Treatment of Femoral Neck Fractures with Arthroplasty Method and Our Results, 6 Years Follow-Up,

Background: While femoral neck fractures occur in elderly patients as a result of lowenergy traumas, they occur in young patients as a result of high-energy traumas. Clinical findings indicate that it generally occurs in female and elderly patients who are not mobilized and patients with comorbidity, hip pain and fractured leg in external rotation. These fractures are associated with avascular necrosis and nonunion with high incidence. Early diagnosis is of great importance in order to prevent the complications. Methods: Various treatment methods are available for femoral neck fractures. Choosing the appropriate treatment in femoral neck fractures treatment is very significant for keeping potential mortality and morbidity at minimum level. Generally surgery is the treatment performed. Fixation is the prioritized treatment in young patients. Arthroplasty is preferred method in elderly patients. Conclusion: In our study, we shared 6-years follow-up results of the cemented partial prosthesis that we applied in 57 patients with femoral neck fracture (the mean age is 73,8). All of the patients were enabled to return to their normal lives with the surgery performed at an early period after fracture and with early mobilization. No serious complication arose except for acetabular cartilage erosion that we faced in the long-term and temporary complications in the early post-operative period (injury problems, sore throat and chest pain etc.). In elderly patients, cemented partial prosthesis use is safe and effective

On the Knee joint arthroscopy – A Review with a Case study,

Arthroscopic surgical interventions can be performed as a surgical day case. The low morbidity of the arthroscopic surgery makes it attractive for both the surgeons and patients and it also has certain advantages such as small incision size and a small amount of bleeding and pain. Therefore, there is a possibility of early ambulation and discharge, which reduces risk of thrombophlebitis. The infection risk is also low due to the small incision size and the disinfection fluids used. Our study included 114 patients with a knee joint injury, on which arthroscopic partial meniscectomy was performed. We observed that pre-operation diagnoses made during physical and radiological examination matched 87% of those made during the surgery. It was also observed that 16 patients had fluid extravasation into the femoral and posterior tibial regions, 22 patients had post-op hemarthrosis, 15 patients had serous fluid blister, 11 patients suffered pain and ecchymosis for a period of 1 month on the side where the tourniquet was released, 9 patients experienced tibial collateral ligament injury and 18 patients had portal infection treated with antibiotics. 89% of problems the patients experienced disappeared

The Results of Local Steroid and Physiological Saline Solution Used for Chronic Achilles Tendinitis, A 2-Year Follow Up,

Background and objectives: Achilles tendon (AT) is the strongest and the thickest tendon of human body. Sarcostyles of this tendon are not exactly vertical and have a spiral shape to some extent. Due to this fact, tendon gets stronger and the contact (friction) between sarcostyles decreases. Achilles tendinitis is a kind of wounding that can be caused by overuse or misuse of achilles tendon, lack of flexibility, genetical structure, gender, age, height, weight, pes cavus deformity, lateral ankle instability, forefoot varus, lateral heel throb during the act of walking and excessive compensatory pronation, decrease in ankle dorsiflexion, lower extremity alignment disorders, endocrine and some metabolic factors and many others. It mostly happens for athletes. If we look with a histopathological perspective at achilles tendinitis, we will see that tendon has an angiofibroblastic hyperplasia. The reaction created against the degenerative process of tendon is an inflammatory response in peritenon. Throughout the treatment, pains and tenderness are tried to be decreased. In order for this purpose, resting, hypothermia and NSAID can be applied. Raising the heel is recommended in order to decrease the burden on tendon. Within the chronic process, the renewal of tendon is preferred. Methods: In our study; a 30 cc local anesthetic and saline physiological injection was applied to 38 of 98 patients while a mixture of 15 cc corticosteroid and local anesthetic injection was applied to 60 patients. Conclusion: It is highly significant that we did not record any relapse within our 2-year follow-up after increasing local blood circulation with the injection of physiological saline and local anesthetic mixed solution although we got the response later than steroid method and the rate of success in this method was relatively low. Moreover, this method has no side effects and can be used securely when steroid method cannot be used

Ön çapraz bağ cerrahisinde kullanılan greftler ve uygulama sonuçlarının 5 yıllık süreçte değerlendirilmesi,

ÖÇB yırtıkları en sık görülen diz yaralanmaları arasındadır ve diz instabilitesine, menisküs yaralanmalarına, erken dejeneratif değişiklerin gelişmesine neden olduğundan bu bağın rekonstrüksiyonu önem taşımaktadır. Günümüzde rekonstrüksiyonda seçilecek greft, tespit yöntemleri, greft tünel uyumunu ve iyileşmesini artıracak yöntemler en çok tartışılan konulardır. ÖÇB rekonstrüksiyonunda allogreftler, otogreftler ve sentetik greftler kulanılır. Ön Çapraz Bağ (ÖÇB) rekonstrüksiyonunda kullanılacak ideal greftin; kolay uygulanabilir, düşük donör saha morbiditesi, ÖÇB»ın normal anatomik yerleşimine uygulanabilir olması, hemen rijit fiksasyonu yapılabilir olması, fiksasyon yerinde hızlı revaskülarize olabilmesi, işlem sonrasında normal ÖÇB mekanik ve ultrastrüktürel özelliklerini kazanması gereklidir. Çalışmada; toplam 106 hastaya uygulanan artroskopik ÖÇB rekonstrüksiyonu ameliyatında, 62 hastaya semitendinosus ve gracilis otogrefti, 28 hastamıza patellar tendon otogrefti ve 16 hastamıza iki ucu kemikli patellar tendon allogrefti kullanıldı. Patellar tendon otogreftli hastalarda 3 ayda, semitendinosus ve gracilis otogreftli hastalarda 4,3 ayda ve allogreftli hastalarda 5,4 ayda aktif yaşama dönüş sağlandı. 5 yıllık takip sonucunda; semitendinosus ve gracilis otogreftli 62 hastanın 5 inde kopma, 28 patellar tendonlu hastaların 3 ünde kopma ve 16 sında diz önü ağrısı, allogreft uygulanan 16 hastanın 7 sinde kopma ve çeşitli eklem sorunları tespit edildi

Humerus pseudartrozlarında eksternal tespit yönteminin değerlendirilmesi,

Humerus pseudartrozu, humerus kemiğinin çeşitli nedenlerden dolayı kaynamaması demektir. Humerus cisim kaynamamasında, omuz ve dirsek eklem sertliği, ağrı ve güçsüzlüğe bağlı morbidite sıktır. Humerus pseudartrozlarının tedavisinin başarılı olması için pseudoartroz tipi¬nin belirlenmesi önemlidir. Fonksiyonel bir üst ekstremite için kabul edilebilir sınırlarda kaynama sağlanması önemlidir. Humerus cisim kırıklarının büyük çoğunluğu konservatif yöntemlerle tedavi edilir. Ancak yüksek enerjili travmalardan kaynaklanan humerus kırıklarında konservatif tedavi başarısız olur. Bu durumda cerrahi tedavi gerekir. Humerus kırıklarında cerrahi tedavi açık kırıklar, kırıkla beraber damar yaralanması olması, bununla birlikte ipsilateral önkol kırığının olması segmenter kırıklar, patolojik kırıklar, bilateral humerus kırıkları, radial sinir lezyonu olması, penetran yaralanmaya bağlı nörolojik defisit olması, kırığın eklem içine uzanması durumlarında uygulanır. Kullanılan cerrahi yöntemlerden eksternal tesbit yöntemleri, gelişen kilitleme özellikleriyle artan mekanik stabiliteleri sayesinde kanal içi çivileme ile de kaynamama tedavisinde başarılı sonuçlar verebilir. Bu bağlamda çalışmada eksternal tespit yöntemlerinin sunulması amaçlanmıştır. Çalışmaya; 12 hastaya humerus avasküler pseudoartrozu nedeniyle uygulanan kırık uçlarını canlandırma sonrası, unilateral eksternal fiksatörle akut kompresyon sonrası, ortalama 4.3 ayda elde edilen tam kaynama vakaları dahil edilmiştir (Figür 1-2-3-4-5-6). Çalışma sonunda hastalarda omuz ve dirsek fonksiyonları etkilenmemiş, herhangi bir komplikasyon gelişmemiştir

Genç hastalarda osteoartrit ve aynı seansta lokal anestezili diz eklemi lavajı ile hyalüronik asit enjeksiyonu uygulama sonuçlarının değerlendirilmesi,

Osteoartrit (OA) kıkırdak dejenerasyonudur ve yaşamı olumsuz etkiler. Daha çok yaşlılarda görülen bu önemli sağlık sorununun gençlerde görülme sebepleri cinsiyet, ırk, kalıtım, obezite, travma, mekanik etkenler, kas güçsüzlüğü, östrojenin azalması ve beslenme yetersizliği olarak sayılabilir. Osteoartritte eklemin durumunu değerlendirmek için direkt grafiler kullanılır. Bu çalışmada; osteoartrite genel bakış ve 164 radiografik kellgren sınıflamasına göre stage 2 ve 3 olan hastalarda, aynı seansta lokal anesteziyle uygulanan diz eklemi lavajı ile hyalüronik asit enjeksiyonu sonrası 1 yıllık takibe göre; sadece eklem lavajı veya eklem içi hyalüronik asid uygulamalarına göre çok daha iyi sonuç veren 2 metodun beraber uygulanma sonuçları sunulmuştur

Classification System in Adolescent Idiopathic Scoliosis,

Scoliosis is defined as the lateral spinal curvature with a 10° Cobb angle or above. Idiopathic scoliosis accounts for nearly 80% of the structural coronal deformities. According to the age groups, it is classified as infantile (the ages between 0-3), juvenile (ages between 4-9), adolescence (the age of 10 – until maturity). King classification and Lenke classification are the mostly widely used classifications in idiopathic scoliosis classification systems. Although the classification system presented by Peking Union Medical College (PUMC) is simple and easy to understand, Lenke system is considered more advantageous for practical use. Lenke classification is the most widely used and accepted classification system

Flexor Tendon Injuries and Evaluation of Treatment Results,

Flexor tendon injury is the most commonly seen hand injury. Tendons are the structures which enable the muscles to adhere to the bones and transmit the movement starting from the muscle to the bones. They have significant role in hand movement. As treatment method, surgical repair: 1. Primary repair; 2. Secondary Repair techniques are used. With the scientific studies conducted, flexor tendon morphology, kinematics, biomechanics, biological properties and tendon improvement became quite understandable, good suturing materials were developed, and consequently successful studies regarding primary repair results were published. Flexor tendon surgery has reached its current level with the accumulation of knowledge obtained from the increased clinical and experimental studies. This study addresses flexor tendon injuries and surgical treatment methods. We achieved 76,12 % full functioning fingers in the results we obtained following the physical treatment application that started on the 10th day after primary repair that we performed in 67 patients who applied with acute flexor tendon Zone 1-2 and 3 incision. Flexion restriction and contracture developed in 16 patients (23,88 %) at various levels. Scar softening and revision surgery for contracture excision was performed in 8 patients (11,94%) with Zone 2 injury due to contracture. Superficial skin infection developed in 21 patients (31,34%) and was treated. Revision surgery was performed in 6 patients with Zone 1 injury due to rupture occurred during rehabilitation

Surgical Treatment of Hallux Valgus

Hallux valgus deformity is an often deformity in which first metatarsophalangeal joint is subluxated due to the lateral deviation of thumb and medial deviation of metatarsal bone. As deformity progresses, it results in function and uniformity loss, with lateral displacement of thumb and deformity of claw toe and hammer toe. Shoes’ pressure on bunion area causes its inflammation and pain. Conservative and surgical treatment methods are used for the treatment of Hallux valgus deformity. According to the results of our study, which we obtained through soft tissue corrective procedures and bunionectomy applied under local anesthesia to 86 patients with Hallux valgus at different times, patients could walk within a short period of time, wear shoes comfortably, and their pains decreased considerably

Femur Intertrochanteric Fractures,

Fractures that occur in the area between large and small trochanter are called intertrochanteric femur fractures. Beside femur neck fractures, intertrochanteric femur fractures are one of the most significant health problems seen in old patients. Over 75% of intertrochanteric fractures occur as a result of simple falls while walking or standing. For intertrochanteric fractures, bipolar leinbach endoprosthesis is the priority treatment option, which is applied easily without any need for further equipment such as much scopy or traction, and allows for mobility in a postoperative short time. Being an easy, effective and safe biological diagnosis method and preferred especially in high risky cases, it also ensures bone setting with little damage to periphery tissue through closed reduction and external fixator. In our study, we involved 38 patients with traumatic femur intertrochanteric fractures to whom we applied partial leinbach endoprosthesis. Patients with intertrochanteric fractures who applied late following the fracture were not included in our study. All of our patients were operated and mobilized in 48 hours following the fracture, and no serious complications occurred