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Öğe Atypical hypothenar hammer syndrome mimicking a peripheral nerve tumor(2023) Özdeş, Hüseyin Utku; Taşkıran, Gültekin; Ertem, KadirAn aneurysm is an abnormal focal dilatation of a blood vessel that increases its width by more than 50%. They are divided into true and pseudo-aneurysms. Ulnar artery pseudoaneurysm that causes pain, numbness and cold intolerance in the hypothenar region and develops after repetitive trauma has been named hypothenar hammer syndrome. Hypothenar ham- mer syndrome is a rare clinical entity that occurs more frequently in males and in the dominant hand as a result of repetitive trauma. Patient history and clinical examination are very important in the diagnosis of this disease, which is seen as an occupational disease and is associated with some sports branches. However, it can also occur with a single blunt trauma, in the non-dominant hand and regardless of occupation. Ultrasonography, Doppler, magnetic resonance and angiography help us to visualize an aneurysm. Although activity regulation and various medications are used among the treatments, surgical treatment is at the forefront in the presence of chronic pain and compression symptoms due to the mass. In the presence of signs of vascular insufficiency or a palpable pulsatile mass in the hand, this rare syndrome may be easy to diagnose and manage. But, in atypical cases, such as our case with no symptoms other than nonspecific pain in the hand, the aneurysm causing hypothenar hammer syndrome may mimic a peripheral nerve tumor.Öğe Bipartitism in tarsal bones: A retrospective analysis of clinical and radiological features(2024) Maras Ozdemir, Zeynep; Karakaplan, Mustafa; Ergen, Emre; Köroğlu, Muhammed; Aslantürk, Okan; Özdeş, Hüseyin Utku; Çoban, İdrisAim: Bipartitism in the foot, especially in the tarsal bones, is a rare anatomical variant characterized by dividing one bone into two separate ossification centers. This condition can be congenital or acquired, often remains asymptomatic, and is only discovered incidentally during radiological imaging. This study aims to present a comprehensive retrospective analysis of bipartitism in tarsal bones, assessing its prevalence, type of articulation, and associated clinical features in a cohort of patients. Materials and Methods: A total of 4,645 patients were retrospectively evaluated from 6,145-foot images consisting of 4,975 computed tomography (CT) and 1,170 magnetic resonance imaging (MRI) scans obtained between 2015 and 2023. 15 patients with tarsal bipartitism were identified and contacted through the hospital system for in-person medical history and examination. Radiological exams assessed partial and complete bipartition, diastasis, and exostosis in the tarsal bones. Age, sex, side, trauma history, pain, foot deformity, gait disturbance, and other clinical findings were also recorded. Results: Bipartitism was detected in 15 patients (0.32%), predominantly affecting males (87%). The most common variant was medial cuneiform bipartitism, observed in 13 patients (0.28%). Talus and calcaneus bipartitism were each observed in one patient (0.02%). Bilateral involvement was present in 67% of the cases, with 60% of patients reporting chronic pain. Complete dissociation of bipartite bones was noted in 80% of cases. Accompanying bipartitism, two patients had pes planovalgus, and one had hallux varus deformity. Conclusion: Although bipartitism of the tarsal bones is rare, it remains a diagnostic challenge due to variability in clinical presentation and possible association with other foot deformities. Accurate diagnosis through advanced imaging techniques is essential to differentiate these variants from fractures and guide appropriate treatment. This study contributes valuable insights into the prevalence and clinical impact of bipartitism in the tarsal bones, emphasizing the importance of early diagnosis and individualized treatment strategies.Öğe Functional outcomes of titanium elastic nail procedure after femoral shaft fracture in pediatric patients(2023) Karakaplan, Mustafa; Ergen, Emre; Köroğlu, Muhammed; Aslantürk, Okan; Özdeş, Hüseyin Utku; Gündüz, EnesPediatric femur diaphyseal fractures are seen after serious traumas such as traffic accidents and fall from height. Although treatment algorithms are made according to age groups, treatment planning is individualized according to the patient and the degree of injury. In our study, we evaluated functional outcomes of pediatric femur fractures treated with titanium elastic nail (TEN). This is a retrospective study including pediatric femoral diaphyseal fractures treated with TEN between 2012 and 2021. Open fractures, pathological fractures, distal fractures involving the femoral condyles, and proximal fractures involving the trochanteric region were not included in our study. Thirty-three femoral diaphyseal fractures with complete data were identified as stable and unstable in length, and functional results and post-treatment complications were recorded by performing TEN in fracture fixation. Clinical functional results were analyzed with Flynn criteria. Thirty-three femoral fractures of 29 patients were included. Eighteen (62.1%) of our patients were boys and 11 (37.9%) were girls. The mean age was 6.51 years (4-13 years). The most common injury mechanism was traffic accidents seen in 19 patients (24.51%). The mean follow-up period after surgery was 26.6 (6-90 months) months. Stable fractures (transverse and short oblique) were found in 26 cases (78.7%) and unstable fractures (spiral/long oblique and comminuted) in 7 cases (21.7%). According to Flynn criteria, excellent results were found in 20 fractures (60.6%) and satisfactory results in 10 fractures (30.3%) and 3 poor (9.09%). There was no significant difference between stable and unstable fractures in terms of functional outcome (p=0.12). Femoral diaphyseal fractures are serious injuries that require surgery. Regardless of the type of fracture, stable or unstable in length, the results of treatment with TEN are very successful. Major complications such as nonunion and re-fracture are rarely seen with this treatment.Öğe Functional results after surgical treatment of pediatric femoral neck fractures(2023) Köroğlu, Muhammed; Aslantürk, Okan; Özdeş, Hüseyin Utku; Çoban, İdrisThis study aims to present the functional outcomes of patients who were treated surgically for childhood femoral neck fractures. In addition, to obtain information about the complications seen after these fractures, especially avascular necrosis of the femoral head (AVN), and to investigate the relationship with the treatment process. Our study is a retrospective study including 22 fractures of 22 patients operated for femoral neck fractures between 2012 and 2021. Thirteen of the patients were boys and 9 were girls The mean age at the time of trauma was 12.6 years (5-17 years). The fractures were classified based on the Delbet/Colonna classification. Fracture type and its effect on functional outcomes and the effect of fracture type on complications were investigated. The relationship between the time and type of treatment and AVN was evaluated. The mean follow-up period of the patients included in the study was 36.9 (12-132 months) months. Orthopedic injury in combination with femoral neck fracture was seen in 4 patients. Femoral neck fractures were classified as type 1 in 1 patient, type 2 in 15 patients, type 3 in 4 patients, and type 4 in 2 patients. In our study, 5 of 8 complications were AVN. The clinical results of the patients were classified with Ratliff score and 14 patients had good, 3 patients had fair and 5 patients had poor results. According to this classification system, 5 patients who developed AVN had a poor outcome, but no significant correlation was found between AVN and the timing of surgery and treatment method. All of the cases with AVN were Type 1 and Type 2 fractures. Pediatric femoral neck fractures are inherently difficult fractures for orthopedists who need long-term follow-up. Although the appropriate time, methods, and materials for surgical management are frequently discussed, the severity of the injury and the anatomical location of the fracture is most important in the development of AVN.Öğe Osteoid osteoma in the hand(2024) Maraş Özdemir, Zeynep; Ertem, Kadir; Özdeş, Hüseyin Utku; Eren, MehmetMany patients associated with non-traumatic wrist or hand pain receive symptomatic treatment. Although temporary improvements are seen with these treatments, the underlying cause is masked, and delayed, or missed. Two patients with osteoid osteoma (OO) localized in the capitate and proximal phalanx are presented in this article. OO is a benign bone tumor typically seen in children, affecting long bones. While cases located in the upper extremities are shared, it is rare in the hand. Surgical intervention remains the primary treatment option. Favorable outcomes are achieved with complete excision of the nidus in an early-detected OO cases.Öğe Posterior interosseous artery flap for severe hand injuries: Outcomes of reconstruction combined with local and regional flaps(Elsevier Ltd, 2026) Ertem, Hakan; Adıgüzel, İbrahim Faruk; Özdeş, Hüseyin Utku; Aslantürk, Okan; Ertem, KadirBackground Severe hand injuries with extensive soft-tissue loss present a significant reconstructive challenge. Achieving stable coverage while preserving hand function often necessitates the combined use of regional and local flaps. The posterior interosseous artery (PIA) flap, in combination with regional flaps harvested from non-salvageable digits, may offer an effective solution. Methods A retrospective analysis was performed on patients with severe hand injuries who underwent reconstruction using a PIA flap between 2022 and 2025. Patients were treated with either an isolated PIA flap or a PIA flap combined with local flaps, including fillet flaps harvested from non-salvageable digits or rotational flaps, depending on the extent and location of the defect. Demographic characteristics, injury mechanisms, defect locations, and surgical details were recorded. Postoperative complications and functional outcomes were assessed using fingertip-to-palm distance, Quick DASH score, and VAS for pain. Results Fourteen patients with severe hand injuries were included in the study. The mean age was 39.4 years, and the mean follow-up period was 19.7 months. Five patients with complex, multi-site defects underwent combined reconstruction using a PIA flap with local flaps (four with fillet flaps, one with a rotational flap), while nine patients were treated with an isolated PIA flap. Successful soft-tissue coverage was achieved in all patients without total flap loss. Partial distal flap necrosis occurred in two patients due to venous congestion and was managed with wound care followed by split-thickness skin grafting. At final follow-up, the mean fingertip-to-palm distance was 2.07 cm, the mean Quick DASH score was 21.89, and the mean VAS pain score was 2.07. All patients achieved stable wound healing and were able to perform daily activities without the need for further reconstructive procedures. Conclusion The PIA flap, either alone or in combination with local flaps, provides reliable soft-tissue coverage and favorable functional outcomes in patients with severe hand injuries. Combined reconstruction strategies should be considered based on defect characteristics, with acceptable complication rates and good functional recovery. This technique represents a valuable option in complex hand trauma reconstruction. Level of evidence IV © 2026 Elsevier Ltd.Öğe Posterior interosseous nerve palsy due to lipoma: A rare case report(2023) Özdeş, Hüseyin Utku; Özdemir, Ekrem; Köse, Harun; Ertem, KadirThe posterior interosseous nerve is the terminal motor branch of the radial nerve without a sensory component. The nerve may be compressed for various reasons along the course of the forearm. Two different clinical pictures occur due to compression of the nerve in the forearm. In radial tunnel syndrome, entrapment of the nerve in the radial tunnel, pain in the elbow is at the forefront, while in the second clinical picture, posterior interosseous nerve syndrome, wrist and finger extension are affected. Posterior interosseous nerve syndrome is rare and develops due to many causes such as trauma, previous surgeries around the elbow, neurologic diseases and abnormal anatomical structures. A rare condition in the etiology of posterior interosseous nerve syndrome is mass lesions causing compression of the forearm.Öğe Publication trends and global collaboration in MAKO robotic-arm assisted total knee arthroplasty: A bibliometric analysis of the last 10 years and future research directions(2025) Özdeş, Hüseyin Utku; Özdemir, Ekrem; Özdeş, Oya OlcayTotal knee arthroplasty (TKA) is a prevalent intervention for end-stage knee osteoarthritis. MAKO robotic-arm assisted technology has emerged to enhance surgical precision, implant positioning, and patient outcomes. This study presents a bibliometric analysis of global research trends on MAKO robotic-arm assisted TKA from 2014 to 2024, aiming to map publication growth, key contributors, and collaboration networks, specifically focusing on the MAKO platform to delineate system-specific research dynamics often obscured in broader robotic TKA analyses, thereby informing future research directions. This study adopts a platform-specific focus to delineate system-level research dynamics often obscured in pooled robotic TKA analyses. A total of 902 publications indexed in the Web of Science database were analyzed using bibliometric tools including VOSviewer, CiteSpace, and Bibliometrix. Publication trends, citation impact, geographic distribution, co-authorship networks, and keyword co-occurrence were examined to identify research hotspots and influential factors. Findings reveal a significant increase in annual publications (CAGR ~28%) and citations, with the United States, India, Germany, and China leading research output. Strong international collaborations were identified, primarily among institutions in the US, Europe, and East Asia. Dominant research themes include implant alignment accuracy, patient-specific surgical planning, and early functional recovery. Most studies were published in high-impact Q1 orthopedic journals. MAKO robotic-arm assisted TKA research has rapidly expanded, reflecting its growing clinical adoption and scientific interest. Despite promising outcomes, challenges such as high costs, learning curves, and limited long-term data persist. While focused on a single CT-based, haptics-enabled platform, these findings complement pooled robotic TKA bibliometrics and motivate cross-platform comparative analyses. Beyond mapping, we synthesize clinical and health-system implications of dominant MAKO-related themes to inform practice and policy. Future research should emphasize long-term clinical outcomes, cost-effectiveness, and integration of artificial intelligence to further optimize robotic TKA and enhance its role in improving patient care.Öğe Reverse shoulder arthroplasty: Short to mid-term clinical and radiological results(2022) Şakcı, M. Şah; Ertem, Kadir; Özdeş, Hüseyin Utku; Türkmen, Ersen; Ergen, Emre; Canbay, AliAim: This paper aimed to review the early and midterm radiological and clinical findings of our patients who were treated surgically with reverse shoulder prosthesis via to rotator cuff arthropathy. Materials and Methods: A total of 22 patients (female: 14, male 8), with shoulder arthrosis due to cuff tears were treated with reverse shoulder prosthesis between 2015 and 2018 in our clinic. The mean age of the patients was detected as 69.4 years (65-93 years). The mean clinical follow-up was detected as 11 months (3-36 month). The patients were evaluated with Visual Analog Scale (VAS), Shoulder Constant Score, American Shoulder/Elbow Surgeons Shoulder Score (ASES) scores, preoperatively. In last outpatient visits, patients were evaluated with radiological views and range of motion, Shoulder Constant, VAS and ASES scores. Results: The mean shoulder flexion, extension, and abduction was measured as 101°, 24°, and 97.9° respectively in the last polyclinic controls. The mean shoulder Constant scores were 30.8 preoperatively and 62.1 at follow-up (p=0.001). Preoperatively, the mean score of ASES was 31.6. And it was increased to 65.9 with the last follow-up (p = 0.001). The mean preoperative VAS scores were 7.42, and the mean postoperative mean were 2.8 (p = 0.001). Periprosthetic fracture developed intraoperatively in one patient who also had a dislocation occurred in the 2nd month postoperatively. In another patient, superficial infection occurred at the postoperative 3rd week. One patient died because of cardiac problems postoperatively and another one had a traumatic periprosthetic fracture at 5th month postoperatively. Conclusion: While clinical presentation of patient is an advanced rotator cuff tear arthropathy, the application of reverse shoulder prosthesis is major surgical procedure. Also, with appropriate rehabilitation protocol, significant improvement in pain and function can be achieved.Öğe Sakroiliyak eklem ayrışması veya kresent kırığı olan hastaların cerrahi tedavi sonrası uzun dönem fonksiyonel sonuçları(İnönü Üniversitesi, 2021) Özdeş, Hüseyin Utku; Harma, AhmetAmaç: Bu çalışmada sakroiliyak eklem ayrışması veya sakroiliyak eklemin kırıklı çıkığı olan kresent kırıklı hastaların cerrahi tedavi sonuçlarının uzun vadeli olarak klinik ve radyolojik olarak değerlendirilmesi amaçlanmıştır. Materyal ve Metot: İnönü Üniversitesi Tıp Fakültesi Ortopedi ve Travmatoloji Anabilim Dalında 2000-2020 yılları arasında tedavi edilen 850 pelvis yaralanmalı hasta retrospektif olarak değerlendirilmiş; bunlar arasından, sakroiliyak eklem yaralanması ve kresent kırığı olan, iliosakral vida ve/veya plak ile tedavi edilen 110 hasta çalışmaya dahil edilmiştir. Hastalar son takiplerinde subjetif pelvik semptom skorlaması kullanılarak değerlendirilmiştir. Hastaların sonuçları aldıkları skora göre çok iyi, iyi, orta ya da kötü olarak sınıflandırılmıştır. İstatiksel değerlendirme için IBM SSPS (İnternational Business Machine Statistical Package for the Social Sciences) Statistics 26,0 paket programı kullanılmıştır. Tanımlayıcı istatistiksel analizlerde sürekli değişkenler için ortalama ± standart sapma ve ortanca (minimum- maksimum); kategorik değişkenler için sayı ve yüzde (%) verilmiştir. Kategorik verilerin karşılaştırılmasında Ki kare testi kullanılmıştır. İstatistiksel anlamlılık düzeyi p<0,05 olarak kabul edilmiştir. Bulgular: Hastaların yaralanma anındaki yaş ortalaması 35.15±17.09 (minimum 6-maksimum 80) 'dur. Hastaların 74'ü erkek(%67,3), 36 'sı(%32,7)' kadındır. Yaralanma etiyolojisinde en sık neden %35.5 ile araç içi trafik kazası olarak bulunmuştur. Hastaların %50.9'unda kırık tipi OTA Tip B2 şeklindedir. Hastaların %48.2'sinde ek ortopedik yaralanma, %40.9'unda ek organ yaralanması bulunmaktadır. Fonksiyonel skorlama sonuçlarına bakıldığında hastaların %47.9'unda mükemmel, %38.2'sinde iyi, %12.7'sinde orta ve %1.8'inde kötü olarak bulunmuştur. Sakroiliyak plak vida ile ARİF, sakroiliyak kapalı redüksiyon perkütan vida ile tespit ve her iki yöntemin birlikte uygulandığı hastaların fonksiyonel skorlama sonuçları arasında istatistiksel olarak anlamlı fark bulunmamıştır (p>0.05). Ayrıca anterior ve posterior sakroiliyak plak vida ile ARİF uygulanan hastalar, anterior sakroiliyak plak vida kullanılarak ARİF ile perkütan sakroiliyak vida yöntemi uygulanan hastalar ve posterior sakroiliyak plak vida kullanılarak ARİF ile perkütan sakroiliyak vida yöntemi uygulanan hastaların fonksiyonel skorlama sonuçları arasında da istatistiksel olarak anlamlı fark bulunmamıştır (p>0.05). Sonuç: Çalışmamızda kresent kırığı ve sakroiliyak eklem ayrışması olan hastalarda uygun cerrahi tedavi ile tatmin edici fonksiyonel sonuçlar alındığı ortaya konmuştur. Anahtar Kelimeler: Kresent kırığı, pelvis kırığı, sakroiliyak eklem yaralanması
