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Öğe Acute tibial tubercle avulsion fractures(Lippincott Williams & Wilkins, 2004) Subasi, M[Abstract Not Available]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, YThe 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.Öğe Child pedestrian fatalities in Diyarbakir, Turkey(Saudi Med J, 2005) Goren, S; Subasi, M; Gurkan, F; Tirasci, Y; Acar, KObjective: As there is an increase in modernization, transportation, unskilled, and drunk drivers, injuries from traffic accidents have taken on an epidemic form all over the world. The present study aims to describe the demographic data of childhood pedestrian fatalities in a large urban area in Turkey. Methods: The demographic data of childhood pedestrian fatalities in a large urban area in Turkey was described retrospectively, with respect to age, gender, injury pattern and location. Cases less than 16 years of age were collected retrospectively from the files of the Branch of the Council of Forensic Medicine in Diyarbakir between 1998 and 2003. Results: There were 232 childhood pedestrian fatalities among a total of 267 children involved in lethal traffic accidents. The mean age of the victims was 7.2 years, most of them being in the 6-10 years of age group (49.1%). Male predominated among our victims (76.3%). With regard to injury location, the most common site was the head (73.7%). There was an increase in pedestrian fatalities in the summer season (33.6%). There was no difference in rates of pedestrian deaths between years. Conclusion: Child pedestrian deaths have constituted a significant percentage of all child fatalities due to traffic accidents in our region. There were 6.4 deaths per 100,000 populations, and this rate was also higher than in other populations.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, MLimb-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.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, IGranulocyte-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.Öğe Effect of neoadjuvant chemotherapy on distraction osteogenesis in the goat model(Lippincott Williams & Wilkins, 2004) Subasi, M; Kapukaya, A[Abstract Not Available]Öğe The effects of electromagnetic field on distraction osteogenesis(Yonsei Univ Coll Medicine, 2003) Kesemenli, CC; Subasi, M; Kaya, H; Sert, C; Büyükbayram, H; Arslan, H; Necmioglu, SThe effects of electromagnetic field on distraction osteogenesis and new bony tissue were investigated. Twenty-five New Zealand rabbits were divided into an experimental (12 rabbits) and a control (13 rabbits) group. An osteotomy was performed on the right tibia in the diaphyseal region in both groups. The experimental group was exposed to a magnetic field of 50 Hz 1.0 mT for 3 hours a day for 13 weeks. The control group was kept in a similar environment but with no electromagnetic field. The distraction was continued until an increase of 10 mm was achieved. At weeks 4, 8, and 13, radiography, scintigraphy, and a biopsy were performed in both groups, and the results were statistically analyzed. The X-ray results were similar in both groups at all times. On the other hand while the scintigraphic and histopathological results were similar at weeks 4 and 13 in both groups, the osteoblastic activity was significantly greater in the experimental group at week 8 (p<0.01). In conclusion an electromagnetic field increases the osteoblastic activity and osteogenesis, but has little effect during the remodeling phase.Öğe Electrocution-related mortality: A review of 123 deaths in Diyarbakir, Turkey between 1996 and 2002(Tohoku Univ Medical Press, 2006) Tirasci, Y; Goren, S; Subasi, M; Gurkan, FElectrical burns are responsible for considerable morbidity and mortality, and are usually preventable with simple safety measures. We conducted a retrospective Study of non-lightening electrocution deaths in Diyarbakir, Turkey between 1996 and 2002. All 123 deaths investigated were accidental. The age range was 2 to 63 years with a mean age of 20.7 +/- 15.3 years. Eighty-six victims (69.9%) were male. The Upper extremity was the most frequently involved contact site in 96 deaths (48%). No electrical burn mark was present in 14 (11.4%) cases. Home accidents were responsible for 56 cases deaths (45.5%). Deaths were caused most frequently by touching an electrical wire (52 cases, 42.3%). There was an increase in electrocution deaths in the summer (47 cases, 38.2%). One hundred one cases (82.1%) were dead oil arrival at hospital. The unique findings of our Study include younger age (0-10 years) of victims (39 cases, 31.7%) and a means of electrocution (electrical water heaters in bathroom) in 23 cases (18.7%). Rate of deaths due to electrocution among all medicolegal deaths was found higher in Out,Study than in previous Studies. The public Should be educated to prevent children to play near electrical appliances and to avoid electrical heaters in the bathroom.Öğe Extremity vascular trauma in civilian population: A 7-year review from North India(Elsevier Sci Ltd, 2006) Subasi, M; Cakir, O[Abstract Not Available]Öğe Failure of reamed nailing in humeral non-union: An analysis of 26 patients(Elsevier Sci Ltd, 2006) Subasi, M[Abstract Not Available]Öğe Fatal falls from heights in and around Diyarbakir, Turkey(Elsevier Ireland Ltd, 2003) Goren, S; Subasi, M; Tyrasci, Y; Gurkan, FFalls from high places, such as from a building, are frequently encountered in suicides, in some accidents, and sometimes in homicides. In this study, we evaluated the demographic data, mortality rates, fall causes, and post-mortem findings of individuals who fell from heights. Our cases were collected retrospectively from the files of the Branch of the Council of Forensic Medicine in Diyarbakir between 1996 and 2001. There were 431 accidental and 53 suicidal deaths due to blunt injury resulting from falls. Of the victims, 188 were female and 296 were male. The average age of the 484 victims was 27.05 years (range: 4 months-100 years). For buildings, the height ranged from 3 to 8 storeys for suicides and from 1 to 8 storeys for accidents. We proceeded to analyse the characteristics of accidental falls as follows. The majority of falls were from balconies or rooftops due to the tendency of people to sit and sleep on these places during the hotter months of the year. Some 54.5% of all falls occurred in May-August. The 53 suicidal jumps all occurred off buildings. The victims ranged in age from 15 to 70 years, and comprised 29 women and 24 men. One of the deceased jumped from the roof of a school in which he was boarding, and another from the seventh storey of a hospital in which he was receiving treatment. The remaining 51 jumped from heights ranging from 3 to 8 storeys. Psychiatric illness was reported in 18 (33.9%) of the suicide deaths, while 10 (18.8%) of the 53 suicides were single women. The results of this study were at variance with literature data with respect to the following: falls from heights were most common in the 0-5 year age group, females had a higher suicide rate than males, and the majority of accidental falls occurred at home rather than in the workplace. (C) 2003 Elsevier Ireland Ltd. All rights reserved.Öğe Female suicides in Diyarbakir, Turkey(Wiley, 2004) Goren, S; Subasi, M; Tirasci, Y; Ozen, SThe aim of this study was to investigate the methods used and demographic data of women suicides by examining postmortem investigation and autopsy reports from the Branch of the Council of Forensic Medicine in Diyarbakir Province, Turkey, between 1996 and 2001. Fifty-eight percent (174/302) of suicides were females and 42% (128/302) were males. The suicide rates were similarly higher for females than for males (2.6 and 1.8 per 10,000 population, respectively). Over half of female suicides (56.3%) occurred in those under 20 years of age. The most common suicide method for women was hanging (32.2%), and for men was firearms (51.7%), but for women younger than 20 years the most frequent method was firearms. Among the female suicides, five (2.8%) were known to have attempted suicide at least once in the past. Twenty-nine women (16.7%) were documented to have any psychiatric illness. None of the women had a history of drug or alcohol abuse. A suicide note was found in only six cases (3.4%). The predominant suicide motive was family problems (in 32% or 56/174). The higher rate of suicide in females than in males, and the absolute female predominance in suicides in Diyarbakir, Turkey, are in contrast to most of the medical literature and statistical information about suicide rates by country, in which suicide rates are usually higher among males.Öğe Firearm-related mortality: A review of four hundred-forty four deaths in Diyarbakir, Turkey between 1996 and 2001(Tohoku Univ Medical Press, 2003) Goren, S; Subasi, M; Tirasci, Y; Kemaloglu, SThe current study is based on a retrospective investigation of firearm deaths in Diyarbakir, which were autopsied by the Diyarbakir Branch of the Council of Forensic Medicine during the 6- year period. Four hundred-forty four deaths were investigated from January 1996 through December 2001, including homicide (296 cases, 66.7%), suicide (120 cases, 27%) and accidental shootings (28 cases, 6.3%). The age range of all firearm deaths in the study period was 5 to 75 years with a median age of 29.8 years. The majority were in the groups aged 16-25 years (38.7%). In the homicide group, 248 subjects (83.8%) were male, and 48 (16.2%) were female. The 31.1% of the homicide victims were in the group aged at 20-30 years. Of the 120 suicide victims, 56 (46.7%) were in the group aged 1620 years. The head was by far the favoured site, accounting for 82 (68.3%) deaths: entry wounds in the right temple accounted for 72 of these. Twenty-eight cases were accidental shootings and 18 of them were male (64.3%). Twelve of the 28 accidental victims (42.9%) were in the group aged 0-10 years. The eight cases were due to their own accidental shootings, and the remaining 20 cases were shot by others. Our findings show that the contributing factors for increasing death by firearm are terrorists' activities, traditional habits of obtaining and using guns and blood feuds.Öğe Floating knee in children(Lippincott Williams & Wilkins, 2003) Arslan, H; Kapukaya, A; Kesemenli, C; Subasi, M; Kayikçi, CThe 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.Öğe Frontal cephalometric analysis in the evaluation of facial asymmetry in torticollis, and outcomes of bipolar release in patients over 6 years of age (vol 122, pg 489, 2003)(Springer-Verlag, 2003) Arslan, H; Gündüz, S; Subasi, M; Kesemenli, C; Necmioglu, S[Abstract Not Available]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, AThe 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.Öğe Limb reconstruction with the callus distraction method after bone tumor resection(Springer, 2000) Kapukaya, A; Subasi, M; Kandiya, E; Özates, M; Yilmaz, FThe 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.Öğe Long-term outcomes of conservatively treated paediatric pelvic fractures(Elsevier Sci Ltd, 2004) Subasi, M; Arslan, H; Necmioglu, S; Onen, A; Özen, S; Kaya, MThe long-term orthopaedic, urologic, and psychiatric outcomes of patients treated non-operativety for unstable pelvic fractures were assessed. There were 55 mates and 3 females with an average age of 7 (3-13). Eighty-one percent of the fractures were caused by motor vehicle accidents, and 68% by auto-pedestrian accidents. Thirty-four of the 58 fractures were type Tile type B and 24 were type C. Posterior urethral injury was determined in 41 patients, and head injury in 21. Three patients with type C injury died within the first 3 days. After an average follow-up period of 7.4 years of the patients with type B injuries, leg length discrepancy of 1 cm was determined in two, and limited motion associated with open-knee wound in one, and tow back pain in two. Of the patients with type C injuries, low back pain was found in four, gait abnormality in three, sacroiliac ankylosis in one, and symphyseal ossification in two. Urethral. stricture was determined in 11 patients, urinary incontinence in 6 and erectile dysfunction in 6. A total of 31 patients were diagnosed with 41 psychiatric illnesses, including dysthymic disorder, social phobia, post-traumatic stress disorder, and major depression. No difference was found in the treatment outcomes of the two groups. From a holistic standpoint, Long hospital stays and urologic complications are associated with serious psychological problems, and thus should be considered during selection of treatment modality. (C) 2004 Elsevier Ltd. All rights reserved.Öğe Long-term urologic, orthopedic, and psychological outcome of posterior urethral rupture in children(Elsevier Science Inc, 2005) Onen, A; Subasi, M; Arslan, H; Ozen, S; Basuguy, EObjectives. To evaluate the long-term urologic, orthopedic, and psychological outcome of children after posterior urethral rupture (PUR) due to pelvic trauma. Methods. We retrospectively reviewed the records of 49 children with PUR from 1986 to 2000. The long-term urologic results were determined by voiding function, continence, and erectile function. The orthopedic results were determined by pelvic radiography and a questionnaire. Psychiatric diagnoses were made using the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV), criteria and the Structured Clinical Interview for DSM-IV Axis I Disorders. Results. The mean follow-up was 12 years (range 4 to 17). The average age was 8 years at the time of the trauma and 20 years at the last follow-up. Urethral continuity was achieved in 97.9% of the children. Of the 49 patients, 19 had at least one urologic complication, 18 had orthopedic pathologic findings, and 21 had psychiatric diagnoses. The number of urologic procedures required (more than three), presence of long-term complications, and total number of hospitalizations (more than three) secondary to the injury significantly affected the development of a psychological disorder. Conclusions. The results of our study have shown that posttraumatic PUR in children is associated with a significant rate of long-term complications. Nonoperative treatment of pediatric pelvic fractures associated with PUR has been quite successful. Repeated operations, the presence of long-term urologic complications, and frequent and long hospital stays result in serious attendant psychological problems. Therefore, careful and prolonged follow-up of posttraumatic urethral injury with a multidisciplinary approach is necessary to provide better outcomes and a better quality of physical and social life for these children.Öğe Lower limb landmine injuries(Sage Publications Ltd, 2004) Necmioglu, S; Subasi, M; Kayikci, C; Young, DBThe medical records of 186 patients seeking treatment for landmine injuries in the authors' re-ion between 1993 and 2001 were evaluated. Of these patients 13 died of accompanying complications. Ten (10) patients with general body trauma and upper limb trauma were excluded from the study. Of 163 patients with lower-limb injuries included in the study, 21, with traumatic amputation underwent surgical amputation at different levels. Patients without traumatic amputation were divided into 2 groups. There were 41 patients (29%) in Group I who were treated by limb salvage procedures. Treatments used in Group I including wound debridement, tendon repair, skin approximation, minimal osteosynthesis, external fixation of long bones and secondary, wound coverage. In Group 11, there were 101 patients (71%) with primary amputation. Trans-tibial amputation was performed in 52 cases (51.4%), ankle disarticulation in 24 (23.7%), trans-femoral amputation in 9 (8.9%), partial foot amputation in 8 (7.9%), knee disarticulation in 7 (6.9%) and hip disarticulation in I case. In Group 1, there was infection in 21 patients (51.2%), revision in 27 (65.8%), and amputation in 15 (36.5%). In Group 11, there was infection in 28 patients (27.7%), revision in 17 (16.8%), and amputation at a higher level in 8 (7%). In crush injuries such as those resulting from landmines, soft tissue, vascular, and neurological assessment must be performed with utmost care. Even so, the desired success in interventions intended to save a limb is complicated by a high infection rate, soft tissue complications, and high revision amputation rates. Therefore, a decision to amputate in the early term based on an accurate preoperative assessment is crucial.
