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Öğe Advantages of Distal Unlocked Proximal Femoral Nails in the Treatment of Stable Intertrochanteric Fractures in Geriatric Patients: A Single-Center Comparative Randomized Study(Sage Publications Inc, 2025) Saglam, Sonmez; Ersen, Omer; Tuzun, Harun Yasin; Yildiz, CemilBackground: This study aimed to investigate the effect of omitting a distal locking screw in intramedullary nailing of stable intertrochanteric femur fractures on clinical outcomes. Methods: Ninety-six patients over 65 years old with stable pertrochanteric fractures (AO/OTA 31-A1 and A2) treated with short/intermediate proximal femoral nails (PFNA-II) were randomly assigned into two groups: Group 1 (distal locked) and Group 2 (distal unlocked). Comparative analyses were conducted on operative time, total fluoroscopy time, blood loss, incision length, complications, and functional outcomes. Results: The mean operative time was significantly shorter in Group 2 (35.73 +/- 7.62 minutes) compared to Group 1 (47.40 +/- 9.96 minutes) (P < 0.001). Fluoroscopy time was also shorter in Group 2 (45.92 +/- 6.08 seconds) compared to Group 1 (54.02 +/- 5.94 seconds) (P < 0.001). Incision length was reduced in Group 2 (9.21 +/- 1.41 centimeters) compared to Group 1 (12.96 +/- 1.68 centimeters) (P < 0.001). Blood loss was lower in Group 2 (187.50 +/- 32.00 milliliters) than in Group 1 (208.65 +/- 49.12 milliliters) (P < 0.05). There were no significant differences between the groups in fracture union time, hospital stay, fracture union weeks, or postoperative blood transfusion rates. Conclusions: Proximal femoral nailing without distal locking offers shorter operative times, reduced fluoroscopy exposure, and lower blood loss and complications, making it a viable option for treating stable intertrochanteric fractures.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 a New Radiographic Technique with MRI Measurements for Tibial Tunnel Evaluation in ACL Reconstruction(Mdpi, 2025) Yucel, Mucahid Osman; Dalaslan, Rasit Emin; Saglam, Sonmez; Karaduman, Zekeriya Okan; Arican, Mehmet; Akar, Bedrettin; Tural, VolkanBackground/Objectives: The correct angular placement of the tibial tunnel is crucial to ensure graft tension, maintain knee stability, and ensure optimal clinical outcomes after anterior cruciate ligament (ACL) reconstruction. While 3D imaging methods such as MRI and CT are the gold standard for evaluating tunnel positioning, their routine use is limited by cost, availability, and time constraints. In clinical practice, 2D radiographs are more accessible but lack established reliability in accurately estimating tunnel angles. The aim of this study was to convert 2D radiographic angular measurements used in the evaluation of patients undergoing anterior cruciate ligament reconstruction into 3D values with a simple method and to compare these measurements with three-dimensional angles calculated using conventional MRI and CT. Methods: This retrospective study included 38 patients who underwent anatomic anterior cruciate ligament reconstruction. Postoperative radiographs and MR images were analyzed to determine the tibial tunnel angles. The angles calculated from 2D radiographs were statistically analyzed for their correlation with the actual 3D angles measured by MRI. Results: The analysis showed a strong correlation between tibial tunnel angles from radiographs and MRI, with minimal, non-significant differences. This suggests that radiographs can provide a reliable estimate of tibial tunnel angles. Conclusions: These findings suggest that radiographs can predict tibial tunnel angles in ACL reconstruction as accurately as MRI. This method can guide the correct tunnel angle and facilitate postoperative evaluation. Further studies are needed to confirm these results across various populations and techniques.Öğe Diabetes, Inflammatory Markers, and Tissue Thickness in Septic and Aseptic Hip Revision Surgeries(Int Scientific Information, Inc, 2025) Yucel, Mucahid Osman; Dalaslan, Rasit Emin; Saglam, Sonmez; Arican, Mehmet; Karaduman, Zekeriya Okan; Celik, Mucahit; Kose, Mehmet AkifBackground: Septic and aseptic loosening are the most common indications for revision hip arthroplasty (RHA), and infection-related revisions pose significant diagnostic and management challenges. This study compared septic and aseptic RHA cases in terms of inflammatory markers, prevalence of diabetes mellitus (DM), surgical time, blood transfusion requirements, soft-tissue thickness, and mortality rates in a cohort of 49 patients. Material/Methods: This retrospective study included 49 patients who underwent RHA between 2015 and 2020. Patients were divided into aseptic (n=34) and septic (n=15) groups. Demographic characteristics, comorbidities, preoperative erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels, soft-tissue thickness, and revision surgery time were compared. Results: ESR and CRP levels were significantly higher in the septic group (P=0.002, P=0.001), soft-tissue thickness was lower (p=0.003), blood transfusion requirements (P<0.001) and surgical times (P<0.00001) were higher, while no significant difference was found in mortality rates between the groups (P=0.576). Conclusions: This study examined septic and aseptic loosening in revision hip arthroplasty, finding higher inflammatory markers, increased transfusion needs, longer operative times, and greater infection risk with diabetes in septic cases. In our study, soft-tissue thickness was found to be lower in infected cases, unlike reports in the literature. While previous studies suggested that soft-tissue thickness was the cause of infection, our study indicates that the decrease in soft-tissue thickness is a consequence of infection.Öğe Effect of Oral plus Topical and Only Topical Tranaxamic Acid Application on Blood Loss and Postoperative Transfusion in Primary Total Hip Arthroplasty(Mdpi, 2025) Mutlu, Tansel; Arican, Mehmet; Karaduman, Zekeriya Okan; Turhan, Yalcin; Kaban, Ilyas; Dalaslan, Rasit Emin; Saglam, SonmezObjectives: Total hip arthroplasty is one of the most common procedures performed to reduce pain and improve hip functions in patients with advanced hip osteoarthritis, but perioperative blood loss, acute anemia and transfusion requirement increase the risk of morbidity and mortality during and after surgery and negatively affect functional recovery. We aimed to present the comparative results of oral + topical and only topical tranexamic acid application to reduce blood loss and postoperative transfusion in primary total hip arthroplasty. Methods: We retrospectively evaluated the patients who applied to the Orthopedics and Traumatology outpatient clinic with complaints of hip pain and limited movement between January 2014 and December 2020, who underwent primary total hip arthroplasty with the diagnosis of coxarthrosis and who were administered oral + topical and only topical tranexamic acid before and during surgery, in terms of blood loss and transfusion requirement. Results: No statistically significant difference was observed between the preoperative, day 0 and day 1 hemoglobin means in those that were applied oral + topical tranexamic acid and those that were applied only topical (p > 0.05). However, the second- and third-day hemoglobin means in those that were treated with topical medication alone were found to be statistically significantly lower than in those that were treated with oral + topical tranexamic acid (p = 0.032, p = 0.0001). Conclusions: Oral + topical tranexamic acid application in total hip arthroplasty surgery is more effective than topical applications alone when it comes to reducing blood loss, hemoglobin and hematocrit decrease without increasing the risk of thromboembolic diseases and wound complications.Öğe The effect of peripheral dopamine on fracture healing: an experimental study in a rat model(Bmc, 2025) Yucel, Mucahid Osman; Dalaslan, Rasit Emin; Saglam, Sonmez; Arican, Mehmet; Karaduman, Zekeriya Okan; Turhan, Banu; Demir, FatihBackgroundDopamine is a versatile biomolecule that functions as a neurotransmitter, hormone, and immune modulator in the body. Although some anabolic effects of dopamine on bone tissue have been described in the literature, its influence on the complex processes involved in fracture healing remains unclear. This study aimed to evaluate the effects of dopamine on bone healing at the peripheral level.MethodsThirty-six male Wistar albino rats were randomly assigned to two groups: a control group with no treatment and a dopamine group that received 12 mg/kg levodopa twice daily via oral gavage following surgery. A standardized femoral fracture was induced under anesthesia in all the rats, which were then fixed with an intramedullary Kirschner wire. Each group consisted of 18 rats, and six rats from each group were randomly sacrificed on postoperative days 15, 30, and 45. The harvested femurs were first evaluated radiologically, followed by biomechanical analysis via a three-point bending test, and finally subjected to histopathological examination.ResultsNo significant differences were observed between the groups on days 15 and 30. However, on day 45, histopathological scores were significantly lower in the dopamine group (p = 0.015), and biomechanical strength was also lower (p = 0.004). Radiological scores were not significantly different between the groups at any time point.ConclusionDespite the known anabolic effects of dopamine on bone cells, it may adversely affect fracture healing. The negative impact of dopamine on bone union could be attributed to the multifactorial and complex nature of fracture healing, the dynamics of inflammatory processes, and the cumulative effects of various dopamine receptor subtypes.Öğe The Effects of Phenyramidol and Diclofenac Treatment on Fracture Healing in Rats(Korean Orthopaedic Assoc, 2024) Celik, Mucahit; Karaduman, Zekeriya Okan; Turhan, Yalcin; Arican, Mehmet; Gamsizkan, Mehmet; Saglam, Sonmez; Uludag, VeyselBackground: Fracture healing or nonunion refers to a process in which many factors interact. In this study, we aimed to evaluate the radiological, histological, and biomechanical effects of phenyramidol and diclofenac, which are frequently used to treat post-fracture ture pain worldwide, on fracture healing and nonunion in a rat femur fracture model. Methods: In this study, 72 male Wistar-Albino rats aged 2-3 months and weighing 250 +/- 30 g were divided into 4 main groups. The rats were divided into 12 subgroups according to the early, middle, and late periods. A fracture model was created in rat femurs, and surgical fixation was performed. Postoperative analgesic treatment protocols included phenyramidol, diclofenac, phenyramidol + diclofenac, and the control group. The rats were sacrificed on the fifteenth, thirtieth, and forty-fifth days and were evaluated radiologically, histopathologically, and biomechanically. Results: Scoring was conducted independently by 2 orthopedists not involved in the study. When the results were analyzed statistically, no statistically significant difference was observed between the fifteenth and thirtieth day radiology score values of the control, diclofenac, phenyramidol, and Phenyramidol + diclofenac groups (p > 0.05), but there was a statistically significant difference (p < 0.05) between the forty-fifth day radiology score values of the control, diclofenac, phenyramidol, and phenyramidol + diclofenac groups. Conclusions: Our study shows that the use of diclofenac or phenyramidol alone negatively affects postoperative fracture healing. However, this effect was less pronounced in the combined treatment group. Histologic examination revealed that neither treatment had a significant effect on healing. There were statistical differences in biomechanical and radiologic properties between the phenyramidol and diclofenac groups; in particular, the diclofenac group had lower biomechanical properties.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 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 Significance of Preoperative Multidisciplinary Assessment with 30-Second Sit-to-Stand and Timed Up-and-Go Tests in Predicting Postoperative Outcomes(Mdpi, 2025) Yucel, Mucahid Osman; Saglam, Sonmez; Dalaslan, Rasit Emin; Arican, Mehmet; Karaduman, Zekeriya Okan; Akar, Bedrettin; Celik, MucahitBackground/Objectives: Evaluating basic daily activities like sitting, standing, and walking is crucial for predicting preoperative risks and postoperative recovery. These functional abilities can be assessed through patient history or measured using objective tests. For this purpose, the 30-Second Sit-to-Stand (30STS) Test and Timed Up-and-Go (TUG) Test are frequently used in clinical settings. However, few studies have evaluated their effectiveness in anesthesia and orthopedics. In this study, we aimed to assess the applicability of these tests across clinical disciplines. Methods: A total of 43 patients who underwent total knee arthroplasty (TKA) surgery between January and December 2023 with American Society of Anesthesiologists (ASA) scores of 2-3 were retrospectively evaluated. The 30STS, TUG, and VAS scores were recorded preoperatively and on postoperative days 90-180. Results: The preoperative 30STS and TUG scores showed no statistically significant difference between the ASA 2-3 groups, but the ASA 2 group demonstrated a more pronounced performance improvement in both tests during the first 90 days postoperatively. The correlation tests revealed a strong positive relationship with the TUG Test and a moderate positive relationship with the 30STS and VAS scores. Conclusions: The correlation between the preoperative and postoperative results of the 30STS and TUG Tests suggests that preoperative tests can predict post-operative functional performance. However, the lack of a significant statistical relationship between the preoperative tests and ASA scores indicates that these tests may not be sufficiently useful for assessing the functional capacity. The better test outcomes in the ASA 2 patients indicate that combining these assessments with anesthetic evaluations may improve postoperative functional predictions, thereby promoting a multidisciplinary approach.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.
