Percutaneous suturing of the ruptured Achilles tendon with endoscopic control

Doral M.N. | Bozkurt M. | Turhan E. | Ayvaz M. | Atay O.A. | Üzümcügil A. | Leblebicioglu G.

Article | 2009 | Archives of Orthopaedic and Trauma Surgery129 ( 8 ) , pp.1093 - 1101

Introduction: A prospective study of modified percutaneous Achilles tendon repair performed between 1999 and 2005 under local infiltration anesthesia is presented; the study evaluated the results of percutaneous repair technique by visualization of the synovia under endoscopic control, followed by early functional postoperative treatment for surgical intervention of acute Achilles tendon ruptures. Patients: Sixty-two patients (58 males, 4 females, mean age 32) were treated by percutaneous suturing with modified Bunnel technique under endoscopic control within 10 days after acute total rupture. Physiotherapy was initiated immediately . . . after the operation and patients were encouraged to weight-bearing ambulation with a walking brace-moon boot as tolerated. Full weight-bearing was allowed minimum after 3 weeks postoperatively without brace. Results: The procedure was tolerated in all patients. There were no significant ROM limitation was observed. Two patients experienced transient hypoesthesia in the region of sural nerve that spontaneously resolved in 6 months. Fifty-nine patients (95%) including professional athletes returned to their previous sportive activities, while 18 of them (29%) had some minor complaints. The interval from injury to return to regular work and rehabilitation training was 11.7 weeks (10-13 weeks). At the latest follow-up (mean: 46 months; range: 12-78 months), all the patients had satisfactory results with a mean American Orthopedic Foot and Ankle Society's ankle-hindfoot score of 94.6. No re-ruptures, deep venous thrombosis or wound problems occurred. Conclusion: The proposed method offers a reasonable treatment option for acute total Achilles tendon rupture with a low number of complications. The rerupture rate and return to preinjury activities are comparable to open and percutaneous without endoscopic control procedures. © Springer-Verlag 2009 Daha fazlası Daha az

Comparison of novel intramedullary nailing with mini-invasive plating in surgical fixation of displaced midshaft clavicle fractures

Zehir S. | Zehir R. | Şahin E. | Çalbıyık M.

Article | 2015 | Archives of Orthopaedic and Trauma Surgery135 ( 3 ) , pp.339 - 344

Introduction: This prospective randomized pilot study sought to determine whether fixation with Sonoma CRx intramedullary pin is a comparable alternative to minimally invasive plating fixation in patients with displaced clavicle fractures. Materials and methods: A total of 45 consecutive patients (Robinson class B1 or B2) were randomly allocated into two groups; intramedullary pin (IMP) group (n = 24, mean age; 33.17 ± 8.60 years, 14 males 58.3 %) received Sonoma CRx Collarbone pin (Sonoma, USA) whereas locking midshaft superior plating (MIPPO) group (n = 21, 32.38 ± 8.41 years, 12 males) patients received minimally invasive locking . . . midshaft superior plating (Acumed, USA). Patients were followed up with a mean time of 11.82 ± 4.22 and 14.45 ± 6.43 months, respectively. Functional status, as the primary outcome measure, was assessed using quick disability of the arm, shoulder and hand (DASH) scores. Results: Mean time of operation and mean time of fluoroscopy were significantly shorter in the IMP group than those in MIPPO group (p Daha fazlası Daha az

Elephantiasis nostras verrucosa complicated with chronic tibial osteomyelitis

Turhan E. | Ege A. | Keser S. | Bayar A.

Article | 2008 | Archives of Orthopaedic and Trauma Surgery128 ( 10 ) , pp.1183 - 1186

Elephantiasis nostras verrucosa represents an infrequent clinical entity with cutaneous changes characterized by dermal fibrosis, hyperkeratotic verrucous and papillamotous lesions resulting from chronic non-filarial lymphedema secondary to infections, surgeries, tumor obstruction, radiation, congestive heart failure, and obesity. Although recurrent streptococcal lymphangitis is believed to play a critical role in the origin of elephantiasis nostras verrucosa, the exact pathogenesis of the disorder is not yet clear. Therapeutic efforts should aim to reduce lymph stasis, which will also lead to improvement of the cutaneous changes bu . . .t unfortunately there is no specific treatment for advanced cases. In this report, we present a patient who was treated by below knee amputation as a result of elephantiasis nostras verrucosa complicated with chronic tibial osteomyelitis. © Springer-Verlag 2007 Daha fazlası Daha az

Bilateral anterior glenohumeral dislocation in a horse rider: A case report and a review of the literature

Turhan E. | Demirel M.

Article | 2008 | Archives of Orthopaedic and Trauma Surgery128 ( 1 ) , pp.79 - 82

A case of bilateral anterior glenohumeral dislocation in a middle aged horse rider was presented. The patient was an amateur rider who sustained the injury when the horse reared suddenly. The rider fell back from the saddle while holding the halter. The shoulders were dislocated by a violent traction when shoulders were in internal rotation and flexion in sagittal plane and slight abduction in coronal plane. To the best of our knowledge this case is the third glenohumeral dislocation by forward traction. A review of the literature is presented. © Springer-Verlag 2007.

Successful repair of a bladder herniation after old traumatic pubic symphysis diastasis using bone graft and hernia mesh

Seckiner I. | Keser S. | Bayar A. | Yesilli C. | Mungan A.

Article | 2007 | Archives of Orthopaedic and Trauma Surgery127 ( 8 ) , pp.655 - 657

Bladder herniation associated with pubic symphysis diastasis is a very rare condition. We report a case with bladder herniation after traumatic pubic symphysis disruption. The patient was treated with open reduction of the bladder and definitive internal fixation of the pubis. We used a bone allograft for closure of the diastasis and a prolene mesh graft for supporting the abdominal wall. We obtained a successful outcome during a 12-month follow-up period. © Springer-Verlag 2007.

Sagittal plane analysis of the open and closed methods in children with displaced supracondylar fractures of the humerus (a radiological study)

Turhan E. | Aksoy C. | Ege A. | Bayar A. | Keser S. | Alpaslan M.

Article | 2008 | Archives of Orthopaedic and Trauma Surgery128 ( 7 ) , pp.739 - 744

Objectives: The aim of this study was to compare the radiological outcome of open and close reduction and osteosynthesis methods in the treatment of type II and III supracondylar humerus fractures in childhood with respect to the immediate post-operative reduction quality in sagittal plane. Method: One hundred and forty four-pediatric patients with type IIb and III supracondylar humerus fractures treated at two centers between 1995 and 2005 were evaluated radiologically within a retrospective study. Seventy-six patients (54 boys, 22 girls, mean age 7.6, range 2-12) were treated by closed reduction and cross percutaneous pinning whil . . .e 68 (49 boys, 19 girls, mean age 7.3, range 2-13) were treated by open reduction. The reduction quality of the open and closed groups was compared on immediate post-operative lateral radiographs by measuring of lateral humerocapitellar angle, anterior humeral line and anterior coronoid line criteria. The reduction quality was classified excellent, good, fair and poor according to the achievement of three, two, one or none of the criteria, respectively. Reductions classified as excellent and good were introduced as acceptable results. Results: At least one criterion was achieved in all the patients of both the groups. The mean humerocapitellar angle was 30.1° in closed reduction group while the mean of it was 29.8° in open reduced group. Radiograph of 48 (63.1%) patients with closed reduction were found to display the anterior humeral line intersecting the middle one-third of capitellum while this criteria was 45 (66%) in open reduction group. The anterior coronoid line was disturbed in three patients in each of both the groups. The reduction quality was evaluated to be excellent in 32 patients, good in 31, fair in 13 at the closed reduction group while these evaluations were 31, 20 and 17 in open reduction group, respectively. Successful reduction was achieved in 74.9% of the patients in closed reduction group and 75% of the patients in open reduction group. Conclusion: It is concluded that there was no significant difference between closed and open reductions of pediatric displaced supracondylar fractures with regard to the radiological criteria of reduction quality in sagittal plane. © Springer-Verlag 2007 Daha fazlası Daha az

The longer pull-out suture as a transmission suture for early active motion of repaired flexor tendon at the proximal zone-2

Ökçesiz I.E. | Ege A. | Turhan E. | Songür M. | Bayar A. | Keser S.

Article | 2011 | Archives of Orthopaedic and Trauma Surgery131 ( 4 ) , pp.573 - 580

Objectives: The purpose of the current study was to clinically evaluate the technique of longer pull-out suture as a transmission suture for early active motion after flexor tendon repair in the proximal zone-2. Method: Eleven patients (eight adult male, two adult female and one child) with 19 proximal zone II flexor tendon lacerations were included. Mean age was 35 years. The patients were encouraged to perform active mobilization of the injured digits by themselves with full range of flexion from the first postoperative day. The pull-out suture was removed at the 8-10 weeks after the operation. Results: The mean follow-up was 39 m . . .onths. The procedure was well tolerated by all of the patients. A patient of whom pull-out suture was traumatized and loosened at 6th week showed fair result. Two other patients with a history of blunt trauma were also found to have fair results. Overall 16 of the 19 digits were evaluated as excellent or good by the Strickland criteria. Conclusion: The results of this method show that the longer pull-out suture technique as a transmission suture followed by early active mobilization is safe, has a low re-rupture rate and is easy to perform for proximal zone-2 flexor tendon injuries. © Springer-Verlag 2010 Daha fazlası Daha az

The effect of intraarticular combinations of tramadol and ropivacaine with ketamine on postoperative pain after arthroscopic meniscectomy

Ayoglu H. | Altunkaya H. | Bayar A. | Turan I.O. | Ozer Y. | Ege A.

Article | 2010 | Archives of Orthopaedic and Trauma Surgery130 ( 3 ) , pp.307 - 312

Introduction: The purpose of this prospective randomized study was to evaluate the effects of intraarticular combinations of tramadol and ropivacaine with ketamine in postoperative pain control of patients undergoing arthroscopic meniscectomy. Materials and methods: We randomly divided 80 patients into four groups to receive intraarticular 50 mg tramadol (Group T), 50 mg tramadol with 0.5 mg kg-1 ketamine (Group TK), 75 mg ropivacaine (Group R), 75 mg ropivacaine with 0.5 mg kg-1 ketamine (Group RK) in 20 ml normal saline at the end of surgery. Postoperative analgesia was provided with patient-controlled analgesia with morphine. Pos . . .toperative pain scores, total morphine consumption amount and side effects were recorded at intervals of 0, 1, 2, 4, 8, 12 and 24 h after the operation. Results: Pain scores were higher in Group T when compared with Group R and Group RK at second and fourth hours, also compared with Group RK at zeroth, first, second, fourth and eighth hours. Total morphine consumption amount was found to be higher in Group T when compared to Group TK at eighth and twelfth hours and Group RK at eighth hours (P < 0.05). Total morphine consumption was lowest in Group TK (P < 0.05). There were no significant differences among the study groups regarding side effects. Conclusions: Administration of intraarticular tramadol- ketamine combination was found to be more effective in decreasing postoperative daily analgesic consumption. © 2008 Springer-Verlag Daha fazlası Daha az

A giant extrasynovial osteochondroma in the infrapatellar fat pad: End stage Hoffa's disease

Turhan E. | Doral M.N. | Atay A.Ö. | Demirel M.

Article | 2008 | Archives of Orthopaedic and Trauma Surgery128 ( 5 ) , pp.515 - 519

The infrapatellar fat pad of Hoffa is commonly injured but rarely discussed in the orthopaedic literature. Hoffa's disease is the extension of various traumatic events due to impingement and inflammation of the infrapatellar fat pad and known as a vague reason for anterior knee pain. Inflammation is foreground during acute phase of the disease while impingement due to fibrosis and scar tissue of infrapatellar fat pad plays a major role in the chronic phase. The osteochondroma of the infrapatellar fat pad secondary to the Hoffa's disease can be more problematic. Although, the fibrocartilaginous transformation and osteochondral metapl . . .asia of infrapatellar fat pad was pointed out frequently in the literature, the published papers seem far from clarifying the relation between chronic impingement and formation of osteochondroma. We present a case of a giant ossifying chondroma in the infrapatellar fat pad that resulted from chronic Hoffa's disease. Complete open resection was performed successfully after arthroscopic examination. The infrapatellar fat pad contains the entire progenitor cells for the development of an osteochondroma and chronic impingement may have promoter affect on this issue, thus, an osteochondroma may occur at the end-stage Hoffa's disease. © Springer-Verlag 2007 Daha fazlası Daha az

Posterior interosseous artery flap in traumatic hand injuries

Ege A. | Tuncay I. | Erçetin Ö.

Article | 2003 | Archives of Orthopaedic and Trauma Surgery123 ( 7 ) , pp.323 - 326

Introduction: Nineteen cases of posterior interosseous artery (PIOA) flap were reviewed. The patients' mean age was 24 (range 14-53) years. Materials and methods: Nine patients were operated on as emergencies, and 10 patients were treated electively. Mean time of delay after trauma was 7.8 h (range 2-20 h) in emergency cases. Nine of them were non-replantable amputations. Skin defects were between 1.9×2.4 cm and 5.0×12.0 cm. Mean hospitalization time was 2.2 (range 1-5) days. Results: Mean flap sensation was evaluated as 2.83-6.65 with the Semmes-Weinstein evaluation scale (only 2 patients scored less than 3.61). Five patients prese . . .nted with discoloration and coolness. Average subjective evaluation was 8.2/10. Mean web opening after first web reconstruction was 40°. One posterior interosseous neuropraxia (recovered in 4 months), one distal flap necrosis, and one flap lost (due to infection) occurred as early complications. Mean follow-up was 12.8 months (range 15 days to 30 months). Conclusions: PIOA flap applications have reduced the need for lateral arm and radial forearm flaps and also shortened hospitalization time in clinical practice Daha fazlası Daha az

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