mehmet demirel | Istanbul University (original) (raw)

Papers by mehmet demirel

Journal of the American Podiatric Medical Association, Feb 26, 2024

Background Ankle fractures constitute 10% of all traumatic fractures in clinical practice. Concur... more Background Ankle fractures constitute 10% of all traumatic fractures in clinical practice. Concurrent tibiotalar dislocations form 21-36% of all ankle fractures. Although mechanism of injury is similar to non-dislocated ankle fractures, fracture-dislocations cause more extensive bone and soft tissue damage. Treatment is a challenge for orthopedic surgeons due to concomitant pathologies. It is associated with malreduction, chronic pain and most importantly, posttraumatic osteoarthritis. We aimed to investigate the relationship between ankle osteoarthritis radiographic stage and clinical outcomes. Methods 27 patients (17 female, 10 male) were included in the study. Records and data were retrospectively analyzed. Clinical status at the final follow-up was evaluated by a single orthopedic surgeon. Range of motion (ROM), American Orthopedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Score, visual analogue scale (VAS) were the clinical parameters that were assessed. Radiological assessment was made by standard anteroposterior [AP], lateral, and mortise views. Pre-operative osseo-ligamentous injury pattern, presence of posterior

Journal of Laboratory Physicians, 2020

We present a case of Abiotrophia defectiva in a prosthetic knee infection following total knee re... more We present a case of Abiotrophia defectiva in a prosthetic knee infection following total knee replacement for the first time. A 69-year-old female was prediagnosed with prosthetic knee infection, and a two-stage revision arthroplasty was applied. A. defectiva was cultured by matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) from the synovial fluid aspirates. Penicillin G and gentamicin had been administered. One year postoperatively, a scintigraphy showed no recurrence. A. defectiva may be missed in culture negative patients with knee or hip arthroplasty. They should be carefully evaluated if they have undergone recent dental procedures.

Acta Orthopaedica et Traumatologica Turcica, 2020

OBJECTIVE The aim of this study was to determine the effect of intravenous (IV) tranexamic acid (... more OBJECTIVE The aim of this study was to determine the effect of intravenous (IV) tranexamic acid (TRX) use on visual clarity during arthroscopic rotator cuff repair. METHODS This prospective, randomized, double-blinded, placebo-controlled study was conducted in patients scheduled for an arthroscopic rotator cuff repair. In total, 60 patients were randomly distributed into two groups: control (28 patients: 11 male, 17 female; mean age=53 years, age range=19-65) and TRX (32 patients: 15 male, 17 female; mean age=50, age range=18-69). In the TRX group, the arthroscopy was performed through the bolus IV administration of 10 mg/kg TRX in 100 ml isotonic saline solution. In the control group, the arthroscopy was performed through the bolus IV administration of 100 ml isotonic saline solution. In both the groups, the IV administration was carried out after the induction of anesthesia. At the end of each procedure, the surgeon rated the visual clarity on a scale from 1 to 10. In addition, operation time (minutes), irrigation amount used in operation (lt), and the need of pressure increase because of bleeding were recorded. RESULTS No adverse effects were seen during the study period. Visual clarity in TRX group was significantly better than the control group (the mean visual clarity scores=8.1/10 (range=7-10) vs 7/10 (range=5-9); p=0.018). The amount of solution was significantly less in the TRX group (10.2 lt (range=3.5-21)) than in the control group (15.8 lt (range=5.8-27); p=0.007, post-hoc power=95.7%), although the operation time was slightly longer in the TRX group (106 minutes (range=50-210)) than in the control group (99 minutes (range=45-165); p=0.24). Moreover, the need for the increase in pressure owing to bleeding was found significantly less in the TRX group (5.8 times (range=(0-9)) than in the control group (9.6 times (range=0-13); p=0.04, post-hoc power=94.5%). CONCLUSION Preoperative IV TRX administration seems to be effective in improving visual clarity and reducing the need for high pressure and the amount of irrigation fluid during the arthroscopic rotator cuff repair. LEVEL OF EVIDENCE Level II, Therapeutic study.

Background Because of the broad anatomical variation in the course of the axillary nerve, several... more Background Because of the broad anatomical variation in the course of the axillary nerve, several cadaveric studies have investigated the acromion-axillary nerve distance and its association with the humeral length to predict the axillary nerve location. This study aimed to analyze the acromion-axillary nerve distance (AAND) and its relation to the arm length (AL) in patients who underwent internal plate fixation for proximal humerus fractures.Methods The present prospective study involved 37 patients (15 female, 22 male; the mean age = 51 years, age range = 19 to 76) with displaced proximal humerus fractures who were treated by open reduction and internal fixation. After anatomic reduction and fixation was achieved, the following parameters were measured in each patient before wound closure without making an extra incision or dissection: (1) the distance from the anterolateral edge of the acromion to the course of axillary nerve was recorded as the acromion-axillary nerve distance ...

Supplemental material, supp_figure_2_last_one for Relationship of Postoperative Achilles Tendon E... more Supplemental material, supp_figure_2_last_one for Relationship of Postoperative Achilles Tendon Elongation With Plantarflexion Strength Following Surgical Repair by Önder Murat Hürmeydan, Mehmet Demirel, Natig Valiyev, Turker Sahinkaya and Önder İsmet Kılıçoğlu in Foot & Ankle International

Supplemental material, supp_figure_1_lastone for Relationship of Postoperative Achilles Tendon El... more Supplemental material, supp_figure_1_lastone for Relationship of Postoperative Achilles Tendon Elongation With Plantarflexion Strength Following Surgical Repair by Önder Murat Hürmeydan, Mehmet Demirel, Natig Valiyev, Turker Sahinkaya and Önder İsmet Kılıçoğlu in Foot & Ankle International

Indian Journal of Orthopaedics, 2022

Indian Journal of Orthopaedics, 2020

Background The literature is scanty on reports directly comparing the outcomes of anterior open r... more Background The literature is scanty on reports directly comparing the outcomes of anterior open reduction (AOR) and medial open reduction (MOR) in the management of developmental dysplasia of the hip (DDH). Purpose of the Study To compare clinical and radiographic outcomes of surgical treatment using either AOR or MOR in children with DDH aged < 24 months and to evaluate the procedure-inherent risks of avascular necrosis of the femoral head (AVN) and need for further corrective surgery (FCS). Methods 61 children who underwent surgical treatment for DDH were categorized into two groups: AOR (31 hips of 28 patients) and MOR (39 hips of 33 patients). The mean age was 17 ± 5.85 (range 7-24) months in group AOR and 13 ± 5.31 (range 6-24) months in group MOR. The mean follow-up was 118 ± 41.2 (range 24-192) months and 132 ± 36.7 (range 24-209) months in group AOR and MOR. At the final follow-up, mid- to long-term clinical and radiographic outcomes were assessed. FCS was recorded. Results Regarding McKay's clinical criteria, both groups exhibited similar results (p = 0.761). No significant differences were observed between the groups in both the center-edge-angle (p = 0.112) and the Severin score (p = 0.275). The AVN rate was 32% in the AOR group and 20% in the MOR group (p = 0.264). The FCS rate was 22% in the AOR group and 12% in the MOR group (p = 0.464). Conclusions This study showed similar clinical and radiological outcomes with AOR and MOR with no significant relation to AVN and FCS. Level of Evidence Level III.

Journal of Orthopaedic Case Reports, 2018

Introduction: Fracture-dislocations of the carpometacarpal (CMC) joints are pretty uncommon injur... more Introduction: Fracture-dislocations of the carpometacarpal (CMC) joints are pretty uncommon injuries with an incidence of 1%. A 17-year-old male was referred due to multiple traumas following a car accident with Glasgow Coma Score of 9. Case Report: Simultaneous metacarpophalangeal dislocation and CMC fracture-dislocation of the ring finger were present in the 4th finger (ring finger) of the right hand. Closed reduction and short arm splint in the intrinsic plus position was applied, and full range of motion was accomplished after 1 year postoperatively. Conclusion: High clinical suspicion with adequate plain radiographs are required to diagnose precisely CMC fracture-dislocation injuries. To the best of our knowledge, any case report similar to the nature of the present injury has yet to be reported to date, addressing CMC fracture-dislocation of the ring finger and concomitant volar MCP joint dislocation in the same finger. Therefore, we can make the argument that our case report ...

BackgroundAlthough Lenke classification analyses the sagittal plane as (+), N, and (-), it does n... more BackgroundAlthough Lenke classification analyses the sagittal plane as (+), N, and (-), it does not consider it in the choice of treatment, and it has limitations with overall thoracic kyphosis (TK). To investigate the importance of TK for treatment preference in patients with Lenke 5C adolescent idiopathic scoliosis (AIS) by comparing radiological outcomes of the patients who underwent selective fusion (SF) or nonselective fusion (NSF). MethodsThirty-two patients with Lenke type 5C AIS were included and then divided into two groups as per the fusion procedure used in the surgical treatment. SF group including 17 patients (15 females; mean age = 16 years, age range, 14–21) with normal TK and NSF group including 15 patients (11 females; mean age = 17 years, age range, 13–26) with thoracic hyper-kyphosis. Thorocolumbar/lumbar (TL/L) Cobb, thoracic (T) Cobb, TK and lumbar lordosis (LL) were measured on standing spine radiographs preoperatively and at the final follow-up. The correction...

İstanbul Tıp Fakültesi Dergisi, 2021

Medicine, 2021

Few studies have investigated the reliability of Reimers' hip migration percentage (RMP) in child... more Few studies have investigated the reliability of Reimers' hip migration percentage (RMP) in children with cerebral palsy (CP). Most studies on the topic reflected rating results of physician with a similar level of experience from the same expertise. This study aimed to determine the effect of clinician's experience and expertise on the intra-and inter-observer reliability of RMP. In this retrospective observational study, hip radiographs of children with CP were identified. 5 observers with different degrees of working experience from 3 different clinical fields, including orthopedics, radiology, and physical medicine and rehabilitation, performed all RMP measurements. All measurements were repeated 6 weeks later by the same observers. Inter-and intra-observer reliability for RMP measurements were assessed using Intraclass Correlation Coeficient (ICC), calculated from 2 sets of repeated measurements on a subset of 50 hips, with a 6 week apart for each observer. Fifty hip radiographs of 25 children with CP (10 females and 15 males; mean age: 6 years; age range: 2-8 years) were examined in the current study. No significant differences existed in intra-and inter-observer measurements. Excellent intra-observer reliability was observed between the 2 separate measurements for each observer, with a mean ICC of 0.976 (range: 0.956-0.989; P < .001). Among 5 observers, inter-observer reliability was excellent for the 2 separate RMP measurements, with the mean ICC minimally increasing between the 2 measurement periods (mean ICC: 0.928, range: 0.838-0.979 and mean ICC: 0.936, range: 0.861-0.983, respectively) (P < .001). Clinician's experience and expertise may not affect inter-and intra-observer reliability of RMP measurements.

Journal of the American Podiatric Medical Association, 2020

Background: Many authors have highlighted the role of muscle strength imbalance around the ankle ... more Background: Many authors have highlighted the role of muscle strength imbalance around the ankle in the development of recurrent clubfoot following Ponseti treatment. Nevertheless, this possible underlying mechanism behind recurrences has not been investigated sufficiently to date. This study aimed to explore whether there is a relationship between Achilles tendon elongation and recurrent metatarsus adductus deformity in children with unilateral clubfeet treated by Ponseti method. Methods: A retrospective chart review was performed on 20 children (14 boys, 6 girls; mean age: 7 years; age range: 5-9) with a recurrent metatarsus adductus deformity treated by the Ponseti method for unilateral idiopathic clubfoot. At the final follow-up, isometric muscle strength was measured using a portable, hand-held dynamometer in reciprocal muscle groups of the ankle. The length of the tendons around the ankle was ultrasonographically measured. Results: The plantar flexion/dorsiflexion ratio was lo...

Journal of Wrist Surgery, 2021

Background Salvage procedures, such as proximal row carpectomy, limited or total wrist arthrodesi... more Background Salvage procedures, such as proximal row carpectomy, limited or total wrist arthrodesis, and wrist replacement, are generally preferred to treat advanced Kienböck's disease. However, these procedures are particularly aggressive and may have unpredictable results and potentially significant complications. Questions/Purpose This study aimed to present the short- to mid-term clinical and functional results of arthroscopic debridement and arthrolysis in the management of advanced Kienböck's disease. Patients and Methods Fifteen patients in whom Lichtman Stages IIIA to IIIC or IV Kienböck's disease was diagnosed and treated by arthroscopic wrist debridement and arthrolysis were included in this retrospective study. The mean age was 30 years (range: 21–45). The mean follow-up period duration was 36 months (range: 18–60). The Disabilities of the Arm, Shoulder, and Hand (DASH) score, visual analog scale (VAS), wrist range of motion (ROM), and grip strength were measur...

The Journal of Knee Surgery, 2020

The present study aims to investigate whether there is a relationship between the ligamentous inj... more The present study aims to investigate whether there is a relationship between the ligamentous injury pattern and concomitant neurovascular injury with long-term functional outcomes in patients with traumatic knee dislocations (TKDs). A total of 42 patients with TKDs were categorized according to the Schenck's classification based on the pattern of ligamentous injury. Concomitant vascular and neural injuries were recorded. Long-term functional outcomes were assessed using several objective and subjective outcome measures. This retrospective study was conducted in two phases: (1) to analyze the impact of ligamentous injury pattern on functional outcomes of patients with TKDs in the overall study population, by comparing all the variables among Schenck's grades; (2) to determine the impact of concomitant vascular and neural injury on ultimate knee function based on the subgroup analyses. In the overall study statistical differences were determined among each pattern of ligament...

$Research paper thumbnail of Long-term comparative study of internal fixation with Kirschner wires or cannulated screws for displaced medial epicondyle fractures of the humerus in children: a 10-year follow-up of 42 cases$

Turkish Journal of Trauma and Emergency Surgery, 2020

Foot & Ankle International, 2019

Background: Little data exist regarding the adverse effects of Achilles tendon (AT) elongation af... more Background: Little data exist regarding the adverse effects of Achilles tendon (AT) elongation after rupture repair on plantarflexion strength. This study aimed to investigate the effect of AT elongation measured using AT resting angle (ATRA) on the plantarflexion strength in patients with surgically treated acute AT rupture. Methods: A retrospective chart review was performed on 40 patients (15 female and 25 female) who underwent open operative repair due to an acute AT rupture. At the final follow-up, AT elongation was assessed using ATRA. Plantarflexion strength (peak torques and angle-specific torques) was measured using an isokinetic dynamometer. All variables were obtained from the operated and unoperated contralateral ankles of the patients. Results: The mean ATRA was greater in the operated ankles (mean, 57 degrees; range, 39-71 degrees) compared with the unoperated ones (mean, 52 degrees; range, 36-66 degrees; P = .009). Except the plantarflexion torque at 20 degrees of pla...

Acta Orthopaedica et Traumatologica Turcica, 2019