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Marangoz S, Buyukdogan K, Karahan S. Is there a correlation between the change in the interscrew angle of the eight-plate and the delta joint orientation angles? Acta Orthop Traumatol Turc 2017; 51:39-43. [PMID: 28041741 PMCID: PMC6197331 DOI: 10.1016/j.aott.2016.05.005] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Revised: 04/21/2016] [Accepted: 05/28/2016] [Indexed: 12/02/2022]
Abstract
Objectives It is known that the screws of the eight-plate hemiepiphysiodesis construct diverge as growth occurs through the physis. Our objective was to investigate whether there is a correlation between the amount of change of the joint orientation angle (JOA) and that of the interscrew angle (ISA) of the eight-plate hemiepiphysiodesis construct before and after correction. Patients and methods After the institutional review board approval, medical charts and X-rays of all patients operated for either genu valgum or genu varum with eight-plate hemiepiphysiodesis were analyzed retrospectively. All consecutive patients at various ages with miscellaneous diagnoses were included. JOA and ISA were measured before and after correction. After review of the X-rays, statistical analyses were performed which included Pearson correlation coefficient and regression analyses. Results There were 53 segments of 30 patients included in the study. Eighteen were males, and 12 were females. Mean age at surgery was 9.1 (range 3–17). Mean follow-up time was 21.5 (range, 7–46) months. The diagnoses were diverse. A strong correlation was found between the delta JOA (d-JOA) and delta ISA (d-ISA) of the eight-plate hemiepiphysiodesis construct (r = 0.759 (0.615–0.854, 95%CI), p < 0.001). This correlation was independent of the age and gender of the patient. Conclusions There is a strong correlation between the d-ISA and the d-JOA. The d-ISA follows the d-JOA at a predictable amount through formulas which regression analysis yielded. This study confirms the clinical observation of the diverging angle between the screws is in correlation with the correction of the JOA. Level of evidence Level IV, Therapeutic study.
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Affiliation(s)
- Salih Marangoz
- Koc University, School of Medicine, Department of Orthopaedics and Traumatology, Istanbul, Turkey.
| | - Kadir Buyukdogan
- Hacettepe University, Faculty of Medicine, Department of Orthopaedics and Traumatology, Ankara, Turkey
| | - Sevilay Karahan
- Hacettepe University, Faculty of Medicine, Department of Biostatistics, Ankara, Turkey
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Kamaci S, Danisman M, Marangoz S. Neonatal physeal separation of distal humerus during cesarean section. Am J Orthop (Belle Mead NJ) 2014; 43:E279-E281. [PMID: 25379758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Diagnosing physeal separation of the distal humerus in a newborn can be challenging. Skeletal immaturity and absence of secondary ossification centers make radiographic diagnosis difficult for inexperienced providers. This fracture is seen in the setting of complicated deliveries with excessive traction and rotation applied to the forearm. We report a case of physeal separation of the distal humerus in a newborn as a complication of cesarean section and describe the intervention used and the short-term results.
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Affiliation(s)
| | | | - Salih Marangoz
- Koç University, School of Medicine, Orthopaedics and Traumatology, Istanbul, Turkey.
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Affiliation(s)
- Ismail Oytun
- Department of Orthopaedic Surgery, Hacettepe University, Faculty of Medicine, Ankara, Turkey
| | - Salih Marangoz
- Department of Orthopaedic Surgery, Hacettepe University, Faculty of Medicine, Ankara, Turkey
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Marangoz S, Atilla B, Gök H, Yavuzer G, Ergin S, Tokgözoğlu AM, Alpaslan M. Gait analysis in adults with severe hip dysplasia before and after total hip arthroplasty. Hip Int 2011; 20:466-72. [PMID: 21157751 DOI: 10.1177/112070001002000409] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/06/2010] [Indexed: 02/04/2023]
Abstract
Anatomical reconstruction of high riding hips by total hip arthroplasty (THA) and subtrochanteric shortening osteotomy aims to normalise gait pattern and improve functional hip scores. We present the medium-term clinical results of a group of patients with high riding dislocated hips in whom a cementless THA and subtrochanteric shortening osteotomy had been performed. We compared them with their preoperative status, with patients who had undergone a cementless THA for primary osteoarthritis, and also with a group of healthy gender and age-matched controls. Prospective computerized, three-dimensional gait analyses were performed in 8 female patients with uni-/ or bilateral severe developmental dysplasia of the hip (Group I). Gait analysis was performed preoperatively and at a mean of 12.5 months postoperatively. A group of 8 individuals who received cementless hip replacement for primary osteoarthritis (Group II), and a control group of 8 able-bodied individuals (Group III) were recruited for comparison. Patients in Group I improved and approached the values of Group II. However both were behind Group III. Limb length discrepancy was reduced from a mean of 4.3 cm (range, 1 - 8 cm) to a mean of 0.8 cm (range, 0 - 2 cm) at the latest follow-up. Pain was reliably relieved and activities of daily living were improved in patients with high riding developmental dysplasia of the hip, but they were still behind the normal population average. Nevertheless, the results can be as satisfactory as those in patients who undergo a THA for primary osteoarthritis.
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Affiliation(s)
- Salih Marangoz
- Hacettepe University, Faculty of Medicine, Department of Orthopaedic Surgery, Ankara, Turkey.
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van Bosse HJP, Marangoz S, Lehman WB, Sala DA. Correction of arthrogrypotic clubfoot with a modified Ponseti technique. Clin Orthop Relat Res 2009; 467:1283-93. [PMID: 19142694 PMCID: PMC2664422 DOI: 10.1007/s11999-008-0685-6] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2008] [Accepted: 12/15/2008] [Indexed: 01/31/2023]
Abstract
Surgical releases for arthrogrypotic clubfeet have high recurrence rates, require further surgery, and result in short, painful feet. We asked whether a modified Ponseti technique could achieve plantigrade, braceable feet. Ten patients (mean age, 16.2 months; range, 3-40 months), with 19 arthrogrypotic clubfeet, underwent an initial percutaneous Achilles tenotomy to unlock the calcaneus from the posterior tibia followed by weekly Ponseti-style casts. A second percutaneous Achilles tenotomy was performed in 53%. Mean number of casts was 7.7 (range, 4-12). From pretreatment to completion of initial series of casts, mean scores of Dimeglio et al. improved from 16 to 5 (ranges, 12-18 and 2-9, respectively), Catterall scores (as modified by Pirani and colleagues) from 4.8 to 0.9 (ranges, 1.5-6.0 and 0.0-2.0), and maximum passive dorsiflexion from -45 degrees (range, -75 degrees to -20 degrees ) to 10 degrees (range, 0 degrees to 40 degrees ). Ankle-foot orthoses maintained correction. At the minimum followup of 13 months (mean, 38.5 months; range, 13-70 months), the mean maximum dorsiflexion was 5 degrees (range, -20 degrees to 20 degrees ), two patients had posterior releases and no patient's ambulatory ability was compromised by foot shape. Arthrogrypotic clubfeet can be corrected without extensive surgery during infancy or early childhood. Limited surgery may be required as the children age.
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Affiliation(s)
- Harold J P van Bosse
- Pediatric Orthopaedic Surgery, Shriners Hospital for Children-Philadelphia, 3551 North Broad Street, Philadelphia, PA 19140, USA.
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Marangoz S, Feldman DS, Sala DA, Hyman JE, Vitale MG. Femoral deformity correction in children and young adults using Taylor Spatial Frame. Clin Orthop Relat Res 2008; 466:3018-24. [PMID: 18810569 PMCID: PMC2628244 DOI: 10.1007/s11999-008-0490-2] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2008] [Accepted: 08/19/2008] [Indexed: 01/31/2023]
Abstract
UNLABELLED The Taylor spatial frame (TSF) has been used commonly in children and young adults. Its use in the tibia is more extensively studied and applied than in the femur. We asked whether normal alignment can be achieved with accuracy during correction of femoral deformities while avoiding major complications in children and young adults. We retrospectively reviewed the clinical and radiographic records of 20 patients (22 limbs), ages 5.9 to 24.6 years, who underwent a TSF for femoral deformity. Etiology included a number of diagnoses of the pediatric age. Minimum followup was 4.5 months (mean, 15.7 months; range, 4.5-35 months). The mean time in frame was 6.2 months (range, 2.6-19 months). Frontal and sagittal plane deformities were corrected to within normal values. A mean limb lengthening of 4.9 cm (range, 1.5-9 cm) was performed in eight femora in seven of which the limb length discrepancy was a secondary concern. External fixation index in the lengthening subgroup was 2.2 months/cm. The 15 complications in 13 limbs included pin tract infection, knee stiffness, delayed union, skin irritation, and posterior knee subluxation. No complications occurred in nine limbs. Computer-assisted femoral deformity correction with six-axis deformity analysis and the TSF is an accurate and safe technique in children and young adults. LEVEL OF EVIDENCE Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.
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Affiliation(s)
- Salih Marangoz
- NYU Hospital for Joint Diseases, 301 East 17th Street, New York, NY 10003 USA
| | - David S. Feldman
- NYU Hospital for Joint Diseases, 67 Irving Place, 8th Floor, New York, NY 10003 USA
| | - Debra A. Sala
- NYU Hospital for Joint Diseases, 301 East 17th Street, New York, NY 10003 USA
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Sayin B, Caliş S, Atilla B, Marangoz S, Hincal AA. Implantation of vancomycin microspheres in blend with human/rabbit bone grafts to infected bone defects. J Microencapsul 2008; 23:553-66. [PMID: 16980276 DOI: 10.1080/02652040600775632] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
In orthopaedic applications, allografts are used for restoration of bone defects. In order to combine the effects of bone repair and to prevent the infection, antibiotic-impregnated bone grafts are under current investigation with promising early results. In this study, to preserve the stability of antibiotics and to provide appropriate release profiles for 4-6 weeks, antibiotic-loaded microspheres were administered in combination with allografts and vancomycin was the antibiotic loaded to microspheres. Particle size, surface characteristics, loading capacity and in vitro release characteristics of the microspheres with and without allografts were determined. In vivo studies were performed on rabbits and antibiotic amount was determined by a fluorescence polarization immunoassay (FPIA) method from synovial fluid sample aspirated. According to the results, although the in vitro study demonstrated effective antibiotic release of vancomycin from antibiotic-impregnated allografts for 5 weeks, in vivo conditions led to an early instability of the antibiotic (in powder form) and contrary to the high initial loading dose an effective release could not be obtained from the allografts after the first week. Following these studies, it was determined that antibiotic release over a minimum inhibitory concentration (MIC) for 6 weeks was realized from vancomycin-loaded microspheres which were implanted in a blend with allografts in bone defects. In conclusion, preservation of the antibiotic in microspheres maintained the bioactivity and provided the controlled antibiotic release, thus implantation of microspheres in a blend with allografts seemed to be a promising carrier system for the orthopaedic applications.
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Affiliation(s)
- Burcu Sayin
- Faculty of Pharmacy, Department of Pharmaceutical Technology, Hacettepe University, Ankara, Turkey
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Oznur A, Komurcu M, Marangoz S, Tasatan E, Alparslan M, Atesalp AS. A new perspective on management of open calcaneus fractures. Int Orthop 2007; 32:785-90. [PMID: 17581751 PMCID: PMC2898954 DOI: 10.1007/s00264-007-0402-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2007] [Revised: 05/11/2007] [Accepted: 05/11/2007] [Indexed: 12/01/2022]
Abstract
The treatment protocol of closed calcaneal fractures has been described in the literature extensively. However, treatment of open calcaneal fractures has not been discussed in detail. Various treatment alternatives have been suggested including external fixator, primary subtalar distraction arthrodesis, and partial calcanectomy according to the type of fracture. We have retrospectively reviewed 36 adult patients with 39 open calcaneal fractures who were treated with our new philosophy. Average follow-up time was 9.29 years (range, 1.25-28 years). The American Orthopaedic Foot and Ankle Society (AOFAS) scoring system was used in functional evaluation. The average score was 77.9 (range, 67-92). All of the patients had limited subtalar movement. We propose an algorithm for the management of open calcaneus fractures, although treatment largely depends on the physical status of the patient, type of the fracture, localisation of the open wound and the surgeon's choice.
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Affiliation(s)
- Ali Oznur
- Department of Orthopaedics and Traumatology, Güven Hospital, Ankara, Turkey
| | - Mahmut Komurcu
- Faculty of Medicine, Department of Orthopaedics and Traumatology, Gülhane Military Medical Academy, Ankara, Turkey
- GATA Ortopedi ve Travmatoloji AD, Etlik, 06018 Ankara, Turkey
| | - Salih Marangoz
- Department of Orthopaedics and Traumatology, John Hopkins University, Baltimore, MD USA
| | - Ersin Tasatan
- Department of Orthopaedics and Traumatology, Iskenderun Military Hospital, Iskenderun, Turkey
| | - Mümtaz Alparslan
- Faculty of Medicine, Department of Orthopaedics and Traumatology, Hacettepe University, Ankara, Turkey
| | - Ali Sabri Atesalp
- Faculty of Medicine, Department of Orthopaedics and Traumatology, Gülhane Military Medical Academy, Ankara, Turkey
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Abstract
Triplication of the thumb is a rare condition described only in several case reports. Radial longitudinal deficiency is a relatively more common entity. These 2 congenital abnormalities generally do not occur within the same extremity. We present a patient with a combination of 3 thumbs (triplication of the thumb) and hypoplastic radius in the same limb.
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Affiliation(s)
- Salih Marangoz
- Division of Hand Surgery and Microsurgery, Department of Orthopaedic Surgery, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
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Marangoz S. Osteosarcoma without radiographic evidence of tumor. Clin Orthop Relat Res 2006; 448:257-8; author reply 258. [PMID: 16826125 DOI: 10.1097/01.blo.0000223997.64647.6c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
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Marangoz S, Leblebicioğlu G. Stability of the distal radioulnar joint contributed by the joint capsule. J Hand Surg Am 2005; 30:868-9; author reply 869. [PMID: 16039394 DOI: 10.1016/j.jhsa.2005.03.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2005] [Revised: 02/15/2005] [Accepted: 03/20/2005] [Indexed: 02/02/2023]
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Alanay A, Cil A, Acaroglu E, Caglar O, Akgun R, Marangoz S, Yazici M, Surat A. Late spinal cord compression caused by pulled-out thoracic pedicle screws: a case report. Spine (Phila Pa 1976) 2003; 28:E506-10. [PMID: 14673376 DOI: 10.1097/01.brs.0000099389.96750.6d] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN A case report. OBJECTIVES To report a late neurologic compromise caused by pulling-out of thoracic pedicle screws. SUMMARY OF BACKGROUND DATA Although screw misplacement is quite common, only few neurologic injuries have been reported because of penetration of the medial wall of pedicles in the thoracic spine. To our knowledge, neurologic compromise caused by pulling-out of the screws has not been reported to date. METHODS A 6-year-old girl with congenital muscle fiber type disproportion was posteriorly instrumented (T3 to L4) for severe kyphosis. Later, she had a junctional kyphosis over the top of the instrument. Her instrumentation was lengthened to T2 by using transpedicular screws. During the follow-up period, T2 screws were pulled-out and intruded into the canal, causing neurologic compromise. The presenting symptoms, imaging studies, and related literature are reviewed in this report. RESULTS Patient's neurologic symptoms subsided after removal of the pedicle screws intruded into the spinal canal. CONCLUSIONS Pulling-out of transpedicular screws inserted at T1 or T2 where the pedicles are oriented more medially may cause late neurologic compromise caused by intrusion of triangulated screws into the spinal canal.
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Affiliation(s)
- Ahmet Alanay
- University Faculty of Medicine, Department of Orthopaedics & Traumatology, Spine Unit, Ankara, Turkey.
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Akalin I, Güllü IH, Kurdoglu M, Marangoz S. Why hepatocellular carcinoma cells are unlikely to metastasize: is there a role for tissue inhibitor of metalloproteinase-1? Med Hypotheses 2001; 57:221-3. [PMID: 11461177 DOI: 10.1054/mehy.2001.1271] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The question 'Why hepatocellular carcinoma cells are unlikely to metastasize although they have a high proliferative activity?' is a major point of interest from a cancer physiopathological viewpoint. Recent articles about the roles and relationships of some cytokines with matrix degrading enzymes and their inhibitors in various types of normal tissues and malignancies give rise to another question: 'Does tissue inhibitor of metalloproteinase-1 prevent the extrahepatic metastasis of hepatocellular carcinoma cells?' On the basis of many evidences, it is highly probable that under the effect of a possible inducing mechanism of the cytokines interleukin-6, -1 beta and transforming growth factor beta, the increase in concentration of tissue inhibitor of metalloproteinase-1 in hepatocellular carcinoma cause increased type I collagen accumulation and consequent prevention of cellular detachment, which explains why highly proliferative malignant hepatocytes have less metastatic ability.
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Affiliation(s)
- I Akalin
- Institute of Oncology, Hacettepe University, Ankara, Turkey.
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Güllü IH, Marangoz S. Quantification and prognostic relevance of angiogenic parameters in invasive cervical cancer. Br J Cancer 1999; 80:1865. [PMID: 10468311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/13/2023] Open
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Marangoz S, Güllü IH. Expression of ras, c-myc, and p53 proteins in cervical intraepithelial neoplasia. Cancer 1999; 85:2668-9. [PMID: 10375117 DOI: 10.1002/(sici)1097-0142(19990615)85:12<2668::aid-cncr25>3.0.co;2-g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Güllü I, Marangoz S. Induction of cachexia in mice. Br J Cancer 1999; 79:1620-1. [PMID: 10188916 PMCID: PMC2362721 DOI: 10.1038/sj.bjc.6690258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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