Reconstruction of the lower extremity, especially the proximal lower leg, is known to be a challe... more Reconstruction of the lower extremity, especially the proximal lower leg, is known to be a challenge for reconstructive surgeons. When there is extensive vascular damage, the use of local flaps and microsurgical methods will be limited, so there are few reconstructive options available. We want to define the use of medial sural artery-based cross-leg flap for the reconstruction of the proximal lower leg. A 51-year-old male had a soft tissue defect on the proximal leg region because of a gun-shot injury. We observed that there was no chance of a local flap as a result of CT angiography. We considered free flap to be risky because of extensive vascular damage and medial sural artery-based cross-leg flap was planned. 12*20-cm-sized medial sural artery-based cross-leg flap was elevated from the contralateral leg and adapted to the defect without tension. Medial sural artery-based flap is mostly used as a vascular island for the reconstruction of knee defects. However, its use as a cross-leg flap has not been found in the literature. We believe that it is a safe option to consider in challenging cases such as after flap failure or patients not suitable for a free flap.
Backgrounds: Proximal interphalangeal (PIP) joint injuries can cause scar contractures by differe... more Backgrounds: Proximal interphalangeal (PIP) joint injuries can cause scar contractures by different mechanisms, leading to significant functional loss, the most important thing in the treatment process is to maintain joint mobility, in this way, scar formation will be reduced. Dynamic external fixators have been used for this purpose. Although it is an old method, it has many unknown aspects. Materials and Methods: Nineteen patients participated in our study. The patients were divided into two groups as those who were treated immediately after the injury and those who applied in the late period. All patients were treated with pin and rubber traction systems (PRTS). After 6 weeks of traction, the fixator was removed. Patients were assessed with X-rays for the amount of distraction, Visual Analog Scale score for pain and quick DASH scores for satisfaction. The patients were also examined for passive and active range of motion (AROM) in all controls. Results: We compared the preoperative and postoperative data of the patients and also we compared the amount of distraction with functional gain. There was no relationship between the increase in PIP joint space distance and posttreatment PIP joint AROM values. Hence, the amount of distraction on the joint space distance has no direct effect on the functional results. Another important result of the study is that the loss of extension in the PIP joint, which can be unregarded in the early period, negatively affects the late results. The other important result of our study is that successful results can be obtained when applied in combination with surgery in delayed cases. Conclusion: The use of PRTS has an important role in the treatment of PIP joint injuries. In our study, we have shown that satisfactory results can be obtained in both acute and delayed cases when combined with additional surgery or applied alone. The change in joint space distance during the patient follow-up is not an important issue in terms of range of motion. Another important result we obtained from the study is the demonstration that PRTS can be successfully used in untreated joint dislocations in a single stage.
The article reports on the results of the first ever scientific investigation of all heliographic... more The article reports on the results of the first ever scientific investigation of all heliographic and heliogravure plates created by Joseph Nicephore Niépce in France that he brought with him in 1827 to England. In hopes of presenting his invention to the Royal Society of London and to the Royal court, he may have selected the best examples of his experiments that were able to demonstrate the entire range of applications of his photographic processes. The in-depth scientific investigation of four still surviving plates in the Royal Photographic Society collection of the National Media Museum in Bradford and the Harry Ransom Center at the University of Texas at Austin provided new insight into the material aspects of J.N. Niépce's experiments, new and sometimes surprising and unexpected information of the image structure and image formation. The microscopic and analytical investigation of the images in combination with a broad battery of supporting analyses, artificial ageing studies and process recreations allowed us to correct many pieces of information previously obtained by interpreting J.N. Niépce's letters and documents. Our investigation also established, for the first time, a scientifically based conservation baseline for the long term monitoring of the state of preservation of these iconic plates and resulted in the development of new, inert, gas filled and sensor equipped enclosures for their long term display and storage.
Reconstruction of the lower extremity, especially the proximal lower leg, is known to be a challe... more Reconstruction of the lower extremity, especially the proximal lower leg, is known to be a challenge for reconstructive surgeons. When there is extensive vascular damage, the use of local flaps and microsurgical methods will be limited, so there are few reconstructive options available. We want to define the use of medial sural artery-based cross-leg flap for the reconstruction of the proximal lower leg. A 51-year-old male had a soft tissue defect on the proximal leg region because of a gun-shot injury. We observed that there was no chance of a local flap as a result of CT angiography. We considered free flap to be risky because of extensive vascular damage and medial sural artery-based cross-leg flap was planned. 12*20-cm-sized medial sural artery-based cross-leg flap was elevated from the contralateral leg and adapted to the defect without tension. Medial sural artery-based flap is mostly used as a vascular island for the reconstruction of knee defects. However, its use as a cross-leg flap has not been found in the literature. We believe that it is a safe option to consider in challenging cases such as after flap failure or patients not suitable for a free flap.
Backgrounds: Proximal interphalangeal (PIP) joint injuries can cause scar contractures by differe... more Backgrounds: Proximal interphalangeal (PIP) joint injuries can cause scar contractures by different mechanisms, leading to significant functional loss, the most important thing in the treatment process is to maintain joint mobility, in this way, scar formation will be reduced. Dynamic external fixators have been used for this purpose. Although it is an old method, it has many unknown aspects. Materials and Methods: Nineteen patients participated in our study. The patients were divided into two groups as those who were treated immediately after the injury and those who applied in the late period. All patients were treated with pin and rubber traction systems (PRTS). After 6 weeks of traction, the fixator was removed. Patients were assessed with X-rays for the amount of distraction, Visual Analog Scale score for pain and quick DASH scores for satisfaction. The patients were also examined for passive and active range of motion (AROM) in all controls. Results: We compared the preoperative and postoperative data of the patients and also we compared the amount of distraction with functional gain. There was no relationship between the increase in PIP joint space distance and posttreatment PIP joint AROM values. Hence, the amount of distraction on the joint space distance has no direct effect on the functional results. Another important result of the study is that the loss of extension in the PIP joint, which can be unregarded in the early period, negatively affects the late results. The other important result of our study is that successful results can be obtained when applied in combination with surgery in delayed cases. Conclusion: The use of PRTS has an important role in the treatment of PIP joint injuries. In our study, we have shown that satisfactory results can be obtained in both acute and delayed cases when combined with additional surgery or applied alone. The change in joint space distance during the patient follow-up is not an important issue in terms of range of motion. Another important result we obtained from the study is the demonstration that PRTS can be successfully used in untreated joint dislocations in a single stage.
The article reports on the results of the first ever scientific investigation of all heliographic... more The article reports on the results of the first ever scientific investigation of all heliographic and heliogravure plates created by Joseph Nicephore Niépce in France that he brought with him in 1827 to England. In hopes of presenting his invention to the Royal Society of London and to the Royal court, he may have selected the best examples of his experiments that were able to demonstrate the entire range of applications of his photographic processes. The in-depth scientific investigation of four still surviving plates in the Royal Photographic Society collection of the National Media Museum in Bradford and the Harry Ransom Center at the University of Texas at Austin provided new insight into the material aspects of J.N. Niépce's experiments, new and sometimes surprising and unexpected information of the image structure and image formation. The microscopic and analytical investigation of the images in combination with a broad battery of supporting analyses, artificial ageing studies and process recreations allowed us to correct many pieces of information previously obtained by interpreting J.N. Niépce's letters and documents. Our investigation also established, for the first time, a scientifically based conservation baseline for the long term monitoring of the state of preservation of these iconic plates and resulted in the development of new, inert, gas filled and sensor equipped enclosures for their long term display and storage.
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Papers by Ahmet Kaplan