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Öğe Assessment of patients applying for emergency services with hand injury(2019) Ekinci, Yakup; Gurbuz, Kaan; Batin, Sabri; Cirakli, AlperAim: The purpose of this study is to evaluate the data of the patients who applied the emergency department due to the hand injuries. Material and Methods: This descriptive study used electronic records of our hospital between January 2014 and December 2017. A total of 4706 patients referred to the emergency department of our hospital were enrolled and 592 hand injury patients who were consulted with the Orthopedics and Traumatology Specialist were included in the study. The diagnosis was coded according to ICD10. Results: The majority of men (77.7%) were found to have a hand injury. 29.9% of injuries occurred in summer, most frequently in August (11.3%); It was the day (20.9%) that hand injury was seen more on Thursday than other days. More than half of the patients (59.1%) had insurance from Social Security Institutions (SSI). Tendon incisions are often not accompanied by hand fractures (23.1%). Conclusion: Hand injuries are important because they cause permanent disability. This research points to many important factors for hand injuries. We hope that these demographic data will contribute to reaching different angles to prevent hand injuries by determining the time zone during the year in which our hand injuries are encountered in our region.Öğe Claudin-5 (tight junction) expression level changes in achilles tendon healing(2019) Cirakli, Alper; Cirakoglu, Derya; Erdem, Havva; Uzun, Erdal; Cankaya, SonerAim: This study aimed to reveal the relationship between changes in Claudin-5 expression and the duration of healing in Achilles tendon injury. Material and Methods: 18 Achilles tendons of Wistar-Albino rats were used in the study. Rats were divided into 3 groups as 6 rats in each group, group 1; sham group, group 2; tendon repair group (sacrificed after 3 weeks), group 3; tendon repair group (sacrificed after 6 weeks). Immunohistochemically, the tendons were stained with Claudin-5 and the degree of staining with light microscope was rated between 0 and 3. The obtained scores were compared with Kruskal Wallis test and Posthoc analysis. Results: The scores were 0.5 ± 1 (0-1) in group 1.1 ± 1 (1-2) in group 2 and 1.5 ± 1 (1-2) in group 3. A statistically significant difference was found between the groups (p = 0.026). In the posthoc analyzes, there was a significant difference between group 1 and 3, but there was no significant difference between groups 1 and 2 and between groups 2 and 3. Conclusion: The expression of claudins is regulated by many factors, including hormones, various cytokines, and epithelialmesenchymal transition-related transcription factors. In this study, the increase in the expression of Claudin-5 was noticed in proportion to the progress of primary wound healing. This relationship may be a part of the repair mechanism. The role of claudin levels in intercellular passage is crucial for function as it is important for cell signaling. Achilles tendon healing can be attributed to a laboratory parameter such as claudin. This can help to understand the recovery rate and can help early return to work or sport. We believe that as a laboratory parameter Claudin-5 may be useful in the evaluation of tendon healing.Öğe Complementary treatment options in carpal tunnel syndrome surgery; Prospective randomized controlled study(2018) Ekinci, Yakup; Ulusoy, Ersin Kasim; Cirakli, AlperAim: In this study, we aimed to determine the efficacy of splinting and exercise modalities in addition to surgical treatment in advanced carpal tunnel syndrome (CTS) cases. Material and Method: Patients were divided into 3 different groups according to the order of application, and after surgical intervention their treatment was continued according to the group they were in. There were 51 hands in 50 female patients in group 1 (control group); 52 hands in 51 female patients in group 2 (exercise group); 52 hands in 50 patients in group 3 (wrist splint group). Patients were given a follow-up number by computer software under which the following data were recorded: age, body mass index (BMI), date of surgery, operated side, preoperative disorders, pre and postoperative EMG findings, surgical technique, pre and postoperative visual analogue scales (VAS), pre and post-operative Boston Carpal Tunnel Questionnaire (BCTQ) and post-operative complications. Kolmogorov-Smirnov test and Spearman’s rho correlation coefficient (r) were used for statistical analysis. Results: There was no statistical difference between the groups in terms of VAS and FSS change. However, there was a statistically significant difference in terms of BSSS change. In the exercise group (Group 2) it was found that the healing was better and faster than the other groups. Conclusion: We believe that early and effective postoperative exercise, which is to be applied in addition to surgical treatment in advanced CTS cases, leads to healing of the patient and, in parallel, early return to work.Öğe Evaluation of the distal adjacent segment after long-segment posterior instrumentation and fusion for adolescent idiopathic scoliosis(2019) Demiroz, Serdar; Bayram, Samet; Coskun, Tamer; Cirakli, Alper; Yanik, Hakan Serhat; Atici, Yunus; Erdem, SevkiAim: The majority of studies about adjacent segment disease (ASD) in the literature concern adult patients who were operated on because of degenerative process-related diseases, such as lumbar instability or lumbar stenosis.Material and Methods: We retrospectively reviewed cases of AIS surgically treated in our institution between 2012 and 2015. Patients with an increase in the amount of disc degeneration at adjacent segment (AS) (the ASD group) were compared with those with no increase in degeneration at AS (the non-ASD group).Results:ASD was observed postoperatively in 24 patients (57.1%), and 18 patients (42.9%) had no increase in disc degeneration at the latest follow-up.The mean follow-up was 13 to 34 months, with an average of 22±7.1 months and the lowest instrumented vertebra for 10 of the patients was L2, and the other 32 patients had L3. The rate of ASD in patients with fusion at T4-L3 was significantly higher than for the other instrumentation levels (p 0.05). All 24 patients in the ASD group had L3 as the lowest instrumented vertebra (LIV) (p 0.05).Conclusion: We believe that ASD is present even in short-term follow-up in patients who undergo long-segment fusion at a young age due to AIS and leaving as many mobile segments as possible will protect from ASD.Öğe Is clinical evaluation sufficient enough to diagnose the cubital tunnel syndrome(2017) Cirakli, Alper; Ekinci, Yakup; Ulusoy, Ersin Kasim; Uzun, ErdalAim: The aim of the study was to determine the diagnostic value of clinical history and neurological examination for cubital tunnel syndrome. Materials and Methods: 132 limbs of 128 patients treated with electromyography with a preliminary clinical diagnosis of cubital tunnel syndrome between the years of January 2009 and January 2016 were evaluated. Patients were evaluated according to gender, affected side and electromyography results to assess the presence of neuropathy. The obtained data were statistically analyzed by Kormogonov-Smirnov and Shapiro-Wilk test. Results: 70 patients (54%) were male and 58 (46%) were female and the average age was 40.25±12.66. The affected side was right extremity in 70 (53%) of cases and left extremity in 62 (47%) who underwent electromyography with a preliminary diagnosis of neuropathy. Symptoms were bilateral in 4 cases. As a result of electromyography 43 (32.6%) (27 male, 16 female) patients had neuropathy. Affected side in 23 of these patients (53.5%) was left limb and 20 (46.5%) was right limb and 30 of involved patients were in the range of 30-60 years. Conclusion: According to the results of our study, we found that history and neurological examination have a low efficiency in the diagnosis of cubital tunnel syndrome. This may be associated with relatively subjective evaluation of neurological examination and history and also many pathologies in the differential diagnosis of cubital tunnel syndrome. We believe that electromyelography application is required in addition to a detailed physical examination for cubital tunnel syndrome in order to avoid delayed diagnosis and incomplete/incorrect treatment.Öğe Readability and quality levels of websites that contain written information about anterior cruciate ligament injury: A survey of Turkish websites(Turkish Assoc Orthopaedics Traumatology, 2022) Sahin, Abdullah Alper; Boz, Mehmet; Kececi, Tolga; Unal, Ahmet; Cirakli, AlperObjective: This study aimed to evaluate the contents and readability levels of informative texts about anterior cruciate ligament (ACL) on Turkish websites. Methods: In this cross-sectional study, online searches were performed using the Google, Yandex, and Yahoo search engines on 16, 17, and 18 November 2020, respectively. In these three search engines, 'anterior cruciate ligament', 'anterior cruciate ligament surgery', 'ACL', and 'ACL surgery' were entered in Turkish. The first 10 pages from each search on the websites were collected. The websites were divided into 3 groups according to their sources. Group 1 was classified as websites prepared by private hospitals or medical centers; group 2, as individual websites of orthopedics and traumatology physicians; and group 3, as non-profit websites providing general health information that does not fall into these two groups. The websites were analyzed based on both the website interface and a specific content scoring guide by two reviewers. The Flesch Kincaid (FK) grade level and the Flesch reading ease (FRE) score were used to determine the readability of information on the websites. Results: Eighty-five unique websites were evaluated. The mean quality score of all the websites was 10.4 +/- 4.5 with a maximum score of 25 (range = 3-21). No significant difference in quality score was found between the groups. The mean FK grade score of all the websites was 11.2 +/- 1.7 (range =7.9-15.3). The mean FRE score of all the websites was 46.8 +/- 7.7 (range = 24.1-63.7). No statistically significant differences in FK grade and FRE score were found between the groups. Although 59 websites (69%) had a third-party seal indicating the certification of one of the organizations established to provide a standard of health information on the Internet, only 21 websites (25%) were updated in the year before the search. Conclusion: The readability level of the informative texts about the ACL on the Turkish websites was above the educational level in Turkey. In addition, the quality score of the Turkish websites related to ACL was low. The content of the informative texts should be organized while taking into account the patients' literacy level.Öğe A Repair Of Tibialis Anterior Hernia With Periosteal Turnover Flap(2017) Deveci, Mustafa; Cirakli, Alper; Uzun, Erdal; Oncel, Eyup SabriThe tibialis anterior muscle herniation was treated with the periosteal turnover flap technique, which has not been previously described in literature. The defect area covered with tibial periosteum by turning the raised flap over on itself at 180º after debridement of the defect edges. Four cases had a history of trauma and the herniation was in the mid-third of the tibia. The mean follow-up period was 84 months (range, 72-96 months) during which no complications or recurrence were observed. In this paper, the periosteal turnover flap technique is described for the first time in literature. The repair of tibialis anterior muscle herniation with periosteal turnover flap can be considered as a safe method.
