Mustafa Kürklü

Gulhane Military Medical Academy, Engüri, Ankara, Turkey

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Publications (41)27.16 Total impact

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    ABSTRACT: Pediatric supracondylar fractures of the humerus are generally associated with neurovascular complications due to the deformity and sharp nature of bone fragments. When treated inadequately, these injuries may result in catastrophic complications, such as Volkmann's contracture and amputation. To our knowledge, late onset brachial arterial thrombosis and total temporary peripheral neuropathy after surgery of pediatric supracondylar fracture in the setting of normal preoperative vascular examination has not been reported yet. In this study, a 2-year and 6- month-old girl, who had delayed brachial arterial thrombosis after a displaced humerus supracondylar fracture surgery treated with embolectomy, was reported. Total lesion of median, ulnar and radial nerves completely resolved four months after surgery. Close neurovascular monitoring on the postoperative phase especially in severely displaced supracondylar fractures is strongly emphasized even in the setting of well-perfused hand.
    No preview · Article · Mar 2015 · Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery: TJTES
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    Mustafa Kürklü · Selim Türkkan · Harun Yasin Tüzün

    Preview · Article · Jan 2015
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    ABSTRACT: Amac: Travma sonrasi gelisen proksimal humerus kiriklarinda konservatif ve cerrahi tedavi secenekleri uygulanmaktadir. Biz bu calismada Philos plagi kullanilarak cerrahi tedavi yapilan hastalarda tedavi sonrasi olusan hareket acikliklari ve komplikasyonlari degerlendirdik. Yontem: 2009-2013 yillari arasinda proksimal humerus kirigi tanisi ile cerrahi tedavi endikasyonu konan yas ortalamasi 50 (dagilim 29-73) olan 36 hasta (19 erkek, 17 kadin) calismaya dahil edildi. Hastalar ortalama 17 ay (12-23) sureyle takip edildi. Kiriklar Neer Siniflamasina gore siniflandirildi. 22 hastada parcali kirik, 6 hastada kirikli cikik, 7 hastada 2 parcali kirik, 1 hastada proksimal metafize uzanan kirik saptandi. Hastalarin tumune deltopektoral insizyonla girilerek plak tespiti uygulandi. Hastalara ameliyat sonrasi 2. gun pasif omuz egzersizleri baslandi ve 4-6 hafta sonra aktif egzersizlere gecildi. Degerlendirmede Constant-Murrley omuz skorlamasi kullanildi. Bulgular: Klinik ve radyolojik olarak 4 hasta disinda tum hastalarda 10. hafta sonunda kaynama saptandi. Constant-Murley skoru ortalama 82 (dagilim 62-95) olarak bulundu. Iki hastada postoperatif enfeksiyon tablosu gelisti. Hiperbarik oksijen tedavisi ve antibioterapi sonrasi bu hastalarda tam iyilesme saglandi. Bir hastada implant gevsemesi sonrasi revizyon ameliyati yapildi. Iki hastada subakromial sikismaya neden olan yuksek plak tespiti yapildigi gozlendi. Bir hastada avaskuler nekroz gelisti. Hicbir hastada intraoperatif komplikasyon veya norovaskuler komplikasyon gelismedi. Sonuc: Cerrahi tedavi endikasyonu olan proksimal humerus kiriklarinin Philos plagi ile tespiti ameliyat sonrasi erken donemde omuz hareketlerine izin vermesi, yuksek kaynama ve dusuk komplikasyon oranlari ile tercih edilebilecek bir tedavi yontemidir.
    Full-text · Article · Jan 2015
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    ABSTRACT: One of the functions of fetuin-A is the restriction of formation and expansion ofextraosseous hydroxyapatite crystals. TIhe exact correlation of fetuin-A with bone mineral density (BMD) has not been clearly elucidated yet. In this study, we aimed to assess the relationship between BMD and fetuin-A in postmenopausal women. Fifty postmenopausal women (25 with osteoporosis, 25 healthy controls) were included in the study. All participants were comparable for age and body mass index. None of the osteoporotic patients had received any medical treatment for osteoporosis. Serum fetuin-A levels were measured by ELISA method. BMD scores of the groups were statistically significant (P < 0.001). Serum fetuin-A levels of the osteoporosis group were significantly lower compared to the control group (P = 0.009). Additionally, there was there was a mild to moderate positive correlation between fetuin-A and lumbar (r = 0.381, P = 0.06) and femoral (r = 0.143, P = 0.50) BMD in the osteoporotic group, though it did not reach statistical significance. Decreased fetuin-A levels in women with postmenopausal osteoporosis suggest that fetuin-A may have a role in the development of osteoporosis. Further studies are required to define the exact role of fetuin-A in bone metabolism.
    No preview · Article · Dec 2014 · Turkish Journal of Medical Sciences
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    ABSTRACT: In this study, we aimed to compare the postoperative analgesic efficiency of an ultrasound-guided fascia iliaca compartment block and a 3 in 1 block in patients who underwent hip prosthesis surgery as a result of hip fracture. With approval from the local ethics committee, 70 patients, aged 20 to 80, undergoing hip prosthesis surgery under elective conditions were included in this randomized, prospective, controlled study. They were informed of the patient-controlled analgesia (PCA) device and visual analog scale (VAS). All patients were separated randomly into three groups. Anaesthesia induction was standardized for all groups. An ultrasound guidance fascia iliaca compartment block (FICB) was applied to the first group before anaesthesia induction. For the second group, a 3 in 1 block was applied, while for the control group no block was applied. After incision on all patients, 20 mg tenoxicam and 1 mg/kg tramadol were injected intravenously. Following surgery, IV tramadol PCA was begun on all patients routinely. In our study, the presence of cortisol and ACTH levels, hemodinamical parameters, nausea and sedation were determined. We observed a decrease in VAS values and opioid consumption, no adverse effects on nausea and sedation, and a suppression of stress hormones in both the ultrasound-guided FICB and 3 in 1 block groups. We believe that the safe and efficient application of the ultrasound-guided 3 in 1 block and the FICB is necessary in multimodal analgesic treatment in order to enable postoperative analgesia in hip prosthesis surgery.
    No preview · Article · Oct 2014 · Agri: Agri (Algoloji) Dernegi'nin Yayin organidir = The journal of the Turkish Society of Algology
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    ABSTRACT: Radial longitudinal deficiency (radial club hand) is a congenital deformity in the upper extremity that can present with a range of thumb deficiencies. A variety of surgical procedures to correct for absence of a thumb have been described, such as pollicization, osteoplastic reconstruction, toe to hand transfer, and extension with distraction. We have reviewed 8 index finger pollicizations in 6 patients after correction of the radial club hand deformity through wrist centralization. Four hands used were the dominant hand. Buck-Gramcko's technique was used with a mean age of 4.6 (range from 2 to 14) years. The mean follow-up time was 6 (range from 2 to 10) years. The mean active range of motion at the pollicized digit was 121.4 (range from 83 to 150) degrees. The result was considered excellent in 5 cases (62.5%), good in 2 cases (25%), and fair in 1 case (12.5%) in accordance with Percival's scoring system; none of the outcomes were poor. The younger patients adapted easier. Index finger pollicization is a method that provides dramatic improvement to hand function in thumb aplasia or severe hypoplasia, which may be preferred in treatment. The operations improved hand cosmetic appearance and functional ability.
    Full-text · Article · Jan 2014 · Eastern Journal of Medicine
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    T. Ege · K. Koca · Y. Yurttas · M. Kürklü · H. Özkan · C. Yildiz · M. Basbozkurt

    Full-text · Article · Feb 2013 · Injury
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    ABSTRACT: Objective: Our study has been performed to compare effects of peripheral nerve block, spinal anesthesia and general anesthesia on anesthesia application, anesthesia and analgesia quality and patient and surgeon satisfaction in ambulatory under-knee extremity surgery. Material and Method: 64 ASA(American Society of Anesthesiologists) I-II patients were randomly divided into peripheral nerve block (Group PSB, n=23), spinal anesthesia (Group SA, n=21) and general anesthesia (Group GA, n=20) groups. All patients were given premedication. Sciatic+femoral (n=8), popliteal+saphenous (n=8) and ankle blocks (n=7) were applied in PSB (peripheral nerve block) group according to extremity region where surgery was applied and tourniquet was placed. Unilateral spinal anesthesia with 15 mg 0.5% hyperbaric bupivakain was applied in SA group. Anesthesia induction was performed with propofol and fentanyl in GA group, and sevofluran was administered as maintenance after insertion of laryngeal mask airway (LMA). Petidin was used for postoperative analgesia. Pain was evaluated by using visual analog scale (VAS), and intraoperative fentanyl and postoperative lornoksikam were used as rescue analgesic. Finally vital signs, termination time of motor and sensory block, additional sedation and analgesia, time until first requirement for analgesic, patient and surgeon satisfaction were evaluated. Results: Anesthesia procedure and time for being ready for surgery after the procedure were longer in PSB group than SA and GA groups; and time for leaving postanesthesia care unit (ASBU) was shorter than SA and GA groups (p<0.001). Again, motor and sensory block lasted longer in PSB group compared to SA and GA groups. First requirement for analgesic was later and less analgesic was consumed (p<0.001). Patient satisfaction was more in PSB group (p<0.001) while surgical satisfaction was similar. Conclusion: We think that PSB may be more reliable and effective method than general and spinal anesthesia in ambulatory lower extremity surgery due to it provides better analgesia and anesthesia, later appearance for first requirement for analgesics and lower analgesic consumption, it provides high percentage of patient satisfaction and ease of application.
    No preview · Article · May 2012 · Nobel medicus
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    ABSTRACT: The aim of this experimental study was to determine the effects of adjunctive hyperbaric oxygen therapy (HBO) on atrophic tibial nonunion treatment using Ilizarov external fixator. Twenty New Zealand white rabbits were randomly divided into two equal groups. A circular external fixator was applied to the right tibia of all the rabbits. A 5-mm bone block was resected and a tibial pseudarthrosis was obtained after a 6-month waiting period. The experimental group rabbits (n=10) underwent daily 2.5 ATA HBO therapy for 2 hours for 20 days and the control group rabbits (n=10) did not receive any corresponding treatment. Osteoblastic activity was evaluated with bone scintigraphy on days 30 and 90. Fracture healing was evaluated by plain radiographs on days 30 and 90. On Day 30, radiological scores were statistically similar in both groups (p=0.167). However, on Day 90, the experimental group displayed significantly higher radiological scores (p<0.001). Osteoblastic activity was also higher in the experimental group on both scintigraphic assessments (p=0.005 and p=0.001). The results of this study suggest that HBO can be used as a supplementary therapy in the management of atrophic tibial nonunion.
    Full-text · Article · Jan 2012 · acta orthopaedica et traumatologica turcica
  • S. Deniz · E. Kurt · A. Atim · M. Kürklü · T. Çayci

    No preview · Article · Sep 2011 · European Journal of Pain Supplements
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    ABSTRACT: The aim of this study was to report our functional results after an intramedullary Kirschner wires (K-wires) and tension band wiring combination for the treatment of a large group of humeral head fractures was performed. Seventy-four patients (54 females, 20 males; mean age 42 years; range 24 to 73 years) who had proximal humerus fractures were treated with an intramedullary K-wire and tension band technique and were retrospectively analyzed. Fracture patterns were according to Neer classification type II in 43 patients, type III in 23 patients and type IV in five patients. The Constant-Murley shoulder score test was used to evaluate the function of both shoulders. The outcome was graded according to Neer's criteria. The pain score was determined with a 10-point visual analog scale. All fractures were healed (radiologically and clinically) within 3.6 months (range 2.5 to 4.7 months) after the surgery. In one patient, the cerclage wire was broken and in eight patients, K-wires produced impingement like symptoms that required a second procedure (wire removal) after healing. The results of the patients with regard to Constant-Murley score and Neer criteria were indifferent when the 6th and the 12th month data were compared (p<0.05). Visual analog scale scores of the patients between the two control visits were significant different (p>0.05). The type of fixation depends on the bone quality and the degree of comminution. But the recent trend is towards osteosynthesis -the limited, less invasive technique- which is performed with minimal soft tissue dissection and minimal osteosynthesis. It allows less stripping of bone and therefore preservation of the blood supply to the humeral head. This procedure is simple to perform and provides good postoperative results.
    Full-text · Article · Aug 2010
  • Halil Yalçin Yüksel · Onur Hapa · Murat Can · Mustafa Kürklü
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    ABSTRACT: Bilateral femoral neck fractures are generally associated with high-energy trauma or defects in bone metabolism. We present a patient who had not been subjected to high-energy trauma and in whom there was no bone metabolism disorder.
    No preview · Article · Apr 2010 · Hip international: the journal of clinical and experimental research on hip pathology and therapy
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    ABSTRACT: In this study we evaluated the stability and effectiveness of the double tension band osteosynthesis technique compared to the double plate osteosynthesis technique used for fixation of distal humerus fractures. The study was performed on two groups, and in each group eight cadaveric, elderly (mean age 70-80) human humeri was used. An osteotomy was performed in the supracondylar region using a manual saw. The first group (group 1) was fixed with double 3.5 mm reconstruction plates, while the second group (group 2) was fixed with the double tension band technique, using crossing Kirschner wires. The osteotomy was designed so that the distal fragment would allow only a single screw per plate. The constructs were evaluated using a material testing machine. A linear non-cyclic load was applied until the failure of the constructs. The force which produced a 3 mm gap (3 mm gap strength), as detected visually with the aid of operating loupes, and the maximum load prior to failure of the fixation (maximum force) were measured from all tests. The mean value for the 3 mm gap strength was 1356.29+/-226.97 N for group 1 and 882.63+/-305.21 N for group 2. The mean value of the maximum load strength was 1487.13+/-298 N for group 1 and 1232+/-107.62 N for group 2. There were significant differences in 3 mm gap strengths of the two groups (p=0.005). There was also a significant difference in the maximum load between the two groups (p=0.016). Double plate osteosynthesis technique is superior to double tension band osteosynthesis for the fixation of distal humerus fractures.
    Full-text · Article · Apr 2010
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    ABSTRACT: Complete absence or variations of extensor pollicis brevis and abductor pollicis longus; absence of the extrinsic extensors, abductor pollicis longus, thenar muscles along with congenital hypoplasia of the thumb; absence of flexor pollicis brevis and abductor pollicis brevis; and bilateral absence of extensor pollicis have been reported previously. Those cases mainly comprised absence/variations of the first extensor compartment either with or without thumb anomalies. This article presents a case of a patient in which the constituents of the first and third compartments (extensor pollicis brevis, abductor pollicis longus and extensor pollicis longus) were absent unilaterally. Herewith, we also highlight the role of static/dynamic sonography for prompt imaging in this regard.A 24-year-old man presented with difficulty using the left thumb. He reported no trauma and had not used the affected thumb since childhood. On physical examination, the left thumb was observed to be in flexion and opposition. He was unable to perform active extension and abduction but passive motion was free. Neurological examination of the left upper extremity was unremarkable. No organ anomaly was present on systemic examination. Radiographs of the left hand revealed no joint problems or hypoplasia. Ultrasonographic evaluation was consistent with absence of the first and third extensor compartment tendons. Tendon transfer was recommended but the patient refused surgery.
    No preview · Article · Apr 2010 · Orthopedics
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    ABSTRACT: Objectives: The aim of this study was to report our functional results after an intramedullary Kirschner wires (K-wires) and tension band wiring combination for the treatment of a large group of humeral head fractures was performed. Patients and methods: Seventy-four patients (54 females, 20 males; mean age 42 years; range 24 to 73 years) who had proximal humerus fractures were treated with an intramedullary K-wire and tension band technique and were retrospectively analyzed. Fracture patterns were according to Neer classification type II in 43 patients, type III in 23 patients and type IV in five patients. The Constant-Murley shoulder score test was used to evaluate the function of both shoulders. The outcome was graded according to Neer's criteria. The pain score was determined with a 10-point visual analog scale. Results: All fractures were healed (radiologically and clinically) within 3.6 months (range 2.5 to 4.7 months) after the surgery. In one patient, the cerclage wire was broken and in eight patients, K-wires produced impingement like symptoms that required a second procedure (wire removal) after healing. The results of the patients with regard to Constant-Murley score and Neer criteria were indifferent when the 6th and the 12th month data were compared (p<0.05). Visual analog scale scores of the patients between the two control visits were significant different (p>0.05). Conclusion: The type of fixation depends on the bone quality and the degree of comminution. But the recent trend is towards osteosynthesis -the limited, less invasive technique- which is performed with minimal soft tissue dissection and minimal osteosynthesis. It allows less stripping of bone and therefore preservation of the blood supply to the humeral head. This procedure is simple to perform and provides good postoperative results.
    No preview · Article · Jan 2010
  • Mustafa Kürklü · Oner Tatar · Levent Ozçakar

    No preview · Article · Sep 2009 · Rheumatology International
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    Full-text · Article · Sep 2009 · American journal of physical medicine & rehabilitation / Association of Academic Physiatrists
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    ABSTRACT: The most common injuries reported in the literature regarding the sport of boxing are to the brain, eyes, kidneys and hands. Shoulder injuries have not been fully reported in the literature until recently, as a result we aimed to present our arthroscopic findings in amateur boxers. Ten amateur boxers with complaints of pain in the shoulder region and decreased performance during sportsplay were enrolled. They were evaluated by physical examination, radiology and arthroscopy. There were no clinical findings of instability. One patient was found to have subacromial impingement; six had crepitation at various degrees during shoulder movements. At arthroscopy, all patients had a variety of pathological findings. Five patients had Grade 1, three had Grade 2, and two had Grade 3 chondropathy. Various degrees of fraying of the anterosuperior and posterosuperior regions of the glenoid labrum were noted in all cases. Three patients had superior labrum anterior and posterior lesions, one patient had a posterior labroligamentous lesion, and one had chondral erosion in the anterosuperior portion of the humeral head. In conclusions, although the injury mechanism of the shoulder during boxing is unknown, this study shows that shoulder complaints in boxers should be considered as possible indicators of serious intra-articular lesions.
    No preview · Article · Sep 2009 · Central European Journal of Medicine
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    ABSTRACT: Our aim was to evaluate the outcomes of combined hamstring release and rectus transfer in children with crouch gait using physical examination and gait analysis. A total of 19 patients (38 knee joints) with crouch were evaluated by static examination and computerized analysis with dynamic EMG. The Ely test was positive together with prolonged and increased activity in the rectus muscle bilaterally in all patients. These patients underwent hamstring release and rectus transfer. Intensive rehabilitation was provided following the surgery and the patients were evaluated again by static examination and gait analysis after an average of 6.3 (4-7.5) months after surgery. The preoperative and postoperative static examination findings, knee and ankle joint kinematics and time-distance parameters were compared in 19 children. There was a significant improvement in static examination findings, knee and ankle kinematics and time-distance parameters. However, there was no significant difference between the preoperative and postoperative swing phase peak knee flexion. This study demonstrated that static parameters, time-distance parameters, knee and ankle kinematics were improved following combined hamstring release and rectus transfer in children with cerebral palsy without any cases of stiff knees.
    No preview · Article · Aug 2009 · Ortopedia, traumatologia, rehabilitacja
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    ABSTRACT: Ankle fractures and fracture dislocations are common injuries in orthopaedic practice however pure ankle dislocation without an associated fracture is extremely rare. There are a few cases reporting such a lesion in the literature. Also this injuries are generally open high energy trauma injuries. Closed treatments are reported to be effective and ligament injuries are generally not reported. In this study, we report a closed pure posteromedial ankle dislocation with anterior talofibular ligament rupture and its treatment and outcome in a 12 year-old boy. We think that this is an extremely rare lesion.
    Full-text · Article · Jul 2009 · Cases Journal