serdar hakan başaran - Academia.edu (original) (raw)

Papers by serdar hakan başaran

Medical journal of Bakirköy, 2011

ABSTRACT

Arthroscopy techniques, Nov 1, 2013

Nonunion of medial femoral condylar coronal fractures are uncommon. In neglected Hoffa fractures ... more Nonunion of medial femoral condylar coronal fractures are uncommon. In neglected Hoffa fractures despite nonunion, there is a risk of missing accompanying ligamentous and intra-articular injuries. Neither preoperative clinical examination nor magnetic resonance imaging showed these injuries before arthroscopy. Arthroscopy before internal fixation gives additional information and changes the surgical protocol for these fractures and nonunions.

Turkish journal of trauma & emergency surgery, 2018

BACKGROUND: The aim of our study was to determine the efficacy and cost-effectiveness of intraope... more BACKGROUND: The aim of our study was to determine the efficacy and cost-effectiveness of intraoperative autotransfusion that uses the cell saver system (CSS) in patients undergoing posterior instrumentation and fusion of thoracic and lumbar vertebral fractures. METHODS: We divided 121 patients who were to undergo posterior instrumentation and fusion due to thoracic and lumbar vertebral fractures into two groups: 59 patients (23 males and 36 females) were in the cell saver group, and 62 patients (22 males and 40 females) were in the control group. Hemoglobin, hematocrit, and red blood cell (RBC) values were recorded for all patients preoperatively, on the postoperative first, second, and third days, and on the hospital discharge day. Transfusion rates and numbers of allogeneic erythrocyte transfusions, as well as the costs of transfused total auto-and allogeneic transfusions were compared. RESULTS: The numbers of erythrocyte suspensions transfused perioperatively were 0.2±0.6 units in the cell saver group and 0.7±1.4 units in the control group (p=0.01). Statistically significant differences were noted between the two groups on the postoperative first, second, and third days in terms of hemoglobin, hematocrit, and RBC values. These differences had disappeared by the hospital discharge day. The average cost of perioperative blood transfusions was 431±27.4inthecellsavergroupand431±27.4 in the cell saver group and 431±27.4inthecellsavergroupand34.5±66.25 in the control group (p<0.001). CONCLUSION: The use of the CSS was not cost-effective, but it was particularly successful at reducing the rate and the number of units of postoperative allogenic blood transfusions.

Joint Diseases and Related Surgery Case Reports, 2022

non-motile gram-negative bacteria that causes severe infection among hospitalized patients. [3] I... more non-motile gram-negative bacteria that causes severe infection among hospitalized patients. [3] It has been gaining resistance against various antibiotics by three mechanisms: deferent β-lactamases, efflux pumps and membrane permeability, and changing the sequence of penicillin-binding proteins. [4] Producing biofilm on the abiotic surfaces is another essential virulence factor, particularly for infections following implant placements, which concerns orthopedic surgeons. [5] Current treatment options include potent antibiotics such as colistin, tigecycline, and meropenem, which are widely accepted as a last resort. [2] This report presents a patient who underwent total hip arthroplasty and subsequently acquired a PJI with

Joint Diseases and Related Surgery, 2021

Objectives: In this study, we describe a novel hemiepiphysiodesis technique to prevent implant-re... more Objectives: In this study, we describe a novel hemiepiphysiodesis technique to prevent implant-related perichondrial ring injury in a rabbit model. Materials and methods: Proximal tibial epiphyseal plates of a total of 16 white New Zealand rabbits were used for this animal model. The subjects were divided into three equal groups as follows: Group 1 (Kirschner wire [K-wire]/cerclage), Group 2 (8-plate) right-hind legs, Group 3 (Control) left hind legs. Using anteroposterior radiography, the medial slope angle (MSA), articular line-diaphyseal angle (ALDA), and the angle between screws of 8-plate in lateral X-ray tibial slope angle (TSA) were measured. The radiographs were taken early postoperative (Day 1) and on sacrification day (Week 8). The histological evaluation of the perichondrial ring was made on a 7-mm axial section that stained with Safranin O/fast green at X10 magnification. Results: In both K-wire and 8-plate groups, the early postoperative ALDA and TSA were greater than t...

International Orthopaedics, 2021

Purpose To evaluate the effect of COVID-19 positivity on inflammatory parameters and 30-day morta... more Purpose To evaluate the effect of COVID-19 positivity on inflammatory parameters and 30-day mortality rates in patients over 65 years of age who were operated on for intertrochanteric femur fractures (IFF). Methods Eighty-seven patients (31 males, 56 females) who had a dynamic hip screw (DHS) or proximal femur nail (PFN) for the IFF between March 2020 and November 2020 were included in the study. The patients were divided into two groups as COVID-19 confirmed and probable positive (Group 1) and COVID-19 negative (Group 2). Time to surgery, operation duration, length of hospital stay, 30-day mortality, rates of the intensive care unit (ICU) referral, and inflammatory parameters such as haemoglobin, CRP, sedimentation, PCT, D-Dimer, and ferritin were evaluated. Results No significant difference was observed in terms of demographic data such as age, gender, comorbidity, and fracture type between the groups. Thirty-day mortality, ICU referral rate, blood transfusion rate, and hospitalization period were higher in Group 1 (p = 0.016, p = 0.012, p = 0.031, and p = 0.011, respectively). The inflammatory parameters were higher in Group 1 compared to Group 2 in the preoperative and postoperative periods (p < 0.05). Conclusion COVID-19 positivity increases inflammatory parameters (as expected) and increases the 30-day mortality and ICU requirement in patients with surgically treated IFF.

Foot and Ankle Surgery, 2020

Background: This study aimed to determine the histological, biochemical, and biomechanical effica... more Background: This study aimed to determine the histological, biochemical, and biomechanical efficacy of fibrin clot and vitamin C in the healing of Achilles tendon ruptures (ATR) in a rat model. Methods: 52 adult Wistar-Albino rats (300-450 g) were used in the study. 12 rats were divided into four groups as Monitor (Group I), Control (Group II), Fibrin Clot (Group III), Fibrin Clot with vitamin C (Group IV). Four rats were used for fibrin clot preparation. Fibroblast Growth Factor (FGF) and Vascular Endothelial Growth Factor (VEGF) were measured on the 3rd, 7th, 14th, and 21st days. Four rats were sacrificed on the 21st day from each group for histological evaluation. The rest of the rats were sacrificed at 42nd day, half for biomechanical and a half for histological evaluation. Results: The 42nd-day HSS score of group IV was significantly lower than those of group I, group II and group III (p = 0.036, p = 0.019, and p = 0.036, respectively). Group IV showed a significantly higher Maximum force N value than those of group I, group II and group III (p = 0.034, p = 0.034 and, p = 0.025, respectively). The blood FGF and VEGF levels of group III and group IV on the 3rd, 7th, 14th, and 21st days were higher than those of group I and group II (p < 0.05). Conclusion: Fibrin clot and vitamin C produced a stronger tendon structure in terms of biomechanics while providing histological and biochemically better quality tendon healing in the surgical treatment of ATR. This model can be used to accelerate high-quality tendon healing after ATR.

Medical Bulletin of Haseki, 2018

Journal of Orthopaedic Surgery, 2017

Aims: The combined (IV (intravenous) + topical) use of tranexamic acid (TXA) has been shown to be... more Aims: The combined (IV (intravenous) + topical) use of tranexamic acid (TXA) has been shown to be a safe method and more effective than single (IV or topical) application. The optimal administration method of TXA is still being investigated and safety, efficiency and cost are the three main crucial parameters in achieving the best administration method. We aimed to determine whether combined (oral + topical) use of TXA reduced blood loss and transfusion rates more than single (topical) administration in TKA and whether oral + topical use is as safe and efficient as the IV + topical use, in addition to the main advantage of relatively low cost. Methods: In this prospective, randomized study, 100 patients were randomly assigned to either the topical TXA group or the combined (oral + topical) TXA group. There were no significant differences between the groups in age, body mass index or gender. The haemoglobin and haematocrit levels of each patient were recorded preoperatively and on po...

Bakirkoy Tip Dergisi / Medical Journal of Bakirkoy, 2016

Araştırmalar / Researches ÖZET Çocuklarda araç dışı trafik kazası nedeniyle gelişen tibia şaft kı... more Araştırmalar / Researches ÖZET Çocuklarda araç dışı trafik kazası nedeniyle gelişen tibia şaft kırıklarının titanyum elastik çiviyle tedavisi Amaç: Bu çalışmada çocuklarda yüksek enerjili araç dışı trafik kazası nedeniyle gelişen tibia şaft kırıklarının titanyum elastik çiviyle (TEN) tedavisinin güvenilirliğini ve etkinliğini araştırdık. Gereç ve Yöntem: Haziran 2010-Aralık 2012 tarihleri arasında araç dışı trafik kazası nedeniyle gelişen ve TEN ile tedavi edilen instabil tibia şaft kırıklı çocuk hastaları geriye dönük olarak taradık. On bir hasta çalışmaya dahil edildi. Bu hastaların altısı (%54.5) erkek, beşi (%45.5) kız idi. Hastaların ortalama yaşı 7.4 (dağılım 3-12 yıl) bulundu. Gustilo-Anderson sınıflamasına göre altı hastada (%54.5) açık kırık, beş hastada (%45.5) kapalı kırık mevcuttu. Hastalar takiplerde klinik ve radyolojik olarak değerlendirildi. Hastaların son takiplerinde rezidüel rotasyonel deformiteyi de değerlendirmek için manyetik rezonans incelemesi (MRI) yapıldı. Bulgular: Hastaların tümünde radyolojik ve klinik olarak kaynama elde edildi. Son takipte, kırıkların ortalama koronal plan açılanması 1.5 derece (0-3.9 derece), ortalama sagittal plan açılanması 2.6 derece (0-8.4 derece) bulundu. Dört hastada (%36.4) 10 mm'den fazla bacak uzunluk eşitsizliği mevcuttu. Ayrıca, üç hastada (%27.3) 10 dereceden fazla eksternal tibial torsion deformitesi tespit ettik. Sonuç: Çocuk hastalarda araç dışı trafik kazası sonucu gelişen yüksek enerjili açık veya kapalı tibia şaft kırıklarının TEN ile tedavisi etkili ve güvenilir bir yöntemdir. Bununla birlikte, bu yöntemle tedavide tibial torsiyonel deformite gelişebileceği akılda tutulmalıdır.

European Journal of Orthopaedic Surgery & Traumatology, 2016

Only a little is known about whether type of surgical intervention has an effect on mortality of ... more Only a little is known about whether type of surgical intervention has an effect on mortality of these patients. Our primary objective was to assess whether different type of surgical procedures has an effect on mortality among elderly patients with hip fracture. A secondary objective was to examine factors that are related to mortality in our patient population. Our hypothesis is that type of surgical procedure, especially external fixation, should have an influence on mortality outcomes. We included 785 patients age 65 years or older, with hip fractures. Operative treatment consisted of external fixation, internal fixation, total hip arthroplasty and hip hemiarthroplasty. Age, gender, type of fracture, type of surgery performed, American Society of Anesthesiology (ASA) grade, clinical comorbidities, anesthesia type, blood transfusion requirement, time to surgery, intensive care unit requirement, operation length and length of hospital stay and number of comorbidities were documented. During the study period, 785 patients (262 male, 523 female) were included to study, Overall mortality rate was 37.2 % (292/785). Their age ranged between 65 and 100 years (mean 81). Surgery type Kaplan-Meier cumulative mortality curves suggested no significant difference between four different types of surgery groups (p = 0.064). Transfusion requirement was significantly lower in external fixation group comparing to other groups (p = 0.014). Cox regression analysis showed the number of comorbidities 2 and ≥ 3 (p = 0.0027, p = 0.015), transfusion requirement (p = 0.0001), ASA 4 (p = 0.016) to be significant predictors of mortality. Transfusion requirement, ASA grade 4 and having more than two comorbidities are risk factors for mortality in geriatric hip fractures. Type of surgical intervention and fracture type had similar mortality rates in our patient population.

Turkish Journal of Trauma and Emergency Surgery, 2015

BACKGROUND: The present objective was to compare medial mini-open and percutaneous treatment of p... more BACKGROUND: The present objective was to compare medial mini-open and percutaneous treatment of pediatric supracondylar fractures according to fluoroscopy time, duration of surgery, and iatrogenic ulnar nerve injury. METHODS: A total of 104 Gartland type III supracondylar humerus fractures were prospectively evaluated between 2011 and 2013. Patients were divided into 2 groups according to type of fixation. In Group A (41 patients), medial pin was inserted with mini-open incision with 2 lateral pins inserted percutaneously. In Group B (63 patients), all pins were inserted percutaneously. Mean follow-up time was 14.1±1.2 months in Group A, and 14.6±2.1 months in Group B. All patients were postoperatively evaluated for nerve injury with both motor and sensory function assessment. Length of surgery, total fluoroscopy time, fluoroscopy time for medial pin insertion, Baumann's angle, humeral capitellum angle, final carrying angle, and range of motion were recorded. RESULTS: Sensorial evaluation showed that Group A had 3 poor, and 1 fair results, and Group B had 2 poor, and 1 fair results. No statistically significant differences were observed, including no differences in either surgery or total fluoroscopy times between groups. However, fluoroscopy time during medial pin placement was significantly lower in the mini-open group. CONCLUSION: In conclusion, similar results of both techniques were observed, and both carry risk of iatrogenic ulnar nerve injury. Medial pin placement is easier and less demanding when used with mini-open technique.

Bakirkoy Tip Dergisi / Medical Journal of Bakirkoy, 2016

Ayak ve ayak bileği yumuşak doku defektli üç olguda sural flep uygulaması ve literatürün gözden g... more Ayak ve ayak bileği yumuşak doku defektli üç olguda sural flep uygulaması ve literatürün gözden geçirilmesi Ayak ve ayak bileği yaralanmalarında subkutan dokunun ince olmasından dolayı tendon ve kemikler sıklıkla açıkta kalmaktadır. Bu defektlerin kapatılması için çeşitli metotlar tarif edilmiştir. Bu çalışmada travma sonrası ayak ve ayak bileğinde gelişen cilt ve cilt altı yumuşak doku kayıplarına bağlı açıkta kalan vital dokuların örtümünde ters akımlı nörokutan sural flep uyguladığımız üç hastanın dört ekstremitesinin tedavi sonuçlarını literatür eşliğinde değerlendirdik. Ters akımlı nörokutan sural flep kolay, etkinliği yüksek, donör saha morbiditesi ve komplikasyon oranları düşük olduğu için özellikle ayak bileği ve topuk bölgelerinde vital dokuların örtümünde tercih edilebilecek bir yöntemdir.

Turkiye Klinikleri Journal of Orthopaedics and Traumatology Special Topics, 2013

SpringerPlus, 2016

Supracondylar humerus fractures are common in children. Displaced fractures are usually treated w... more Supracondylar humerus fractures are common in children. Displaced fractures are usually treated with closed reduction and cross pin fixation. But, medial pinning may cause the ulnar nerve injury. The aim of this study was to compare the parents-based cosmetic satisfaction of the incision scars in children with displaced supracondylar humerus fractures treated by closed reduction and cross pin fixation with or without small medial incision. We retrospectively reviewed the medical records of 72 children with displaced supracondylar humerus fractures treated two different closed reduction and percutaneous pinning methods at our institution from January 2010 through December 2013. A group has 36 patients treated with small medial incision and crossed K-wires fixation after closed reduction. The other group has 36 patients treated with closed reduction and K-wires fixation. At the final follow-up, the patients were evaluated radiologically and clinically with Flynn's criteria. Furthermore, a visual analogue scale was used to determine of the parents-based cosmetic satisfaction score. All fractures healed without major complications at the final clinical and radiological assessment. Although, between the two groups did not differ in terms of Flynn cosmetic and functional outcomes, there were statistically significant differences between both groups according to the parents-based cosmetic satisfaction scores. The closed reduction and crossed pin fixation without small medial incision should be preferred first because of better the parents-based cosmetic satisfaction.

The Open Orthopaedics Journal, 2015

Objectives : It is unclear that how long reconstruction may be delayed before additional intraart... more Objectives : It is unclear that how long reconstruction may be delayed before additional intraarticular injuries occur. Our aim was to determine the relationship of time period from injury to surgery with the incidence of meniscal and chondral injuries recorded at the time of surgical treatment for ACL tears. The effect of sportive activity restriction, grade of chondral lesions and their locations were also evaluated Patients and Methods : 213 patients who underwent arthroscopic anterior cruciate ligament reconstruction were evaluated retrospectively. Data were analyzed for association between time period before surgery and patients sportive activity restriction with rates of meniscal and chondral injuries. According to time from initial trauma to surgery less than 12 months grouped as group I (101 patients) and 12 months and longer defined as group II (81 patients). Patients who had surgery before 12 months were divided into groups of smaller time scales (0 to 3 months, 4 to 6 mon...

European Journal of Orthopaedic Surgery & Traumatology, 2015

There is no consensus about the measurement techniques to determine the tibial torsion by using M... more There is no consensus about the measurement techniques to determine the tibial torsion by using MRI. The primary research question of this study was to find out which MRI-based tibial torsion measurement method is more reliable and reproducible. Secondly, we compared tibial torsion values measured by three measurement methods in T1- and T2-weighted images. We retrospectively analyzed voluntary children performed MRI for determination of the lower limb torsional alignment after the surgical treatment between January 2013 and December 2013. Thirty-four extremities of 17 patients were included in the present study. The mean age of patients was 7.3 years (range 3-12 years). The transmalleolar, posterior intermalleolar and anterior talus angles were used for the measurement of tibial torsion. All tibial torsion measurements were calculated by three blinded observers in T1- and T2-weighted images, and these measurements were repeated blindly after 2 months. All measured intra- and interobserver intra-class correlations were greater than 0.60. The best scores were achieved with the anterior talus angle. It was followed by the posterior malleolar angle and the intermalleolar angle, respectively. Furthermore, there were no statistically significant differences between tibial torsion values measured by each observer in T1- and T2-weighted images of each method. MRI-based tibial torsion measurements were reliable and reproducible for all three methods. But we think that the anterior talus angle and the posterior malleolar angle are easier and more successful in determination of the tibial torsion. Also, both T1- and T2-weighted images can be used successfully for this purpose.

Turkiye Klinikleri Journal of Medical Sciences, 2014

Halluks Valgus Tedavisinde Lindgren-Turan Operasyonu Etkili midir? Ö ÖZ ZE ET T A Am ma aç ç: :Bu... more Halluks Valgus Tedavisinde Lindgren-Turan Operasyonu Etkili midir? Ö ÖZ ZE ET T A Am ma aç ç: :Bu çalışmada, halluks valgus tanılı hastalarda Lindgren-Turan osteotomisinin etkinliği ve hastaların memnuniyeti değerlendirildi. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : Kliniğimizde halluks valgus tanısı ile 2007-2011 yılları arasında Lindgren-Turan osteotomisi uygulanan 30 hastanın 43 ayağı retrospektif olarak değerlendirildi. Hastaların ameliyat öncesi, erken ameliyat sonrası ve son kontrol sonrası halluks valgus açıları, intermetatarsal açı, distal metatarsal artiküler açı, metatars uzunluğu, eklem subluksasyonu, eklemde artroz olup olmadığı araştırıldı. Klinik olarak değerlendirme Amerikan Ortopedik Ayak-Ayak Bileği Derneği (AOFAS) halluks metatarsofalangeal-interfalangeal skalası ve visuel analog skala (VAS) kullanılarak yapıldı. B Bu ul lg gu ul la ar r: : Dört erkek, 26 kadın hastanın ortalama yaşları 44,4 yıl, ortalama takip süresi 13,2 ay olarak hesaplandı. Ameliyat öncesi, erken ameliyat sonrası ve ameliyat sonrası son kontroldeki halluks valgus açıları, intermetatarsal açılar ve distal metatarsal eklem açıları karşılaştırıldığında, bu açılarda erken ve ameliyat sonrası son kontrol dönemlerinde istatistiksel olarak anlamlı derecede farklılık olduğu görüldü (p=0,0001). Hastaların AOFAS ve VAS skorlarında ameliyat sonrası dönemde ameliyat öncesi döneme göre istatistiksel olarak anlamlı oranda iyileşme tespit edildi (p=0,0001). Hastaların ameliyat öncesi ve ameliyat sonrası metatarsofalangeal eklem artroz değerlendirmesinde istatistiksel olarak anlamlı bir farklılık saptanmadı. Metatars uzunluklarında ameliyat sonrasında istatistiksel olarak anlamlı, ortalama 3,19 mm kısalma meydana geldi. S So on nu uç ç: : Lindgren-Turan operasyonu adolesan ve erişkinlerdeki halluks valgusun cerrahi tedavisinde, fonksiyonel, radyolojik ve klinik değerlendirme açısından başarılı bir yöntemdir. Bu yöntemin teknik olarak kolay uygulanabilir olması, kısa ameliyat süresi ve düşük komplikasyon oranı nedeniyle güvenli bir yöntem olduğu kanaatindeyiz.

Medical journal of Bakirköy, 2011

ABSTRACT

Arthroscopy techniques, Nov 1, 2013

Nonunion of medial femoral condylar coronal fractures are uncommon. In neglected Hoffa fractures ... more Nonunion of medial femoral condylar coronal fractures are uncommon. In neglected Hoffa fractures despite nonunion, there is a risk of missing accompanying ligamentous and intra-articular injuries. Neither preoperative clinical examination nor magnetic resonance imaging showed these injuries before arthroscopy. Arthroscopy before internal fixation gives additional information and changes the surgical protocol for these fractures and nonunions.

Turkish journal of trauma & emergency surgery, 2018

BACKGROUND: The aim of our study was to determine the efficacy and cost-effectiveness of intraope... more BACKGROUND: The aim of our study was to determine the efficacy and cost-effectiveness of intraoperative autotransfusion that uses the cell saver system (CSS) in patients undergoing posterior instrumentation and fusion of thoracic and lumbar vertebral fractures. METHODS: We divided 121 patients who were to undergo posterior instrumentation and fusion due to thoracic and lumbar vertebral fractures into two groups: 59 patients (23 males and 36 females) were in the cell saver group, and 62 patients (22 males and 40 females) were in the control group. Hemoglobin, hematocrit, and red blood cell (RBC) values were recorded for all patients preoperatively, on the postoperative first, second, and third days, and on the hospital discharge day. Transfusion rates and numbers of allogeneic erythrocyte transfusions, as well as the costs of transfused total auto-and allogeneic transfusions were compared. RESULTS: The numbers of erythrocyte suspensions transfused perioperatively were 0.2±0.6 units in the cell saver group and 0.7±1.4 units in the control group (p=0.01). Statistically significant differences were noted between the two groups on the postoperative first, second, and third days in terms of hemoglobin, hematocrit, and RBC values. These differences had disappeared by the hospital discharge day. The average cost of perioperative blood transfusions was 431±27.4inthecellsavergroupand431±27.4 in the cell saver group and 431±27.4inthecellsavergroupand34.5±66.25 in the control group (p<0.001). CONCLUSION: The use of the CSS was not cost-effective, but it was particularly successful at reducing the rate and the number of units of postoperative allogenic blood transfusions.

Joint Diseases and Related Surgery Case Reports, 2022

non-motile gram-negative bacteria that causes severe infection among hospitalized patients. [3] I... more non-motile gram-negative bacteria that causes severe infection among hospitalized patients. [3] It has been gaining resistance against various antibiotics by three mechanisms: deferent β-lactamases, efflux pumps and membrane permeability, and changing the sequence of penicillin-binding proteins. [4] Producing biofilm on the abiotic surfaces is another essential virulence factor, particularly for infections following implant placements, which concerns orthopedic surgeons. [5] Current treatment options include potent antibiotics such as colistin, tigecycline, and meropenem, which are widely accepted as a last resort. [2] This report presents a patient who underwent total hip arthroplasty and subsequently acquired a PJI with

Joint Diseases and Related Surgery, 2021

Objectives: In this study, we describe a novel hemiepiphysiodesis technique to prevent implant-re... more Objectives: In this study, we describe a novel hemiepiphysiodesis technique to prevent implant-related perichondrial ring injury in a rabbit model. Materials and methods: Proximal tibial epiphyseal plates of a total of 16 white New Zealand rabbits were used for this animal model. The subjects were divided into three equal groups as follows: Group 1 (Kirschner wire [K-wire]/cerclage), Group 2 (8-plate) right-hind legs, Group 3 (Control) left hind legs. Using anteroposterior radiography, the medial slope angle (MSA), articular line-diaphyseal angle (ALDA), and the angle between screws of 8-plate in lateral X-ray tibial slope angle (TSA) were measured. The radiographs were taken early postoperative (Day 1) and on sacrification day (Week 8). The histological evaluation of the perichondrial ring was made on a 7-mm axial section that stained with Safranin O/fast green at X10 magnification. Results: In both K-wire and 8-plate groups, the early postoperative ALDA and TSA were greater than t...

International Orthopaedics, 2021

Purpose To evaluate the effect of COVID-19 positivity on inflammatory parameters and 30-day morta... more Purpose To evaluate the effect of COVID-19 positivity on inflammatory parameters and 30-day mortality rates in patients over 65 years of age who were operated on for intertrochanteric femur fractures (IFF). Methods Eighty-seven patients (31 males, 56 females) who had a dynamic hip screw (DHS) or proximal femur nail (PFN) for the IFF between March 2020 and November 2020 were included in the study. The patients were divided into two groups as COVID-19 confirmed and probable positive (Group 1) and COVID-19 negative (Group 2). Time to surgery, operation duration, length of hospital stay, 30-day mortality, rates of the intensive care unit (ICU) referral, and inflammatory parameters such as haemoglobin, CRP, sedimentation, PCT, D-Dimer, and ferritin were evaluated. Results No significant difference was observed in terms of demographic data such as age, gender, comorbidity, and fracture type between the groups. Thirty-day mortality, ICU referral rate, blood transfusion rate, and hospitalization period were higher in Group 1 (p = 0.016, p = 0.012, p = 0.031, and p = 0.011, respectively). The inflammatory parameters were higher in Group 1 compared to Group 2 in the preoperative and postoperative periods (p < 0.05). Conclusion COVID-19 positivity increases inflammatory parameters (as expected) and increases the 30-day mortality and ICU requirement in patients with surgically treated IFF.

Foot and Ankle Surgery, 2020

Background: This study aimed to determine the histological, biochemical, and biomechanical effica... more Background: This study aimed to determine the histological, biochemical, and biomechanical efficacy of fibrin clot and vitamin C in the healing of Achilles tendon ruptures (ATR) in a rat model. Methods: 52 adult Wistar-Albino rats (300-450 g) were used in the study. 12 rats were divided into four groups as Monitor (Group I), Control (Group II), Fibrin Clot (Group III), Fibrin Clot with vitamin C (Group IV). Four rats were used for fibrin clot preparation. Fibroblast Growth Factor (FGF) and Vascular Endothelial Growth Factor (VEGF) were measured on the 3rd, 7th, 14th, and 21st days. Four rats were sacrificed on the 21st day from each group for histological evaluation. The rest of the rats were sacrificed at 42nd day, half for biomechanical and a half for histological evaluation. Results: The 42nd-day HSS score of group IV was significantly lower than those of group I, group II and group III (p = 0.036, p = 0.019, and p = 0.036, respectively). Group IV showed a significantly higher Maximum force N value than those of group I, group II and group III (p = 0.034, p = 0.034 and, p = 0.025, respectively). The blood FGF and VEGF levels of group III and group IV on the 3rd, 7th, 14th, and 21st days were higher than those of group I and group II (p < 0.05). Conclusion: Fibrin clot and vitamin C produced a stronger tendon structure in terms of biomechanics while providing histological and biochemically better quality tendon healing in the surgical treatment of ATR. This model can be used to accelerate high-quality tendon healing after ATR.

Medical Bulletin of Haseki, 2018

Journal of Orthopaedic Surgery, 2017

Aims: The combined (IV (intravenous) + topical) use of tranexamic acid (TXA) has been shown to be... more Aims: The combined (IV (intravenous) + topical) use of tranexamic acid (TXA) has been shown to be a safe method and more effective than single (IV or topical) application. The optimal administration method of TXA is still being investigated and safety, efficiency and cost are the three main crucial parameters in achieving the best administration method. We aimed to determine whether combined (oral + topical) use of TXA reduced blood loss and transfusion rates more than single (topical) administration in TKA and whether oral + topical use is as safe and efficient as the IV + topical use, in addition to the main advantage of relatively low cost. Methods: In this prospective, randomized study, 100 patients were randomly assigned to either the topical TXA group or the combined (oral + topical) TXA group. There were no significant differences between the groups in age, body mass index or gender. The haemoglobin and haematocrit levels of each patient were recorded preoperatively and on po...

Bakirkoy Tip Dergisi / Medical Journal of Bakirkoy, 2016

Araştırmalar / Researches ÖZET Çocuklarda araç dışı trafik kazası nedeniyle gelişen tibia şaft kı... more Araştırmalar / Researches ÖZET Çocuklarda araç dışı trafik kazası nedeniyle gelişen tibia şaft kırıklarının titanyum elastik çiviyle tedavisi Amaç: Bu çalışmada çocuklarda yüksek enerjili araç dışı trafik kazası nedeniyle gelişen tibia şaft kırıklarının titanyum elastik çiviyle (TEN) tedavisinin güvenilirliğini ve etkinliğini araştırdık. Gereç ve Yöntem: Haziran 2010-Aralık 2012 tarihleri arasında araç dışı trafik kazası nedeniyle gelişen ve TEN ile tedavi edilen instabil tibia şaft kırıklı çocuk hastaları geriye dönük olarak taradık. On bir hasta çalışmaya dahil edildi. Bu hastaların altısı (%54.5) erkek, beşi (%45.5) kız idi. Hastaların ortalama yaşı 7.4 (dağılım 3-12 yıl) bulundu. Gustilo-Anderson sınıflamasına göre altı hastada (%54.5) açık kırık, beş hastada (%45.5) kapalı kırık mevcuttu. Hastalar takiplerde klinik ve radyolojik olarak değerlendirildi. Hastaların son takiplerinde rezidüel rotasyonel deformiteyi de değerlendirmek için manyetik rezonans incelemesi (MRI) yapıldı. Bulgular: Hastaların tümünde radyolojik ve klinik olarak kaynama elde edildi. Son takipte, kırıkların ortalama koronal plan açılanması 1.5 derece (0-3.9 derece), ortalama sagittal plan açılanması 2.6 derece (0-8.4 derece) bulundu. Dört hastada (%36.4) 10 mm'den fazla bacak uzunluk eşitsizliği mevcuttu. Ayrıca, üç hastada (%27.3) 10 dereceden fazla eksternal tibial torsion deformitesi tespit ettik. Sonuç: Çocuk hastalarda araç dışı trafik kazası sonucu gelişen yüksek enerjili açık veya kapalı tibia şaft kırıklarının TEN ile tedavisi etkili ve güvenilir bir yöntemdir. Bununla birlikte, bu yöntemle tedavide tibial torsiyonel deformite gelişebileceği akılda tutulmalıdır.

European Journal of Orthopaedic Surgery & Traumatology, 2016

Only a little is known about whether type of surgical intervention has an effect on mortality of ... more Only a little is known about whether type of surgical intervention has an effect on mortality of these patients. Our primary objective was to assess whether different type of surgical procedures has an effect on mortality among elderly patients with hip fracture. A secondary objective was to examine factors that are related to mortality in our patient population. Our hypothesis is that type of surgical procedure, especially external fixation, should have an influence on mortality outcomes. We included 785 patients age 65 years or older, with hip fractures. Operative treatment consisted of external fixation, internal fixation, total hip arthroplasty and hip hemiarthroplasty. Age, gender, type of fracture, type of surgery performed, American Society of Anesthesiology (ASA) grade, clinical comorbidities, anesthesia type, blood transfusion requirement, time to surgery, intensive care unit requirement, operation length and length of hospital stay and number of comorbidities were documented. During the study period, 785 patients (262 male, 523 female) were included to study, Overall mortality rate was 37.2 % (292/785). Their age ranged between 65 and 100 years (mean 81). Surgery type Kaplan-Meier cumulative mortality curves suggested no significant difference between four different types of surgery groups (p = 0.064). Transfusion requirement was significantly lower in external fixation group comparing to other groups (p = 0.014). Cox regression analysis showed the number of comorbidities 2 and ≥ 3 (p = 0.0027, p = 0.015), transfusion requirement (p = 0.0001), ASA 4 (p = 0.016) to be significant predictors of mortality. Transfusion requirement, ASA grade 4 and having more than two comorbidities are risk factors for mortality in geriatric hip fractures. Type of surgical intervention and fracture type had similar mortality rates in our patient population.

Turkish Journal of Trauma and Emergency Surgery, 2015

BACKGROUND: The present objective was to compare medial mini-open and percutaneous treatment of p... more BACKGROUND: The present objective was to compare medial mini-open and percutaneous treatment of pediatric supracondylar fractures according to fluoroscopy time, duration of surgery, and iatrogenic ulnar nerve injury. METHODS: A total of 104 Gartland type III supracondylar humerus fractures were prospectively evaluated between 2011 and 2013. Patients were divided into 2 groups according to type of fixation. In Group A (41 patients), medial pin was inserted with mini-open incision with 2 lateral pins inserted percutaneously. In Group B (63 patients), all pins were inserted percutaneously. Mean follow-up time was 14.1±1.2 months in Group A, and 14.6±2.1 months in Group B. All patients were postoperatively evaluated for nerve injury with both motor and sensory function assessment. Length of surgery, total fluoroscopy time, fluoroscopy time for medial pin insertion, Baumann's angle, humeral capitellum angle, final carrying angle, and range of motion were recorded. RESULTS: Sensorial evaluation showed that Group A had 3 poor, and 1 fair results, and Group B had 2 poor, and 1 fair results. No statistically significant differences were observed, including no differences in either surgery or total fluoroscopy times between groups. However, fluoroscopy time during medial pin placement was significantly lower in the mini-open group. CONCLUSION: In conclusion, similar results of both techniques were observed, and both carry risk of iatrogenic ulnar nerve injury. Medial pin placement is easier and less demanding when used with mini-open technique.

Bakirkoy Tip Dergisi / Medical Journal of Bakirkoy, 2016

Ayak ve ayak bileği yumuşak doku defektli üç olguda sural flep uygulaması ve literatürün gözden g... more Ayak ve ayak bileği yumuşak doku defektli üç olguda sural flep uygulaması ve literatürün gözden geçirilmesi Ayak ve ayak bileği yaralanmalarında subkutan dokunun ince olmasından dolayı tendon ve kemikler sıklıkla açıkta kalmaktadır. Bu defektlerin kapatılması için çeşitli metotlar tarif edilmiştir. Bu çalışmada travma sonrası ayak ve ayak bileğinde gelişen cilt ve cilt altı yumuşak doku kayıplarına bağlı açıkta kalan vital dokuların örtümünde ters akımlı nörokutan sural flep uyguladığımız üç hastanın dört ekstremitesinin tedavi sonuçlarını literatür eşliğinde değerlendirdik. Ters akımlı nörokutan sural flep kolay, etkinliği yüksek, donör saha morbiditesi ve komplikasyon oranları düşük olduğu için özellikle ayak bileği ve topuk bölgelerinde vital dokuların örtümünde tercih edilebilecek bir yöntemdir.

Turkiye Klinikleri Journal of Orthopaedics and Traumatology Special Topics, 2013

SpringerPlus, 2016

Supracondylar humerus fractures are common in children. Displaced fractures are usually treated w... more Supracondylar humerus fractures are common in children. Displaced fractures are usually treated with closed reduction and cross pin fixation. But, medial pinning may cause the ulnar nerve injury. The aim of this study was to compare the parents-based cosmetic satisfaction of the incision scars in children with displaced supracondylar humerus fractures treated by closed reduction and cross pin fixation with or without small medial incision. We retrospectively reviewed the medical records of 72 children with displaced supracondylar humerus fractures treated two different closed reduction and percutaneous pinning methods at our institution from January 2010 through December 2013. A group has 36 patients treated with small medial incision and crossed K-wires fixation after closed reduction. The other group has 36 patients treated with closed reduction and K-wires fixation. At the final follow-up, the patients were evaluated radiologically and clinically with Flynn's criteria. Furthermore, a visual analogue scale was used to determine of the parents-based cosmetic satisfaction score. All fractures healed without major complications at the final clinical and radiological assessment. Although, between the two groups did not differ in terms of Flynn cosmetic and functional outcomes, there were statistically significant differences between both groups according to the parents-based cosmetic satisfaction scores. The closed reduction and crossed pin fixation without small medial incision should be preferred first because of better the parents-based cosmetic satisfaction.

The Open Orthopaedics Journal, 2015

Objectives : It is unclear that how long reconstruction may be delayed before additional intraart... more Objectives : It is unclear that how long reconstruction may be delayed before additional intraarticular injuries occur. Our aim was to determine the relationship of time period from injury to surgery with the incidence of meniscal and chondral injuries recorded at the time of surgical treatment for ACL tears. The effect of sportive activity restriction, grade of chondral lesions and their locations were also evaluated Patients and Methods : 213 patients who underwent arthroscopic anterior cruciate ligament reconstruction were evaluated retrospectively. Data were analyzed for association between time period before surgery and patients sportive activity restriction with rates of meniscal and chondral injuries. According to time from initial trauma to surgery less than 12 months grouped as group I (101 patients) and 12 months and longer defined as group II (81 patients). Patients who had surgery before 12 months were divided into groups of smaller time scales (0 to 3 months, 4 to 6 mon...

European Journal of Orthopaedic Surgery & Traumatology, 2015

There is no consensus about the measurement techniques to determine the tibial torsion by using M... more There is no consensus about the measurement techniques to determine the tibial torsion by using MRI. The primary research question of this study was to find out which MRI-based tibial torsion measurement method is more reliable and reproducible. Secondly, we compared tibial torsion values measured by three measurement methods in T1- and T2-weighted images. We retrospectively analyzed voluntary children performed MRI for determination of the lower limb torsional alignment after the surgical treatment between January 2013 and December 2013. Thirty-four extremities of 17 patients were included in the present study. The mean age of patients was 7.3 years (range 3-12 years). The transmalleolar, posterior intermalleolar and anterior talus angles were used for the measurement of tibial torsion. All tibial torsion measurements were calculated by three blinded observers in T1- and T2-weighted images, and these measurements were repeated blindly after 2 months. All measured intra- and interobserver intra-class correlations were greater than 0.60. The best scores were achieved with the anterior talus angle. It was followed by the posterior malleolar angle and the intermalleolar angle, respectively. Furthermore, there were no statistically significant differences between tibial torsion values measured by each observer in T1- and T2-weighted images of each method. MRI-based tibial torsion measurements were reliable and reproducible for all three methods. But we think that the anterior talus angle and the posterior malleolar angle are easier and more successful in determination of the tibial torsion. Also, both T1- and T2-weighted images can be used successfully for this purpose.

Turkiye Klinikleri Journal of Medical Sciences, 2014

Halluks Valgus Tedavisinde Lindgren-Turan Operasyonu Etkili midir? Ö ÖZ ZE ET T A Am ma aç ç: :Bu... more Halluks Valgus Tedavisinde Lindgren-Turan Operasyonu Etkili midir? Ö ÖZ ZE ET T A Am ma aç ç: :Bu çalışmada, halluks valgus tanılı hastalarda Lindgren-Turan osteotomisinin etkinliği ve hastaların memnuniyeti değerlendirildi. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : Kliniğimizde halluks valgus tanısı ile 2007-2011 yılları arasında Lindgren-Turan osteotomisi uygulanan 30 hastanın 43 ayağı retrospektif olarak değerlendirildi. Hastaların ameliyat öncesi, erken ameliyat sonrası ve son kontrol sonrası halluks valgus açıları, intermetatarsal açı, distal metatarsal artiküler açı, metatars uzunluğu, eklem subluksasyonu, eklemde artroz olup olmadığı araştırıldı. Klinik olarak değerlendirme Amerikan Ortopedik Ayak-Ayak Bileği Derneği (AOFAS) halluks metatarsofalangeal-interfalangeal skalası ve visuel analog skala (VAS) kullanılarak yapıldı. B Bu ul lg gu ul la ar r: : Dört erkek, 26 kadın hastanın ortalama yaşları 44,4 yıl, ortalama takip süresi 13,2 ay olarak hesaplandı. Ameliyat öncesi, erken ameliyat sonrası ve ameliyat sonrası son kontroldeki halluks valgus açıları, intermetatarsal açılar ve distal metatarsal eklem açıları karşılaştırıldığında, bu açılarda erken ve ameliyat sonrası son kontrol dönemlerinde istatistiksel olarak anlamlı derecede farklılık olduğu görüldü (p=0,0001). Hastaların AOFAS ve VAS skorlarında ameliyat sonrası dönemde ameliyat öncesi döneme göre istatistiksel olarak anlamlı oranda iyileşme tespit edildi (p=0,0001). Hastaların ameliyat öncesi ve ameliyat sonrası metatarsofalangeal eklem artroz değerlendirmesinde istatistiksel olarak anlamlı bir farklılık saptanmadı. Metatars uzunluklarında ameliyat sonrasında istatistiksel olarak anlamlı, ortalama 3,19 mm kısalma meydana geldi. S So on nu uç ç: : Lindgren-Turan operasyonu adolesan ve erişkinlerdeki halluks valgusun cerrahi tedavisinde, fonksiyonel, radyolojik ve klinik değerlendirme açısından başarılı bir yöntemdir. Bu yöntemin teknik olarak kolay uygulanabilir olması, kısa ameliyat süresi ve düşük komplikasyon oranı nedeniyle güvenli bir yöntem olduğu kanaatindeyiz.