Yazar "Kapukaya, A" seçeneğine göre listele

Listeleniyor 1 - 16 / 16
  • [ X ]
    Öğe
    Anthropometric study of patients treated for clubfoot
    (Lippincott Williams & Wilkins, 2003) Kesemenli, CC; Kapukaya, A; Subasi, M; Necmioglu, S; Arslan, H; Ozbag, D; Çelik, Y
    The anthropometric characteristics of patients treated for clubfoot were used to investigate whether the dimensions of the foot were affected by the method of treatment. A total of 68 patients followed up for an average of 9 years were divided into three groups: group 1, conservatively treated; group 2, surgically treated; group 3, conservatively treated on one side and surgically treated on the other. The following average discrepancies in foot length were obtained: group 1, 0.91 cm; group 2, 1.5 cm; group 3, 1.09 cm. Toe lengths were shorter to the same extent as the other dimensions of the foot. These discrepancies were statistically significant. The following average discrepancies in foot width were obtained: group 1, 0.05 cm; group 2, 0.37 cm; group 3, 0.054 cm; these were insignificant. The authors believe that the degree of discrepancy may depend not solely on the method, but on the severity of the deformity as well.
  • [ X ]
    Öğe
    Characteristics of traumatic spinal cord injuries in south-eastern Anatolia, Turkey: a comparative approach to 10 years' experience
    (Lippincott Williams & Wilkins, 2005) Gur, A; Kemaloglu, MS; Cevik, R; Sarac, AJ; Nas, K; Kapukaya, A; Sahin, H
    The purpose of this study was to determine the demographic and epidemiological characteristics of traumatic spinal cord-injured patients. The hospital records of 539 patients (416 men, 123 women) with spinal cord injuries (SCIs) admitted to four hospitals that were major referral centers for trauma in the south-eastern region of Turkey from 1990 to 1999 were reviewed retrospectively. The patients with SCI were investigated for two periods; the first period covered patients admitted between 1990 and 1994 during which time an influx of people from rural to urban areas occurred and firearm injuries were common. In the second period (1995-1999) the influx of people declined and firearm injuries were reduced. The most common causes of injuries were road traffic accidents (200, 37.12%), followed by falls (172, 31.90%) and bullet wounds (115, 21.34%). In the first period, incomplete paraplegia was encountered more often than in the second period (P < 0.001).
  • [ X ]
    Öğe
    Effect of chemotherapeutic agents on distraction osteogenesis - An experimental investigation in rabbits
    (Springer-Verlag, 2001) Subasi, M; Kapukaya, A; Kesemenli, C; Balci, TA; Buyukbayram, H; Ozates, M
    Limb-salvage operations such as vascularised or non-vascularised osseous grafts and allograft and callus distraction methods have replaced amputations because of the increase in the life expectancy of patients with malignant tumours. In this study we aimed to evaluate the effects of chemotherapeutic agents on distraction osteogenesis. For this purpose, 23 rabbits randomly divided into two groups were included in the study. The experimental group and the control group consisted of 12 rabbits and I I rabbits, respectively. The experimental group were administered chemotherapeutic agents with the protocol identified in the osteogenic sarcoma regimen. All the subjects were corticotomised in the metaphyseal-diaphyseal region, and both groups underwent distraction with a circular ring fixator. X-ray films, bone scintigraphy and histopathological examination were pet-formed three times during the study. No difference between the two groups was observed in radiological, scintigraphical and histopathological studies carried out before the distraction period and following the end of the distraction period. In this study, it was shown that the use of antineoplastic drugs has no significant negative effect on distraction osteogenesis applied for reconstruction in rabbits. We think that it can be an alternative treatment method in humans as well.
  • [ X ]
    Öğe
    Effect of granulocyte-macrophage colony-stimulating factor on treatment of acute osteomyelitis - An experimental investigation in rats
    (Springer-Verlag, 2001) Subasi, M; Kapukaya, A; Kesemenli, C; Kaya, H; Sari, I
    Granulocyte-macrophage colony-stimulating factor (GM-CSF) is a cytokine that affects the various developmental steps of hematopoietic cells and enhances the phagocytic activity of these cells. The effect of GM-CSF on acute osteomyelitis, developed in rats, was investigated. For this purpose, osteomyelitis was firstly developed through the direct inoculation of Staphylococcus aureus into rat tibial metaphysis. Twenty-four rats in which diagnosis of osteomyelitis was histopathologically established were divided into two groups. Antibiotic only was given to the first group, and antibiotic as well as CM-CSF to the second roup. Rats were followed up for 3 months with plain radiographs and scintigraphic methods using (67)Gacitrate. Material obtained from the rats that had been killed at the end of the 3rd month were histopathologicalIy investigated. One rat in the first group died. In another rat, chronic osteomyelitis developed and fracture was observed. In 12 rats of the second group, physical examination, plain radiographs, and histopathologic findings were normal. In scintigraphic studies with Ga-67-citrate, when the pre- and posttreatment values of the same groups were evaluated by the Mann-Whitney U-test, the mean values at 48 h after treatment were found to be significant (P < 0.05), indicating a decrease in the 2nd group (experimental group). In conclusion, the antibiotics were effective in the elimination of infection only together with neutrophils. In this manner, infections may be eliminated by strengthening the host's defense mechanism as well as by administering antibiotics. We believe that an adequate number of long-term studies will shed light on this issue. Besides we consider that this factor will be more important in the study of chronic osteomyelitis.
  • [ X ]
    Öğe
    Effect of neoadjuvant chemotherapy on distraction osteogenesis in the goat model
    (Lippincott Williams & Wilkins, 2004) Subasi, M; Kapukaya, A
    [Abstract Not Available]
  • [ X ]
    Öğe
    Floating knee in children
    (Lippincott Williams & Wilkins, 2003) Arslan, H; Kapukaya, A; Kesemenli, C; Subasi, M; Kayikçi, C
    The outcomes of 18 ipsilateral displaced femoral and tibial fractures in 17 children are assessed and a new classification system is proposed. Average age was 8.75 years, and follow-up averaged 3.2 years. In the modified Bohn and Durbin classification used, eight cases were type I, four were type 11, three were type IIIa, one was type IIIb, and two were type IV. In tibial fractures there was angulation in three cases, and in femoral fractures there were dislocation and angulation in four cases, refracture in one case, leg length discrepancy in four cases, and asymptomatic knee ligament injury and meniscal tearing in five cases. According to Yue et at's criteria, seven outcomes were excellent, eight were good, two were fair, and two were poor. The cases with poor outcomes were those with open knee injury, and those with fair outcomes were those with angulation. It was concluded that knee ligament injuries do not affect the outcome of floating knee trauma in children, although they do in adults, but that open knee injuries do affect the outcome, and operative treatment of the femoral fracture is the treatment of choice for all ages.
  • [ X ]
    Öğe
    Is external fixation in pediatric femoral fractures a risk factor for refracture?
    (Lippincott Williams & Wilkins, 2004) Kesemenli, CC; Subasi, M; Arslan, H; Tüzüner, T; Necmioglu, S; Kapukaya, A
    The aim of this study was to investigate whether external fixation is a risk factor for refracture by comparing the outcomes of children who received three different forms of treatment of femoral fractures. One hundred ninety-two patients treated for femoral fracture between 1990 and 1999 who underwent final examination were assessed. One hundred were treated with hip spica casting after traction, 57 with closed reduction and external fixation, and 35 with open reduction and external fixation. Morbidity results such as time to union, length of hospital stay, refracture, and wire site infection were statistically evaluated. Patients undergoing open reduction had a greater time to union and length of hospital stay and a higher refracture rate. The difference was statistically significant. Wire site infection occurred in all three groups; there was no statistically significant difference between groups. The authors concluded that external fixation is not a risk factor for refracture in the treatment of pediatric closed femoral diaphyseal fractures, and that it may be used with case in clinics with shortages of personnel and space.
  • [ X ]
    Öğe
    Limb reconstruction with the callus distraction method after bone tumor resection
    (Springer, 2000) Kapukaya, A; Subasi, M; Kandiya, E; Özates, M; Yilmaz, F
    The callus distraction method was applied to nine patients who were referred to us because of a bone tumor. Their mean age was 17 years and 3 months (range 7-37 years). Three were female, and 6 were male. All of the tumors were localised on the femur, and the histological diagnosis was two chondrosarcomas, one Ewing's sarcoma, three osteosarcomas, one giant cell bone tumor, and the remainder-benign fibrous histiocytoma. The mean length of the defect after resection of the tumor was 11.5 (range 8-20) cm. Preoperative and postoperative chemotherapy were applied to patients with osteosarcoma and Ewing's sarcoma. The patients were followed up for 22 (range 15-30) months on average. The mean period of use of the external fixator was 12.5 (range 8-18) months. One patient suffered a tumour recurrence and died after 20 months. Complications included one deep infection, one skin invagination, and one premature consolidation and bone bridge in the defect area. All of the complications were successfully treated. Functional evaluation gave excellent results in four patients, good in three, and fair in two. This method can be used without any need for massive autogenous bone graft in repairing defects of any length and diameter produced after excision of the lesion and thus can be considered as an alternative to other techniques.
  • [ X ]
    Öğe
    Non-reducible, open tibial plafond fractures treated with a circular external fixator (is the current classification sufficient for identifying fractures in this area?)
    (Elsevier Sci Ltd, 2005) Kapukaya, A; Subasi, M; Arslan, H; Tuzuner, T
    While some researchers advocate primary arthrodesis for the treatment of open, severely comminuted tibial plafond fractures, others argue that an external fixator is an alternative. In this study, we obtained intermediate clinical and radiological outcomes on treating such fractures with a circular external fixator. Twelve patients with non-reducible, open tibia( plafond fractures were treated with a circular external fixator and minimal osteo-synthesis. The fractures were grouped using a modification of the Ruedi and Allgower classification: eight, two, and two of the patients had Type III, IVA, and IVB fractures, respectively. The bone transport technique was applied in the patients with a Type IVB fracture. Four parameters were tracked in the patients: the reduction score of the joint surface, early complications, and the radiological and clinical findings of the ankle. The average follow-up period of the patients was 54.5 months. In the postoperative radiological examinations, the reduction score of the joint surface exceeded 15 in four patients and was 12-15 in eight patients. Type III and IVA fractures united with an average heating time of 4.25 months. Surface wound infection was observed in three patients. One patient each developed fibular osteomyelitis, claw toe, and 2 cm shortness. Among the patients with Type IVB fractures, nonunion and malunion in the newly forming callus was observed in one patient, and nonunion alone was observed in another patient. On the final check, both the clinical and radiological findings were poor for all of the patients, with a reduction score exceeding 15. High-energy and poor joint surface reduction scores are two important factors affecting both the clinical and radiological results. For the fractures with reduction scores below 15, it is particularly difficult to predict the clinical results. Therefore, we recommend that such fractures be treated with a circular external fixator and believe that arthrodesis in accordance with the patient's choice is a desirable treatment method. (c) 2005 Elsevier Ltd. All rights reserved.
  • [ X ]
    Öğe
    Problem fractures associated with gunshot wounds in children
    (Elsevier Sci Ltd, 2002) Arslan, H; Subasi, M; Kesemenli, C; Kapukaya, A; Necmioglu, S; Kayikçi, C
    Twenty-seven fractures in 22 children (14 female, 8 male; average age: 10.5) who suffered gunshot wounds were retrospectively evaluated. Fourteen of the fractures were caused by high-velocity weapons, four by low-velocity weapons, and nine by shotguns. One of the fractures was undisplaced, two were displaced, 10 were comminuted, seven were comminuted and displaced, and seven had bony defects. Accompanying pathologies included four physeal, three articular, four visceral, four arterial, six peripheral nerve, and one spinal cord injury. Initial treatment involved external fixation in 15 patients and internal fixation in one patient for bone stabilization, while the remaining patients were treated conservatively. Late-stage surgery was necessary to achieve soft-tissue coverage in three patients and to achieve union in six patients. Major complications included amputation in one patient, non-union in two, delayed union in one, osteomyelitis in one, paraplegia in one, and loss of peripheral nerve functions in three. The treatment of fractures associated with firearm injuries in children is never simple. Fracture defects, accompanying peripheral nerve damage and involvement of the joint negatively is affect the outcome, increasing the chance that late-stage surgery will be necessary. Internal bone transport appears to be an efficacious technique in the treatment of bone and soft-tissue defects associated with firearm injuries in children. (C) 2002 Elsevier Science Ltd. All rights reserved.
  • [ X ]
    Öğe
    Technique and complications of callus distraction in the treatment of bone tumors
    (Springer, 2006) Kapukaya, A; Subasi, M; Arslan, H; Tuzuner, T; Selek, S
    Introduction: This study investigated the effects of chemotherapy, defect length, and patient age on the outcome and complications of callus distraction as a limb salvage technique in 17 patients. Materials and methods: The mean patient age was 18.4 years (range 7-47). Of 17 patients, 8 received chemotherapy and the remaining 9 patients did not. The mean defect length after excision of the lesion was 13 cm (range 8-20). The mean follow-up period for the patients whose treatments were completed was 55 months (range 20-90), the mean distraction index was 12.55 days/cm (range 11-15.7), and the mean external fixation index was 34.73 days/cm (range 30-41). Results: In two patients, local recurrence occurred before distraction was completed. Two patients died, and one of them was a patient in whom local recurrence had occurred. Complications included non-union in one patient, osteomyelitis in one patient, and premature callus, osseous bridge, and varus of the femur in one patient. The extremity functional score was 80% (range 26-100). Chemotherapy and defect length had no significant effect on the distraction or external fixation indices. In contrast, the increase in the external fixation index in those over 20 years old was significant (P=0.043). Conclusion: We found that chemotherapy and defect length have no significant effect on the outcome and complications with this technique, which was more successful in patients younger than 20 years.
  • [ X ]
    Öğe
    Treatment of closed femoral diaphyseal fractures with external fixators in children
    (Springer Verlag, 1998) Kapukaya, A; Subasi, M; Necmioglu, S; Arslan, H; Kesemenli, C; Yildirim, K
    From August 1992 to July 1996, 57 patients with closed femoral fractures were treated by external fixator in the Orthopaedic and Traumatology Clinics, School of Medicine, Dicle University. The technique was applied to children with closed femoral fractures. Their mean age was 6 (range 4-12) years old. The mean hospitalisation period was 8 (range 5-15) days. Fixators were removed on an average of 55 (range 38-79) days. The mean follow-up period was 18 (range 9-36) months. Pintract infection was observed in 3 and refracture in 1 patient. Infection was controlled with oral antibiotics and local dressing;. An external fixator was applied to a patient in whom refracture developed. No patient had malunion, nonunion, or leg length discrepancy. We propose that external fixation in closed femoral shaft fractures of children could be a rational alternative mode of therapy, since it has some advantages and can be easily removed without undergoing a second round of anaesthesia.
  • [ X ]
    Öğe
    Treatment of multifragmentary fractures of the femur by indirect reduction (biological) and plate fixation
    (Elsevier Sci Ltd, 2002) Kesemenli, C; Subasi, M; Necmioglu, S; Kapukaya, A
    We present a retrospective review of the results of 43 multifragmentary femur fractures treated under the principle of indirect reduction (biological) and plate fixation. Fractures were caused by high-energy trauma in all patients. Sixteen were subtrochanteric, 14 diaphyseal and 13 supracondylar. There were 13 open fractures. In six of the patients with diaphyseal fractures, a plate wits inserted through isolated proximal and distal incisions only, deep to the vastus lateralis. None of the fractures was treated with bone graft. The mean follow-up time was 28.3 months. Union was achieved in 41 patients within a mean period of 4.25 months. There was delayed union in one patient (subtrochanteric), non-union ill two, infection in three, malunion in three, leg shortening in six and mild knee stiffness in seven. In eight patients with diaphyseal fractures in whom a single incision was performed, the average time for fracture healing was 4.14 months ill seven and non-union developed in one. In six patients with diaphyseal fractures, in whom proximal and distal incisions were performed, the average time for fracture healing was 4 months. There was no difference (P > 0.05) between single and double incision with reference to infection and time to union, but the indirect reduction methods must be meticulously implemented. The implants we used are cheaper and more easily Supplied than many others. The Success rate is high when the technique is correctly implemented. We believe that this is a treatment of choice ill Countries with low socioeconomic status, no efficient health insurance system and no intraoperative image intensification. (C) 2002 Elsevier Science Ltd. All rights reserved.
  • [ X ]
    Öğe
    Treatment options in pediatric femoral shaft fractures
    (Lippincott Williams & Wilkins, 2006) Subasi, M; Kapukaya, A
    [Abstract Not Available]
  • [ X ]
    Öğe
    Tuberculosis of the metacarpals and phalanges of the hand
    (Lippincott Williams & Wilkins, 2004) Subasi, M; Bukte, Y; Kapukaya, A; Gurkan, F
    Skeletal tuberculosis (TB) is less common than the pulmonary form. Involvements of the metacarpals and phalanges of the hand are infrequent. The authors report their experience with treatment and outcome of TB of the metacarpals and phalanges of the hand in 7 patients. There were 4 women and 3 men in the study who ranged in age from 3 to 60 years (average age, 22.7 years). The duration of complaints at presentation ranged from 4 to 17 months (average, 9 months). The most common presentation was pain and swelling. The presumptive preoperative diagnoses were bone tumor in 4 patients, spina ventosa in 2, and chronic pyogenic osteomyelitis in 1 patients. The results of the laboratory examination showed a mild increase in the erythrocyte sedimentation rate. No patient had an active tubercular lesion or history of pulmonary disease. The diagnosis was based on the clinical picture and radiographic features, and was confirmed by open biopsy. No patient had bony debridement or arthrodesis to control the infection. The treatment of all patients began with a 4-drug regimen for 2 months, followed by a 2-drug regimen for 10 months. The mean follow-up was 30.28 months (range, 16-52 months). At the time of the last follow-up, all lesions had heated with no recurrence. The functional results were satisfactory in all patients. One patient with thumb metacarpophalangeal TB had joint irregularity and thumb metacarpal shortening. Arthrodesis was not needed in any patient. TB of the metacarpals and phalanges of the hand can be difficult to diagnose during the early stages. TB should be suspected in cases of long-standing pain and swelling in the metacarpals and phalanges. It is necessary to keep TB in mind when making the differential diagnosis of several osseous pathologies.
  • [ X ]
    Öğe
    Tuberculosis of the shoulder joint
    (Elsevier France-Editions Scientifiques Medicales Elsevier, 2006) Kapukaya, A; Subasi, M; Bukte, Y; Gur, A; Tuzuner, T; Kilnc, N
    Objectives. - Skeletal tuberculosis is less common than the pulmonary form. The involvement of the shoulder joint is infrequent. We report our experience treating tuberculosis of the shoulder in 11 patients. Methods. - There were seven men and four women, ranging in age from 19 to 55 years (average 28.09 years). The duration of their complaints at presentation ranged from 3 to 24 months. The most common presentation was pain, which was seen in 10 joints. All of the patients had mild to moderate restriction of motion of the shoulder. On laboratory examination, the erythrocyte sedimentation rate was increased mildly. No patient had an active tuberculosis lesion or history of pulmonary disease. The diagnosis was based on the clinical picture and radiographic features, and was confirmed by open biopsy. The diagnosis was not confirmed by biopsy in one patient, but the family history and clinical and radiological features were highly suggestive of tuberculosis. Surgical debridement was done in two patients and open biopsy in eight patients in order to obtain samples for pathology. Arthrodesis was done in only one patient. In all patients, treatment began with a four-drug regimen for 2 months, followed by a two-drug regimen for 10 months. Results. -The mean follow-up period after the end of treatment was 28.72 months (range, 22-52 months). At the time of the last visit, all the lesions had healed without recurrence. Five cases had a painless, mobile shoulder, while three had mildly restricted shoulder motion without pain, and three had residual limitation of motion of the affected shoulder. Conclusions. - Tuberculosis of the shoulder can be difficult to diagnose in the early stages. If not diagnosed early, bony tuberculosis may reduce the quality of life. Therefore, tuberculosis should be suspected in cases of long-standing pain in the shoulder. It is necessary to keep tuberculosis in the differential diagnosis of several osseous pathologies. Arthrodesis should be reserved only for lesions that fail to heal after adequate chemotherapy and rehabilitation. (c) 2005 Elsevier SAS. All rights reserved.