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Öğe A Comparison of Three Different Surgical Treatments in Late Stage Kienböck's Disease(Thieme Medical Publ Inc, 2026) Ozdemir, Ferdi; Ozdes, Huseyin Utku; Karakaplan, Mustafa; Ergen, Emre; Aslanturk, Okan; Cicek, Ipek Balikci; Ertem, KadirObjective Different treatment options exist for the late-stage Kienb & ouml;ck disease (KD). The functional outcomes of patients undergoing scaphocapitate fusion (SCF), tendon ball arthroplasty (TBA), and radius metaphyseal core decompression in stages 3 to 4 KD were investigated. Materials and Methods This is a retrospective study spanning similar to 11 years, conducted at our clinic, involving the operated patient KD. The study included 51 patients with an average follow-up duration of 68 months (range: 16-130 months). Patients who underwent SCF, TBA, and radius metaphyseal core decompression were divided into three groups based on the surgical approach. The range of motion of the wrist joint and grip strength of the operated wrists were assessed alongside the unaffected wrist during follow-up evaluations. Satisfaction levels among patients were measured by comparing groups internally and based on disease stages. Functional outcomes were evaluated using quick disabilities of the arm, shoulder, and hand (Q-DASH) and Mayo wrist scoring scales. Results Of the patients, 28 were female (54.9%) and 23 were male (45.1%). The mean age was 34 years (range: 19-62 years). There were 12 patients (23.53%) in the radial decompression group, 10 patients (19.61%) in the SCF group, and 29 patients (56.86%) in the TBA group. When the wrist joint Range of motion (ROM)s are analyzed, the losses in both stages 3A and 3B disease are significant compared with the intact wrist in all three surgical methods. When the groups were compared, a higher loss of wrist joint ROM was observed in the TBA group, especially in Kienb & ouml;ck stage 3B patients ( p < 0.001). Furthermore, there were no differences between patient scores in stage 3A when assessments were made using Q-DASH and Mayo scores ( p = 0.156 for Q-DASH and p = 0.060 for Mayo). In stage 3B, Mayo's results were similar, while the radial decompression group was reported to be more favorable in terms of Q-DASH scores ( p = 0.035). Conclusion KD is surgically treated with various operations identified. In terms of functional outcomes, all three surgeries are considered satisfactory. However, in young and active patients, even in advanced stages of the disease, metaphyseal core decompression should be attempted as an initial treatment due to its easier approach and the avoidance of direct manipulation of the carpus.Öğe A rare mass with atypical localization: Heterotopic ossification associated with flexor hallucis longus(Turkish Joint Diseases Foundation, 2024) Koroglu, Muhammed; Karakaplan, Mustafa; Ozdes, Huseyin Utku; Ozdemir, Zeynep MarasHeterotopic ossification (HO), characterized by the formation of ectopic bone, is a benign mass observed in soft tissues. Depending on its location, it can cause symptoms beyond compression, such as mechanical blockage when associated with joints, leading to limitations in joint movements. In the majority of cases, involvement of the hip and elbow joints is common, while HO can sometimes be observed in atypical locations. Trauma, head injury, and spinal cord injuries are well-recognized risk factors for HO development. However, on rare occasions, in non-traumatic cases are identified without any known risk factors. Herein, we present a rare non-traumatic HO case associated with the flexor hallucis longus (FHL) tendon in a 58-year-old female patient. She complained of pain under the first toe of her right foot while wearing shoes for a year, and a mass was detected on the plantar surface of the foot along with limitation of movement in the first metatarsophalangeal joint. Further examinations revealed that the identified mass was a mature HO lesion. Surgical treatment was performed, and during one-year follow-up, the pain subsided, and joint movements returned to normal, resulting in a satisfactory outcome. In conclusion, although many cases of HO are associated with traumatic injuries, it can sometimes be idiopathic, as in our case, and rarely it is accompanied tendon such as FHL in the foot.Öğe Acute patellar dislocation with multiple ligament injuries after knee dislocation and single session reconstruction(Pakistan Medical Assoc, 2016) Gormeli, Gokay; Gormeli, Cemile Ayse; Karakaplan, Mustafa; Gurbuz, Sukru; Ozdemir, Zeynep; Ozer, MustafaKnee dislocation is a relatively rare condition of all orthopaedic injuries. Accompanying multiple ligament injuries are common after knee dislocations. A 41-year-old male presented to the emergency department suffering from right knee dislocation in June 2013. The patient had anterior cruciate ligament, medial collateral ligament (MCL), medial patellofemoral ligament (MPFL) rupture, and lateral meniscal tear. A single-bundle anatomic reconstruction, medial collateral ligament reconstruction, medial patellofemoral ligament reconstruction and meniscus repair were performed in single session. At twelve months follow-up; there was 160 degrees flexion and 10 degrees extension knee range of motion. Lysholm knee score was 90. Extensive forces can cause both MCL and MPFL injury due to overload and the anatomical relationship between these two structures. Therefore, patients with valgus instability should be evaluated for both MPFL and MCL tears to facilitate successful treatment.Öğe Adsorbtif sıyırma voltametrisi ve diferansiyel puls polarografisi ile molibdenin çevre örneklerinde tayini(İnönü Üniversitesi, 1992) Karakaplan, Mustafa[Abtsract Not Available]Öğe Analysis of posttraumatic embitterment disorders by machine learning: Could sullenness be a predictor of posttraumatic embitterment disorder?(Kare Publ, 2022) Kilic, Bahar; Karakaplan, Mustafa; Unal, SuheylaObjective: This study aimed to determine some fundamental factors specific to posttraumatic embitterment disorder (PTED) using deep machine learning (ML) and network analysis techniques. Method: Sociodemographic data form, Buss-Perry Aggression Questionnaire, Brief Symptom Inventory (BSI), PTED Self-Rating Scale (PTED Scale), and list of stressful life events were administered to 557 people who applied to the outpatient anxiety clinic. ML method and network analysis were applied with the 33 most significant variables. Results: PIED was found in urban areas (p=0.006), individual health problems (p=0.029), early separation from their families (p=0.040), previous trauma (p=0.021), describing childhood sexual abuse (p<0.001), and those with the illness for more than 10 years (p<0.001) were detected at a higher rate than those without. The PIED score was higher in those with an anxiety disorder (p=0.043) and a personality disorder (p<0.001). Almost all life stressors were higher in the PIED group. There was a statistically significant difference between the groups in all subscales of the BSI. When the ML procedure was applied, sullenness was identified as the main symptom of PIED. The factors most associated with sullenness were well-being, hopelessness, and painful event experience. Conclusion: The higher rate of chronic trauma in the group with PTED and the detection of sullenness as the main symptom have been important data for understanding the psychopathological process.Öğe Arthroscopic limited intercarpal fusion without bone graft in patients with Kienbock's disease(Turkish Joint Diseases Foundation, 2016) Ertem, Kadir; Gormeli, Gokay; Karakaplan, Mustafa; Aslanturk, Okan; Karakoc, YunusObjectives: This study aims to present our clinical results obtained in arthroscopic limited intercarpal fusion performed without using bone graft in patients with Kienbock's disease. Patients and methods: The study included 11 patients with Kienbock's disease (6 males, 5 females; mean age 28.9 years; range 14 to 51 years) who were performed arthroscopic lunate excision and scaphocapitate fusion between November 2012 and December 2013. Bain and Begg Arthroscopic Classification was used for the staging of Kienbock's disease. Quick Disabilities of Arm, Shoulder and Hand and Mayo Wrist scorings were used for clinical evaluation. Results: Intercarpal fusion was achieved in approximately 7.2 weeks. There was a statistically significant difference in Mayo Wrist scores of postoperative third and sixth months and pre- and postoperative Quick Disabilities of Arm, Shoulder and Hand scores. There was no postoperative complication. Conclusion: According to our study findings, arthroscopic limited intercarpal fusion without using bone graft may be performed in patients with Kienbock's disease. Satisfactory clinical and functional results were obtained as a result of treatment with this method in stage 3 and 4 Kienbock's disease.Öğe Arthroscopic limited intercarpal fusion without bone graft in patients with Kienböck’s disease(2016) Ertem, Kadir; Görmeli, Gökay; Karakaplan, Mustafa; Aslantürk, Okan; Karakoç, YunusAmaç: Bu çalışmada Kienböck hastalığı olan hastalarda kemik grefti kullanmadan uygulanan artroskopik kısmi interkarpal füzyonda elde edilen klinik sonuçlarımız sunuldu.Hastalar ve yöntemler: Kienböck hastalığı olan ve Kasım 2012-Aralık 2013 tarihleri arasında artroskopik lunat eksizyonu ve skafokapitat füzyon uygulanan 11 hasta (6 erkek, 5 kadın; ort. yaş 28.9 yıl; dağılım 14-51 yıl) çalışmaya dahil edildi. Kienböck hastalığının evrelendirilmesinde Bain ve Begg Artroskopik Sınıflaması kullanıldı. Klinik değerlendirme için Hızlı Kol Omuz El Disabiliteleri ve Mayo El Bilek puanlamaları kullanıldı.Bulgular: İnterkarpal füzyon yaklaşık 7.2 haftada sağlandı. Hastaların ameliyat sonrası üçüncü ve altıncı ay Mayo El Bilek puanları arasında ve ameliyat öncesi ve sonrası Hızlı Kol Omuz El Disabiliteleri puanları arasında istatistiksel olarak anlamlı farklılık vardı. Ameliyat sonrası komplikasyon yoktu.Sonuç: Çalışma bulgularımıza göre, Kienböck hastalığı olan hastalarda artroskopik kısmi interkarpal füzyon kemik grefti kullanmaksızın gerçekleştirilebilmektedir. Evre 3 ve 4 Kienböck hastalarında bu yöntemle tedavi sonucunda tatmin edici klinik ve fonksiyonel sonuçlar elde edildiÖğe Aşil tendon rüptürlerinin onarımı sonrası devamlı pasif hareketinin etkisi(İnönü Üniversitesi Tıp Fakültesi Dergisi, 2001) Ertem, Kadir; Elmalı, Nurzat; İnan, Muharrem; Harma, Ahmet; Ayan, İrfan; Karakaplan, MustafaÖz: Bu kesitsel çabşma, Malatya kent merkezinde yaşayan kişilerin yıllık ortalama hekime başvuru sayısı ve bunu etkileyen gönenler ile son bir yılda yatarak tedavi görenlerin hastanelerden memnuniyetlerini belirlemek amacıyla yapılmıştır. Malatya'da mahallelerin sosyoekonomik düzeyine göre tabakalı örnekleme yöntemiyle saptanan adreslerde 1962 kişiye Ekim-Kasım 1998'de yüzyüze görüşme yöntemiyle anket uygulanmıştır. Kişi başına yılda ortalama hekime başvuru sayısı üçtür. Hekime başvuruyu etkileyen en önemli etken, kronik hastalık varlığıdır. Son 15 gün içinde hekime başvuranların sadece %3'ü Malatya dışındaki hekimlere başvurmuştur. Başvurulan kurumlar içinde Malatya SSK Hastanesi %33.2 ile en çok başvurulan kurumdur; bunu %20.3 ile özel hekimler ve %16.5 ile Malatya Devlet Hastanesi izlemektedir. Hekime muayene olabilmek için bekleme süresi 52 dakika (ortanca)dır ve başvuranların yarısı bu süreyi uzun bulmaktadır. Muayene süresi ise beş dakika (ortanca) olup, başvuranların %43'ü bu süreyi yetersiz bulmaktadır. Araştırmaya katılanların %4.4'ü son bir yıl içinde hastaneye yatırılmışlardır. Bunların %15'i Malatya'nın dışındaki şehirlerde yatırılmışlardır. Hastanelerden en çok şikayet edilen konular; hastalardan hastane dışından ilaç-malzeme getirmelerinin istenmesi, ücretlerin yüksekliği, yemekler ve temizliktir. Sağlık hizmetlerinin kullanımının artırılması için sağlık kuruluşlarının daha iyi organize olmaları ve hastaların memnuniyetine daha çok önem verilmesi önerilebilir. Başlık (İngilizce): The effect of continuous passive motion after repair of achilles tendon ruptures Öz (İngilizce): This cross-sectional study was performed to determine the annual average physician contacts number of people living in central Malatya with influencing factors and also to determine the patients' satisfaction who were hospitalized during last year. Stratified cluster sampling was used according to the socioeconomic status of the localities and 1962 individuals were administered a face to face questionnaire during October-November 1998. Annual average physician contact number was three. The main influencing factor related to contact with physician is the presence of a chronic disease. Within the last 15 days, only three percent of applicants had contacted with the physicians who work outside Malatya. The most applied health institution was SSK Hospital (33.2 %) followed by private physicians (20.3 %) and Malatya State Hospital (16.5%). Median waiting time to see the physician was 52 minutes and 50.0% of the applicants thought that this duration is too long. Median examination time was five minutes and 43.0% of applicants believe that examination time was not sufficient. 4.4% of the participitants were hospitalized during last year. 15.0% of the hospitalized patients were hospitilized in cities outside Malatya. Main complaints against hospitals are, patients' being asked to bring drug and other supply outside hospital, and high costs, meals and cleanliness. To increase the utilization of health services, a better organization of health institutions and taking patient satisfaction into consideration could be suggested.Öğe An attempt to understand the observed plateau of the magnetization in tetranuclear iron(II) complexes of thiacalixarene macrocycles(Indian Acad Sciences, 2010) Bayri, Ali; Bakir, H. Gokhan; Sulu, Mustafa; Karakaplan, MustafaThe next-nearest-neighbour (NNN) effect in tetranuclear iron(II) complexes of thiacalixarene macrocycles using the isotropic Heisenberg model has been investigated in order to understand its effects on the observed plateau of magnetization. Although NNN effect is generally very weak in these kinds of systems, it was calculated that its response is quite significant to the external perturbations in certain temperature regions. Using the isotropic Heisenberg exchange Hamiltonian, zero-field energy spectra have been calculated for this particular tetranuclear system. The average magnetic moments with and without next-nearest-neighbour interactions were also calculated. In order to verify the calculations, the results were compared with experimental data taken from the literature, whence, it is suggested that observed magnetic behaviour can be improved by taking into account the NNN effect.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 Bilateral Achilles Tendon Xanthomas in a Patient with Cerebrotendinous Xanthomatosis A Case Report(Amer Podiatric Med Assoc, 2017) Karakaplan, Mustafa; Ergen, Emre; Gormeli, Gokay; Korkmaz, Mehmet Fatih; Elmali, NurzatCerebrotendinous xanthomatosis is a rare, autosomal recessive, lipid storage disease with accumulation of cholestanol in most tissues, particularly in the Achilles tendons. We described a 23-year-old female patient who had progressive painfull swelling of both Achilles tendons due to cerebrotendinous xanthomatosis. We performed surgery on both-side Achilles tendon tumors. Wide degenerative areas of the tendons were resected, and the flexor hallucis longus tendon was harvested and transferred to reconstruct motion function.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 Cerebrotendinous Xanthomatosis patients with late diagnosed in single orthopedic clinic: two novel variants in the CYP27A1 gene(Bmc, 2024) Koroglu, Muhammed; Karakaplan, Mustafa; Gunduz, Enes; Kesriklioglu, Betul; Ergen, Emre; Aslanturk, Okan; Ozdemir, Zeynep MarasBackground Cerebrotendinous Xanthomatosis (CTX) is a rare autosomal recessive lipid storage disorder caused by loss of function variants in the CYP27A1 gene which encodes sterol 27-hydroxylase, on chromosome 2q35. Although the symptoms begin commonly in infancy, CTX diagnosis is often delayed. The aim of this study is to review the orthopedic findings of the disease by providing an overview of the clinical features of the disease. It is to raise awareness of this condition for which early diagnosis and treatment are important. Methods We retrospectively evaluated the clinical, laboratory, radiological, and genetic findings of eight patients from four families who were admitted to our Orthopedics and Traumatology Department between 2017 and 2022 due to bilateral Achilles tendon xanthomas, were found to have high cholestanol and CYP27A1 gene mutations. Results The mean age of patients was 37, and five of them were male. The mean age at the onset of symptoms was 9.25 years. The mean age of initial diagnosis was 33.75 years. Between symptom onset and clinical diagnosis, an average delay of 24.5 years was observed. All patients had bilateral Achilles tendon xanthoma. Notably, a novel variant (c.670_671delAA) in CYP27A1 gene was identified in three patients who also presented with peripheral neuropathy and bilateral pes cavus. One patient had osteoporosis and four patients had osteopenia. Five patients had a history of bilateral cataracts. Furthermore, three of the patients had early-onset chronic diarrhea and three of the patients had ataxia. Two of the patients had epilepsy and seven of the patients had behavior-personality disorder. All patients had low intelligence, but none of them had cardiac disease. Conclusion We present the diagnostic process and clinical features which the largest CTX case series ever reported from single orthopedic clinic. We suggest that patients with normal cholesterol levels presenting with xanthoma being genetically analyzed by testing at their serum cholestanol level, and that all siblings of patients diagnosed with CTX be examined.Öğe Chainsaw-Related Extremity Injuries(Mdpi, 2025) Ozdes, Hueseyin Utku; Ergen, Emre; Koroglu, Muhammed; Karakaplan, Mustafa; Acet, Omer; Al, Firat; Coban, IdrisBackground: Chainsaw-related injuries vary from skin lacerations to amputation and may cause serious loss of work time in addition to temporary or permanent disability. Most studies in the literature have reported injuries to the lower or upper extremities separately. The aim of our study is to compare the loss of work time between upper- and lower-extremity chainsaw-related non-occupational injuries in rural areas. Methods: Chainsaw-related injuries that occurred in rural areas and were treated in our center between 2012 and 2022 were retrospectively reviewed. The patients' demographics, the injured side and structures, the hand dominance of operators, lengths of hospital stays, the numbers of operations, complications, and loss of work time were recorded. Results: In total, 185 patients (181 males and four females) were enrolled in this study. The mean age was 45.5 years (range: 17-81). The mean follow-up time was 9.3 months (range: 6-24). The lower extremities were affected in 109 patients, while the upper extremities were affected in 76. The loss of work time was 60 and 75 days for lower- and upper-extremity injuries, respectively, and was statistically significantly higher for upper-extremity injuries (p < 0.001). The fracture rate was higher in the upper than the lower extremities, at 50% and 26.6%, respectively. Conclusions: Chainsaws may cause severe injuries in both the upper and lower extremities, and while the lower extremities were affected more frequently, upper-extremity injuries caused a greater loss of work time. Through the use of protective gear and simple precautions, chainsaw-related injuries and the associated loss of work time can be prevented.Öğe Classification of some chemical drugs by genetic algorithm and deep neural network hybrid method(Wiley, 2021) Karakaplan, Mustafa; Avcu, Fatih MehmetDeep neural networks (DNN) and genetic algorithm (GA) are gaining importance quickly with many successful applications in the field of science and technology. They are indispensable tool for the numerical solution of difficult problems. It is possible to optimize DNNs using the GA and this combination can be used to classify data. In this article, some drugs are classified by Monte Carlo sampling with combination of GA and DNN due to stochastic nature of the domain, exponential number of variables and small number of chemical species. In addition to the values obtained from the databases of selected drugs, molecular dynamic and ab initio molecular mechanical calculation results were also used. The aim of this study is to generalize the molecular classification with the data obtained from chemical databases as well as molecular docking results by using the combination of deep learning and GA and its usability in drug design. The selected drugs are some agonist and antagonist drugs that bind to dopamine receptors, which are widely studied and well known in the literature. To train the DNN, input datasets were chosen by the GA framework written in pure Python named PyEvolve. Classification of drugs has been analyzed with the focus on orbital energies and docking results. It is possible to use this algorithm in many in silico calculations such as affinity and separation processes. The reliability of the algorithm was tested with the results given in the literature and the expected values were estimated at 93.8%.Öğe Clinical Effects of Platelet-Rich Plasma and Hyaluronic Acid as an Additional Therapy for Talar Osteochondral Lesions Treated with Microfracture Surgery: A Prospective Randomized Clinical Trial(Sage Publications Inc, 2015) Gormeli, Gokay; Karakaplan, Mustafa; Gormeli, Cemile Ayse; Sarikaya, Baran; Elmali, Nurzat; Ersoy, YukselBackground: Osteochondral ankle injuries commonly affect the dome of the talus, and these injuries are a common cause of athletic disability. Various treatment options are available for these injuries including intra-articular hyaluronic acid (HA) and platelet-rich plasma (PRP) injections. The purpose of this study was to compare the effects of HA and PRP as adjunct therapies after arthroscopic microfracture in osteochondral lesions (OCLs) of the talus. Methods: In this prospective, randomized blinded study, 40 patients with talar OCLs in their ankle joints were treated with arthroscopic debridement and a microfracture technique. Thirteen randomly selected patients received PRP, 14 patients received HA, and the remaining 13 patients received saline as a control group. The participants were assessed using the American Orthopaedic Foot & Ankle Society (AOFAS) and visual analog pain scale (VAS) scores after a 15.3-month (range, 11-25 months) follow-up. Results: Postoperatively, all the groups exhibited significantly increased AOFAS scores and decreased VAS scores compared with their preoperative results (P < .005). The AOFAS scores were significantly increased in the PRP group versus the HA and control groups (P < .005), although the increased AOFAS scores in the HA group versus the control group were also significant (P < .005). Similar to the AOFAS scores, the decrease in the VAS scores was significantly lower in the PRP group versus the HA and control groups (P < .005). In addition, the HA group had significantly lower VAS scores than the control group (P < .005). Conclusion: Both PRP and HA injections improved the clinical outcomes of patients who underwent operation for talar OCLs in the midterm period and can be used as adjunct therapies for these patients. Because a single dose of PRP provided better results, we recommend PRP as the primary adjunct treatment option in the talar OCL postoperative period. Level of Evidence: Level I, prospective randomized study.Öğe Clinical Results of Minor Upper Extremity Replantation and Revascularisation Patients in Comparison to the Literature: A Clinical Study(Turgut Özal Tıp Merkezi Dergisi, 2015) Doğan, Seyfullah; Ertem, Kadir; Karakaplan, Mustafa; Sevimli, Reşit; Arı, Bünyamin; Yılmaz, ÖzgürÖz: Amaç: Üst ekstremite minör replantasyon ve revaskülarizasyon uygulanan hastaların klinik sonuçlarının değerlendirilip literatür ile karşılaştırılması amaçlandı. Gereç ve Yöntem: Kliniğimizde 2008-2011 tarihleri arasında üst ekstremitelerin\'de travma sonucu total veya subtotal amputasyon oluşan 30 hastanın 35 parmağı ameliyat edildi. Total ampute 15 hastanın 15 parmağına replantasyon, ve subtotal ampute 15 hastanın 20 parmağına revaskülarizasyon yapıldı. Tedavi edilen tüm hastaların erken dönem sonuçları ile ortalama 17 ay (6 ay - 3.5 yıl) izlenen 28 hastanın 30 parmağı retrospektif olarak incelendi. Bulgular: Erken dönem sonuçlar incelendiğinde, yaşama oranları; replantasyon yapılan parmaklarda %93,3, revaskülarizasyon yapılan parmaklarda %80 olarak saptandı. Zon iki seviyesindeki yaralanmalarda yaşama oranı %66,6 iken zon 3 seviyesindeki yaralanmalarda %92,3 idi. Giyotin tipi yaralanmalarda ise %100 yaşama oranı mevcut iken, ezilme- avülsiyon tipi yaralanmalarda %68,8 olarak bulundu. Yaralanma şekillerine göre fonksiyonel sonuçlar Chen kriterlerine göre değerlendirildiğinde, giyotin tipi kesi ile yaralanan olguların %89.9\'unda çok iyiiyi, ezilme ve avulsiyon tipi kesi ile yaralanan olguların %33,3\'ünde çok iyi-iyi, %44.4\'ünde orta sonuç bulundu. Yapılan istatiksel değerlendirmede giyotin tipi kesilerle yaralanan olguların tedavi sonrası distal parçalarda yaşama oranları ve fonksiyonel sonuçlarının ezilme ve avulsiyon tipi yaralanmalara göre anlamlı olarak daha iyi olduğu bulundu. Sonuç: Minör replantasyon ve revaskülarizasyon uygulamaları teknik olarak zor ve donanımlı ekip gerektirmektedir. Replantasyon sonuçlarımız literatürle uyumlu olup daha geniş serili çalışmaların gerektiği kaçınılmazdırÖğe Clinical results of surgical neurectomy of Morton’s neuroma(2024) Koroglu, Muhammed; Karakaplan, Mustafa; Turkmen, Ersen; Ozdes, Huseyin Utku; Acet, Omer; Ergen, Emre; Aslanturk, OkanAim: Morton’s neuroma (MN), specifically with its forefoot placement, sometimes significantly impacting patients’ quality of life. The aim of this study is to present the outcomes of neurectomy surgeries performed for MN disease. Investigating the impact of this surgery, which has a complication such as hypoesthesia, on postoperative patient satisfaction, is the targeted objective. Materials and Methods: Seventeen masses of 16 patients were studied. In patients diagnosed with MN mass through physical examination and imaging techniques, a 3 cm incision was made to excise the nerve mass either dorsally or plantar under spinal anesthesia. During routine outpatient follow-ups, the American Orthopedic Foot and Ankle Society (AOFAS) score, Visual Analog Scale (VAS) score, and Coughlin’s criteria were assessed both preoperatively and postoperatively. The effects of conservative treatments such as preoperative orthoses and steroid injections on pain scores were recorded and evaluated. Recurrence of mass development and wound issues were investigated to evaluate the outcomes. Results: The mean age at the time of surgery was 46.75 years (26-58 years). The mean follow-up period was 23.12 (6-75 weeks) weeks. After surgery, excellent results were achieved in 9 patients (64.3%), and good results were obtained in 4 patients (28.6%). Recurrent mass development occurred in two patients (12.5%). Two patients (12.5%) were operated on with a plantar approach, and one patient with recurrent massbelonged to this group. Hypoesthesia was described in 15 out of 16 patients. There were significant improvements between patients’ preoperative VAS and AOFAS scores and postoperative VAS and AOFAS scores, which were statistically significant (p <0.001). Conclusion: Numerous studies have been conducted on the diagnosis and treatment of MN disease, yet a common procedure has not been developed. Among existing treatments, excision of the mass with some healthy nerve tissue and a dorsal approach to the foot are commonly employed methods. Dorsal neurectomy surgeries demonstrate a success rate exceeding 80%. Informing patients about the possibility hypoesthesia before surgery and establishing realistic expectations can make this procedure safely applicable.Öğe A Clue Finding for to Detect the Localization of Pellet in Elbow Arthroscopy(2015) Ertem, Kadir; Görmeli, Gökay; Karakaplan, Mustafa; Aslantürk, Okan; Yılmaz, Özgür; Karakoç, YunusAbstract: In this case report, we aimed to share our experience of arthroscopic finding of chondral lesion can be helpful to detect the location of pellet that between brachial muscle and capsule in a 15 years male subject with left elbow gunshot injuryÖğe A Comparison of Dual-Energy CT with MRI in the Detection of Traumatic Bone Marrow Edema in Distal Extremity Bones(Erciyes Univ Sch Medicine, 2023) Kaya, Ahmet Turan; Ozdemir, Zeynep Maras; Erbay, Mehmet Fatih; Kahraman, Aysgul Sagir; Karaca, Leyla; Karakaplan, Mustafa; Gurbuz, SukruObjective: Our objective was to evaluate the performance of dual-energy computed tomography (DECT) in detecting post-traumatic bone marrow edema (BME) in distal extremities.Materials and Methods: We prospectively studied 31 consecutive patients (25 males) who presented within the first four weeks following distal extremity traumas (wrist, n=19; ankle, n=14) (protocol number: 2017/74). All patients underwent DECT and magnetic resonance imaging (MRI) within three days of presentation. Two independent radiologists analyzed DECT images for fractures and BME qualitatively. Computed tomography (CT) numbers on Virtual non-calcium (VNCa) images were obtained in both edematous and non-edematous areas for quantitative consensus assessment. We used MRI as a reference standard. Results: MRI identified BME in 56/71 bones (78.9%). The rates of BME detection on CT compared to MRI at the patient level were found to be statistically significantly lower, ex-cept for individuals over 40 years of age, women, those with 7-30 days between trauma and admission, and those with CT-detected fractures (p<0.05). The rates of BME detection on CT at the bone level, compared to MRI, were found to be statistically significantly lower (p<0.01), except for women and those with fractures detected on CT. The interobserver agreement for the qualitative analysis of BME was fair (kappa=0.407 and p<0.001). DECT's diagnostic accuracy rates in predicting BME were significantly higher in patients with fractures (p=0.028). CT numbers in edematous areas were significantly higher than in non-edematous areas (p<0.001).Conclusion: DECT may serve as an alternative for detecting post-traumatic BME in distal extremity bones. However, in our heterogeneous bone sample group, it exhibited low sensitivity and a low negative predictive value.
