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Öğe The effect of injury level, associated injuries, the type of nerve repair, and age on the prognosis of patients with median and ulnar nerve injuries(2005) Ertem K.; Denizhan Y.; Yologlu S.; Bora A.OBJECTIVES: In this study, we aimed to evaluate the functional results of nerve repair (median and/or ulnar) in patients with forearm clean-cut injuries and investigated the effect of injury level, associated injuries, the type of repair (primary or secondary), and age on the prognosis. METHODS: The study included 42 patients (34 males, 8 females; mean age 31 years; range 9 to 62 years) who were treated for forearm clean-cut injuries. Involvement was in the proximal forearm in four, mid-forearm in 11, and distal forearm in 27 cases. There were 51 nerve injuries affecting the median nerve (n=30) and the ulnar nerve (n=21). Nerve injuries were isolated in 12 patients, associated with tendon injuries in nine patients, and with tendon and artery injuries in 21 patients. The patients were evaluated in four age groups including 0-15, 16-30, 31-45 years, and 46 years or above. Functional evaluations were made using the Seddon classification. The effect of injury level, associated injuries, the type of repair, and age on the prognosis was assessed. The mean follow-up was 39 months (range 11 to 57 months). RESULTS: Although the clinical and functional results of primary and late-primary repairs were less favorable than those of secondary repairs, the difference did not reach a significant level (p>0.05). The injury level, associated injuries, and age did not influence the Seddon scores significantly (p>0.05). In the age group of 0-15 years, the results were very good in all the patients (100%), but good and very good results accounted for only 20% in the age group of 46 years or above. CONCLUSION: In appropriate cases with clean-cut nerve injuries, primary repair must be the first choice. Taking the low regeneration capacity into consideration, priority should be given to reconstructive procedures in patients at older ages.Öğe Radial artery pellet embolism: a case report(2004) Ertem K.; Ayan I.; Harma A.; Türköz R.; Bora A.[No abstract available]Öğe Somatotrophic reorganization in the brain after extremity replantation, revascularization and amputations: Investigated by SPECT analysis(2006) Ertem K.; Kekilli K.E.; Ya?mur C.; Ayan I.; Turgut S.; Bostan H.; Bora A.BACKGROUND: We wanted to investigate the somatotropic reorganization occurring in the motor and somatosensory cortex by using 99mTc-HMPAO SPECT analyses, after the extremity revascularization, replantation or amputation. METHODS: Twelve patients (11 men, 1 female; mean age 38.9±14.7 years) and controls (5 men, mean age 32.2±7.9 years) were enrolled in this study. After reconstruction, lower, middle and upper orbitomeatal slices with precentral and postcentral slices were obtained. All images were visually and semi-quantitatively evaluated. Mann-Whitney U-test was used for statistical analysis. RESULTS: In the revascularization and replantation patients, postcentral and precentral hypoperfusions were seen at dominant hemisphere. In the amputated patients, postcentral (in 3 of 4 cases) and precentral hypoperfusions were seen at non-dominant hemisphere and postcentral hypoperfusion (in 1 of 4 cases) was seen at dominant hemisphere. In our patients, most significant difference in regional cerebral blood flow was found in posterior parietal cortex (somatic associated area). CONCLUSION: Changes that take place in precentral and postcentral cortical areas subsequent to the extremity replantation-revascularization of the organ is a good indicator of somatotrophic reorganization.
