Ozgur Baysal - Academia.edu (original) (raw)

Papers by Ozgur Baysal

Journal of Hand Surgery (European Volume)

This retrospective study evaluates outcomes after treatment of upper-extremity soft tissue sarcom... more This retrospective study evaluates outcomes after treatment of upper-extremity soft tissue sarcoma in 44 patients. We re-resected 19 tumours that had been resected elsewhere without adequate preoperative planning, and we made 25 well-planned primary resections. Four patients in the unplanned group and five in the planned group eventually received amputations. Thirty-three patients were alive at a median follow-up time of 33 months (IQR 18 to 57). Tumour size > 7 cm, tumour Grade 3 and the presence of distant organ metastases were the main factors affecting the oncological outcomes. We found no statistical differences between the planning groups. Functional outcomes and quality of life were significantly worse after amputation or major nerve resections. We conclude with this sized sample that the lack of planning in itself did not influence the final results, but there were differences in tumour size, grade and localization between the groups that may play a role. Level of evidenc...

Marmara Medical Journal

Objective: This study aimed to examine the factors affecting the loss of workforce, including the... more Objective: This study aimed to examine the factors affecting the loss of workforce, including the time to return to work and workrelated situations in patients with traumatic hand injury who were taken to a hand rehabilitation program. Materials and Methods: The patients aged between 18-65 years with a history of traumatic hand injury in the last five years were analyzed retrospectively. Demographic and clinic data were taken from the medical records, and work-related problems were obtained by telephone calls. The severity of hand injury was assessed with Modified Hand Injury Severity Score (MHISS). Results: A total of 147 patients (129 males, 18 females; mean age 39.83±10.4 years) were included. The duration of return to work was correlated with total MHISS (rho=0.262 p=0.003) while not related to age, education level, gender, or injured hand’s dominance (p>0.05). Duration of return to work after hand injury and total MHISS were lower in the patients who had job modifications (p

Journal of Investigative Surgery

Sakarya Medical Journal

Objective: Successful treatment of intertrochanteric fractures depends on an appropriate implant ... more Objective: Successful treatment of intertrochanteric fractures depends on an appropriate implant and is decided according to fracture classification and stability. In the present study, the purpose was to investigate the interobserver and intraobserver consistency of x-ray and/or Computed Tomography (CT) in fracture classification and implant preference for treatment in intertrochanteric fractures. Materials and Methods: The patients who were diagnosed with 80 intertrochanteric fractures by two orthopedists with 5 or more years of trauma experience and who had pelvic CT scans for suspected accompanying fractures were evaluated in the study. AO/OTA classification and implant preference for treatment were based on x-ray and/or CT. Second evaluations were made two weeks later. Cohen’s Kappa was calculated for interobserver reliability in the first evaluation and intraobserver reliability in the first and second evaluations. Results: Intra-observer ICC ranged between 0.861 and 0.973 for...

Okmeydanı Tıp Dergisi, 2017

Journal of Orthopaedic Research, 2021

We aimed to examine the predictability of the need for soft tissue reconstruction during limb‐spa... more We aimed to examine the predictability of the need for soft tissue reconstruction during limb‐sparing surgery through preoperative magnetic resonance (MR) imaging in patients diagnosed with a malignant bone tumor in the distal femur. The study included 42 patients who were operated for a bone sarcoma of the distal femur at our clinic between 2016 and 2018. The recorded parameters included the demographic characteristics of the patients, tumor diagnosis, tumor side, total tumor volume, tumor soft tissue component volume, tumor soft tissue component volume‐to‐total tumor volume ratio, tumor localization by MR imaging, the need for soft tissue reconstruction, the muscles used for soft tissue reconstruction, the biopsy site, and the biopsy type. Tumor volume was calculated on MR imaging of the distal femur region performed before surgery. Our study established cut‐off values for soft tissue reconstruction need following resection as a total tumor volume of 96.4 cm3, a tumor soft tissue component volume of 22 cm3, a tumor soft tissue component volume‐to‐total tumor volume ratio of 48.9%, and tumor localization in two different regions on axial distal femoral MR images. Considering these cut‐off values, by calculating tumor volume values preoperatively we can predict the need for rotational muscle flaps for soft tissue coverage following distal femur bone sarcoma resection and endoprosthesis reconstruction. Anticipating the need for soft tissue reconstruction may affect the duration and success of the operation.

Northern Clinics of Istanbul, 2021

Is physical examination as effective as magnetic resonance imaging in the diagnosis of suspected ... more Is physical examination as effective as magnetic resonance imaging in the diagnosis of suspected pediatric scaphoid fractures? Orıgınal Article ORTHOPEDICS & TRAUMATOLOGY Cite this article as: Saglam F, Baysal O. Is physical examination as effective as magnetic resonance imaging in the diagnosis of suspected pediatric scaphoid fractures? North Clin Istanb 2021;8(5):507-512. C arpal bone fractures are rarely seen in children, but the most common of these are scaphoid fractures [1]. These fractures, which constitute 0.45% of all upper extremity fractures and 0.34% of all childhood fractures [2], are seen more in children over the age of 11 years and rarely in those aged <8 years [3-5]. As the majority of these fractures are incomplete, and not dislocated or accompanied by a bone fragment, they can be treated conservatively [4, 6-9]. Early diagnosis and correct treatment are extremely important for the prevention of complications. As the primary mechanism of these fractures is a fall on the open hand in pronation, this increases the possibility of fractures seen in children involved in sporting activities [1]. Physical examination, X-rays, magnetic resonance imaging (MRI), computed tomography ABSTRACT OBJECTIVE: The aim of this study was to evaluate whether careful physical examination is as effective in diagnosis as magnetic resonance imaging (MRI) in pediatric patients with suspected scaphoid fractures and whether radiography is sufficient in the follow-up of these patients. METHODS: This prospective study included patients with tenderness of the anatomic snuffbox on physical examination and no fracture on radiography between 2015 and 2019, and the data were evaluated retrospectively. A short-arm thumb spica casting was applied for an initial diagnosis of suspected scaphoid fracture. MRI was performed within 1 week after initial trauma. Physical examination and X-rays at 2-week intervals were applied during the follow-up period. The functional outcomes were evaluated using the Modified Mayo Wrist score. RESULTS: A total of 92 patients (28 girls and 64 boys; mean age: 12.32±2.22 years) were diagnosed with suspected scaphoid fracture on physical examination and MRI was performed. The MRI confirmed the suspected scaphoid fracture at the rate of 77.2% (n=71). The sensitivity obtained for the radiograph was 14.08%, specificity was 100%, positive predictive value was 100%, and negative predictive value was 25.61%. The mean Modified Mayo Wrist score was 92.43±2.64 (range, 85-98). CONCLUSION: Detection of tenderness on the anatomic snuffbox without determination of fracture radiographically should be evaluated and treated in favor of a scaphoid fracture. These fractures are mostly treated successfully with conservative treatment.

GIRIŞ ve AMAC: Omuz cerrahisi uygulanan hastalarda postoperatif agri onemli bir sorundur. Calisma... more GIRIŞ ve AMAC: Omuz cerrahisi uygulanan hastalarda postoperatif agri onemli bir sorundur. Calismamizda artroskopi omuz cerrahisinde interskalen blok ile, tek doz perioperatif eklem ici lokal anestezik uygulamasinin postoperatif analjezik etkinliklerinin karsilastirilmasi amaclandi. YONTEM ve GERECLER: Etik kurul ve hasta onayi sonrasi ASA I-II 36 hasta randomize olarak ikiye ayrildi. Grup I’deki hastalara tek doz interskalen blok uygulamasi yapildi ve Grup II’deki hastalara tek doz perioperatif eklem ici lokal anestezik uygulamasi yapildi. Hastalarin postoperatif vizuel analog skala (VAS) degerleri 0, 1, 4, 8, 12 ve 24. saatlerde sorgulandi, ilk analjezik uygulama zamani, ek analjezik ihtiyaclari ve 24’uncu saat sonunda hasta memnuniyeti ve yan etkiler sorgulandi. BULGULAR: Calismadaki gruplarin yas, cinsiyet, ASA I/II dagilimi ve cerrahi sureleri karsilastirildiginda istatistiksel olarak anlamli fark gorulmedi. Her iki grupta da tum hastalarda yeterli analjezi saglandi (VAS< 4)....

Southern Clinics of Istanbul Eurasia, 2018

The purpose of this study was to evaluate the consistency of the angle between the posterior cond... more The purpose of this study was to evaluate the consistency of the angle between the posterior condylar line (PCL) and the transepicondylar axis (TEA) measured during surgery (sTEA) with that of the clinical transepicondylar axis (cTEA) measured using computerized tomography (CT) before primary total knee arthroplasty (TKA). Methods: The records of patients who had undergone primary TKA between 2013 and 2105 and with a preoperative CT measurement of the knee were evaluated. During surgery, following the distal femoral incision, PCL and sTEA lines were drawn on the surface with a ruler and a pencil and recorded with a digital camera. The angle between the cTEA, or the line joining the most prominent points of the medial and lateral epicondyles, and the PCL was measured using a picture archiving communication system (PACS). Results: The study group consisted of 9 knees of 9 patients (1 male, 8 female; mean age: 67 years, range: 59-80 years). The photographs indicating the angle between the sTEA line and the PCL revealed external rotation in 9 knees (100%), with a mean angle of 2.67±1.41° (range: 1-6°). The preoperative axial CT images also demonstrated external rotation in 9 knees (100%), with a mean angle of 4.67±1.41° (range: 2-7°). Conclusion: There was a difference between the sTEA, which is used to determine the rotation of femoral component during TKA, and the cTEA measured preoperatively using CT. It is safe to use 1 of these 2 techniques to check the result of the other. In the future, measurements made using CT will be used to design personalized anatomical prostheses.

Sinir sistemi cerrahisi dergisi, Apr 29, 2022

© Telif hakkı Sinir Sistemi Cerrahisi Dergisi. Bu dergide yayınlanan bütün makaleler Creative Com... more © Telif hakkı Sinir Sistemi Cerrahisi Dergisi. Bu dergide yayınlanan bütün makaleler Creative Commons 4.0 Uluslararası Lisansı (CC-BY) ile lisanslanmıştır.

$Research paper thumbnail of Immobilization after pediatric supracondylar humerus fracture surgery: Cast or splint?$

Marmara Medical Journal, 2022

Archives of Orthopaedic and Trauma Surgery, 2021

Different approaches are applied for reconstruction in patients with a musculoskeletal malignancy... more Different approaches are applied for reconstruction in patients with a musculoskeletal malignancy which require a proximal femoral or total femoral resection. We aimed to evaluate the treatment outcomes of patients who underwent a proximal femoral or total femoral resection due to bone and soft tissue tumors and had an endoprosthetic reconstruction by a bipolar hemiarthroplasty type of hip articulation. We retrospectively identified 133 patients who underwent a proximal femoral or total femoral endoprosthetic replacement after resection of a bone or soft tissue malignancy. There were 74 male and 59 female patients, with a mean age of 55.02 ± 16.92 years (range 11–84 years) and a median follow-up of 24.47 ± 24.45 months (range 6–164 months). Patient demographics, surgical, and oncological data were recorded. Acetabular wear was measured using the classification proposed by Baker. Functional assessment was performed using the Musculoskeletal Tumor Society (MSTS) functional score. There was no statistically significant difference among primary diagnostic groups in terms of gender, prosthesis type, trochanter major resection, local recurrence, complication/revision rate, and MSTS Score (p > 0.05, for each parameter). On the other hand, a statistically significant difference was detected in terms of degree of acetabular erosion among diagnostic groups (p < 0.001); the acetabular erosion rate (AER) was found to be lower in patients with metastatic carcinoma than in patients with a diagnosis of primary bone or soft tissue sarcoma. The univariable analysis revealed that the effect of age, primary diagnosis, localization, follow-up time, and presence and number of distant organ metastasis variables on AER were found to be statistically significant (p = 0.018, p = 0.035, p = 0.002, p = 0.007, p = 0.031, p = 0.040, respectively). In patients who undergo a proximal femoral or a total femoral resection due to a musculoskeletal tumor, bipolar hemiarthroplasty is an adequate type of hip articulation method, since it does not affect the revision requirements and functional outcomes of patients with acetabular erosion.

$Research paper thumbnail of The impact of pathological fractures on surgery, morbidity, functional and oncological outcomes in patients with primary bone sarcomas$

Injury, 2021

Background Although rare, pathological fractures may occur in primary bone sarcomas. There have b... more Background Although rare, pathological fractures may occur in primary bone sarcomas. There have been studies reporting that such patients have a poorer prognosis than those without a pathological fracture. This study investigates the impact of pathological fractures on surgery, morbidity, functional and oncological outcomes in patients with primary bone sarcomas. Patients and methods A retrospective analysis of 568 patients with primary bone sarcomas, treated between 2005 and 2019, was performed. The study included 41 patients with a pathological fracture and 51 control patients who did not have a pathological fracture. A multivariate Cox regression analysis was used to investigate the impact of pathological fractures and further independent variables on amount of intraoperative bleeding, duration of surgery, number of muscles and major neurovascular structures included in resection, tumor volume, surgical volume, Musculoskeletal Tumor Society (MSTS) functional score, postoperative complication rate, and local recurrence, distant metastasis, and survival rates. Results There were 36 (39%) female and 56 (61%) male patients. No statistically significant difference was noted in tumor volume, tumor/surgical volume percentage, number of major neurovascular structures included in resection, postoperative complication rate, and local recurrence, distant metastasis, and survival rates between the two groups (p > 0.05). A significantly higher amount of intraoperative bleeding and number of transfused blood components, a longer duration of surgery, and a higher amount surgical volume and number of resected muscles were detected in Group 1 compared to Group 2 (p=0.001, p=0.002, p=0.007, p=0.007, p < 0.001, respectively). The MSTS functional scores were lower in patients with a pathological fracture than in those without a pathological fracture (p=0.001). Conclusion We conclude that a pathological fracture through a primary bone sarcoma has no adverse effect on prognostic factors such as local recurrence, distant metastasis, and survival. However, pathological fractures increase the amount of intraoperative bleeding and surgical volume and result in a longer surgery, in addition to decreased functional outcomes.

There are limited data in the literature about the short‐ to mid‐term results of children with fl... more There are limited data in the literature about the short‐ to mid‐term results of children with flexor tendon injuries. We aim to evaluate the short‐ to mid‐term functional outcomes of children with flexor tendon injuries and to disclose whether the injured side affects the results.

OBJECTIVE This study aimed to investigate amputation-related factors after limb-salvage surgery (... more OBJECTIVE This study aimed to investigate amputation-related factors after limb-salvage surgery (LSS) in patients with extremity-located bone and soft-tissue sarcomas and determine the relationship between these factors and patient survival. METHODS In this retrospective study at our institution, patients in whom LSS was first performed because of an extremity-located musculoskeletal sarcoma, and subsequently amputation was carried out for various indications were included. Patient and tumor characteristics, details of surgical procedures, indications of amputation, number of operations, presence of metastasis before amputation, and post-amputation patient survival rates were analyzed. RESULTS A total of 25 patients (10 men, 15 women; mean age=41.96±21.88 years), in whom amputation was performed after LSS as initial resection of an extremity sarcoma or re-resection(s) of a local recurrence, were included in the study. The leading oncological indication for amputation was local recur...

Journal of Bone and Joint Surgery, 2021

BACKGROUND In patients undergoing iliosacral resections, pelvic ring reconstruction can maintain ... more BACKGROUND In patients undergoing iliosacral resections, pelvic ring reconstruction can maintain stability of the pelvis and spinal column, which is expected to achieve good functional outcomes. However, no optimal reconstruction method has been established. We aimed to analyze the outcome of pelvic ring reconstruction using double-barreled free vascularized fibular graft (FVFG) and internal fixation after iliosacral resections in children. METHODS We retrospectively reviewed 16 children with pelvic Ewing sarcoma who underwent pelvic ring reconstruction using double-barreled FVFG after iliosacral resection. The fibular graft was placed between the supraacetabular region distally and the remaining ilium or sacrum proximally. The stability of the remaining pelvis and spinal column was provided by minimal spinal instrumentation. RESULTS Eleven Type-I and 5 Type-I+IV resections were performed for 10 boys and 6 girls, who had a mean age of 13.4 years (range, 10 to 18 years). The mean follow-up was 49.8 months (range, 28 to 96 months). At the time of the final follow-up, 14 patients were alive and 2 patients had died of disease. The mean time for bone union was 9 months (range, 6 to 12 months). Graft hypertrophy was evident in all patients at 12 months. The median Musculoskeletal Tumor Society (MSTS) score at the time of the final follow-up was 80% (range, 60% to 96.6%). Seven patients had complications. Three complications required reoperation: 1 deep infection, 1 hematoma, and 1 wound dehiscence. Three patients had disease relapse in terms of lung metastases. CONCLUSIONS This reconstruction method can achieve a high rate of bone union and can provide good functional outcomes following resection of pediatric pelvic Ewing sarcomas with iliosacral involvement. Complications are usually manageable without a need for revision surgical procedures. LEVEL OF EVIDENCE Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

Journal of Investigative Surgery, 2020

BACKGROUND We aimed to compare the oncological outcomes of patients who underwent re-excision fol... more BACKGROUND We aimed to compare the oncological outcomes of patients who underwent re-excision following unplanned surgery and those who underwent planned surgery. METHODS Patients who were referred to our hospital after a mass was inappropriately resected and reported to have a malignant pathology with a positive surgical margin, as well as patients diagnosed with malignant soft tissue tumors, and operated on following a multidisciplinary assessment and staging between 2012 and 2018. All patients were followed up at least 6 months. RESULTS Our study included a total of 125 patients. Forty percent (n = 50) underwent unplanned excision and sixty percent (n = 75) underwent planned excision.There was no statistically significant difference in the survival curves between the two groups (p = 0.248). Tumor size was larger, and the rate of deep-localized tumors was higher in patients undergoing planned surgery than in the unplanned surgery group (p = 0.001). The rate of tumors localized in the upper extremities was significantly higher in the unplanned surgery group than in the planned surgery (p = 0.033). MRI examinations could detect residual tumors with an accuracy of 80%. Age (>48 years), tumor size (>8 cm), tumor grade (grade 3), and distant organ metastasis at follow-up, which were among risk factors found to have a significant effect on mortality. CONCLUSION Patients undergoing re-excision after an inappropriate resection and undergoing planned resection had a similar prognosis. Superficial, upper extremity-localized, and relatively small-size tumors are more prone to inadequate surgical resection. MRI can be used to detect residual tumors at a high rate in patients who have undergone unplanned surgery. Distant organ metastasis is the most important factor affecting survival.

International Wound Journal, 2020

The aim of the study is to investigate the risk factors identified in literature that have been a... more The aim of the study is to investigate the risk factors identified in literature that have been associated with prolonged Negative Pressure Wound Therapy (NPWT). Our study included patients who developed local wound problems after bone or soft tissue sarcoma surgery with negative margin at our clinic between 2012 and 2018 and treated with NPWT. All patients were followed up of at least 6 months. Sex, albumin level, skin infiltration, type of wound problem, postoperative intensive care unit (ICU) requirement, and intraoperative blood loss were found to be influential factors on NPWT > 10 sessions. We conclude that treatment may be prolonged and the necessary precautions need to be taken in patients with an impaired preoperative nutritional condition, with intraoperative high amount of blood loss, and with long postoperative stays in the ICU as well as if the underlying cause for wound problem is an infection.

JBJS Case Connector, 2019

Case: A 32-year-old man presented to the emergency department with several carpal bone fractures ... more Case: A 32-year-old man presented to the emergency department with several carpal bone fractures and a locked distal pisiform dislocation after trauma. Treatment consisted of open surgical and reduction, osteosynthesis with a single Kirschner wire, and ligament repair. The patient's functional outcome was excellent, and his Mayo wrist score was 90 at 36 months after injury. Conclusions: Pisiform dislocations may be difficult to diagnose because anteroposterior and lateral radiographs may not be sufficient to visualize the injury. A 30°semisupinated wrist x-ray and computed tomography can be helpful. A satisfactory clinical result may be achieved if distal pisiform dislocations are detected early and managed surgically with open reduction and ligament repair.

Medeniyet Medical Journal, 2018

Aim: Bone marrow edema syndrome (BMES) describes nonspecific, ill-defined areas of hypo intense a... more Aim: Bone marrow edema syndrome (BMES) describes nonspecific, ill-defined areas of hypo intense and hyper intense signal on T1 and T2 sequences, respectively. BMES has unknown etiology and resolves without sequel. In this study, we aimed to evaluate the initial clinical and radiological features and clinical course of patients with standing BMES. Method: We evaluated 19 feet of 17 patients who applied to our clinic between January 2014 and December 2016. X-Ray and MRI were taken in patients with clinical suspicion of BMES. Initial vitamin-D levels, hemogram, sedimentation, C-reactive protein (CRP), rheumatoid factor (RF) and Anti-CCP values of patients were evaluated. After the diagnosis, indomethacin and vitamin-D therapy and weight-bearing protection with double crutches was given for 6 weeks. Result: All patients mentioned that sudden onset of pain. The mean duration of symptoms was 7.12(2-20) months. Mean serum 25(OH)D level was 14 IU, sedimentation values were slightly higher in 7 patients, CRP, RF and Anti-CCP values were normal. BMES mostly detected in talus. The mean AOFAS score of the patients was 63 and the last control was 92. Conservative treatments should be considered as the first-line treatment option in BMES. Conclusion: The importance of laboratory tests in BMES should not be forgotten. Vitamin-D may play a role in the etiology of the disease. For that reason, patients need to be investigated in that way.