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    Big and deep seated lipomatous tumours in children: results of surgical treatment
    (ARSMB-KVBMG, 2021) Özkul E.; Elçi S.; Elçi M.; Alemdar C.
    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. © 2021, Acta Orthopædica Belgica.
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    Management of infectious fractures with "Non-Contact Plate" (NCP) method
    (ARSMB-KVBMG, 2015) Alemdar C.; Azboy I.; Atiç R.; Özkul E.; Gem M.; Kapukaya A.
    The aim of this study was to evaluate the outcomes of internal fixation with Non-Contact Plating (NCP) after deep infection caused by previous surgeries of the tibia or femur fractures. The study included 15 patients (4 female and 11 male). The mean age patients was 36.6 years (range, 21-64 years). There were 6 femur and 9 tibia fractures. The mean followup period was 25.7 months (range, 15-45 months). The study comprised 11 open and 4 closed fractures. External fixator was used in 3, plate in 4, and intramedullary nail in 8 patients for index surgery. Deep infection was diagnosed via clinical findings, laboratory parameters, and microbiological evaulation. Deep infection was diagnosed within a mean period of 5.5 weeks (range, 2-10 weeks). The infecting organism was methicillin-resistant staphylococcus aureus (MRSA) in 5, methicillin-sensitive staphylococcus aureus (MSSA) in 6, pseudomonas auroginosa in 2, and enterobacteriacea in 2 patients. Union achieved in all patients. Mean time to union was 17 (range, 11- 38) weeks. Delayed union was observed in 3 patients who required additional surgeries. Of these one patient developed osteomyelitis. The NCP is an effective alternative method in the treatment of deep infection encountered after internal or external fixation for the tibia, or femur fractures. © 2015, Acta Orthopædica Belgica.
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    The usage of low-dose lidocaine fentanyl in intravenous regional anesthesia
    (2013) Guzel A.; Çelik F.; Uludag O.; Dogan E.; Alemdar C.; Yildirim B.
    We aimed to present our IVRA practices by adding low-dose lidocaine fentanyl for the patients who have undergone forearm and hand surgery. After approval Ethics Committee and the permission of patients, 36 patients which were undergone elective, forearm or hand surgery, aged 18-60 years, were included in the study. The intravenous route was opened with 20 G cannula from the hand back (dorsum) which will operated and double-cuffed pneumatic tourniquet was inserted into the arm proximal. The arm was uplift for ten minutes and had veins drained by firmly wrapping the arm from finger tips towards shoulder to distal arm with the Esmarch bandage. First, the proximal cuff was inflated so as to be 150 mmHg more than systolic pressure. The distal cuff was lowered and the Esmarch bandage was removed. The 100 mg lidocaine+100 ?g fentanyl from the IV cannula on the hand back which will be operated, was given in 40 ml and the distal cuff was inflated after 5 min then proximal cuff was put out. The sensory block was assessed and sensory block initial time and motor block initial time was recorded. The regression times of sensory and motor block were recorded. Also the complications during and after the operation were recorded. Duration of surgery was determined as 30.3±10.1 min and the duration of tourniquet was 41.3±9.1 min. Sensory block initial time was recorded as 8.1±2.6 min, and the time for sensory block regression was recorded as 6.2±3.1 min. The motor block initial time was recorded as 13.4±5.2 min and motor regression time was recorded as 5.6±2.8 min. The clinical diagnoses of the patients were shown in Table 2. According to the VAS scores, it was observed that adequate level of anesthesia and analgesia was maintained for all patients. The addition of low-dose lidocaine to fentanyl in IVRA may provide both sufficient and effective anesthesia and decrease the complications related with local anesthetic toxicity.