination was made of tibia shaft fractures treated with tibia intra... more Objective: A retrospective examination was made of tibia shaft fractures treated with tibia intramedullary nail (IMN), which are designed with distal retractable claws, unlike classic imtramedullar nails. It was aimed to evaluate the effect on healing of the nail diameter and the distance between the fracture line and the proximal and distal fixation points of the IMN. Material and Method: The study included 28 patients (18 males, 10 females; mean age 43.75 (18-69) years) treated with distal retractable claw tibia IMN (Dunitech Nite Tibial IMN Oliga Med Ankara-Turkey) for a diagnosis of unilateral tibia diaphyseal fracture between January 2020 and January 2022. The midpoint of the fracture line (F), the proximal fixation point of the locking screw (S), the distal fixation point of the retractable claw (T), and the isthmus mid-point (I) were determined as reference points. The FT, ST, and IT distances, the nail diameter (ND) and isthmus diameter (ID) were measured and the FT/ ST ratio was calculated. Statistical evaluations were made of the relationships between the diameter and length measurements and the visual analog scale (VAS) and radiographic union score for tibia (RUST) scores at the end of one year. Results: No statistically significant correlation was determined between the RUST and VAS scores and the diameter measurements or the distance between the proximal and distal fixation points of the IMN. Conclusion: There was no effect on the fracture healing scores of the nail diameter or the distance between the proximal and distal fixation points in tibia shaft fractures treated with a tibia nail with distal retractable claws. The nail design with retractable claws provides strong fixation and stable fracture healing. The operating time is shorter resulting in less radiation exposure.

Cureus, May 19, 2022

Background Surgical site infections (SSIs) are seen in the postoperative period in orthopedic and... more Background Surgical site infections (SSIs) are seen in the postoperative period in orthopedic and traumatology clinics. Just as in all surgical clinics, SSIs lead to patient dissatisfaction with the results, prolong the length of stay in the hospital, and increase treatment costs. SSIs are known to occur as a result of wound contamination through inoculation of microorganisms found mainly in the air or in the surgical area. Because of the coronavirus disease 2019 pandemic, N95 masks have been widely used in the operating rooms of our hospital by nurses, residents, and surgeons since March 2020. This study aims to evaluate the effect of N95 respirator use by the surgical team on SSIs determined in patients operated on in our clinic compared to surgical mask use. Methodology In this retrospective study, the use of N95 respirators by the surgical team was compared with the use of surgical masks to evaluate the effect on SSIs in patients operated on in our clinic. Two groups were formed of patients operated on by the surgical team wearing surgical masks between February 2019 and February 2020 and those operated on with the surgical team using N95 respirators between March 2020 and March 2021. Each patient was diagnosed with postoperative SSIs by two different surgeons in the same clinic and by an infection clinic specialist based on clinical and laboratory findings. Results A total of 1,486 patients were examined; 729 patients in February 2019-February 2020 period (Group 1) and 757 in March 2020-March 2021 period (Group 2). In total, 124 and 104 patients were excluded from the first and second groups, respectively, for various reasons, including revision surgery, open fractures, diabetes, smoking, peripheral vascular disease, or other comorbidities that could affect infection rates. SSIs were determined in 35 patients in Group 1 and 13 patients in Group 2. The SSI rates in the second period in both types of procedures (arthroplasty and trauma surgeries) were determined to be significantly lower. Conclusions Because of the use of intraoperative N95 respiratory masks by surgical teams in orthopedics and traumatology procedures, the number of SSIs decreased significantly compared to the use of surgical masks.

Joint diseases and related surgery, Dec 27, 2022

Distal radius fractures (DRFs) are one of the common fragility fractures in the practice of ortho... more Distal radius fractures (DRFs) are one of the common fragility fractures in the practice of orthopedic traumatology, and surgical treatment options include open reduction and internal fixation, external fixator application, and various combinations of these techniques. [1-3] Osteosynthesis with a volar plate is currently frequently used in the treatment of unstable DRFs. [4-6] It allows early joint movement, provides functional healing, and is an extremely stable method biomechanically. Reported surgical complication rates show variability. Extensor tendon complications associated with screw penetration from the dorsal cortex have been reported in 1 to 15% of cases. [4-6] Ultrasound (US) is a reliable method for the follow-up of screw penetration and complications. [6,7] The complex anatomy and irregular shape of the dorsal cortex of the distal radius make it difficult to Objectives: The aim of this study was to evaluate the relationship between the length of the protruded screws from the dorsal cortex and extensor tendon damage in all compartments. Patients and methods: Between May 2020 and April 2021, a total of 29 patients (13 males, 16 females; mean age: 52.3±13.0 years; range, 30 to 78 years) who were operated and followed in our clinic for AO A2 and A3 distal radius fractures were included in this prospective study. Surface ultrasound (US) imaging was made to the dorsal sides of both wrists of the operated patients at different timepoints postoperatively. The length of screws with radius dorsal cortex penetration and the presence of tendinitis were recorded. Results: In 15 of 23 patients, the presence of 29 protruding screws was accompanied by tendinitis and, in eight patients, no tendinitis was observed, despite the partial protrusion of screws. A statistically significant correlation was found between the screw protrusion and presence of tendinitis (p<0.05). The number of protruding screws and tendinitis were seen mostly in the second compartment. There was a statistically significant correlation between the protruding screw length of >1.6 mm and the presence tendinitis (p<0.05). Conclusion: Dorsal cortex screw protrusions in the application of volar plate for distal radius fractures can cause tendinitis. Screw protrusions occur more frequently in the second compartment and the development of tendinitis in this compartment is associated with a screw length of >1.6 mm. Screw penetration can be easily identified with intraoperative US to prevent tendinitis and potential tendon ruptures.

Children (Basel), May 13, 2023

This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY

Indian Journal of Orthopaedics, Sep 14, 2022

Annals of Physiotherapy & Occupational Therapy, 2020

Objective: Internal rotation contracture of the shoulder area developing on the follow-up of pedi... more Objective: Internal rotation contracture of the shoulder area developing on the follow-up of pediatric patients with obstetric brachial plexus palsy (OBPP) can lead to glenoidal and humeral head dysplasia and glenohumeral joint (GHJ) posterior dislocation. OBPP patients accompanied by the shoulder area problems and made early surgical intervention, long-term effects (> 2 years) of the balance between internal and external rotator muscle groups provided with tendon transfers and reduction of the joint on GHJ remodelling and on periscapular muscle development have been evaluated through magnetic resonance imaging (MRI) guided. Patients and methods: 14 patients with OBPP having had secondary shoulder surgery were placed retrospectively under examination to be evaluated in terms of GHJ remodelling, volumetric changes of internal (subscapularis) and external rotator muscles (infraspinatus and teres minor) groups. Current MRI of healthy sides is assessed in order to assess whether changes on patient group having preoperative and postoperative shoulder MR reviews of side with palsy are at the close rate to the healthy side. Proximal humeral head anterior ratio (PHHA) has been used for the assessment of subluxation in MRI reviews. Measured glenoid version (GV) changes have been examined in terms of seeing responses of glenoid dysplasia to surgical treatment and elliptical index (EI) changes have also been examined in terms of seeing responses of humeral head dysplasia to surgical treatment. Subscapularis (SS) and external rotators (ER) muscle groups have also been examined into areas in MRI scans and change amount has been determined by converting these values into volumetric data. Results: GV and ER values from examined parametric changes have shown statistically significant (p <0.05) change as being very close to healthy shoulder side values. In terms of last GV and ER values obtained, statistically significant difference couldn't be found between the shoulder values of the side with palsy and the shoulder values of the healthy side. Namely, even though significant and positive changes after the surgery have been observed in terms of PHHA and SS, these values cannot catch the healthy side values. The most negative results in the study have been obtained in ER changes. Any statistically significant changes haven't been observed in terms of ER volumetric changes after surgery. Conclusion: In the cases with OBPP accompanied by the shoulder problems it has been found that significant osseous remodelling has been provided with surgery of early secondary shoulder region in long-term follow-up

$Research paper thumbnail of Which of the three different intramedullary nail designs is superior in the treatment of femoral shaft fractures?$

Journal of health sciences and medicine, Mar 27, 2023

The aim of this study a retrospective comparison was the clinical and radiological results result... more The aim of this study a retrospective comparison was the clinical and radiological results results of patients with femoral shaft fracture made oftreated with three different types of intramedullary nail (IMN). Material and Method: The study included 54 patients operated on in our clinic because of femoral shaft fracture. The records were retrospectively examined of 18 patients applied with locked IMN (LIMN), 17 with blade expandable IMN (BEIMN), and 19 with talon distalfix IMN (TDIMN). The groups were compared statistically in respect of age, gender, BMI, affected side, operating time (mins), radiation exposure (number of shots), time to union (weeks), visual analog scale (VAS) score, soft tissue problems associated with implant irritation, amount of shortening (mm), coronal, sagittal and torsional angulation (degrees). Results: The mean VAS score of the TDIMN group was determined to be statistically significantly higher than that of the LIMN and BEIMN groups (p=0.008, p=0.045). The operating times were similar in the BEIN and TDIMN groups (p=0.768) and significantly shorter than in the LIMN group (p<0.001). Radiation exposure was similar in the TDIMN and BEIMN groups (p=0.039), and the number of shots in the LIMN group was significantly higher than in the other two groups (p<0.001). The coronal angulation values were lower in the TDIMN group than in the BEIMN and LIMN groups (p=0.001, p=0.020). The sagittal angulation values were lower in the TDIMN group than in the BEIMN and LIMN groups (p=0.001, p<0.001). No significant difference was determined between the groups in respect of time to union, limb shortness, rotational deformity, and soft tissue problems related to implant irritation (p>0.05). Conclusion: TDIMN is less resistant to axial loads due to its hook structure design. In fact, this is sometimes seen as a hook break. High VAS scores explain this. The sagittal and coronal angulation of the TDIMN is less, but the time to union, rotational angulation, and shortness development are similar in all three nails. This showed that all three nails did not have a significant advantage over each other in providing fracture stability.

Journal of Health Sciences and Medicine

$Research paper thumbnail of Which of the three different intramedullary nail designs is superior in the treatment of femoral shaft fractures?$

Journal of Health Sciences and Medicine

Aim: The aim of this study a retrospective comparison was the clinical and radiological results r... more Aim: The aim of this study a retrospective comparison was the clinical and radiological results results of patients with femoral shaft fracture made oftreated with three different types of intramedullary nail (IMN). Material and Method: The study included 54 patients operated on in our clinic because of femoral shaft fracture. The records were retrospectively examined of 18 patients applied with locked IMN (LIMN), 17 with blade expandable IMN (BEIMN), and 19 with talon distalfix IMN (TDIMN). The groups were compared statistically in respect of age, gender, BMI, affected side, operating time (mins), radiation exposure (number of shots), time to union (weeks), visual analog scale (VAS) score, soft tissue problems associated with implant irritation, amount of shortening (mm), coronal, sagittal and torsional angulation (degrees). Results: The mean VAS score of the TDIMN group was determined to be statistically significantly higher than that of the LIMN and BEIMN groups (p=0.008, p=0.045...

Children

Since the natural course of obstetric brachial plexus palsy is variable, several problems are enc... more Since the natural course of obstetric brachial plexus palsy is variable, several problems are encountered. One important question, in considering patients with OBPP under observation in outpatient clinical settings, is whether children will have length discrepancies in their arms. The aim of this study was to determine differences in the length of the affected extremity, in comparison to the opposite upper extremity. As such, 45 patients, aged 6 months to 18 years, with unilateral brachial plexus palsy developed due to obstetric reasons, were included in the study. Affected and healthy side humerus, ulna, radius, 2nd metacarpal and 5th metacarpal lengths were evaluated according to gender, age, side, Narakas classification, primary and secondary surgery. Statistically significant differences were found in the change rates of affected/healthy humerus, radius, 2nd metacarpal and 5th metacarpal lengths according to age (93%, 95%, 92%, 90% and 90%, respectively). Affected/healthy change...