Publications (13)4.54 Total impact
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Article: Osteoid osteoma of the cuboid bone: a rare cause of foot pain.
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ABSTRACT: Osteoid osteoma, a common bone lesion of benign nature, is more rarely seen in feet. It most commonly involves the talus yet rarely the cuboid. The atypical symptoms of foot involvement may delay the diagnosis. Differential diagnosis most commonly includes ankle sprain, monoarticular arthritis, anterior impingement syndrome, tarsal spur, osteomyelitis, stress fracture, eosinophilic granuloma. The delay in diagnosis and treatment of osteoid osteoma in the foot may be a cause of chronic foot pain. In this study, we present a 17-year-old boy with osteoid osteoma in his right cuboid bone. The patient was undiagnosed during the first year of his symptoms. After surgical removal of the tumor, his complaints were resolved. The pathological examination confirmed the diagnosis of osteoid osteoma. Osteoid osteoma is an unusual bone tumor of the foot. It should be included in the differential diagnosis of patients exhibiting foot pain. In speculative cases with no obvious radiographic findings, further imaging studies, such as CT, should be considered.acta orthopaedica et traumatologica turcica 01/2011; 45(1):66-9. · 0.34 Impact Factor -
Article: [Results of limited open rotator cuff repair with partial acromioplasty for rotator cuff tears with subacromial impingement syndrome].
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ABSTRACT: Short term results of partial acromioplasty and rotator cuff repair with a limited open surgical technique were evaluated in patients with rotator cuff tears. Forty-eight patients (16 males, 32 females; mean age 52 years; range 29 to 70 years) with rotator cuff rupture were recruited to the study between January 2001 and December 2006. A limited open rotator cuff repair along with partial acromioplasty (via rasper) was applied in all cases. The Constant-Murley shoulder score was used before and after surgery. Mean duration of follow-up was 38 months (range 14 to 70 months). Pre- and postoperative Constant-Murley scores averaged 44 (range 36 to 51) and 88 (range 75 to 96) respectively. Anchoring sutures were displaced in one subject (2%) and tendon insufficiency recurred, another two cases (4%) had impingement from secondary granulation tissue that developed due to sutures in the tendon repair site. We believe that minimal acromioplasty via a limited open surgical approach is an applicable technique with good results in the treatment of rotator cuff tears with subacromial impingement syndrome.Eklem hastalıkları ve cerrahisi = Joint diseases & related surgery. 08/2010; 21(2):73-9. -
Article: [Retrograde intramedullary interlocking nailing in fractures of the distal femur].
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ABSTRACT: We evaluated retrograde locked intramedullary nail applications in patients with distal femur fractures. Distal femur fractures of 16 patients (11 males, 5 females; mean age 45 years; range 25 to 69 years) were treated with retrograde locked intramedullary nailing. One patient had bilateral fractures. According to the AO classification, the fractures were A1 (n=8), A2 (n=4), A3 (n=4), and C1 (n=1). There were 13 closed (76.5%), and four open (23.5%) fractures. The mean time to surgery was 10 days (range 2 to 20 days). Open technique was used for nine fractures, and percutaneous technique for eight fractures. Preoperatively, three patients with a floating knee were evaluated with magnetic resonance imaging and were found to have a ruptured cruciate ligament. All patients underwent intraoperative knee examination, which showed a ruptured cruciate ligament in five patients. Functional results were assessed using the modified HSS (Hospital for Special Surgery) knee rating scale at the end of a mean follow-up period of 32.6 months (range (12 to 68 months). The mean time to union was 25 weeks (range 14 to 42 weeks). One patient had delayed union (42 weeks). Joint range of motion was normal in three knees (17.7%), was 100 to 110 degrees in nine knees (52.9%), 80 degrees in four knees (23.5%), and below 80 degrees in one knee (5.9%). According to the modified HSS knee scale, the results were excellent in five femurs (29.4%), good in six femurs (35.3%), moderate in five femurs, and poor in one femur (5.9%). Postoperative radiographic examination showed varus angulation (10 degrees ) in four patients (23.5%), and posterior angulation (10-20 degrees ) in four patients. In one patient, healing occurred with extreme deformation (30 degrees posterior angulation). None of the patients experienced wound site problems or infections. One patient developed deep vein thrombosis in the early postoperative period. Treatment of distal femur fractures with retrograde locked intramedullary nailing yields satisfactory results in adults.acta orthopaedica et traumatologica turcica 02/2009; 43(3):199-205. · 0.34 Impact Factor -
Article: Re: intraneural perineurioma of the median nerve. A rare cause of carpal tunnel syndrome.
Journal of Hand Surgery (European Volume) 03/2008; 33(1):88-9. · 1.17 Impact Factor -
Article: [Treatment of pediatric displaced supracondylar humerus fractures by fixation with two cross K-wires following reduction achieved after cutting the triceps muscle in a reverse V-shape].
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ABSTRACT: We evaluated the results of surgical treatment for pediatric displaced supracondylar humerus fractures. The study included 98 pediatric patients (72 boys, 26 girls; mean age 7 years; range 3 months to 14 years). According to the Gartland classification, all the displaced supracondylar humerus fractures were type III, being of flexion type in 10 patients (10.2%), and extension type in 88 patients (89.8%). Five were Gustilo-Anderson type 1 open fractures. All fractures were approached posteriorly. Reduction was achieved by cutting the triceps muscle in a reverse V-shape, followed by fixation using two cross K-wires from the epicondyles. The results were assessed according to the criteria of Flynn et al. At final follow-ups, elbow range of motion, the strength of the triceps muscle and, on radiographs, the carrying angle of the elbow, Baumann angle, and lateral humerocapitellar angle were measured. The mean follow-up was 42.6 months (range 7 to 80 months). According to the criteria of Flynn et al., 95 patients (96.9%) had perfect or good cosmetic results, 84 patients (85.7%) had perfect or good functional results. Elbow angles, elbow range of motion, and the strength of the triceps muscle were similar to those measured on the normal side (p>0.05). Time from injury to surgery did not have a significant influence on cosmetic and functional results (p>0.05). None of the patients exhibited procedure-related pin tract infection or insufficient bone union. Three patients (3.1%) developed cubitus varus deformity. Reduction of pediatric displaced supracondylar humerus fractures may be achieved easily by the posterior approach, after cutting the triceps muscle in a reverse V-shape, and fixation with two cross-pinned K-wires provides adequate stability. This procedure does not result in weakness of the triceps muscle.acta orthopaedica et traumatologica turcica 02/2008; 42(3):154-60. · 0.34 Impact Factor -
Article: [Evaluation of pediatric patients with traumatic hip dislocation].
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ABSTRACT: We evaluated pediatric patients who were treated for traumatic dislocation of the hip. Traumatic dislocation of the hip was detected in five children (all boys; mean age 9 years; range 7 to 13 years) between 1991 and 2005. Dislocations occurred in the right hip in four cases, and in the left hip in one, all of which had posterior localization. Etiology was fall during play in two children, and fall from height or car crash in three. One patient had posterior wall avulsion fracture of the acetabulum. Early radiologic follow-ups included conventional radiographs and computed tomography. Functional results were assessed with the Harris hip scoring system. Four patients had a sufficient follow-up period with a mean of 44 months (range 19 to 64 months). All the patients were treated with closed reduction under general anesthesia after a mean of 6.4 hours (range 2 to 16 hours) following trauma. Functional results were excellent in all the patients, with a mean Harris hip score of 92 (range 84 to 96). Based on early postoperative radiologic control with computed tomography, no surgical intervention was considered for posterior wall avulsion fracture of the acetabulum in one patient. At 40-month follow-up, he had no complaints, had a full range of motion and a hip score of 92. While no complications were observed in patients undergoing early reduction, one patient whose dislocation was reduced 16 hours after trauma developed avascular necrosis of the femur head 18 months after treatment, at which time his hip score was 84. Early reduction is of particular importance for the follow-up course of traumatic hip dislocations in childhood.acta orthopaedica et traumatologica turcica 02/2006; 40(5):392-5. · 0.34 Impact Factor -
Article: Can a pin-tract infection cause an acute generalized soft tissue infection and a compartment syndrome?
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ABSTRACT: A patient who developed soft tissue infection and osteomyelitis secondary to pin tract infection after skeletal traction was evaluated. Tibial traction was performed on a patient who had exposed to a femoral pertrochanteric fracture after falling from a tree in a rural public hospital. On the first postoperative day shortly after development of soft tissue swelling, redness, and tenderness in the affected leg, compartment syndrome was noted with subsequent removal of the pin at the same health center. After arrival of the case in our center surgical decompression with an open faciatomy and proper antibiotherapy were instituted. Simultaneously hyperbaric oxygen was administered. After eradication of soft tissue infection we treated the fracture with a Richards compression screw-plate device. The patient was discharged with complete cure. This case presented how seriously a simple pin-tract infection can cause a grave clinical entity resulting in potential loss of an extremity.Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery: TJTES 11/2005; 11(4):344-7. · 0.33 Impact Factor -
Article: [Injury to the spinal cord without any radiographic abnormality in a child].
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ABSTRACT: Spinal cord injury without radiographic abnormalities (SCIWORA) is a diagnostic challenge most commonly encountered in pediatric patients. The unique hypermobility and ligamentous laxity of the pediatric bony cervical and thoracic spine may predispose to SCIWORA. A four-year-old girl was admitted for polytrauma. During monitorization deterioration in her neurological status was observed. Magnetic resonance imaging (MRI) showed an abnormal intensity in the spinal cord at the level of T11-L3, suggesting SCIWORA. We did not consider surgery and treated the patient with a conservative approach and rehabilitation program. The patient achieved a functional capacity sufficient to perform essential activities. A detailed neurologic examination should be undertaken particularly in polytrauma pediatric patients and MRI should be employed in suspected cases.acta orthopaedica et traumatologica turcica 02/2002; 36(3):268-72. · 0.34 Impact Factor -
Article: Total Excision Of Comminuted Radial Head Fractures And Subsequent Elbow Posterolateral Rotatory Instability
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ABSTRACT: Background: We evaluated outcomes of radial head excisions and the subsequent elbow posterolateral rotator instability concept.Methods: Among 27 patients who had undergone radial head excisions due to Mason type 3 radial head fractures between 1996 and 2006, 23 patients who had no ipsilateral upper extremity pathology and attended routine follow-up visits were included in the study. The mean duration of follow-up was 65.5 months (range: 23–115). At last visits, patients were assessed clinically and radiologically. The Steinberg criteria were used for clinical outcomes. Patients were also evaluated with respect to elbow posterolateral rotator instability.Results: Clinically, 12 patients had good, 7 had fair, and 4 had poor clinical results, according to the Steinberg criteria. Eight patients had elbow posterolateral rotator instability, while 16 patients had radiologically confirmed elbow joint degeneration. Ulna plus variation was observed in 12 cases.Conclusion: Although used frequently, total radial head excision in comminuted radial head fractures has not been found to give satisfactory results. Furthermore, patients should be subjected to intraoperative assessment for lateral ulnar collateral ligament ruptures that may lead to elbow posterolateral rotator instabilityJournal of Orthopaedics. 01/0200; -
Article: A new index for the assessment of distal radius fractures involving the ulnar styloid.
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ABSTRACT: The aim of this retrospective study was to evaluate the relation between a new index we created for the assessment of distal radius fractures involving the ulnar styloid, and the clinical outcome. We devised a radiographic separation index (RSI), to evaluate the displacement of the ulnar styloid. We used this index in 44 patients (28 men and 16 women; mean age: 43.2 years; range: 24-64 years) with distal radius fractures involving the the ulnar styloid. In all cases, the distal radius fracture was fixed using a volar locking plate. The styloid fracture was treated conservatively. The relation between the RSI value and clinical results was then investigated. In the 44 patients there were clinically 38 excellent, 4 good, and 2 moderate results. RSI ratios ranged from 2% to 11%. The patients with an excellent result had an RSI ratio of less than 5%. We found a significant correlation between the RSI ratio values and the clinical outcomes. Our results suggested that the RSI can be used as a predictor of the clinical outcome in patients with distal radius fractures involving the ulnar styloid.acta orthopaedica et traumatologica turcica 45(4):261-5. · 0.34 Impact Factor -
Article: [Treatment of adult tibial diaphysis fractures with reamed and locked intramedullary nailing].
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ABSTRACT: We evaluated the results of reamed and locked intramedullary nailing for tibial diaphysis fractures. The study included 73 patients (68 males, 5 females; mean age 31 years; range 17 to 68 years) who were treated with reamed and locked intramedullary nailing for tibial diaphysis fractures. There were 28 AO/ASIF type A, 29 type B, and 16 type C fractures. The fractures involved the proximal 1/3 (n=12), middle 1/3 (n=50), and distal 1/3 (n=11) of the tibial diaphysis. Twenty-eight fractures (38.4%) were closed. According to the Gustilo-Anderson classification, 30 patients (41.1%) had grade I, 10 patients (13.7%) had grade II, and five patients (6.9%) had grade IIIA open fractures. Intramedullary nailing was performed following open reduction in 17 patients (23.3%), and closed reduction in 56 patients (76.7%). The mean time to surgery was 3.4 days (range 2 to 11 days) and the mean follow-up was 48 months (range 24 to 60 months). The patients were evaluated with respect to range of motion, time to union, and complications. Functional results were assessed using the Johner-Wrush criteria. Union was achieved in all the patients within a mean of 18.2 weeks (range 8 to 52 weeks). Four patients required dynamization because of delayed union and grafting was performed in one patient. Transient sensorial deficit occurred in one patient after dynamization. One patient underwent revision surgery because of migration of the distal locking screws. The only limitation of range of motion was seen in flexion of two patients (2.7%) who developed anterior knee pain. According to the Johner-Wrush criteria, functional results were very good in 45 patients (61.6%), and good in 28 patients (38.4%). Treatment of tibial diaphysis fractures with reamed and locked intramedullary nailing is an appropriate choice with a low complication rate. It can be safely used in moderately contaminated open fractures.acta orthopaedica et traumatologica turcica 43(1):7-13. · 0.34 Impact Factor -
Article: Complete transiliac pelvic osteotomy for patients with developmental dysplasia of the hip without internal fixation.
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ABSTRACT: Several problems are encountered with pelvic osteotomy in hip dysplasia including insufficient coverage, avascular necrosis, graft instability and fixation of secondary bone grafts. We evaluated results of pelvic osteotomy in 4-8 year olds in our institution. 44 cases of developmental dysplasia of the hip between 1994 and 1999 were reviewed. 14 hips in 12 patients were treated with a step-cut osteotomy and the results are discussed. The mean age was 5.6 (range: 4-8) years, and mean follow up was 87.7 months (60-120). The patients were followed up according to the Severin clinical assessment criteria, and their radiological findings were evaluated and classified in accordance with the Tonnis criteria. Radiologically, a marked correction was obtained in center-edge angle, which was increased to 22.30 from the preoperative value of -11.20. No graft shift or loss was observed in any cases. There was also no loss in coverage achieved by surgical intervention. Coxofemoral positioning was found to be normal in eighty percent of cases. 8% of cases had avascular necrosis. Full range of hip motion was achieved in 84% of cases, and 84% of cases exhibited negative Trendelenburg's sign. The modified osteotomy we describe eliminated the need for fixation and secondary surgery. Graft stability and bone conservation were achieved.Hip international: the journal of clinical and experimental research on hip pathology and therapy 19(1):13-7. · 0.34 Impact Factor -
Article: [Open reduction and K-wire fixation of mallet finger injuries: mid-term results].
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ABSTRACT: We evaluated mid-term results of surgical treatment of mallet finger injuries in patients in whom close reduction was not successful. The study involved 34 patients (26 males, 8 females; mean age 27 years; range 21 to 37 years) with mallet finger deformity due to avulsion fracture of the proximal dorsal lip of the distal phalanx. According to the Doyle classification, all injuries were type IVb. Following unsuccessful attempts of closed reduction, the patients were treated with open reduction and K-wire fixation. Cast immobilization of the distal interphalangeal joint was employed for four weeks and rehabilitation was started after removing the K-wires in the sixth week. Radiographic and clinical assessments were made according to the Doyle and Crawford criteria, respectively, after a mean follow-up period of 18 months (range 11 to 34 months). Radiographic union was achieved in all the patients and an anatomic reduction was obtained in 31 patients (91.2%). According to the Crawford criteria, the results were excellent in 27 patients (79.4%), good in four patients (11.8%), and moderate in three patients (8.8%). Patients with a good result had a mean extension loss of 5 degrees , and those with a moderate result had a mean flexion loss of 10 degrees . The remaining patients had full range of motion of the distal interphalangeal joint. None of the patients developed joint subluxation, narrowing of the joint space, or degenerative changes. An anatomical reduction is essential in mallet finger deformities. Open reduction and internal K-wire fixation can be preferred due to its low complication rate and ease of application in patients whose mallet deformity cannot be treated by closed reduction.acta orthopaedica et traumatologica turcica 43(5):395-9. · 0.34 Impact Factor
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2002–2010
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Lutfi Kirdar Kartal Education and Research Hospital
İstanbul, Istanbul, Turkey
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