Tetik Parmak Tedavisinde Perkütan Cerrahi Gevşetme

Amaç: Tetik parmak tedavisinde yaygınlaşmaya başlayan perkütan cerrahinin sonuçlarının hasta memnuniyeti açısından incelenmesi, hekim ve hasta açısından avantajların değerlendirilmesi amaçlandı. Metod: 2005-2012 yılları arasında 32 hastanın33 parmağına 19 Kadın 13 Erkek Ortalama yaş 48 16 G enjektör iğnesi ile perkütan gevşetme uygulandı. Hastalar ortalama 10 ay izlendi. Bulgular: Uygulama sonunda tüm hastalarda kilitlenme takılma hemen düzelmiş ,ağrı hissi ise ortalama 3 gün içinde geçmişti.Müdahale sonrası ortalama 3. Günde 1gün-5gün tüm hastalarda ağrısız tam eklem hareket açıklığı elde edilmişti .Bazı hastalarda 7 Hasta ençok 30 gün süren müdahale bölgesindeki sertlik hissi dışında ciddi bir komplikasyon görülmedi. Sonuç: Tetik parmak tedavisinde perkütan cerrahi teknik kolay uygulanabilir olması,kısa sürede uygulanabilmesi,insizyon ve sütür gerektirmemesi, hastanın ertesi günü işine dönebilmesi avantajları nedeniyle, tecrübeli ellerce yapıldığı taktirde oldukça başarılı bir yöntemdi

Simultaneous bilateral tibal tubercle avulsion: A rare fracture

Tibial tuberosity avulsion is a rare fracture in adolescence.Due to the shear forces on the immature epiphysis. Thirteenyears old girl was admitted to the emergency departmentwith knee pain and tenderness in both knees afterjumping from a height of about one meter. İn examinationshe had tenderness and swelling over both tibial tuberosities.The patient could not do active knee extension. TypeIIA fracture on the left and type IIIA fracture on the rightknee were detected. For the patient’s fractures, closedreduction and fixation with 3 smooth Kirschner wires wasperformed. After immobilization in long-leg brace for threeweeks the brace was removed and she include in therehabilitation program. In this report, we discuss similarcases in the literature and the results of the treatment appliedto our patient.Key words: Tuberositas tibia, avulsion fracture, percutaneouspinnin

The effect of iliac osteotomy on the femoral head circulation,a groving rabbit model

Gelişimsel kalça displazisi gerek tanı ve tedavisi gerekse komplikasyonlarıyla ortopedik sorunlar içinde önemli bir yer tutmaktadır. Tanı ve tedavideki ilerlemelere rağmen komplikasyon oranları azalmakla birlikte devam etmektedir.En önemli komplikasyonu femur başı avasküler nekrozudur. Avasküler nekrozun patogenezi ve önlenmesine yönelik günümüzde yeterli bilgiye sahip değiliz.Çalışmamızın amacı tavşan modelinde, asetabuler osteotomilerin, asetabuler displazi ve femur başı üzerine etkilerini değerlendirmekti. Bu amaca yönelik olarak biz çalışmamızda 2 grupta 8'er tavşan olmak üzere 16 adet tavşan kullandık. 1.gruptaki 8 tavşanın sol iliak kemiklerine medial korteksler sağlam kalacak şekilde in-situ osteotomi yaptık. Sağ kalça eklemlerine müdahele edilmedi. 2.grup 8 tavşanın yine sol iliak kemiklerine komplet osteotomi yapıldı ve araya önceden tasarlanıp steril edilen titanyum kama yerleştirilerek distraksiyon uygulandı.Distraksiyon ile femur başına binen yükün arttırılması amaçlandı. İşlem sonrası tavşanlar 3 hafta gövde alçısı ile tespit edildi. İkinci gruptaki 3 tavşan ilk hafta içinde öldü ancak onların kalça eklemleri de incelemeye tabi tutuldu. Üç hafta gözlemin sonunda her iki gruptaki hayvanlar sakrifiye edilip kalça eklemlerine %10'luk formol solüsyonunda bekletildikten sonra Hematoksilen Eozin'le boyanarak histopatolojik inceleme yapıldı.Birinci grupta, sadece osteotomi yapılan tavşanlarda asetabulumda kıkırdak değişikliklerinin yanında yeni kemik oluşumu, femur başında ise bir değişikliğin olmadığı görüldü. İkinci grupta ise asetabulumdaki birinci grupla benzer değişikliklere ilave olarak femur başı epifizinde kemikleşme artışı, epifiz hattında incelme ile beraber hücre dizilimlerinin düzensizleşmesi ve femur başında şekil değişikliği tespit edildi. İlk haftada ölen tavşanların femur başında bu bulgulara rastlanmadı.Sonuç olarak asetabular osteotomi sonrası femur başında basınç artışı olmasının epifizde erken kapanma, deformasyon ve avasküler nekroza yol açabileceği düşünülmektedir.Diagnosis, treatment and complications of developmental dysplasia of the hip have a great importance in orthopaedic problems . Despite progression in diagnosis and treatment, complications are stil present and difficult to control The most important complication is avascular necrosis of the femoral head.The aim of our study to investigate the effect of acetabular osteotomy on Acetabular development and on the femoral head. For this purpose, 16 rabbits were divided into 2 groups; unilateral insitu asetabular osteotomy was performed in the first group remaining the medial asetabular cortex intact, and unilateral complete osteotomy and distraction of the acetabular site was applied to the second group. Titanium wedge was placed into the osteotomy side to sustain distraction and pressure to the femoral head. The right side asetabuli were accepted as controls. The rabbits were kept in body cast for 3 weeks.Three rabbits in 2nd group died within the first week, but their hip joints were also subjected to pathologic examination. Both groups of animals were sacrificed at the end of 3 weeks. Hip joints were kept in 10% formalin solution and histopathologic examination was performed with Hematoxylin Eozin stain.Cartilage changes with new bone formation were seen at the acetabular side of the first group compared to the control site. In the second group, columnar pattern of the femoral head physis was changed and deformation of the femoral head was observed in addition to the asetabular changes of the first group. These femoral side pathologies were not observed at the 3 rabbits of the second group that were died in the first week.In conclusion, distraction of the acetabular osteotomy increase pressure on the femoral head and may produce deformation and avascular necrosis of the femoral head epiphysis

Trombositten zengin Fibrinin periferik sinir iyileşmesi üzerindeki histopatolojik etkileri

Objectives: Experimental studies have been carried out with various materials in order to accelerate and improve the quality of nerve healing. Purpose of our study to investigate the histopathological effects of platel et rich fibrin (PRF) on sciatic nerve healing in an experimental rat model. Methods:16 Sprague Dawley rats were randomly divided into the two groups (8 controls, 8 PRF). The sciatic nerves of all rats were transected and repaired with a 2 mm defect. In the PRF group, the defective zone was surrounded with PRF. Both group rats were sacrified and histopathologically examined at the end of 6 weeks. Result: PRF group histological scores were statistically significant (P = 0.001) compared to the control group. Axonal continuity was present in the PRF group nerves. In the control group, improvement of the defect with granulation texture was observed. Conclusion: PRF, which contains abundant amounts of cellular content and growth factors, provides a positive contribution to nerve healing

Treatment of End-Stage Hallux Rigidus Using Total Joint Arthroplasty: A Short-Term Clinical Study

The treatment of advanced hallux rigidus remains controversial. Only a few studies have analyzed the short and mid-term results of metatarsophalangeal (MTP) joint arthroplasty to treat patients with advanced hallux rigidus. We present the short-term follow-up results of patients who underwent MTP joint arthroplasty. We reviewed the medical records of 15 consecutive patients (3 males and 12 females) who had had grade 3 or 4 hallux rigidus diagnosed according to the Coughlin and Shurnas classification. The age range at surgery was 44 to 74 (mean 61.6) years. The mean follow-up period was 21.7 (range 18 to 28) months. The mean change in the overall American Orthopaedic Foot and Ankle Society Hallux-First Ray scale score was from 26.9 +/- 2.3 preoperatively to 78.7 +/- 8.8 postoperatively (p < .005). The mean change in the overall visual analog scale score was from 8.3 +/- 0.8 preoperatively to 1.7 +/- 0.7 postoperatively (p < .005). The mean preoperative first MTP joint range of motion was 22.3 degrees +/- 7.7 degrees (range 15 degrees to 45 degrees), which had increased to 77 degrees (range 65 degrees to 90 degrees) at the final follow-up visit. No patient required revision surgery or removal. These results indicate that for patients with advanced -stage hallux rigidus refractory to conservative treatment, total joint arthroplasty can lead to good satisfaction and good functional results in the short term. (C) 2017 by the American College of Foot and Ankle Surgeons. All rights reserved

Evaluation of the Effect of Platelet-Rich Fibrin on Long Bone Healing: An Experimental Rat Model

Pseudoarthrosis, or nonunion, of the long bones is a challenging medical condition for orthopedic surgeons to treat. Therefore, healing enhancer materials are commonly used. The authors investigated whether platelet-rich fibrin accelerates long bone healing by comparing radiological and histological findings in a rat model of open femoral fracture. Platelet-rich fibrin is a current biomaterial that contains many growth factors and platelets. There are no studies in the literature investigating the effects of platelet-rich fibrin on fracture healing. Sixteen mature male rats were divided into 2 groups. In both groups, an open femoral fracture was created. The platelet-rich fibrin was obtained by centrifuging blood collected from the rats. Rats in the study group were treated with sterile platelet-rich fibrin, and those in the control group were administered saline. The rats were killed at the end of 4 weeks and examined histologically and radiologically. The radiographic and histological scores of the 2 groups differed significantly (P<.05). These results indicate that platelet-rich fibrin is an efficient biomaterial in fracture healing and that it increases the amount of osseous tissue formation. Platelet-rich fibrin does not cause an allergic reaction, is cost-effective, and is easy to obtain. Additional studies are necessary to determine whether platelet-rich fibrin accelerates the fracture healing process or induces a better quality of fracture healing

Trigger wrist and carpal tunnel syndrome caused by hand intramuscular intrasynovial angiofibrolipoma: A rare case report

Trigger wrist is a clinical entity characterized by triggering or the crackling of the wrist. Here, a case is reported of intrasynovial angiofibrolipoma that caused trigger wrist and carpal tunnel syndrome. This is the only case report where trigger wrist and carpal tunnel syndrome caused by the intrasynovial angiofibrolipoma were developed simultaneously. it is believed that that adhesive tenosynovitis developing in the tendons may have contributed to the triggering and carpal tunnel syndrome in the wrist as a result of inflammation occuring as a consequence of intrasynovial angiofibrolipoma. [Hand Microsurg 2016; 5(2.000): 107-109