Yazar "Gem, Mehmet" seçeneğine göre listele

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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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    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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    Candida arthritis in a patient diagnosed with spondyloarthritis
    (Sociedade Brasileira de Medicina Tropical, 2016) Çevik, Remzi; Tekin, Recep; Gem, Mehmet
    Candida arthritis is an unusual manifestation that usually affects the knees. A 35-year-old man presented with a 2-month history of pain and swelling in the right knee. Swelling persisted after anti-inflammatory treatment. Peripheric spondyloarthritis was considered, but methotrexate, sulfasalazine, and methylprednisolone did not reduce the swelling. Direct examination of synovial fluid and a culture were positive for Candida albicans. Intravenous and intra-articular amphotericin-B were administered. The arthritis regressed and a culture and direct staining showed negative results. Candida arthritis should be considered in patients with arthritis that is resistant to treatment and prolonged, even if risk factors are absent.
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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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    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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    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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    A comparison of proximal femoral locking plate versus 95-degree angled blade plate in the treatment of reverse intertrochanteric fractures
    (Turkish Joint Diseases Foundation, 2014) Azboy, Ibrahim; Demirtas, Abdullah; Gem, Mehmet; Cakir, Idris Ahmet; Tutak, Yilmaz
    Objectives: This study aims to compare the results of the proximal femoral locking plate (PFLP) and the 95-angled blade plate in the treatment of AO/OTA 31-A3 reverse intertrochanteric fractures with fracture line extending to the greater trochanter. Patients and methods: Forty-four patients with reverse intertrochanteric fracture which fracture line extending to the greater trochanter were retrospectively analyzed. Of those, 20 were treated with PFLP (PFLP group) and 24 were treated with ABP (ABP group). The AO/OTA classification was used for the classification of the fractures. Patients were assessed clinically and radiologically for the union at the fracture site and implant-related complications. Hip functions were evaluated with the Harris hip score. Results: The mean time to union was 17 weeks (range 14-28) and 18 weeks (range 16-32) in the PFLP group and ABP group, respectively. Implant failure and/or nonunion was observed in two patients (10%) in the PFLP group and in three patients (12%) in the ABP group. There was no statistically significant difference between the groups with regard to the Harris hip scores, time to union, need for reoperation due to mechanical problems, and complication rates (p > 0.05). Conclusion: Our study results show that these two fixation methods seem to produce similar results in the treatment of reverse intertrochanteric fractures with greater trochanteric comminution. However, we suggest that ABP still remains as a good choice with less expense in such fractures.
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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 effect of local microvibration and pulsed electromagnetic field application on bone fracture
    (Wiley-Blackwell, 2015) Bilgin, Hakki Murat; Celik, Ferhat; Akpolat, Veysi; Yildiz, Ismail; Ekinci, Aysun; Gem, Mehmet
    [Abstract Not Available]
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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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    Demographic and clinical characteristics of traumatic shoulder dislocations in an urban city of Turkey: a retrospective analysis of 208 cases
    (Turkish Assoc Orthopaedics Traumatology, 2013) Tas, Mahmut; Canbora, M. Kerem; Kose, Ozkan; Egerci, Omer Faruk; Gem, Mehmet
    Objective: The aim of this study was to investigate the demographic and clinical characteristics of traumatic shoulder dislocations in an urban city of Turkey. Methods: The digital patient database was reviewed to identify all patients with glenohumeral dislocation of the shoulder admitted to the emergency departments of the two hospitals in Diyarbakir between January 2008 and December 2010. Incidence, demographics, clinical characteristics, recurrence, associated injuries, and mechanism of injury were evaluated. Results: Two hundred and eight patients (163 male, 45 female; mean age: 37.2+/-21.3) experienced traumatic shoulder dislocation during the study period. The overall incidence of primary shoulder dislocations was 5.3 per 100,000 person-years. Age distribution peaked between 21 and 30 years (96.5% male) and between 61 and 70 years (66.7% female) Primary shoulder dislocation occurred in 172 patients (82.7%) and recurrent dislocations in 36 (17.3%). Patients with recurrent shoulder dislocations were younger than those with primary dislocations (mean age, 29.7+/-14.5 and 38.8+/-22.2, respectively; p=0.020). There were 195 (93.4%) anterior dislocations. The mechanism of injury was falls in 155 (74.5%) cases. Reduction was achieved in 165 patients (79.3%) in the emergency department. General anesthesia was used for 43 patients (20.7%). Conclusion: The 5.3 per 100,000 person-years incidence of traumatic shoulder dislocations in Turkey was much lower than previous studies. Demographic characteristics also showed various differences closely related to the population pyramid.
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    Depression, Social Phobia and Quality of Life after Major Lower Limb Amputation
    (2020) Şahin, İlhami; Gem, Mehmet; Demirtaş, Abdullah; Özkul, Emin; Azboy, İbrahim; Tutak, Yılmaz; Adıyeke, Levent
    Introduction: In this study, we aimed to compare the social phobia, depression and quality of life in patients with major lower limb amputation to non-amputated.Methods: Patients who were underwent above or below the knee amputation in the past were evaluated retrospectively by examining the hospital records. All the participants were administered Liebowitz Social Anxiety Scale (LSAS), Hospital Anxiety and Depression Scale (HADS), and Short-Form 36 (SF-36).Results: The number of patients was 30 (21 males, nine females) in the amputated group and 30 (22 males, eight females) in the control group. The mean age was 41.8±14.09 years in the amputated group and 43.3±18.68 years in the control group. All LSAS and HADS scores were higher, and SF-36 scores were lower in the amputation group compared to the control group (p<0.05). The patients who were amputated more than five years ago had higher LSAS social fear scores, and lower HAD depression scores compared to patients less than five years (p=0.035, p=0.024, respectively). The employed patients had lower HAD depression and HAD total scores compared to unemployed patients (p=0.008, p=0,049, respectively). The patients amputated due to medical complications had higher scores in anxiety compared to the patients with traumatic amputation (p=0.005, p=0.016, respectively).Discussion and Conclusion: Social phobia, depression and poor quality of life are common problems in patients with major lower limb amputation. After five years, it should not be forgotten that social phobia will increase; depression will decrease along with its seriousness. Therefore, amputated patients should be psychiatrically counseled and treated. It is important to provide permanent employment opportunities to improve the quality of life.
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    The differences between cases with primary and recurrent shoulder dislocation: A tertiary center study
    (Dicle Üniversitesi Tıp Fakültesi, 2021) Yeşil, Ahmet; İçer, Mustafa; Güloğlu, Cahfer; Gem, Mehmet
    Objective: The aim of this study is to compare demographic and clinical characteristics of cases with primary and recurrent shoulder dislocations. Methods: Cases who presented to a tertiary center Emergency Medicine Clinic with shoulder dislocation between January 2013 and December 2016 were evaluated.The cases were divided into two groups as primary (Group 1) and recurrent (Group 2) dislocations.Characteristics such as age, gender, seasonal period, dislocation side, causes of trauma, accompanying additional injuries and treatment modalities were compared between the groups. Results: 119 cases were included in the study. 64.7% (n=77) of the cases were classified as Group 1, and 35.3% (n=42) as Group 2. There was no difference between Group 1 and Group 2 in terms of age, gender and dislocation side (P values: 0.484, 0.570, 0.251, respectively). Inferior dislocations were more common in Group 1 (n=7/77) compared to Group 2 (n=1/42), and a statistically significant difference was found (p=0.009). Group 2 cases (n=19/42) were found to be more common in the spring than group 1 (n=17/77) (p=0.012). Additional injuries were detected in 8.4% of the cases (n=10/119), 8 of them were in group 1 and 2 of them were in group 2, and there was no statistically significant difference between the groups in terms of additional injury (p=0.491). 11.8% (n=14) of the cases were hospitalized by orthopedics for surgery (open reduction) or closed reduction under general anesthesia. Surgical treatment (open reduction) was applied in 23.8% (n=10/42) in Group 2, and 5.2% (n=4/77) in Group 1, and a statistically significant difference was found between the groups ( p= 0.005). Conclusion: It was found that surgical treatment was preferred more frequently on recurrent dislocations compared to primary dislocations. Therefore, we recommend that cases with a history of primary dislocation should take precautions for trauma during active periods of social life.
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    Effect of 4 Hz and multifrequency pulsed electromagnetic field (PEMF) on bone fracture healing
    (Taylor & Francis Ltd, 2024) Akdag, Mehmet Zulkuf; Dasdag, Suleyman; Gelir, Ali; Akdag, Mahmut Berat; Gem, Mehmet; Baksi, Nazan; Akpinar, Fuat
    Pulsed electromagnetic fields (PEMF) have been used in bone fracture healing for many years. However, it is still not clear which frequencies are more effective. Therefore, the aim of this study was to investigate the effect of single frequency of 4 Hz and a package of multiple frequencies (220 Hz, 727 Hz, 880 Hz and 10 kHz) on bone fractures of rats. Rats were randomly divided into three groups: sham, R4 and RM. A transverse osteotomy was created in the right medial tibias diaphysis of each rat under anesthesia. The right tibia of the rats in the R4 and RM groups was exposed to 4 Hz, and a package of multiple frequencies, respectively. The rats in both irradiation groups were exposed to a pulsed magnetic field with an amplitude of 10 mT for 1 h/day during 1 month under anesthesia with ketamine (90 mg/kg, i.p.) and xylazine hydrochloride (9 mg/kg, i.p.). The rats in the sham group were kept under the same experimental conditions without any field exposure. At the end of the study, the right tibia of each rat was removed and bone healing was evaluated histopathologically and radiologically, and the concentrations of some elements were measured, such as Na, Mg, K, Cr, Mn, Fe, Zn, Se, Ca and P. The results showed that 4 Hz exposure was more effective in bone fracture healing than the other frequencies in this study. Further studies need to be conducted to determine the mechanisms underlying the effect of 4 Hz PEMF.
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    Effect of graft application and nebivolol treatment on tibial bone defect in rats
    (Sci Printers & Publ INC, 2021) Gem, Mehmet; Şahin, İlhami; Uzel, Kadir; Ermiş, Işılay Sezen; Deveci, Engin
    OBJECTIVE: To evaluate the results of the effect of nebivolol on tibial bone defect and graft application in new bone development in the rat. STUDY DESIGN: Thirty Wistar albino rats were divided into 3 groups. In the Control group, tibia bone defect was created without any treatment. In the Defect+ Graft group, allograft treatment was performed by forming a 6 mm tibial bone defect. In the Defect+ Graft+ Nebivolol group, alloplastic bone graft was placed in the calvarial bone defect and then nebivolol (0.34 mg/mL solution/day) treatment was intraperitoneally applied for 28 days. RESULTS: Histopathological examination revealed inflammation in the defect area, congestion in the vessels, degeneration in collagen fibers, and an increase in osteoclast cells. There was an increase in inflammation and blood vessel structure in graft application, and osteoblastic activity matrix formation after reorganization nebivolol application in collagen fibers. Osteonectin expression was positive in the collagen fiber and matrix, starting in the Graft group, in osteoblasts, whereas in the Nebivolol group, osteoblasts increased in osteocytes and new bone formation. CONCLUSION: Nebivolol is thought to have a positive effect on osteoinductive bone growth factors and contribute to the cell-matrix interaction, in addition to the supporting effect of the graft with its antioxidative effect.
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    The effect of low magnitude high frequency vibration on bone healing by clamp method in nonunion tibial fractures
    (Dicle Üniversitesi Tıp Fakültesi, 2022) Çelik, Ferhat; Bilgin, Hakkı Murat; Akkoç, Hasan; Özkul, Emin; Gem, Mehmet; Özerdem, Mehmet Siraç; Karıksız, Mesut; Erdem, Mustafa; Elçi, Serhat
    Introduction: This study aimed to investigate the clinical effect of Low Magnitude High Frequency Vibration (LMHFV) on nonunion tibial fractures, noninvasively. Methods: The Experimental (n=5) and control (n=5) groups were age-matched and pooled based on the Nonunion Tibia Score System (NUSS) (p>0.05). LMHFV (0.35g, 50 Hz, 20 minutes x 4/day) was applied to the experimental group for three months by a mechanical stimulator that we developed using a ‘clamp method’. The control group was followed during three months without any application other than routine treatment. The results were evaluated using the Radiographic Union Score for Tibial Fractures (RUST) and American Orthopedics Foot and Ankle Score (AOFAS). No statistically significant difference was observed between the groups at the beginning and in the end of the 3- month application for RUST and AOFAS scores (p>0.05). Results: Pain and function assessment, at the beginning and end of the study, as a part of The AOFAS scorewere not statistically different (p>0.05) in the control group. However, increases in pain and function AOFAS scores were statistically significant in the experimental group at the end of the 3- month application (p<0.034 and p<0.043, respectively). Conclusion: In this study, LMHFV contributed to the pain and function parameters of AOFAS in the experimental group; however, there was no significant difference between the groups in terms of total RUST and AOFAS scores.
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    Effects of local vibration and pulsed electromagnetic field on bone fracture: A comparative study
    (Wiley, 2017) Bilgin, Hakkı Murat; Çelik, Ferhat; Gem, Mehmet; Akpolat, Veysi; Yıldız, İsmail; Ekinci, Aysun; Özerdem, Mehmet Siraç; Tunik, Selçuk; 0000-0002-6040-9989; 0000-0003-2585-9981; 0000-0002-2435-7800; 0000-0002-0547-4139; 0000-0001-5505-838X; 0000-0002-9368-8902; 0000-0002-0549-8472
    The effectiveness of various therapeutic methods on bone fracture has been demonstrated in several studies. In the present study, we tried to evaluate the effect of local low-magnitude, high-frequency vibration (LMHFV) on rat tibia fracture in comparison with pulsed electromagnetic fields (PEMF) during the healing process. Mid-diaphysis tibiae fractures were induced in 30 Sprague-Dawley rats. The rats were assigned into groups such as control (CONT), LMHFV (15 min/day, 7 days/week), and PEMF (3.5 h/day, 7 days/week) for a three-week treatment. Nothing was applied to control group. Radiographs, serum osteocalcin levels, and stereological bone analyses of the three groups were compared. The X-rays of tibiae were taken 21 days after the end of the healing process. PEMF and LMHFV groups had more callus formation when compared to CONT group; however, the difference was not statistically significant (P = 0.375). Serum osteocalcin levels were elevated in the experimental groups compared to CONT (P <= 0.001). Stereological tests also showed higher osteogenic results in experimental groups, especially in LMHFV group. The results of the present study suggest that application of direct local LMHFV on fracture has promoted bone formation, showing great potential in improving fracture outcome. (C) 2017 Wiley Periodicals, Inc.
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    Evaluation of serum interleukin-38 levels in different radiographic grades of idiopathic knee osteoarthritis
    (Mary Ann Liebert, INC, 2021) Duman, Baver Akcan; Duman, Serda; Çamurcu, Yalkın; Gem, Mehmet; Erdinç, Levent
    The aim of this study was to assess interleukin-1 beta (IL-1 beta), IL-1Ra, IL-36, and IL-38 levels together with hs-CRP levels in patients with different radiographic grades of knee osteoarthritis (OA) in comparison to healthy individuals. Consecutive patients aged over 50 years who were admitted to our Orthopaedics and Traumatology department between November 2018 and March 2019 and diagnosed as knee OA according to the American College of Rheumatology criteria were included in this prospective case-control study. Patients with knee OA were staged according to radiographic Kellgren-Lawrence (K-L) classification and 20 patients were assigned to each group. An age and gender matched control group consisted healthy volunteers with no clinical and radiographic sign of arthritis were conducted as the control group. Venous blood samples were collected and assessed for hs-CRP, IL-1 beta, IL-1Ra, IL-36, and IL-38 levels using the double-antibody sandwich ELISA method. The hs-CRP, IL-1 beta, IL-36 and IL-38 levels did not significantly differ among controls and independent radiographic stage groups except IL-1Ra levels which was significantly higher in K-L grade 4 knee OA groups compared to healthy controls (P = 0.045). When we compared all patients with knee OA and healthy controls, we detected that IL-1 and IL-1Ra were significantly lower and IL-38 levels were significantly higher in healthy control group compared to patients with knee OA (P = < 0.001, < 0.001, and 0.019, respectively). According to results obtained from our study, IL-1 beta, IL-1Ra, and IL-38 levels significantly differed between healthy individuals and patients with knee OA. However, we did not observe a significant difference and correlation between radiographic grade of knee OA and interleukin levels.
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    EVALUATION OF SERUM LEVELS OF OSTEOPONTIN AND BONE SIALOPROTEIN IN FEMALE PATIENTS WITH TENDINOPATHY
    (Derman Medical Publ, 2017) Hira, Serdar; Tamam, Cuneyt; Demirpek, Ugur; Gem, Mehmet
    Aim: The pathogenesis of tendinopathy remains unclear. Small integrin-binding ligand N-linked glycoproteins (SIBLING), a family of non-collagenous proteins including osteopontin (OPN) and bone sialoprotein (BSP), were initially thought to be limited to mineralized tissue, but recent studies have reported that they are more widely distributed and are expressed in non-mineralized tissues. The aim of this study was to investigate relationships between serum OPN and BSP levels and tendinopathy disease. Material and Method: 39 female tendinopathy patients and 39 female healthy volunteers were recruited for this prospective observational study. Serum OPN and BSP levels were measured using enzyme-linked immunosorbent assay. We also measured body mass index and erythrocyte sedimentation rate (ESR), white blood cells (WBC), and neutrophil-lymphocyte ratio (NLR). Results: There were no significant differences in serum BSP levels between the two groups (41.83 +/- 52.03 vs. 53.64 +/- 53.06 ng/mL, p=0.276). There were also no significant differences in serum OPN levels between the two groups (57.37 +/- 21.61 vs. 77.72 +/- 72.14 ng/mL, p=0.363). There were no significant differences in WBC, NLR, and ESR values between the two groups (p=0.897, p=0.795, p=0.405, respectively). There was no correlation between serum BSP levels and OPN, WBC, NLR, and ESR levels in the patient group. Patients with tendinopathy had a negative correlation between serum OPN levels and NLR levels. Discussion: The results of this study have indicated that BSP and OPN levels are not involved in the pathogenesis of tendinopathy.