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Çelik M, Çiftçi MU, Çelik S, Öztürk V, Bayrak A, Duramaz A, Kural A, Kural C. Can The Systemic Immune-Inflammation Index (SII) and Charlson Comorbidity Index (CCI) be used to predict mortality in patients with necrotizing fasciitis? Int Orthop 2024:10.1007/s00264-024-06190-9. [PMID: 38653817 DOI: 10.1007/s00264-024-06190-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 04/16/2024] [Indexed: 04/25/2024]
Abstract
PURPOSE This study aimed to determine the impact of mortality and morbidity indices on the diagnosis and prognosis of patients suffering from necrotizing fasciitis. METHODS A retrospective analysis was performed on 41 patients (26 females, 15 males) with necrotizing fasciitis (NF). The SII (Systemic Immune-Inflammation Index) was computed using the formula SII = (P × N)/L, where P, N, and L measure the counts of peripheral platelets, neutrophils, and lymphocytes, respectively. This study evaluated the clinicopathological characteristics and follow-up information to assess the comparative effectiveness of SII, CCI (Charlson Comorbidity Index), and LRINEC (Laboratory Risk Indicator for Necrotizing Fasciitis) scores as mortality and morbidity indices for patients with NF. RESULTS The optimal cut-off for SII was determined to be 455. The SII value in the group with mortality was significantly higher compared to the group without mortality (p < 0.05). The CCI value in the group with mortality was significantly higher than the group without mortality (p < 0.05). The SII and CCI values were found to be effective in distinguishing between patients who suffered mortality and those who did not. CONCLUSION SII is a powerful tool for predicting mortality in patients with necrotizing fasciitis (NF). The SII index provides a novel, easily accessible, and inexpensive indicator for monitoring the progress and predicting the survival of patients with NF.
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Affiliation(s)
- Malik Çelik
- Bakirkoy Dr. Sadi Konuk Research and Training Hospital Orthopaedics and Traumatology Clinic, Zuhuratbaba Mah. Tevfik Sağlam Cad. No:11, 34147, Istanbul, Turkey.
| | - Mehmet Utku Çiftçi
- Bakirkoy Dr. Sadi Konuk Research and Training Hospital Orthopaedics and Traumatology Clinic, Zuhuratbaba Mah. Tevfik Sağlam Cad. No:11, 34147, Istanbul, Turkey
| | - Semih Çelik
- Siirt Research and Training Hospital, Anesthesia And Reanimation Clinic, Siirt, Turkey
| | - Vedat Öztürk
- Bakirkoy Dr. Sadi Konuk Research and Training Hospital Orthopaedics and Traumatology Clinic, Zuhuratbaba Mah. Tevfik Sağlam Cad. No:11, 34147, Istanbul, Turkey
| | - Alkan Bayrak
- Bakirkoy Dr. Sadi Konuk Research and Training Hospital Orthopaedics and Traumatology Clinic, Zuhuratbaba Mah. Tevfik Sağlam Cad. No:11, 34147, Istanbul, Turkey
| | - Altuğ Duramaz
- Bakirkoy Dr. Sadi Konuk Research and Training Hospital Orthopaedics and Traumatology Clinic, Zuhuratbaba Mah. Tevfik Sağlam Cad. No:11, 34147, Istanbul, Turkey
| | - Alev Kural
- Bakirkoy Dr. Sadi Konuk Research and Training Hospital Department Of Biochemistry, Istanbul, Turkey
| | - Cemal Kural
- Bakirkoy Dr. Sadi Konuk Research and Training Hospital Orthopaedics and Traumatology Clinic, Zuhuratbaba Mah. Tevfik Sağlam Cad. No:11, 34147, Istanbul, Turkey
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Çakmur BB, Duramaz A, Çakmur KN, Duramaz A. Do the management and functional outcomes of the surgically treated spinal fractures change in suicidal jumpers? Eur Spine J 2024:10.1007/s00586-024-08259-w. [PMID: 38652295 DOI: 10.1007/s00586-024-08259-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 02/20/2024] [Accepted: 04/03/2024] [Indexed: 04/25/2024]
Abstract
PURPOSE The aim of the study was to determine the effect of trauma etiology on the management, functional outcomes and psychiatric characteristics of suicide jumpers and patients who accidentally fall from height. METHODS 89 patients (48 accidental falls and 41 suicidal jumpers) who had undergone spinal surgery were included in the study. The patients were evaluated clinically and radiologically. Visual Analog Scale (VAS), Roland Morris Disability Questionnaire (RMDQ) and McGill Pain Questionnaire (MPQ) were performed for functional evaluation. BECK hopelessness scale (BHS), BECK depression inventory (BDI), and SF-36 scales were used for the psychiatric evaluation. All outcomes were compared between suicidal jumpers and accidental falls. RESULTS The RMDQ and ODI questionnaires stated a higher disability in the suicide jump group (p = 0.001 and p = 0.029, respectively). However, the VAS and MPQ questionnaires did not differ in significance between groups (p = 0.182 and p = 0.306, respectively). The SF-36 scale showed that physical function, role emotional, vitality and mental health subdomains were worse in the suicide jump group (p = 0.001, p = 0.029, p = 0.014 and p = 0.030, respectively). BDI scores were significantly higher in the suicide jump group while no difference was observed between the groups in terms of BSH (p = 0.017 and p = 0.940, respectively). CONCLUSION Psychiatric disorders are more common in patients in the suicidal jumpers. The presence of underlying psychiatric problems adversely affects the postoperative functional outcomes of patients with surgically treated spinal fractures. A multidisciplinary approach together with raising awareness in this way can improve the clinical outcomes after orthopedic treatment, even if there is physical disability.
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Affiliation(s)
- Başar Burak Çakmur
- Department of Orthopedics and Traumatology, Hamidiye Medical School, Istanbul Başakşehir Çam ve Sakura City Hospital, University of Health Sciences, Başakşehir St., G-434 Ave., Number 2L Başakşehir, 34494, Istanbul, Turkey
| | - Altuğ Duramaz
- Department of Orthopedics and Traumatology, Hamidiye Medical School, Bakırköy Dr. Sadi Konuk Education and Research Hospital, University of Health Sciences, Tevfik Sağlam St. Number 11, Bakırköy, 34147, Istanbul, Turkey.
| | - Kadriye Nur Çakmur
- Department of Psychiatry, Hamidiye Medical School, Bakırköy Prof Mazhar Osman Education and Research Hospital for Psychiatry Neurology and Neurosurgery, University of Health Sciences, Tevfik Sağlam St. Number 11 Bakırköy, 34147, Istanbul, Turkey
| | - Altan Duramaz
- Republic of Turkey Ministry of National Education, Gazi Mustafa Kemal Street, Number 1 Yenişehir, 27090, Mersin, Turkey
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Öztürk V, Çelik M, Koluman AC, Duramaz A, Kural C, Bilgili MG. Fluroscopy-assisted transiliac antegrade lag screw placement technique in both columns of acetabulum: A novel procedure. Orthop Traumatol Surg Res 2024:103872. [PMID: 38548224 DOI: 10.1016/j.otsr.2024.103872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Revised: 02/09/2024] [Accepted: 03/21/2024] [Indexed: 04/05/2024]
Abstract
The use of pelvic osseous fixation corridors and lag screw fixation in acetabular and pelvic surgery has gained popularity, especially with the recent development of intraoperative imaging and navigation techniques. However, advanced intraoperative imaging and navigation techniques require technical equipment and are costly. Therefore, traditional fluoroscopic techniques still maintain their importance. In this article, we describe a novel pelvic osseous fixation corridor that traverses both columns of the acetabulum, along with the detailed methodology of its fluoroscopic imaging and the techniques for fluoroscopy-assisted screw placement. The technique of placing screws in this current fixation corridor is only under fluoroscopy assistance, without using any specially produced guide or navigation device. LEVEL OF PROOF: IV.
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Affiliation(s)
- Vedat Öztürk
- Bakırköy Dr. Sadi Konuk Education and Research Hospital, Department of Orthopedics and Traumatology, Tevfik Sağlam St. Number 11, 34147 Bakırköy/Istanbul, Turkey.
| | - Malik Çelik
- Bakırköy Dr. Sadi Konuk Education and Research Hospital, Department of Orthopedics and Traumatology, Tevfik Sağlam St. Number 11, 34147 Bakırköy/Istanbul, Turkey
| | - Ali Can Koluman
- Bakırköy Dr. Sadi Konuk Education and Research Hospital, Department of Orthopedics and Traumatology, Tevfik Sağlam St. Number 11, 34147 Bakırköy/Istanbul, Turkey
| | - Altuğ Duramaz
- Bakırköy Dr. Sadi Konuk Education and Research Hospital, Department of Orthopedics and Traumatology, Tevfik Sağlam St. Number 11, 34147 Bakırköy/Istanbul, Turkey
| | - Cemal Kural
- Bakırköy Dr. Sadi Konuk Education and Research Hospital, Department of Orthopedics and Traumatology, Tevfik Sağlam St. Number 11, 34147 Bakırköy/Istanbul, Turkey
| | - Mustafa Gökhan Bilgili
- Bakırköy Dr. Sadi Konuk Education and Research Hospital, Department of Orthopedics and Traumatology, Tevfik Sağlam St. Number 11, 34147 Bakırköy/Istanbul, Turkey
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Ziroglu N, Birinci T, Koluman A, Şahbaz Y, Çiftçi MU, Baca E, Duramaz A. Reliability and Validity of the Turkish Version of the American Orthopaedic Foot and Ankle Society Hallux Metatarsophalangeal-Interphalangeal Joint Scale. Foot Ankle Spec 2023:19386400231214285. [PMID: 38018560 DOI: 10.1177/19386400231214285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2023]
Abstract
BACKGROUND The American Orthopaedic Foot and Ankle Society Hallux Metatarsophalangeal-Interphalangeal (AOFAS Hallux MTP-IP) scale is one of the most widely used outcome measures to evaluate hallux pathologies. This study aimed to translate the AOFAS Hallux MTP-IP scale into Turkish and investigate its psychometric properties. METHODS The psychometric properties of the Turkish version of the AOFAS Hallux MTP-IP (AOFAS Hallux MTP-IP-T) scale were tested in 66 patients with hallux pathologies (52 women; mean age, 47.64 ± 12.75 years). Cronbach's alpha was used to assess internal consistency. The intraclass correlation coefficient (ICC) was used to estimate test-retest. Construct validity was analyzed with the Turkish version of the Manchester-Oxford Foot Questionnaire (MOXFQ), Visual Analogue Scale (VAS), and 12-item Short-Form Health Survey(SF-12). RESULTS The AOFAS Hallux MTP-IP-T scale had adequate internal consistency (α = 0.71) and test-retest reliability (ICC2,1 = 0.93 for pain, ICC2,1 = 0.97 for function, and ICC2,1 = 0.97 for total score). The AOFAS Hallux MTP-IP-T total score has a moderate to strong correlation with VAS-activity and MOXFQ (ρ = -0.77, P = .001; ρ = -0.69, P = .001, respectively). The weakest correlation was found between the AOFAS Hallux MTP-IP-T and the SF-12 mental component scale (ρ = 0.31, P = .01). CONCLUSION AOFAS Hallux MTP-IP-T has sufficient reliability and validity to evaluate Turkish-speaking individuals with a variety of forefoot pathologies including the hallux. LEVELS OF EVIDENCE Level II.
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Affiliation(s)
- Nezih Ziroglu
- Department of Orthopedics and Traumatology, Atakent Hospital, Acibadem University, Istanbul, Turkey
| | - Tansu Birinci
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Istanbul Medeniyet University, Istanbul, Turkey
| | - Alican Koluman
- Department of Orthopedics and Traumatology, Bakırköy Dr. Sadi Konuk Education and Research Hospital, Istanbul, Turkey
| | - Yasemin Şahbaz
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Istanbul Beykent University, Istanbul, Turkey
| | - Mehmet Utku Çiftçi
- Department of Orthopedics and Traumatology, Bakırköy Dr. Sadi Konuk Education and Research Hospital, Istanbul, Turkey
| | - Emre Baca
- Department of Orthopedics and Traumatology, Bakırköy Dr. Sadi Konuk Education and Research Hospital, Istanbul, Turkey
| | - Altuğ Duramaz
- Department of Orthopedics and Traumatology, Bakırköy Dr. Sadi Konuk Education and Research Hospital, Istanbul, Turkey
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Duramaz A, İlter MH, Tuzlali H. Correction to: Is magnetic resonance imaging needed for decision making diagnosis and treatment of thoracic and lumbar vertebral fractures? Eur J Orthop Surg Traumatol 2023; 33:117. [PMID: 35076749 DOI: 10.1007/s00590-022-03211-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Affiliation(s)
- Altuğ Duramaz
- Department of Orthopedics and Traumatology, Bakırköy Dr. Sadi Konuk Education and Research Hospital, Tevfik Sağlam St. Number 11, Bakırkö, 34147, Istanbul, Turkey.
| | - Mehmet Hakan İlter
- Department of Orthopedics and Traumatology, Letoon Hospital, Pazaryeri St., Küçükçoban Ave, Number 22, 48300, Fethiye/Muğla, Turkey
| | - Hatice Tuzlali
- Department of Radiology, Wexham Park Hospital, Wexham Street, Slough Berkshire, London, UK
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Bayrak A, Duramaz A, Koluman A, Kural C, Ziroglu N, Gözügül K, Peker G. Does plate-screw density affect the functional outcomes in the treatment of proximal humerus fractures? ULUS TRAVMA ACIL CER 2022; 28:824-831. [PMID: 35652884 PMCID: PMC10443008 DOI: 10.14744/tjtes.2021.99078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Accepted: 03/04/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND The aim of the study is to evaluate the relationship between plate-screw density (PSD), functional results, and complication rates in the treatment of proximal humerus fractures (PHFs) with proximal humerus locking anatomical plate (PHLAP). METHODS Consecutive 43 patients (22 females and 21 males) who underwent PHLAP for the treatment of PHF between 2010 and 2016 were evaluated. AO classifications were used for the classification of fractures. Based on the biomechanical stability the-ory of Erhardt et al., the patients were divided into two groups as <60% and >60% according to the number of screws fixed to the humeral head for the determination of PSD. The patients were divided into two groups as PSD <60% (n=21) and PSD>60% (n=22) according to the number of screws fixed to the humeral head for the determination of PSD. Functional results were evaluated using the Constant-Murley shoulder score (CMS). Radiological evaluation was performed with collodiaphyseal angle (CDA), varus-valgus angulation, avascular necrosis (AVN), and arthrosis. The groups were compared in terms of demographic characteristics, functional results, radiological scores, and complications. RESULTS The mean age was 54.47±17.43 years and the mean follow-up time was 19.51±5.27 months. Although the CMS scores of patients with a PSD of over 60% were higher than those below 60%, the CMS score did not differ statistically. In groups, the mean CDA of the operated shoulder was significantly lower than that of the non-injured side (p=0.002). Eight patients had varus angulation, whereas two patients had humerus head AVN. No significant relationship was observed between PDS and functional scores, radiolog-ical results, and complications. CONCLUSION Functional results of PSD >60% are higher than PSD <60% group but there is no statistical difference between groups according to functional, radiological results, and complications.
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Affiliation(s)
- Alkan Bayrak
- Department of Orthopedics and Traumatology, University of Health Sciences Bakırköy Dr. Sadi Konuk Training and Research Hospital, İstanbul-Turkey
| | - Altuğ Duramaz
- Department of Orthopedics and Traumatology, University of Health Sciences Bakırköy Dr. Sadi Konuk Training and Research Hospital, İstanbul-Turkey
| | - Alican Koluman
- Department of Orthopedics and Traumatology, University of Health Sciences Bakırköy Dr. Sadi Konuk Training and Research Hospital, İstanbul-Turkey
| | - Cemal Kural
- Department of Orthopedics and Traumatology, University of Health Sciences Bakırköy Dr. Sadi Konuk Training and Research Hospital, İstanbul-Turkey
| | - Nezih Ziroglu
- Department of Orthopedics and Traumatology, Beylikdüzü State Hospital, İstanbul-Turkey
| | - Kadir Gözügül
- Department of Orthopedics and Traumatology, Iğdır State Hospital, Orthopedics and Traumatology, Iğdır-Turkey
| | - Gökhan Peker
- Department of Orthopedics and Traumatology, University of Health Sciences, Trabzon Kanuni Training and Research Hospital, Trabzon-Turkey
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Duramaz A, Koluman AC, Bayrak A, Ziroğlu N, Bilgili MG, Kural C. Fibular fixation improves ankle functional outcomes and alignment in the intramedullary nailing of distal third tibiofibular diaphyseal fractures. Eur J Trauma Emerg Surg 2022; 48:4019-4029. [PMID: 35275243 DOI: 10.1007/s00068-022-01934-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 02/20/2022] [Indexed: 11/28/2022]
Abstract
PURPOSE The study aims to determine the effect of fibular fixation on alignment and fracture healing of tibia, and ankle functional outcomes in the treatment of distal third tibiofibular diaphyseal fractures. METHODS Consecutive 111 patients (33 females and 78 males) with distal third tibiofibular diaphyseal fracture who met the inclusion criteria were included in the study. Patients were divided into two groups as those who underwent fibular fixation with tibia intramedullary nailing (study group) and those who did not (control group). Groups were compared in terms of demographic features, trauma and fracture characteristics, functional and radiological outcomes. RESULTS No significant difference was observed between the groups in terms of demographic features, trauma characteristics, complications, and follow-up time (p > 0.05). Surgery time was significantly lower in the control group (p = 0.001). Ankle joint range of motion, AOFAS score, OMAS score, and full weight-bearing time were significantly better in the fibular fixation group (p = 0.023, p = 0.001, p = 0.001 and p = 0.039, respectively). Significantly better coronal alignment and sagittal alignment were found in the fibular fixation group (p = 0.001 and p = 0.001, respectively). Patients who underwent fibular fixation had significantly better radiological outcomes in terms of fibular rotation angle and ankle arthrosis (p = 0.000 and p = 0.022, respectively). CONCLUSION Fibular fixation not only contributes to fracture union, early full weight-bearing, and alignment but also improves ankle functional outcomes in the distal third tibiofibular fractures treated with intramedullary nailing for tibia. LEVEL OF EVIDENCE Level III, retrospective study.
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Affiliation(s)
- Altuğ Duramaz
- Department of Orthopedics and Traumatology, Bakırköy Dr. Sadi Konuk Education and Research Hospital, Tevfik Sağlam St., Number 11, 34147, Bakırköy, Istanbul, Turkey.
| | - Ali Can Koluman
- Department of Orthopedics and Traumatology, Bakırköy Dr. Sadi Konuk Education and Research Hospital, Tevfik Sağlam St., Number 11, 34147, Bakırköy, Istanbul, Turkey
| | - Alkan Bayrak
- Department of Orthopedics and Traumatology, Bakırköy Dr. Sadi Konuk Education and Research Hospital, Tevfik Sağlam St., Number 11, 34147, Bakırköy, Istanbul, Turkey
| | - Nezih Ziroğlu
- Department of Orthopedics and Traumatology, Beylikdüzü State Hospital, Pınartepe Ave, 253 St, Number 8, 34500, Büyükçekmece, Istanbul, Turkey
| | - Mustafa Gökhan Bilgili
- Department of Orthopedics and Traumatology, Bakırköy Dr. Sadi Konuk Education and Research Hospital, Tevfik Sağlam St., Number 11, 34147, Bakırköy, Istanbul, Turkey
| | - Cemal Kural
- Department of Orthopedics and Traumatology, Bakırköy Dr. Sadi Konuk Education and Research Hospital, Tevfik Sağlam St., Number 11, 34147, Bakırköy, Istanbul, Turkey
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Çelik M, Bayrak A, Duramaz A, Başaran SH, Kızılkaya C, Kural C, Kural A, Sar M, Kaymakçı O. The effect of fibrin clot and C vitamin on the surgical treatment of Achilles tendon injury in the rat model✰. Foot Ankle Surg 2021; 27:681-687. [PMID: 33011100 DOI: 10.1016/j.fas.2020.09.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 09/09/2020] [Indexed: 02/04/2023]
Abstract
BACKGROUND This study aimed to determine the histological, biochemical, and biomechanical efficacy of fibrin clot and vitamin C in the healing of Achilles tendon ruptures (ATR) in a rat model. METHODS 52 adult Wistar-Albino rats (300-450 g) were used in the study. 12 rats were divided into four groups as Monitor (Group I), Control (Group II), Fibrin Clot (Group III), Fibrin Clot with vitamin C (Group IV). Four rats were used for fibrin clot preparation. Fibroblast Growth Factor (FGF) and Vascular Endothelial Growth Factor (VEGF) were measured on the 3rd, 7th, 14th, and 21st days. Four rats were sacrificed on the 21st day from each group for histological evaluation. The rest of the rats were sacrificed at 42nd day, half for biomechanical and a half for histological evaluation. RESULTS The 42nd-day HSS score of group IV was significantly lower than those of group I, group II and group III (p = 0.036, p = 0.019, and p = 0.036, respectively). Group IV showed a significantly higher Maximum force N value than those of group I, group II and group III (p = 0.034, p = 0.034 and, p = 0.025, respectively). The blood FGF and VEGF levels of group III and group IV on the 3rd, 7th, 14th, and 21st days were higher than those of group I and group II (p < 0.05). CONCLUSION Fibrin clot and vitamin C produced a stronger tendon structure in terms of biomechanics while providing histological and biochemically better quality tendon healing in the surgical treatment of ATR. This model can be used to accelerate high-quality tendon healing after ATR. LEVEL OF EVIDENCE Level II, experimental study.
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Affiliation(s)
- Malik Çelik
- Batman State Hospital, Department of Orthopedics and Traumatology, Gültepe Mah. Eflatun St. Nb:1, Merkez/Batman, Turkey.
| | - Alkan Bayrak
- University of Health Sciences, Bakırköy Dr. Sadi Konuk Education and Research Hospital, Department of Orthopedics and Traumatology, Tevfik Sağlam St. Number 11, 34147 Bakırköy/Istanbul, Turkey.
| | - Altuğ Duramaz
- University of Health Sciences, Bakırköy Dr. Sadi Konuk Education and Research Hospital, Department of Orthopedics and Traumatology, Tevfik Sağlam St. Number 11, 34147 Bakırköy/Istanbul, Turkey.
| | - Serdar Hakan Başaran
- University of Health Sciences, Bakırköy Dr. Sadi Konuk Education and Research Hospital, Department of Orthopedics and Traumatology, Tevfik Sağlam St. Number 11, 34147 Bakırköy/Istanbul, Turkey.
| | - Cemal Kızılkaya
- Bahçelievler State Hospital, Department of Orthopedics and Traumatology, Kocasinan Merkez Mah. Hastane St. Nb:48, Bahçelievler/Istanbul, Turkey.
| | - Cemal Kural
- University of Health Sciences, Bakırköy Dr. Sadi Konuk Education and Research Hospital, Department of Orthopedics and Traumatology, Tevfik Sağlam St. Number 11, 34147 Bakırköy/Istanbul, Turkey.
| | - Alev Kural
- University of Health Sciences, Bakırköy Dr. Sadi Konuk Education and Research Hospital, Department of Biochemistry, Tevfik Sağlam St. Number 11, 34147 Bakırköy/Istanbul, Turkey.
| | - Mehmet Sar
- Istanbul University, Cerrahpaşa Medicine Faculty, Department of Pathology, Kocamustafapaşa St. Number 53, 34098 Fatih/Istanbul, Turkey.
| | - Orkun Kaymakçı
- Technology Team Leader, Arçelik R&D, Sifa Mah., 34950 Tuzla/Istanbul, Turkey.
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Bayrak A, Duramaz A, Kızılkaya C, Çelik M, Kural C, Altınay S, Kural A, Başaran SH. Comparison of two types of fixation for proximal tibial epiphysiodesis: An experimental study in a rabbit model. Jt Dis Relat Surg 2021; 32:468-477. [PMID: 34145826 PMCID: PMC8343849 DOI: 10.52312/jdrs.2021.80219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 03/03/2021] [Indexed: 11/23/2022] Open
Abstract
Objectives
In this study, we describe a novel hemiepiphysiodesis technique to prevent implant-related perichondrial ring injury in a rabbit model. Materials and methods
Proximal tibial epiphyseal plates of a total of 16 white New Zealand rabbits were used for this animal model. The subjects were divided into three equal groups as follows: Group 1 (Kirschner wire [K-wire]/cerclage), Group 2 (8-plate) right-hind legs, Group 3 (Control) left hind legs. Using anteroposterior radiography, the medial slope angle (MSA), articular line-diaphyseal angle (ALDA), and the angle between screws of 8-plate in lateral X-ray tibial slope angle (TSA) were measured. The radiographs were taken early postoperative (Day 1) and on sacrification day (Week 8). The histological evaluation of the perichondrial ring was made on a 7-mm axial section that stained with Safranin O/fast green at X10 magnification. Results
In both K-wire and 8-plate groups, the early postoperative ALDA and TSA were greater than the sacrification ALDA and TSA (p=0.028 and p<0.001, respectively). The early postoperative MSA was lower than the sacrification MSA in groups, (p<0.001). The MSA in the control group was lower than the K-wire and 8-plate groups (p<0.001 and p=0.009; respectively). The perichondrial ring thickness of the K-wire group was greater than the 8-plate group in histological evaluation (p<0.001). Conclusion
Both of the K-wire and 8-plate groups showed similar angulation effects in the proximal tibia, although histologically less damage to the perichondrial ring was observed in the K-wire group, compared to the 8-plate group.
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Affiliation(s)
- Alkan Bayrak
- SBÜ Dr. Sadi Konuk Eğitim ve Araştırma Hastanesi Ortopedi ve Travmatoloji Kliniği, 34147 Bakırköy, İstanbul, Türkiye.
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Duramaz A, Polat Ö, İlter MH, Bayram B, Bayrak A, Baca E. Could percutaneous fixation with crossed Schanz pins be an alternative to open reduction in the treatment of intra-articular calcaneal fractures? Int Orthop 2021; 45:731-741. [PMID: 33517475 DOI: 10.1007/s00264-021-04944-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 01/07/2021] [Indexed: 02/05/2023]
Abstract
PURPOSE Despite modern operative techniques and a considerable number of studies in the literature, the best treatment for calcaneal fractures remains an enigma for orthopaedic surgeons. The purpose of the study was to compare clinical and radiographic outcomes between anatomic calcaneal plate (ACP) fixation and crossed Schanz pin (CSP) fixation in the treatment of Sanders type II and III displaced intra-articular calcaneus fractures (DICFs). METHODS Consecutive 65 patients (49 males, 16 females) who underwent surgery for DCIFs between January 2009 and February 2013 were retrospectively evaluated. The patients were divided into two groups as ACP and CSP according to the operative technique. The groups were compared in terms of demographic features, injury mechanism, operation time, fluoroscopy exposure, complications, full weight-bearing time, functional, and radiological outcomes. RESULTS VAS-rest score did not differ significantly between the groups while the VAS-activity score was significantly higher in the CSP group (p = 0.001 and p = 0.645, respectively). Foot Function Index (FFI) was significantly lower, Maryland Foot Score (MFS) and the American Orthopaedic Foot and Ankle Society-hindfoot score (AOFAS) were significantly higher in the ACP group (p = 0.047, p = 0.016, and p < 0.001, respectively). While no difference was observed between the preoperative and the early post-operative (1st day) Böhler angle and Gissane angle, both were significantly higher in the ACP group at the post-operative last control (p < 0.001 and p < 0.001, respectively). CONCLUSION Although crossed Schanz pin fixation shortens the operation time in displaced intra-articular calcaneus fractures compared to anatomic calcaneal plate, increased fluoroscopy exposure rates and low functional and radiological outcomes are disadvantageous of crossed Schanz pin. Anatomic calcaneal plate is still a better technique for preserving the alignment and elevating the displaced intra-articular segment for good to excellent mid-term results.
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Affiliation(s)
- Altuğ Duramaz
- Department of Orthopedics and Traumatology, Bakırköy Dr. Sadi Konuk Education and Research Hospital, Tevfik Sağlam St. Number 11, 34147, Bakırköy/Istanbul, Turkey.
| | - Ömer Polat
- Department of Orthopedics and Traumatology, Ümraniye Education and Research Hospital, Adem Yavuz St. Number 1, 34764, Ümraniye/Istanbul, Turkey
| | - Mehmet Hakan İlter
- Department of Orthopedics and Traumatology, Bakırköy Dr. Sadi Konuk Education and Research Hospital, Tevfik Sağlam St. Number 11, 34147, Bakırköy/Istanbul, Turkey
| | - Berhan Bayram
- Department of Orthopedics and Traumatology, Bakırköy Dr. Sadi Konuk Education and Research Hospital, Tevfik Sağlam St. Number 11, 34147, Bakırköy/Istanbul, Turkey
| | - Alkan Bayrak
- Department of Orthopedics and Traumatology, Bakırköy Dr. Sadi Konuk Education and Research Hospital, Tevfik Sağlam St. Number 11, 34147, Bakırköy/Istanbul, Turkey
| | - Emre Baca
- Department of Orthopedics and Traumatology, Bakırköy Dr. Sadi Konuk Education and Research Hospital, Tevfik Sağlam St. Number 11, 34147, Bakırköy/Istanbul, Turkey
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Duramaz A, Koluman A, Duramaz A, Kural C. The relationship between impulsivity and anxiety and recurrent metacarpal fractures due to punch injury. Int Orthop 2020; 45:1315-1328. [PMID: 32910241 DOI: 10.1007/s00264-020-04794-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 08/27/2020] [Accepted: 09/01/2020] [Indexed: 11/30/2022]
Abstract
PURPOSE The study aimed to determine the relationship between impulsivity and anxiety and recurrent metacarpal fractures (RMF) due to punching injury. METHODS Consecutive 368 patients (301 men and 67 women) with metacarpal fracture who met the inclusion criteria and 214 healthy controls were included in the study. The study group was divided into two as the first metacarpal fracture (FMF) (245 patients) and RMF (123 patients). The control group consisted of sex- and age-matched 214 healthy participants (175 men and 39 women). Beck anxiety inventory (BAI), Barratt impulsiveness scale (BIS 11), and Quick DASH scores were the assessment of the patients in the sixth month of treatment. The groups were compared in terms of demographic features (including education status, marital status, work status, and level of income), fracture side, fracture location, dominant hand, treatment, anxiety, impulsivity, and functional results. RESULTS In the RMF, BIS 11, BAI, and Quick DASH scores were significantly higher than the FMF and the healthy controls (p = 0.001 and p = 0.001, respectively). The patients with RMF have higher impulsivity and anxiety, worse short-term functional outcomes, and lower level of income and education status compared with healthy controls and FMF. CONCLUSION Anxiety and impulsivity are higher in patients with RMF. It adversely affects the clinical outcome after the treatment. Psychiatric consultation is an important step for especially intentional RMF patients to prevent recurrent hand injuries and metacarpal fractures and to improve clinical outcomes associated with these injuries.
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Affiliation(s)
- Altuğ Duramaz
- Department of Orthopedics and Traumatology, Bakırköy Dr. Sadi Konuk Education and Research Hospital, Tevfik Sağlam St. Number 11, 34147, Bakırköy, Istanbul, Turkey.
| | - Alican Koluman
- Department of Orthopedics and Traumatology, Bakırköy Dr. Sadi Konuk Education and Research Hospital, Tevfik Sağlam St. Number 11, 34147, Bakırköy, Istanbul, Turkey
| | - Altan Duramaz
- Republic of Turkey Ministry of National Education, Şehit Mehmet Öter Street, Number 1, 27090, Şehitkamil, Gaziantep, Turkey
| | - Cemal Kural
- Department of Orthopedics and Traumatology, Bakırköy Dr. Sadi Konuk Education and Research Hospital, Tevfik Sağlam St. Number 11, 34147, Bakırköy, Istanbul, Turkey
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Duramaz A, İlter MH. The impact of proximal femoral nail type on clinical and radiological outcomes in the treatment of intertrochanteric femur fractures: a comparative study. Eur J Orthop Surg Traumatol 2019; 29:1441-1449. [DOI: 10.1007/s00590-019-02454-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Accepted: 05/25/2019] [Indexed: 10/26/2022]
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Duramaz A, Ilter MH, Yıldız Ş, Edipoğlu E, İpek C, Bilgili MG. The relationship between injury mechanism and sexual dysfunction in surgically treated pelvic fractures. Eur J Trauma Emerg Surg 2019; 46:807-816. [PMID: 30617402 DOI: 10.1007/s00068-018-01067-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Accepted: 12/26/2018] [Indexed: 11/30/2022]
Abstract
PURPOSE The aim of the study was to identify the incidence of new sexual dysfunction reported by the patient in surgical treatment of pelvic ring injuries, and to describe the relationship between new sexual dysfunction and type of fracture. METHODS Ninety-five patients who were operated for pelvic fracture were included in the study. Patients were evaluated according to age, gender, marital status, body mass index, trauma mechanism, fracture classification, genitourinary injury, accompanying injury, injury severity score, surgical technique, fixation material, duration of operation, functional outcomes, blood loss, complications, and sexual dysfunction. Functional outcomes were assessed with Female Sexual Functioning Index (FSFI), International Index of Erectile Function-5 (IIEF5), Arizona Sexual Experience Scale (ASEX), and Modified Majeed's pelvic outcomes grading scale (MPS). RESULTS Genitourinary symptoms were erectile dysfunction (ED) in 13 men, ejaculatory dysfunction in 9 men, and dyspareunia in 23 women. Urethral stricture developed in 4 males and 1 female with the urethral injury. FSFI score, ASEX score, and MPS score showed the statistically significant difference between the fracture types (p = 0.021, p = 0.032 and p = 0.020, respectively). There were no significant difference between fracture types in terms of the IIEF5 score, and no significant relationship between fracture type and ED development (p = 0.141). CONCLUSION Anteroposterior compression (APC) is the most common cause of sexual dysfunction in both sexes, independent of surgery. In addition, the most common cause of ED in men is vertical shear (VS). Especially patients with APC and VS injuries should be multidisciplinary evaluated with gynecology, urology, and psychiatry departments.
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Affiliation(s)
- Altuğ Duramaz
- Department of Orthopedics and Traumatology, Bakırköy Dr. Sadi Konuk Education and Research Hospital, Tevfik Sağlam St. Number 11, 34147, Bakırköy, Istanbul, Turkey.
| | - Mehmet Hakan Ilter
- Department of Orthopedics and Traumatology, Bakırköy Dr. Sadi Konuk Education and Research Hospital, Tevfik Sağlam St. Number 11, 34147, Bakırköy, Istanbul, Turkey
| | - Şükrü Yıldız
- Department of Gynecology and Obstetrics, Bakırköy Dr. Sadi Konuk Education and Research Hospital, Tevfik Sağlam St. Number 11, 34147, Bakırköy, Istanbul, Turkey
| | - Erdem Edipoğlu
- Department of Orthopedics and Traumatology, Bakırköy Dr. Sadi Konuk Education and Research Hospital, Tevfik Sağlam St. Number 11, 34147, Bakırköy, Istanbul, Turkey
| | - Cem İpek
- Department of Urology, Kanuni Sultan Süleyman Education and Research Hospital, Atakent St. Number 46, 34307, Küçükçekmece, Istanbul, Turkey
| | - Mustafa Gökhan Bilgili
- Department of Orthopedics and Traumatology, Bakırköy Dr. Sadi Konuk Education and Research Hospital, Tevfik Sağlam St. Number 11, 34147, Bakırköy, Istanbul, Turkey
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Çümen H, Duramaz A, Kural C. Does computerized tomography help to shorten the immobilization period in the plaster treatment of nondisplaced scaphoid fractures? ULUS TRAVMA ACIL CER 2018; 24:468-473. [PMID: 30394503 DOI: 10.5505/tjtes.2018.32069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND There are conflicting results regarding the duration of the plaster treatment of nondisplaced scaphoid fractures. The aim of the present study was to evaluate the healing process and to determine the role of computed tomography (CT) on shortening the duration of plaster treatment of nondisplaced scaphoid fractures. METHODS A total of 42 patients diagnosed with nondisplaced scaphoid fractures between January 2012 and January 2014 were investigated. Fractures were classified according to anatomical locations and displacement degree. Fractures were short-arm plastered enclosing thumb after non-displacement was confirmed by CT. Radiological evaluation was performed using two-planned radiographs at 2-week intervals. Patients were divided into two groups as union and non-union according to their bone healing in the CT scan at week 4 of the fracture. The cast was removed in the union group. RESULTS Regarding anatomical location, 8 patients were classified as distal, 30 were waist region, and 4 were proximal fractures. Among 42 patients with a mean age of 31.95±13.11 years, the union was determined in 41 patients, and the plasters were removed at the end of 4 weeks. Patients were divided into two groups, non-union and union, in terms of fracture healing at the end of 4 weeks. There were highly statistically significant differences between the groups regarding translation degree, contact surface rates, and displacement status (p=0.001, p=0.001, and p=0.001, respectively). CONCLUSION It has been shown that determination of high union rates in CT accomplishes the non-requirement of long-term plaster treatment in patients with nondisplaced scaphoid fractures after follow-up with plasters.
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Affiliation(s)
| | - Altuğ Duramaz
- Department of Orthopedics and Traumatology, Bakırköy Dr. Sadi Konuk Training and Research Hospital, İstanbul-Turkey.
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Duramaz A, Baca E. Microfracture provides better clinical results than debridement in the treatment of acute talar osteochondral lesions using arthroscopic assisted fixation of acute ankle fractures. Knee Surg Sports Traumatol Arthrosc 2018; 26:3089-3095. [PMID: 29696318 DOI: 10.1007/s00167-018-4963-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Accepted: 04/23/2018] [Indexed: 01/22/2023]
Abstract
PURPOSE Ankle arthroscopy is a useful tool for detection and treatment of accompanying intraarticular pathologies in acute ankle fractures. The purpose of this study was to compare the treatment results of talus osteochondral lesions (OLT) with debridement and microfracture in arthroscopy assisted surgery of acute ankle fractures. METHODS Eleven consecutive patients who were treated with arthroscopic acute debridement and 14 consecutive patients who were treated with arthroscopic acute microfracture in the treatment of ankle fracture were included in the study. All patients were controlled clinically and radiologically in the postoperative period. Ankle pain was evaluated with the visual analog score (VAS), ankle functions were assessed with American Orthopaedic Foot and Ankle Society Ankle-Hindfoot Scale (AOFAS), and osteoarthritic changes were analyzed with Van Dijk score. RESULTS There was no significant difference between the groups in terms of age, gender, injury side and trauma mechanism (n.s). Mean time to surgery, fracture healing duration, first weight-bearing and full weight-bearing, follow-up period and Van Dijk score were all similar in both groups (n.s). The AOFAS score and VAS activity score were statistically significantly better in the microfracture group (p = 0.044 and p = 0.001). CONCLUSIONS The clinical relevance of the present study is to define the acute treatment of the first osteochondral damage that occurred simultaneously with ankle fracture, to improve postoperative functional outcomes and to prevent post-traumatic osteoarthritis. Both debridement and microfracture yield good functional outcomes in the second year of the treatment. Microfracture ensures significantly more successful clinical results than debridement. LEVEL OF EVIDENCE Level III.
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Affiliation(s)
- Altuğ Duramaz
- Department of Orthopedics and Traumatology, Bakırköy Dr. Sadi Konuk Education and Research Hospital, Tevfik Sağlam St. Number 11, Bakırköy, 34147, Istanbul, Turkey.
| | - Emre Baca
- Department of Orthopedics and Traumatology, Bakırköy Dr. Sadi Konuk Education and Research Hospital, Tevfik Sağlam St. Number 11, Bakırköy, 34147, Istanbul, Turkey
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Bayrak A, Kural C, Duramaz A, Kaya Bayrak S, Kızılkaya C, Avkan MC. Functional and Radiological Outcomes of the Proximal Humeral Fractures Treated with Proximal Anatomic Locking Plate. Haseki 2018. [DOI: 10.4274/haseki.88597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Duramaz A, Yılmaz S, Ziroğlu N, Bursal Duramaz B, Kara T. The effect of deformity correction on psychiatric condition of the adolescent with adolescent idiopathic scoliosis. Eur Spine J 2018; 27:2233-2240. [PMID: 29802465 DOI: 10.1007/s00586-018-5639-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Revised: 04/14/2018] [Accepted: 05/17/2018] [Indexed: 12/17/2022]
Abstract
PURPOSE The purpose of this prospective study was to evaluate the effects of deformity correction on body image, quality of life, self-esteem, depression and anxiety in patients with adolescent idiopathic scoliosis (AIS) who underwent surgery. METHODS Between June 2014 and July 2015, 41 consecutive patients who underwent surgery for AIS were compared with the control group of 52 healthy patients regarding the changes in the pre- and postoperative quality of life and psychiatric status of patients with deformity correction. Body Cathexis Scale (BCS), Pediatric Quality of Life Inventory (PedsQL), Children's Depression Inventory (CDI), Piers-Harris self-esteem questionnaire (PH-SEQ) and state-trait Anxiety Inventory for Children were used to evaluate the patients. RESULTS There was a significant decrease in postoperative first-year Cobb angle and trunkal shift imbalance compared with the preoperative values (p = 0.0001 and p = 0.0001). Postoperative first-year thoracic kyphosis angle and body height showed a significant increase according to preoperative values (p = 0.0001 and p = 0.0001). Postoperative PH-SEQ score and PedsQL total score showed a significant increase in the study group compared to the preoperative level, but no significant difference was found between the control group. Postoperative CDI score, BCS score, STAI-state and STAI-trait scores decreased significantly in the study group compared with preoperative scores. CONCLUSIONS Surgical correction of deformity in AIS provided significant improvements regarding quality of life and psychiatric condition. Spinal surgeons should be aware of the possible psychological problems of AIS patients and should keep in mind that deformity correction not only improves physical health but also improves mental health. These slides can be retrieved under Electronic Supplementary Material.
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Affiliation(s)
- Altuğ Duramaz
- Department of Orthopedics and Traumatology, Bakırköy Dr. Sadi Konuk Education and Research Hospital, Tevfik Sağlam St. Number 11, 34147, Bakırköy, Istanbul, Turkey.
| | - Semra Yılmaz
- Department of Child and Adolescent Psychiatry, Bakırköy Dr. Sadi Konuk Education and Research Hospital, Tevfik Sağlam St. Number 11, 34147, Bakırköy, Istanbul, Turkey
| | - Nezih Ziroğlu
- Department of Orthopedics and Traumatology, Bakırköy Dr. Sadi Konuk Education and Research Hospital, Tevfik Sağlam St. Number 11, 34147, Bakırköy, Istanbul, Turkey
| | - Burcu Bursal Duramaz
- Department of Pediatric Infectious Diseases, Bezmiâlem Vakıf University, Adnan Menderes Avenue, Vatan Street, 34093, Fatih, Istanbul, Turkey
| | - Tayfun Kara
- Department of Child and Adolescent Psychiatry, Bakırköy Dr. Sadi Konuk Education and Research Hospital, Tevfik Sağlam St. Number 11, 34147, Bakırköy, Istanbul, Turkey
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Duramaz A, Bilgili MG, Karaali E, Bayram B, Ziroğlu N, Kural C. Volar locking plate versus K-wire-supported external fixation in the treatment of AO/ASIF type C distal radius fractures: A comparison of functional and radiological outcomes. ULUS TRAVMA ACIL CER 2018; 24:255-262. [PMID: 29786822 DOI: 10.5505/tjtes.2017.35837] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND The aim of this study was to compare the functional and radiological outcomes of K-wire-supported bridging external fixation (KW-EF) and volar locking plate (VLP) in the treatment of comminuted intra-articular distal radius fractures. METHODS Patients treated for complex intra-articular distal radius fractures between February 2010 and April 2013 were retrospectively investigated. A total of 114 patients (42 females and 72 males) with a mean age of 44.9±15.4 (range: 18-86) years were evaluated. Wrist ranges of motion were measured using a universal goniometer, and hand grip strength was determined using hand dynamometers. The results were evaluated with Gartland-Werley score. QuickDASH questionnaire was administered in subjective functional assessment. Radiological evaluations were performed, with wrist radiographs obtained on the 3rd month and 2nd year. RESULTS Wrist flexion, extension, pronation, and supination were all significantly better in the VLP group than in the KW-EF group at last control (p=0.001). Gartland-Werley, QuickDASH, and Visual Analog Scale were significantly better in the VLP than group than in the KW-EF group (p=0.003, p=0.003, and p=0.001, respectively). At the last follow-up, loss of grip strength compared with that on the uninjured side was 4% in the VLP group and 7% in the KW-EF group. CONCLUSION VLP is a safe method with low complication rates. It is superior to KW-EF as it facilitates early return to daily activities and shows better functional and radiological outcomes in the 2nd year of treatment.
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Affiliation(s)
- Altuğ Duramaz
- Department of Orthopedics and Traumatology, Bakırköy Dr. Sadi Konuk Training and Research Hospital, İstanbul-Turkey.
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Duramaz A, Yilmaz S, Ziroğlu N, Bursal Duramaz B, Bayram B, Kara T. The role of psychiatric status on pediatric extremity fractures: a prospective analysis. Eur J Trauma Emerg Surg 2018; 45:989-994. [PMID: 29651505 DOI: 10.1007/s00068-018-0955-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Accepted: 04/11/2018] [Indexed: 10/17/2022]
Abstract
PURPOSE The aim of the study was to investigate the relationship between attention deficit and hyperactivity disorder (ADHD), anxiety, and depression with pediatric extremity fractures. METHODS Between November 2014 and November 2016, consecutive 138 patients with pediatric extremity fractures were prospectively investigated in terms of the tendency to anxiety, depression, or ADHD in the study group. Consecutive 168 non-trauma patients who were admitted to general pediatrics outpatient clinic were included the control group. Patients were performed with Turgay DSM-IV-Based Child and Adolescent Behavior Disorders Screening and Rating Scale-Parents Form (T-DSM-IV S), The Screen for Child Anxiety-Related Emotional Disorders (SCARED), and The Children's Depression Inventory (CDI). RESULTS There were not any significant differences between study and control groups regarding the age, gender distribution, economical level, or previous psychiatric admission rates (p > 0.05). In the study group, the previous ADHD history and previous fracture history were significantly higher than the control group (p < 0.05). In the study group, the severity of depressive signs and anxiety were significantly higher than the control group (p = 0.000 and p = 0.019; respectively). Regarding the previous fracture history, conduct disorder and tendency to depression were significantly higher in the study group (p = 0.001 and p = 0.011; respectively). CONCLUSIONS The signs of ADHD, anxiety, and depression were determined to be higher in children with extremity fractures compared with the non-traumatic population. In patients with especially behavioral problems and depressive signs, directing to the child and adolescent psychiatrists will be protective to prevent re-fractures and high-energy traumas.
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Affiliation(s)
- Altuğ Duramaz
- Department of Orthopedics and Traumatology, Bakırköy Dr. Sadi Konuk Education and Research Hospital, Tevfik Sağlam St. Number 11, 34147, Bakırköy, Istanbul, Turkey.
| | - Semra Yilmaz
- Department of Child and Adolescent Psychiatry, Bakırköy Dr. Sadi Konuk Education and Research Hospital, Tevfik Sağlam St. Number 11, 34147, Bakırköy, Istanbul, Turkey
| | - Nezih Ziroğlu
- Department of Orthopedics and Traumatology, Bakırköy Dr. Sadi Konuk Education and Research Hospital, Tevfik Sağlam St. Number 11, 34147, Bakırköy, Istanbul, Turkey
| | - Burcu Bursal Duramaz
- Department of Pediatric Infectious Diseases, Bezmiâlem Vakıf University, Adnan Menderes Avenue, Vatan Street, 34093, Fatih, Istanbul, Turkey
| | - Berhan Bayram
- Department of Orthopedics and Traumatology, Bakırköy Dr. Sadi Konuk Education and Research Hospital, Tevfik Sağlam St. Number 11, 34147, Bakırköy, Istanbul, Turkey
| | - Tayfun Kara
- Department of Child and Adolescent Psychiatry, Bakırköy Dr. Sadi Konuk Education and Research Hospital, Tevfik Sağlam St. Number 11, 34147, Bakırköy, Istanbul, Turkey
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Albayrak A, Kaya Bayrak S, Duramaz A, Kızılkaya C, Seller A, Aslantaş FÇ. Proksimal Femur Kırıklarında Demografik Ve Klinik Sonuçlar. Acta Medica Alanya 2017. [DOI: 10.30565/medalanya.347588] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Duramaz A, Bilgili MG, Bayram B, Ziroğlu N, Edipoğlu E, Öneş HN, Kural C, Avkan MC. The role of intraoperative cell salvage system on blood management in major orthopedic surgeries: a cost-benefit analysis. Eur J Orthop Surg Traumatol 2017; 28:991-997. [PMID: 29214459 DOI: 10.1007/s00590-017-2098-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2017] [Accepted: 11/30/2017] [Indexed: 01/15/2023]
Abstract
INTRODUCTION The aim of this study was to compare the efficiency and cost of cell salvage systems with allogeneic blood transfusions in patients who had major elective orthopedic surgeries. MATERIALS AND METHODS Consecutive 108 patients who had intraoperative cell saver (CS) performed routinely constitute the study group. In control group, consecutive 112 patients who were operated without intraoperative CS were investigated. Hemoglobin (Hb) level less than 8 mg/dL was regarded as the absolute transfusion indication. The patients were evaluated for age, gender, body mass index, operation period, mean intraoperative estimated blood loss (EBL), postoperative hemovac drainage volume; preoperative, postoperative first day and discharge Hb levels, allogeneic blood transfusion (ABT) volume, hospitalization and cost parameters. RESULTS The mean intraoperative EBL was 507 mL in the study group and 576 mL in control group. The mean ABT was 300 mL in the study group and 715 mL in control group. In the study group, intraoperative EBL, ABT usage and hospitalization period were significantly lower compared with the control group (p = 0.009, p = 0.000 and p = 0.000; p < 0.05, respectively). The mean cost was 771 Turkish liras (TL) in the study group and 224 TL in control group. In the study group, the cost was significantly higher than the control group (p = 0.000). The postoperative first day Hb level was significantly higher in the study group (p = 0.010). CONCLUSION Although CS usage was determined to increase the costs in this study, it significantly decreases intraoperative and postoperative ABT requirements. We believe that the increase in cost may be neglected when the complications and prolonged hospitalization due to ABT usage were regarded.
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Affiliation(s)
- Altuğ Duramaz
- Department of Orthopedics and Traumatology, Bakırköy Dr. Sadi Konuk Education and Research Hospital, Tevfik Sağlam St. Number 11, 34147, Bakırköy, Istanbul, Turkey.
| | - Mustafa Gökhan Bilgili
- Department of Orthopedics and Traumatology, Bakırköy Dr. Sadi Konuk Education and Research Hospital, Tevfik Sağlam St. Number 11, 34147, Bakırköy, Istanbul, Turkey
| | - Berhan Bayram
- Department of Orthopedics and Traumatology, Bakırköy Dr. Sadi Konuk Education and Research Hospital, Tevfik Sağlam St. Number 11, 34147, Bakırköy, Istanbul, Turkey
| | - Nezih Ziroğlu
- Department of Orthopedics and Traumatology, Bakırköy Dr. Sadi Konuk Education and Research Hospital, Tevfik Sağlam St. Number 11, 34147, Bakırköy, Istanbul, Turkey
| | - Erdem Edipoğlu
- Department of Orthopedics and Traumatology, Bakırköy Dr. Sadi Konuk Education and Research Hospital, Tevfik Sağlam St. Number 11, 34147, Bakırköy, Istanbul, Turkey
| | - Halil Nadir Öneş
- Department of Orthopedics and Traumatology, Bakırköy Dr. Sadi Konuk Education and Research Hospital, Tevfik Sağlam St. Number 11, 34147, Bakırköy, Istanbul, Turkey
| | - Cemal Kural
- Department of Orthopedics and Traumatology, Bakırköy Dr. Sadi Konuk Education and Research Hospital, Tevfik Sağlam St. Number 11, 34147, Bakırköy, Istanbul, Turkey
| | - Mustafa Cevdet Avkan
- Department of Orthopedics and Traumatology, Avrasya Hospital, Hekimsuyu St. Number 26/34, Küçükköy, 34255, Gaziosmanpaşa, Istanbul, Turkey
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Abstract
Category: Bunion Introduction/Purpose: AOFAS score and angular changes are used widely to assess hallux valgus surgery. But our previous study showed us that these parameters do not reflect patient subjective satisfaction after surgery, angular changes do not correlate with patient satisfaction, and a subjective satisfaction scale must be used. So can we find a measurable parameter that reflects patient satisfaction? The purpose of the study was to evaluate the effect of percental reduction of first web space length (FWSL) on patient satisfaction, and if it can be used as a measurable parameter for this. Methods: Fifty feet of thirty-seven patients were included to the study. All patients were operated between 2010 and 2014. Same surgical technique (Lindgren-Turan osteotomy)used for operations. Patients were evaluated by using hallux valgus angle (HVA),1-2 intermetatarsal angle (IMA), first web space length (FWSL), AOFAS scores. On the final follow-up they were asked to scale their postoperative satisfaction between 1-10;as for 1-2 very unsatisfied, 3-4 unsatisfied, 5-6 neither unsatisfied nor satisfied, 7-8 satisfied, 9-10 very satisfied. The percental changes of HVA, IMA, and FWSL were compared with AOFAS score, and satisfaction scales. Results: Average age was 45,50±12,23 (22-68) years. Mean follow-up was 41,68±14,46 (24-68) months. 29 of 50 feet were right side, 21 were left. Preoperative HVAs have been changed from 32,52±5,19 to 11,58±4,70 degrees (p=0,001; p<0,01). Preoperative IMAs have been changed from 15,00±3,56 to 5,75±2,45 degrees (p=0,001; p<0,01). Preoperative AOFAS scores have been changed from 75,04±5,54 to 93,14±6,25 points (p=0,001; p<0,01). Preoperative FWSL changed from 14,5 (10-22) mm to 7,5 (5-14) mm (p=0,001; p<0,01). Postoperative satisfaction scale was 8,60±0,67 (7-10) points. When HVA and IMA percental changes were compared with AOFAS percental changes, they have shown a negative statistical significance according to Spearman’s Correlation Analysis. When AOFAS percental changes have been compared with satisfaction scale, they have shown a positive statistical significance. When FWSL percental changes were compared with AOFAS percental changes and satisfaction scale it has shown a positive statistical significance for both parameters according to Spearman’s Correlation Analysis. Conclusion: According to our results; we believe that the changes of FWSL have an influence on patient satisfaction. It is correlated both with AOFAS, and subjective satisfaction scale. It can be used as a measurable parameter to search for patients satisfaction. Angular changes do not have an influence on patients satisfaction. May be FWSL should also be used for surgical indications?
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Duramaz A, Ursavaş HT, Bilgili MG, Bayrak A, Bayram B, Avkan MC. Platelet-rich plasma versus exchange intramedullary nailing in treatment of long bone oligotrophic nonunions. Eur J Orthop Surg Traumatol 2017; 28:131-137. [DOI: 10.1007/s00590-017-2024-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Accepted: 07/17/2017] [Indexed: 12/31/2022]
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Duramaz A, Bilgili MG, Bayram B, Ziroğlu N, Bayrak A, Avkan MC. Orthopedic trauma surgery and hospital cost analysis in refugees; the effect of the Syrian civil War. International Orthopaedics (SICOT) 2017; 41:877-884. [DOI: 10.1007/s00264-016-3378-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Accepted: 12/16/2016] [Indexed: 11/28/2022]
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Duramaz A, Peker G, Arslan L, Bilgili MG, Erçin E, Kural C. Hip Ultrasonography in the Diagnosis of Developmental Dysplasia of the Hip: Bakırköy Experience. Haseki 2014. [DOI: 10.4274/haseki.1669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Duramaz A, Sarı C, Bilgili MG, Erçin E, Kural C, Avkan MC. Outcomes of Four Different Surgical Techniques in the Treatment of Geriatric Intertrochanteric Femur Fractures. Haseki 2014. [DOI: 10.4274/haseki.1667] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Bilgili MG, Erçin E, Peker G, Kural C, Başaran SH, Duramaz A, Avkan C. Efficiency and cost analysis of cell saver auto transfusion system in total knee arthroplasty. Balkan Med J 2014; 31:149-53. [PMID: 25207187 DOI: 10.5152/balkanmedj.2014.13267] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2013] [Accepted: 04/20/2014] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Blood loss and replacement is still a controversial issue in major orthopaedic surgery. Allogenic blood transfusion may cause legal problems and concerns regarding the transmission of transfusion-related diseases. Cellsaver Systems (CSS) were developed as an alternative to allogenic transfusion but CSS transfusion may cause coagulation, infection and haemodynamic instability. AIMS Our aim was to analyse the efficiency and cost analysis of a cell saver auto-transfusion system in the total knee arthroplasty procedure. STUDY DESIGN Retrospective comparative study. METHODS Those patients who were operated on by unilateral, cemented total knee arthroplasty (TKA) were retrospectively evaluated. Group 1 included 37 patients who were treated using the cell saver system, and Group 2 involved 39 patients who were treated by allogenic blood transfusion. The groups were compared in terms of preoperative haemoglobin and haematocrit levels, blood loss and transfusion amount, whether allogenic transfusion was made, degree of deformity, body mass index and cost. RESULTS No significant results could be obtained in the statistical comparisons made in terms of the demographic properties, deformity properties, preoperative laboratory values, transfusion amount and length of hospital stay of the groups. Average blood loss was calculated to be less in Group 1 (p<0.05) and cost was higher in Group 1 (p<0.05). CONCLUSION Cell saver systems do not decrease the amount of allogenic blood transfusion and costs more. Therefore, the routine usage of the auto-transfusion systems is a controversial issue. Cell saver system usage does not affect allogenic blood transfusion incidence or allogenic blood transfusion volume. It was found that preoperative haemoglobin and body mass index rates may affect allogenic blood transfusion. Therefore, it is foreseen that auto-transfusion systems could be useful in patients with low haemoglobin level and body mass index.
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Affiliation(s)
- Mustafa Gökhan Bilgili
- Department of Orthopedics and Traumatology, Bakırköy Dr. Sadi Konuk Research and Training Hospital, İstanbul, Turkey
| | - Ersin Erçin
- Department of Orthopedics and Traumatology, Bakırköy Dr. Sadi Konuk Research and Training Hospital, İstanbul, Turkey
| | - Gökhan Peker
- Department of Orthopedics and Traumatology, Trabzon Kanuni Research and Training Hospital, Trabzon, Turkey
| | - Cemal Kural
- Department of Orthopedics and Traumatology, Bakırköy Dr. Sadi Konuk Research and Training Hospital, İstanbul, Turkey
| | - Serdar Hakan Başaran
- Department of Orthopedics and Traumatology, Karabük University Faculty of Medicine, Zonguldak, Turkey
| | - Altuğ Duramaz
- Department of Orthopedics and Traumatology, Bakırköy Dr. Sadi Konuk Research and Training Hospital, İstanbul, Turkey
| | - Cevdet Avkan
- Department of Orthopedics and Traumatology, Bakırköy Dr. Sadi Konuk Research and Training Hospital, İstanbul, Turkey
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