Publications (16)11.04 Total impact
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Article: Hip osteonecrosis in Cushing’s disease treated with bone-preserving procedures
Journal of Orthopaedic Science 04/2012; 14(5):662-665. · 0.84 Impact Factor -
Article: Physical therapy with subacromial tenoxicam injection in patients with open subacromial decompression and rotator cuff tear repair: a pilot randomized controlled study
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ABSTRACT: IntroductionTo investigate the effects of subacromial tenoxicam injection during physical therapy after rotator cuff tear and subacromial decompression. Materials and methodsThis is a prospective controlled clinical study. Fourteen patients who had a moderate-size rotator cuff tear were included in the study. Two injections of tenoxicam were made to patients in the tenoxicam group into the subacromial space, and two injections of serum physiologic were made to patients in the control group. The same rehabilitation program was done to both of the two groups. Passive anterior shoulder flexion was evaluated, and VAS score was noted at the end of 3weeks following the operation. The first week of painless full range of motion achieved was noted. ResultsThe mean passive anterior shoulder flexion was 137.1° (range, 130–145°) for tenoxicam group and 121.4° for control group. The mean VAS score was 2.42 (range, 1–3) for tenoxicam group and 4 (range, 3–5) for the control group. The mean first week of painless full range of motion was being achieved in 6.14 (range, 6–7) in the tenoxicam group and 8.28 (range, 8–9) in the control group. Statistically significant difference was observed between the tenoxicam and control groups in terms of the mean passive anterior shoulder flexion, the VAS score during flexion and the first day of painless full range of motion achieved. DiscussionSubacromial tenoxicam injection after rotator cuff tear and subacromial decompression may help the physical therapy. KeywordsInjection-Physical therapy-Rotator cuff-SubacromialEuropean Journal of Orthopaedic Surgery & Traumatology 04/2012; 20(8):603-606. · 0.10 Impact Factor -
Article: Can bone quality be predicted accurately by Singh index in patients with rheumatoid arthritis?
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ABSTRACT: The aim of this study was to evaluate Singh index as a simple and inexpensive means of estimation of bone quality in patients with rheumatoid arthritis. Singh index evaluation was made on digital pelvis radiographs in 50 consecutive patients by three observers. Bone mineral density T scores of the spine and left proximal femur were assessed using dual energy X-ray absorptiometry. Singh index was correlated with densitometry measurements after grouping the patients as normal, osteopenia and osteoporosis. Intra- and interobserver agreements were evaluated by kappa correlations. Sensitivity, specificity, positive and negative predictive values and likelihood ratio's of Singh index were calculated. Both intra- and interobserver agreements were 0.71 (range, 0.69 to 0.72) on average. Singh index proved highly sensitive for the diagnosis of osteopenia at the proximal femur (91%) and spine (90%), whereas the specificity of Singh index for identifying of osteoporosis at the femoral neck (93%) and spine (91%) was higher than sensitivity. Predictive values for osteoporosis at the proximal femur and spine were acceptable and positive likelihood ratios of Singh index for osteopenia and osteoporosis at the proximal femur were 2.4 and 10.1, respectively. Singh index can identify osteoporosis with a high specificity in patients with rheumatoid arthritis. However, the patients who are graded as osteopenia by the Singh index should undergo further evaluation with dual energy X-ray absorptiometry.Clinical Rheumatology 06/2011; 31(1):85-9. · 2.00 Impact Factor -
Article: Early results of distal metatarsal osteotomy with K-wire fixation in the treatment of tailor's bunion.
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ABSTRACT: Tailor's bunion deformity is a lateral side bone and soft tissue prominence of the fifth metatarsal bone. The aim of our study was to assess the clinical and radiographic results of distal metatarsal osteotomies in patients with tailor's bunion deformity. This study included 24 feet of 14 patients with tailor's bunion who were treated with distal metatarsal osteotomy of the 5th metatarsal between 2006 and 2009. The mean follow-up time was 24.45 (range: 12 to 47) months. Patients were evaluated clinically and radiographically, using the American Orthopaedic Foot and Ankle Society (AOFAS) scoring system with weight-bearing anteroposterior and lateral foot radiographs. Average AOFAS scores of the patients were 64.83 preoperatively and 91.62 at the final follow-up. Three patients had complications; avascular necrosis, delayed union, and superficial wound infection. Distal metatarsal osteotomy is a safe and easy treatment option for the painful tailor's bunion deformity and provides patient satisfaction rate of up to 96%.acta orthopaedica et traumatologica turcica 01/2011; 45(6):431-6. · 0.34 Impact Factor -
Article: Treatment of reverse oblique trochanteric femoral fractures with proximal femoral nail.
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ABSTRACT: Treatment of reverse oblique trochanteric femoral fractures is still challenging. We present the results of our proximal nailing surgery performed for reverse obliquity intertrochanteric fractures using two lag screws and evaluated the quality of the reduction, operative time, complications and functional status of the patients. Fifteen patients with AO/OTA 31 A-A3 fractures were treated by proximal femoral nailing in our trauma centre. The mean Harris hip score was 74.66 (range 65-96) and the mean Barthel activity score was 15.71 (range 12-20). The mean duration of surgery was 48 minutes and the average consolidation time was 8.6 weeks. No intraoperative complications or postoperative technical failures and no stress shielding as evidenced by the lack of cortical hypertrophy at the level of the tip of the implant were detected. Intramedullary nailing with proximal femoral nails may be a good option in the treatment of reverse obliquity intertrochanteric fractures.International Orthopaedics 03/2010; 35(4):595-8. · 2.03 Impact Factor -
Article: Transosseous capsuloplasty improves the outcomes of Lindgren-Turan distal metatarsal osteotomy in moderate to severe hallux valgus deformity.
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ABSTRACT: Lindgren-Turan osteotomy used in hallux valgus deformity is a subcapital, transverse displacement osteotomy of the first metatarsal without any additional capsular repair. The aims of this study are to describe a transosseous capsuloplasty technique in this procedure and evaluate whether capsuloplasty would improve the clinical and radiological outcomes in patients with moderate to severe hallux valgus deformity. Twenty-three feet operated by Lindgren-Turan osteotomy (Group B) and 25 feet operated by the same osteotomy combined with transosseous capsuloplasty (Group A) were evaluated retrospectively for the correction of the hallux valgus, intermetatarsal and distal metatarsal articular angles, sesamoid reduction, American Orthopaedic Foot and Ankle Society (AOFAS) Clinical Rating Scale as well as patient satisfaction. The mean postoperative follow-up was 14 (range 12-28) months. All radiological parameters improved considerably as a result of both groups. However, postoperative improvements in intermetatarsal and distal metatarsal articular angles were greater in Group A. Complete reduction of medial sesamoid was achieved in 52% of patients in Group A, whereas 17.4% of patients in Group B had complete reduction. AOFAS scores and number of patients with complete satisfaction in Group A were significantly greater than that in Group B. Better clinical and radiological outcomes can be achieved in patients with moderate to severe hallux valgus deformity operated by Lindgren-Turan distal metatarsal osteotomy, when it combines with transosseous capsuloplasty.Archives of Orthopaedic and Trauma Surgery 10/2009; 130(10):1201-7. · 1.37 Impact Factor -
Article: Hip osteonecrosis in Cushing's disease treated with bone-preserving procedures.
Journal of Orthopaedic Science 09/2009; 14(5):662-5. · 0.84 Impact Factor -
Article: Treatment of Tönnis type II hip dysplasia with or without open reduction in children older than 18 months: a preliminary report.
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ABSTRACT: In this study, we aim to investigate whether the hip with Tönnis type II dysplasia in children older than 18 months can be treated without open reduction. In our study, 47 hips (47 patients) with type II developmental dysplasia of the hip according to the Tönnis classification were treated by a combination of open reduction through an anterolateral approach with iliopsoas tenotomy followed by innominate osteotomy and capsulorrhaphy or iliopsoas tenotomy followed by innominate osteotomy. The patients with open reduction constitute the open Salter group (32 hips), while the rest of the patients with innominate osteotomy alone constitute the closed Salter group (15 hips). The acetabular index (AI) and Smith's c-b and h-b index were assessed on the preoperative, immediate postoperative and final follow-up hip X-rays. There were no statistically significant differences related to sex distribution, age and postoperative follow-up time between the patients of each group. There was also no statistically significant difference between the preoperative AI of the open and closed Salter osteotomy groups. Overall, 80% of hips with open reduction had Smith's c-b ratio greater than the value of 1 and h-b ratio lower than the value of 0.05. The preoperative c-b index of the open osteotomy group was statistically greater than the c-b index of the closed osteotomy group and the preoperative h-b index of the open Salter group was statistically smaller than the h-b index of the closed Salter group, which means that most of the hips in the open osteotomy group are more in a lateralised and superior position compared to the closed osteotomy group. To us, there exists a subgroup of hips with less lateralisation and superior displacement according to the Smith's c-b and h-b ratio in Tönnis type II hip dysplasia. These hips might be less amenable to capsulorrhaphy because of the lower capsular instability and treatment may be done with closed reduction after iliopsoas tenotomy with Salter osteotomy in this select group of patients.Journal of Children s Orthopaedics 08/2009; 3(4):307-11. -
Article: A new radiographic measurement method for evaluation of tibial torsion: a pilot study in adults.
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ABSTRACT: Computed tomography (CT) frequently is used to determine torsional abnormalities. However, its use in clinical practice may be limited. We present a new method for measuring tibial torsion using conventional radiographs. We compared the method with several clinical methods and with CT measurement in 44 lower extremities of 25 subjects. The radiographic method agreed well with all of the clinical methods, and this agreement was better than agreement between CT and clinical examination. The best agreement was between thigh-foot angle and the radiographic method. The proposed radiographic measurement is a practical method for evaluation of tibial torsion in outpatient clinics without the need for specialized equipment. LEVEL OF EVIDENCE: Level II, diagnostic study.Clinical Orthopaedics and Related Research 01/2009; 467(7):1807-12. · 2.53 Impact Factor -
Article: "Floating arm" injury in a child with fractures of the proximal and distal parts of the humerus: a case report.
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ABSTRACT: Simultaneous supracondylar humerus fracture and ipsilateral fracture of the proximal humerus in children is rare. A 10-year-old Turkish boy with an extension type supracondylar humerus fracture and ipsilateral fracture at the proximal metaphyseal-diaphyseal junction of the humerus was treated by closed reduction and percutaneous Kirschner wire fixation. Closed reduction was performed using a Kirschner wire as a "joystick" to manipulate the humeral shaft after some swelling occurred around the elbow and shoulder. The combination of fractures at the proximal and distal parts of the humerus can be termed as "floating arm" injury. Initial treatment of this unusual injury should be focused on the supracondylar humerus fracture. However, closed reduction can be difficult to perform with the swelling around the elbow and shoulder. A temporary Kirschner wire can be used as a "joystick" to fix and reduce the fracture.Journal of Medical Case Reports 01/2009; 3:9287. -
Article: Successful treatment of bilateral open calcaneal fractures with concomitant lower extremity injuries: A case report.
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ABSTRACT: Open calcaneal fractures are high morbidity injuries and the risk of complications depends on the concomitant injuries, on the size and the position of the traumatic wound. A 53-year-old male patient with bilateral open calcaneal fractures and associated concomitant lower extremity injuries such as subtalar dislocation, talonavicular dislocation and open distal tibial metaphyseal fracture was immediately operated by percutaneous Kirschner wire fixation combined with external fixators. He was able to walk with full weight bearing without any assistance at the end of the first postoperative year. Early aggressive debridement and irrigation followed by fixation with percutaneous Kirschner wires and external fixator can supply bony alignment in open comminuted calcaneal fractures associated with concomitant lower extremity injuries and should be considered for the healthy and active patients before primary arthrodesis.Cases Journal 10/2008; 1(1):194. -
Article: Correlation between posteromedial or posterolateral displacement and cubitus varus deformity in supracondylar humerus fractures in children.
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ABSTRACT: Cubitus varus deformity is one of the most common complications after displaced supracondylar humeral fractures in children. The purpose of this study was to evaluate the relationship between the fracture displacement and cubitus varus deformity in displaced supracondylar humerus fractures. Seventeen patients (11 males/6 females; mean age 7 years) with cubitus varus deformities occurring after Gartland type III posteromedial or posterolateral displaced supracondylar humerus fractures were evaluated with clinical and serial radiographic examinations. All patients had been treated surgically by open reduction through a medial approach and percutaneous cross-pinning. All fractures were reduced anatomically. Ten of the patients were operated within the first 24 h. The time interval between the initial injury and the surgical procedure for the remaining seven patients was 5.3 days on average (range 2-10 days). The carrying angle and range of motion of the elbow were measured throughout the follow-up period. The mean follow-up time was 3.7 years (range 2-12 years). Five patients with type III-B fractures had a mean carrying angle loss of 8.8 degrees (range 6-10 degrees ), whereas for the remaining 12 type III-A patients the mean loss was 15 degrees (range 6-29 degrees ) (P = 0.019). None of the patients in this study demonstrated limited elbow motion. According to the Flynn criteria, the results were good in five type III-B patients. There was no statistically significant relationship between the loss of carrying angle and the delay before the surgical procedure (P = 0.615 in type III-A, P = 0.096 in type III-B). The carrying angle loss was more significant in type III-A fractures compared with type III-B in this series. These results suggest that although anatomic reduction has been achieved by surgical treatment without loss of reduction, there is still a risk for cubitus varus deformity for type III-A fractures due to the initial compression of the medial column or, in other words, physeal injury.Journal of Children s Orthopaedics 04/2008; 2(2):85-9. -
Article: Charcot joint of shoulder
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ABSTRACT: Neuropathic arthropathy involving the shoulder is a relatively rare chronic disorder characterized by the destruction of the joint which is also associated with decreased sensory innervation (Lequesne et al. in Rev Rhum Mal Osteoartic 49(6):427–437, 1982; Yanık et al. in Rheumatol Int 24(4):238–241, 2004). Here, we report a case of neuropathic arthropathy of the shoulder (charcot shoulder), secondary to syringomyelia with classic clinical and radiographic features of the entity. Les arthropathies neurologiques affectant l’épaule sont des affections rares associant une destruction articulaire à une perte de sensibilité. Nous rapportons ici un cas d’épaule de Charcot secondaire à une syringomyélie avec ses caractériqtiques cliniques et radiologiques.European Journal of Orthopaedic Surgery & Traumatology 03/2008; 18(3):229-231. · 0.10 Impact Factor -
Article: Unusual fracture combination with Charcot arthropathy and juvenile-onset diabetes
Injury Extra 03/2008; 39:291 - 295. -
Article: [The results of the Grice subtalar extra-articular arthrodesis for pes planovalgus deformity in patients with cerebral palsy].
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ABSTRACT: We evaluated the results of the Grice subtalar extra-articular arthrodesis for pes planovalgus deformity in patients with cerebral palsy and its effectiveness in providing hindfoot alignment. Grice subtalar extra-articular arthrodesis was performed for pes planovalgus deformity in 14 feet of nine patients (5 males, 4 females; mean age 10.3 years; range 6 to 12 years) with cerebral palsy. Six patients were diplegic, two patients were paraplegic, and one patient was hemiplegic. Four patients had unilateral, five patients had bilateral involvement. A fibular graft taken from the distal third of the fibula above the syndesmosis was used in all the patients without any fixation material. The patients were assessed with the AOFAS (American Orthopaedic Foot and Ankle Society) hindfoot scoring system pre- and postoperatively. The mean follow-up was 30 months (range 6 to 81 months). Compared with the preoperative values, the mean AOFAS hindfoot score increased from 53 (range 41 to 81) to 68.4 (range 51 to 96), the mean talocalcaneal angle decreased from 52.6 degrees to 30.4 degrees , and from 55.8 degrees to 35.9 degrees in frontal and sagittal planes, respectively (p<0.05). The mean ankle valgus angle measured on anteroposterior radiographs remained unchanged (mean 5 degrees ). Of five patients who underwent bilateral surgery, three (21.4%) developed donor-site fibular nonunion on one side. One (7.1%) of these patients also had graft nonunion and displacement. Treatment was rated as satisfactory by the parents of seven patients (77.8%; p<0.05). Despite donor-site morbidity, the Grice subtalar extra-articular arthrodesis is an effective procedure for the correction of hindfoot alignment in patients with pes planovalgus deformity secondary to cerebral palsy.acta orthopaedica et traumatologica turcica 42(1):31-7. · 0.34 Impact Factor -
Article: An unusual cause of a cystic lesion with an osteochondral defect in the talus: intraosseous lipoma.
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ABSTRACT: An intraosseous lipoma is a rare benign bone lesion that proliferates from mature lipocytes. It occurs most frequently in the lower limb, particularly in the calcaneus. The talus is an unusual location for this rare lesion. A review of the literature produced only two reports with talar intraosseous lipomas under the name of intraosseous lipomatosis, which described multiple lipomas in different areas. We describe a 38-year-old male patient who had an isolated intraosseous lipoma with an osteochondral defect in the talus and was treated with autologous osteochondral graft transplantation by medial malleolar osteotomy. He could walk with full weightbearing without any assistance at the end of 12 months. Intraosseous lipoma localized in the talus may be confused radiologically with other bone lesions, especially with unicameral bone cyst, if it is associated with an osteochondral defect. Autologous osteochondral graft transplantation is a successful treatment method for talar intraosseous lipoma.Journal of the American Podiatric Medical Association 101(3):269-74. · 0.57 Impact Factor
Top co-authors
Top Journals
Institutions
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2009
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Kasimpasa Military Hospital
İstanbul, Istanbul, Turkey -
Kanuni Sultan Süleyman Training and Research Hospital Istanbul
İstanbul, Istanbul, Turkey -
Abant İzzet Baysal Üniversitesi
Bolu, Bolu, Turkey
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2008–2009
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Göztepe Teaching And Research Hospital
İstanbul, Istanbul, Turkey
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