Objectives: We evaluated the effectiveness of interlocking intramedullary nailing in the treatmen... more Objectives: We evaluated the effectiveness of interlocking intramedullary nailing in the treatment of humeral shaft fractures. Methods: Forty-three patients (30 men, 13 women; mean age 42 years; range 20 to 83 years) were treated with interlocking intramedullary nailing for humeral shaft fractures. All fractures but one (type II open) were closed. Three patients had radial nerve, one patient had radial and ulnar nerve dysfunction. As all the nerve lesions were assessed as neuropraxia, no immediate surgical exploration was performed. Intramedullary nailing was performed by closed (18 fractures) and open technique (25 fractures), with (n=22) or without (n=21) reaming. Functional evaluation was made according to the Constant-Murley's shoulder scoring system. The mean follow-up was 16.5 months (range 5 to 40 months). Results: Radiologically, union was achieved in all patients in a mean of 15.6 weeks. No surgery-associated nerve injuries or infections were encountered. Preoperative nerve dysfunction resolved in all patients in a mean of 12.5 weeks. No signs of rotator cuff impingement or restriction were detected in two patients in whom the nails were placed high in close proximity to the shoulder girdle. Of these, one patient underwent reoperation for the removal of the nail after the fracture union completed. Functional results were excellent in all patients at the end of postoperative three months. No significant correlation was found between the techniques employed and time to union and functional outcome. Conclusion: Interlocking intramedullary nailing provides adequate fixation and early mobilization, and results in satisfactory radiographic and functional results in the treatment of humeral shaft fractures.
We evaluated 230 chronic osteomyelitis patients in GATA Haydarpasa Training Hospital Underwater a... more We evaluated 230 chronic osteomyelitis patients in GATA Haydarpasa Training Hospital Underwater and Hyperbaric Medicine Department. Hyperbaric Oxygen (HBO) Therapy was applied to patients at 2.5 ATA per day lasted 90 -120 min between the years 1995-2001. Medical treatments and surgical intervention were also applied in addition to Hyperbaric Oxygen Therapy. The rate of the sedimentation, CRP, radiography and the clinical view were made use of as an evaluation criteria. Among all, 135 patients (58.69%) were recovered. The number of HBO therapy sessions were 53.6 ± 8. As a result HBO therapy is evaluated as valuable as an adjunctive treatment in the chronic osteomyelitis in addition to medical and surgical treatments.
We report our experience, treatment protocol, and 2-year follow-up results of 24 fingertip replan... more We report our experience, treatment protocol, and 2-year follow-up results of 24 fingertip replantations treated using the artery-only technique without vein or nerve repair. We performed a retrospective review of 24 patients who had undergone fingertip replantation at the same center between 2005 and 2011. All patients in this study had complete fingertip amputation at or distal to the distal interphalangeal joint of the fingers or interphalangeal joint of the thumb. Patients with incomplete and complete amputations who had undergone vein and/or nerve repair along with artery repair were excluded. All patients received the same protocol including removal of the nail at the surgery and intravenous heparin 70 U/kg administered at the time of arterial anastomosis. After surgery, the nailbed was mechanically made to bleed with a sterile needle and mechanically scrubbed with a heparin-saline gauze. All patients received the same postoperative medical treatment protocol until physiological outflow was restored. Successful replantation was confirmed with clinical observation. Twenty-one of the 24 fingertip replantations (88%) were successful. The mean length of hospital stay was 7 days (range, 4-9 d). Fifteen of 22 patients required blood transfusion. The average amount of blood transfusion was 1.2 U (range, 0-3 U). This study shows that the described technique and protocol reconstructed circulation without vein anastomosis and with a high success rate. Furthermore, adequate sensory recovery without any nerve repair had occurred by the 2-year follow-up. Therapeutic IV.
We read with interest this article in which the authors described an unusual localisation of an a... more We read with interest this article in which the authors described an unusual localisation of an aneurysmal bone cyst in the trapezium, which they believed had not been recorded previously in the literature, with a brief and concise review. However, another case was ...
Acta Orthopaedica et Traumatologica Turcica, Jul 23, 2004
We present a 21-year-old male patient with an isolated ulnopalmar dislocation of the fifth carpom... more We present a 21-year-old male patient with an isolated ulnopalmar dislocation of the fifth carpometacarpal joint that occurred due to a fall on the hand. Diagnosis was delayed for five weeks and closed reduction was not successful. He was treated with open reduction and internal fixation. Upon removal of fixation materials six weeks after surgery, he developed reflex symphatic dystrophy and limitation in joint movements, which disappeared following rehabilitation and medical treatment at the end of 15 weeks. Functional and radiographic results were satisfactory.
The surgical procedures for unicameral solitary calcaneal bone cysts have ranged from simple cure... more The surgical procedures for unicameral solitary calcaneal bone cysts have ranged from simple curettage and grafting to subperiosteal resection with internal fixation and grafting. In this article, an endoscopically assisted technique is proposed for the curettage of a simple calcaneal cyst that takes advantage of direct visualization of the cyst wall and contents and permits accurate assessment of the extent of the lesion. After curettage, percutaneous filling of the defect with corticocancellous allograft makes the technique a complete, minimally invasive surgical approach for this condition. The technique uses 2 lateral portals, one for viewing and the other for manipulation, both of which are created under fluoroscopic control. Once the cyst has been located, the 30 degrees arthroscope is used to evacuate fluid, after which more solid cyst contents are fragmented and removed. Thereafter, curettage of the inner surface of the cavernous cyst wall is performed. Finally, complete packing of the previously cystic cavity with crushed corticocancellous allograft is performed under endoscopic visualization and confirmed radiographically.
Journal of the American Podiatric Medical Association, 2004
Twenty-six patients with moderate-to-severe hallux valgus deformities were evaluated before and a... more Twenty-six patients with moderate-to-severe hallux valgus deformities were evaluated before and after treatment. All of the patients had incongruent great toe joints. The patients underwent modified proximal crescentic osteotomy, which was termed proximal oblique crescentic osteotomy. The results were evaluated at an average follow-up time of 55 weeks. Objective criteria were hallux valgus angle, intermetatarsal angle, shortening of the first metatarsal, and angulation at the osteotomy site. Clinical evaluation was made according to the rating system of the American Orthopaedic Foot and Ankle Society. The mean correction of the hallux valgus and intermetatarsal angles was 22.1° and 9.9°, respectively. Short-term results indicate that proximal oblique crescentic osteotomy is effective in the treatment of hallux valgus; its advantages over other procedures include its technical ease and low rate of complications. (J Am Podiatr Med Assoc 94(1): 43-46, 2004)
Objectives: We evaluated the effectiveness of interlocking intramedullary nailing in the treatmen... more Objectives: We evaluated the effectiveness of interlocking intramedullary nailing in the treatment of humeral shaft fractures. Methods: Forty-three patients (30 men, 13 women; mean age 42 years; range 20 to 83 years) were treated with interlocking intramedullary nailing for humeral shaft fractures. All fractures but one (type II open) were closed. Three patients had radial nerve, one patient had radial and ulnar nerve dysfunction. As all the nerve lesions were assessed as neuropraxia, no immediate surgical exploration was performed. Intramedullary nailing was performed by closed (18 fractures) and open technique (25 fractures), with (n=22) or without (n=21) reaming. Functional evaluation was made according to the Constant-Murley's shoulder scoring system. The mean follow-up was 16.5 months (range 5 to 40 months). Results: Radiologically, union was achieved in all patients in a mean of 15.6 weeks. No surgery-associated nerve injuries or infections were encountered. Preoperative nerve dysfunction resolved in all patients in a mean of 12.5 weeks. No signs of rotator cuff impingement or restriction were detected in two patients in whom the nails were placed high in close proximity to the shoulder girdle. Of these, one patient underwent reoperation for the removal of the nail after the fracture union completed. Functional results were excellent in all patients at the end of postoperative three months. No significant correlation was found between the techniques employed and time to union and functional outcome. Conclusion: Interlocking intramedullary nailing provides adequate fixation and early mobilization, and results in satisfactory radiographic and functional results in the treatment of humeral shaft fractures.
We evaluated 230 chronic osteomyelitis patients in GATA Haydarpasa Training Hospital Underwater a... more We evaluated 230 chronic osteomyelitis patients in GATA Haydarpasa Training Hospital Underwater and Hyperbaric Medicine Department. Hyperbaric Oxygen (HBO) Therapy was applied to patients at 2.5 ATA per day lasted 90 -120 min between the years 1995-2001. Medical treatments and surgical intervention were also applied in addition to Hyperbaric Oxygen Therapy. The rate of the sedimentation, CRP, radiography and the clinical view were made use of as an evaluation criteria. Among all, 135 patients (58.69%) were recovered. The number of HBO therapy sessions were 53.6 ± 8. As a result HBO therapy is evaluated as valuable as an adjunctive treatment in the chronic osteomyelitis in addition to medical and surgical treatments.
We report our experience, treatment protocol, and 2-year follow-up results of 24 fingertip replan... more We report our experience, treatment protocol, and 2-year follow-up results of 24 fingertip replantations treated using the artery-only technique without vein or nerve repair. We performed a retrospective review of 24 patients who had undergone fingertip replantation at the same center between 2005 and 2011. All patients in this study had complete fingertip amputation at or distal to the distal interphalangeal joint of the fingers or interphalangeal joint of the thumb. Patients with incomplete and complete amputations who had undergone vein and/or nerve repair along with artery repair were excluded. All patients received the same protocol including removal of the nail at the surgery and intravenous heparin 70 U/kg administered at the time of arterial anastomosis. After surgery, the nailbed was mechanically made to bleed with a sterile needle and mechanically scrubbed with a heparin-saline gauze. All patients received the same postoperative medical treatment protocol until physiological outflow was restored. Successful replantation was confirmed with clinical observation. Twenty-one of the 24 fingertip replantations (88%) were successful. The mean length of hospital stay was 7 days (range, 4-9 d). Fifteen of 22 patients required blood transfusion. The average amount of blood transfusion was 1.2 U (range, 0-3 U). This study shows that the described technique and protocol reconstructed circulation without vein anastomosis and with a high success rate. Furthermore, adequate sensory recovery without any nerve repair had occurred by the 2-year follow-up. Therapeutic IV.
We read with interest this article in which the authors described an unusual localisation of an a... more We read with interest this article in which the authors described an unusual localisation of an aneurysmal bone cyst in the trapezium, which they believed had not been recorded previously in the literature, with a brief and concise review. However, another case was ...
Acta Orthopaedica et Traumatologica Turcica, Jul 23, 2004
We present a 21-year-old male patient with an isolated ulnopalmar dislocation of the fifth carpom... more We present a 21-year-old male patient with an isolated ulnopalmar dislocation of the fifth carpometacarpal joint that occurred due to a fall on the hand. Diagnosis was delayed for five weeks and closed reduction was not successful. He was treated with open reduction and internal fixation. Upon removal of fixation materials six weeks after surgery, he developed reflex symphatic dystrophy and limitation in joint movements, which disappeared following rehabilitation and medical treatment at the end of 15 weeks. Functional and radiographic results were satisfactory.
The surgical procedures for unicameral solitary calcaneal bone cysts have ranged from simple cure... more The surgical procedures for unicameral solitary calcaneal bone cysts have ranged from simple curettage and grafting to subperiosteal resection with internal fixation and grafting. In this article, an endoscopically assisted technique is proposed for the curettage of a simple calcaneal cyst that takes advantage of direct visualization of the cyst wall and contents and permits accurate assessment of the extent of the lesion. After curettage, percutaneous filling of the defect with corticocancellous allograft makes the technique a complete, minimally invasive surgical approach for this condition. The technique uses 2 lateral portals, one for viewing and the other for manipulation, both of which are created under fluoroscopic control. Once the cyst has been located, the 30 degrees arthroscope is used to evacuate fluid, after which more solid cyst contents are fragmented and removed. Thereafter, curettage of the inner surface of the cavernous cyst wall is performed. Finally, complete packing of the previously cystic cavity with crushed corticocancellous allograft is performed under endoscopic visualization and confirmed radiographically.
Journal of the American Podiatric Medical Association, 2004
Twenty-six patients with moderate-to-severe hallux valgus deformities were evaluated before and a... more Twenty-six patients with moderate-to-severe hallux valgus deformities were evaluated before and after treatment. All of the patients had incongruent great toe joints. The patients underwent modified proximal crescentic osteotomy, which was termed proximal oblique crescentic osteotomy. The results were evaluated at an average follow-up time of 55 weeks. Objective criteria were hallux valgus angle, intermetatarsal angle, shortening of the first metatarsal, and angulation at the osteotomy site. Clinical evaluation was made according to the rating system of the American Orthopaedic Foot and Ankle Society. The mean correction of the hallux valgus and intermetatarsal angles was 22.1° and 9.9°, respectively. Short-term results indicate that proximal oblique crescentic osteotomy is effective in the treatment of hallux valgus; its advantages over other procedures include its technical ease and low rate of complications. (J Am Podiatr Med Assoc 94(1): 43-46, 2004)
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