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Öğe The Characteristics and Outcomes of Contralateral Non-Concurrent Hip Fractures: A Retrospective Study in Geriatric Patients(Mdpi, 2024) Saglam, Sonmez; Arican, Mehmet; Karaduman, Zekeriya Okan; Yucel, Mucahid Osman; Degirmenci, Erdem; Uludag, VeyselBackground and Objectives: This study aimed to determine the relationship between non-simultaneous contralateral hip fractures, urban and rural differences, fracture localization, time between fractures, physiotherapy applications, comorbidity, and the second fracture outcomes. Materials and Methods: We retrospectively analyzed 107 patients aged 65 and older with proximal femur fractures (PFFs) who underwent surgery at D & uuml;zce University Medical Faculty between January 2010 and December 2022. High-energy fractures, pathological fractures, and patients with a history of old fractures were excluded. Results: The study included 66 females (61.7%) and 41 males (38.3%), with a mean age of 83.76 years. The mean interval between two fractures was 28.3 months. There was no statistical difference between the localization of the first and second fractures (p = 0.107). However, there was a significant difference in the first PFF localizations of patients living in rural areas (p = 0.023). Patients with heart failure, respiratory failure, osteoporosis, and cognitive impairment had shorter intervals between fractures (p < 0.001). Conclusions: This study shows that age, female gender, place of residence, comorbid diseases, and whether physical therapy is received after the first fracture are significant risk factors for a second hip fracture in patients over 65 years of age.Öğe Comparison of conventional MR arthrography and 3D volumetric MR arthrography in detection of cartilage defects accompanying glenoid labrum pathologies(Springer, 2024) Gokce, Ayse; Guclu, Derya; Unlu, Elif Nisa; Kazoglu, Ibrahim; Arican, Mehmet; Ogul, HayriObjectivesIn this study, we aimed to compare conventional and T1-weighted volumetric magnetic resonance arthrography (MRA) in the diagnosis and grading of glenoid cartilage defects that accompany labral pathologies.Materials and methodsA total of 79 patients who were prediagnosed with labrum pathologies based on shoulder magnetic resonance imaging (MRI) had MRA and CTA between December 2021 and May 2022. CTA was regarded as reference standard. CTA images were examined by a radiologist experienced in musculoskeletal radiology, and MRA images were examined by two radiologists independently to determine presence, grade, and localization of any glenoid cartilage defect, if present. Sensitivity, specificity, and accuracy were calculated separately for conventional and T1-weighted volumetric MRA. In addition, at the last stage, two observers examined all MRAs together, and the presence of a cartilage defect was decided by consensus, and the overall sensitivity, specificity, and accuracy were calculated.ResultsCartilage defect was detected on CTAs of 48 (60.75%) cases of among 79 patients with labrum pathology. The sensitivity, specificity, and accuracy of conventional MRA for two examiners were 17-19%, 100-100%, and 49-51%, respectively, while those values were 67-65%, 92-97%, and 84-77%, respectively, for T1-weighted volumetric MRA. Inter-examiner agreement was excellent for diagnosis of cartilage defects on all MRAs. The overall sensitivity, specificity, and accuracy for detection of glenoid cartilage lesions by MRA were 69%, 97%, and 80%, respectively.ConclusionT1-weighted volumetric MRA seems to demonstrate cartilage defects accompanied with labrum pathologies accurately with high sensitivity, specificity, and excellent inter-examiner agreement.Öğe Comparison of histopathological and biomechanical changes of ligamentum mucosum in patients with anterior cruciate ligament rupture(Turkish Joint Diseases Foundation, 2024) Turhan, Yalcin; Arican, Mehmet; Karaduman, Zekeriya Okan; Sungur, Mehmet Ali; Gamsizkan, MehmetObjectives: The aim of this study was to identify the biomechanical and histopathological changes of ligamentum mucosum (LM) in patients with intact versus ruptured anterior cruciate ligament (ACL). Patients and methods: A total of 67 patients (45 males, 22 females; mean age: 33.2 +/- 7.9 years; range, 18 to 45 years) who underwent arthroscopic knee surgery for intraarticular pathologies between July 2022 and January 2023 were prospectively analyzed. The patients with LM were divided into two groups as the ACL intact group (n=31) and ACL ruptured group (n=36). Biomechanical tests and histopathological examinations were performed in all LM patients. Results: Age and body mass index distributions were similar between the groups (p>0.05). Peak force values of the LM in the ACL ruptured group were significantly higher than the ACL intact group (p=0.037). No significant difference was found between the groups in terms of collagen index (p=0.103) and fibroblast count (p=0.821). Conclusion: The peak force values of the LM were significantly higher in the ACL ruptured group as compared to the ACL intact group, which is probably due to the adaptation of LM in patients with ACL rupture against increased deforming forces to maintain knee stability.Öğe Evaluation of Clinical, Radiological and Functional Outcomes of Surgically Treated Ankle Fractures(Duzce Univ, Fac Medicine, 2022) Guler, Cemal; Karaduman, Zekeriya Okan; Orhan, Safak; Turhan, Yalcin; Arican, Mehmet; Turhal, Ozan; Orhan, ZaferObjective: The ankle is an important joint in the walking function of the body. Surgical treatment is required in cases where displaced and unstable fractures and joint compatibility cannot be achieved by conservative methods. The main goal of surgical treatment is to restore the anatomical position of the talus within the ankle for a normal tibiotalar joint relationship. Methods: 73 patients who were admitted to our outpatient clinics between January 2006 and October 2015, who were diagnosed with ankle fracture and underwent surgical treatment, were retrospectively evaluated and compared with the intact ankle. Results: Of the patients who had surgery; Bimalleol fracture in 34 (46.58%), trimalleol fracture in 8 (10.96%), lateral malleolar fracture in 14 (19.18%), medial malleolar fracture in 13 (17.81%), with posterior malleolar fracture in 1 ankle dislocation (1.37%) and 1 had posterior malleolar fracture with medial malleolus fracture (1.37%). According to the Lauge Hansen classification, the most common type of SER (Supination External Rotation) fracture (14 cases) (19.18%), followed by the second most common PER (Pronation External Rotation) fracture type (14 cases) (19.18%). According to the Danis -Weber classification, Type C (21 cases) (52.50%) was the most common and Type B (14 cases) (35.00%) was the second most common. When the union time was analyzed according to the fracture type, no statistically significant difference was observed (p=0.064). Conclusions: If surgical treatment is applied in ankle fractures the length of the fibula should be ensured, rigid internal fixation should be made with the aim of anatomical reduction of the joint surface, and ankle movements should be started early.Öğe Innovative approaches in the treatment of chronic plantar fasciitis: comparison of pulsed radiofrequency ablation and surgical intervention(Springer, 2024) Armagan, Celal; Karaduman, Zekeriya Okan; Arican, Mehmet; Turhan, Yalcin; Kaban, Ilyas; Uludag, VeyselPurpose This study aimed to compare the effectiveness of Pulsed Radiofrequency Ablation (PRFA) and surgery for treating chronic plantar fasciitis, focusing on pain relief and functional outcomes. Methods A prospective study involved 30 patients with chronic plantar fasciitis unresponsive to 12 months of conservative treatment. Patients were divided into PRFA (n = 17) and surgical (n = 13) groups. Clinical evaluations were conducted preoperatively and at three, six and 12 months postoperatively using VAS, AOFAS, FFI, and RMS scores. Radiological measurements assessed foot structure impact. Results Both PRFA and surgery significantly reduced pain and improved function. PRFA had a shorter operative time and quicker return to activities (p < 0.001). At 3 months, PRFA showed superior VAS, FFI, and RMS scores (p < 0.05). Long-term outcomes were similar. No major complications occurred, but minor complications were higher in the surgical group (p < 0.01). Conclusions PRFA is a minimally invasive, effective treatment for chronic plantar fasciitis with quicker recovery and lower complication rates compared to surgery. Both treatments offer comparable long-term benefits. Further studies are needed to confirm these findings.Öğe Investigation of the effects of pentoxifylline and alpha tocopherol treatment on recovery in rats with Achilles tendon rupture(Wiley, 2024) Toker, Mustafa; Karaduman, Zekeriya Okan; Arican, Mehmet; Turhan, Yalcin; Coskun, Sinem Kantarcioglu; Dalaslan, Rasit Emin; Celik, MuecahitAlthough the Achilles tendon is the largest and strongest tendon in the body, healing of the Achilles tendon is the most common injury, and this process is difficult due to poor tendon circulation; moreover, the underlying mechanism has not been fully elucidated. In our study, we aimed to investigate the effects of pentoxifylline and alpha-tocopherol administered separately or in combination on rats with Achilles tendon injury. Forty-eight male Wistar rats weighing 230 +/- 30 g were used in the study. The rats were randomly divided into eight groups of six animals each. Tendons were evaluated histopathologically and biomechanically. According to the statistical analysis, the vascularity density in the pentoxifylline group on day 14 was significantly greater than that in the other groups (p < 0.05). The collagen arrangement in the pentoxifylline and alpha-tocopherol groups on day 14 was found to be firmer and smoother than that in the control group (p < 0.05). The collagen arrangement in the pentoxifylline group on day 28 was greater than that in the other groups (p < 0.05). The biomechanical results were significantly greater in all groups (p < 0.05). Pentoxifylline contributed to tendon healing both through neovascularization in the early period and by improving collagen orientation in the late period, while alpha-tocopherol had a positive effect on collagen orientation in the early period. No beneficial effects were observed when pentoxifylline and alpha-tocopherol were used together. We believe that further research is needed to understand the effects of this combination therapy on tendon healing.Öğe Investigation of the Relationship Between Cervical Disc Herniations and Shoulder Complex Pathologies(Duzce Univ, Fac Medicine, 2024) Tuncer, Cengiz; Kilic, Rabia Tugba; Kilic, Guven; Karaduman, Zekeriya Okan; Arican, Mehmet; Akbari, Pouriya; Uludag, VeyselObjective: The aim of our study was to investigate whether there is a relationship between shoulder complex pathologies and cervical disc herniations. Materials and Methods: This study retrospectively included 524 patients with both dominant extremity shoulder and neck magnetic resonance examinations obtained from the information processing unit of Duzce University Faculty of Medicine between 01.08.2009-01.08.2023. The results were compared in Statistical Package for Social Sciences (SPSS). Results: A total of 524 patients, 153 (29.2%) males and 371 (70.8%) females, with a mean age of 51.17 +/- 13.70 (range, 13-93) years, were included in the study. According to the statistical analysis of our study, 410 of the participants had supraspinatus pathology, 234 had infraspinatus pathology, 243 had subscapularis pathology and 11 had teres minor pathology. In addition, a statistically significant relationship was found between other shoulder pathologies and herniations at the C4 -C5 and C5 -C6 disc level (p<0.05). Conclusions: In conclusion, even if there is a significant relationship between cervical disc herniations and shoulder pathologies, different methods should be developed for treatment algorithms and pain management. Evaluation of the cervical region should not be neglected in patient groups with shoulder pathologies.Öğe Investıgatıon of the effects of treatment with enoxaparın sodıum and hyperbarıc oxygen therapy on the recovery of rats wıth achılles tendon rupture(Bmc, 2024) Aytekin, Cafer Erman; Turhan, Yalcin; Karaduman, Zekeriya Okan; Arican, Mehmet; Saglam, Sonmez; Coskun, Sinem Kantarcioglu; Uludag, VeyselPurpose In this study, we aimed to investigate the effects of hyperbaric oxygen therapy and enoxaparin sodium, which are known to accelerate bone tissue healing as well as tendon and soft tissue healing, on the healing of Achilles tendon rupture. Methods Thirty-six rats were used in the present study. All rats were divided into groups of nine. The groups were the enoxaparin sodium group, enoxaparin sodium and hyperbaric oxygen group, hyperbaric oxygen group and control group. After 21 days, the process was completed, and the rats were sacrificed. Achilles tendon samples were evaluated histopathologically. Results The groups were compared according to the results of statistical analysis based on the histopathological data. There was no significant difference between the groups in terms of acute inflammation (p = 0.785) or chronic inflammation (p = 0.827) scores, but there were significant differences in neovascularization (p = 0.009), proliferation (p < 0.001) and fibrosis (p = 0.006) scores. Conclusion Our study showed that the use of enoxaparin sodium and hyperbaric oxygen had a positive effect on the healing of the Achilles tendon. Based on these results, we believe that the use of enoxaparin sodium and hyperbaric oxygen therapy after Achilles tendon rupture will be beneficial for healing and preventing complications.Öğe A Pregnant Woman with Multi-Fragmented Giant Cell Tumor of Tendon Sheath A Rare Anatomical Location(Amer Podiatric Med Assoc, 2020) Arican, Mehmet; Turhan, YalcinGiant cell tumor of the tendon sheath (GCTTS) in the foot is a rare pathology and is involved in the differential diagnosis of soft-tissue tumors of the foot and ankle. Although it can affect any age group, GCTTS mainly occurs at the 3rd and 5th decade and is more common in females. Histopathologic examination is a major definitive method for diagnosis, although physical examination and radiologic imaging are helpful in reaching a diagnosis preoperatively. Many treatment options exist but marginal excision is the most commonly used treatment. We describe the case of a 26-year-old pregnant woman with a multi-fragmented mass extending from the first web space to the plantar aspect of the metatarsophalangeal joint (MTP) of the left great toe associated with flexor hallucis longus tendon after trauma. She had pain that worsened with activity and wearing shoes. After pregnancy, a marginal excision with dorsal longitudinal incision in the first web space was performed under spinal anesthesia. The lesion was diagnosed as a localized type tenosynovial giant cell tumor. At the last follow-up appointment in the 23rd month, the patient was doing well and there was no recurrence of the lesion. GCSST should be considered in the differential diagnosis of plantar masses of foot. Although, GCTTS is frequently seen in females, it has not been previously reported in a pregnant woman with an extremely rare condition after trauma.Öğe Radiologic and histopathologic effects of favipiravir and hydroxychloroquine on fracture healing in rats(Springer, 2024) Tekce, Giray; Arican, Mehmet; Karaduman, Zekeriya Okan; Turhan, Yalcin; Saglam, Sonmez; Yucel, Muecahid Osman; Coskun, Sinem KantarciogluFracture healing is a process in which many factors interact. In addition to many treatments, physical and biological therapy methods that affect different steps of this process, there are many biological and chemical agents that cause fracture union delay. Although the number of studies on fracture healing is increasing day by day, the mechanism of fracture healing, which is not fully understood, still attracts the attention of all researchers. In this study, we aimed to investigate the effects of favipiravir and hydroxychloroquine used in the treatment of COVID-19. In this study, 48 male Wistar rats weighing 300 +/- 50 g were used. Each group was divided into eight subgroups of six rats each to be sacrificed at the 2nd and 4th weeks and evaluated radiologically and histologically. Favipiravir (group 1), hydroxychloroquine (group 2), favipiravir + hydroxychloroquine (group 3), and random control (group 4) were used. A statistically significant difference was observed between the 15th day histological scoring averages of the groups (p < 0.05). Although there was no statistically significant difference between the 15th day radiological score distributions of the groups (p > 0.05), we obtained different results in terms of complete bone union distributions and radiological images of the fracture line. Although favipiravir has a negative effect on fracture union in the early period, favipiravir may have a positive effect on fracture union in the late period. We did not find any effect of hydroxychloroquine on fracture union.Öğe Systemic tranexamic acid promotes bone healing in a rat model of femur fracture(Turkish Joint Diseases Foundation, 2020) Karaduman, Zekeriya Okan; Arican, Mehmet; Turhan, Yalcin; Turhal, Ozan; Orhan, Zafer; Gamsizkan, MehmetObjectives: This study aims to investigate the effect of tranexamic acid (TXA) on the union of closed femoral fractures using radiological and histological methods in an experimental rat model. Materials and methods: This experimental study was conducted between June 2017 and February 2018. Closed femoral fractures were created in 36 male Wistar albino rats (age: three months [range. 2.5-3.5 months]. weighing 200 grams [range. 180-220 grams]). Half of the animals randomly divided into two groups were administered intravenous single dose of TXA (30 mg/kg). whereas the animals in the control group did not receive any medication. The animals in the two groups were randomly divided into three groups with six animals each and cervical dislocation was performed at days 15, 30, and 45, and radiological and histopathological healing scores were compared. Results: When the mean radiological scores of the TXA and control groups were compared. a statistically significant difference was found in favor of the TXA group at day 15 (p=0.019). but no significant difference was found in the mean scores on days 30 and 45 (p=0.138 and p=0.269. respectively). Histopathological examination also showed a statistically significant difference between the 15-day mean score values in favor of the TXA group (p=0.017). Conclusion: The use of systemic TXA accelerates early bone formation and fracture healing.Öğe Topical or intravenous administration of tranexamic acid accelerates wound healing(Turkish Joint Diseases Foundation, 2024) Saglam, Sonmez; Orhan, Zafer; Arican, Mehmet; Turhan, Yalcin; Karaduman, Zekeriya Okan; Tekce, Yildiray; Yucel, Muecahid OsmanObjectives: In this study, we aimed to investigate the morphological and histological effects of tranexamic acid (TA) on wound healing in a rat wound model.Materials and methods: A total of 24 adult mal e Wistar Albino rats were used in this study. All rats were simple randomly divided into three groups including eight rats in each group. A full-thickness skin defect was created on the back of the rats in all groups. Serum physiological (2 mL) was instilled saline drops after wound formation (control group). Wound was created and topical TA (0.12 to 0.15 mL [30 mg/kg]) was applied (local group). Intravenous TA (0.12 to 0.15 mL [30 mg/kg]) was applied intravenously before the wound was created (intravenous group). The wound diameters of the groups were photographed and measured on Days 0, 3, 7, 10, 14 and, at the end of Day 14, the rats were sacrificed and their histopathological results and wound diameters were compared.Results: Fibroblast count values of the control group were found to be significantly lower than the local group (p=0.002), and no significant difference was observed between the local and intravenous groups (p>0.05). The collagen density (%) values of the control group were found to be significantly higher than the local and intravenous groups (p=0.016 and p=0.044). Wound diameter values of the control group on Day 10 day were found to be significantly higher than the local and intravenous groups (p=0.001). In addition, the wound diameter values of the control group on Day 14 were found to be significantly higher than the local and intravenous groups (p=0.001 and p=0.0001). The wound diameter changes of the control group on Days 0-10 were found to be significantly lower than the local and intravenous groups (p=0.001). In addition, the wound diameter changes of the control group on Days 0-14 were found to be lower than those of the local and intravenous groups (p=0.001 and p=0.0001).Conclusion: The use of local or intravenous TA may have positive effects on the fibroblast count and wound contraction in a rat wound model.
