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    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 Ali
    Objectives: 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.
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    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 Ali
    We 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.
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    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, Fatih
    Aim: 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.
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    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 Ali
    In 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.