Mesut Sonmez

Sisli Etfal Training and Research Hospital, İstanbul, Istanbul, Turkey

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Publications (3)4.97 Total impact

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    ABSTRACT: Intra-articular glenohumeral injections have an important role for therapeutic benefit and diagnostic information. Therefore, it is very important that the injected material should reach its desired target. This study assessed the accuracy of an anterior intra-articular injection in fresh cadavers. A total of 50 shoulders of 25 fresh cadavers were included in the study. Anterior placement of a spinal needle using a location just 1 cm lateral to the coracoid, without radiographic assistance were performed. After the needle was placed and estimated to be intra-articular 1 cc of acrylic dye was injected into the joint to determine accuracy of position. Ninety-six percent of injections were accurately administered into the glenohumeral joint and 4% in the surrounding soft tissues and capsule. Based on our cadaveric study, an unassisted anterior injection to the glenohumeral joint could be accurately placed.
    Archives of Orthopaedic and Trauma Surgery 02/2009; 130(3):297-300. · 1.36 Impact Factor
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    ABSTRACT: The purpose of the study was to evaluate the accuracy of injections into the carpal tunnel using three different portals in cadavers, and to define safe guidelines. In this study, 150 wrists of 75 cadavers (54 male, 21 female) were included. To compare three injection sites, 50 wrists of 25 cadavers were used for each technique; we used 23 gauge needles, and acrylic dye. The first injection technique: the needle was inserted 1cm proximal to the wrist crease and directed distally by roughly 45 in an ulnar direction through the flexor carpi radialis tendon. The second injection technique: the needle was inserted into the carpal tunnel from a point just ulnar to the palmaris longus tendon and 1cm proximal to the wrist crease. The third injection technique: the needle was inserted just distal to the distal skin crease of the wrist in line with the fourth ray. The first injection technique gave the highest accuracy rate, and this was also the safest injection site. Median nerve injuries caused by injection was seen mostly with the second technique. Although a steroid injection may provide symptomatic relief in patients with carpal tunnel syndrome, the median nerve and other structures in the carpal tunnel are at risk of injury. Because of that, the injection should be given using the correct technique by physicians skilled in carpal tunnel surgery.
    Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery 02/2008; 42(6):300-4. · 0.94 Impact Factor
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    ABSTRACT: Although intra-articular knee injection is not a complicated procedure, it could be difficult to assess whether the tip of the needle lies free in the joint or is embedded in synovium or other intra-articular soft tissues. The purpose of this study was to evaluate the accuracy rate of intra-articular injection using anteromedial (AM), anterolateral (AL), lateral midpatellar (LMP), and medial midpatellar (MMP) portals in cadavers. In this study 156 knees of 78 fresh cadavers were included. Anterolateral and AM injection to both knees of 39 cadavers (78 knees) were performed. MMP and LMP injection to both knees of other 39 cadavers were also performed. Accuracy rate was the highest (85%) in the AL injection portal and lowest in the MMP portal (56%). In conclusion, the accuracy obtained with use of the MMP portal was significantly lower than that obtained with the use of either the AM (P < 0.05), AL (P < 0.0001), or LMP (P < 0.05) portal. Although AL injection site resulted in good intra-articular delivery with 85% accuracy rate and with a lower incidence of soft tissue infiltration, the results were not statistically significant when compared to AM and LMP portals. Therefore, any of these three portals might be preferred depending on the experience of the physician. On the other hand, 100% accuracy could not be obtained through any portals in the study, which should be kept in mind when treating knee problems with intra-articular medications.
    Knee Surgery Sports Traumatology Arthroscopy 05/2007; 15(5):573-7. · 2.68 Impact Factor