Mehmet Talmaç - Academia.edu (original) (raw)
Papers by Mehmet Talmaç
Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca
Besides, this situation may depend also on experience level of the radiology technician. As a con... more Besides, this situation may depend also on experience level of the radiology technician. As a consequence, operation room staff and patients may be exposed to high level of ionizing radiation during surgery. In this study, we have aimed to evaluate the effect of use of the double-fluoroscopy on the level of radiology emission and duration of surgery in the patients who underwent osteosynthesis by cannulated screw fixation for femoral neck fracture. Our hypothesis to conduct this study is that use of double fluoroscopy reduces both duration of surgery and level of the exposure to ionizing radiation. MATERIAL AND METHODS Our retrospective study included 35 patients who were performed osteosynthesis by cannulated screw fixation for femoral neck fracture between December 2013 and
Acta Orthopaedica et Traumatologica Turcica, Apr 3, 2020
The role of the platelet-to-lymphocyte ratio and neutrophil-to-lymphocyte ratio in the prediction... more The role of the platelet-to-lymphocyte ratio and neutrophil-to-lymphocyte ratio in the prediction of length and cost of hospital stay in patients with infected diabetic foot ulcers: A retrospective comparative study
Acta Orthopaedica et Traumatologica Turcica, Sep 1, 2018
Objective: Tibial derotation osteotomy can be used in the treatment of rotational deformities in ... more Objective: Tibial derotation osteotomy can be used in the treatment of rotational deformities in case of ineffective conservative management. Our aim was to evaluate the results of the patients who underwent minimal invasive plate osteosynthesis for tibial derotation osteotomies. Methods: Total of 16 patients (17 procedures) were included in this study. Mean age was 11.5 (3e25) years. We clinically assessed the tibial torsion by measuring the thigh-foot angle (TFA). No immobilization was used postoperatively and range of motion exercises were begun immediately. The patient was allowed weight-bearing activity, as tolerated, when callus formation was seen on the radiographs, at approximately three to four weeks after surgery. Results: The mean follow-up time was 27.5 months. Mean preoperative and follow up TFA were 27 of internal rotation and 3.74 of external rotation, respectively. A mean of 22.3 improvement was achieved postoperatively. There was only one wound detachment, which was accepted as a complication and healed with local wound care. Conclusions: The recurrence risk and correction loss can be decreased with plate-screw fixation. Minimal invasive surgery would also decrease the risk of wound complications.
JCPSP. Journal of the College of Physicians & Surgeons Pakistan, Dec 1, 2020
Osteoid osteoma with multiple nidi is a rare condition. The aim of this report is to share a case... more Osteoid osteoma with multiple nidi is a rare condition. The aim of this report is to share a case of an osteoid osteoma with two separate nidi, which underwent radio-frequency ablation (RFA) treatment under CT-guidance for each of the nidi in the same session. A 15-year girl with osteoid osteoma in left tibia was referred to our clinic for percutaneous RFA. She had pain that worsened at nights. The patient was diagnosed as osteoidosteoma, according to radiologic findings and the clinical symptoms. After CT-guided percutaneous RFA of each nidi in the same procedure, pain was relieved in 24 hours. Each of the RFA-treatments was successful in pain control without any complications and no recurrence occurred during eight months of follow-up period. To our knowledge, this case is one of the very few cases with double nidi, which was treated with RFA in one session. RFA is safe in treatment of osteoid osteomas; even two close and separate nidi can safely be treated in the same session.
Yonsei Medical Journal, 2003
Journal of the College of Physicians and Surgeons Pakistan
Objective: To observe the necessity and usefulness of follow-up Magnetic Resonance Imaging (MRI) ... more Objective: To observe the necessity and usefulness of follow-up Magnetic Resonance Imaging (MRI) and Computed Tomography Imaging (CTI) after RFA of osteoid osteoma. Study Design: A descriptive study.
Revista Brasileira de Ortopedia, 2021
Resumo Objetivo Comparar os níveis séricos de vitamina D e minerais de crianças com ou sem fratur... more Resumo Objetivo Comparar os níveis séricos de vitamina D e minerais de crianças com ou sem fraturas isoladas da extremidade distal do rádio. Métodos Este estudo clínico prospectivo incluiu 50 crianças (com idade entre 5 e 15 anos) com fratura isolada distal do rádio que deram entrada em nossa unidade de emergência entre fevereiro e maio de 2018 como grupo de estudo (grupo A), e 50 crianças saudáveis sem histórico de fratura como grupo controle (grupo B). Foram obtidas e analisadas amostras de sangue venoso periférico para medições de 25-hidroxivitamina D (25(OH)D), Cálcio (Ca), Magnésio (Mg), Fósforo (P), fosfatase alcalina (FA) e hormônio da paratireoide (HPT) em ambos os grupos. As características dos pacientes e as amostras de sangue venoso periférico foram comparadas entre os grupos. Resultados A média de idade, altura, peso, índice de massa corporal (IMC) e distribuição de gênero foram semelhantes em ambos os grupos. Não houve diferenças estatísticas nas análises sanguíneas, in...
All nonsteroidal anti-inflammatory drugs (NSAIDs), including selective COX-2 inhibitors, have ant... more All nonsteroidal anti-inflammatory drugs (NSAIDs), including selective COX-2 inhibitors, have anti-inflammatory analgesic and antipyretic effects, and some of them also have antithrombotic effects. Although NSAIDs are structurally organic acids, chemically they constitute a heterogeneous group. Long-term use of NSAIDs may cause many side effects, especially in older patients, so they should be used cautiously. Corticosteroids effectively suppress inflammation, and they are used in the treatment of both systemic and local inflammation. This chapter mainly discusses local intra-articular injections of steroids, to the tendon sheath, in bursitis and simple bone cysts.
Stress fracture in non-weight bearing bones is uncommon. Complete stress fracture of both forearm... more Stress fracture in non-weight bearing bones is uncommon. Complete stress fracture of both forearm bones without overt risk factors is a very rare condition. This report presents the case of a 68-year-old female patient with displaced stress fracture of both bones of forearm. The fractures were treated with open reduction and plate fixation. To our knowledge this is the first case in the literature presenting with complete stress fracture of both forearm bones in the absence of intrinsic risk factors. Awareness of stress fractures of forearm may prevent displacement and progression to complete fractures.
Journal of Orthopaedic Science, 2020
SiSli Etfal Hastanesi Tip Bulteni / The Medical Bulletin of Sisli Hospital, 2018
K nee replacement surgery is one of the most common procedures for knee osteoarthritis. This proc... more K nee replacement surgery is one of the most common procedures for knee osteoarthritis. This procedure can lead to significant blood loss, and the blood transfusion rate is high. In 34% of patients who underwent total knee replacement (TKR), perioperative blood transfusions are being performed at least once. [1] Allogeneic blood transfusion is associated with a variety of risks such as transfusion reaction, volume overload of the heart, and inhibition of immune system. [2-4] Blood transfusion increases hospitalization cost. [5] In clinical practice, different protective measures such as autologous blood transfusion have been used to reduce postoperative blood transfusion rates. [6-8] Other methods for prevention of perioperative blood loss include preoperative administration of erythropoietin, preoperative administration of iron supplements, normovolemic hemodilution, controlled hypotension, tourniquet use, and application of antifibrinolytic agents. [9-12] Tranexamic acid (TA) is a lysine analog that blocks plas-Objectives: This study aimed to analyze the efficacy of single-dose tranexamic acid (TA) 20 mg/kg preoperatively to reduce blood loss in patients undergoing total knee replacement (TKR). Methods: A total of 387 patients (82 males, 305 females) undergoing TKR between January 2014 and December 2018 were included in the study. The T + group was administrated intravenous (iv) TA 20 mg/kg 20 min before the skin incision. We determined perioperative blood loss, the amount of drainage postoperative 24 h, the amount of drainage after postoperative 24-48 h, total volume of drains, total volume of blood loss, postoperative hemoglobin and hematocrit levels, and amount of total blood transfusion. Results: In terms of demographic data, no statistically significant difference was observed between the groups. Perioperative blood loss and total volume of blood loss was found statistically higher in T − group compared to T + group. Postoperatively, the mean hemoglobin and hematocrit levels of T − group were statistically significantly lower than T + group. Conclusion: A single 20 mg/kg iv TA administration before TKR reduces bleeding during surgery and within 24 h postoperatively.
Joint Diseases and Related Surgery, 2019
Bu çalışmada açık redüksiyon ve internal fiksasyon (ARİF) ile tedavi edilen çoklu dorsal karpomet... more Bu çalışmada açık redüksiyon ve internal fiksasyon (ARİF) ile tedavi edilen çoklu dorsal karpometakarpal (KMK) eklem kırıklı çıkığı olan hastaların klinik ve radyolojik sonuçları değerlendirildi. Hastalar ve yöntemler: Ocak 2013-Aralık 2017 tarihleri arasında 14 hasta (12 erkek, 2 kadın; ortalama yaş 35.1 yıl; dağılım, 22-64 yıl) değerlendirildi. Başlıca sonuç ölçümlerimiz Hızlı Kol, Omuz ve El sorunları (QuickDASH) skoru, kavrama gücü kaybı, eklem hareket aralığı (EHA)'nda kısıtlılık ve radyografiler ve bilgisayarlı tomografi görüntüleri ile tanımlanan Kellgren-Lawrence osteoartrit sınıflandırması idi. Bulgular: Yedinci haftada ve üçüncü ayda ortalama QuickDASH skorları sırasıyla 73.57 (dağılım, 65-90) ve 29.11 (dağılım, 25-42.5) idi. Yedinci, dokuzuncu ve 12. aydaki ve son takipteki ortalama QuickDASH skoru 4.64 (dağılım, 0-30) idi ve bu takip dönemlerinde QuickDASH skoru 0 olmayan sadece üç hasta vardı. Son takipte ortalama kavrama gücü kaybı %32.14 idi ve iki hastada (%14.29) üçüncü proksimal interfalangeal EHA'da kısıtlılık vardı. Son takipte Kellgren-Lawrence sınıflandırmasına göre dört hastada evre I, dokuz hastada evre II ve bir hastada evre III osteoartrit vardı. Sonuç: Fonksiyonel sonuçlar, çoklu KMK eklem kırıklı çıkıkların ARİF ile tedavi edilebileceğini göstermesine rağmen, yüksek osteoartrit oranı bir dezavantajdır.
Turkish Journal of Trauma and Emergency Surgery, 2019
BACKGROUND: The aim of this study was to compare the clinical and radiological results of the pro... more BACKGROUND: The aim of this study was to compare the clinical and radiological results of the proximal femoral nail antirotation (PFNA) with those of the dynamic hip screw (DHS) and percutaneous compression plate (PCCP) in the treatment of simple pertrochanteric fractures. METHODS: A total of 203 patients were included in the study. PFNA fixations were performed in 73 patients (PFNA group), DHS in 68 patients (DHS group), and PCCP in 62 patients (PCCP group). The main outcome measurements were perioperative properties, the Harris hip score, changes in the neck-shaft angle, and loss of the abductor muscle strength. Data were compared between the groups. RESULTS: The mean estimated total blood loss and the number of patients receiving the blood transfusion rate in the PFNA group were statistically significantly lower. The mean operation and fluoroscopy times in the PCCP group were statistically significantly higher. The mean loss of the abductor muscle strength and changes in the neck-shaft angle in the PFNA group were statistically significantly higher. The mean Harris hip scores were similar. CONCLUSION: Our findings demonstrated that although PFNA was superior with regard to the perioperative data, DHS and PCCP were superior in maintaining the reduction and the abductor muscle strenght. All three implants were similar and had satisfactory functional outcomes.
The Turkish Journal of Geriatrics, 2019
Introduction: Septic arthritis of the knee is a serious disease usually caused by bacterial infec... more Introduction: Septic arthritis of the knee is a serious disease usually caused by bacterial infection. Although this disease is not age-restricted, many cases involve elderly people and young children. The present study evaluated the clinical and laboratory findings of patients aged ≥65 years who underwent surgery for diagnosed septic arthritis of the knee. Materials and Method: We retrospectively reviewed all patients' preoperative demographic data and comorbidities, as well as preoperative and postoperative clinical and laboratory findings. All patients were followed postoperatively at the 3rd and 6th weeks and 6th month and until a mean final follow-up of 36.0±21.6 (12-95) months. Results: This retrospective clinical study included 56 patients (34 men, 22 women) who underwent surgery during 2010-2017. The mean age and body mass index (kg/m²) were 77.3 and 27.6, respectively. In 43 patients (76.8%), at least one infectious agent could be isolated from joint debridement material. The most commonly isolated bacterium was Staphylococcus aureus (28 patients, 50%). Between all follow-up time points, we observed statistically significant decreases in C-reactive protein levels and erythrocyte sedimentation rates (both p<0.001), well as significant increases in SF-36 scores (p<0.001). Furthermore, visual analog scale scores decreased significantly between all follow-up time points (p<0.001) except between the 6th postoperative month and final follow-up (p=0.021). Conclusion: Geriatric septic arthritis should be operated early. During postoperative empirical antibiotherapy, kidney function tests should be performed regularly. Further research is required for optimal management of geriatric knee SA.
SiSli Etfal Hastanesi Tip Bulteni / The Medical Bulletin of Sisli Hospital, 2018
I n upper extremity surgery, brachial plexus blocks are often preferred due to their advantages, ... more I n upper extremity surgery, brachial plexus blocks are often preferred due to their advantages, such as long postoperative analgesic efficacy and shortening the length of hospital stay. This application reduces the use of opioids for postoperative analgesia and provides protection from their side effects. However, procedure failure, nerve injury and intravascular injection are the most common complications. These blocks were performed with a nerve stimu-Objectives: Brachial plexus block is the most effective analgesia and anesthesia procedure for the upper extremity surgeries in pediatric patients. In recent years, ultrasound guidance for this procedure has reduced the fail and complications like pneumothorax, intravascular injection and nerve damage. However, the number of studies about brachial plexus block is not enough, particularly in pediatric patients, which remained under-researched. In our study, we aimed to discuss the efficacy and safety of the ultrasoundguided brachial plexus block in pediatric patients by retrospectively examining their data. Methods: We retrospectively reviewed the data of pediatric patients who underwent ultrasound-guided brachial block in our clinic between January 2015-January 2017. Demographic data, diagnosis, procedure and operation times, medications, motor and sensorial block times were recorded. Results: Between January 2015 and January 2017, the number of pediatric patients who underwent ultrasound-guided peripheral nerve block in our clinic was 24. In 15 of these patients, the supraclavicular block was applied in 15, and the infraclavicular block was applied in nine patients. The mean age of the patients was 9.6±3.12, with a male/female ratio 14/10. The mean duration of the procedure was 9.54±2.14 minutes in patients for the supraclavicular block and 12.9 ± 2.8 minutes for the infraclavicular block. The mean surgery time was 64±13.6 minutes. As a local anesthetic, bupivacaine was used in three patients; bupivacaine+lidocaine combination was used in 21 patients and adjuvants were added in eight patients. The block procedure was performed under general anesthesia in 12 patients and under sedation in 12 patients. The mean motor block time was 7.5±2 hours in patients who received supraclavicular block, and 7.4±1.5 hours in patients who received infraclavicular block. The mean sensorial block time was 10.5±1.7 hours in the supraclavicular block, and 10.45±1.15 hours in the infraclavicular block. The mean motor block period with added adjuvants was 7.7±0.5 hours, and the sensorial block period was 11.12±1.1 hours. No complications were seen during the procedure, intraoperative and postoperative follow-up. Conclusion: Ultrasound-guided brachial plexus block in pediatric patients is effective and safe, with longer analgesia duration and lower complication rates. Prospective studies with a larger number of patients are needed in this regard.
Musculoskeletal Research and Basic Science, 2016
Indian Journal of Surgery, 2012
This study is a comparison between three methods that are frequently used for the surgical treatm... more This study is a comparison between three methods that are frequently used for the surgical treatment of pilonidal disease all over the world: modified excision and repair, wide excision and secondary repair, and wide excision and flap. The first technique is done by our group for the first time, and has not been described previously in the literature. This is an interventional study performed at Omid, Sadr, and Rasoul Akram hospitals on patients who had undergone operation because of pilonidal sinus disease and met the inclusion criteria between 2004 and 2007. Exclusion criteria were (1) acute pilonidal sinus diseases, (2) history of pilonidal sinus surgery, (3) history of systemic diseases (DM, malignancy, etc.), and (4) pilonidal abscess. Essential information was extracted from complete medical archives. Any data not available in files or during follow-up visits (all patients supposed to be followed at least for 1 year) were gathered by a telephone interview. A total of 194 patients met the criteria and had complete archived files. Longer duration of hospital stay was found in the "wide excision and closing with flap" method comparing with two other methods (P<0.05). Length of incapacity for work was not different between the "wide excision and modified repair" and "wide excision" (P>0.5) methods, but longer for "wide excision and flap" in comparison with two others (P<0.05). Healing time was significantly longer in the "wide excision" method in comparison with two other methods (P<0.05). However, "wide excision and modified repair" method had the least healing time between all above techniques, except for length of leaving the office. All the three recurrences (1.5 %) occurred in the wide excision and flap method (P<0.05). The frequency of postoperative complications was 2 (3.3 %) in wide excision and modified repair, 15 (18.5 %) in wide excision, and 17 (32.7 %) in wide excision and flap closure; these differences in complications were statistically significant (P<0.05). Our results show that the wide excision and modified repair technique, which has been described for the first time, is an acceptable method due to a low recurrence rate and better wound outcomes comparing with wide excision alone and wide excision and flap techniques for the surgical treatment of pilonidal sinus disease.
Ankara Medical Journal, 2014
Amac: Osteoporotik kiriklarin onlenmesi icin osteoporozun tanisi ve tedavisi onemli bir yer tutm... more Amac: Osteoporotik kiriklarin onlenmesi icin osteoporozun tanisi ve tedavisi onemli bir yer tutmaktadir. Bu tani icin en sik kullanilan yontem BMD olmakla beraber, davranis, kas fonsiyonlari ve kalsiyum dengesi; dolayli olarak da kemik yapisinin dongusunu saglayan vitamin D’ nin osteoporotik kiriklarin olusmasinda etkilidir; ama bu etkinin kalca kiriginin tipinin olusmasindaki etkisini degerlendirmeye calistik. Gerec-Yontem: Dusuk enerjili travma sonrasi meydana gelen 20 intertrokanterik ve 20 kollum femoris kirik tanisi ile servise yatirilan tum hastalarin BMD ve 25-OH vitamin D3 degerleri olculdu. Bulgular: Intertrokanterik femur kirigi olan hastalarda 25-OH vitamin D degeri ortalama 10,42; kollum femoris kirigi olan hastalarda 24,84 olarak bulundu. Sonuc: Osteoporotik, yasli hastalarda vitamin D eksikliginin tani ve tedavisi yapildigi takdirde, intertrokanterik kalca kiriklarinin, kollum femoris kiriklarina gore daha az gorulebilecegi kanaatindeyiz.
TOTBİD Dergisi, 2014
FBEK ilk olarak 1572 de Pare (Ambrose Pare, 1510-1590) tarafından femur başı epifiz kayması olara... more FBEK ilk olarak 1572 de Pare (Ambrose Pare, 1510-1590) tarafından femur başı epifiz kayması olarak tanımlanmış [3] ve Boyd (John Boyd Colquhoun, 1899-1974) ilk olarak 1909'da femur başı epifizini pin ile stabilize etmiştir. [4] EPİDEMİYOLOJİ FBEK sıklığı, ırk, cinsiyet ve coğrafik bölgeye göre değişmekle birlikte, ortalama 100 000'de 2 oranında F emur başı epifiz kayması (FBEK) adolesan çağda en sık görülen kalça patolojisidir. [1] Femur başı epifizinin proksimal femur metafizinden ayrışıp kaymasıdır. Hızlı büyüme çağındaki obez adolesan çocuklarda fazla görülmesi, zayıf femur başı epizinin fazla yük taşımasına bağlanır. Femur başı epifizinin asetabulum ile ilişkisi bozulmaz ve femur boynu anterosuperiora deplase olup epifiz nispeten posteriora deplase olmuş gibi görünür. Valgustaki FBEK olgularında femur boynu postero-inferiora deplase olabilir. [2] Femur başı epifiz kayması olan hastalara güncel tanı ve tedavi yaklaşımı Current diagnostic and therapeutic approach to patients with slipped capital femoral epiphysis
Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca
Besides, this situation may depend also on experience level of the radiology technician. As a con... more Besides, this situation may depend also on experience level of the radiology technician. As a consequence, operation room staff and patients may be exposed to high level of ionizing radiation during surgery. In this study, we have aimed to evaluate the effect of use of the double-fluoroscopy on the level of radiology emission and duration of surgery in the patients who underwent osteosynthesis by cannulated screw fixation for femoral neck fracture. Our hypothesis to conduct this study is that use of double fluoroscopy reduces both duration of surgery and level of the exposure to ionizing radiation. MATERIAL AND METHODS Our retrospective study included 35 patients who were performed osteosynthesis by cannulated screw fixation for femoral neck fracture between December 2013 and
Acta Orthopaedica et Traumatologica Turcica, Apr 3, 2020
The role of the platelet-to-lymphocyte ratio and neutrophil-to-lymphocyte ratio in the prediction... more The role of the platelet-to-lymphocyte ratio and neutrophil-to-lymphocyte ratio in the prediction of length and cost of hospital stay in patients with infected diabetic foot ulcers: A retrospective comparative study
Acta Orthopaedica et Traumatologica Turcica, Sep 1, 2018
Objective: Tibial derotation osteotomy can be used in the treatment of rotational deformities in ... more Objective: Tibial derotation osteotomy can be used in the treatment of rotational deformities in case of ineffective conservative management. Our aim was to evaluate the results of the patients who underwent minimal invasive plate osteosynthesis for tibial derotation osteotomies. Methods: Total of 16 patients (17 procedures) were included in this study. Mean age was 11.5 (3e25) years. We clinically assessed the tibial torsion by measuring the thigh-foot angle (TFA). No immobilization was used postoperatively and range of motion exercises were begun immediately. The patient was allowed weight-bearing activity, as tolerated, when callus formation was seen on the radiographs, at approximately three to four weeks after surgery. Results: The mean follow-up time was 27.5 months. Mean preoperative and follow up TFA were 27 of internal rotation and 3.74 of external rotation, respectively. A mean of 22.3 improvement was achieved postoperatively. There was only one wound detachment, which was accepted as a complication and healed with local wound care. Conclusions: The recurrence risk and correction loss can be decreased with plate-screw fixation. Minimal invasive surgery would also decrease the risk of wound complications.
JCPSP. Journal of the College of Physicians & Surgeons Pakistan, Dec 1, 2020
Osteoid osteoma with multiple nidi is a rare condition. The aim of this report is to share a case... more Osteoid osteoma with multiple nidi is a rare condition. The aim of this report is to share a case of an osteoid osteoma with two separate nidi, which underwent radio-frequency ablation (RFA) treatment under CT-guidance for each of the nidi in the same session. A 15-year girl with osteoid osteoma in left tibia was referred to our clinic for percutaneous RFA. She had pain that worsened at nights. The patient was diagnosed as osteoidosteoma, according to radiologic findings and the clinical symptoms. After CT-guided percutaneous RFA of each nidi in the same procedure, pain was relieved in 24 hours. Each of the RFA-treatments was successful in pain control without any complications and no recurrence occurred during eight months of follow-up period. To our knowledge, this case is one of the very few cases with double nidi, which was treated with RFA in one session. RFA is safe in treatment of osteoid osteomas; even two close and separate nidi can safely be treated in the same session.
Yonsei Medical Journal, 2003
Journal of the College of Physicians and Surgeons Pakistan
Objective: To observe the necessity and usefulness of follow-up Magnetic Resonance Imaging (MRI) ... more Objective: To observe the necessity and usefulness of follow-up Magnetic Resonance Imaging (MRI) and Computed Tomography Imaging (CTI) after RFA of osteoid osteoma. Study Design: A descriptive study.
Revista Brasileira de Ortopedia, 2021
Resumo Objetivo Comparar os níveis séricos de vitamina D e minerais de crianças com ou sem fratur... more Resumo Objetivo Comparar os níveis séricos de vitamina D e minerais de crianças com ou sem fraturas isoladas da extremidade distal do rádio. Métodos Este estudo clínico prospectivo incluiu 50 crianças (com idade entre 5 e 15 anos) com fratura isolada distal do rádio que deram entrada em nossa unidade de emergência entre fevereiro e maio de 2018 como grupo de estudo (grupo A), e 50 crianças saudáveis sem histórico de fratura como grupo controle (grupo B). Foram obtidas e analisadas amostras de sangue venoso periférico para medições de 25-hidroxivitamina D (25(OH)D), Cálcio (Ca), Magnésio (Mg), Fósforo (P), fosfatase alcalina (FA) e hormônio da paratireoide (HPT) em ambos os grupos. As características dos pacientes e as amostras de sangue venoso periférico foram comparadas entre os grupos. Resultados A média de idade, altura, peso, índice de massa corporal (IMC) e distribuição de gênero foram semelhantes em ambos os grupos. Não houve diferenças estatísticas nas análises sanguíneas, in...
All nonsteroidal anti-inflammatory drugs (NSAIDs), including selective COX-2 inhibitors, have ant... more All nonsteroidal anti-inflammatory drugs (NSAIDs), including selective COX-2 inhibitors, have anti-inflammatory analgesic and antipyretic effects, and some of them also have antithrombotic effects. Although NSAIDs are structurally organic acids, chemically they constitute a heterogeneous group. Long-term use of NSAIDs may cause many side effects, especially in older patients, so they should be used cautiously. Corticosteroids effectively suppress inflammation, and they are used in the treatment of both systemic and local inflammation. This chapter mainly discusses local intra-articular injections of steroids, to the tendon sheath, in bursitis and simple bone cysts.
Stress fracture in non-weight bearing bones is uncommon. Complete stress fracture of both forearm... more Stress fracture in non-weight bearing bones is uncommon. Complete stress fracture of both forearm bones without overt risk factors is a very rare condition. This report presents the case of a 68-year-old female patient with displaced stress fracture of both bones of forearm. The fractures were treated with open reduction and plate fixation. To our knowledge this is the first case in the literature presenting with complete stress fracture of both forearm bones in the absence of intrinsic risk factors. Awareness of stress fractures of forearm may prevent displacement and progression to complete fractures.
Journal of Orthopaedic Science, 2020
SiSli Etfal Hastanesi Tip Bulteni / The Medical Bulletin of Sisli Hospital, 2018
K nee replacement surgery is one of the most common procedures for knee osteoarthritis. This proc... more K nee replacement surgery is one of the most common procedures for knee osteoarthritis. This procedure can lead to significant blood loss, and the blood transfusion rate is high. In 34% of patients who underwent total knee replacement (TKR), perioperative blood transfusions are being performed at least once. [1] Allogeneic blood transfusion is associated with a variety of risks such as transfusion reaction, volume overload of the heart, and inhibition of immune system. [2-4] Blood transfusion increases hospitalization cost. [5] In clinical practice, different protective measures such as autologous blood transfusion have been used to reduce postoperative blood transfusion rates. [6-8] Other methods for prevention of perioperative blood loss include preoperative administration of erythropoietin, preoperative administration of iron supplements, normovolemic hemodilution, controlled hypotension, tourniquet use, and application of antifibrinolytic agents. [9-12] Tranexamic acid (TA) is a lysine analog that blocks plas-Objectives: This study aimed to analyze the efficacy of single-dose tranexamic acid (TA) 20 mg/kg preoperatively to reduce blood loss in patients undergoing total knee replacement (TKR). Methods: A total of 387 patients (82 males, 305 females) undergoing TKR between January 2014 and December 2018 were included in the study. The T + group was administrated intravenous (iv) TA 20 mg/kg 20 min before the skin incision. We determined perioperative blood loss, the amount of drainage postoperative 24 h, the amount of drainage after postoperative 24-48 h, total volume of drains, total volume of blood loss, postoperative hemoglobin and hematocrit levels, and amount of total blood transfusion. Results: In terms of demographic data, no statistically significant difference was observed between the groups. Perioperative blood loss and total volume of blood loss was found statistically higher in T − group compared to T + group. Postoperatively, the mean hemoglobin and hematocrit levels of T − group were statistically significantly lower than T + group. Conclusion: A single 20 mg/kg iv TA administration before TKR reduces bleeding during surgery and within 24 h postoperatively.
Joint Diseases and Related Surgery, 2019
Bu çalışmada açık redüksiyon ve internal fiksasyon (ARİF) ile tedavi edilen çoklu dorsal karpomet... more Bu çalışmada açık redüksiyon ve internal fiksasyon (ARİF) ile tedavi edilen çoklu dorsal karpometakarpal (KMK) eklem kırıklı çıkığı olan hastaların klinik ve radyolojik sonuçları değerlendirildi. Hastalar ve yöntemler: Ocak 2013-Aralık 2017 tarihleri arasında 14 hasta (12 erkek, 2 kadın; ortalama yaş 35.1 yıl; dağılım, 22-64 yıl) değerlendirildi. Başlıca sonuç ölçümlerimiz Hızlı Kol, Omuz ve El sorunları (QuickDASH) skoru, kavrama gücü kaybı, eklem hareket aralığı (EHA)'nda kısıtlılık ve radyografiler ve bilgisayarlı tomografi görüntüleri ile tanımlanan Kellgren-Lawrence osteoartrit sınıflandırması idi. Bulgular: Yedinci haftada ve üçüncü ayda ortalama QuickDASH skorları sırasıyla 73.57 (dağılım, 65-90) ve 29.11 (dağılım, 25-42.5) idi. Yedinci, dokuzuncu ve 12. aydaki ve son takipteki ortalama QuickDASH skoru 4.64 (dağılım, 0-30) idi ve bu takip dönemlerinde QuickDASH skoru 0 olmayan sadece üç hasta vardı. Son takipte ortalama kavrama gücü kaybı %32.14 idi ve iki hastada (%14.29) üçüncü proksimal interfalangeal EHA'da kısıtlılık vardı. Son takipte Kellgren-Lawrence sınıflandırmasına göre dört hastada evre I, dokuz hastada evre II ve bir hastada evre III osteoartrit vardı. Sonuç: Fonksiyonel sonuçlar, çoklu KMK eklem kırıklı çıkıkların ARİF ile tedavi edilebileceğini göstermesine rağmen, yüksek osteoartrit oranı bir dezavantajdır.
Turkish Journal of Trauma and Emergency Surgery, 2019
BACKGROUND: The aim of this study was to compare the clinical and radiological results of the pro... more BACKGROUND: The aim of this study was to compare the clinical and radiological results of the proximal femoral nail antirotation (PFNA) with those of the dynamic hip screw (DHS) and percutaneous compression plate (PCCP) in the treatment of simple pertrochanteric fractures. METHODS: A total of 203 patients were included in the study. PFNA fixations were performed in 73 patients (PFNA group), DHS in 68 patients (DHS group), and PCCP in 62 patients (PCCP group). The main outcome measurements were perioperative properties, the Harris hip score, changes in the neck-shaft angle, and loss of the abductor muscle strength. Data were compared between the groups. RESULTS: The mean estimated total blood loss and the number of patients receiving the blood transfusion rate in the PFNA group were statistically significantly lower. The mean operation and fluoroscopy times in the PCCP group were statistically significantly higher. The mean loss of the abductor muscle strength and changes in the neck-shaft angle in the PFNA group were statistically significantly higher. The mean Harris hip scores were similar. CONCLUSION: Our findings demonstrated that although PFNA was superior with regard to the perioperative data, DHS and PCCP were superior in maintaining the reduction and the abductor muscle strenght. All three implants were similar and had satisfactory functional outcomes.
The Turkish Journal of Geriatrics, 2019
Introduction: Septic arthritis of the knee is a serious disease usually caused by bacterial infec... more Introduction: Septic arthritis of the knee is a serious disease usually caused by bacterial infection. Although this disease is not age-restricted, many cases involve elderly people and young children. The present study evaluated the clinical and laboratory findings of patients aged ≥65 years who underwent surgery for diagnosed septic arthritis of the knee. Materials and Method: We retrospectively reviewed all patients' preoperative demographic data and comorbidities, as well as preoperative and postoperative clinical and laboratory findings. All patients were followed postoperatively at the 3rd and 6th weeks and 6th month and until a mean final follow-up of 36.0±21.6 (12-95) months. Results: This retrospective clinical study included 56 patients (34 men, 22 women) who underwent surgery during 2010-2017. The mean age and body mass index (kg/m²) were 77.3 and 27.6, respectively. In 43 patients (76.8%), at least one infectious agent could be isolated from joint debridement material. The most commonly isolated bacterium was Staphylococcus aureus (28 patients, 50%). Between all follow-up time points, we observed statistically significant decreases in C-reactive protein levels and erythrocyte sedimentation rates (both p<0.001), well as significant increases in SF-36 scores (p<0.001). Furthermore, visual analog scale scores decreased significantly between all follow-up time points (p<0.001) except between the 6th postoperative month and final follow-up (p=0.021). Conclusion: Geriatric septic arthritis should be operated early. During postoperative empirical antibiotherapy, kidney function tests should be performed regularly. Further research is required for optimal management of geriatric knee SA.
SiSli Etfal Hastanesi Tip Bulteni / The Medical Bulletin of Sisli Hospital, 2018
I n upper extremity surgery, brachial plexus blocks are often preferred due to their advantages, ... more I n upper extremity surgery, brachial plexus blocks are often preferred due to their advantages, such as long postoperative analgesic efficacy and shortening the length of hospital stay. This application reduces the use of opioids for postoperative analgesia and provides protection from their side effects. However, procedure failure, nerve injury and intravascular injection are the most common complications. These blocks were performed with a nerve stimu-Objectives: Brachial plexus block is the most effective analgesia and anesthesia procedure for the upper extremity surgeries in pediatric patients. In recent years, ultrasound guidance for this procedure has reduced the fail and complications like pneumothorax, intravascular injection and nerve damage. However, the number of studies about brachial plexus block is not enough, particularly in pediatric patients, which remained under-researched. In our study, we aimed to discuss the efficacy and safety of the ultrasoundguided brachial plexus block in pediatric patients by retrospectively examining their data. Methods: We retrospectively reviewed the data of pediatric patients who underwent ultrasound-guided brachial block in our clinic between January 2015-January 2017. Demographic data, diagnosis, procedure and operation times, medications, motor and sensorial block times were recorded. Results: Between January 2015 and January 2017, the number of pediatric patients who underwent ultrasound-guided peripheral nerve block in our clinic was 24. In 15 of these patients, the supraclavicular block was applied in 15, and the infraclavicular block was applied in nine patients. The mean age of the patients was 9.6±3.12, with a male/female ratio 14/10. The mean duration of the procedure was 9.54±2.14 minutes in patients for the supraclavicular block and 12.9 ± 2.8 minutes for the infraclavicular block. The mean surgery time was 64±13.6 minutes. As a local anesthetic, bupivacaine was used in three patients; bupivacaine+lidocaine combination was used in 21 patients and adjuvants were added in eight patients. The block procedure was performed under general anesthesia in 12 patients and under sedation in 12 patients. The mean motor block time was 7.5±2 hours in patients who received supraclavicular block, and 7.4±1.5 hours in patients who received infraclavicular block. The mean sensorial block time was 10.5±1.7 hours in the supraclavicular block, and 10.45±1.15 hours in the infraclavicular block. The mean motor block period with added adjuvants was 7.7±0.5 hours, and the sensorial block period was 11.12±1.1 hours. No complications were seen during the procedure, intraoperative and postoperative follow-up. Conclusion: Ultrasound-guided brachial plexus block in pediatric patients is effective and safe, with longer analgesia duration and lower complication rates. Prospective studies with a larger number of patients are needed in this regard.
Musculoskeletal Research and Basic Science, 2016
Indian Journal of Surgery, 2012
This study is a comparison between three methods that are frequently used for the surgical treatm... more This study is a comparison between three methods that are frequently used for the surgical treatment of pilonidal disease all over the world: modified excision and repair, wide excision and secondary repair, and wide excision and flap. The first technique is done by our group for the first time, and has not been described previously in the literature. This is an interventional study performed at Omid, Sadr, and Rasoul Akram hospitals on patients who had undergone operation because of pilonidal sinus disease and met the inclusion criteria between 2004 and 2007. Exclusion criteria were (1) acute pilonidal sinus diseases, (2) history of pilonidal sinus surgery, (3) history of systemic diseases (DM, malignancy, etc.), and (4) pilonidal abscess. Essential information was extracted from complete medical archives. Any data not available in files or during follow-up visits (all patients supposed to be followed at least for 1 year) were gathered by a telephone interview. A total of 194 patients met the criteria and had complete archived files. Longer duration of hospital stay was found in the "wide excision and closing with flap" method comparing with two other methods (P<0.05). Length of incapacity for work was not different between the "wide excision and modified repair" and "wide excision" (P>0.5) methods, but longer for "wide excision and flap" in comparison with two others (P<0.05). Healing time was significantly longer in the "wide excision" method in comparison with two other methods (P<0.05). However, "wide excision and modified repair" method had the least healing time between all above techniques, except for length of leaving the office. All the three recurrences (1.5 %) occurred in the wide excision and flap method (P<0.05). The frequency of postoperative complications was 2 (3.3 %) in wide excision and modified repair, 15 (18.5 %) in wide excision, and 17 (32.7 %) in wide excision and flap closure; these differences in complications were statistically significant (P<0.05). Our results show that the wide excision and modified repair technique, which has been described for the first time, is an acceptable method due to a low recurrence rate and better wound outcomes comparing with wide excision alone and wide excision and flap techniques for the surgical treatment of pilonidal sinus disease.
Ankara Medical Journal, 2014
Amac: Osteoporotik kiriklarin onlenmesi icin osteoporozun tanisi ve tedavisi onemli bir yer tutm... more Amac: Osteoporotik kiriklarin onlenmesi icin osteoporozun tanisi ve tedavisi onemli bir yer tutmaktadir. Bu tani icin en sik kullanilan yontem BMD olmakla beraber, davranis, kas fonsiyonlari ve kalsiyum dengesi; dolayli olarak da kemik yapisinin dongusunu saglayan vitamin D’ nin osteoporotik kiriklarin olusmasinda etkilidir; ama bu etkinin kalca kiriginin tipinin olusmasindaki etkisini degerlendirmeye calistik. Gerec-Yontem: Dusuk enerjili travma sonrasi meydana gelen 20 intertrokanterik ve 20 kollum femoris kirik tanisi ile servise yatirilan tum hastalarin BMD ve 25-OH vitamin D3 degerleri olculdu. Bulgular: Intertrokanterik femur kirigi olan hastalarda 25-OH vitamin D degeri ortalama 10,42; kollum femoris kirigi olan hastalarda 24,84 olarak bulundu. Sonuc: Osteoporotik, yasli hastalarda vitamin D eksikliginin tani ve tedavisi yapildigi takdirde, intertrokanterik kalca kiriklarinin, kollum femoris kiriklarina gore daha az gorulebilecegi kanaatindeyiz.
TOTBİD Dergisi, 2014
FBEK ilk olarak 1572 de Pare (Ambrose Pare, 1510-1590) tarafından femur başı epifiz kayması olara... more FBEK ilk olarak 1572 de Pare (Ambrose Pare, 1510-1590) tarafından femur başı epifiz kayması olarak tanımlanmış [3] ve Boyd (John Boyd Colquhoun, 1899-1974) ilk olarak 1909'da femur başı epifizini pin ile stabilize etmiştir. [4] EPİDEMİYOLOJİ FBEK sıklığı, ırk, cinsiyet ve coğrafik bölgeye göre değişmekle birlikte, ortalama 100 000'de 2 oranında F emur başı epifiz kayması (FBEK) adolesan çağda en sık görülen kalça patolojisidir. [1] Femur başı epifizinin proksimal femur metafizinden ayrışıp kaymasıdır. Hızlı büyüme çağındaki obez adolesan çocuklarda fazla görülmesi, zayıf femur başı epizinin fazla yük taşımasına bağlanır. Femur başı epifizinin asetabulum ile ilişkisi bozulmaz ve femur boynu anterosuperiora deplase olup epifiz nispeten posteriora deplase olmuş gibi görünür. Valgustaki FBEK olgularında femur boynu postero-inferiora deplase olabilir. [2] Femur başı epifiz kayması olan hastalara güncel tanı ve tedavi yaklaşımı Current diagnostic and therapeutic approach to patients with slipped capital femoral epiphysis