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Öğe Floating phalanx; simultaneous double dislocation of the interphalangeal joint in a finger: A case report and literature review(Turkish Assoc Trauma Emergency Surgery, 2022) Sağlam, Fevzi; Baysal, Özgür; Sağlam, Sönmez; Sirin, Evrim; Sofulu, ÖmerIsolated proximal and distal interphalangeal joint (DIPJ) dislocations are widely seen as a result of sporting injuries and major trauma. The combination of dorsal dislocation of the DIPJ in the same finger concomitant to traumatic dorsal dislocation of the proximal interphalangeal joint (PIPJ) is a rarely seen injury. The case is, here, presented of a 65-year-old female patient with proximal and DIPJ dislocation of the right-hand ring finger accompanied by volar and dorsal plate injuries in the proximal and distal joints.With this case, it was aimed to introduce a new term of floating phalanx into medical literature.The treatment was applied to the patient of closed reduction under peripheral block and the application of an aluminium finger splint in semiflexion. In a 24-month follow-up period, the 4th finger of the patient was observed to be stable and has pain-free range of movement. This case is an uncommon case of volar and dorsal plate avulsion fractures with PIPJ and DIPJ dorsal dislocation treated successfully with closed reduction and conservative treatment with excellent functional results.Öğe Locked Traumatic Pisiform Dislocation: A Case Report(Lippincott Williams and Wilkins, 2019) Sağlam, Fevzi; Dağtaş, Mirza Zafer; Sağlam, Sönmez; Baysal, ÖzgürCase:A 32-year-old man presented to the emergency department with several carpal bone fractures and a locked distal pisiform dislocation after trauma. Treatment consisted of open surgical and reduction, osteosynthesis with a single Kirschner wire, and ligament repair. The patient's functional outcome was excellent, and his Mayo wrist score was 90 at 36 months after injury.Conclusions:Pisiform dislocations may be difficult to diagnose because anteroposterior and lateral radiographs may not be sufficient to visualize the injury. A 30° semisupinated wrist X-ray and computed tomography can be helpful. A satisfactory clinical result may be achieved if distal pisiform dislocations are detected early and managed surgically with open reduction and ligament repair. © 2019 BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED.Öğe Rifaximine spacer application is not superior to local teicoplanin treatment in a rat model of osteomyelitis(Kare Publ, 2022) Yücel, Mücahid Osman; Turhan, Yalçın; Arıcan, Mehmet; Karaduman, Zekeriya Okan; Sağlam, Sönmez; Tekçe, Yıldıray; Gamsızkan, MehmetOBJECTIVE: Acute and chronic osteomyelitis generally require long-term antibiotic therapy and surgical debridement. Implant-associated osteomyelitis, particularly from methicillin-resistant Staphylococcus aureus (MRSA) strains, is difficult to treat. Rifaximin is an antibiotic derived from rifamycin which may be effective in the treatment of osteomyelitis in terms of its wide spectrum of action and pharmacological properties. The aim of this experimental study was to investigate the local efficacy of rifaximin in rat models with MRSA and implant associated osteomyelitis.METHODS: This study was carried out with 40 adult Wistar albino rats. The rats were randomly divided into 4 equal groups with 10 rats in each. An implant related MRSA osteomyelitis was created in the right tibia metaphysis of each rat by Norden's experimental osteomyelitis model. After 4 weeks, the implants of each tibia were removed and debridement was applied. Group 1 was designed as control group and no other treatment was applied other than debridement. Bone cement without any antibiotic was applied to Group 2, bone cement with teicoplanin was applied to Group 3 and bone cement with rifaximin was applied to Group 4. After 4 weeks from the second surgery, euthanasia was performed to the rats and the clinical, histopathological and microbiological results were compared.RESULTS: There was no statistically significant difference between the groups in clinical scoring. A statistically significant difference was found between the histopathological scores of Group 1 and Group 2 and the histopathological scores of Groups 3 and 4; the histopathological scores of Group 1 and Group 2 were found to be higher than Group 3 and Group 4. When the pre-and post-treatment colony numbers were compared, although there was a statistically significant difference between Group 3 and Group 2, no statistically significant difference was found between Group 4 and Group 1 results.CONCLUSION: In spite of its wide spectrum, the local efficacy of rifaximin in the treatment of osteomyelitis could not be demonstrated. This study shows the ability to shed light on some future comprehensive studies with the inclusion of infection markers.Öğe Rifaximine spacer application is not superior to local teicoplanin treatment in a rat model of osteomyelitis(2022) Yücel, Mücahid Osman; Turhan, Yalçın; Arıcan, Mehmet; Karaduman, Zekeriya Okan; Sağlam, Sönmez; Tekçe, Yıldıray; Gamsızkan, MehmetOBJECTIVE: Acute and chronic osteomyelitis generally require long-term antibiotic therapy and surgical debridement. Implant- associated osteomyelitis, particularly from methicillin-resistant Staphylococcus aureus (MRSA) strains, is difficult to treat. Rifaximin is an antibiotic derived from rifamycin which may be effective in the treatment of osteomyelitis in terms of its wide spectrum of action and pharmacological properties. The aim of this experimental study was to investigate the local efficacy of rifaximin in rat models with MRSA and implant associated osteomyelitis. METHODS: This study was carried out with 40 adult Wistar albino rats. The rats were randomly divided into 4 equal groups with 10 rats in each. An implant related MRSA osteomyelitis was created in the right tibia metaphysis of each rat by Norden’s experimental osteomyelitis model. After 4 weeks, the implants of each tibia were removed and debridement was applied. Group 1 was designed as control group and no other treatment was applied other than debridement. Bone cement without any antibiotic was applied to Group 2, bone cement with teicoplanin was applied to Group 3 and bone cement with rifaximin was applied to Group 4. After 4 weeks from the second surgery, euthanasia was performed to the rats and the clinical, histopathological and microbiological results were compared. RESULTS: There was no statistically significant difference between the groups in clinical scoring. A statistically significant difference was found between the histopathological scores of Group 1 and Group 2 and the histopathological scores of Groups 3 and 4; the histopathological scores of Group 1 and Group 2 were found to be higher than Group 3 and Group 4. When the pre-and post-treatment colony numbers were compared, although there was a statistically significant difference between Group 3 and Group 2, no statistically significant difference was found between Group 4 and Group 1 results. CONCLUSION: In spite of its wide spectrum, the local efficacy of rifaximin in the treatment of osteomyelitis could not be demonstrated. This study shows the ability to shed light on some future comprehensive studies with the inclusion of infection markers.Öğe Topikal veya intravenöz uygulanan traneksamik asitin ratlarda yara iyileşmesi üzerine etkileri(Düzce Üniversitesi, 2019) Sağlam, Sönmez; Orhan, ZaferAmaç: Yara iyileşmesi tarih boyunca gerek major travmalar gerekse de majör cerrahi girişimler sonrası önemli bir sorun olmayı sürdürmektedir. TA kanama durdurucu olarak cerrahi operasyonlarda intravenöz veya topikal yolla yaygın şekilde kullanılmaktadır. Antifibrinolitik özelliği sayesinde TA; yara yerinde erken dönemde oluşan fibrin tıkacının çözünmesini bloke eder. Bu çalışma rat yara modelinde TA'nin yara iyileşmesi üzerine morfolojik ve histolojik etkileri değerlendirmektir. Gereç ve Yöntemler: Çalışmada 24 adet erişkin erkek Wistar Albino cinsi rat kullanıldı. Tüm ratlar 8'erlı 3 gruba ayrıldı. Grup 1'e yara oluşumu sonrası serum fizyolojik damlatıldı. Grup 2'ye cilt yarası oluşturulup topikal TA uygulandı. Grup 3'e yara oluşturulmadan önce intravenöz TA uygulandı sonrasında yara oluşturuldu. Grupların belli günlerde (0-3-7-10-14. günler) yara çapları fotoğraflandı. 14 gün sonra süreç tamamlanıp sakrifiye edildi. Histopatolojik sonuçları ve yara çapları kıyaslandı. Sonuçlar: Grup 1, grup 2 ve grup 3'ün lenfosit sayısı ve PMNL değerleri, skar kalınlığı değerleri arasında istatistiksel olarak anlamlı farklılık gözlenmemiştir (p=0,087; p=0,994; p=0,098). Grup 1, grup 2 ve grup 3 fibroblast sayısı değerleri arasında istatistiksel olarak anlamlı farklılık gözlenmiştir (p=0,018). Grup 1 fibroblast sayısı değerleri grup 2'den istatistiksel olarak anlamlı derecede düşük bulunmuş (p=0,002), diğer gruplar arasında istatistiksel olarak anlamlı farklılık gözlenmemiştir (p=0,05). Grup 1, grup 2 ve grup 3 kollajen yoğunluğu (%) değerleri arasında istatistiksel olarak anlamlı farklılık gözlenmiştir (p=0,049). Grup 1 kollajen yoğunluğu (%) değerleri grup 2 ve grup 3'den istatistiksel olarak anlamlı derecede yüksek bulunmuş (p=0,016, p=0,044), grup 2 ve grup 3 arasında istatistiksel olarak anlamlı farklılık gözlenmemiştir (p=0,999). Grup 1, grup 2 ve grup 3'ün yara çapı 3. ve 7.gün değerleri arasında istatistiksel olarak anlamlı farklılık gözlenmemiştir (p=0,074, p=0,978). Grup 1, grup 2 ve grup 3'ün yara çapı 10.gün değerleri arasında istatistiksel olarak anlamlı farklılık gözlenmiştir (p=0,0001). Grup 1 yara çapı 10.gün değerleri grup 2 ve grup 3'den istatistiksel olarak anlamlı derecede yüksek bulunmuş (p=0,001); grup 2 ve grup 3 arasında istatistiksel olarak anlamlı farklılık gözlenmemiştir (p=0,998). Grup 1, grup 2 ve grup 3 yara çapı 14. gün değerleri arasında istatistiksel olarak anlamlı farklılık gözlenmiştir (p=0,0001). Grup 1yara çapı 14. gün değerleri grup 2 ve grup 3'den istatistiksel olarak anlamlı derecede yüksek bulunmuş (p=0,001, p=0,0001); grup 2 ve grup 3 arasında istatistiksel olarak anlamlı farklılık gözlenmemiştir (p=0,144). Çıkarımlar: TA'nin topikal veya intravenöz uygulamansı yara iyileşmesi üzerine pozitif yönde etki eder. Anahtar Kelimeler, Traneksamik asit, yara iyileşmesi, rat
