Preoperative Albumin and Postoperative CRP/Albumin Ratio (CARS) are Independent Predictive Factors in Estimating 1-Year Mortality in Patients Operated for Proximal Femoral Metastasis with Endoprosthesis
Journal of Clinical and Investigative Surgery, Nov 20, 2022
Septic arthritis is a medical emergency with a mortality rate of approximately 10%, the knee bein... more Septic arthritis is a medical emergency with a mortality rate of approximately 10%, the knee being the most commonly affected joint (about 50% of cases). The systemic inflammatory response caused by septic arthritis may be affected by the severity of the infection or the success of surgical joint debridement. Materials and Methods. This article was a retrospective study on patients admitted to our hospital (between 2013 and 2020) with septic arthritis of the knee. Patients were diagnosed based on history, examination, blood test results, and knee aspirate fluid. The patient's response to antibiotic therapy was monitored in the outpatient setting using serological markers. Results. Of the 48 patients included in the study, 26 were male, and 22 were female. Based on the ROC analysis, the optimal cutoff value of preoperative NLR was 8.33. The AUC was 0.782 for postoperative NLR level (95% CI,0,626-0.938; p:0.009) and 0.922 for postoperative CAR level (95% CI,0.844-0.999; p <0.001). Postoperative NLR and CAR cutoff values are 15.4 and 115, respectively. Conclusions. Preoperative NLR elevation in septic arthritis may be associated with recurrent surgical debridement postoperatively. In addition, postoperative NLR and CAR values can predict debridement rates in patients after septic arthritis surgery.
The usage of electric scooters has been popular because it is a cheap and fast transportation met... more The usage of electric scooters has been popular because it is a cheap and fast transportation method. Its use has increased in recent years because public transportation is less preferred during the covid-19 pandemic and in parallel, the publications reporting e-scooter accidents are increasing. There is no article examining the relationship between e-scooter and anterior cruciate ligament (ACL) injury in current literature. We aim to examine the relationship between e-scooter accidents and ACL injury incidence. Patients over the age of 18 years who applied to our orthopedics outpatient clinic with the diagnosis of ACL injury between January 2019- June 2021 were evaluated. 80 e-scooter accidents resulting with ACL tears were reviewed. The electronic medical records of the patients were reviewed retrospectively. Information about the age, gender, trauma history of the patients, and type of trauma was obtained. Fifty-eight patients had a history of falling while stopping the scooter, ...
Acta Orthopaedica et Traumatologica Turcica, Nov 12, 2014
The aim of this study was to investigate the relationship between the axillary nerve and the perc... more The aim of this study was to investigate the relationship between the axillary nerve and the percutaneously inserted proximal humeral locking plate and to evaluate the risk of axillary nerve injury during percutaneous plate insertion. Methods: The study included 50 shoulders of 25 fresh frozen cadavers. A 5 cm incision was made from the anterolateral border of the acromion to the arm and a 5-hole 3.5-mm proximal humeral plate was inserted. The axillary nerve was then dissected. Plate holes which crossed the axillary nerve were noted. The distance between the axillary nerve and the lateral edge of the acromion and the length of the arm were measured and their relations evaluated with a correlation test. Results: The average arm length was 319 mm. The average distance between the axillary nerve and the lateral edge of the acromion was 60 mm. There was a significant correlation between the arm length and acromion-axillary nerve distance (p<0.05). The plate was inserted under the deltoid fascia in all shoulders except one. There were no axillary nerve lesions. In 1 case, the distal end of the plate was inserted in the deltoid muscle. No constant relationship between the plate holes and the axillary nerve was detected. Conclusion: There is a risk of axillary nerve injury during percutaneous plate insertion. It must be ensured that the plate is inserted under the deltoid fascia during the surgery. The axillary nerve must be visible during application of the screws due to the impossibility of knowing which holes cross the axillary nerve.
Medicine Science | International Medical Journal, 2018
The aim of the study was to evaluate the type of trauma, additional injury, age, additional disea... more The aim of the study was to evaluate the type of trauma, additional injury, age, additional diseases, need for ICU and blood transfusion, postoperative complications, mid-term patient satisfaction and hip functions of the patients who underwent surgical treatment for acetabulum fracture in our clinic. A total of 17 patients (15 males, 2 females, mean age 40,7 years ) who admitted to the emergency department between 2013 and 2016, and treated surgically due to acetabulum fractures were included in the study. According to Judet Letournel classification, 7 anterior wall fractures, 4 anterior column fractures, 3 posterior column fractures and 3 both column fractures were determined. Mean hospital stay was 14.5 days (range 3-45 days) and mean follow-up was 26 months (14 to 57 months). ICU needed in 3 (17.6%) cases, mean stay was 10.3 days (range 1-29 days). 6 (35.2%) patients required blood transfusion, mean amount was 4.1 units (range 2-6 units). Harris hip scores were excellent -good in 12 cases (70.5%) and 5 cases (29.5%) had moderate -poor results at 12th month. There was no statistically significant relationship between severity of trauma, type of injury, age, additional diseases, intensive care and blood transfusion requirements, postoperative complications and patient satisfaction (p> 0.05). In selected acetabular fracture cases with proper planning according to fracture type, in early period, surgery may lead to satisfactory results in terms of patient satisfaction and hip functions.
Background: Knowing the configuration of a meniscus tear is important for planning the treatment ... more Background: Knowing the configuration of a meniscus tear is important for planning the treatment protocol. Objectives: The aim of this study was to evaluate the accuracy of magnetic resonance imaging (MRI) in determining meniscus tear configurations through a retrospective assessment of MR images from patients who underwent arthroscopy for an initial diagnosis of meniscus tear. Patients and Methods: A retrospective comparison was made between MRI findings and arthroscopic results of patients to whom arthroscopy was applied by a single experienced surgeon for an initial diagnosis of meniscus tear. The MR images were taken with a 1.5 Tesla unit. The meniscus tears were classified in subgroups as horizontal, longitudinal, radial, flap, bucket handle, and complex. Results: In 60 knees of 57 patients, 32 lateral meniscus and 48 medial meniscus lesions were identified by MRI. Of these tears, 33 were complex, 15 longitudinal, 13 radial, 11 bucket handle, 5 flap, and 3 horizontal. For the total 80 meniscus tears, MRI gave the same diagnosis as arthroscopy in 60 (75%). Longitudinal and flap tears had low sensitivity (79% in medial and 50% in lateral meniscus for longitudinal tears; 33% to 57%, respectively, for flap tears) but high specificity. Conclusion: MRI is an important tool in the imaging of meniscus tears, but for longitudinal and flap tear configurations that require arthroscopy, MRI diagnostics are especially insensitive. Nonetheless, MRI evaluation paired with good clinical evaluation can be considered useful when planning a surgical protocol and when defining the postoperative prognosis.
Medicine Science | International Medical Journal, 2015
The rotator cuff tear etiology is still unclear. Especially for atraumatic ruptures, degenerative... more The rotator cuff tear etiology is still unclear. Especially for atraumatic ruptures, degenerative processes come into prominence. This study aims to correlate between four most commonlyseen sleeping positions and patients with rotator cuff pathology. 87 patients who applied to the institute for suffering from shoulder pain for more than 6 months without a trauma and 93 voluntary people (as control group) above the age of 50 who applied to the institution for reasons other than shoulder pain included in the study. Rotator cuff ruptures and acromion types of the patients are diagnosed via magnetic resonance imaging. In face-to-face interviews, all the patients are asked to show their favorite sleeping positions on the visual cards and also questioned about their smoking habits and overhead activities. There are not any statistically substantive parameters between the patients and the control group in terms of age and sex. 83.9% of the patients with rotator cuff rupture have stated preferring lateral decubitus position while this rate is 61.3% among the control group (p=0.003). Atraumatic rotator cuff tears are increase with age. The increase pressure in the subacromial space can lead distribution in microvascular circulation of rotator cuff. Decrease in the microvascular circulation also affects the regeneration potential of rotator cuff. Laboratory studies demonstrated that lateral decubitus position has the most prominent increase in the subacromial pressure over all sleeping positions. We consider that sleeping in the lateral decubitus position causes long-term high subacromial pressure, leading to a microcirculatory disorder in the rotator cuff, which is a risk factor for the rotator cuff etiology.
Objective: To reveal the clinical and radiological results of Schatzker Type V and VI tibial plat... more Objective: To reveal the clinical and radiological results of Schatzker Type V and VI tibial plateau fractures operated using classic anterior midline incision. A total of 17 patients (5 females, 12 male) were included in the study. The mean age was 44.8 years (actual age range 26-71 years). An anterior midline incision was used for all patients. Patients were clinically and radiologically assessed 6 months after surgery. Clinical results were evaluated using the visual analog scale, Hospital for Special Surgery (HSS) knee score, and range of motion. Radiological results were evaluated for the presence of bony union, medial proximal tibial angle (MPTA), posterior proximal tibial angle (PPTA), and step-off on the fracture line. Union was observed in all patients. Infection and neurological deficits were not identified. The mean HSS knee score was 92.7. According to the HSS score, one patient had a poor outcome. The mean flexion was 110.5°. The mean MPTA was 88.1° with the mean PPTA at 82.2°. Anatomic reduction was achieved in all patients. A classic anterior midline incision and the elevation of the anterior horn of the menisci allow visualization of the whole plateau. Fracture reduction and fixation can be easily performed. This technique should be considered for tibial plateau fractures owing to its advantages.
Türk Ortopedi ve Travmatoloji Birliği Derneği grubu bileşimindeki bu değişikliklerin; önemli sosy... more Türk Ortopedi ve Travmatoloji Birliği Derneği grubu bileşimindeki bu değişikliklerin; önemli sosyal, ekonomik, politik ve sağlık sonuçlarına sahip olması şaşırtıcı olmamalıdır. Bu nedenle, insan fizyolojisindeki yaşa bağlı değişiklikleri ve bunların sonuçlarını anlamak önemlidir ve üzerinde durulmalıdır. İleri yaşla ilişkili temel zorluklar; birçok fizyolojik işlevde önemli değişiklikler, birden çok işlev bozukluğunun gelişimi, genel işlevsel kapasitede düşüş ve morbid sorunlarda artış olarak sıralanabilir. Bunların sonucunda yaşlıların en çok korktuğu bağımsızlık kaybı ortaya çıkar. [1] D ünya Sağlık Örgütü (DSÖ), dünyanın birçok ülkesinde nüfusun yaşlanmasını yirmi birinci yüzyılın en önemli sorunlarından biri olarak görmektedir. Asya ve Avrupa'daki birçok ülkede, ortalama yaşam beklenti süresi, özellikle kadınlar arasında 80 yılı aşmıştır. Amerika Birleşik Devletleri'nde en hızlı artan yaş grubu, 85 yaş üzeri gruptur. 2025 yılında dünyada 60 yaş üzeri insan nüfusunun 1 milyarı, 2050 yılına gelindiğinde ise 2 milyarı aşacağı beklenmektedir. [1] Ülkemizde de 2017 nüfus sayımına göre 65 yaş üzeri kişilerin oranı %8,5'e ulaşmıştır. [2] Nüfusun yaş Kas iskelet sisteminin yaşlanması ve yaşlılarda kalça anatomisinde değişiklikler Aging of the musculoskeletal system and changes in hip anatomy in the elderly
Objective: We examined the clinical, functional and radiological outcomes in patients 65 years an... more Objective: We examined the clinical, functional and radiological outcomes in patients 65 years and older who underwent primary shoulder hemiarthroplasty for a 4-part acute fracture of the proximal humerus, and evaluated efficacy of treatment, patient satisfaction and our procedural deficiencies. Patients and Methods: Eighteen patients were treated with primary hemiarthroplasty for acute proximal humerus Neer type-IV fracture. During follow-up, active forward elevation, abduction, internal/external rotation of the shoulder were assessed.
Objective: To evaluate the functional and radiological outcomes of anterograde headless cannulate... more Objective: To evaluate the functional and radiological outcomes of anterograde headless cannulated screw fixation for medial malleolar fractures. Subjects and Methods: This study included 12 patients (8 males, 4 females; age 27-55 years) with medial malleolar type B fractures according to the Herscovici fracture classification who had undergone anterograde headless cannulated screw fixation surgery between 2012 and 2014. Seven had an isolated medial malleolar fracture and 5 a bimalleolar fracture. All of the bimalleolar fractures were classified as 44-B2 based on the Arbeitsgemeinschaft für Osteosynthesefragen/Orthopaedic Trauma Association (AO/OTA) classification. Postoperatively, bone union was evaluated on direct radiographs at the final follow-up examination. The American Orthopaedic Foot and Ankle Society (AOFAS) scoring system was used for clinical evaluation. Results: The mean follow-up period was 17.2 ± 5.3 months (range 12-23). Full union was achieved in all fractures. The ...
The Medical Journal of Okmeydani Training and Research Hospital, 2014
Bu çalışmada taze ayak bileği kadavra piyeslerinde, sindesmoz ligamanlarının yaralanmalarında olu... more Bu çalışmada taze ayak bileği kadavra piyeslerinde, sindesmoz ligamanlarının yaralanmalarında oluşan distal tibio-fibular eklem değişiklikleri araştırıldı. Gereç ve Yöntemler: On adet taze kadavrada yirmi ayak bilek piyesi rastgele iki eşit gruba ayrıldı. Sindesmozu oluşturan bağlar diseke edilip kesilerek ayak bileğindeki değişiklikler anatomik ve radyolojik olarak incelendi. İlk grupta anteriorden başlanarak, ikinci grupta ise posteriordan başlanarak sırası ile sindesmoz ligamanları diseke edildi. Distal tibio-fibular eklemdeki anatomik ayrışma ölçüldü. Bu sırada alınan dinamik skopi görüntüleri ile de radyolojik ölçümler yapıldı. Bulgular: Diseksiyonun her aşamasında anatomik olarak eklemde ayrışma saptandı. İki grup arasında anlamlı fark tespit edilmedi. Tek ligaman sağlamken radyolojik olarak belirgin bir değişim saptanmadı. Her iki seride de kesi anterior-posterior tüm katları içerdiğinde distal tibiofibular ayrışmada belirgin artış görülmekle birlikte radyolojik olarak tibiofibuler açık alanda belirgin artış tespit edildi. Buna rağmen medial açık alan ve talo-krural açı değişimi saptanmadı. Sonuç: Sindesmoz ligamanlarından yalnızca bir tanesi kesildiğinde bile distal tibio fibuler eklem anatomisi laterale ayrışma şeklinde bozulmaktadır. Direkt grafi ile kısmi yaralanmalar saptanamadığından dolayı klinik şüphe varlığında MRG gibi radyolojik ilave tanı yöntemlerine başvurmak gereklidir.
Purpose The appropriate management of supracondylar humerus fractures in children is frequently d... more Purpose The appropriate management of supracondylar humerus fractures in children is frequently delayed due to various factors, and there is still no agreement on the treatment of choice. The purpose of this study was to evaluate the effects of delayed treatment of displaced supracondylar humerus fractures on the treatment results and complication rate. Methods A total of 31 children with supracondylar humerus fractures who had not received adequate treatment for their displaced fractures were included in this study. The conditions leading to delayed treatment mainly included severe swelling or skin problems around the elbow and the health facility problems unique to our district. The mean delaying time was 6 days (range 2–19 days). There were 24 males and 7 females with a mean age of 7 years (range 1–13 years). The fractures were classified as type III-A ( n = 15; 48%) and type III-B ( n = 16; 52%) according to Gartland. Surgical treatment consisting of sentiment manual reduction t...
Preoperative Albumin and Postoperative CRP/Albumin Ratio (CARS) are Independent Predictive Factors in Estimating 1-Year Mortality in Patients Operated for Proximal Femoral Metastasis with Endoprosthesis
Journal of Clinical and Investigative Surgery, Nov 20, 2022
Septic arthritis is a medical emergency with a mortality rate of approximately 10%, the knee bein... more Septic arthritis is a medical emergency with a mortality rate of approximately 10%, the knee being the most commonly affected joint (about 50% of cases). The systemic inflammatory response caused by septic arthritis may be affected by the severity of the infection or the success of surgical joint debridement. Materials and Methods. This article was a retrospective study on patients admitted to our hospital (between 2013 and 2020) with septic arthritis of the knee. Patients were diagnosed based on history, examination, blood test results, and knee aspirate fluid. The patient's response to antibiotic therapy was monitored in the outpatient setting using serological markers. Results. Of the 48 patients included in the study, 26 were male, and 22 were female. Based on the ROC analysis, the optimal cutoff value of preoperative NLR was 8.33. The AUC was 0.782 for postoperative NLR level (95% CI,0,626-0.938; p:0.009) and 0.922 for postoperative CAR level (95% CI,0.844-0.999; p <0.001). Postoperative NLR and CAR cutoff values are 15.4 and 115, respectively. Conclusions. Preoperative NLR elevation in septic arthritis may be associated with recurrent surgical debridement postoperatively. In addition, postoperative NLR and CAR values can predict debridement rates in patients after septic arthritis surgery.
The usage of electric scooters has been popular because it is a cheap and fast transportation met... more The usage of electric scooters has been popular because it is a cheap and fast transportation method. Its use has increased in recent years because public transportation is less preferred during the covid-19 pandemic and in parallel, the publications reporting e-scooter accidents are increasing. There is no article examining the relationship between e-scooter and anterior cruciate ligament (ACL) injury in current literature. We aim to examine the relationship between e-scooter accidents and ACL injury incidence. Patients over the age of 18 years who applied to our orthopedics outpatient clinic with the diagnosis of ACL injury between January 2019- June 2021 were evaluated. 80 e-scooter accidents resulting with ACL tears were reviewed. The electronic medical records of the patients were reviewed retrospectively. Information about the age, gender, trauma history of the patients, and type of trauma was obtained. Fifty-eight patients had a history of falling while stopping the scooter, ...
Acta Orthopaedica et Traumatologica Turcica, Nov 12, 2014
The aim of this study was to investigate the relationship between the axillary nerve and the perc... more The aim of this study was to investigate the relationship between the axillary nerve and the percutaneously inserted proximal humeral locking plate and to evaluate the risk of axillary nerve injury during percutaneous plate insertion. Methods: The study included 50 shoulders of 25 fresh frozen cadavers. A 5 cm incision was made from the anterolateral border of the acromion to the arm and a 5-hole 3.5-mm proximal humeral plate was inserted. The axillary nerve was then dissected. Plate holes which crossed the axillary nerve were noted. The distance between the axillary nerve and the lateral edge of the acromion and the length of the arm were measured and their relations evaluated with a correlation test. Results: The average arm length was 319 mm. The average distance between the axillary nerve and the lateral edge of the acromion was 60 mm. There was a significant correlation between the arm length and acromion-axillary nerve distance (p<0.05). The plate was inserted under the deltoid fascia in all shoulders except one. There were no axillary nerve lesions. In 1 case, the distal end of the plate was inserted in the deltoid muscle. No constant relationship between the plate holes and the axillary nerve was detected. Conclusion: There is a risk of axillary nerve injury during percutaneous plate insertion. It must be ensured that the plate is inserted under the deltoid fascia during the surgery. The axillary nerve must be visible during application of the screws due to the impossibility of knowing which holes cross the axillary nerve.
Medicine Science | International Medical Journal, 2018
The aim of the study was to evaluate the type of trauma, additional injury, age, additional disea... more The aim of the study was to evaluate the type of trauma, additional injury, age, additional diseases, need for ICU and blood transfusion, postoperative complications, mid-term patient satisfaction and hip functions of the patients who underwent surgical treatment for acetabulum fracture in our clinic. A total of 17 patients (15 males, 2 females, mean age 40,7 years ) who admitted to the emergency department between 2013 and 2016, and treated surgically due to acetabulum fractures were included in the study. According to Judet Letournel classification, 7 anterior wall fractures, 4 anterior column fractures, 3 posterior column fractures and 3 both column fractures were determined. Mean hospital stay was 14.5 days (range 3-45 days) and mean follow-up was 26 months (14 to 57 months). ICU needed in 3 (17.6%) cases, mean stay was 10.3 days (range 1-29 days). 6 (35.2%) patients required blood transfusion, mean amount was 4.1 units (range 2-6 units). Harris hip scores were excellent -good in 12 cases (70.5%) and 5 cases (29.5%) had moderate -poor results at 12th month. There was no statistically significant relationship between severity of trauma, type of injury, age, additional diseases, intensive care and blood transfusion requirements, postoperative complications and patient satisfaction (p> 0.05). In selected acetabular fracture cases with proper planning according to fracture type, in early period, surgery may lead to satisfactory results in terms of patient satisfaction and hip functions.
Background: Knowing the configuration of a meniscus tear is important for planning the treatment ... more Background: Knowing the configuration of a meniscus tear is important for planning the treatment protocol. Objectives: The aim of this study was to evaluate the accuracy of magnetic resonance imaging (MRI) in determining meniscus tear configurations through a retrospective assessment of MR images from patients who underwent arthroscopy for an initial diagnosis of meniscus tear. Patients and Methods: A retrospective comparison was made between MRI findings and arthroscopic results of patients to whom arthroscopy was applied by a single experienced surgeon for an initial diagnosis of meniscus tear. The MR images were taken with a 1.5 Tesla unit. The meniscus tears were classified in subgroups as horizontal, longitudinal, radial, flap, bucket handle, and complex. Results: In 60 knees of 57 patients, 32 lateral meniscus and 48 medial meniscus lesions were identified by MRI. Of these tears, 33 were complex, 15 longitudinal, 13 radial, 11 bucket handle, 5 flap, and 3 horizontal. For the total 80 meniscus tears, MRI gave the same diagnosis as arthroscopy in 60 (75%). Longitudinal and flap tears had low sensitivity (79% in medial and 50% in lateral meniscus for longitudinal tears; 33% to 57%, respectively, for flap tears) but high specificity. Conclusion: MRI is an important tool in the imaging of meniscus tears, but for longitudinal and flap tear configurations that require arthroscopy, MRI diagnostics are especially insensitive. Nonetheless, MRI evaluation paired with good clinical evaluation can be considered useful when planning a surgical protocol and when defining the postoperative prognosis.
Medicine Science | International Medical Journal, 2015
The rotator cuff tear etiology is still unclear. Especially for atraumatic ruptures, degenerative... more The rotator cuff tear etiology is still unclear. Especially for atraumatic ruptures, degenerative processes come into prominence. This study aims to correlate between four most commonlyseen sleeping positions and patients with rotator cuff pathology. 87 patients who applied to the institute for suffering from shoulder pain for more than 6 months without a trauma and 93 voluntary people (as control group) above the age of 50 who applied to the institution for reasons other than shoulder pain included in the study. Rotator cuff ruptures and acromion types of the patients are diagnosed via magnetic resonance imaging. In face-to-face interviews, all the patients are asked to show their favorite sleeping positions on the visual cards and also questioned about their smoking habits and overhead activities. There are not any statistically substantive parameters between the patients and the control group in terms of age and sex. 83.9% of the patients with rotator cuff rupture have stated preferring lateral decubitus position while this rate is 61.3% among the control group (p=0.003). Atraumatic rotator cuff tears are increase with age. The increase pressure in the subacromial space can lead distribution in microvascular circulation of rotator cuff. Decrease in the microvascular circulation also affects the regeneration potential of rotator cuff. Laboratory studies demonstrated that lateral decubitus position has the most prominent increase in the subacromial pressure over all sleeping positions. We consider that sleeping in the lateral decubitus position causes long-term high subacromial pressure, leading to a microcirculatory disorder in the rotator cuff, which is a risk factor for the rotator cuff etiology.
Objective: To reveal the clinical and radiological results of Schatzker Type V and VI tibial plat... more Objective: To reveal the clinical and radiological results of Schatzker Type V and VI tibial plateau fractures operated using classic anterior midline incision. A total of 17 patients (5 females, 12 male) were included in the study. The mean age was 44.8 years (actual age range 26-71 years). An anterior midline incision was used for all patients. Patients were clinically and radiologically assessed 6 months after surgery. Clinical results were evaluated using the visual analog scale, Hospital for Special Surgery (HSS) knee score, and range of motion. Radiological results were evaluated for the presence of bony union, medial proximal tibial angle (MPTA), posterior proximal tibial angle (PPTA), and step-off on the fracture line. Union was observed in all patients. Infection and neurological deficits were not identified. The mean HSS knee score was 92.7. According to the HSS score, one patient had a poor outcome. The mean flexion was 110.5°. The mean MPTA was 88.1° with the mean PPTA at 82.2°. Anatomic reduction was achieved in all patients. A classic anterior midline incision and the elevation of the anterior horn of the menisci allow visualization of the whole plateau. Fracture reduction and fixation can be easily performed. This technique should be considered for tibial plateau fractures owing to its advantages.
Türk Ortopedi ve Travmatoloji Birliği Derneği grubu bileşimindeki bu değişikliklerin; önemli sosy... more Türk Ortopedi ve Travmatoloji Birliği Derneği grubu bileşimindeki bu değişikliklerin; önemli sosyal, ekonomik, politik ve sağlık sonuçlarına sahip olması şaşırtıcı olmamalıdır. Bu nedenle, insan fizyolojisindeki yaşa bağlı değişiklikleri ve bunların sonuçlarını anlamak önemlidir ve üzerinde durulmalıdır. İleri yaşla ilişkili temel zorluklar; birçok fizyolojik işlevde önemli değişiklikler, birden çok işlev bozukluğunun gelişimi, genel işlevsel kapasitede düşüş ve morbid sorunlarda artış olarak sıralanabilir. Bunların sonucunda yaşlıların en çok korktuğu bağımsızlık kaybı ortaya çıkar. [1] D ünya Sağlık Örgütü (DSÖ), dünyanın birçok ülkesinde nüfusun yaşlanmasını yirmi birinci yüzyılın en önemli sorunlarından biri olarak görmektedir. Asya ve Avrupa'daki birçok ülkede, ortalama yaşam beklenti süresi, özellikle kadınlar arasında 80 yılı aşmıştır. Amerika Birleşik Devletleri'nde en hızlı artan yaş grubu, 85 yaş üzeri gruptur. 2025 yılında dünyada 60 yaş üzeri insan nüfusunun 1 milyarı, 2050 yılına gelindiğinde ise 2 milyarı aşacağı beklenmektedir. [1] Ülkemizde de 2017 nüfus sayımına göre 65 yaş üzeri kişilerin oranı %8,5'e ulaşmıştır. [2] Nüfusun yaş Kas iskelet sisteminin yaşlanması ve yaşlılarda kalça anatomisinde değişiklikler Aging of the musculoskeletal system and changes in hip anatomy in the elderly
Objective: We examined the clinical, functional and radiological outcomes in patients 65 years an... more Objective: We examined the clinical, functional and radiological outcomes in patients 65 years and older who underwent primary shoulder hemiarthroplasty for a 4-part acute fracture of the proximal humerus, and evaluated efficacy of treatment, patient satisfaction and our procedural deficiencies. Patients and Methods: Eighteen patients were treated with primary hemiarthroplasty for acute proximal humerus Neer type-IV fracture. During follow-up, active forward elevation, abduction, internal/external rotation of the shoulder were assessed.
Objective: To evaluate the functional and radiological outcomes of anterograde headless cannulate... more Objective: To evaluate the functional and radiological outcomes of anterograde headless cannulated screw fixation for medial malleolar fractures. Subjects and Methods: This study included 12 patients (8 males, 4 females; age 27-55 years) with medial malleolar type B fractures according to the Herscovici fracture classification who had undergone anterograde headless cannulated screw fixation surgery between 2012 and 2014. Seven had an isolated medial malleolar fracture and 5 a bimalleolar fracture. All of the bimalleolar fractures were classified as 44-B2 based on the Arbeitsgemeinschaft für Osteosynthesefragen/Orthopaedic Trauma Association (AO/OTA) classification. Postoperatively, bone union was evaluated on direct radiographs at the final follow-up examination. The American Orthopaedic Foot and Ankle Society (AOFAS) scoring system was used for clinical evaluation. Results: The mean follow-up period was 17.2 ± 5.3 months (range 12-23). Full union was achieved in all fractures. The ...
The Medical Journal of Okmeydani Training and Research Hospital, 2014
Bu çalışmada taze ayak bileği kadavra piyeslerinde, sindesmoz ligamanlarının yaralanmalarında olu... more Bu çalışmada taze ayak bileği kadavra piyeslerinde, sindesmoz ligamanlarının yaralanmalarında oluşan distal tibio-fibular eklem değişiklikleri araştırıldı. Gereç ve Yöntemler: On adet taze kadavrada yirmi ayak bilek piyesi rastgele iki eşit gruba ayrıldı. Sindesmozu oluşturan bağlar diseke edilip kesilerek ayak bileğindeki değişiklikler anatomik ve radyolojik olarak incelendi. İlk grupta anteriorden başlanarak, ikinci grupta ise posteriordan başlanarak sırası ile sindesmoz ligamanları diseke edildi. Distal tibio-fibular eklemdeki anatomik ayrışma ölçüldü. Bu sırada alınan dinamik skopi görüntüleri ile de radyolojik ölçümler yapıldı. Bulgular: Diseksiyonun her aşamasında anatomik olarak eklemde ayrışma saptandı. İki grup arasında anlamlı fark tespit edilmedi. Tek ligaman sağlamken radyolojik olarak belirgin bir değişim saptanmadı. Her iki seride de kesi anterior-posterior tüm katları içerdiğinde distal tibiofibular ayrışmada belirgin artış görülmekle birlikte radyolojik olarak tibiofibuler açık alanda belirgin artış tespit edildi. Buna rağmen medial açık alan ve talo-krural açı değişimi saptanmadı. Sonuç: Sindesmoz ligamanlarından yalnızca bir tanesi kesildiğinde bile distal tibio fibuler eklem anatomisi laterale ayrışma şeklinde bozulmaktadır. Direkt grafi ile kısmi yaralanmalar saptanamadığından dolayı klinik şüphe varlığında MRG gibi radyolojik ilave tanı yöntemlerine başvurmak gereklidir.
Purpose The appropriate management of supracondylar humerus fractures in children is frequently d... more Purpose The appropriate management of supracondylar humerus fractures in children is frequently delayed due to various factors, and there is still no agreement on the treatment of choice. The purpose of this study was to evaluate the effects of delayed treatment of displaced supracondylar humerus fractures on the treatment results and complication rate. Methods A total of 31 children with supracondylar humerus fractures who had not received adequate treatment for their displaced fractures were included in this study. The conditions leading to delayed treatment mainly included severe swelling or skin problems around the elbow and the health facility problems unique to our district. The mean delaying time was 6 days (range 2–19 days). There were 24 males and 7 females with a mean age of 7 years (range 1–13 years). The fractures were classified as type III-A ( n = 15; 48%) and type III-B ( n = 16; 52%) according to Gartland. Surgical treatment consisting of sentiment manual reduction t...
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