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  • Küçük Resim
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    356 nolu Diyarbakır Şer'iye sicilinin transkripsiyonu ve değerlendirmesi (H.1217-1218/M.1803-1804)
    (Dicle Üniversitesi, 2013) Bulut, Mehmet
    ÖZET Şer’iye sicilleri, Osmanlı Devleti’nin hukuki kayıtlarını ihtiva eden birinci elden kaynaklardır. Osmanlı tarihinin temel kaynakları arasında yer alan siciller, Osmanlı Devleti’nin siyasi, sosyal, ekonomik ve kültürel hayatına dair çok çeşitli bilgiler içermektedirler. Bu çalışmada; Diyarbekir Eyaleti’nde bulunan Amid kazasına (Diyarbakır) ait ve XIX. yüzyılın başlarında (1217-1218/1803-1804) Amid mahkemesinde görülen davaları konun edinen meselelerin kaydedildiği ve günümüzde Milli Kütüphane’de 356 numara ile kayıtlı bulunan Diyarbakır şer’iye sicilinin transkipsiyonunu ve değerlendirmesi yapılmıştır. Bu çalışma, giriş ve üç bölümden oluşuyor. Giriş bölümünde, şer’î mahkemeler ve şer’iye sicillerinin ne olduğu ile sicillerde bulunan belge türleri hakkında bilgiler verilmiştir. Birinci bölümde, Osmanlı öncesi ve sonrası Diyarbekir tarihi hakkında kısa bir bilgi verilmiştir. İkinci bölümde, 356 numaralı şer’iye sicilinin (1217-1218/1803-1804) transkipsiyonu yapılmış ve bunun özeti hazırlanmıştır. Üçüncü bölümde ise, söz konusu defterde geçen bilgiler tahlil edilerek burada geçen hususların değerlendirilmesi yapılmıştır. Defterde, anlaşmazlıklardan dolayı meydana gelen davalar, miras hususu, vasi tayini, merkezden yapılan yazışmalar, fermanlar, beraatlar, defterde geçen Amid’in mahalleleri, köyleri ve kazaları, esnaf, gayrimüslim ve vergi konuları incelenmiştir. Anahtar Sözcükler : Şer’iye Sicili, Amid, Mahkeme, Kadı, Diyarbekir Eyaleti. vi ABSTRACT Sharia Court registers are primary sources containing legal records of the Ottoman Empire. The registers, among main sources of the history of the Ottomans as well, contain a very wide variety of information on the political, social, economic and cultural life of the Ottoman Empire. In this study; a transcription and an evaluation of Sharia Court Registers of Diyarbakir, the lawsuits records of the Court of Amid, a district of Diyarbekir State, in the early 19th century (1217-1218/1803-1804) now stored in the National Library with the number 356, has been made. This study consists of an introduction and three sections. In the introduction part, a description of Sharia courts and Sharia court registers and information about the types of the documents in the Sharia court registers is given. In the first section, a brief overview of the history of Diyarbekir before and after the Ottomans is provided. In the second section, the transcription of the Sharia Court Registers numbered 356 (1217-1218/1803-1804) has been made and a summary of has been given. In the third section, the veri in the metioned register has been analysed and an evaluation of it has been made. Cases arising from disagreements, inheritance issues, appointment of guardianship, government correspondence, the districts and villages of Amid, tradesmen, artisans, non-muslims and tax issues in the registers have been studied. Key words Sharia Court Registers, Amid, the Court, Qadi (Judge), Diyarbekir State.
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    Öğe
    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.
  • Küçük Resim
    Öğe
    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 radiological results of posterior instrumentation without fusion for thoracolumbar fractures
    (Academic Journals, 2011) Sargin, Serdar; Ucar, Bekir Yavuz; Necmioglu, Serdar; Bulut, Mehmet; Gem, Mehmet
    A retrospective study of clinical and radiological results of nonfusion operative treatment for thoracolumbar fractures. In this study, we aimed to demonstrate that fusion was not always required in the surgical treatment with posterior instrumentation for thoracolumbar vertebral fractures and to show the success of surgical treatment without fusion. Fusion was added considering failure of the implant and inability to maintain the corrected kyposis angle after posterior instrumentation for thoracolumbar vertebral fractures. Fusion related problems such as the fusion-induced loss of stability in posterior elements, graft donor site problems, increased blood loss, allograft associated infections, and prolonged operation time, focus attention on surgical treatment without fusion. We intended to demonstrate the alignment and stability of the spine in the coronal and sagittal planes after treatment without fusion. Kyphosis angle and the extent of the collapse were measured in preoperative, postoperative and final examination films of 60 patients with thoracolumbar vertebral fractures. Based on the computerized tomography and magnetic resonance images of the patients, we evaluated intracanal fragments, the presence of pedicle and laminar fractures, posterior ligamentous complex status and the presence of medullary edema. With an aim to evaluate pain and quality of life of the patients, the oswestry disability index (ODI) and Roland morris disability questionnairre were tested. The obtained results were evaluated and the final postoperative conditions of the patients were investigated. For the statistical analysis of local kyphosis angle, sagittal index and percentage of anterior collapse that were measured in preoperative, postoperative and final examinations of the patients, descriptive analysis and one way analysis of variance for related samples were conducted. And Pearson's correlation test was used for the analysis of the relationship between radiological measurements and clinical functions. It can be concluded that the patients derived radiological and statistically significant benefit from the surgery in terms of restoration of anterior column height and that postoperative radiological values were maintained with minimal reduction until the final examination (p>0.05) and that the surgery was effective in remodeling of the vertebral body. When evaluated in terms of the clinical results, a negative relationship (r = 0.300) between Oswestry scores and percentage of anterior collapse was found to be statistically significant (p<0.05). Our findings that the patients derived statistically significant benefit radiologically, in terms of local kyphosis angle and sagittal index correction from the posterior instrumentation without fusion and that postoperative radiological values were maintained with minimal increase (p>0.05) until the final examination, support our conclusion that fusion is not required. Hence, we can eliminate complications of fusion surgery.
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    Öğe
    Clinical and radiological results of posterior instrumentation without fusion for thoracolumbar fractures
    (Academic Journals, 2011) Sargin, Serdar; Ucar, Bekir Yavuz; Necmioglu, Serdar; Bulut, Mehmet; Gem, Mehmet
    A retrospective study of clinical and radiological results of nonfusion operative treatment for thoracolumbar fractures. In this study, we aimed to demonstrate that fusion was not always required in the surgical treatment with posterior instrumentation for thoracolumbar vertebral fractures and to show the success of surgical treatment without fusion. Fusion was added considering failure of the implant and inability to maintain the corrected kyposis angle after posterior instrumentation for thoracolumbar vertebral fractures. Fusion related problems such as the fusion-induced loss of stability in posterior elements, graft donor site problems, increased blood loss, allograft associated infections, and prolonged operation time, focus attention on surgical treatment without fusion. We intended to demonstrate the alignment and stability of the spine in the coronal and sagittal planes after treatment without fusion. Kyphosis angle and the extent of the collapse were measured in preoperative, postoperative and final examination films of 60 patients with thoracolumbar vertebral fractures. Based on the computerized tomography and magnetic resonance images of the patients, we evaluated intracanal fragments, the presence of pedicle and laminar fractures, posterior ligamentous complex status and the presence of medullary edema. With an aim to evaluate pain and quality of life of the patients, the oswestry disability index (ODI) and Roland morris disability questionnairre were tested. The obtained results were evaluated and the final postoperative conditions of the patients were investigated. For the statistical analysis of local kyphosis angle, sagittal index and percentage of anterior collapse that were measured in preoperative, postoperative and final examinations of the patients, descriptive analysis and one way analysis of variance for related samples were conducted. And Pearson's correlation test was used for the analysis of the relationship between radiological measurements and clinical functions. It can be concluded that the patients derived radiological and statistically significant benefit from the surgery in terms of restoration of anterior column height and that postoperative radiological values were maintained with minimal reduction until the final examination (p>0.05) and that the surgery was effective in remodeling of the vertebral body. When evaluated in terms of the clinical results, a negative relationship (r = 0.300) between Oswestry scores and percentage of anterior collapse was found to be statistically significant (p<0.05). Our findings that the patients derived statistically significant benefit radiologically, in terms of local kyphosis angle and sagittal index correction from the posterior instrumentation without fusion and that postoperative radiological values were maintained with minimal increase (p>0.05) until the final examination, support our conclusion that fusion is not required. Hence, we can eliminate complications of fusion surgery.
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    Öğe
    Clinical comparison of cross-pin and EndoButton for fixation of hamstring grafts in reconstruction of the anterior cruciate ligament
    (2012) Bulut, Mehmet; Gürger, Murat
    Amaç: Hamstring tendonları kullanılarak yapılan ön çapraz bağ (ÖÇB) rekonstrüksiyonlarında EndoButton ve cross-pin femoral tespit yöntemlerinin klinik sonuçlarının karşılaştırılması. Hastalar ve yöntem: Kliniğimizde Ocak 2006 - Aralık 2009 tarihleri arasında ÖÇB rüptürü nedeniyle opere edilen hastalar geriye dönük olarak incelendi. Hastaların 50 tanesine cross-pin, 50 tanesine ise EndoButton yöntemi kullanılarak, otojen hamstring tendon grefti ile artroskopik ön çapraz bağ rekonstrüksiyonu yapılmıştı. Her iki grupta hastaların ameliyat öncesi ve sonrası klinik değerlendirmesi uluslararası diz dökümantasyon sistemi (IKDC) ve Lysholm II skorlama sistemine göre yapıldı. Sonuçlar: Ameliyat sonrası cross-pin grubunda IKDC skorlama sistemine göre hastaların, %52’sinde A, %40’ında B, %8’inde C skoru bulundu. EndoButton grubunda hastaların %48’inde A, %42’sinde B, %10’unda C skoru bulundu. Ameliyat sonrası cross-pin grubunda Lysholm II skorlama sistemine göre hastaların %48’inde mükemmel, %44’ünde iyi ve %8’inde orta sonuç bulundu. EndoButton grubunda hastaların %50’sinde mükemmel, %44’ünde iyi, %6’sında orta sonuç bulundu. Gruplar arasında ek hastalık, IKDC ve Lysholm II skorları ve komplikasyonlar açısından fark yoktu. EndoButton grubunda ortalama ameliyat süresi daha kısaydı. Sonuç: Her iki femoral tespit tekniğinin, klinik sonuçları arasında istatistiksel olarak anlamlı fark bulunmadı. Ameliyat süresinin daha kısa, öğrenme eğrisinin daha kolay oluşu ÖÇB rekonstrüksiyonunda EndoButton tekniğinin avantajlarıdır.
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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
  • Küçük Resim
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    Comparison of iliac and femoral autograft practices in pemberton pelvic osteotomy
    (Lippincott Williams and Wilkins, 2021) Bulut, Mehmet; Azboy, İbrahim; Özkul, Emin; Karakurt, Lokman
    Background:There is no consensus in regard to grafts used after pelvic osteotomy in developmental dysplasia of the hip in the literature. The aim of this study was to compare iliac and femoral autografts used after Pemberton pelvic osteotomy (PPO).Methods:In this prospective, randomized study, 60 hips with dysplasia of the hip were included. All patients underwent open reduction, PPO, and femoral shortening osteotomy. Iliac autograft (group I; n=30 hips; mean age, 39.07; range, 18 to 72 mo) and femoral autograft (group II; n=30 hips; mean age, 42.53; range, 19 to 70 mo) were used to fill the iliac osteotomy. The height and width of the iliac and femoral autografts were measured intraoperatively. Anteroposterior pelvic radiographs were obtained on the 45th day, and in the 2nd, 3rd, 6th, and 12th months postoperatively. Acetabular index angle, height of the graft, loss of graft position, graft resorption, operative time, blood loss, and union time were compared between the groups.Results:There was a significant difference in each group in terms of loss of graft height between the intraoperative measurement and the postoperative measurement at the 6th week and 3rd month. The intraoperative width of the grafts was significantly greater, loss of graft height was significantly less, and the amount of bleeding was significantly lower in group II (P<0.001 for all 3). However, time to union was significantly shorter in group I (P<0.001). There was no significant difference between the groups in terms of acetabular index angle at the last controls. There were loss of graft position in 2 cases and graft resorption in 1 case for group I, but no such cases occurred for group II.Conclusions:Graft height and position loss, donor site morbidity, and graft resorption were less in the femoral autografts group compared with the iliac autografts group in the treatment PPO with femoral shortening osteotomy.Level of Evidence:Level II.
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    Comparison of soft-tissue and bone surgeries in the treatment of developmental dysplasia of the hip in 18-24-month-old patients
    (Lippincott Williams & Wilkins, 2013) Bulut, Mehmet; Karakurt, Lokman; Azboy, Ibrahim; Demirtas, Abdullah; Ersoz, Galip; Belhan, Oktay
    The aim of this study was to compare soft-tissue and bone surgeries in 18-24-month-old patients with developmental dysplasia of the hip (DDH). A total of 77 hips of 53 patients were analyzed. Soft-tissue surgery was performed in 31 hips of 25 patients. In the final examination, 23 hips, excluding hips of eight patients who underwent secondary bone surgery, were evaluated (group I). Bone surgery was performed on 46 hips of 28 patients (group II). In group I, the acetabular index was 41 degrees preoperatively and was 20.4 degrees in the final examinations. In group II, the acetabular index was 42 degrees preoperatively and was 15 degrees in the final examinations. To avoid unnecessary surgeries and complications, soft-tissue surgery should be preferred for DDH in 18-24-month-old patients.
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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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    The comparison of triceps-reflecting anconeus pedicle and olecranon osteotomy approaches in the treatment of intercondylar fractures of the humerus
    (Turkish Assoc Trauma Emergency Surgery, 2016) Azboy, Ibrahim; Bulut, Mehmet; Ancar, Cahit; Demirtas, Abdullah; Ozkul, Emin; Gem, Mehmet; Karadeniz, Hilmi
    BACKGROUND: This study aimed to evaluate the functional outcomes of patients with intra-articular distal humerus fractures treated with triceps-reflecting anconeus pedicle (TRAP) and olecranon osteotomy. METHODS: Forty patients with intra-articular distal humerus fractures were retrospectively analyzed. TRAP approach was used in 22 patients (12 males, 10 females; mean age 37.8 years, range 17-70), and olecranon osteotomy in 18 patients (11 males, 7 females; mean age 35.4 years, range 18-62). Fractures were classified using the AO/ASIF classification. Functional results were evaluated with the Mayo elbow performance score (MEPS) and the Disabilities of Arm, Shoulder and Hand (DASH) questionnaire score. RESULTS: The overall mean arc of elbow motion was 108 degrees (range 70 degrees-140 degrees) in the TRAP group, whereas that of the olecranon osteotomy group was 98 degrees (range 70 degrees-115 degrees). A significant difference was observed between the two groups in terms of overall mean arc of elbow motion (p=0.038). There were no significant differences noted between the two groups in terms of mean MEPS and DASH scores (p=0.412, p=201, respectively). The overall complication rate was 27.2% in the TRAP group and 55% in the olecranon osteotomy group. CONCLUSION: TRAP is a succesful approach in the treatmet of intra-articular distal humerus fractures that provides better arc of elbow motion, reduces complications and reoperation rates.
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    Congenital Pseudoarthrosis of the Tibia: Case Reports
    (Derman Medical Publ, 2015) Bulut, Mehmet; Karakut, Lokman; Belhan, Oktay; Sagiroglu, Muhittin Soner; Gurger, Murat
    Congenital pseudoarthrosis of the tibia is rarely seen disease which is very difficult to treat. Congenital pseudoarthrosis of the tibia is frequently seen together with neurofibromatosis. Especially according to Boyd classification, type II and V are in the high risk group. In this study, we presented the treatment result of the three years old male patient with type V congenital pseudoarthrosis of the tibia.
  • Küçük Resim
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    Diz kıkırdak lezyonlarında mikrokırık tedavi yöntemi sonuçları ve sonuca etki eden faktörler
    (Dicle Üniversitesi Tıp Fakültesi, 2011) Bulut, Mehmet; Tosun, H. Bayram; Serbest, Sancar; Palancı, Yılmaz; Yılmaz, Erhan
    Amaç: Bu çalışmanın amacı diz ekleminde kıkırdak lezyonlarının tedavisinde mikrokırık yöntemi ile tedavi edilen olguların sonuçlarını ve sonuçlara etki eden faktörleri değerlendirmektir. Gereç ve yöntem: Femoral kondilde kıkırdak hasarı nedeniyle mikrokırık yöntemi ile tedavi edilen 26 hasta retrospektif olarak incelendi. Hastaların 15 tanesi erkek, 11 tanesi bayan ve yaş ortalaması 37.2 yıl (dağılım 23-56 yıl) idi. Şikayetlerin başlangıcı ile ameliyat arasında geçen süre ortalama 9.7 ay (dağılım 3-35 ay) ve ortalama defekt alanı 1,6 cm2 (dağılım 0.7-2.4cm2 ) idi. Ortalama takip süresi 24.3 ay (dağılım 10-44 ay) idi. Hastalar ameliyat öncesi ve sonrası subjektif hasta memnuniyeti ve Lysholm skalasına göre değerlendirildi. İstatistiksel analiz için Paired sample t-test ve Pearson-Spearman korelasyon testi kullanıldı. Bulgular: Ameliyat öncesi Lysholm skoru ortalama 56.9 (43-72) iken ameliyat sonrası Lysholm skoru ortalama 77.9 (62-100) olarak bulundu. Lysholm skoruna göre, 9 (34.6%) olguda mükemmel, 7 (27%) olguda iyi, 10 (38.4%) olguda orta sonuç elde edildi. Hastaların tümü diz fonksiyonlarından memnundular. Ameliyat sonrası 6. ayda çekilen MRG sonuçları subjektif hasta memnuniyeti ve Lysholm skorları ile doğru orantılı idi. Sonuç: İyi ve mükemmel sonuçlanan hastaların aktif, genç ve semptom sürelerinin daha kısa ve lezyon alanının daha küçük olduğu gözlemlendi. Kıkırdak lezyonlarının tedavisinde erken yapılan mikrokırık tedavi yönteminin, günlük aktivitelere geri dönüşü hızlandıran, maliyeti düşük, etkili ve başarılı bir tedavi seçeneği olduğu sonucuna varıldı.
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    Doğumsal radius psödoartrozunda yan yana distal radioulnar bifurkasyon sinostoz tekniği ile ön kola tek kemik yapımı
    (Dicle Üniversitesi Tıp Fakültesi, 2011) Tosun, H. Bayram; Bulut, Mehmet; Karakurt, Lokman; Serbest, Sancar
    Konjenital radius psödoartrozu, tedavisi güç ve nadir görülen bir durumdur. Tedavi için birçok cerrahi seçenek bildirilmiştir. Ön kolda tek kemik oluşturma bunlardan biridir. Bu makalede, ön kol instabiliteli ve defektif doğumsal radius psödoartrozu olan yedi yaşında bir hastaya, distal radioulnar eklemi koruyan “yan yana distal radioulnar bifurkasyon sinostoz” tekniği ile ön kola tek kemik oluşturduğumuz ve fonksiyonel açıdan iyi sonuç elde ettiğimiz bir olguyu sunmayı amaçladık.
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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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    Öğe
    The effect of Seprafilm on adhesion formation and tendon healing after flexor tendon repair in chicken
    (2010) Yılmaz, Erhan; Avcı, Mustafa; Bulut, Mehmet; Keleştimur, Halidun; Karakurt, Lokman; Özercan, İbrahim
    Adhesion of the tendon, which can occur during healing of tendon repair, is negatively affected by the outcome of surgery. In this experimental study, we sought to prevent adhesion of the tendon, and determined the mechanical stiffness of repair tissue by wrapping sodium hyaluronate and carboxymethylcellulose (Seprafilm; Genzyme, Cambridge, Massachusetts) around the repaired tendon segments. The study group comprised 2 groups of 20 chickens. In group I, the right gastrocnemius tendons of the chickens were cut smoothly, and after tendon and sheath repair, the skin was sutured. In group II, the right gastrocnemius tendons of the chickens were cut, the tendons were repaired, and before skin closure, Seprafilm was wrapped around the repaired tendon segments. Plastic splints were used for holding the chickens' ankles in a neutral position, and they were allowed weight bearing for 8 weeks. In group II, anatomic space between the tendon-sheath and tendon was clear and the tendon-sheath complex was sliding easily around the repaired tendon segment, and this complex was more functional both biomechanically and histologically. Also, the Seprafilmapplied tendons (group II) were observed to be biomechanically more resistant to the tensile forces in group I. Seprafilm is an easily applied interpositional material that can be used safely to prevent adhesion during the tendon healing process.
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    Öğe
    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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    Öğe
    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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    Öğe
    Ev hanımlarında kronik bel ağrısı
    (2011) Uçar, Bekir Yavuz; Azboy, İbrahim; Bulut, Mehmet; Bozkurt, Mehtap; Uçar, Demet
    Amaç: Bu çalışmanın amacı ev işleri ile uğraşan kadınların bel ağrılarını belirlemek ve ev hanımlarının ruhsal durumları, eğitim düzeyleri ile fiziki sağlıkları arasındaki ilişkiyi araştırmaktır. Gereç ve yöntem: Çalışmaya 33-45 yaş arası 30 kronik bel ağrılı ev hanımı ve kontrol grubu olarak sağlıklı 30 ev hanımı alındı. Fizik muayeneleri yapıldı. Hastaların yaş, boy, kilo, eğitim düzeyi, çocuk sayısı, sigara ve alkol alışkanlıkları kaydedildi. Vücut kitle indeksleri (VKI) hesaplandı. Bel ağrısının şiddeti Oswestry Bel Ağrı Sorgulama İndeksi (OBAS), ağrının hasta psikolojisi üzerine olan etkisi Beck Depresyon Ölçeği (BDÖ) kullanılarak değerlendirildi. Karın ve sırt kasları gücü manuel yöntemle ölçüldü. Bulgular: Hastalar ve kontrol grubu arasında demografik veriler açısından fark yoktu. Kronik bel ağrılı hastalarda BDÖ skorları kontrollere göre anlamlı yüksek bulundu (p<0,01). Kontrol grubunda karın ve sırt kasları güçleri daha yüksek bulundu fakat istatistiksel olarak anlamlı değildi (p>0,05). Hasta grubunda OBAS değerleri, BDÖ ve VKİ değerleri ile pozitif yönde (sırasıyla, r:0,457 p:0,011 ve r:0,583 p:0,001), karın ve sırt kasları güçleri ile negatif yönde (r:-0,591 p:0,006 / r:-0,493 p:0,001) korele bulundu. Hastalarda karın ve sırt kaslarının gücü ile VKİ, OBAS ve BDÖ arasında negatif yönde anlamlı korelasyon tespit edildi (r:-0,726 r:-0,591 r:-0,737 / r:-0,526 r:-0,493 r:-0,615). Yüksek eğitim düzeyi OBAS ve BDÖ skorlarını olumlu yönde etkiledi. Sonuç: Düzenli egzersiz alışkanlığı olmayan kronik bel ağrılı ev hanımları günlük yaşam aktivitelerinde kısıtlamaya gitmektedirler. Bu nedenle bel ve karın kasları zayıflığı görülmektedir. Kronik bel ağrılı hastalarda BDÖ skorları daha yüksek bulunduğu için kronik ağrılı hastalar psikiyatrik yönden de değerlendirilmelidir. Klin Deney Ar Derg 2011; 2 (3): 295-298.
  • Küçük Resim
    Öğe
    Functional outcomes and quality of life in adult ipsilateral femur and tibia fractures
    (Elsevier (Singapore) Pte Ltd, 2019) Demirtaş, Abdullah; Azboy, İbrahim; Alemdar, Celil; Gem, Mehmet; Özkul, Emin; Bulut, Mehmet; Uzel, Kadir
    Objective: The aim of our study is to evaluate the functional outcomes and quality of life in adult ipsilateral femur and tibia fractures. Methods: 26 patients (21 male, 5 female; mean age 30 years, range: 18 to 66) treated for adult ipsilateral femur and tibia fractures were evaluated retrospectively. For femur fractures, intramedullary nails were used in 15 patients (12 antegrade, 3 retrograde), plate in 11 patients (10 locked-plate, and 1 blade-plate with a 95 degree angle). For tibia fractures, locked-plate were used in 13 patients, intramedullary nails in 9 patients, external fixator in 3 patients and multiple screws in 1 patient. According to Blake and McBryde classification, 17 fractures were type I, 9 fractures were type II (7 type 2A and 2 type 2B). The functional outcomes were evaluated by Karlström and Olerud criteria, and quality of life was evaluated by Short Form-36. The mean follow-up duration was 4.4 years (range: 1.1 to 7.3 years). Results: The functional outcomes were excellent in 6 patients, good in 8 patients, acceptable in 6 patients and poor in 6 patients. The mean values of quality of life scales were; physical function: 64.8, physical role limitation: 60.5, pain: 68.2, general health: 63.3, vitality: 58.4, social function: 68.2, emotional role limitation: 62.7, and mental health: 65.8. Conclusion: Adult ipsilateral femur and tibia fractures are severe injuries and adversely affect the quality of life and functional outcomes. The quality of life scales should be used along with functional outcome scores in evaluating these injuries. The translational potential of this article: Adult ipsilateral femur and tibia fractures cause severe morbidity. Functional outcomes and quality of life scales should be used together to evaluate these fractures. Karlström and Olerud criteria for functional outcomes and Short Form-36 scales for quality of life are suitable methods to evalute these fractures.