Ismail Turkmen - Academia.edu (original) (raw)

Papers by Ismail Turkmen

International Orthopaedics, 2015

There are many alternatives for post-operative pain relief in patients who have had general anaes... more There are many alternatives for post-operative pain relief in patients who have had general anaesthesia. The aim of this study was to evaluate the efficacy of intra-articular bupivacaine + morphine and bupivacaine + tenoxicam applications in post-operative pain control in patients undergoing knee arthroscopy with general anaesthesia. This was a prospective study. Standard anaesthesia procedures were applied to each patient, and the 240 patients chosen at random were then divided into two groups. Each group received a different combination of drugs for this double-blind study. The first group (group A: 120 patients) received 0.5 % bupivacaine 100 mg + tenoxicam 20 mg (22 ml); the second group (group B) received 0.5 % bupivacaine 100 mg + morphine 2 mg (22 ml); both groups received their drugs at the end of the intra-articular operation before tourniquet deflation. Before the operation, patients were asked about their post-operative pain at particular periods over the following 24 hours using the visual analogue scale (VAS) and the numeric rating scale (NRS). An additional analgaesic requirement and possible side effects were also recorded. Group A patients needed analgaesics sooner after operation than patients in group B. In Group B, VAS and NRS values were statistically higher compared with group A at the 12th hour. There were also fewer side effects seen in group A versus group B. Effective and reliable results were obtained in post-operative pain control in bupivacaine added to the morphine or tenoxicam groups following arthroscopic meniscectomy. In the tenoxicam group, patients reported less pain, fewer side effects and less need for analgesics at 12 hours after the operation. level 1, therapeutic, randomised, multicentric study.

Indian Journal of Orthopaedics, 2015

The incidence of fractures in the trochanteric area has risen with the increasing numbers of elde... more The incidence of fractures in the trochanteric area has risen with the increasing numbers of elderly people with osteoporosis. Although dynamic hip screw fixation is the gold standard for the treatment of stable intertrochanteric femur fractures, treatment of unstable intertrochanteric femur fractures still remains controversial. Intramedullary devices such as Gamma nail or proximal femoral nail and proximal anatomic femur plates are in use for the treatment of intertrochanteric femur fractures. There are still many investigations to find the optimal implant to treat these fractures with minimum complications. For this reason, we aimed to perform a biomechanical comparison of the proximal femoral nail and the locking proximal anatomic femoral plate in the treatment of unstable intertrochanteric fractures. Twenty synthetic, third generation human femur models, obtained for this purpose, were divided into two groups of 10 bones each. Femurs were provided as a standard representation of AO/Orthopedic Trauma Associationtype 31-A2 unstable fractures. Two types of implantations were inserted: the proximal femoral intramedullary nail in the first group and the locking anatomic femoral plate in the second group. Axial load was applied to the fracture models through the femoral head using a material testing machine, and the biomechanical properties of the implant types were compared. Nail and plate models were locked distally at the same level. Axial steady load with a 5 mm/m velocity was applied through the mechanical axis of femur bone models. Axial loading in the proximal femoral intramedullary nail group was 1.78-fold greater compared to the plate group. All bones that had the plate applied were fractured in the portion containing the distal locking screw. The proximal femoral intramedullary nail provides more stability and allows for earlier weight bearing than the locking plate when used for the treatment of unstable intertrochanteric fractures of the femur. Clinicians should be cautious for early weight bearing with locking plate for unstable intertrochanteric femur fractures.

International Journal of Case Reports and Images, 2013

Introduction: Isolated traumatic posterior hip dislocation is seen as an extremely rare incident ... more Introduction: Isolated traumatic posterior hip dislocation is seen as an extremely rare incident during sport activities. In this case report we aimed to present an isolated traumatic posterior hip dislocation of an amateur tennis player. Case Report: A 26 years old female patient who was injured during playing tennis was brought to our orthopaedic emergency unit and diagnosed with pure posterior hip dislocation. Her hip was immediately reduced under sedation which then a rehabilitation programme was begun. Conclusion: Amateur people generally play tennis on cement floor which can be slippery. To prevent these kind of extreme injuries non slippery shoes and shock absorbable realtively soft surfaces to play must be preffered by the players.

International journal of clinical and experimental medicine, 2015

The aim of this experimental study was to evaluate and compare the chondroprotective efficacy of ... more The aim of this experimental study was to evaluate and compare the chondroprotective efficacy of intra-articular hyaluronic acid, tenoxicam and vitamin E in osteoarthritis. An osteoarthritis model was created by anterior cruciate ligament transection and medial menisectomy in knees of 28 rats. The rats were randomized into four groups; first group served as a control group and received intra-articular injections of saline solution, intra-articular HA, intra-articular tenoxicam and intra-articular Vit E were applied to the treatment groups. First intra-articular injections were applied at second week postoperatively and repeated once a week for 5 weeks. At 8th week after the operation groups were compared based on the histologic scores of cartilage degeneration by Mankin Histological Grading Scale. Total cartilage degeneration score was significantly increased in the control group (P=0.004). Total Mankin scores of HA, tenoxicam and Vit E groups were significantly lower than the contr...

Acta orthopaedica Belgica, 2013

Bone marrow oedema has a long recovery time. Conservative and surgical treatments have been used.... more Bone marrow oedema has a long recovery time. Conservative and surgical treatments have been used. This study aimed at identifying a profile of patients who may benefit from nonsurgical management. We compared the results of periodic clinical and radiological examinations of patients who visited our clinic with knee pain and were diagnosed with bone marrow oedema following magnetic resonance imaging (MRI) examinations. Clinically, the patients were evaluated using the Lysholm knee score and a visual analogue scale. The study included 67 patients (31 males, 36 females) who were followed for 6-24 months. Patient age, gender, body mass index, affected area, and concomitant intra-articular pathology were analysed. Of the 67 patients, 63 were treated conservatively, and four underwent decompression. Patients with involvement of both the medial femoral condyle and tibial plateau were found to be more resistant to treatment than those in which only the tibial plateau was affected. Intra-art...

Open Journal of Orthopedics, 2013

Achilles tendon ruptures and malleol fractures are commonly seen injuries in orthopaedic and trau... more Achilles tendon ruptures and malleol fractures are commonly seen injuries in orthopaedic and traumatology practice, but what is rare is their concomitant. In this report, we aimed to present a rare case of a patient who has isolated medial malleolar fracture and achilles tendon rupture in ipsilateral ankle after an ankle sprain due to a fall from stairs and mechanism of injury.

Case Reports in Orthopedics, 2013

Schwannomas are rarely seen on the sciatic nerve and can cause sciatica. In this case report we a... more Schwannomas are rarely seen on the sciatic nerve and can cause sciatica. In this case report we aimed to present an unusual location of schwannoma along sciatic nerve that causes sciatica. A 60-years-old-man was admitted to us with complaints of pain on his thigh and paresthesia on his foot. Radiography of the patient revealed a solitary lesion on the sciatic nerve. The lesion was excised and the symptoms resolved after surgery.

Case reports in orthopedics, 2013

Solitary metastasis of uveal melanoma to bone is extremely rare and usually associated with other... more Solitary metastasis of uveal melanoma to bone is extremely rare and usually associated with other organ involvement. We present a rare case of an ocular melanoma patient presenting with solitary metastasis to the clavicle two years after enucleation, without any other organ involvement. In this report, we tried to present our treatment strategy for the solitary metastasis of bone.

Case Reports in Orthopedics, 2013

Osteoid osteomas are well-known benign tumors, seen generally in long bones. When seen in phalanx... more Osteoid osteomas are well-known benign tumors, seen generally in long bones. When seen in phalanxes or toes, they can cause a diagnostic dilemma. A young male presented to us with complaints of enlargement of the great toe and severe pain. He had had an ingrown toe-nail operation before, and this situation caused a diagnostic dilemma. In this case report, we emphasize that osteoid osteomas can cause diagnostic dilemmas and it should be kept in mind as a differential diagnosis.

Open Journal of Orthopedics, 2013

Multiple intraarticular loose bodies are pathognomonic for the Synovial chondromatosis. This diso... more Multiple intraarticular loose bodies are pathognomonic for the Synovial chondromatosis. This disorder affects a wide age range from adults to childhood with no sex dominance. Malignant transformation is rare to date, and there are approximately 34 cases in literature about the transformation of synovial chondromatosis to chondrosarcoma. Case: We present case of a 27-year-old patient who had synovial chondromatosis in his elbow. Discussion: Radiographic findings are usually pathognomonic for the diagnosis. Multiple calcified loose bodies can be seen in the joint in radiographs. Computed tomography (CT) optimally depicts the calcified intraarticular fragments and extrinsic bone erosion. However, because the radioopacity cannot be detected in 1/3 of the cases, diagnosis becomes difficult. Treatment modalities include arthroscopic or open extraction of the loose bodies and arthropasty in the presence of severe osteoarthritis. Conclusion: Synovial chondromatosis should be kept in the differential dignosis of the chronic monoarticular pain and painful limitations of the range of motions of the joints.

International Journal of Surgery Case Reports, 2013

ACTA ORTHOPAEDICA et TRAUMATOLOGICA TURCICA, 2014

The aim of this study was to determine whether or not there is an association between attention d... more The aim of this study was to determine whether or not there is an association between attention deficit and hyperactivity disorder (ADHD) and Perthes disease. The study included 3 groups of patients: Perthes patients, trauma patients, and orthopedic patients without Perthes disease or history of trauma. Each group was comprised of 56 males and 4 females. Patients were evaluated for present or past diseases, exposure to second-hand smoke, the age at which they had begun to walk, history of trauma prior to Perthes diagnosis in the Perthes group, weight, height and body mass index (BMI). Eighteen questions on the DSM-4 (Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition) ADHD checklist was used in the psychiatric evaluation of patients. The rate of ADHD was compared between groups. Attention deficit and hyperactivity disorder was diagnosed in 7 patients in the Perthes group, 3 in the trauma group, and 3 in the non-trauma group; and this difference was not significant (p=0.160). There were no significant differences in the rate of ADHD between trauma and non-trauma groups of Perthes patients, which suggests no association between ADHD and Perthes disease.

Journal of Children's Orthopaedics, 2015

Treatment is easier and complications are less likely to occur if developmental dysplasia of the ... more Treatment is easier and complications are less likely to occur if developmental dysplasia of the hip (DDH) is diagnosed early. In this study, we examined the early results of open reduction using a medial approach which we had modified for DDH and analyzed the success of this technique and the associated complication rates, with a focus on avascular necrosis (AVN). This is an Institutional Review Board-approved retrospective review of all patients diagnosed with DDH and treated with a modified medial approach at a single institution from July 1999 to December 2010. The patients' charts were analyzed for clinical and radiographic features. Fifty-five hips of 41 patients, all of whom were treated by open reduction using a modified medial approach due to DDH, were evaluated retrospectively. The mean age of the patients at surgery was 19 (range 11-28) months, and the average follow-up was 5.5 (range 3-9.5) years. AVN was the most important complication in terms of radiological outcomes as assessed according to the Kalamchi-McEwen classification. Radiologic results were excellent or good in 51 hips (92.7 %) and fair-plus in four (7.3 %). Type 1 temporary AVN was detected in only two hips (3.6 %), and the lesions had disappeared completely in the final control graphs of these two patients. A secondary intervention was needed for two hips (3.6 %) of the same patients who were operated on due to bilateral DDH. No other complications, such as infection, re-dislocation, or subluxation, were seen in the operated patients. We believe that treatment for DDH using a modified medial approach during early childhood is an effective and reliable method with low AVN rates. As shown here, this method achieves great success in radiological and clinical outcomes after a minimum 3-year follow-up.

International Orthopaedics, 2015

There are many alternatives for post-operative pain relief in patients who have had general anaes... more There are many alternatives for post-operative pain relief in patients who have had general anaesthesia. The aim of this study was to evaluate the efficacy of intra-articular bupivacaine + morphine and bupivacaine + tenoxicam applications in post-operative pain control in patients undergoing knee arthroscopy with general anaesthesia. This was a prospective study. Standard anaesthesia procedures were applied to each patient, and the 240 patients chosen at random were then divided into two groups. Each group received a different combination of drugs for this double-blind study. The first group (group A: 120 patients) received 0.5 % bupivacaine 100 mg + tenoxicam 20 mg (22 ml); the second group (group B) received 0.5 % bupivacaine 100 mg + morphine 2 mg (22 ml); both groups received their drugs at the end of the intra-articular operation before tourniquet deflation. Before the operation, patients were asked about their post-operative pain at particular periods over the following 24 hours using the visual analogue scale (VAS) and the numeric rating scale (NRS). An additional analgaesic requirement and possible side effects were also recorded. Group A patients needed analgaesics sooner after operation than patients in group B. In Group B, VAS and NRS values were statistically higher compared with group A at the 12th hour. There were also fewer side effects seen in group A versus group B. Effective and reliable results were obtained in post-operative pain control in bupivacaine added to the morphine or tenoxicam groups following arthroscopic meniscectomy. In the tenoxicam group, patients reported less pain, fewer side effects and less need for analgesics at 12 hours after the operation. level 1, therapeutic, randomised, multicentric study.

Indian Journal of Orthopaedics, 2015

The incidence of fractures in the trochanteric area has risen with the increasing numbers of elde... more The incidence of fractures in the trochanteric area has risen with the increasing numbers of elderly people with osteoporosis. Although dynamic hip screw fixation is the gold standard for the treatment of stable intertrochanteric femur fractures, treatment of unstable intertrochanteric femur fractures still remains controversial. Intramedullary devices such as Gamma nail or proximal femoral nail and proximal anatomic femur plates are in use for the treatment of intertrochanteric femur fractures. There are still many investigations to find the optimal implant to treat these fractures with minimum complications. For this reason, we aimed to perform a biomechanical comparison of the proximal femoral nail and the locking proximal anatomic femoral plate in the treatment of unstable intertrochanteric fractures. Twenty synthetic, third generation human femur models, obtained for this purpose, were divided into two groups of 10 bones each. Femurs were provided as a standard representation of AO/Orthopedic Trauma Associationtype 31-A2 unstable fractures. Two types of implantations were inserted: the proximal femoral intramedullary nail in the first group and the locking anatomic femoral plate in the second group. Axial load was applied to the fracture models through the femoral head using a material testing machine, and the biomechanical properties of the implant types were compared. Nail and plate models were locked distally at the same level. Axial steady load with a 5 mm/m velocity was applied through the mechanical axis of femur bone models. Axial loading in the proximal femoral intramedullary nail group was 1.78-fold greater compared to the plate group. All bones that had the plate applied were fractured in the portion containing the distal locking screw. The proximal femoral intramedullary nail provides more stability and allows for earlier weight bearing than the locking plate when used for the treatment of unstable intertrochanteric fractures of the femur. Clinicians should be cautious for early weight bearing with locking plate for unstable intertrochanteric femur fractures.

International Journal of Case Reports and Images, 2013

Introduction: Isolated traumatic posterior hip dislocation is seen as an extremely rare incident ... more Introduction: Isolated traumatic posterior hip dislocation is seen as an extremely rare incident during sport activities. In this case report we aimed to present an isolated traumatic posterior hip dislocation of an amateur tennis player. Case Report: A 26 years old female patient who was injured during playing tennis was brought to our orthopaedic emergency unit and diagnosed with pure posterior hip dislocation. Her hip was immediately reduced under sedation which then a rehabilitation programme was begun. Conclusion: Amateur people generally play tennis on cement floor which can be slippery. To prevent these kind of extreme injuries non slippery shoes and shock absorbable realtively soft surfaces to play must be preffered by the players.

International journal of clinical and experimental medicine, 2015

The aim of this experimental study was to evaluate and compare the chondroprotective efficacy of ... more The aim of this experimental study was to evaluate and compare the chondroprotective efficacy of intra-articular hyaluronic acid, tenoxicam and vitamin E in osteoarthritis. An osteoarthritis model was created by anterior cruciate ligament transection and medial menisectomy in knees of 28 rats. The rats were randomized into four groups; first group served as a control group and received intra-articular injections of saline solution, intra-articular HA, intra-articular tenoxicam and intra-articular Vit E were applied to the treatment groups. First intra-articular injections were applied at second week postoperatively and repeated once a week for 5 weeks. At 8th week after the operation groups were compared based on the histologic scores of cartilage degeneration by Mankin Histological Grading Scale. Total cartilage degeneration score was significantly increased in the control group (P=0.004). Total Mankin scores of HA, tenoxicam and Vit E groups were significantly lower than the contr...

Acta orthopaedica Belgica, 2013

Bone marrow oedema has a long recovery time. Conservative and surgical treatments have been used.... more Bone marrow oedema has a long recovery time. Conservative and surgical treatments have been used. This study aimed at identifying a profile of patients who may benefit from nonsurgical management. We compared the results of periodic clinical and radiological examinations of patients who visited our clinic with knee pain and were diagnosed with bone marrow oedema following magnetic resonance imaging (MRI) examinations. Clinically, the patients were evaluated using the Lysholm knee score and a visual analogue scale. The study included 67 patients (31 males, 36 females) who were followed for 6-24 months. Patient age, gender, body mass index, affected area, and concomitant intra-articular pathology were analysed. Of the 67 patients, 63 were treated conservatively, and four underwent decompression. Patients with involvement of both the medial femoral condyle and tibial plateau were found to be more resistant to treatment than those in which only the tibial plateau was affected. Intra-art...

Open Journal of Orthopedics, 2013

Achilles tendon ruptures and malleol fractures are commonly seen injuries in orthopaedic and trau... more Achilles tendon ruptures and malleol fractures are commonly seen injuries in orthopaedic and traumatology practice, but what is rare is their concomitant. In this report, we aimed to present a rare case of a patient who has isolated medial malleolar fracture and achilles tendon rupture in ipsilateral ankle after an ankle sprain due to a fall from stairs and mechanism of injury.

Case Reports in Orthopedics, 2013

Schwannomas are rarely seen on the sciatic nerve and can cause sciatica. In this case report we a... more Schwannomas are rarely seen on the sciatic nerve and can cause sciatica. In this case report we aimed to present an unusual location of schwannoma along sciatic nerve that causes sciatica. A 60-years-old-man was admitted to us with complaints of pain on his thigh and paresthesia on his foot. Radiography of the patient revealed a solitary lesion on the sciatic nerve. The lesion was excised and the symptoms resolved after surgery.

Case reports in orthopedics, 2013

Solitary metastasis of uveal melanoma to bone is extremely rare and usually associated with other... more Solitary metastasis of uveal melanoma to bone is extremely rare and usually associated with other organ involvement. We present a rare case of an ocular melanoma patient presenting with solitary metastasis to the clavicle two years after enucleation, without any other organ involvement. In this report, we tried to present our treatment strategy for the solitary metastasis of bone.

Case Reports in Orthopedics, 2013

Osteoid osteomas are well-known benign tumors, seen generally in long bones. When seen in phalanx... more Osteoid osteomas are well-known benign tumors, seen generally in long bones. When seen in phalanxes or toes, they can cause a diagnostic dilemma. A young male presented to us with complaints of enlargement of the great toe and severe pain. He had had an ingrown toe-nail operation before, and this situation caused a diagnostic dilemma. In this case report, we emphasize that osteoid osteomas can cause diagnostic dilemmas and it should be kept in mind as a differential diagnosis.

Open Journal of Orthopedics, 2013

Multiple intraarticular loose bodies are pathognomonic for the Synovial chondromatosis. This diso... more Multiple intraarticular loose bodies are pathognomonic for the Synovial chondromatosis. This disorder affects a wide age range from adults to childhood with no sex dominance. Malignant transformation is rare to date, and there are approximately 34 cases in literature about the transformation of synovial chondromatosis to chondrosarcoma. Case: We present case of a 27-year-old patient who had synovial chondromatosis in his elbow. Discussion: Radiographic findings are usually pathognomonic for the diagnosis. Multiple calcified loose bodies can be seen in the joint in radiographs. Computed tomography (CT) optimally depicts the calcified intraarticular fragments and extrinsic bone erosion. However, because the radioopacity cannot be detected in 1/3 of the cases, diagnosis becomes difficult. Treatment modalities include arthroscopic or open extraction of the loose bodies and arthropasty in the presence of severe osteoarthritis. Conclusion: Synovial chondromatosis should be kept in the differential dignosis of the chronic monoarticular pain and painful limitations of the range of motions of the joints.

International Journal of Surgery Case Reports, 2013

ACTA ORTHOPAEDICA et TRAUMATOLOGICA TURCICA, 2014

The aim of this study was to determine whether or not there is an association between attention d... more The aim of this study was to determine whether or not there is an association between attention deficit and hyperactivity disorder (ADHD) and Perthes disease. The study included 3 groups of patients: Perthes patients, trauma patients, and orthopedic patients without Perthes disease or history of trauma. Each group was comprised of 56 males and 4 females. Patients were evaluated for present or past diseases, exposure to second-hand smoke, the age at which they had begun to walk, history of trauma prior to Perthes diagnosis in the Perthes group, weight, height and body mass index (BMI). Eighteen questions on the DSM-4 (Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition) ADHD checklist was used in the psychiatric evaluation of patients. The rate of ADHD was compared between groups. Attention deficit and hyperactivity disorder was diagnosed in 7 patients in the Perthes group, 3 in the trauma group, and 3 in the non-trauma group; and this difference was not significant (p=0.160). There were no significant differences in the rate of ADHD between trauma and non-trauma groups of Perthes patients, which suggests no association between ADHD and Perthes disease.

Journal of Children's Orthopaedics, 2015

Treatment is easier and complications are less likely to occur if developmental dysplasia of the ... more Treatment is easier and complications are less likely to occur if developmental dysplasia of the hip (DDH) is diagnosed early. In this study, we examined the early results of open reduction using a medial approach which we had modified for DDH and analyzed the success of this technique and the associated complication rates, with a focus on avascular necrosis (AVN). This is an Institutional Review Board-approved retrospective review of all patients diagnosed with DDH and treated with a modified medial approach at a single institution from July 1999 to December 2010. The patients' charts were analyzed for clinical and radiographic features. Fifty-five hips of 41 patients, all of whom were treated by open reduction using a modified medial approach due to DDH, were evaluated retrospectively. The mean age of the patients at surgery was 19 (range 11-28) months, and the average follow-up was 5.5 (range 3-9.5) years. AVN was the most important complication in terms of radiological outcomes as assessed according to the Kalamchi-McEwen classification. Radiologic results were excellent or good in 51 hips (92.7 %) and fair-plus in four (7.3 %). Type 1 temporary AVN was detected in only two hips (3.6 %), and the lesions had disappeared completely in the final control graphs of these two patients. A secondary intervention was needed for two hips (3.6 %) of the same patients who were operated on due to bilateral DDH. No other complications, such as infection, re-dislocation, or subluxation, were seen in the operated patients. We believe that treatment for DDH using a modified medial approach during early childhood is an effective and reliable method with low AVN rates. As shown here, this method achieves great success in radiological and clinical outcomes after a minimum 3-year follow-up.