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    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.
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    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.
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    Tibial fractures associated with crush injuries to the soft tissues of the dorsal foot in children
    (Elsevier Sci Ltd, 2005) Subasi, M; Tuzuner, T
    [Abstract Not Available]
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    Transection of the ulnar nerve as a complication of two-portal endoscopic carpal tunnel release
    (Israel Medical Assoc Journal, 2004) Subasi, M; Ay, S; Tuzuner, T
    [Abstract Not Available]
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    The trapezium: A new location for an aneurysmal bone cyst
    (Churchill Livingstone, 2006) Tuzuner, T; Subasi, M; Alper, M
    [Abstract Not Available]
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    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.