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  • Küçük Resim
    Öğe
    Açık tibia kırıklarının minimal invaziv teknikle kilitli plakla tedavinin orta dönem sonuçları
    (Dicle Üniversitesi Tıp Fakültesi, 2018) Atiç, Ramazan; Alemdar, Celil; Uludağ, Abuzer; Aydın, Abdulkadir; Kapukaya, Ahmet; Sargın, Serdar
    Amaç: Açık tibia kırıklarının tedavisinde minimal invazivperkütan plakla osteosentez (MIPPO) tekniğiyle yerleştirilen kilitli kompresyon plağı (LCP) ile tedavinin orta dönem sonuçlarını değerlendirmektir. Yöntemler: Mart 2008 - Aralık 2009 yılları arasında, açık tibiakırığı nedeniyle MIPO tekniğiyle cerrahi olarak tedavi edilen ortalama yaşı 32 (dağılım 16-64 yaş) ve ortalama takip süresi 18 ay (dağılım 12-30 ay) olan 41 hastanın (32 Erkek, 9 kadın) tedavi sonuçları retrospektif olarak değerlendirildi. Hastalarınaçık kırık sınıflaması içinGustillo-Anderson sınıflandırması kullanıldı. Buna göre 13 (%31,7) kırık Tip I, 21 (%51,2) kırık Tip II , 6 (%14,6) kırık Tip IIIA, 1 (%2,4) kırık Tip III C olarak değerlendirildi. Hastaların fonksiyonel sonuçları Karlstrom-Olerud fonksiyonel değerlendirme ölçütlerine göre belirlendi. Bulgular: Kırıkların kaynama süresi ortalama 29 hafta (dağılım 20-60 hafta) idi. 41 hastanın 38’inde tam kaynama, 3’ünde kaynama gecikmesi görüldü. 2 hastamızda plak yetmezliği gelişti, bu hastaların birine otogreftle beraber plak değişimi diğerine sadece plak değişimi yapıldı. Kalstrom-Olerudskorlamasına göre 7 (%17,1) hasta mükemmel, 27 (%65,9) hasta iyi, 4 (%9,8) hasta orta, 3 (%7,3) hastada tatmin edici sonuç elde edildi. On hastada yüzeyelenfeksiyon, bir hastada derin enfeksiyon bir hastada da osteomyelit gelişti. Yüzeyelenfeksiyon oral antibioterapiyle tedavi edilirken derin enfeksiyon ve osteomyelit seri debridman ve parenteralantibioterapiyle tedavi edildi. Sonuç: MIPPO tekniğiyle biyolojik tespit düşük enfeksiyon, yüksek kaynama oranı ile açık tibia kırıklarının acil ve kalıcı tedavisinde uygulanabilecek etkili bir yöntemdir.
  • Küçük Resim
    Öğe
    Alt ekstremite cerrahisinde uygulanan kombine femoral siyatik sinir bloğu deneyimlerimiz
    (Modestum Publishing Ltd., 2011) Çelik, Feyzi; Tüfek, Adnan; Yıldırım, Zeynep Baysal; Tokgöz, Orhan; Karaman, Haktan; Alemdar, Celil; Atiç, Ramazan; Çiftçi, Taner; Kavak, Gönül Ölmez
    Amaç: Bu çalışmada alt ekstremite cerrahisinde uygulanan kombine femoral - siyatik sinir bloğunun etkinliğinin araştırılması amaçlandı. Gereç ve yöntem: Alt ekstremite cerrahisi geçiren, ASA I-III grubu, 18-70 yaş arası kombine femoral - siyatik sinir bloğu uygulanmış hastalar retrospektif olarak incelendi. Çalışmaya 110 hasta dahil edildi. Hastalar kullanılan lokal anestezik ilaçlara göre dört gruba ayrıldı. Grup I: 30 ml %0.5 Bupivakain + 10 ml %0.9 NaCl, Grup II: 30 ml %0.5 Levobupivakain + 10 ml %0.9 NaCl, Grup III: 30 ml %0.5 Levobupivakain + 10 ml %2 Prilokain HCl, Grup IV: 20 ml %0.5 Bupivakain + 20 ml %2 Prilokain HCl. Hastaların demografik özellikleri, klinik tanıları, kullanılan lokal anestezik dozu ve volümü, tekniğin uygulanma süresi ve cerrahi sure, blok başarı oranları, girişim öncesi ve sonrası hemodinamik parametreler, postoperatif ilk analjezik ihtiyaç zamanı ve postoperatif ilk 24 saatlik analjezik tüketim miktarı, işlem esnasında ve sonrasında gelişen komplikasyonlar, hasta ve cerrahi memnuniyet verileri kaydedildi. Bulgular: Hastaların demografik özellikleri benzer bulundu. Cerrahi anestezi ve postoperatif analjezi kalitesi açısından gruplar arasında farklılık bulunmadı. En sık ayak bileği cerrahisi nedeni ile kombine femoral - siyatik sinir bloğu uygulanmıştı. Hastalara uygulanan faklı doz lokal anesteziklerle yeterli anestezi sağladığı görüldü. İşlem başarısı %96 olarak bulundu. Sonuç: Alt ekstremite cerrahisinde uygulanan kombine femoral - siyatik sinir bloğunun %96 başarıyla uygulandığı, yeterli düzeyde anestezi oluşturduğu ve postoperatif dönemde ortalama 426 dk analjezi sağladığı görüldü.
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    Application of vac in type III open fractures
    (Derman Medical Publ, 2018) Atic, Ramazan; Alemdar, Celil; Azboy, Ibrahim; Bulut, Mehmet; Cacan, Mehmet Akif; Gem, Mehmet
    Aim: Functional results of patients with Type III open long bone fractures treated with vacuum-assisted closure (VAC) and approximating sutures were evaluated. Material and Method: A total of 21 patients (4 female, 17 male with a mean age of 27 years, range: 3-64 years) with Gustilo-Andersen Type 3 open fracture were included in the study. The mean follow-up period was 25.67 months (range, 9-52 months). Thirteen patients had Type IIIB and eight patients had Type IIIC open fractures. Following a large debridement and irrigation in an operating room setting, wound dimensions were measured. Subsequently, VAC was applied. During the application, skin traction sutures were applied over the vacuum sponge. During the last dressing change in which a dean granulation tissue was obtained, the wound was closed following the measurement of its dimensions. Wound dimensions measured during the large debridement in the operating room were compared with the wound dimensions measured after the final VAC application. Results: Mean duration between trauma and operation was 7.57 hours (range, 2-23 hours). The wound was closed with delayed primary suturing in seven patients. In the remaining 14 patients, wound dimensions measured following the last VAC application were found to be decreased with a mean of 40.02% (range, 20-60%). Seven patients underwent a skin graft, two had a free flap application, four had a fasciocutaneous flap, and one had a fasciocutaneous flap + graft application. Two patients underwent revision operations for graft failure. Five patients (23.8%) developed a deep wound infection. The infections resulted in osteomyelitis in two patients (9.5%). Discussion; VAC application together with skin traction sutures in Type IIIB and C open fractures decreases wound size dimension of a graft or flap to be applied. Also it may reduce the requirement for secondary interventions.
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    Big and deep seated lipomatous tumours in children : results of surgical treatment
    (Acta Medica Belgica, 2021) Ozkul, Emin; Elci, Serhat; Elci, Muhsin; Alemdar, Celil
    The objective of the study is to evaluate results of our pediatric patients with big and deep-seated lipomatous tumors Results of 32 children who underwent resection for 5 cm or larger and deep-seated lipomas were evaluated. The mean age of the patients was 9.1 years (range, 0-16 ; 11 female/21 male), and median follow-up period was 3.21 years (range, 1-10 years). The median size of the excised tumour was 11 cm (range, 6-28 cm) in maximal dimension. Big lipomas in children can be treated with marginal resection procedures without biopsy with lower complication and local recurrence ratio compared to adult patients with similar tumours in similar size and location.
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    Big and deep seated lipomatous tumours in children : results of surgical treatment
    (Acta Medica Belgica, 2021) Ozkul, Emin; Elci, Serhat; Elci, Muhsin; Alemdar, Celil
    The objective of the study is aimed to evaluate results of our pediatric patients with big and deep-seated lipomatous tumors Results of 32 children who underwent resection for 5 cm or larger and deep-seated lipomas were evaluated. The mean age of the patients was 9.1 years (range, 0-16 ; 11 female/21 male), and median follow-up period was 3.21 years (range, 1-10 years). The median size of the excised tumour was 11 cm (range, 6-28 cm) in maximal dimension. Big lipomas in children can be treated with marginal resection procedures without biopsy with lower complication and local recurrence ratio compared to adult patients with similar tumours in similar size and location.
  • Küçük Resim
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    Bölgemizdeki kırıkçı sekellerinin ortopedik açıdan değerlendirilmesi
    (Galenos Yayınevi, 2014) Alemdar, Celil; Azboy, İbrahim; Demirtaş, Abdullah; Özkul, Emin; Gem, Mehmet; Bulut, Mehmet; Uçar, Bekir Yavuz; Tutak, Yılmaz
    Amaç: Kırıkçı sekellerinin bölgemizde önemli bir sorun olduğunu, kırıkçı müdahalesi nedeniyle gecikmiş tedavi alan hastalardaki ciddi ortopedik problemleri ve kliniğimizde bu tür hastalara uyguladığımız tedavi yaklaşımını sunmayı amaçladık.Yöntemler: Çalışmamızda kırıkçı sekeli olarak kliniğimize başvuran 51 has-tanın (30 erkek, 21 kadın, yaş ortalaması: 14,8) dosyası retrospektif olarak incelendi. Kırığın yeri, hastaların kırıkçıya ve hastaneye başvuru sebepleri, hastaneye başvurma süreleri, fizik muayene ve radyolojik bulguları incelenip uygulanan tedavi yöntemleri değerlendirildi. Bulgular: Sekellerin 42'si (%82) üst, 9'u (%18) alt ekstremitede idi. Kırıkçıların kolay ulaşılabilir olması (20 olguda), kırıkçıların kırık ve çıkık tedavisini doktor-lardan daha iyi yaptığı düşüncesi (10) en sık kırıkçıya başvurma sebepleriydi. Kırıkçı sonrası hastaneye en sık başvuru sebepleri deformite (43), ağrı (38) ve hareket kısıtlılığı (37) idi. Olguların 28'ine cerrahi, 18'ine konservatif tedavi uy-gulandı. Beş olguya ise sadece takip önerildi. Hastaların 20 (%40) sinde sekel kalıcı idi.Sonuç: Gecikmiş ve uygun olmayan tedavi kalıcı sakatlıkların ortaya çıkmasına sebep olmaktadır. Bu problemin ortadan kaldırılması için insanların eğitilme-si ve sağlık politikalarının yeniden gözden geçirilmesi gerekmektedir.
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    Clinical and radiologic results of open reduction and fixation with locked plate screws in proximal humerus fracture-dislocation
    (Derman Medical Publ, 2019) Degnek, Orhan; Atic, Ramazan; Alemdar, Celil; Aydin, Abdulkadir; Yildirim, Azad; Ozkul, Emin
    Aim: Proximal fracture dislocations of the humerus are rarely seen in society compared to other fractures. In our study, we evaluated the clinical and radiological results of patients who underwent open reduction and locked plate-screw fixation with proximal humerus fracture-dislocation. Material and Method: Between January 2009 and January 2016, 17 patients were treated with open reduction and locking plate screws in the Department of Orthopedics and Traumatology at the Faculty of Medicine, Dicle University. Patients were divided into two groups according to age. Group 1 consisted of 6 patients over 65 years of age and the mean age was 77.5 (69-87). Group 2 consisted of 11 patients under 65 years of age and the mean age was 41.6 (24-60). Group 1 consisted of all female patients and Group 2 consisted of all male patients. Patient fractures were classified according to the Neer classification. Oxford Shoulder Scale, DASH Score, and Constant Murley Score were used in the clinical evaluation of the patients. Avascular necrosis phase was performed according to Cruess phase. Results: The mean follow-up period of the patients was 13.8 months (range 10-38). The mean duration of surgery was 1.11 days (range 0-4). According to the Neer classification, 11.8% of the cases were two-part fracture dislocation, 64.7% were three-part fracture dislocation, and 23.5% were four-part fracture dislocation. There was a statistically significant difference between Oxford and DASH scores in the clinical outcome according to age groups (p = 0.001, p=0.049). Avascular necrosis was observed in 14 of 17 (82.3%) patients. Additional complications such as wound infection, nonunion were not observed. Discussion: In proximal humerus fracture-dislocations, the first surgical choice should be open reduction and internal fixation in young patients, whereas internal fixation in addition to arthroplasty should be considered in elderly patients.
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    Çocuk Femur Diyafiz Kırıklarının Titanyum Elastik İntrameduller Çivileme ile Tedavisi
    (2013) Uçar, Bekir Yavuz; Demirtaş, Abdullah; Alemdar, Celil; Şükür, Erhan; Azboy, İbrahim; Bulut, Mehmet
    Amaç: Titanyum intramedüller elastik çivi (TEN) ile tedavi edilen çocuk femur diyafiz kırıklarının klinik ve radyolojik sonuçlarının değerlendirilmesi. Yöntemler: Femur diyafiz kırığı tanısı ile 22 hastaya (15 erkek, 7 kız; Ortalama yaş: 7,6; dağılım 6-12 yaş) retrograd yolla TEN ile tedavi edildi. Kırıkların 15'i femur orta diyafiz, 4'ü proksimal diyafiz, 3'ü distal diyafiz kırığı şeklinde idi. Kapalı redüksiyon elde edilemeyen olgularda kırık hattına lateral insizyonla ulaşılıp açık redüksiyon uygulandı. Hastaların takiplerinde ön arka ve yan femur grafileri kullanıldı. Olgular yürüme şekilleri, diz ve kalça hareketleri, hastanede kalış süreleri, kırıkların kaynama süresi, ekstremitelerde oluşabilecek uzunluk eşitsizliği, komplikasyon gelişip gelişmemesi yönünden değerlendirildi. Olguların değerlendirmesinde Flynn TEN skorlama sistemi kullanıldı. Bulgular: Tüm kırıklarda ortalama 6.8 haftada (dağılım: 5-11 hafta) kaynama elde edildi. Ön arka planda 19 hastada normal dizilim elde edilirken iki hastada 5 derece varus, bir hastada 6 derece valgus görüldü. Lateral planda iki hastada 6 derece anterior angulasyon görüldü. İki hastada ortalama 7 mm uzunluk, üç hastada ortalama 6 mm kısalık görüldü. Bir hasta kalça ve diz hareketlerinde hafif kısıtlıklık gelişti. Bir hasta dışında tüm hastaların yürüyüşü simetrikti. Bir hastada yüzeyel enfeksiyon gelişti. Hiç- bir hastada kaynamama, epizifiz plağı kapanması, TEN çıkarılması sonrasında kırık görülmedi. Flynn kriterlerine göre 15 hastada mükemmel, yedi hastada başarılı sonuç elde edildi. Hastanede ortalama kalış süresi 4,2 gün (dağılım: 3-9 gün). Ortalama izlem süresi 20,2 ay (dağılım: 14-24 ay) idi. Sonuç: Çocuk femur diyafiz kırıklarının tedavisinde titanyum intramedüller elastik çiviler başarı ile uygulanabilen bir tedavi yöntemidir
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    Çocuklarda suprakondiller humerus kırığı sonrası damarsal yaralanmalar
    (2016) Gem, Mehmet; Alemdar, Celil; Arslan, Hüseyin; Azboy, İbrahim; Özkul, Emin; Çelik, Velat
    AMAÇ: Çocuk suprakondiller humerus kırığı sonrası ekstremite distalinde nabız alınamayan hastaların sonuçlarını değerlendirmektir.GEREÇ VE YÖNTEM: Suprakondiler humerus kırığı sonrası ekstremite distalinde nabız alınamayan 42 hasta geriye dönük olarak değerlendirildi. Bu hastaların ortalama yaşı 7.3 (dağılım, 5-14 yaş) yıl idi. Hastaların 27'si (%64) erkek 15'i (%36) kızdı. Ameliyat öncesi ve sonrası nörolojik muayene bulguları, yaralanma şekli, yaralanma ile hastaneye başvuru arasında geçen süre ve ameliyata alınma zamanı, hastanede kalma süresi ve ameliyat sonrası görülen komplikasyonlar açısından hastalar değerlendirildi.BULGULAR: Tüm hastalarda Gartland tip 3 kırık mevcuttu. Yirmi yedi hastada redüksiyon sonrası radial nabız palpe edilmeye başlandı. On hastada sadece Doppler ile belirlenen akım mevcut iken, iki hastada akım alınamadı. Dolaşım bozukluğu olmayan bu iki hastada da ameliyattan bir gün sonra Doppler ile akım alınmaya başlandı. Redüksiyon sonrası dolaşım bozukluğu devam eden ve Doppler ultrasonografi ile akım alınamayan diğer üç (%7) hastaya acil vasküler eksplorasyon uygulandı. Bir hastaya primer sütürasyon, diğer iki hastaya ise safen greft ile tamir uygulandı.SONUÇ: Suprakondiller humerus kırığına bağlı nabızsız el gelişen hastalar, redüksiyon sonrası yeniden değerlendirilmeli; ekstremite dolaşımı düzelenler ve dolaşım bozuluğu bulguları olmayanlar için sadece yakın takip, dolaşım bozukluğu devam edenlere ise damar tamiri yapılmalıdır
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    Comparative Analysis of Percutaneous Excision and Radiofrequency Ablation for Osteoid Osteoma
    (Int Scientific Information, Inc, 2023) Atic, Ramazan; Alemdar, Celil; Elci, Serhat; Dusak, Abdurrahim; cacan, Mehmet Akif; Ozkul, Emin; Aytekin, Mahmut Nedim
    Background: This retrospective study aims to compare the efficacy of computed tomography-guided percutaneous excision and radiofrequency ablation in the treatment of osteoid osteoma. Material/Methods: We evaluated 40 patients with osteoid osteoma who underwent either percutaneous excision or radiofrequency ablation between 2012 and 2015. The cohort consisted of 10 female and 30 male patients, with a mean age of 15.1 years (range: 4-27 years) and a mean follow-up time of 19.02 months (range: 11-39 months). Percutaneous excision was performed in 20 patients, while radiofrequency ablation was performed in the remaining 20 patients. Results: The success rates of percutaneous excision and radiofrequency ablation were comparable, with unsuccessful outcomes observed in 10% and 5% of patients, respectively. The reasons for failure in the percutaneous excision group were attributed to a marking error and incomplete excision of the wide-based nidus. Complications were limited to pathological fracture (n=1) and deep infection (n=1) in the percutaneous excision group, while no complications were encountered in the radiofrequency ablation group. Conclusions: Both percutaneous excision and radiofrequency ablation demonstrate high success rates in treating osteoid osteoma. However, radiofrequency ablation offers the advantage of a quicker return to daily activities without the need for activity restrictions or splints. While being a more cost-effective option, percutaneous excision should be considered cautiously to minimize potential complications.
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    A comparison of percutaneous trephine excision and open surgery in the treatment of osteoid osteoma
    (Springer, 2016) Alemdar, Celil; Cacan, Mehmet Akif; Dusak, Abdurrahim; Ozkul, Emin; Atic, Ramazan; Kapukaya, Ahmet
    Purpose The aim of this study was to compare CT-assisted percutaneous excision, which is a closed, economic method and a more cosmetic approach, and open surgery in the treatment of osteoid osteoma. Materials and methods Fifty-three patients (12 female and 41 male patients) who had percutaneous excision (n = 24) and open surgery (n = 29) were evaluated retrospectively. The mean age was 16.6 years and the mean duration of follow-up was 53.5 months. During percutaneous excision, a trephine was advanced through the labeling wire and the site, including the nidus, was excised en-bloc and the incision walls were curetted. During the open surgery, the localization of the nidus was marked using c-arm X-ray and the nidus was accessed by lifting the cortical bone, layer-by-layer, using burr. The nidus was excised and its cavity curetted. Results The result was successful in 22 and a failure in three patients who had closed excision. The result was successful in 20 and a failure in nine patients who had open surgery. The mean duration of operation was 44.37 minutes in the percutaneous excision group and 80.6 minutes in the open surgery group. There was no difference in the pre-operative VAS values between the two groups, whereas the post-operative VAS values were statistically significantly different. There was also a statistically significant difference in the duration of the operation and the length of the hospital stay between the groups. Conclusion Percutaneous excision with trephine is a more successful, effective, minimally invasive, safe and a better cosmetic approach in the treatment of osteoid osteoma. This method is also a cheap method that does not require expensive equipment.
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    Comparison of retrograde intramedullary nailing and bridge plating in the treatment of extra-articular fractures of the distal femur
    (Turkish Assoc Orthopaedics Traumatology, 2014) Demirtas, Abdullah; Azboy, Ibrahim; Ozkul, Emin; Gem, Mehmet; Alemdar, Celil
    Objective: The aim of this study was to compare retrograde intramedullary nailing (RIMN) and bridge plating for the treatment of extra-articular distal femur fractures. Methods: The study retrospectively examined 15 patients (13 males and 2 females; mean age: 36 years, range: 17 to 55 years) who underwent bridge plating and 13 patients (11 males and 2 females; mean age: 31.1 years, range: 17 to 49 years) who underwent RIMN for the treatment of extra-articular distal femur fractures between 2007 and 2012. Functional results were evaluated using the Sanders criteria. The mean follow-up time was 31.3 (range: 20 to 46) months and 26.7 (range: 18 to 62) months in the plate and the nail groups, respectively. Results: Mean duration until union was 25.7 (range: 12 to 72) weeks in the plate group and 22.3 (range: 12 to 52) weeks in the nail group. Nonunion was observed in 2 patients in the plate group and in 1 in the nail group, delayed union in 3 patients in the plate and 2 in the nail groups, malalignment (>10 degrees) in 2 patients in the plate group and 1 in the nail group and implant failure in 1 patient in the plate group. Excellent/good functional results were obtained in 12 and 10 patients in the plate and the nail groups, respectively. No significant difference was found between the groups in terms of duration of union, complications and functional results (p>0.05). Conclusion: Bridge plating and RIMN have similar results in the treatment of extra-articular distal femur fractures. Both methods can be applied to all fractures, with the exception of Gustilo-Anderson Type 3B and C open fractures.
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    A comparison of the anteromedial and transtibial drilling technique in ACL reconstruction after a short-term follow-up
    (Springer, 2014) Azboy, Ibrahim; Demirtas, Abdullah; Gem, Mehmet; Kiran, Seymuz; Alemdar, Celil; Bulut, Mehmet
    The purpose of this study was to compare clinical and radiological outcomes of patients who underwent single-bundle anterior cruciate ligament (ACL) reconstruction with anteromedial portal (AMP) and transtibial (TT) techniques. Arthroscopic single-bundle ACL reconstruction was performed using AMP technique in 34 patients and TT technique in 30 patients. The patients were evaluated retrospectively. Aperture fixation was used for femoral fixation, and absorbable screws and U staples were used for tibial fixation of the graft. Pivot shift test, Lachman test, Lysholm, Tegner, and International Knee Documentation Committee (IKDC-2000) scoring systems were used in the clinical and functional evaluation of patients before and after the surgery. Time to return sports and activity level were assessed. In the radiological evaluation of non-anatomic bone tunnel placement, the criteria developed by lllingworth et al. were used. The mean duration of follow-up was 20.4 and 24.6 months in the AMP and TT groups, respectively. There was a significant difference between the AMP group (86.7 %) and the TT (14.7 %) group in terms of anatomical placement of the femoral tunnels and grafts (p < 0.001). No significant difference was observed between the two groups in terms of the Pivot shift test, Lachman test, Lysholm, Tegner, and IKDC scores, and activity level (p > 0.05). The patients in the AMP group returned to sports 1.5 months earlier on average (p < 0.001). It was shown that AMP technique was superior to the TT technique in providing anatomical placement of the graft and in recovery time to return sports; however, there was no difference between groups in early periods in terms of the clinical and functional outcomes.
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    Comparison of the clinical and radiologic outcomes of two treatment methods in patients with thoracolumbar junction distraction fracture: Short- versus long-segment posterior stabilization
    (Thieme Medical Publ Inc, 2023) Çetin, Hakan; Bayram, Serkan; Alemdar, Celil; Atiç, Ramazan
    Background We compare the radiologic and clinical results between the short-segment fixation and the long-segment fixation in the thoracolumbar junction distraction fractures.Methods We retrospectively reviewed the prospectively recorded data of patients who underwent posterior approach and pedicle fixation treatment for thoracolumbar distraction fracture (Arbeitsgemeinschaft fur Osteosynthesefragen/Orthopaedic Trauma Association AO/OTA 5-B) with a minimum of 2 years of follow-up. A total of 31 patients were operated on; they were divided into two groups: (1) patients treated with short-level fixation (SLF; one level above and below the fracture level) and (2) patients treated with long-level fixation (LLF; two levels above and below the fracture level). The clinical outcomes were evaluated with the neurologic status, operation time, and time to surgery. The functional outcomes were evaluated with the Oswestry Disability Index (ODI) questionnaire and visual analog scale (VAS) at the final follow-up. Radiologic outcomes were measured with the local kyphosis angle, anterior body height, posterior body height, and sagittal index of the fractured vertebra.Results SLF was performed in 15 patients and LLF was performed in 16 patients. The average follow-up period was 30.13 +/- 11.3 months for the SLF group and 35.3 +/- 17.2 months for group 2 ( p = 0.329). The two groups were similar in regard to age, gender, follow-up period, fracture level, fracture type, and pre- and postoperative neurologic status. The operating time was significantly shorter in the SLF group than in the LLF group. There were no significant differences between the groups in all radiologic parameters, ODI score, and VAS.Conclusion SLF was associated with a shorter operation time and allowed the preservation of two or more segments of vertebral motion.
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    The effect of hyperbaric oxygen therapy on fracture healing in nicotinized rats
    (Turkish Assoc Trauma Emergency Surgery, 2014) Demirtas, Abdullah; Azboy, Ibrahim; Bulut, Mehmet; Ucar, Bekir Yavuz; Alemdar, Celil; Alabalik, Ulas; Akpolat, Veysi
    BACKGROUND: The aim of the present study was to investigate the effect of hyperbaric oxygen therapy on fracture healing in nicotinized rats. METHODS: Thirty-two rats were divided as follows: nicotinized group (1), hyperbaric oxygen group (2), nicotinized + hyperbaric oxygen group (3), and control group (4). For 28 days, nicotine was administered in Groups 1 and 3. Then, a standard shaft fracture was induced in the left femur of rats. Groups 2 and 3 underwent hyperbaric oxygen therapy for 21 days. At the end of the experiment, fracture site, left femur and whole body bone mineral content and density were measured. RESULTS: The radiological and histopathological scores of Group 1 were statistically significantly lower compared to Groups 2, 3 and 4, and there was no statistically significant difference between the Groups 2, 3 and 4. In a comparison between the groups, no statistically significant difference was found in terms of bone mineral content and density values measured at the fracture site, left femur and whole body. CONCLUSION: The negative effects of nicotine on fracture healing are eliminated with hyperbaric oxygen therapy, but hyperbaric oxygen alone does not cause significant changes in healing (radiologically and histopathologically).
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    Effect of insulin-like growth factor-1 and hyaluronic acid in experimentally produced osteochondral defects in rats
    (Medknow Publications & Media Pvt Ltd, 2016) Alemdar, Celil; Yucel, Istemi; Erbil, Baris; Erdem, Havva; Atic, Ramazan; Ozkul, Emin
    Background: The common purpose of almost all methods used to treat the osteochondral injuries is to produce a normal cartilage matrix. However current methods are not sufficient to provide a normal cartilage matrix. For that reason, researchers have studied to increase the effectiveness of this methods using chondrogenic and chondroprotective molecules in recent experimental studies. Insulin-like growth factor-1 (IGF-1) and hyaluronic acid (HA) are two important agents used in this field. This study compared the effects of IGF-1 and HA in an experimental osteochondral defect in rat femora. Materials and Methods: The rats were divided into three groups ( n = 15 per group) as follows: The IGF-1 group, HA group, and control group. An osteochondral defect of a diameter of 1.5 mm and a depth of 2 mm was created on the patellar joint side of femoral condyles. The IGF-1 group received an absorbable gelatin sponge soaked with 15 g/15 l of IGF-1, and the HA group received an absorbable gelatin sponge soaked with 80 g HA. The control group received only an absorbable gelatin sponge. Rats were sacrificed at the 6 (th) week, and the femur condyles were evaluated histologically. Results: According to the total Mankin scale, there was a statistically significant difference between IGF-1 and HA groups and between IGF-1 and control groups. There was also a significant statistical difference between HA and control groups. Conclusion: It was shown histopathologically that IGF-1 is an effective molecule for osteochondral lesions. Although it is weaker than IGF-1, HA also strengthened the repair tissue.
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    Effectiveness of Locking Versus Dynamic Compression Plates for Diaphyseal Forearm Fractures
    (Slack Inc, 2013) Azboy, Ibrahim; Demirtas, Abdullah; Ucar, Bekir Yavuz; Bulut, Mehmet; Alemdar, Celil; Ozkul, Emin
    This study compares the results of the locking compression plate (LCP) and the dynamic compression plate (DCP) in the treatment of diaphyseal forearm fractures in adults and defines the indications for the use of the LCP. Forty-two patients with diaphyseal forearm fractures were retrospectively analyzed. Of those, 22 had been treated with the LCP (LCP group) and 20 had been treated with the DCP (DCP group). The AO/ASIF classification was used to classify the fractures. Patients were assessed using the Grace-Eversmann criteria and the Disabilities of the Arm and Shoulder and Hand questionnaire during the final follow-up. Mean follow-up was 21 months (range, 20-24 months) in the LCP group and 23 months (range, 19-26 months) in the DCP group. Union was achieved in all patients. Mean time to union was 15 weeks (range, 12-25 weeks) in the LCP group and 17 weeks (range, 13-24 weeks) in the DCP group. In each group, 1 patient experienced delayed union, which required no additional surgical intervention. No significant difference was found regarding the time to union between the groups (P>.05). No significant difference existed between the 2 groups in terms of Grace-Eversmann criteria and Disabilities of the Arm and Shoulder and Hand scores (both P>.05). The results of these different fixation methods for forearm fractures in adults are similar. As such, the correct selection and application of surgical technique is more important than the type of plate used.
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    Effects of enoxaparin and rivaroxaban on tissue survival in skin degloving injury: an experimental study
    (Turkish Assoc Orthopaedics Traumatology, 2014) Azboy, Ibrahim; Demirtas, Abdullah; Bulut, Mehmet; Alabalik, Ulas; Ucar, Yavuz; Alemdar, Celil
    Objective: The aim of this study was to evaluate the effects of the antithrombotic agents enoxaparin, and rivaroxaban on tissue survival following skin degloving injury in an experimental rat tail model. Methods: The study included 24 rats divided into three equal groups of 8; the enoxaparin group (Group 1), the rivaroxaban group (Group 2) and the saline control group (Group 3). A degloving injury was created by making a circular incision 5 cm distal to the base of the tail; manual traction was applied to the tail skin distal to the incision. After 15 minutes, the ends of the incision were sutured back in place. Antithrombotic agents were administered immediately after suturing and repeated once a day for 15 days. At the end of Day 15, the experiment was terminated. Gross morphological tissue survival and histopathology were evaluated. Results: Histopathological examination of the enoxaparin and rivaroxaban groups revealed that the skin was mostly normal or intact with minimal inflammation. The mean length of necrotic area was significantly higher in the saline group compared to the enoxaparin and rivaroxaban groups (p < 0.05). No statistically significant differences were noted between the rivaroxaban and enoxaparin groups (p=0.451). The mean extent of skin necrosis was significantly higher in the control group than the study groups (p < 0.05), while there was no significant difference in the length of necrotic area between Group 1 and 2 (p=0.722). Conclusion: Rivaroxaban and enoxaparin improved tissue survival in skin degloving injuries in terms of gross morphological and histopathological findings in a rat tail model.
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    Effects of Extracorporeal Shock Wave Therapy on the Quality of Life and Pain in Patients with Lateral Epicondylitis
    (2018) Atiç, Ramazan; Çevik, Remzi; Alemdar, Celil; Aydın, Abdulkadir; Çelepkolu, Tahsin; Aydın, Zekiye Sevinç
    Aim: We aimed to evaluate the effects of extracorporeal shock wave therapy (ESWT) on clinical and functional status, quality of life and level of pain for short and long terms in patients with lateral epicondylitis. Methods: In total, 34 patients with lateral epicondylitis were included in the study. The patients received three sessions of ESWT administered 1day apart. The Short Form (SF-36) Health Survey evaluating the quality of life, the Turkish version of the patient-rated tennis elbow evaluation (PRTEET) evaluating the level of pain during various activities of daily living, the Nirschl pain phase scale evaluating pain during activity of the affected arm and patient-rated visual analogue scale (VAS) evaluating pain localised in the affected arm were used before andafter therapy and at 6 and 12 weeks after therapy. Results: There were significant decreases in the PRTEE-T, Nirschl and VAS scores at 6 and 12 weeks and significant increases in the SF-36 survey scores. There was a significant decrease in the total PRTEE-T,Nirschl and VAS scoresat 6 and 12 weeks. There were significant increases in all subscale scores of the SF-36 survey. Furthermore, there was a sustained decrease in the PRTEE-T, Nirschl and VAS scores and increase in the SF-36 score from 6 to 12 weeks. Conclusion: This study revealed that ESWT is effective in treating lateral epicondylitis by improving the quality of life, reducing pain during activity, decreasing pain during activities of daily living and reducing pain localised in the arm.