Yazar "Kaygusuz M.A." seçeneğine göre listele
Listeleniyor 1 - 4 / 4
Sayfa Başına Sonuç
Sıralama seçenekleri
Öğe Assessment of the vulnerability of the proximal tibiofibular joint to injury during osteotomies(2006) Esenkaya I.; Elmali N.; Kaygusuz M.A.; Misirlio?lu M.; Atasever A.OBJECTIVES: We evaluated the dimensions and anatomic localization of the proximal tibiofibular joint (PTFJ) in human cadaver and amputated knees. In addition, we assessed the relation between the osteotomy line and the PTFJ and its vulnerability to injury on radiographs of patients after proximal tibial medial open wedge osteotomy (PT-MOWO). METHODS: In the first phase, dimensions of the tibial part of the PTFJ lying between the lateral tibial condyle and the fibular head were measured by digital calipers in six human cadaver and six fresh amputed tibiae (4 females, 8 males; mean age 57 years) to evaluate the relation between the tibial surface of the PTFJ and the posterior part of the lateral tibial plateau. In the second phase, anteroposterior, lateral, and medial oblique radiographs were assessed with respect to the relation of the osteotomies with the PTFJ following PT-MOWO in 46 knees of 44 consecutive patients (38 females, 6 males; mean age 51 years). RESULTS: On cadaver and fresh amputation materials, the mean long and short axis dimensions of the ellipsoidal articular surface of the PTFJ in the posterolateral aspect of the tibial plateau measured 18.8 mm (range 13 mm to 20 mm) and 14.9 mm (13 mm-17 mm), respectively. The upper articular border lied at a mean of 6.3 mm (2 mm to 11 mm) distal to the posterior border of the articular surface of the lateral tibial plateau. Medial oblique radiographs showed that the osteotomy line extended to the PTFJ in cases in which it was proximally located, particularly in three cases (6.5%) where lateral cortex continuity was interrupted. CONCLUSION: The osteotomy line may encroach upon the PTFJ unless preoperative oblique radiographs are evaluated and a parallel course to the tibial slope of the lateral tibial plateau is followed. In addition, insufficient evaluation of PT-MOWO candidates may result in damage to the lateral cortex, which increases the risk for injury to the PTFJ.Öğe Comparison of the pull-out strengths of three different screws in pedicular screw revisions: a biomechanical study(2006) Esenkaya I.; Denizhan Y.; Kaygusuz M.A.; Yetmez M.; Keleştemur M.H.OBJECTIVES: We investigated the possible effects of three pedicular screws on axial pull-out strength in pedicular revision surgery. METHODS: Two study groups were formed from calf lumbar vertebrae. Initially, Alici pedicular screws with an outer diameter of 6.5 mm were applied (with or without tapping) to all the pedicles. All the pedicles were subjected to axial pull-out testing to induce pedicular insufficiency. Then, Alici pedicular screws with an outer diameter of 7 mm were applied to the left pedicles. The right pedicles in the two study groups were assigned to receive two different types of pedicular screws with an expandable (enlargeable) end, respectively. Axial pull-out testing was repeated in both groups and the results were compared with the initial pull-out strength values. RESULTS: In the first group, 65% and 64% of the initial pull-out strengths were obtained with 7-mm Alici pedicular screws and with expandable pedicular screws, for the left and right pedicles, respectively. The corresponding pull-out strengths in the other study group were 70% and 68.5% of the initial values, respectively. Tapping of the screw hole entrance resulted in a mean decrease of 13% in the pull-out strength compared to screw applications without tapping. CONCLUSION: Pedicular screw revisions using a 0.5 mm greater screw in diameter did not provide adequate screw-bone inter-face strength and pedicle filling. Similarly, expandable pedicular screws did not contribute to screw stability.Öğe The effect of continuous passive motion after repair of Achilles tendon ruptures: an experimental study in rabbits(2002) Ertem K.; Elmali N.; Kaygusuz M.A.; Inan M.; Ayan I.; Güner G.; Karakaplan M.OBJECTIVES: The effect of continuous early passive motion on morphologic and histologic healing following repair of Achilles tendon rupture was evaluated in comparison with cast immobilization. METHODS: Achilles tendons of 20 adult rabbits were repaired with the use of modified Kessler technique after surgical transection. Throughout the postoperative six weeks, the rabbits were randomly assigned to cast immobilization (n=10) and to continuous early passive motion four hours a day (n=10). All the rabbits were sacrificed at the end of six weeks and their tendon tissues were removed for macroscopic and histologic examinations. RESULTS: On macroscopic evaluation, findings on adhesions at the operation site, periarticular atrophy, and the ROM of the ankle joint were found significantly more favorable with continuous early passive motion than those of the control group (p<0.001, p<0.05, and p<0.001, respectively). On histologic evaluation, regular collagen bundle alignment was 70% and 20% in the study and control groups, respectively (p<0.05), whereas findings on hyalinization and inflammatory infiltration were not significantly different. CONCLUSION: The utilization of continuous controlled passive motion following repair of Achilles tendon rupture was shown to have beneficial effects on tendon healing and ankle range of movement, without leading to eventual ruptures.Öğe Our clinical experience in the treatment of snakebites(2005) Ertem K.; Esenkaya I.; Kaygusuz M.A.; Turan C.OBJECTIVES: We evaluated the results of medical and surgical treatment for venomous snakebites and reviewed current principles of first aid and therapy for affected patients. METHODS: Fourteen venomous snakebite victims (8 males, 6 females; mean age 22 years; range 7 to 75 years) were enrolled in the study. Six patients received medical treatment alone, while eight patients required both medical and surgical treatments. Injury was in the upper and lower extremities in nine and five patients, respectively. Fasciotomy was performed in seven patients due to ensuing compartment syndrome, which was manifest with extreme swelling in the affected extremity and severe pain on passive stretching of the muscles at the site of the lesion. Fasciotomy site was primarily closed in three patients, whereas four patients required debridement and skin grafting. One patient, who developed necrosis due to an excessively tight tourniquet at the time of first aid, underwent amputation of the third finger at the level of the middle phalanx. The mean follow-up was 11.5 months (range 3 to 30 months). RESULTS: Following fasciotomy, a long incision line remained in all the patients and a marked scar tissue due to skin grafting, which were associated with flexion contracture deformities in two elbows (35 and 105 degrees). Hemopericardium detected in one patient was dealt with by medical treatment. The mean length of hospital stay was 11.3 days for medically treated patients, and 18.2 days following surgical treatment. No incidence of late serum disease or mortality was encountered. CONCLUSION: Management of snakebite victims include an appropriate first aid and treatment at the hospital; identification of compartment syndrome through clinical means and measurements should lead to an indication for fasciotomy.
