Serkan Erkan - Academia.edu (original) (raw)
Papers by Serkan Erkan
lanmas› sonucu geliflen bir durumdur. Kas zay›f oldu¤u zaman tutulan tarafta omuz düflme e¤ilimin... more lanmas› sonucu geliflen bir durumdur. Kas zay›f oldu¤u zaman tutulan tarafta omuz düflme e¤ilimindedir. Kas›n normal konturu kaybolur, boyun-omuz aç›s› genifller, skapula afla¤› ve d›fla do¤ru yer de¤ifltirir. Skapulan›n di¤er döndürücü kaslar› olan levator skapula ve romboid kaslar skapulan›n kanatlanmas›n› ve afla¤› düflmesini engelleyemez. Klinik olarak kolun uzun süreli kullan›m› a¤r›l› ve yorucu olur. Hasta s›kl›kla omuzda 90 derecenin üstünde abdüksiyonda a¤r› duyar ve bazen abdüksiyonda kay›p olabilir. Bu yaz›da, trapezius felci geliflen aktif bir sporcunun modifiye Eden-Lange prosedürü ile tedavisi sunuldu.
![Research paper thumbnail of [Factors causing stiff knee after total knee arthroplasty]](https://attachments.academia-assets.com/83312101/thumbnails/1.jpg)
](Eklem hastaliklari ve cerrahisi = Joint diseases & related surgery, 2011
OBJECTIVES In this study, the factors causing stiff knee after primary total knee arthroplasty (T... more OBJECTIVES In this study, the factors causing stiff knee after primary total knee arthroplasty (TKA) in patients with medial compartment osteoarthrosis were evaluated. PATIENTS AND METHODS Primary TKA surgery was performed in fifty-three knees in 48 patients (42 females, 6 males; mean age 67.2±8.5; range 59 to 76 years) diagnosed with medial compartment osteoarthrosis. Five patients (10%) out of forty-eight underwent bilateral primary TKA. In the patients who had bilateral TKA, the second operation was performed six months later. Patello-femoral arthroplasty was performed in none of the patients. In the final follow-up, the knees, which had more than 10° of extension limitation and less than 95° of flexion, were defined as post-TKA stiff knee. The patients who developed stiff knee were classified as group 1 and the patients who did not develop stiff knee were classified as group 2. The possible factors that may cause stiff knee after TKA such as age, gender, range of knee flexion an...
Aim: The accuracy of joint line tenderness (JLT) and magnetic resonance imaging (MRI) were determ... more Aim: The accuracy of joint line tenderness (JLT) and magnetic resonance imaging (MRI) were determined in the diagnosis of meniscal tears in patients with complete rupture of the anterior cruciate ligament (ACL). Additionally, the effects of time from injury (to arthroscopy) and medial femoral condyle (MFC) lesions on diagnosis with JTL and MRI were established. Methods: A total of 133 male patients, whose first arthroscopy was performed by MU, were included. Preoperative MRI findings, the initial knee trauma causing ACL rupture, and the time from injury (TFI) were recorded. Physical examinations including JLT were performed within 1 week preceding the operation by the same observer. MRIs were performed within 6 weeks preoperatively by a 1.5 T imager. The first 6 week period after the initial trauma was defined as the acute (Grup I), 6 weeks to 12 months as the subchronic (Grup II) and 12 months or longer as the chronic period (Grup III). The sensitivity, specificity, and accuracy fo...
Joint Diseases and Related Surgery, 2020
Objectives This study aims to evaluate the clinical and radiological outcomes of patients with ch... more Objectives This study aims to evaluate the clinical and radiological outcomes of patients with chronic severe slipped capital femoral epiphysis (SCFE) treated by surgical dislocation and modified Dunn osteotomy (MDO). Patients and methods This retrospective study, conducted between January 2010 and December 2017, included nine patients (8 males, 1 female; mean age 12.6 years; range, 7 to 16 years) with nine hips. The degree of corrections in Southwick angle and alpha angle were measured on frog-leg views. Range of motion (ROM) of the hips was measured at each follow-up visit. Heyman and Herndon classification system and Harris Hip Score (HHS) were evaluated for clinical and functional outcomes at the latest follow-up visit. Results The mean follow-up time was 34.8 months. Avascular necrosis complication was observed in one hip. Except two patients with lateral femoral cutaneous neuropathy, none of the patients suffered from any other complications. Mean preoperative Southwick angle ...
Mitos Üyeleri. Ankara Üniversitesi Açık Erişim Sistemi; Atatürk Üniversitesi Açık Erişim Sistemi;... more Mitos Üyeleri. Ankara Üniversitesi Açık Erişim Sistemi; Atatürk Üniversitesi Açık Erişim Sistemi; Atılım Üniversitesi Açık Erişim Sistemi; Bahçeşehir Üniversitesi Açık Erişim Sistemi; Çukurova Üniversitesi Açık Erişim Sistemi; Dokuz ...
Acta orthopaedica Belgica, 2010
The objective of this prospective consecutive cohort study was to investigate the effect of sagit... more The objective of this prospective consecutive cohort study was to investigate the effect of sagittal cervical profile, gender and age on the thoracic kyphosis in 228 subjects, mainly adults, free of spinal complaints and with a thoracic kyphosis of less than 500. The subjects, who were actually treated for lower extremity problems, were divided into two groups: the 68 subjects in group 1 (30%) had loss of cervical lordosis, while the 160 subjects in group 2 (70%) had a physiological cervical lordosis. In group 1 (loss of cervical lordosis) the mean angles of the upper (T1T6), lower (T7T12), and whole (T1T12) thoracic kyphosis were 8 degrees +/- 2 (range: 3-28 degrees), 15 degrees +/- 4 (range: 6-400), and 24 degrees +/- 6 (range: 10-46 degrees), respectively. In group 2 the normal cervical lordosis seemed to lead to a compensatory increase in these values: 13 degrees +/- 4 (range, 4-35 degrees) (p = 0.008), 21 degrees +/- 5 (range: 6-45 degrees) (p = 0.012), and 34 degrees +/- 8 (ra...
The objective of this prospective consecutive cohort study was to compare the clinical outcomes, ... more The objective of this prospective consecutive cohort study was to compare the clinical outcomes, the radiographic outcomes and the complication rates of symptomatic acute (< 10 weeks) and chronic (> 16 weeks) osteoporotic vertebral compression fractures (VCFs) treated with kyphoplasty. Twenty-eight consecutive patients had 52 symptomatic osteoporotic VCFs treated with kyphoplasty; 5 of these patients were treated in two sessions. The Oswestry Disability Index (ODI) for back pain, a Visual Analog Scale for pain assessment, a patients' satisfaction scale, and medication usage served to evaluate the clinical outcomes. All these variables improved significantly in both groups, and more so in the acute group, but the difference was most often not significant. Vertebral height, local kyphosis angle, global sagittal alignment and dynamic fracture mobility significantly improved in both groups (except global sagittal alignment), and again more so in the acute group (except global ...
Injury
BACKGROUND Spinopelvic dissociation (SPD) is difficult to manage and is associated with high mort... more BACKGROUND Spinopelvic dissociation (SPD) is difficult to manage and is associated with high mortality and morbidity, including concomitant orthopaedic polytrauma, spine injuries, pelvic ring disruptions, neurological, soft-tissue, and vascular injuries. The purpose of this study is to evaluate the functional and radiological outcomes; health related quality of life and complication rates of patients with traumatic spinopelvic dissociation underwent bilateral triangular osteosynthesis (TOS). METHODS The study was approved by the medical school's institutional review board (IRB). Prospective data collection of nineteen consecutive cases of traumatic SPD were included in the study from October 2015 to August 2018. Bilateral TOS was performed to manage all patients with SPD. The clinical outcome for fractures was analyzed with Majeed function assessment. Health Related Quality of Life (HRQoL) was assessed with the EQ-6D questionnaire. The reduction quality was evaluated according to Matta criterion. CT scanning was used to verify the fracture union in patients at 24th weeks postoperatively. RESULTS There were 12 women and 7 men with an average age of 47.2±8.4 years (range, 17-62 years). The average follow-up time was 25.2±3.7 months (average, 22-45 months). The most common mechanism of injury was falling (57%). According to Majeed functional scoring, the results were excellent in 12 cases, good in 5 cases and fair in 2 cases. The median EQVAS score was 78.9±8.4. 15 patients (78.9%) turned back to their original occupation. Pain and mood disorders mainly influenced patients' present general health status. According to Matta criterion for fracture reduction, the results were excellent in 14 cases, good in 4 cases and fair in 1 case. Complications were noted as wound healing problems (26%), implant loosening (5%) and iatrogenic nerve injury (5%). CONCLUSION Bilateral TOS demonstrates satisfactory functional and radiological outcomes with low complication rates except infection rate in patients with traumatic spinopelvic dissociation. HRQoL is mainly dominated by pain and mood disorders. 78.9% of the patients turned back to their original occupation. Surgeons should be aware of wound healing problems in case of increased muscle mobilization and degloving injuries.Implant removal is required to improve the lumbopelvic mobility.
İstanbul Tıp Fakültesi Dergisi, 2017
İntrakalkaneal lipom nadir görülür ve sıklıkla asemptomatiktir. Semptomatik olan vakalarda ise ço... more İntrakalkaneal lipom nadir görülür ve sıklıkla asemptomatiktir. Semptomatik olan vakalarda ise çoğunlukla ilk ve en sık şikâyet basit topuk ağrısıdır. Bu çalışmanın amacı, topuk ağrısı sebebiyle başvurdukları kliniklerde çeşitli ön tanılar alarak cerrahi dışı yöntemler ile tedavi edilmeye çalışılan ve kliniğimizde cerrahi olarak başarıyla tedavi edilmiş 9 olgunun retrospektif analizini ve literatür derlemesini sunmaktır. Gereç ve Yöntem: Kliniğimizde 2008 ve 2015 yılları arasında intrakalkaneal lipom tanısı ile ameliyat edilen 9 hasta (4 kadın, 5 erkek) çalışmaya dahi edildi. Ortalama yaş 40,6 (19-70) yıl idi. Ortalama takip süresi 50,4 (12-114) ay idi. Başlangıçtaki yanlış tanı ile gerçek tanı arasındaki süre 20,8 (12-48) ay idi. Hastalar kliniğimize başvurmadan önce, Achilles tendiniti, epin kalkanei, retrokalkaneal bursit ve plantar fasiit tanıları almış ve tedavi edilmeye çalışılmıştır. Bulgular: Yedi hasta küretaj & kemik grefti ve 2 hasta küretaj & kemik sementi ile tedavi edildi. Tüm hastalar ortalama 5 (3-11) ayda tamamen ağrısız iyileşti. Kemik greftlerinin tam olarak konsolidasyonu ortalama 6 (5-9) ayda görüldü. Ortalama AOFAS skoru ameliyat öncesi 80,4 ten birinci yılda 95,3'e yükseldi. Sonuç: Topuk ağrısı olan hastalarda intrakalkaneal lipom ayırıcı tanıda düşünülmelidir. Küretaj ve kemik grefti ile grefonaj ağrılı ve kritik boyutta intrakalkaneal lipomlar için iyi bir cerrahi tedavi seçeneği olabilir. Anahtar kelimeler: Topuk ağrısı; kemik içi lipomlar; kalkaneus.
Objectives: This study aimed to evaluate the incidence and risk factors associated with adjacent ... more Objectives: This study aimed to evaluate the incidence and risk factors associated with adjacent segment fracture (ASF) following percutaneous vertebroplasty (PVP) to treat osteoporotic vertebral compression fractures (VCF). Methods: From January 2009 to September 2012, 68 patients (47 women, 21[for full text, please go to the a.m. URL]
Turkiye Klinikleri Journal of Orthopaedics and Traumatology Special Topics, 2011
Acta Orthopaedica Belgica, Oct 1, 2010
The objective of this prospective consecutive cohort study was to investigate the effect of sagit... more The objective of this prospective consecutive cohort study was to investigate the effect of sagittal cervical profile, gender and age on the thoracic kyphosis in 228 subjects, mainly adults, free of spinal complaints and with a thoracic kyphosis of less than 500. The subjects, who were actually treated for lower extremity problems, were divided into two groups: the 68 subjects in group 1 (30%) had loss of cervical lordosis, while the 160 subjects in group 2 (70%) had a physiological cervical lordosis. In group 1 (loss of cervical lordosis) the mean angles of the upper (T1T6), lower (T7T12), and whole (T1T12) thoracic kyphosis were 8 degrees +/- 2 (range: 3-28 degrees), 15 degrees +/- 4 (range: 6-400), and 24 degrees +/- 6 (range: 10-46 degrees), respectively. In group 2 the normal cervical lordosis seemed to lead to a compensatory increase in these values: 13 degrees +/- 4 (range, 4-35 degrees) (p = 0.008), 21 degrees +/- 5 (range: 6-45 degrees) (p = 0.012), and 34 degrees +/- 8 (range: 12-50 degrees) (p = 0.007). In both groups gender had no significant effect on the values of the thoracic kyphosis (p&amp;amp;amp;amp;amp;gt; 0.05). Also age had no influence, neither in group 1 nor in group 2 as a whole, but in group 2 advanced age (&amp;amp;amp;amp;amp;gt; 50 years) was correlated with a significant increase in the lower (T7T12) (p = 0.009) and whole (T1T12) thoracic kyphosis (p = 0.007). This study yields standards for reference for the normal curvatures of the spine in the sagittal plane. The literature is quite controversial on this matter.
Acta Orthopaedica Belgica, Jun 1, 2011
The purpose of this study was to evaluate the factors affecting muscle strength of ACL-deficient ... more The purpose of this study was to evaluate the factors affecting muscle strength of ACL-deficient knees before and after ACL reconstruction. The study included 122 male patients who underwent primary ACL reconstruction with a bone-patellar tendon-bone autograft. Preoperative loss and change in muscle strength in both extensor and flexor muscle groups after ACL reconstruction were calculated separately at 60 degrees/sec and 180 degrees/sec angular velocities. We evaluated the effect of surgical delay on the preoperative deficit and on its change after surgery. Muscle strength change after ACL reconstruction was also evaluated in relation to patient compliance to treatment. The longer the delay of ACL reconstruction the more the muscle strength deficit of flexor and extensor muscles increased. In the ACL deficient knees with high strength deficit, improvement in muscle strength was higher after ACL reconstruction for both muscle groups. When delay of ACL reconstruction was short and the patient was compliant to treatment, flexor muscle strength recovery was early. Shortening the delay to reconstruction had a positive influence on muscle strength after ACL reconstruction when preoperative muscle strength deficit was high.
Injury, 2015
Operative treatment consisting of fracture reduction and fixation, or arthroplasty to permit earl... more Operative treatment consisting of fracture reduction and fixation, or arthroplasty to permit early patient mobilization, continues to be the treatment of choice for most femoral neck fractures. Options for internal fixation have included a variety of implants; however most recent reports and textbooks cite parallel multiple cancellous screws as the surgical technique of choice. The study was prospective, randomized and IRB approved. Inclusion criteria included skeletal maturity, closed femoral neck fracture without concomitant fractures or injuries with complete charts and adequate radiographs obtained from the initial injury till the last follow-up. Forty-four patients were enrolled in this study during one-year period at two university centers. 22 were randomized to be treated with full threaded, cannulated compression screws (Acutrak 6/7, ACUMED) (Group 1) and the other 22 with 16mm partial threaded, 6.5mm or 7.3mm cannulated screws (SYNTHES) (Group 2). Three or four screws were used in both groups according to fracture type and surgeon&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s preference. Data evaluated included surgical time, fluoroscopy time, fracture type, radiological outcome, complications and functional status using the Harris Hip Score. Both groups were comparable in terms of age and gender. There was not a significant difference in terms of surgical time, follow-up period, fracture type, or fluoroscopy time. There were eight complications in Group 1 and two in Group 2 (P=0.049) Time to union was significantly longer in Group 1 (P=0.001). However, Hip Scores were not significantly different in both groups (P=0.20). When compared with full threaded compression screws, partial-threaded cannulated screws provides a shorter union time and less complication rate while providing equivalent functional results in adult femoral neck fractures.
The Spine …, 2008
The Spine Journal, Volume 8, Issue 5, Pages 114S-115S, September 2008, Authors:Serkan Erkan, MD; ... more The Spine Journal, Volume 8, Issue 5, Pages 114S-115S, September 2008, Authors:Serkan Erkan, MD; Brian Hsu, MD; Chunhui Wu, PhD; Amir Mehbod, MD; John Perl, MD; Ensor Transfeldt, MD. ...Serkan Erkan, MD: Affiliations. Minneapolis, MN, USA. ,; Brian Hsu, MD: Affiliations ...
![Research paper thumbnail of [The modifed Eden-Lange procedure for paralysis of the trapezius muscle]](https://attachments.academia-assets.com/45097270/thumbnails/1.jpg)
](Acta Orthopaedica Et Traumatologica Turcica, Feb 1, 2007
Trapezius muscular paralysis is a case that results from injury of spinal accessory nerve. When t... more Trapezius muscular paralysis is a case that results from injury of spinal accessory nerve. When the muscle is weak, the shoulder tends to fall towards the stiffen side. The normal counter of the muscle disappears, the neck and shoulder angle enlarges, and the scapula moves downwards and outwards. The levator scapula and rhomboid muscles that are the other rotator muscles of the scapula cannot prevent folding and falling down of the scapula. Clinically, the arm gets pain and gets tired when it is used for a long time. Most probably, the patient feels pain in the abductions over 90º, and sometimes loss of abduction is observed.
European Spine Journal Official Publication of the European Spine Society the European Spinal Deformity Society and the European Section of the Cervical Spine Research Society, Apr 8, 2009
Single level axial lumbar interbody fusion (AxiaLIF) using a transsacral rod through a paracoccyg... more Single level axial lumbar interbody fusion (AxiaLIF) using a transsacral rod through a paracoccygeal approach has been developed with promising early clinical results and biomechanical stability. Recently, the transsacral rod has been extended to perform a two-level fusion at both L4-L5 and L5-S1 levels (AxiaLIF II). No biomechanical studies have been conducted on multilevel fusion using the AxiaLIF technique. In this study, the biomechanics of L4-S1 motion segments instrumented with the AxiaLIF II transsacral rod was evaluated. Six human cadaveric lumbosacral spine segments from L4 to S1 were used (age ranges 46-74 years). Unconstrained and nondestructive pure moments in axial torsion, lateral bending, and flexion extension were applied to each specimen following intact, standalone AxiaLIF II, and AxiaLIF II with two posterior fixation options: facet screws and pedicle screws with rods. Range of motion was calculated from the raw data collected with an optical motion tracking system. The two-level transsacral rod was successfully inserted in all the specimens. At L4-L5 level in axial torsion (AT) and flexion extension (FE), none of the surgical treatments showed statistically significant difference between the procedures (all P [ 0.05) although facet screws and pedicle screws had higher stability on average. In lateral bending (LB), the two posterior fixation techniques had significantly higher construct stability (P \ 0.05) than the standalone rod. No significant difference was found between facet screws and pedicle screws (P = 0.821). At L5-S1 level in AT and LB, none of the surgical treatments were found to be statistically significant (all P [ 0.05). In FE, standalone two-level transsacral rod had significantly higher range of motion (ROM) compared with the posterior fixation techniques (P \ 0.05). In conclusion, the standalone rod reduced intact ROM significantly. Supplementary fixations including facet screws and pedicle screws are required to achieve higher construct stability for successful fusion. Further clinical studies are essential to evaluate the practical success of this technique.
lanmas› sonucu geliflen bir durumdur. Kas zay›f oldu¤u zaman tutulan tarafta omuz düflme e¤ilimin... more lanmas› sonucu geliflen bir durumdur. Kas zay›f oldu¤u zaman tutulan tarafta omuz düflme e¤ilimindedir. Kas›n normal konturu kaybolur, boyun-omuz aç›s› genifller, skapula afla¤› ve d›fla do¤ru yer de¤ifltirir. Skapulan›n di¤er döndürücü kaslar› olan levator skapula ve romboid kaslar skapulan›n kanatlanmas›n› ve afla¤› düflmesini engelleyemez. Klinik olarak kolun uzun süreli kullan›m› a¤r›l› ve yorucu olur. Hasta s›kl›kla omuzda 90 derecenin üstünde abdüksiyonda a¤r› duyar ve bazen abdüksiyonda kay›p olabilir. Bu yaz›da, trapezius felci geliflen aktif bir sporcunun modifiye Eden-Lange prosedürü ile tedavisi sunuldu.
Eklem hastaliklari ve cerrahisi = Joint diseases & related surgery, 2011
OBJECTIVES In this study, the factors causing stiff knee after primary total knee arthroplasty (T... more OBJECTIVES In this study, the factors causing stiff knee after primary total knee arthroplasty (TKA) in patients with medial compartment osteoarthrosis were evaluated. PATIENTS AND METHODS Primary TKA surgery was performed in fifty-three knees in 48 patients (42 females, 6 males; mean age 67.2±8.5; range 59 to 76 years) diagnosed with medial compartment osteoarthrosis. Five patients (10%) out of forty-eight underwent bilateral primary TKA. In the patients who had bilateral TKA, the second operation was performed six months later. Patello-femoral arthroplasty was performed in none of the patients. In the final follow-up, the knees, which had more than 10° of extension limitation and less than 95° of flexion, were defined as post-TKA stiff knee. The patients who developed stiff knee were classified as group 1 and the patients who did not develop stiff knee were classified as group 2. The possible factors that may cause stiff knee after TKA such as age, gender, range of knee flexion an...
Aim: The accuracy of joint line tenderness (JLT) and magnetic resonance imaging (MRI) were determ... more Aim: The accuracy of joint line tenderness (JLT) and magnetic resonance imaging (MRI) were determined in the diagnosis of meniscal tears in patients with complete rupture of the anterior cruciate ligament (ACL). Additionally, the effects of time from injury (to arthroscopy) and medial femoral condyle (MFC) lesions on diagnosis with JTL and MRI were established. Methods: A total of 133 male patients, whose first arthroscopy was performed by MU, were included. Preoperative MRI findings, the initial knee trauma causing ACL rupture, and the time from injury (TFI) were recorded. Physical examinations including JLT were performed within 1 week preceding the operation by the same observer. MRIs were performed within 6 weeks preoperatively by a 1.5 T imager. The first 6 week period after the initial trauma was defined as the acute (Grup I), 6 weeks to 12 months as the subchronic (Grup II) and 12 months or longer as the chronic period (Grup III). The sensitivity, specificity, and accuracy fo...
Joint Diseases and Related Surgery, 2020
Objectives This study aims to evaluate the clinical and radiological outcomes of patients with ch... more Objectives This study aims to evaluate the clinical and radiological outcomes of patients with chronic severe slipped capital femoral epiphysis (SCFE) treated by surgical dislocation and modified Dunn osteotomy (MDO). Patients and methods This retrospective study, conducted between January 2010 and December 2017, included nine patients (8 males, 1 female; mean age 12.6 years; range, 7 to 16 years) with nine hips. The degree of corrections in Southwick angle and alpha angle were measured on frog-leg views. Range of motion (ROM) of the hips was measured at each follow-up visit. Heyman and Herndon classification system and Harris Hip Score (HHS) were evaluated for clinical and functional outcomes at the latest follow-up visit. Results The mean follow-up time was 34.8 months. Avascular necrosis complication was observed in one hip. Except two patients with lateral femoral cutaneous neuropathy, none of the patients suffered from any other complications. Mean preoperative Southwick angle ...
Mitos Üyeleri. Ankara Üniversitesi Açık Erişim Sistemi; Atatürk Üniversitesi Açık Erişim Sistemi;... more Mitos Üyeleri. Ankara Üniversitesi Açık Erişim Sistemi; Atatürk Üniversitesi Açık Erişim Sistemi; Atılım Üniversitesi Açık Erişim Sistemi; Bahçeşehir Üniversitesi Açık Erişim Sistemi; Çukurova Üniversitesi Açık Erişim Sistemi; Dokuz ...
Acta orthopaedica Belgica, 2010
The objective of this prospective consecutive cohort study was to investigate the effect of sagit... more The objective of this prospective consecutive cohort study was to investigate the effect of sagittal cervical profile, gender and age on the thoracic kyphosis in 228 subjects, mainly adults, free of spinal complaints and with a thoracic kyphosis of less than 500. The subjects, who were actually treated for lower extremity problems, were divided into two groups: the 68 subjects in group 1 (30%) had loss of cervical lordosis, while the 160 subjects in group 2 (70%) had a physiological cervical lordosis. In group 1 (loss of cervical lordosis) the mean angles of the upper (T1T6), lower (T7T12), and whole (T1T12) thoracic kyphosis were 8 degrees +/- 2 (range: 3-28 degrees), 15 degrees +/- 4 (range: 6-400), and 24 degrees +/- 6 (range: 10-46 degrees), respectively. In group 2 the normal cervical lordosis seemed to lead to a compensatory increase in these values: 13 degrees +/- 4 (range, 4-35 degrees) (p = 0.008), 21 degrees +/- 5 (range: 6-45 degrees) (p = 0.012), and 34 degrees +/- 8 (ra...
The objective of this prospective consecutive cohort study was to compare the clinical outcomes, ... more The objective of this prospective consecutive cohort study was to compare the clinical outcomes, the radiographic outcomes and the complication rates of symptomatic acute (< 10 weeks) and chronic (> 16 weeks) osteoporotic vertebral compression fractures (VCFs) treated with kyphoplasty. Twenty-eight consecutive patients had 52 symptomatic osteoporotic VCFs treated with kyphoplasty; 5 of these patients were treated in two sessions. The Oswestry Disability Index (ODI) for back pain, a Visual Analog Scale for pain assessment, a patients' satisfaction scale, and medication usage served to evaluate the clinical outcomes. All these variables improved significantly in both groups, and more so in the acute group, but the difference was most often not significant. Vertebral height, local kyphosis angle, global sagittal alignment and dynamic fracture mobility significantly improved in both groups (except global sagittal alignment), and again more so in the acute group (except global ...
Injury
BACKGROUND Spinopelvic dissociation (SPD) is difficult to manage and is associated with high mort... more BACKGROUND Spinopelvic dissociation (SPD) is difficult to manage and is associated with high mortality and morbidity, including concomitant orthopaedic polytrauma, spine injuries, pelvic ring disruptions, neurological, soft-tissue, and vascular injuries. The purpose of this study is to evaluate the functional and radiological outcomes; health related quality of life and complication rates of patients with traumatic spinopelvic dissociation underwent bilateral triangular osteosynthesis (TOS). METHODS The study was approved by the medical school's institutional review board (IRB). Prospective data collection of nineteen consecutive cases of traumatic SPD were included in the study from October 2015 to August 2018. Bilateral TOS was performed to manage all patients with SPD. The clinical outcome for fractures was analyzed with Majeed function assessment. Health Related Quality of Life (HRQoL) was assessed with the EQ-6D questionnaire. The reduction quality was evaluated according to Matta criterion. CT scanning was used to verify the fracture union in patients at 24th weeks postoperatively. RESULTS There were 12 women and 7 men with an average age of 47.2±8.4 years (range, 17-62 years). The average follow-up time was 25.2±3.7 months (average, 22-45 months). The most common mechanism of injury was falling (57%). According to Majeed functional scoring, the results were excellent in 12 cases, good in 5 cases and fair in 2 cases. The median EQVAS score was 78.9±8.4. 15 patients (78.9%) turned back to their original occupation. Pain and mood disorders mainly influenced patients' present general health status. According to Matta criterion for fracture reduction, the results were excellent in 14 cases, good in 4 cases and fair in 1 case. Complications were noted as wound healing problems (26%), implant loosening (5%) and iatrogenic nerve injury (5%). CONCLUSION Bilateral TOS demonstrates satisfactory functional and radiological outcomes with low complication rates except infection rate in patients with traumatic spinopelvic dissociation. HRQoL is mainly dominated by pain and mood disorders. 78.9% of the patients turned back to their original occupation. Surgeons should be aware of wound healing problems in case of increased muscle mobilization and degloving injuries.Implant removal is required to improve the lumbopelvic mobility.
İstanbul Tıp Fakültesi Dergisi, 2017
İntrakalkaneal lipom nadir görülür ve sıklıkla asemptomatiktir. Semptomatik olan vakalarda ise ço... more İntrakalkaneal lipom nadir görülür ve sıklıkla asemptomatiktir. Semptomatik olan vakalarda ise çoğunlukla ilk ve en sık şikâyet basit topuk ağrısıdır. Bu çalışmanın amacı, topuk ağrısı sebebiyle başvurdukları kliniklerde çeşitli ön tanılar alarak cerrahi dışı yöntemler ile tedavi edilmeye çalışılan ve kliniğimizde cerrahi olarak başarıyla tedavi edilmiş 9 olgunun retrospektif analizini ve literatür derlemesini sunmaktır. Gereç ve Yöntem: Kliniğimizde 2008 ve 2015 yılları arasında intrakalkaneal lipom tanısı ile ameliyat edilen 9 hasta (4 kadın, 5 erkek) çalışmaya dahi edildi. Ortalama yaş 40,6 (19-70) yıl idi. Ortalama takip süresi 50,4 (12-114) ay idi. Başlangıçtaki yanlış tanı ile gerçek tanı arasındaki süre 20,8 (12-48) ay idi. Hastalar kliniğimize başvurmadan önce, Achilles tendiniti, epin kalkanei, retrokalkaneal bursit ve plantar fasiit tanıları almış ve tedavi edilmeye çalışılmıştır. Bulgular: Yedi hasta küretaj & kemik grefti ve 2 hasta küretaj & kemik sementi ile tedavi edildi. Tüm hastalar ortalama 5 (3-11) ayda tamamen ağrısız iyileşti. Kemik greftlerinin tam olarak konsolidasyonu ortalama 6 (5-9) ayda görüldü. Ortalama AOFAS skoru ameliyat öncesi 80,4 ten birinci yılda 95,3'e yükseldi. Sonuç: Topuk ağrısı olan hastalarda intrakalkaneal lipom ayırıcı tanıda düşünülmelidir. Küretaj ve kemik grefti ile grefonaj ağrılı ve kritik boyutta intrakalkaneal lipomlar için iyi bir cerrahi tedavi seçeneği olabilir. Anahtar kelimeler: Topuk ağrısı; kemik içi lipomlar; kalkaneus.
Objectives: This study aimed to evaluate the incidence and risk factors associated with adjacent ... more Objectives: This study aimed to evaluate the incidence and risk factors associated with adjacent segment fracture (ASF) following percutaneous vertebroplasty (PVP) to treat osteoporotic vertebral compression fractures (VCF). Methods: From January 2009 to September 2012, 68 patients (47 women, 21[for full text, please go to the a.m. URL]
Turkiye Klinikleri Journal of Orthopaedics and Traumatology Special Topics, 2011
Acta Orthopaedica Belgica, Oct 1, 2010
The objective of this prospective consecutive cohort study was to investigate the effect of sagit... more The objective of this prospective consecutive cohort study was to investigate the effect of sagittal cervical profile, gender and age on the thoracic kyphosis in 228 subjects, mainly adults, free of spinal complaints and with a thoracic kyphosis of less than 500. The subjects, who were actually treated for lower extremity problems, were divided into two groups: the 68 subjects in group 1 (30%) had loss of cervical lordosis, while the 160 subjects in group 2 (70%) had a physiological cervical lordosis. In group 1 (loss of cervical lordosis) the mean angles of the upper (T1T6), lower (T7T12), and whole (T1T12) thoracic kyphosis were 8 degrees +/- 2 (range: 3-28 degrees), 15 degrees +/- 4 (range: 6-400), and 24 degrees +/- 6 (range: 10-46 degrees), respectively. In group 2 the normal cervical lordosis seemed to lead to a compensatory increase in these values: 13 degrees +/- 4 (range, 4-35 degrees) (p = 0.008), 21 degrees +/- 5 (range: 6-45 degrees) (p = 0.012), and 34 degrees +/- 8 (range: 12-50 degrees) (p = 0.007). In both groups gender had no significant effect on the values of the thoracic kyphosis (p&amp;amp;amp;amp;amp;gt; 0.05). Also age had no influence, neither in group 1 nor in group 2 as a whole, but in group 2 advanced age (&amp;amp;amp;amp;amp;gt; 50 years) was correlated with a significant increase in the lower (T7T12) (p = 0.009) and whole (T1T12) thoracic kyphosis (p = 0.007). This study yields standards for reference for the normal curvatures of the spine in the sagittal plane. The literature is quite controversial on this matter.
Acta Orthopaedica Belgica, Jun 1, 2011
The purpose of this study was to evaluate the factors affecting muscle strength of ACL-deficient ... more The purpose of this study was to evaluate the factors affecting muscle strength of ACL-deficient knees before and after ACL reconstruction. The study included 122 male patients who underwent primary ACL reconstruction with a bone-patellar tendon-bone autograft. Preoperative loss and change in muscle strength in both extensor and flexor muscle groups after ACL reconstruction were calculated separately at 60 degrees/sec and 180 degrees/sec angular velocities. We evaluated the effect of surgical delay on the preoperative deficit and on its change after surgery. Muscle strength change after ACL reconstruction was also evaluated in relation to patient compliance to treatment. The longer the delay of ACL reconstruction the more the muscle strength deficit of flexor and extensor muscles increased. In the ACL deficient knees with high strength deficit, improvement in muscle strength was higher after ACL reconstruction for both muscle groups. When delay of ACL reconstruction was short and the patient was compliant to treatment, flexor muscle strength recovery was early. Shortening the delay to reconstruction had a positive influence on muscle strength after ACL reconstruction when preoperative muscle strength deficit was high.
Injury, 2015
Operative treatment consisting of fracture reduction and fixation, or arthroplasty to permit earl... more Operative treatment consisting of fracture reduction and fixation, or arthroplasty to permit early patient mobilization, continues to be the treatment of choice for most femoral neck fractures. Options for internal fixation have included a variety of implants; however most recent reports and textbooks cite parallel multiple cancellous screws as the surgical technique of choice. The study was prospective, randomized and IRB approved. Inclusion criteria included skeletal maturity, closed femoral neck fracture without concomitant fractures or injuries with complete charts and adequate radiographs obtained from the initial injury till the last follow-up. Forty-four patients were enrolled in this study during one-year period at two university centers. 22 were randomized to be treated with full threaded, cannulated compression screws (Acutrak 6/7, ACUMED) (Group 1) and the other 22 with 16mm partial threaded, 6.5mm or 7.3mm cannulated screws (SYNTHES) (Group 2). Three or four screws were used in both groups according to fracture type and surgeon&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s preference. Data evaluated included surgical time, fluoroscopy time, fracture type, radiological outcome, complications and functional status using the Harris Hip Score. Both groups were comparable in terms of age and gender. There was not a significant difference in terms of surgical time, follow-up period, fracture type, or fluoroscopy time. There were eight complications in Group 1 and two in Group 2 (P=0.049) Time to union was significantly longer in Group 1 (P=0.001). However, Hip Scores were not significantly different in both groups (P=0.20). When compared with full threaded compression screws, partial-threaded cannulated screws provides a shorter union time and less complication rate while providing equivalent functional results in adult femoral neck fractures.
The Spine …, 2008
The Spine Journal, Volume 8, Issue 5, Pages 114S-115S, September 2008, Authors:Serkan Erkan, MD; ... more The Spine Journal, Volume 8, Issue 5, Pages 114S-115S, September 2008, Authors:Serkan Erkan, MD; Brian Hsu, MD; Chunhui Wu, PhD; Amir Mehbod, MD; John Perl, MD; Ensor Transfeldt, MD. ...Serkan Erkan, MD: Affiliations. Minneapolis, MN, USA. ,; Brian Hsu, MD: Affiliations ...
Acta Orthopaedica Et Traumatologica Turcica, Feb 1, 2007
Trapezius muscular paralysis is a case that results from injury of spinal accessory nerve. When t... more Trapezius muscular paralysis is a case that results from injury of spinal accessory nerve. When the muscle is weak, the shoulder tends to fall towards the stiffen side. The normal counter of the muscle disappears, the neck and shoulder angle enlarges, and the scapula moves downwards and outwards. The levator scapula and rhomboid muscles that are the other rotator muscles of the scapula cannot prevent folding and falling down of the scapula. Clinically, the arm gets pain and gets tired when it is used for a long time. Most probably, the patient feels pain in the abductions over 90º, and sometimes loss of abduction is observed.
European Spine Journal Official Publication of the European Spine Society the European Spinal Deformity Society and the European Section of the Cervical Spine Research Society, Apr 8, 2009
Single level axial lumbar interbody fusion (AxiaLIF) using a transsacral rod through a paracoccyg... more Single level axial lumbar interbody fusion (AxiaLIF) using a transsacral rod through a paracoccygeal approach has been developed with promising early clinical results and biomechanical stability. Recently, the transsacral rod has been extended to perform a two-level fusion at both L4-L5 and L5-S1 levels (AxiaLIF II). No biomechanical studies have been conducted on multilevel fusion using the AxiaLIF technique. In this study, the biomechanics of L4-S1 motion segments instrumented with the AxiaLIF II transsacral rod was evaluated. Six human cadaveric lumbosacral spine segments from L4 to S1 were used (age ranges 46-74 years). Unconstrained and nondestructive pure moments in axial torsion, lateral bending, and flexion extension were applied to each specimen following intact, standalone AxiaLIF II, and AxiaLIF II with two posterior fixation options: facet screws and pedicle screws with rods. Range of motion was calculated from the raw data collected with an optical motion tracking system. The two-level transsacral rod was successfully inserted in all the specimens. At L4-L5 level in axial torsion (AT) and flexion extension (FE), none of the surgical treatments showed statistically significant difference between the procedures (all P [ 0.05) although facet screws and pedicle screws had higher stability on average. In lateral bending (LB), the two posterior fixation techniques had significantly higher construct stability (P \ 0.05) than the standalone rod. No significant difference was found between facet screws and pedicle screws (P = 0.821). At L5-S1 level in AT and LB, none of the surgical treatments were found to be statistically significant (all P [ 0.05). In FE, standalone two-level transsacral rod had significantly higher range of motion (ROM) compared with the posterior fixation techniques (P \ 0.05). In conclusion, the standalone rod reduced intact ROM significantly. Supplementary fixations including facet screws and pedicle screws are required to achieve higher construct stability for successful fusion. Further clinical studies are essential to evaluate the practical success of this technique.