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Öğe Can American Orthopaedic Foot and Ankle Society (AOFAS) score prevent unnecessary MRI in isolated ankle ligament injuries?(SAGE Publications Ltd, 2022) Kandemir, Veysel; Akar, Mehmet Sait; Yiğit, Şeyhmus; Durgut, Fatih; Atiç, Ramazan; Özkul, EminIntroduction and Objective: Ankle injuries are the most common musculoskeletal injuries. Its incidence is also high among sports injuries. Direct X-ray, ultrasound and MRI can be requested after the history and physical examination in the patient who presents with ankle ligament injury. Some classifications are used for requesting direct X-ray after ankle injury. Since clear limits are not specified in the literature for MRI, the rate of unnecessary MRI examinations is high. We argue that the decision can be made according to the AOFAS score to be checked before MR is requested, and thus unnecessary MR requests can be reduced. Material and Method: Ankle MRI images of patients who underwent ankle MRI due to ankle trauma between January 2018 and December 2020 were scanned. 328 patients who met the criteria were included in the study. Patients with AOFAS scores in their outpatient clinic records were identified. AOFAS scores of patients with at least one ligament injury and those with normal MR images were statistically compared. Sensitivity and specificity were determined for the AOFAS score using ROC analysis. Results: Patients with ligament damage as a result of MRI examination were 21.3% (n=70), and patients without any ligament damage were 78.7% (n=258). There was a statistically significant difference in terms of AOFAS between the group with ligament damage and the group without ligament damage (p< 0.05). In the ROC analysis, the AOFAS threshold value for MR request was determined as 80.5 (84.3% sensitivity and 72.3% specificity). Based on the determined threshold value, 73 patients who had unnecessary MRI would have been eliminated, thus reducing the number of MRIs by 42.6%. Conclusion: The AOFAS scores of patients with ligament damage were statistically significantly lower than those of patients without ligament pathology. Unnecessary MRI can be significantly prevented by using the AOFAS score in ankle traumas without bone fractures.Öğe Clinical differences between nasogastric tube and Hunter's rod for staged Zone II flexor tendon reconstruction(Turkish Joint Diseases Foundation, 2023) Sahin, Erdem; Ozdemir, Ali; Ergin, Musa; Durgut, Fatih; Acar, Mehmet AliObjectives: This study aims to compare the outcomes of twostage flexor tendon reconstruction in Zone II of the hand and to evaluate the results of a nasogastric tube as a potential alternative to Hunter's rod. Patients and methods: Between November 2012 and January 2022, a total of 45 patients (26 males, 19 females; median age: 31 years; range, 12 to 61 years) who underwent two-stage flexor tendon reconstruction were retrospectively analyzed. Of the patients 24 underwent nasogastric tube reconstruction (NT group) and 21 underwent Hunter's rod reconstruction (HR group). Patients' demographic and clinical characteristics, the number of surgeries, the occurrence of complications, the presence of infection during the procedure, and the range of motion of the finger joints at the final follow- up examination were recorded. The assessment of the cases was conducted using the total active motion system. Results: Twenty-four digits underwent two-stage flexor tendon reconstruction with the nasogastric tube. Among these, three index fingers, nine middle fingers, seven ring fingers, and five little fingers were operated. Twenty-one digits underwent two- stage flexor tendon reconstruction using Hunter's rod. Among these, two index fingers, eight middle fingers, six ring fingers, and five little fingers were operated. In the NT group, excellent results were observed in 58.3% (14 digits), good results in 25% (six digits), fair results in 8.3% (two digits), and poor results in 8.3% (two digits). In the HR group, excellent results were seen in 57.1% (12 digits), good results in 33.3% (seven digits), fair results in 4.7% (one digit), and poor results in 4.7% (one digit). Conclusion: The utilization of a nasogastric tube offers a convenient and cost-effective option to Hunter's rod in the two-stage flexor tendon reconstruction, leading to favorable outcomes characterized by high rates of excellence and improvement, while effectively minimizing the occurrence of complications.Öğe Comparison of the modified moberg flap versus first dorsal metacarpal artery flap for thumb pulp reconstruction(Lippincott William & Wilkins, 2022) Durgut, Fatih; Özdemir, Ali; Ergin, Musa; Güleç, Ali; Acar, Mehmet AliWe assessed and compared outcomes of 2 different flap techniques for thumb pulp defect reconstruction. Twenty-three patients who underwent modified Moberg and first dorsal metacarpal artery flap because of thumb pulp defect were retrospectively evaluated. Flap survival; venous congestion; cold intolerance; static 2-point discrimination (s2-PD); Semmes-Weinstein monofilament (SWM) test scores; paresthesia; defect size; time to return to work; interphalangeal and metacarpophalangeal joint flexion of the thumb; Disability of the Arm, Shoulder and Hand questionnaire scores; and follow-up time were evaluated. Flap survival, venous congestion, time to return to work, paresthesia, defect size, SWM test scores, range of motion of the proximal interphalangeal and metacarpophalangeal joints, and Disability of the Arm, Shoulder and Hand questionnaire scores were similar in both groups. Cold intolerance and s2-PD were found to be statistically better in the modified Moberg flap group. Although these techniques provided similar results, the modified Moberg was found to be superior in terms of cold intolerance and s2-PD.Öğe The effect of prolonged immobilization on elbow range of motion in supracondylar humerus fractures treated with closed reduction and percutaneous pinning(Bayrakol Medical Publisher, 2022) Şahin, Erdem; Tuğrul, Ali İhsan; Ergin, Musa; Durgut, FatihAim: The purpose of this study was to evaluate the effect of prolonged immobilization on elbow range of motion in Gartland type III supracondylar humerus fractures treated with closed reduction and percutaneous pinning. Material and Methods: In this retrospectively designed study, patients whose k-wires and cast were removed after sufficient callus tissue was visible were classified as Group A, and patients who had k-wires removed and arm casts used for more than 2 weeks prolonged were classified as Group B. All patients had Gartland type III supracondylar humerus fracture. Clinical outcomes of two patient groups were analyzed and compared. Results: The final analysis included 72 patients. Group A consisted of 37 patients. Group B consisted of 35 patients. Group B had a significantly lower ROM than Group A in the second month (p< 0.001). Group B had a significantly lower ROM than Group A in the third month (p=0.004). There was no significant difference in ROM between Group A and Group B in the sixth (p=0.48) and twelfth months (p=0.54). Discussion: In this study, there was no significant difference in ROM between patients who used long-arm casts for two weeks after their pins were removed and those who started mobilization early. Some patients may have to use long arm casts for a more extended period of time. However, it should be kept in mind that early rehabilitation reduces elbow contracture.Öğe The effect of single plate and double plate application on union and functional results in humeral diaphyseal nonunions(Acta Medica Belgica, 2022) Durgut, Fatih; Ozdemir, Ali; Ergin, Musa; Gulec, Ali; Acar, Mehmet AliIn this study, we assessed and compared the outcomes of two different fixation techniques for humeral diaphyseal fracture nonunions. A retrospective evaluation of 22 patients who underwent single-plate and double-plate fixation due to humeral diaphyseal nonunions was conducted. Union rates, union times, and functional outcomes of the patients were assessed. There was no significant difference between single-plate and double-plate fixation in terms of union rates or union times. The double-plate fixation group achieved significantly better functional outcomes. Nerve damage or surgical site infection were not encountered in either group.Due to its considerable effect on stability, double-plate fixation, offers both patients and surgeons confidence in terms of early adaptation to daily life in the postoperative period.Öğe The Effects of Surgical Timing on Treatment Outcomes in Carpal Tunnel Syndrome(Galenos Publ House, 2022) Durgut, Fatih; Sahin, Erdem; Akar, Mehmet Sait; Ozdemir, Ali; Yigit, SeyhmusObjective: The purpose of this study is to assess and compare outcomes of two different timing surgery for moderately carpal tunnel syndrome (CTS).Methods: Eighty-eight patients who underwent early and late due to CTS were evaluated retrospectively. Patients with early surgery and late surgery were divided into two groups. Preoperative and postoperative visual analog scale (VAS) score and postoperative Boston Carpal Tunnel Questionnaire (BCTQ) scores of both groups were compared.Results: Preoperative and postoperative VAS scores were compared, there was a significant decrease in both groups. When BCTQ results of both groups were compared, the results of patients who underwent early surgery were statistically better.Conclusion: In conclusion, we think that early surgery is better clinically in patients with moderately CTS.Öğe How understandable are the patient education materials about flat foot on the Internet for parents?(Lippincott Williams & Wilkins, 2023) Ciftci, Sadettin; Sahin, Erdem; Aktas, Suha Ahmet; Safali, Selim; Durgut, Fatih; Aydin, Bahattin KeremFlat foot is a common reason for parents to visit orthopedic clinics. As the Internet has become an easy-search platform, parents often seek online educational materials before seeking out a professional. The aim of this study was to investigate the quality, readability, and understandability of such online materials for parents. An Internet search was performed for flat foot and pes planus using the Google search engine. The readability was evaluated using 6 different grading systems: Flesch Reading Ease Score, Flesch-Kincaid Grade Level, Simple Measure of Gobbledygook, Fry Readability score, Gunning Fog Index tests, and Automated Readability Index. The Patient Education Materials Assessment Tool test was used to assess the understandability. For quality assessment, the Journal of American Medical Association benchmark criteria and Health on the Net code were applied. One hundred nine websites were included and evaluated for readability, understandability, and quality. The mean readability grade for all websites was 10.5 +/- 2.0. The mean Gunning Fog Index tests and Flesch-Kincaid Grade Level scores for all websites were 12.4 +/- 2.2 and 9.7 +/- 2.1 sequentially. The mean Coleman-Liau index score was 10.0 +/- 1.5, and the average Fry Readability score was 9.9 +/- 2.0. The automated readability index for all websites was 10.3 +/- 2.5. The average Flesch Reading Ease score for all educational materials was 59.3 +/- 10.1. The average Patient Education Materials Assessment Tool score for all educational materials was 81% (range, 70-87%). The mean Journal of American Medical Association benchmark criterion for all websites was 1.0, with a range from 1.0 and 2.0. Eighteen (16.5%) websites had Health on the Net certificates. Readability, understandability, and quality of patient education materials about flat feet on the Internet vary and are often worse than professional recommendations.Öğe Outcomes of lumbosacral fixation in patients with suicidal jumper's fractures: A retrospective study from a single center in Turkey(International Scientific Information, Inc., 2023) Atiç, Ramazan; Alemdar, Celil; Ulus, Sait Anıl; Yazar, Cihan; Durgut, Fatih; Sayar, Şafak; Aydın, AbdulkadirBackground: Suicide attempts that involve jumping from a great height may not be fatal but can result in lumbosacral facture-dislocations. This retrospective study aimed to present the experience from a single center in Turkey of 21 patients with lumbosacral facture-dislocations, or suicidal jumper fractures, treated with lumbosacral fixation between 2015 and 2022. Material/Methods: The study included 21 patients. The diagnosis was established through X-ray and computed tomography (CT) examinations. Neurological damage was assessed using the Gibbons score. Among the patients, 2 were classified as Roy-Camille type 1, 12 as Roy-Camille type 2, and 7 as Roy-Camille type 3. Morphologically, 8 patients had H-type fractures, 7 had T-type fractures, and 6 had U-type fractures. Bilateral spinopelvic fixation was performed. Functional outcomes were evaluated using the Majeed score. Results: The average Injury Severity Score (ISS) was 31.6±12.2. The mean duration of surgery was 123.6±44.9 minutes. According to the Majeed score, excellent results were observed in 8 individuals (40%), good results in 5 individuals (25%), fair results in 5 individuals (25%), and poor results in 2 individuals (10%). Out of 18 patients with neurological deficits, 14 showed improvement after surgery, while 4 continued to experience deficits. Conclusions: The findings from this study highlight the importance of obtaining a clear history of the cause of lumbosacral facture-dislocation, as attempted suicide by jumping from a height can cause specific types of injury to the lumbar spine and sacrum that require rapid diagnosis and management to reduce the incidence of permanent paraplegia.Öğe Pott's disease associated with bilateral psoas abscess: a case report on surgical management using anterior approach(Pakistan Medical Association, 2022) Durgut, Fatih; Güleç, Ali; Eravsar, Ebubekir; Odabaşı, EgemenPott's disease may accompany psoas abscesses, but bilateral psoas abscess is rarely encountered. Computerised Tomography (CT) is the gold standard for the diagnosis of psoas abscesses. Treatment of psoas abscess usually involves drainage of abscess and antibiotic therapy. CT and USG-guided catheters are often utilised for abscess drainage. In cases where neurological symptoms are observed, open surgery may be required. Pott's disease accompanied by bilateral psoas abscess was detected in a 21-year-old male patient who was admitted to the clinic with complaints of low back pain and weakness in his left leg at the Selcuk University, Turkey, in 2018. The reason for the development of neurological deficit only on the left side was the compression of the nerve roots by the abscess tissue. The patient underwent debridement and anterior instrumentation with an anterior approach. In the postoperative follow-up it was observed that the patient's complaints were relieved. Pott's disease with bilateral psoas abscesses, in which debridement and instrumentation with an anterior approach is applied, has not been previously reported in the literature, and the current case is a first in this respect.Öğe Proximal femoral nail antirotation versus cemented calcar-replacement hemiarthroplasty for unstable intertrochanteric fracture in elderly: an overall survival study(TÜBİTAK, 2022) Durgut, Fatih; Şahin, Erdem; Çiftçi, Sadettin; Aydın, Bahattin KeremBackground/aim: The aim of this study is to compare the perioperative complications and overall survival of patients who underwent proximal femoral nail antirotation (PFNA) and patients who underwent cemented calcar-replacement hemiarthroplasty (CCRH) for unstable intertrochanteric fracture in patients aged 75 years and older. Materials and methods: A total of 94 patients who underwent PFNA or CCRH between 2010 and 2012 because of femur fracture (A2.2 and A2.3 according to the Arbeitsgemeinschaft für Osteosynthesefragen/Orthopaedic Trauma Association (AO/OTA) classification) were analyzed retrospectively. Hospitalization times, blood transfusion needs, reoperation rates, and overall survival were compared. Results: Forty-eight patients in the PFNA group and 46 patients in the CCRH group were included for analysis. There was no statistically significant difference between the two groups in terms of hospitalization times, blood transfusion needs, reoperation rates, and survival rates. Conclusions: Both PFNA and CCRH techniques can be used for surgical treatment of unstable intertrochanteric femur fractures.Öğe A technical trick for extracting a stingray spine from hand: a case report(Türk Ortopedi ve Travmatoloji Derneği, 2022) Akar, Mehmet Sait; Ulus, Sait Anıl; Durgut, Fatih; Yiğit, ŞeyhmusInjuries from stingray fish are among the most common fish stings, and their frequency is increasing with the increase in global tourism. It most commonly causes injuries to the extremities and causes morbidity if not treated appropriately. Less commonly, life-threatening injuries can be observed due to injuries in the thorax and abdomen and damage to large vessels and vital organs. In addition to severe pain, tissue necrosis, and secondary infection after injury, systemic symptoms may occur. Since these injuries can occur in both fresh and salt water, it is possible to encounter such a case at any time. Flat spines are sharp, with backward barbs or serrations that make them difficult to extract once they penetrate tissue. After first aid, surgical extraction of the stingray spine with minimal damage is essential in addition to local and systemic treatments. In the literature, there are studies on envenomation and other systemic findings after stingray spine injuries, but few publications are available on the stingray spine extracted technique after injury. This case report presents a new and helpful technique for stingray spine extraction.
