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Öğe Anatomik Ön Çapraz Bağ Rekonstrüksiyonun Femoral Tünel Oblisitesi İle İlişkisinin Klinik Olarak Değerlendirilmesi(2019) Turhal, Ozan; Karaduman, Zekeriya Okan; Turhan, Yalçın; Güler, Cemal; Cangür, Şengül; Arıcan, MehmetAmaç: Artroskopik ön çapraz bağ (ÖÇB) rekonstrüksiyonlarında hamstring tendon grefti, patellar tendon grefti,allogreft gibi çeşitli tendon greftleri kullanılmaktadır. Çalışmamızda, Otojen Hamstring Tendonlar kullanılarakAnatomik Ön Çapraz Bağ Rekonstrüksiyonu uygulanan hastalarda femoral tünel oblisitesinin sonuçlarını güncelliteratür eşliğinde değerlendirmeyi amaçladık.Gereç ve Yöntemler: Ocak 2013 – Haziran 2016 tarihleri arasında ön çapraz bağ rüptürü nedeniyle kliniğimizdecerrahi olarak tedavi edilen hastalar telefonla aranarak hastaneye davet edildi. Bunlar içerisinden fizik muayeneleri,grafi kontrolleri ve ölçümleri yapılan 64 hasta çalışmaya dâhil edildi.Bulgular: Hastalarımızın 55’i erkek, 9’u bayandı. Hastaların yaş ortalaması 29.3±8.12 (14-47) idi. Ortalama takipsüremiz 14.47±7.44 (6-36) aydır. Kontrol Lysholm ve Tegner skoru ameliyat öncesi değerlerle karşılaştırıldığındaistatistiksel açıdan ileri derecede anlamlı farklılıklar bulundu (p<0.001). International Knee Documentation Committee(IKDC) diz bağları değerlendirme sistemine göre ameliyat öncesi 3 hasta (%4.7) B, 18 hasta (%28.12) C ve 43 hasta(%67.18) D olarak saptandı. Ameliyat sonrası yapılan son kontrol muayenesinde 41 hasta (%64.06) A, 21 hasta(%32.81) B ve 2 hasta (%3.12) C grubuna dâhil edildi. Ortalama femur tüneli oblisitesi 41.2±7.2° bulundu.Sonuç: Ön çapraz bağ’ın rotasyonel stabilitesine oblik femoral tünel yerleşiminin daha fazla yarar sağladığıdüşünülmektedir. Biz bu çalışmamızın sonucunda ön çapraz bağın otojen hamstring tendon grefti kullanarak anatomikteknikle uygulanmasının femoral tünel oblisite artışının fonksiyonel sonuca katkısının daha yararlı olduğukanaatindeyiz.Öğe Chondroprotective effect of Nigella sativa oil in the early stages of osteoarthritis: an experimental study in rabbits(Jmni, 2019) Turhan, Yalçın; Arıcan, Mehmet; Karaduman, Zekeriya Okan; Turhal, Ozan; Gamsızkan, Mehmet; Aydın, Davut; Özkan, KorhanPurpose: Nigella sativa oil possesses a well-known ability to protect certain organs from oxidative, neoplastic, and inflammatory damage. This study investigated the potential chondroprotective effects of intraarticular injections of Nigella sativa oil in a rabbit osteoarthritis model. Methods: Osteoarthritis models were created by performing anterior cruciate ligament transections in 20 New Zealand rabbits. Rabbits were randomly divided into two groups of 10 and given intraarticular injections in their right knees weekly for 5 weeks, beginning in the third week post-operation. Injections given to the first group contained whole Nigella sativa oil, whereas the second group was injected with a saline solution. Knee joints were harvested 8 weeks after surgery. Knee joint surfaces were examined macroscopically, and medial femoral condyle sections were examined microscopically. Results: There was a statistically significant difference in the macroscopic grading results of the groups, with the Nigella sativa group having better results (p=0.001). The Nigella sativa group also received significantly better total Osteoarthritis Research Society International (OARSI) scores (p=0.035). Conclusions: Intraarticular administration of Nigella sativa oil has the potential to protect cartilage from degeneration in the early stages of osteoarthritis.Öğe Comparative Study of the Functional and Clinical Outcomes of Two Different Rotator Cuff Repair Techniques: Suture Anchor versus Transosseous Sharc-FT(2020) Karaduman, Zekeriya Okan; Arıcan, Mehmet; Turhal, Ozan; Turhan, Yalçın; Solak, Kazım; Akkurt, Mehmet Orçun; Cangür, ŞengülAim: The aim of the present study was to compare the functional and clinical outcomes of suture anchor andtransosseous Sharc-FT fixation options in mini-open repair of rotator cuff tears.Material and Methods: Between January 2010 and July 2016, 60 patients were operated on in the Orthopedics andTraumatology Clinics of Duzce University Hospital and Duzce State Hospital. Thirty patients in whom repair wasperformed with suture anchor (Group 1) and 30 patients in whom repair was performed with Transosseous Sharc-FT®(Group 2) were compared. Preoperative and postoperative shoulder ranges of motion, the visual analog scale scores,constant shoulder scores, Oxford shoulder scores, and Q-DASH shoulder scores were evaluated in Group 1 and Group 2patients.Results: A total of 62% of the participants were male and 38% were female. Gender distribution was homogeneous inboth groups (P=0.426). The mean age of the subjects was 57.35 ± 8.69 (41-78) years. No significant difference wasnoted between the groups in terms of mean age (P=0.232). On the basis of the post-hoc test results, the postoperativeconstant score was significantly higher in Group 2 compared with that in Group 1 (P<0.001).Conclusion: Rotator cuff repair using transosseous Sharc-FT fixation material provides tighter stability compared withsuture anchor and has superior functional, radiological, and pain scores. Furthermore, early rehabilitation is anotheradvantage of using Transosseous Sharc-FT in patients who prefer undergoing rotator cuff repair over other fixationoptions.Öğe Comparison of the Effects of Nigella sativa Oil and Nano-silver on Wound Healing in an Experimental Rat Model(Kowsar Publ, 2019) Turhan, Yalçın; Arıcan, Mehmet; Karaduman, Zekeriya Okan; Turhal, Ozan; Gamsızkan, Mehmet; Aydın, Davut; Özkan, KorhanBackground: Various topical treatments are available for skin defects. Chronic and complicated wounds can affect a patient's quality of life and cause significant economic burden and even mortality. Nigella sativa (NS) oil and silver-containing solutions are separately used to treat various skin disorders. Objectives: The current study aimed at examining the healing potential of NS oil, Nano-silver (AgNPs) solution, and their combination to manage skin wounds in a rat model. Methods: The current clinical experimental study was conducted in the Experimental Animal Unit of Abant Izzet Baysal University, Bolu, Turkey, in 2017. Full-thickness skin defects with a 1 cm(2) surface area were created on the backs of 20 adult Wistar albino rats. The wounds were covered with 1 cm(2) of absorbable oxidized regenerated cellulose (SURGICEL). The rats were numbered and assigned to four groups by simple random sampling. The agents to be compared (saline, NS oil, and AgNPs solution) were administered to the wounds twice daily forts days. The wounds were observed for the percentage reduction in original wound size every three days. Scars were harvested on day15 for histological morphometric analysis. Results: There were no significant differences in the mean vertical scar thickness among the saline (group 1) [1.06 +/- 0.18], NS oil (group 2) [0.76 +/- 0.14], AgNPs (group 3)10.98 +/- 0.44], and NS oil + AgNPs (group 4) [0.87 +/- 0.38] groups (P = 0.556). However, the mean collagen density was significantly lower in groups 1 and 3 [56.50 +/- 11.18 and 59.60 +/- 3.16] compared with groups 2 and 4 [73.57 +/- 6.30 and 80.99 +/- 7.19] (P < 0.001). Conclusions: Wounds treated with the combination of NS oil and Nano-silver healed significantly faster, with less scar formation, than the ones treated with NS oil or Nano-silver alone.Öğe A Comparison of the Modified Bosworth and Endobutton Techniques in the Surgical Treatment of Rockwood Type III Acromioclavicular Joint Dislocations(2020) Karaduman, Zekeriya Okan; Orhan, Zafer; Turhan, Yalçın; Arıcan, Mehmet; Değirmenci, Erdem; Turhal, OzanAim: In this study, we aimed to retrospectively compare the long-term clinical and radiological outcomesobtained with the modified Bosworth technique and Endobutton technique in surgical treatment of type IIIacromioclavicular dislocations.Materials and Methods: Thirty-two patients (26 males, 6 females) (mean age 37, range 15–78 years) weretreated surgically for acromioclavicular joint (ACJ) dislocation. All patients had type III dislocation. Twentytwo patients had right ACJ dislocation and 10 patients had left ACJ dislocation. Of the dislocations, 18 occurred due to falls; 9, sports injuries; and 5, traffic accidents. Of the patients, 18 were operated on with theEndobutton technique and 14 with the modified Endobutton technique. Patients were evaluated postoperatively in terms of functional Constant, DASH, and VAS scores and radiologically with coracoclavicular distance(CCD) assessment. The mean follow-up was 52 (37–66) months.Results: The alignment of the acromioclavicular joint was normal in all patients. No joint degeneration wasobserved in any patient. Shoulder movements were painless and complete in all patients. The mean postoperative 3rd, 12th, and 24th month Constant scores were found significantly higher for the Endobutton group thanfor the modified Bosworth group (p=0.001). The mean postoperative 3rd, 12th, and 24th month DASH scoreswere significantly lower for the Endobutton Group than for the modified Bosworth group (p=0.003). Themean postoperative 3rd, 12th, and 24th month VAS scores were significantly lower for the Endobutton groupthan for the modified Bosworth group (p=0.001). However, no statistically significant difference was foundbetween the mean preoperative and postoperative CCD values of the two groups (p=0.104).Discussion and Conclusion: The Endobutton technique is a good alternative to the modified Bosworthtechnique in the surgical treatment of acromioclavicular dislocations.Öğe Comparison of transtibial and anteromedial portal techniques used in anterior cruciate ligament repair using autogenous hamstring tendon graft(Duzce University Medical School, 2019) Karaduman, Zekeriya Okan; Turhal, Ozan; Turhan, Yalçın; Arıcan, Mehmet; Cangür, ŞengülAim: The aim of this study was to investigate the effects of transtibial (TT) and anteromedial portal (AMP) techniques used in anterior cruciate ligament repair on knee joint function after anterior cruciate ligament reconstruction. Material and Methods: Sixty patients who were surgically treated in our clinic for anterior cruciate ligament tear were included in the study. Thirty patients underwent TT technique and 30 patients underwent AMP. Functional evaluations were performed according to Lysholm, International Knee Documentation Committee (IKDC) and Tegner scoring preop and postop. The angle between the femoral tunnel and the distal joint face was measured in postoperative Anteroposterior and Lateral knee graphs and its effect on the knee joint functional outcome was examined. Results: Eighty percent of the patients included in the study were male (n=47) and 20% were female (n=13). The gender distribution according to the groups was homogeneous (p=0.476). The mean age of the subjects was 32.75±8.81 (16-53) years. The postoperative Lysholm score was significantly higher in the AMP group than in the TT group (p<0.001). The postoperative Tegner score was significantly higher in the AMP group than in the TT group (p<0.001). Mean femoral tunnel obliquity was 59.3° in the TT group and 41.4° in the AMP group. Conclusion: It is thought that oblique femoral tunnel placement is more beneficial for the rotational stability of anterior cruciate ligament. In our study, we think that AMP technique is more beneficial than femoral obliquity in terms of functional outcome. © 2019, Duzce University Medical School. All rights reserved.Öğe Comparison of Two Different Approaches to Treat a Hallux Valgus Deformity: Intramedullary Self-Locked Plates and Herbert Screws(Mdpi, 2019) Karaduman, Zekeriya Okan; Turhal, Ozan; Turhan, Yalçın; Arıcan, Mehmet; Güler, Cemal; Cangür, ŞengülBackground and objectives: Hallux valgus is a complex deformity of the first metatarsophalangeal joint characterized by varus deformity of the first metatarsal bone, valgus deformity of the big toe, and lateral deviation of the extensor tendons and sesamoid bones. Several surgical methods have been described for correction of the deformity. Different materials have been used for the fixation of osteotomy. We compared the functional, radiological, and pain results of intramedullary self-locked plates and Herbert screws for the treatment of a hallux valgus deformity. Materials and Methods: Distal metatarsals were treated with self-locking intramedullary plate-screw systems in 18 feet from 12 patients (Group 1) and with Herbert screws in 18 feet from 12 patients (Group 2). The hallux valgus angle (HVA) and intermetatarsal angle (IMA) in patients of Group 1 and 2 were examined radiologically during the pre- and postoperative periods. We also determined the American Orthopedic Foot and Ankle Society (AOFAS), EQ-5D General Life Quality Scale, and Visual Analogue Scale (VAS) scores during the pre- and postoperative periods and compared the scores between groups. Results: Post hoc test results of HVA and IMA angles measured after the operation were significantly higher in Group 2 than in Group 1. In each group, the AOFAS scores during the preoperation period were significantly lower than those during the postoperation period (p < 0.001). According to the post hoc test results, the VAS scores after the operation were significantly higher in Group 2 than in Group 1 (p < 0.001). Conclusions: For the surgical treatment of hallux valgus, operations using self-locked plates compared to a single screw are superior in terms of providing rigid stability and for functional, radiological, and pain scores.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 Evaluation of the Clinical Efficacy of Using Thermal Camera for Cryotherapy in Patients with Total Knee Arthroplasty: A Prospective Study(Mdpi, 2019) Karaduman, Zekeriya Okan; Turhal, Ozan; Turhan, Yalçın; Orhan, Zafer; Arıcan, Mehmet; Uslu, Mustafa; Cangür, ŞengülBackground and objectives: Cryotherapy is a method of treatment using cold application. This study aimed to evaluate postoperative clinical and hematological parameters and pain associated with total knee arthroplasty in patients and compared cryotherapy to the conventional method of cold ice pack compressions. Materials and Methods: Between January 2015 and January 2016, 90 patients who underwent total knee arthroplasty for grade 4 gonarthrosis were prospectively evaluated. The patients were divided into three groups (n = 30, each): Group 1, cryotherapy was applied in the pre- and postoperative periods; Group 2, cryotherapy was applied only in the postoperative period; and Group 3 (control group), only a cold pack (gel ice) was applied postoperatively. In all groups, pre- and postoperative evaluations at 6, 24, and 48 h, hemorrhage follow-up, knee circumference measurement, visual analog scale pain score, knee circumference, and temperature measured by thermal camera were recorded. Results: Of the 90 patients, 10% were men and 90% were women. The mean age was 64.3 +/- 8.1 (range: 46-83) years. The patella upper end diameter values were significantly lower in the postoperative period in Groups 1 and 2 than in Group 3 (p = 0.003). Hemoglobin levels at 24 and 48 h postoperatively were significantly lower in Group 3 than in Group 1 (p < 0.001, each) and Group 2 (p = 0.038, p < 0.001). At 6, 24, and 48 h follow-ups, pain values were significantly lower in Group 2 than in Group 3 (p < 0.001). Preoperative 6, 24, and 48 h temperature values were significantly lower in Group 1 than in Group 3 (p < 0.001 for each). It was found that the difference between preoperative and postoperative knee flexion measurements was significantly different in both groups or the difference between the groups was changed in each period (p < 0.001). Conclusions: Postoperative cryotherapy is a potentially simple, noninvasive option and beneficial for the reduction of reducing pain, bleeding, length of stay, analgesic requirement and swelling after total knee arthroplasty. Moreover, there was no early or late prosthesis infection in cryotherapy groups, which may be considered as an additional measure to prevent prosthesis infection.Öğe Is there an Advantage of Subchondral Drilling and Bone Marrow to Hyaluronic Acid Injection at Rabbit's Knee Osteoarthritis? An Experimental Study(2021) Turhal, Ozan; Arıcan, Mehmet; Gamsızkan, Mehmet; Agar, Anıl; İyetin, Yusuf; Kılıç, Bülent; Turhan, YalçınObjective: The objective of this study is to compare the individual histopathological changes caused by subchondral drilling (SCD) and bone marrow injection accompanied by hyaluronic acid (HA) in rabbits with knee osteoarthritis (OA) that is stimulated by the anterior cruciate ligament transection. Method: An OA design was created in 20 New Zealand rabbits, which were then randomly divided into two groups of ten rabbits each. The first group was named as the SCD group, in which 0.3 mL bone marrow aspirate was taken from the proximal medial tibial region and injected into the same knee joint; thereafter, retrograde SCD was applied to the proximal tibial region. The second group (HA) received intra-articular injections of 0.3 mL HA oil once weekly for three weeks. The knee joints were removed nine weeks post-surgery after the animals were killed. The knee joint articular cartilage areas were examined macroscopically, and the medial femoral condyle sections were examined histopathologically. Results: Significantly better macroscopic grading results were observed in the SCD group than in the HA group (p = 0.0001). There was no significant difference in the OA cartilage histopathology (OACH) grade between the groups (p = 0.752), but the SCD group showed a significantly better OACH stage result than the HA group (p = 0.039). The total OACH score inclined to be lower in the SCD group than in the HA group (p = 0.192). Conclusion: This study demonstrated that SCD with intra-articular bone marrow injection slowed the progression of OA and protected the cartilage surface during the early stages of OA better than HA.Öğe Nonoperative Treatment of Type IIA Supracondylar 3 Humerus Fractures: Comparing 2 Modalities(Lippincott Williams & Wilkins, 2019) Turhal, Ozan; Karaduman, Zekeriya O.; Turhan, Yalçın…Öğe Otojen hamstring tendon grefti ile anatomik ön çapraz bağ rekonstrüksiyonu orta dönem sonuçlarımız(Düzce Üniversitesi, 2017) Turhal, Ozan; Karaduman, Zekeriya OkanGİRİŞ VE AMAÇ: Ön çapraz bağ yaralanmaları, bağın kendi iyileşme potansiyelinin düşük olması nedeniyle ortopedistlerin sıkça karşılaştığı tedavi sürecinin uzun zaman aldığı en önemli spor yaralanmalarının başında gelir. Çalışmamızda, kliniğimizde cerrahi olarak tedavi edilmiş ön çapraz bağ yaralanması olan olgularda, Otojen Hamstring Tendonlar kullanılarak Anatomik Ön çapraz Bağ Rekonstrüksiyonu Orta Dönem Sonuçlarını güncel literatür eşliğinde değerlendirmeyi amaçladık. GEREÇ VE YÖNTEM: Ocak 2013 – Haziran 2016 tarihleri arasında ön çapraz bağ rüptürü nedeniyle kliniğimizde cerrahi olarak tedavi edilen hastalar telefonla aranarak hastaneye davet edildi. Davetimizi kabul eden hastalarımıza çalışma hakkında bilgi verilerek yazılı onamları alındı, kabul edenlerin; fizik muayeneleri, grafi kontrolleri ve ölçümleri yapılarak 64 hasta çalışmaya dahil edildi. BULGULAR: Hastalarımızın 55' i erkek, 9' u bayandı. Hastaların yaş ortalaması 29,3 ± 8,12 (14-47) idi. Ortalama takip süremiz 14,47 ± 7,44 (6-36) aydır. Hastalarımızın ameliyat öncesi yapılan değerlendirmelerinde Lysholm Skorlaması ortalama 40,58 olarak saptandı. Operasyon sonrası yapılan son kontrol muayenesinde Lysholm Skoru ortalama 89,19 olarak saptandı. Lysholm Skorlamasına göre operasyon sonrası yapılan son kontrol muayenesinde 21 hasta mükemmel, 32 hasta iyi ve 7 hasta orta grupta yer aldı. Hastalarımızın İnternational Knee Documentation Committee (IKDC) diz bağları değerlendirme sistemine göre ameliyat öncesi 3 hasta B, 18 hasta C ve 43 hasta D olarak saptandı. Ameliyat sonrası yapılan son kontrol muayenesinde 41 hasta A, 21 hasta B ve 2 hasta C grubuna dahil edildi. Cincinatti Skorlama sistemine göre ameliyat öncesi skor ortalama 14,86 iken ameliyat sonrası 6. ayda bu değer 26,67 olarak saptandı. SONUÇ: Biz bu çalışmamızın sonucunda ön çapraz bağın otojen hamstring greft kullanarak anatomisine en uygun olacak şekilde tamir edilmesi ile fonksiyonel ve radyolojik olarak başarılı neticeler alındığını düşünmekteyiz. Ayrıca dört katlı otojen hamstring otogreftinin ön çapraz bağı en çok taklit edebilen ve güçlü olması sebebiyle erken rehabilitasyona izin vermesi avantaj olarak nitelendirilebilir.Öğe Rotator Manşet Onarımında İki Farklı Tekniğin Fonksiyonel ve Klinik Sonuçlarının Karşılaştırmalı Olarak İncelenmesi: Sütür Ankor ve Transosseöz Sharc-FT(Düzce Üniversitesi, 2020) Karaduman, Zekeriya Okan; Arıcan, Mehmet; Turhal, Ozan; Turhan, Yalçın; Solak, Kazım; Akkurt, Mehmet Orçun; Cangür, ŞengülAmaç: Bu çalışmada,rotator manşet yırtıklarında sütür ankor ve transosseöz sharc-FT fiksasyonseçeneklerinin mini-açık onarımının fonksiyonel ve klinik sonuçlarınıkarşılaştırmayı amaçladık.Gereç veYöntemler:Ocak 2010 - Temmuz 2016 arasında Düzce Üniversitesi Hastanesi Ortopedi veTravmatoloji Kliniğinde ve Düzce Devlet Hastanesi Ortopedi ve TravmatolojiKliniğinde Ocak 2010 - Temmuz 2016 tarihleri arasında 60 hasta ameliyat edildi.30 hasta sütür ankor (grup 1) ile tamir edilen ve 30 Transosseöz Sharc -FT®(grup 2) ile ameliyat edilen hastalar karşılaştırıldı. Preoperatif vepostoperatif omuz hareket açıklığı, VAS skoru, Constant omuz skoru, Oxford omuzskoru ve Q-DASH omuz skoru grup 1 ve 2 hastada değerlendirildi.Bulgular: Katılımcıların%62’si erkek, %38'si kadındı. Gruplara göre cinsiyet dağılımı homojendi (P=0,426).Deneklerin yaş ortalaması 57,35 ± 8,69 (41-78) idi. Gruplar arasında yaşortalaması açısından anlamlı fark yoktu (P=0,232). Post-hoc testine göre,ameliyat sonrası Constant skoru Grup 2'de Grup 1'den anlamlı olarak yüksekbulundu (P lt;0,001).Sonuç: TransosseözSharc-FT fiksasyon malzemesi ile rotator manşet onarımının, sütür ankor’a göresıkı stabilite sağladığı ve üstün fonksiyonel, radyolojik ve ağrı skorlarınasahip olduğu sonucuna vardık. Ayrıca, erken rehabilitasyonun Transosseöz Sharc-FTkullanılarak diğer tespit seçeneklerine göre rotator manşet onarımı geçirenhastalar için bir avantaj olduğu sonucuna vardık.Öğe Surgically Treated Posterior Acetabular Fractures Via Iselin’s Modified Approach with A Short-Term Follow-Up(Ordu Üniversitesi, 2019) Değirmenci, Erdem; Orhan, Zafer; Arıcan, Mehmet; Karaduman, Zekeriya; Turhan, Yalçın; Turhal, OzanObjective: The main purpose of the surgical treatment of posterior acetabular fracture is to achieve anatomical reduction to attain a functional and stable hip joint without pain. Although Kocher-Langenbeck (K-L) approach is the most commonly used surgical exposure, various modified approaches have been described in the literature. The aim of this study to determine the early surgical results of the acetabulum posterior fractures surgery via Iselin's modified K-L approach. Methods: We reviewed the hospital records of patients who were operated for acetabulum posterior wall fractures via Iselin's modified approach between 2016 and 2018. All patients had detailed radiological, clinical evaluation and fractures were classified by AO/ASIF classification. All patients had radiological and clinical evaluation at the end of the postoperative 1st year. Results: There were 16 men and 4 women with an average age of 42.8±18.0 (range 18-77) years. The average follow-up was 14.8±6.1 (range 6-28) months. The right hip was involved in 12 (60%) patients and the left in 8 (40%) patients. The average operative time was 78.6±16.7 (range, 54–115) minutes. Average blood loss during the operation was 179.22±51.9 (range, 100–260) ml. The postoperative reduction was graded as anatomic (0–1 mm of displacement) for 17 hips and imperfect (2–3 mm of displacement) for 3 patients. No patient had a deep infection, implant loosening, recurrent dislocation, deep venous thrombosis (DVT), pulmonary embolism (PE) or revision fixation. Conclusion: The modified approach of Iselin is a successful approach with its ease in the surgery of displaced fractures that extending proximally and early radiological and functional results.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 Temporary Fixation of Reduction with Fabric Adhesive Bandage in the Surgical Treatment of Pediatric Supracondylar Humerus Fractures(Mdpi, 2019) Turhal, Ozan; Kınaş, Mustafa; Karaduman, Zekeriya Okan; Turhan, Yalçın; Kaya, Onur; Güler, CemalBackground and objectives: Supracondylar humerus fractures are common in children and can be surgically treated. However, the general surgical procedures involving reduction and fixation might lead to reduction loss, failure to direct the Kirschner (K)-wire toward the desired position, prolonged surgery, or chondral damage. This study aimed to show that temporary fixation of closed reduction with a fabric adhesive bandage in pediatric supracondylar humerus fractures could maintain reduction so that surgical treatment can be easily performed by a single physician. Materials and Methods: Forty-six patients with Gartland type 3 supracondylar humerus fractures who underwent surgical treatment between May 2017 and June 2018 were retrospectively evaluated. Fluoroscopy-guided reduction and fixation were performed from the distal third of the forearm to the proximal third of the humerus using a fabric adhesive bandage. Two crossed pins were applied on the fracture line by first inserting a lateral-entry K-wire and then inserting another K-wire close to the anterior aspect of the medial epicondyle and diverging from the ulnar nerve tunnel. A tourniquet was not applied in any patient and no patients required open reduction. Results: The study included 32 boys (69.6%) and 14 girls (30.4%) (mean age, 7.1; range, 2-16 years). The mean hospital stay and follow-up duration were 4.3 +/- 3.9 days and 48.1 +/- 14.3 weeks, respectively. Heterotopic ossification was detected in one patient, and ulnar nerve neuropraxia was detected in another patient. Functional (according to Flynn criteria) and cosmetic outcomes were excellent in 95.6%, moderate in 2.2%, and poor in 2.2% of patients. The mean duration of fixation of the closed reduction with a fabric adhesive bandage was 8.1 +/- 3.9 min, and the mean duration of pinning was 7.9 +/- 1.4 min. Conclusions: Temporary preoperative fixation of supracondylar humerus fractures that require surgical treatment with a fabric adhesive bandage may be significantly convenient in practice.
