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Öğe Axillary Artery Injury Following Inferior Dislocation of the Glenohumeral Joint(Derman Medical Publ, 2013) Korkmaz, Mehmet Fatih; Disli, Olcay Murat; Karakaplan, Mustafa; Akca, Baris; Erdem, Mehmet NuriIn this paper, we described a case of axillary artery injury following a primary traumatic inferior shoulder dislocation. It is aimed at raising the index of awareness for identifying this limb threatening injury based on its pathognomonic triad of findings during clinical examination, and to consolidate current thinking on its subsequent management and outcome. To our knowledge, this is the only report in the English literature describing vascular injury in primary traumatic inferior shoulder dislocation in a young man.Öğe Comparison of Lag Screw Versus Buttress Plate Fixation of Posterior Malleolar Fractures(Sage Publications Inc, 2014) Erdem, Mehmet Nuri; Erken, H. Yener; Burc, Halil; Saka, Gursel; Korkmaz, Mehmet Fatih; Aydogan, MehmetBackground: The goal of this study was to report the results of selective open reduction and internal fixation of fractures of the posterior malleolus with a posterolateral approach and to compare the results of the 2 techniques. Methods: We prospectively evaluated 40 patients who underwent posterior malleolar fracture fixation between 2008 and 2012. The patients were treated with a posterolateral approach. We assigned alternating patients to receive plate fixation and the next screw fixation, consecutively, based on the order in which they presented to our institution. Fixation of the posterior malleolus was made with lag screws in 20 patients and a buttress plate in 20 patients. We used American Orthopaedic Foot and Ankle Society (AOFAS) scores, range of motion (ROM) of the ankle, and radiographic evaluations as the main outcome measurements. The mean follow-up was 38.2 (range, 24-51) months. Results: Full union without any loss of reduction was obtained in 38 of the 40 patients. We detected a union with a step-off of 3 mm in 1 patient in the screw group and a step-off of 2 mm in 1 patient in the plate group. At the final follow-up, the mean AOFAS score of the patients regardless of fixation type was 94.1 (range, 85-100). The statistical results showed no significant difference between the patients regardless of the fixation type of the posterior malleolus in terms of AOFAS scores and ROM of the ankle (P > .05). Conclusions: Good (AOFAS score of 94/100) and equivalent (within 3 points) results were obtained using the 2 techniques (screws or plate) for fixation after open reduction of posterior malleolar fragments.Öğe Comparison of lateral deltoid splitting and deltopectoral approaches in the treatment of proximal humerus fractures(Turkish Assoc Trauma Emergency Surgery, 2015) Korkmaz, Mehmet Fatih; Erdem, Mehmet Nuri; Karakaplan, Mustafa; Gormeli, Gokay; Selcuk, Engin Burak; Maras, Zeynep; Karatas, TurgayBACKGROUND: Fractures of the proximal humerus that limit function are quite common. The objective of this retrospective study was to compare deltoid splitting and deltopectoral approaches by using the same fixation method. METHODS: Eighty-six patients who underwent surgical treatment between September 2005 and July 2011 were included into the study group. Deltoid splitting approach was used by exploring the axillary nerve on Group A patients as described by Codman, and deltopectoral approach was used on Group B patients. Group A consisted of a total of fifty-six patients of whom twenty-two were male and thirty-four were female patients, with a mean age of 62.5 years (range, 26 to 90 years). Group B consisted of a total of thirty patients of whom fourteen were male and sixteen were female patients, with a mean age of 54.8 years (range, 24 to 84 years). PHILOS plate system was utilized as an internal fixation tool in all patients. Functional results and complications of the two groups were compared using Constant scores. RESULTS: It was observed that humeral head and tubercular fragment reduction were better with lateral deltoid splitting approach, and Constant shoulder scores were higher in the early stages (66.8-57.4 consecutively; p0.05). DISCUSSION: Deltoid splitting approach, especially with AO/ASIF B and C type fractures, enables reduction and plate fixing under 270 degree control of the proximal humerus without forceful retraction and soft tissue damage, providing easy access to posterior tubercular fragment. Compared to deltopectoral approach, patients treated with deltoid splitting approach achieved higher Constant scores at an earlier stage. Lateral deltoid splitting approach, by exploring the axillary nerve, is a useful surgical technique which provides an expansive and multi-dimensional control without risking the deltoid muscle function and the axillary nerve.Öğe COMPREHENSIVE MANAGEMENT OF TRAUMATIC THORACOLUMBAR VERTEBRAL FRACTURE(2014) Korkmaz, Mehmet Fatih; Karatas, Mehmet; Sevimli, Reşit; Erdem, Mehmet NuriÖz: Vertebral omurganın orta bölümü çubuk ve plakaların oluşan üç boyutlu trabeküler ağından oluşur. Bu trabeküler yapı özellikle bel omurları içinde basınç dayanımının % 90'ı sağlar. Ayrıca, trabeküler ağ içindeki kemik iliği basınç dayanımı ve enerji emilimini artırır. Belkemiğinin anterior bileşenleri (silindirik vertebral gövde ve disk) sıkıştırıcı kuvvetlere karşı direnç sağlarken, posterior ligamantöz elemanlar gerilme kuvvetlerine karşı direnç sağlar. Anterior ve posterior elemanlar diyagonal ve rotasyonel kuvvetlere ve eğilme momentinede direnç sağlarÖğe Kord basısı oluşturan çok seviyeli vertebra hemanjiyomlarında cerrahi tedavinin etkinliği ve güvenirliğinin değerlendirilmesi(Journal of Turkish Spinal Surgery, 2014) Korkmaz, Mehmet Fatih; Saraç, Kaya; Karakaplan, Mustafa; Görmeli, Gökay; Erdem, Mehmet Nuri; Selçuk, Engin BurakÖz: Bu çalışmada farklı düzeylerde spinal kord basısı yapan birden fazla vertebra hemanjiomları olan 69 yaşındaki kadın sunuldu. T12 vertebra çökme kırığı nedeniyle posterior cerrahi uygulanmış ve asemptomatik geçen 5 yılın ardından 4 aydır bel ağrısı, alt ekstremitelerde ilerleyici güç kaybı ve yürüme güçlüğü, 4 haftadır idrar ve gaita inkontinansı mevcuttu. Torakal ve lomber Manyetik Rezonans Görüntülemede (MRG ) birden fazla torakal ve lomber vertebra hemanjiomları görüldü. T10 ve L4 de hemanjiom ekstraossöz uzantısı kord basısına neden oluyordu. Seçici embolizasyonlar preoperatif yapıldı ve nöromonitörizasyon eşliğinde kordun dekompresyonu anterior T10 korpektomi ile ve L4 PVCR (Posterior Vertebral Kolon Rezeksiyonu) ile 18 ay arayla sağlandı. Postoperatif radyoterapi uygulandı. Hastanın nörolojik durumu ameliyat sonrası hızla düzeldi ve nörolojik olarak sağlam ve bağımsız olarak yürüyebildi. Vertebra hemanjiyomları ciddi ilerleyici kord basısı nedeni olabilirler. Multidisipliner yaklaşımla tedavi prensipleri doğru uygulandığı takdirde cerrahi olarak güvenle tedavi edilebilirlerÖğe Outcomes of trochanteric femoral fractures treated with proximal femoral nail: an analysis of 100 consecutive cases(Dove Medical Press Ltd, 2014) Korkmaz, Mehmet Fatih; Erdem, Mehmet Nuri; Disli, Zeliha; Selcuk, Engin Burak; Karakaplan, Mustafa; Gogus, AbdullahPurpose: In this study, we aimed to report the results of a retrospective study carried out at our institute regarding cases of patients who had suffered proximal femoral fractures between January 2002 and February 2007, and who were treated with a proximal femoral nail. Materials and methods: One hundred consecutive cases were included in the study. A case documentation form was used to obtain intraoperative data including age, sex, mechanism of injury, type of fracture according to Association for Osteosynthesis/Association for the Study of Internal Fixation (AO/ASIF) classification and the American Society of Anesthesiologists' (ASA) physical status classification (ASA grade). Clinical and radiographic examinations were performed at the time of admission and at the 6th week; subsequent visits were organized on the 3rd month, 6th month, and 12th month, and in patients with longer - follow-up and annually postoperatively. The Harris score of hip function was used, and any change in the position of the implants and the progress of the fracture union, which was determined radiologically, was noted. Results: The mean age of the patients was 77.66 years (range: 37-98 years), and the sex distribution was 32 males and 68 females. Seventy-three fractures were reduced by closed means, whereas 27 needed limited open reduction. The mean follow-up time for the study group was 31.3 months (range: 12-75 months). Postoperative radiographs showed a near-anatomical fracture reduction in 78% of patients. The Harris hip score was negatively correlated with the ASA score and patient age. No cases of implant failure were observed. Three patients died before discharge (one due to pulmonary embolism, two due to cardiac arrest), and five patients died due to unrelated medical conditions within the first 3 months of the follow-up. Conclusion: Our study showed that proximal femoral nail is a reliable fixation with good fracture union, and it is not associated with major complications in any type of trochanteric femoral fracture.Öğe Proksimal humerus kırıklarının tedavisinde lateral deltoid split girişim ile deltopektoral girişimin karşılaştırılması(Ulusal Travma ve Acil Cerrahi Dergisi, 2015) Korkmaz, Mehmet Fatih; Erdem, Mehmet Nuri; Karakaplan, Mustafa; Görmeli, Gökay; Selçuk, Engin Burak; Maraş, Zeynep; Karataş, TurgayÖz: AMAÇ: Proksimal humerus kırıkları sık görülen ve fonksiyonel kısıtlanmaya neden olan kırıklardandır. Bu geriye dönük çalışmanın amacı aynı fiksasyon metodu kullanılarak deltopektoral ile deltoid split girişimin karşılaştırılmasıdır.GEREÇ VE YÖNTEM: Eylül 2005 ile Temmuz 2011 arasında bu iki girişim kullanılarak cerrahi tedavi edilen 86 hasta çalışmaya alındı. Grup A deltoid split girişim, Grup B deltopektoral girişim kullanılan hastalardan oluşturuldu. Grup A 22 erkek, 34 kadın toplam 56 hastanın yaş ortalaması 62.5 yıl (26-90 yıl), Grup B 14 erkek, 16 kadın, toplam 30 hastanın yaş ortalaması 54.8 yıl (24-84 yıl) idi. Tüm hastalarda internal fiksasyon aracı olarak PHİLOS plak vida sistemi kullanıldı. Her iki grubun fonksiyonel sonuçları ve komplikasyonları karşılaştırıldı.BULGULAR: Lateral deltoid split girişim kullanılan olgularda baş ve tüberküler fragman redüksiyonunun daha iyi olduğu ve Constant omuz skorunun erken dönemde daha yüksek olduğu saptandı (sırasıyla, 66.8-57.4; p<0.01). Aksiller sinir gözlenip askıya alındığı için bu sinire ait komplikasyon saptanmadı. Altıncı aydaki Constant skorları arasında anlamlı farklılık saptanmadı (sırasıyla, 92.2-91.3; p>0.05).SONUÇ: Deltoid split girişim, özellikle AO/ASİF B ve C tipi kırıklarda proksimal humerusun 270 derece kontrolüne, tüberküler parçalardan ve döndürücü manşet tendonlarından geçirilen dikişlerle redüksiyon ve plağa tespitine olanak sağlamaktadır. Deltopektoral girişime göre hastanın iyileşme sürecinde Constant skorları anlamlı olarak farklıdır. Aksiller siniri eksplore ederek yapılan lateral deltoid split girişim, deltoid kas fonksiyonlarını ve aksiller siniri tehlikeye atmadan geniş ve çok yönlü kırık kontrolü sağlayan faydalı bir cerrahi girişim tekniğidirÖğe The therapeutic efficacy of dexpanthenol on sciatic nerve injury in a rat model(Taylor & Francis Ltd, 2020) Korkmaz, Mehmet Fatih; Parlakpinar, Hakan; Erdem, Mehmet Nuri; Ceylan, Mehmet Fethi; Ediz, Levent; Samdanci, Emine; Kekilli, ErsoyObjective: The aim of this study was to evaluate histopathological, functional and bone densitometry examinations of the beneficial effects of dexpanthenol (DEX) on nerve regeneration in a rat model of peripheral nerve crush injury. Methods: Thirty adult Sprague-Dawley rats were divided equally into three groups. A crush injury was simulated in all rats by clamping the right sciatic nerve for one minute. In group 1, one day before the surgical procedure, 500 mg/kg DEX administered via intraperitoneally (ip) was initiated and continued three times in a week during the experiment period as 28 days. In group 2, rats received a dose of 10 mg/kg DEX to investigate possible effects of DEX alone. Group 3 served as the control (sciatic nerve injury) and was not given any drugs. Results: Performance was significantly lower in group 3 compared to the drug treatment groups during the rotarod test (30 rpm and 40 rpm) (p < 0.05). After a while, the rats which were able to remain on the rod was significantly lower in group 3 during the acceleration test (p < 0.05). Hot plate latency test results in group 3 were significantly lower when compared to the other groups (p < 0.05). Conclusion: DEX appears to be useful as a supportive clinical agent for the treatment of pain and nerve damage.Öğe Vertebral hydatid disease and its treatment by anterior-posterior radical excision, fusion and chemotherapy with albendazole. case report - eleven years follow - up result.(2013) Erdem, Mehmet Nuri; Sever, Cem; Korkmaz, Mehmet Fatih; Oltulu, İsmail; Gürgen, Erkan; Tezer, MehmetHidatit kist Echinococcus granülozusun larva formu ile oluşan bir zoonozdur. Bu çalışmada 11 yıl önce paravertebral apse ile birlikte vertebral hidatit kist nedeni ile ameliyat edilen olgu sunulmuştur. 32 yaşındaki kadın hastada T11-T12 ve L1 seviyelerinde yaygın paravertebral apse, L1 seviyesinde vertebral hidatit kiste bağlı patolojik kırık saptandı. Posterior enstrümantasyon ve füzyon, anterior L1 korpektomi ve füzyon uygulandı. Bir yıl sonraki kontrolde hastanın semptomları tamamen düzelmişti. Radyolojik tetkiklerde apse nüksü görülmedi. Oldukça nadir rastlanan vertebra kist hidatiği tanısı ve tedavisi zor bir enfestasyondur. Nüks ihtimali oldukça yüksektir. Omurganın stabilitesinin temin edilmesi ve füzyon kitlesinin elde edilmesi vertebral hidaditozun cerrahi tedavi kararında oldukça önemlidir.
