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Öğe Comment on "subacromial space volume in patients with rotator cuff tear: the effect of surgical repair" by Pepe et al(Aves Yayincilik, 2021) Turan, Kaya; Çabuk, HalukWe read with interest the article by M. Pepe et al. about the effect of arthroscopic rotator cuff repairs on subacromial space volume.1 It was stated that the group considered healthy was the contralateral side of the patients who had undergone arthroscopic surgery for rotator cuff tears.Öğe Comment on “Subacromial space volume in patients with rotator cuff tear: The effect of surgical repair” by Pepe et al.(2021) Çabuk, Haluk; Turan, KayaDear Editor, We read with interest the article by M. Pepe et al. about the effect of arthroscopic rotator cuff repairs on subacromial space volume.1 It was stated that the group considered healthy was the contralateral side of the patients who had undergone arthroscopic surgery for rotator cuff tears. Physical examination findings of the contralateral shoulders were reported to be normal, but it is a known fact that patients treated for rotator cuff tears have high rates of asymptomatic tears in the contralateral shoulders.2,3 It would be more appropriate to determine the group considered as the healthy group as patients without tear on the contralateral shoulders, and accordingly, the statistical difference between the groups could be more significant. We also agree and believe that arthroscopic rotator cuff repair will contribute to preserving the subacromial volume and improve shoulder functions in the long term.Öğe Comparison of pain, muscle strength, and functional status following unicompartmental knee arthroplasty, total knee arthroplasty, and conservative management of gonarthrosis(Springer, 2021) Atar, Sevgi; Demírhan, Esma; Çabuk, Haluk; Turan, Kaya; Dedeoğlu, Süleyman SemihBackground: Treatment options and surgical decision for grade 3–4 gonarthrosis remains controversial. We aimed to compare the pain level, muscle strength, physical performance, lower extremity functions, and other physical activity levels between patients who underwent arthroplasty and those who received conservative management for grade 3–4 gonarthrosis. Methods: This prospective analytical observational study was conducted in a tertiary referral hospital. A total of 30 unicompartmental knee arthroplasty (UKA) and 30 total knee arthroplasty (TKA) patients as two different study groups and 30 patients were treated conservatively as the control group were included. The rehabilitation and complication rates were recorded. The values of the range of motion, quadriceps diameter, were measured and also the isokinetic muscle strength, pick-up, repeated sit-to-stand, stair ascending and descending, straight-line walking, timed up and go, and 20-m walk tests, the knee injury and osteoarthritis-outcome-score (KOOS), the hospital for special-surgery-knee-score (HSS), and Oxford-Knee-Score (OKS) were performed. Results: Postoperative rehabilitation and complication rates were significantly higher in the TKA group compared to the UKA group (p = 0.029 and p = 0.026, respectively). Six months after the treatment, the knee extension muscle strength value at 180°/s, knee flexion degree, total work flexion, stair ascending, VAS at night, all KOOS symptom, pain and daily function and total scores in the UKA group was significantly different than the TKA and the control groups (p < 0.001). Total work extension values, knee flexion degree, in the control group were found to be significantly higher than the TKA group (p = 0.033, p < 0.001, respectively). Conclusions: The UKA was significantly superior to TKA and conservative treatment concerning pain, muscle strength, and quality of life. Level of Evidence: IIa. © 2021, Indian Orthopaedics AssociationÖğe Comparison of the radiological parameters between dynamic-referencing tactile guidance robotic system and microplasty (r) instrumentation in unicompartmental knee arthroplasty(TURKISH JOINT DISEASES FOUNDATION, 2022) Çabuk, Haluk; Turan, Kaya; Muratoğlu, Osman Görkem; Ergün, Tuğrul; Öztürk, Çağatay; Ertürer, Ramazan ErdenObjectives: This study aims to compare the radiological outcomes of unicompartmental knee arthroplasty (UKA) performed by a navigation-based robotic system versus Microplasty (R) instrumentation. Patients and methods: Between January 2018 and January 2019, a total of 90 knees of 75 patients (65 males, 10 females; mean age: 62.0 +/- 9.4 years; range, 50 to 73 years) were included. Among these, 54 knees underwent Oxford mobile-bearing UKA with an Microplasty (R) instrumentation set and 36 knees were operated with the aid of a Restoris (R) MCK with MAKO navigation-based robotic system. Postoperative anteroposterior and lateral X-rays of all patients were evaluated according to nine different parameters. On the femoral side, femoral varus-valgus angle, flexion-extension angle, femoral condyle posterior fit; on tibial side, tibial component varus/valgus, tibial posterior slope, medial, anterior, posterior and lateral fit of tibial component assessed. Results: There was no significant difference between groups in terms of age, sex, and affected side. On the femoral side, no significant difference was observed in the component position between groups. On the tibial side, tibial component medial fit (p=0.032) and anterior fit (p=0.007) were better in navigation-based robotic system group. Conclusion: Microplasty (R) instrumentation may lead to comparable implant positioning compared to a tactile-based navigated robotic instrumentation.Öğe Current approaches and problems faced by orthopedic surgeons in all-inside arthroscopic meniscus repairs(2023) Turan, Kaya; Erturer, Ramazan Erden; Çabuk, Haluk; Muratoğlu, Osman Görkem; Ergün, TuğrulAim: All-inside meniscal sutures are frequently the treatment of choice in arthroscopic practice. However, the literature contains limited evidence of the technical issues experi- enced during the procedure. We aimed to evaluate the technical difficulties encountered during the placement of all-inside meniscal repair sutures according to the surgeon’s ex- perience and the success rate of the suture placement. Materials and Methods: We invited orthopedic surgeons across the country to com- plete a questionnaire through an online platform. Participants were asked ten questions about their demographic information, general surgical approach to meniscal tears, and experience with intraoperative complications specific to all inside meniscus sutures. Results: A total of 100 orthopedic surgeons participated in our study. Of these, 37% had been working as an orthopedic surgeon for more than ten years. Twenty-five per cent performed more than two arthroscopic knee surgeries per week. Fifty-six per cent of the surgeons were protective for the displaced red-white zone meniscal tears. Although 90% of the participants stated that the technique was more effortless, only 12% thought the clinical results were better than the other techniques. More than 50% of the participants indicated that they had difficulty when placing the sutures successfully. The most common problem was the inability to fix the meniscus sufficiently and the deformation of the instruments inside the joint. When we compared the complications according to the surgeon’s experience, even among the surgeons who performed more than 100 arthroscopic surgeries per year, 34% had trouble applying these sutures successfully. Conclusion: Although all-inside meniscus sutures are generally believed to decrease the operative time and be technically more straightforward, even the most experienced surgeons have difficulty applying these sutures, and the reliability of these sutures is low.Öğe Does the clamping method in local and systemic TXA applications in total knee arthroplasty change the game?: a retrospective comparative cohort study(Lippincott Williams and Wilkins, 2022) Turan, Kaya; Muratoğlu, Osman Görkem; Ergün, Tuğrul; Çabuk, Haluk; Ertürer, Ramazan ErdenMany different methods and drain clamping periods have been described in systemic and local tranexamic acid (TXA) applications, and the superiority of the methods to each other has not been clearly demonstrated. The method of local infusion in combined TXA applications may not alter the Hb drop or total or hidden blood loss. We aim to compare two different combined TXA application methods. We retrospectively analyzed 182 patients who underwent total knee arthroplasty between 2018 and 2021. Patients over 40 years of age who underwent TKA for degenerative knee arthritis were included in the study. Unicondylar, revision, or bilateral arthroplasties and patients with the cardiovascular or cerebrovascular disease were excluded from the study. All patients in the study received 1 g TXA intravenously half an hour before the incision. For the first group, 1 g TXA was given intra-articularly at the drain site after closure, and the clamp was kept closed for 1 hour. In the second group, the drain was clamped for an additional 6 hours, and a 1 g intravenous dose was administered at the 5th hour postoperatively. No local applications were used in the control group. Total, hidden, and visible blood loss (total blood loss, hidden blood loss, visible blood loss), postoperative decreases in hemoglobin and hematocrit level (?Hgb, ?Htc), blood transfusion rates, and hospital stay durations were evaluated. There were 72 patients in the first group, 52 in the second, and 58 in control. A total of 37 patients received one or more blood transfusions postoperatively, and there was no statistical difference in the need for blood transfusions between the groups (P?=?.255). Although a statistically significant difference (P?=?.001) in total blood loss, hidden blood loss, visible blood loss and ?Hgb values was observed between the groups, the difference between the first and second groups was insignificant (P?=?.512). The duration of hospital stay was observed to be less in the first and second groups (P?=?.024). Local and systemic TXA applications were observed to be more effective than only systemic applications in reducing blood loss after total knee arthroplasty, regardless of the local method.Öğe The effect of weekday preference on length of stay in unilateral bicompartmental total knee arthroplasty(Galenos Publishing House, 2022) Turan, Kaya; Ergün, Tuğrul; Muratoğlu, Osman Görkem; Çabuk, Haluk; Öztürk, ÇağatayAim: There are few studies in the literature evaluating the effect of the day of surgery on length of hospital stay. This study evaluates the effect of the day of surgery on the duration of hospitalization in unilateral primary total knee arthroplasty (TKA) in a group of hospitals providing wide-ranging health services and clarifies the implications for reducing economic burdens. Methods: Between March 2020 and January 2022, patients treated by TKA with the code P612420 according to the Health Practice Communique were retrospectively scanned in a group of hospitals with different levels. Patients who underwent bilateral TKA on the same day or during hospitalization, underwent any secondary surgical procedures, or developed early complications were excluded from the evaluation. Results: The data of 743 patients who underwent unilateral TKA were evaluated. The mean hospital stay was 3.32 (2-14) days. It was seen that the shortest hospitalization periods were in the surgeries performed on Saturday (3.15 days), while the longest ones were on Friday (3.62 days). It was found that the patients who underwent surgery on Saturday had significantly shorter hospital stays than on Friday (p=0.006). Conclusion: While planning TKA, the choice of surgery day is a factor that should be addressed to reduce hospital stays and, therefore, costs. © 2022 by The Medical Bulletin of Istanbul Haseki Training and Research Hospital The Medical Bulletin of Haseki published by Galenos Yayinevi.Öğe The effects of patient related factors on hidden and total blood loss in single-level open transforaminal lumbar interbody fusion surgery(Acta Orthopaedica et Traumatologica Turcica, 2022) Kara, Gökhan Kürşat; Kavak, Huseyin; Gökçen, Bahadır; Turan, Kaya; Öztürk, Çağatay; Aydınlı, UfukObjective: The aim of this retrospective study was to identify the amount of TBL and HBL and analyse the risk factors using multivariate linear regression analysis during single-level OTLIF surgery. Methods: In this study 62 patients (32 male, 30 female, mean age 49.22 ± 13.26) who underwent single-level interbody fusion proce dures by a single surgeon between 2015 and 2021 were included. Retrospectively, relevant statistics regarding body mass index (BMI), American Society of Anesthesiologist Score (ASA), preoperative mean arterial pressure (MAP), and age were gathered. Preoperative MR images were used to assess and measure radiological parameters such as skin-disc distance (SDA), canal area (CA), paravertebral muscle area (PVMA),lumbosacral maximum subcutaneous fat thickness (LSMSF), operation level subcutaneous fat thickness (OPSF) and spi nous process length (SPL).Total blood loss (TBL) was calculated according to Nadler's formula. Hidden blood loss (HBL) was measured by deducting the measured (visible) blood loss from TBL. TBL, HBL and their relationship with preoperative parameters were assessed. Results: HBL was determined to be significantly higher in older patients (P = 0.012). MAP was seen to have a statistically significant cor relation with operating time (P = 0.002), operative bleeding (P = 0.002), TBL (P = 0.006), and HBL (P = 0.001), and an inverse correlation with postoperative drainage (P = 0.007). The ASA scores were observed to be statistically significantly correlated with TBL (P = 0.001), and HBL (P = 0.001). LSMSF showed a significant correlation with TBL (P = 0.005) and HBL (P = 0.002). OPSF was determined to be correlated with TBL (P = 0.011), HBL (P = 0.009) and length of stay in hospital (P =0.034). SDD was correlated with TBL (P =0.043), and SPL with HBL (P = 0.013). It was shown that age (P =0.012), MAP (P =0.001), ASA (P =0.001), LSMFS (P = 0.002), OPSF (P = 0.009), SPL (P = 0.013) were risk factors for HBL. According to multivariate logistic regression analysis; two anatomical factors LSMSF and SPL were independent risk factors for HBL (P < 0.05). Conclusion: This results of this study have revealed that most patient-related parameters have a significant effect on HBL and TBL.The study has also demonstrated that LSMSF and SPL are independent risk factors for HBL. Level of evidence: Level IV, Therapeutic Study.Öğe Evaluation of smartphone-assisted infrared thermal imaging efficiency in carpal tunnel syndrome(Springer, 2024) Turan, Kaya; Muratoglu, Osman Gorkem; Ergun, Tugrul; Cabuk, HalukBackground Thermography is an industrial method for surface temperature measurements, and although it is medically safe and non-invasive, its place in daily practice has been limited. With the development of technology, thermal cameras have become more accessible and practical via adaptation to mobile phones. Among patients evaluated with bilateral nerve conduction studies (NCS) for suspected carpal tunnel syndrome (CTS), those with electrophysiological findings consistent with mild-to-moderate unilateral CTS were accepted for this prospective study. The hands with positive NCS findings were the study group, and the unaffected hands were the control group. The images were evaluated with the thermal analysis software (FLIR Tools ver. 6.4, Windows 10) and compared with NCS for statistical significance. In addition, thermal images were examined by three orthopaedic surgeons, and interobserver correlation was analyzed. Our study aims to evaluate the mobile phone-assisted thermal camera (FLIR One Pro, FLIR Systems, Wilsonville, OR, USA) as a suitable tool to diagnose CTS. Results 48 patients, 35 women and 13 men were included in the study. Bilaterally, a total of 96 hands were evaluated. 18 patients had mild, and 30 patients had moderate NCS stages unilaterally. The mean temperature difference at the region of interest in the palm, first and third fingers were statistically significant between the study and control groups (p < 0.05). NCS values and stages were correlated with the temperature difference in the third finger (p = 0.002). The inter-observer reliability was high (ICC = 0.858) while detecting temperature differences. Conclusions Since smartphone-assisted thermal cameras are easy and convenient to use, we think they are helpful in the daily practice of diagnosing mild-to-moderate carpal tunnel syndrome.Öğe Increased acromiohumeral distance in a double-row arthroscopic rotator cuff surgery compared to a single-row surgery after 12 months(BioMed Central Ltd, 2021) Turan, Kaya; Çabuk, Haluk; Köroğlu, Cenk; Öztürk, Ça?atayBackground: Arthroscopic rotator cuff surgery is an effective treatment for rotator cuff tears with the considered use of double-row repair techniques becoming popular in the last decade. We aim to compare the effects of double- and single-row arthroscopic rotator cuff repairs (ARCR) on repair integrity (RI) and acromiohumeral distance (AHD). Methods: In this observational study, we retrospectively identified 98 patients with degenerative rotator cuff tear treated with arthroscopic rotator cuff repair between 2016 and 2019. We excluded 22 patients with partial-thickness tears, 15 with associated subscapularis or SLAP tears, 13 with massive tears, and 5 patients lost to follow-up; we included 43 patients who had ARCR for full-thickness cuff tear and clinical, radiologic follow-up. Of these 43 patients, 23 are grouped as double-row repair group (DRG) and 20 as single-row repair group (SRG). A minimum of 12 months after the surgery, bilateral shoulder MRIs were obtained. Contralateral shoulders without asymptomatic rotator cuff tears served as a control group (CG). The operating surgeon and two other surgeons experienced in arthroscopy blindly measured the AHD and determined the RI at the control MRIs in all groups. Functional assessments relied on UCLA and qDASH Scores. Results: The mean age was 57.89 (45–78) years, and the mean follow-up time was 28,65 (21–43) months. The mean AHD of the CG was 9.7 ± 0.96 mm, the preoperative AHD of DRG was 8.62 ± 1.45 mm, and SRG was 9.71 ± 0.95 mm. The postoperative mean AHD of DRG 9.61 ± 1.83 mm and SRG was 10.21 ± 1.97 mm. AHD differences between the preoperative and postoperative groups were significant (P=0.009). The increase of the AHD in the double-row group was significantly higher than the single-row group (P=0.004). There was a high correlation between the RI and DASH scores (P=0.005). RI did not correlate with the repair method (P=0.580). Conclusion: Although double-row repairs can maintain greater AHD than single-row repairs in the clinical setting, this difference did not affect functional results. Regardless of the surgical intervention, functional results are favourable if RI is achieved. Level of evidence: Level III, Retrospective Cohort Study.Öğe The intra- and interobserver reliability of five commonly used intertrochanteric femur fracture classification systems(2022) Yıldırım, Cem; Turan, Kaya; Ergün, Turğul; Mısır, Abdulhamit; Aydın, Mahmud; Muratoğlu, Osman GörkemObjectives: This study aims to evaluate the effect of surgical experience on reliability for Boyd-Griffin, Evans/Jensen, Evans, Orthopaedic Trauma Association (main and subgroups), and Tronzo classification systems. Patients and methods: Between January 2013 and December 2014, radiological images of a total of 60 patients (13 males, 47 females; mean age: 78.9±21.9 years; range, 61 to 96 years) with the diagnosis of intertrochanteric femur fracture were analyzed. Radiographs were evaluated and classified by five residents and five orthopedics and traumatology surgeons according to the Evans, Boyd-Griffin, Evans/Jensen, OTA, and Tronzo classification systems. Intra- and interobserver reliability were calculated using the kappa statistics. Results: The worst intraobserver compatibility among the residents was the classification system with OTA subgroups (?=0.516), while the classification system with the best intraobserver fit was found to be OTA main groups (?=0.744). The worst agreement among surgeons was in the Evans classification system (?=0.456). However, the best intraobserver agreement was in the OTA main groups (?=0.741). The best interobserver agreement was observed regarding the OTA main groups (?=0.699). Conclusion: The classification that has the best harmony both among residents and surgeons, and between residents and surgeons is the OTA main group classification.Öğe Late presenting pediatric radial neck fracture: a case report and review of the literature(2021) Turan, Kaya; Köroğlu, Cenk; Çabuk, HalukIntroduction: A pediatric radial neck fracture, when the diagnosis is delayed, is still a challenging problem for the treating orthopedic surgeon. We report a pediatric patient with late presenting radial neck fracture and results of open reduction and fixation with Kirschner wires. Case report: A 13-year-old right-handed girl fell on an out-stretched right arm after being tackled during playing basketball and had a radial neck fracture. However, the diagnosis of her fracture was delayed for 3 weeks. At the first radiologic examination, the anteroposterior and lateral radiographs were showing over 80 degrees of angulation at the radial neck and subluxation of the radiocapitellar joint. We tried to obtain a closed reduction, but we could not succeed. Then, we performed open reduction while preserving medial periosteal continuity and vascular supply of the radial head by meticulous surgical dissection. Sixth-month radiography control and clinical examination confirmed the complete healing of the fracture without any epiphyseal injury. Painless full range of motion without any restriction of pronation and supination was achieved. The patient and her parents were satisfied with the outcome. Conclusions: Even if the diagnosis of pediatric radial fractures is delayed if we can preserve medial periosteal continuity and vascularity of the radial head with open reduction, satisfactory results are obtainable.Öğe A novel percutaneous intrafocal reduction technique for brachialis penetrating irreducible type 4 supracondylar humerus fracture(DergiPark, 2022) Turan, Kaya; Cabuk, HalukType 4 supracondylar fractures are challenging to treat. Closed reduction may become impossible due to brachialis muscle penetration and devastating results like a neurovascular injury that may occur during recurrent manipulations. We here report an intra-focal percutaneous reduction technique for maintaining closed reduction. An extensively posterior displaced type 4 supracondylar fracture with a dimple at the antecubital fossa and an extensive ecchymosis is presented. During surgery, we could not obtain closed reduction with the milking maneuver. We inserted an intrafocal K-Wire from the posterior side into the fracture site. With the levering of the wire, the dimple disappeared, after which we maintained the anatomical reduction and fixed the fracture with two lateral K-wires. Neither complication nor residual deformity was observed during postoperative follow-up. To show the exact long-term effects and the safety of this procedure, we need more fractures with brachialis penetration operated on by the described techniqueÖğe Patient anxiety levels in orthopedic outpatient clinics at hospitals with different patient population densities(DergiPark, 2022) Turan, Kaya; Tuncez, Mahmut; Muratoğlu, Osman Görkem; Ergün, Tuğrul; Çabuk, HalukBackground/Aim: Prolonged wait times for examination and delayed hospital appointment times can negatively affect patients. Increased anxiety in orthopedic outpatient clinic patients can disrupt diagnosis and treatment, and increase psychological tension in both patients and healthcare professionals. The aim of our study is to compare the anxiety levels of patients at institutions with different patient population densities. Methods: This cross-sectional survey study included 189 patients who voluntarily completed the Beck Anxiety Scale while registering for treatment of non-traumatic conditions at the orthopedics and traumatology outpatient clinics of two tertiary health care hospitals. Patients were grouped by hospital attended. The study assessed patients’ age, education level, estimated monthly income levels, and anxiety levels. Results: 99 patients from the public hospitals and 90 from the private hospitals participated in the survey. A significant positive correlation existed between educational status and income level (P<0.001). No significant difference in income level existed between the two groups (P=0.063), but the education level of patients in the private hospital group was significantly higher than in the public hospital group (P<0.001). The anxiety levels of the patients in the private hospital group was significantly higher (P=0.043); this difference was correlated to education level rather than income level. Patients with higher education levels demonstrated significantly higher anxiety levels (P<0.001). Conclusion: The study concluded that the anxiety levels of patients who applied to the orthopedic outpatient clinics were independent of facility patient density and related primarily to patient attributes. Prospective studies are needed examining the relationship between patient anxiety levels and waiting time.Öğe Proprioception analysis of patients with anterior cruciate ligament reconstruction(2023) Erkurt, Nazım; Yerli, Mustafa; Yüce, Ali; Bayraktar, Tahsin Olgun; Atar, Sevgi; Turan, Kaya; Çabuk, HalukObjectives: This study evaluates the effect of tibial stump mechanoreceptor preservation on proprioception, muscle strength, recovery and functional outcomes after arthroscopic anterior cruciate ligament surgery (ACLS). Methods: Patients undergoing ACLS between January-July 2019 were evaluated by a single surgeon. The HUMAC NORM 2 device measured patients' proprioceptive sensation and muscle strength before and after surgery; KOOS and Oxford scales were used to score patients’ functional results. The patients were divided into two groups: those who underwent stump-preserving surgery (SP group) and those who underwent conventional surgery (C group). Results: Our study evaluated 27 patients, 11 in the SP and 16 in the C groups. The two groups had no statistical difference in muscle strength, proprioception, and functional scores in the first and third postoperative months. In the sixth-month evaluation, significantly better functional scores were found in the C group. Further, the athletic function was better in patients with good proprioception recovery, regardless of the group comparison. Conclusions: Preserving the stump and mechanoreceptors on the tibial face was not determined to provide additional benefit to the patients in the first six months after surgery. Returning to sports was faster and functional scores were better in patients with good proprioception recovery.Öğe The time from injury to surgery is an important factor affecting the mechanoreceptors at stump of torn anterior cruciate ligament(Springer Nature, 2022) Çabuk, Haluk; Çabuk, Fatmagül Kuşku; Turan, KayaIntroduction: Restoration of proprioceptive function after anterior cruciate ligament (ACL) reconstruction is as important as mechanical stability. For this purpose, remnant of the torn ACL is the only source of nerve endings. Our aim in this study is to investigate the quantity of mechanoreceptors in the remnants ACL stumps in injured knees and to correlate that with the quantity in intact ACL in control cases. Materials and methods: 48 patients that underwent ACL reconstruction between January 2016 and December 2018 as study group and 20 knees of 10 fresh frozen cadavers that as control group included in the study. Remaining stumps from study group and native ACL from control group were collected and investigated with S100 immunostaining. The type and number of mechanoreceptors in standardized areas was determined. The correlation of number of mechanoreceptors and time to surgery after ACL rupture were evaluated. Results: The free nerve endings (FNE) and total number of mechanoreceptors were significantly lower in the study group as compared to the control group (p < 0.001 and p = 0.004, respectively). The number of Golgi-Mazzoni corpuscle decreased significantly with time (p = 0.041 CC: - 0.438). Conclusion: The time from injury to surgery is an important factor affecting the mechanoreceptors at stump of torn ACL. The surgeon and patient should be aware of the fact that delay in surgery could lead to the loss of mechanoreceptors.Öğe Total diz artroplastisi sonrası geç dönemde gelişen peroneal palsi: Vaka sunumu(DergiPark, 2021) Turan, Kaya; Çabuk, Haluk; Muratoğlu, Osman GörkemTotal diz artroplastisi sonrası gelişen peroneal sinir palsi klinik sonuçları önemli derecede olumsuz etklileyen ve nadir görülen bir sorundur. Bu çalışmamızda 62 yaşında sağ dizde ileri derecede gonartroz nedeniyle total diz artroplastisi uyguladığımız hastada ameliyat sonrası 15. günde gelişen peroneal palsinin klinik ve elektrofizyolojik takip sonuçlarını sunuyoruz. Elektromyografik değerlendirmede peroneal sinir motor dalının fibula başı seviyesinde ağır derecede parsiyel aksonal hasarı izlendi. Medikal tedavi ile takibi sonrası 6. Haftadan itibaren klinik iyileşme bulguları başlayan hastada, peroneal sinir eksplorasyon ve nöroliz gerekliliği olmadan, 6. ayda total klinik ve elektrofizyolojik iyileşme sağlandı. Dejeneratif disk hastalığına bağlı klinik bulgu vermeyen kök basısı olan hastalarda uygulanan total diz artroplastisinde peroneal palsi yatkınlığında artış olabileceği akılda tutulmalıdır.Öğe Treatment of ingrown toenail with a minimally invasive nail fixator: Comparative study with winograd technique(Sheridan Publications, 2022) Ergün, Tuğrul; Korkmaz, Mehmet; Ergün, Dilan; Turan, Kaya; Muratoğlu, Osman Görkem; Çabuk, HalukBackground: Many surgical techniques have been reported for the treatment of ingrown toenails. Occurrences of infection after matricectomy procedures could cause clinicians to prefer using external braces to treat ingrown toenails. This study compares patients with ingrown toenails who underwent the nail fixation technique and the Winograd technique. Methods: Patients who underwent ingrown toenail surgery were retrospectively reviewed. The patients' demographic characteristics (age, gender, body mass index [BMI] morphology according to Heifetz classification, surgical technique, visual analog scale (VAS) values, time to return to daily activities (days), complications, and satisfaction levels were all recorded. Results: Seventy patients were included in the study. Of the patients, 33 underwent nail fixation and 37 underwent the Winograd technique. No significant statistical differences were found in terms of patients' age, gender, BMI, preoperative clinical features, long-term satisfaction, and ingrown toenail recurrence rates between the two groups, but time to return to daily activities and VAS values were statistically significantly lower in patients treated using nail fixation compared with the Winograd technique. Conclusion: Nail fixation can be an effective surgical treatment option for an ingrown toenail.Öğe Ultrasonography vıew for acute ankle ınjury: comparison of ultrasonography and magnetic resonance ımaging(Springer, 2022) Ergün, Tuğrul; Peker, Ahmet; Aybay, Muhsin N.; Turan, Kaya; Muratoğlu, Osman Görkem; Çabuk, HalukIntroduction: We aim to asses the diagnostic performance of ankle ultrasonography in patients presenting with acute ankle sprain injury, with comparison to MRI (Manyetik Rezonans İmaging). Materials and methods: The study included patients who applied to the hospital within 48 h after an ankle sprain, and who presented with signs of pain, swelling, and tenderness in the ankle. Ankle ultrasonography examination was performed and an ankle MRI took place the same day. Results: 30 patients were included in the study. 53.3% (n = 16) were female. The mean age was 30 ± 6.4 years. The ultrasonography examination determined 76.6% (n = 23) of the patients to have anterior talofibular ligament (ATFL) injury, 33.3% to have (n = 10) CFL injury, and 33.3% to have (n = 10) anterior inferior tibia-fibular ligament (AITFL) injury. The MRI of the patients determined 73.3% (n = 22) of the patients to have ATFL injury, 43.3% (n = 13) to have calcaneal fibular ligament (CFL) injury, and 33.3% to have (n = 10) AITFL injury. The ATFL, CFL, and AITFL injuries diagnosed on ultrasonography correlated with the MRI results (ICC = 0.875, ICC = 0.879, and ICC = 0.858). However, among the ATFL injuries observed on MRI, 26.6% (n = 8) were grade I, 26.6% (n = 8) were grade II, and 20% (n = 6) were grade III injuries. Of the ATFL injuries observed on ultrasonography, 46.6% (n = 14) were grade I, 8.6% (n = 2) were grade II, and 30.4% (n = 7) were grade III injuries. Conclusions: Findings on all types of ATFL, CFL and AITFL appear to have a higher degree of correlation. Ultrasonography could have an added role as a triaging tool, to fast-track MRI.Öğe Ultrasound guided versus blinded injection in trigger finger treatment: a prospective controlled study(Bmc, 2023) Tuncez, Mahmut; Turan, Kaya; Aydin, Ozgur Dogan; Tuncez, Hulya CetinBackgroundTrigger finger is a common disease with a lifetime prevalence of 2%. One of the frequently preferred non-surgical treatments is blinded injection around the A1 pulley. This study aims to compare the clinical results of ultrasound-guided and blinded corticosteroid injection in the trigger finger.MethodsIn this prospective clinical study, 66 patients who had persistent symptoms of a single trigger finger were included. Patients with similar baseline characteristics such as age, gender, triggering period, and comorbidities were randomized. 34 patients had ultrasound-guided (UG), and 32 had blinded injections (BG). QDASH, VAS, time to return to work, and complications were compared between the groups.ResultsThe mean age was 52,66 (29-73) years. There were 18 male and 48 female patients. In the UG, the triggering resolved faster, returning to work was earlier, and the medication period was shorter (p < 0.05). A total of 17 patients who had diabetes mellitus received re-injections, 11 of which were in BG and 6 in UG (p < 0.05). Although statistically significantly lower scores were obtained in UG at the 1st and 4th weeks in the QDASH and VAS scores (p < 0.05), at the 12th and 24 weeks, there was no significant difference (p > 0.05).ConclusionUsing ultrasound guidance for corticosteroid injections is more effective for treating trigger fingers than the blinded method, leading to better results and a faster return to work in the early stages of treatment.
