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    Biomechanical comparison of three different surgical methods in the surgical treatment of distal tibial metaphyseal fractures. An animal model study
    (Turkish Assoc Trauma Emergency Surgery, 2023) Yildirim, Cem; Muratoglu, Osman Gorkem; Ordu, Samed; Ceylan, Hasan; Muslu, Duran Can; Atlihan, Dogan
    BACKGROUND: The aim of this study is to investigate mechanical properties of minimally invasive plate osteosynthesis (MIPO), supracutaneousplating (SP), and unilateral external fixators (UEF) which can be performed for open tibial fractures.METHODS: An unstable diaphysial tibia fracture was created in 60 fresh sheep tibia specimens by performing an osteotomy at the middle of bones. Specimens were divided into 3 groups. Specimens underwent fracture fixation with a standard MIPO technique, implanting the plate 15 mm from the bone for SP group. Unilateral uniplanar external fixators were achieved for UEF group. First, thirty specimens (10 specimen for each group) were loaded vertically along the tibial axis to 1800 N. Second, other 30 preperated bones were used for cyclical loading to avoid metal fatigue. For dynamic tests, a 350 N force was applied for 10,000 cycles.RESULTS: In compression testing (vertical loading up to 1800 N) of the three fixation instruments; construct stiffness was highest in MIPO group when compared with SP and UEF groups. While the stiffness of the MIPO group was similar to SP group, it was statistically higher than UEF group (P=0.08 and P=0.002, respectively). SP group was significantly stiffer than UEF group (P=0.0021). The mean peak load was highest in SP group and lowest in UEF group. The peak load in SP group was similar to the MIPO group, it was statistically higher than the UEF group (P=0.743 and P=0.002, respectively).CONCLUSION: Based on the biomechanical properties from this in vitro animal model study, SP technique was biomechanically stronger than UEF and has similar biomechanical properties with MIPO in terms of axial loading.
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    Clinical and radiological evaluation of surgically treated acetabulum fractures
    (DergiPark, 2022) Muratoğlu, Osman Görkem; Yılmaz, Murat; Atlihan, Doğan; Yıldırım, Cem; Muslu, Duran Can
    Aim: Acetabular fractures were evaluated by Judet and Letournel in two main groups as elementary and associated fractures. There are publications in the literature that the results are worse as the complexity of the fracture increases. The aim of this study was to evaluate whether clinical outcomes are worse in associated fractured patients. Material and Methods: The study included 48 acetabular fractures admitted to the emergency room and treated surgically between December 2011 and October 2020. Patient’s trauma, additional injuries, surgical method, early or late complications, and range of motion at the last follow-up were documented. Clinical and radiological results of the patients were evaluated by modified Merle d'Aubigné, functional capacities by Harris hip scoring systems. Results: There were 25 elementary fractures and 23 associated fractures in patients. When the complication rates were examined, the rate of those without complications was 52.0% (n=13) among elementary fractures, while the rate was 34.8% (n=8) in associated fractures. When the fracture types were evaluated according to the Harris hip score, elementary fractures have better score than associated fractures, but no statistically significant difference was observed between them (p=0.056). When evaluated according to Merle d'Aubigne score, it was observed that elementary fractures had significantly better scores (p=0.004). Conclusion: As the complexity of the fracture increases, it can be predicted that the clinical outcomes of the patient will be worse. It is also concluded that the elementary fracture type had better clinical outcomes than the associated fracture type in our own surgically treated acetabular fractures.