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ABSTRACT: AIM: The aim of this prospective study was to evaluate the outcome of open reduction and Tönnis acetabuloplasty as the first method of treating developmental dysplasia of the hip (DDH) in children in early childhood at walking age. MATERIALS AND METHODS: Between 2005 and 2009, 34 hips of 34 children were operated on with the aforementioned method. Mean age was 25.6 (range 12-44) months, and mean follow-up was 3.6 years. During the follow-up period ,the hips were evaluated using the acetabular index and for development of avascular necrosis and redislocation. Functional evaluation was also conducted. RESULTS: Clinically, 97.3 % of patients had excellent and good results. The acetabular angle decreased from 45° preoperatively to 21° early postoperatively and at the last follow-up had improved to 18°. In two hips, type 2 avascular necrosis developed. Hip instability was not observed, and no additional surgery was performed. CONCLUSION: Tönnis acetabuloplasty is a powerful tool to increase primary stability of the hip when acetabular coverage is inadequate in DDH. Besides its acute correction ability, when performed properly, it has no unwanted effects on acetabular growth. As an isolated procedure or as a part of combined open reduction and/or femoral osteotomy, Tönnis type acetabuloplasty is a safe and effective method.
Journal of Orthopaedic Science 08/2012; · 0.84 Impact Factor
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ABSTRACT: To evaluate knee function in patients having femoral diaphyseal fractures treated with antegrade or retrograde intramedullary nail insertion.
Prospective.
Level I referral center.
Seventy patients having 71 OTA 32 fractures were randomly allocated into 2 groups to be treated with either antegrade or retrograde intramedullary nails inserted with reaming.
Antegrade nail in 41 fractures and retrograde femoral intramedullary nails in 30 fractures.
Postoperative knee range of motion, Lysholm Knee Score, and isokinetic knee muscle function testing at least 6 months after documented fracture healing, minimum 1 year postoperatively.
Groups had similar data with regard to demographics and injury patterns. Mean follow-up time was 44 (range: 25-80) months. Mean knee flexion angle was 132 and 134 degrees, and mean Lysholm Score was 84 and 83.1 in antegrade and retrograde groups, respectively (P = 0.893 and P = 0.701). Isokinetic evaluation revealed similar results for peak torque deficiencies at 30 and 180 degrees per second and total work deficiencies at 180 degrees per second (P > 0.05). Age affected the knee functioning as the higher the age of the patient is, the lower the Lysholm Score and knee flexion angle (r = -0.449, P = 0.0321 and r = -0.568, P = 0.001, respectively).
Knee function seems to have similar clinical results after either antegrade or retrograde nail insertion for femoral diaphyseal fractures when knee range of motion, Lysholm Scores, and isokinetic knee evaluation are considered as outcome measures. With increasing patient age, a decrease in knee functioning should be anticipated in patients with femoral fractures treated with intramedullary nails regardless of technique.
Journal of orthopaedic trauma 10/2009; 23(9):640-4. · 1.78 Impact Factor
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Journal of Pediatric Orthopaedics 09/2009; 29(7):834. · 1.16 Impact Factor
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Knee Surgery Sports Traumatology Arthroscopy 09/2009; 17(10):1270-1; author reply 1272-3. · 2.21 Impact Factor
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ABSTRACT: We describe a case of a previously healthy 35-year-old man who presents with meniscal symptoms, and present the arthroscopic findings of a complicated tear of black lateral meniscus. Investigations revealed that he had underlying alkaptonuria, which was previously undiagnosed without any other findings. After the surgical treatment, the patient's complaints were alleviated and almost no complaints were registered, during the next follow-up.
Knee Surgery Sports Traumatology Arthroscopy 09/2009; 18(4):540-2. · 2.21 Impact Factor
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Skeletal Radiology 06/2009; 38(8):813-4, 831-2. · 1.54 Impact Factor
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Skeletal Radiology 06/2009; · 1.54 Impact Factor
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ABSTRACT: Triceps tendon ruptures are rare injuries. Coexistence of ipsilateral ulnar collateral ligament injury is even rarer. Here, we describe an unusual combination injury to elbow of a 39-year-old male construction worker consisting of triceps tendon rupture, avulsion of elbow ulnar collateral ligament and flexor pronator muscle origin ipsilaterally. A simultaneous repair and reconstruction of all damaged structures was proposed with individualized postoperative rehabilitation. Return to pre-injury level of activities obtained with this treatment protocol. High degree of suspicion and careful examination were needed to prevent missed diagnosis and prolonged instability which may be inevitable after inappropriate treatment of such injury.
Strategies in Trauma and Limb Reconstruction 05/2009; 4(1):35-9.
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Injury 05/2009; 40(6):676-8. · 1.98 Impact Factor
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ABSTRACT: Severe disability originating from feet generally requires surgery. In addition to a number of other techniques, triple arthrodesis is still used to treat deformity and instability unresponsive to conservative measures. The aim of this study was to evaluate the results of the triple arthrodesis operation in two groups of patients with different primary etiologies and to identify the possible factors affecting the results.
During a 4-year period, triple arthrodesis was performed on 25 feet in 20 patients (average age 24.9 years). These patients were divided into two groups according to the primary etiology of the disability: neurogenic and nonneurogenic. Patients were evaluated with pre-and postoperative clinical examinations, American Orthopedic Foot and Ankle Society (AOFAS) Hindfoot and Ankle Scale, radiography, pedobarography, and a general health questionnaire (Short Form 36, SF-36). The need for orthotics and the effect of previous treatments on the end results were also evaluated.
The preoperative average AOFAS score improved from 24 to 71 postoperatively. Preoperative AOFAS values of neurogenic cases were significantly lower than those of nonneurogenic cases. Postoperative AOFAS values were found to be lower in neurogenic cases (64.0 vs. 77.6). Marked improvement was observed for all angular measurements. No relation was found between the AOFAS, changes in angular measurements, and pre-and postoperative plantar pressure analysis results. SF-36 results improved postoperatively in both groups. Triple arthrodesis decreased the use of orthotics postoperatively in both groups. Previous treatments were not found to affect the end results in this series.
Triple arthrodesis operation is a surgical option with limited alternatives in patients with disabilities originating from feet. Both neurogenic and nonneurogenic patient groups improved significantly, and we were unable to show any significant differences in the results of these two groups.
Journal of Orthopaedic Science 08/2008; 13(4):341-7. · 0.84 Impact Factor
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Journal of Orthopaedic Trauma 04/2008; 22(3):213; author reply 213. · 2.13 Impact Factor
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Orthopedics 11/2006; 29(10):948-50. · 2.66 Impact Factor
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ABSTRACT: The clinical and conventional bi-planar determinations of femoral torsion were compared with the tomographic technique, the reliability of which was confirmed. Femoral torsions were measured with the trochanteric prominence angle test, the sinus-wave bi-planar conventional radiographic technique, the modified Hermann bi-planar conventional radiographic technique and the limited three-dimensional volumetric tomography technique in 34 femora of 17 patients. There was a strong correlation between the modified Hermann and the limited tomography techniques for 14 intact and 20 fractured femora. If limited three-dimensional volumetric tomography cannot be obtained, the modified Hermann bi-planar conventional radiographic technique must be used in patients who have scarring about the proximal femur and obesity. Otherwise use of the trochanteric prominence angle test is much more cost-effective and is as accurate as the limited three-dimensional volumetric tomography technique.
Journal of Pediatric Orthopaedics B 02/2006; 15(1):28-33. · 0.47 Impact Factor
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British Journal of Oral and Maxillofacial Surgery 03/2003; 41(1):59-61. · 1.95 Impact Factor
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ABSTRACT: Cubitus varus is a common complication after supracondylar fractures of the humerus, and there have been several discussions about the timing of correction of deformity. Although surgery is performed mainly for cosmetic purposes, the authors in this article show the relationship between cubitus varus and dislocation of the ulnar nerve and posterior instability of the ipsilateral shoulder with a Bankart lesion in three children. A special type of osteotomy to obtain three-dimensional correction was made. All shoulders were found to be clinically stable at follow-up with full pain-free range of motion. Corrective osteotomy of the distal humerus itself corrected the varus angulation and dislocation of the medial portion of the triceps in two patients and prevented the ulnar nerve from dislocating. The authors' experience illustrates the importance of biomechanics in understanding the pathoanatomy of cubitus varus; this deformity should not be regarded as a cosmetic deformity and should be treated early.
Journal of Pediatric Orthopaedics 22(2):198-202. · 1.16 Impact Factor
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Journal of pediatric orthopedics 29(7):834. · 1.23 Impact Factor
