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    Mid-term Results of Two-Stage Tendon Reconstruction of Zone II Flexor Tendon Injuries
    (Wolters Kluwer Medknow Publications, 2021) Karakaplan, M.; Kilinc, O.; Ceylan, M. F.; Ertem, K.; Aslanturk, O.
    Background: Secondary repair of flexor tendon injuries remains a challenging procedure for hand surgeons. Usually, secondary reconstruction should be performed by a staged approach. Two-stage surgical reconstruction of the flexor tendons by the Hunter technique is the salvage option in case of a severely damaged fibro-osseous canal or neglected flexor tendon injury. Aims: We report the results of staged flexor tendon reconstruction in 10 patients (10 fingers) with neglected or failed primary repair of flexor tendon injuries in zone II. Materials and Methods: Between 2012-2016, patients who underwent two-stage tendon reconstruction due to flexor digitorum profundus (FDP) sectioning or tearing in zone II with destruction of flexor pulleys and extensive scarring in the flexor tendon bed were included in the study. Results: Ten patients included to study with a mean follow-up of 34 months (range 12-70 months) and the results were assessed by clinical examination and questionnaire. According to the Strickland score, one (20%) of the results were excellent, five (50%) were good, two (20%) were fair and two (20%) were poor. After the second stage, good to excellent results were achieved in 60% of patients, one patient needed graft tenolysis. These results were similar to the subjective scores given by the patients, four of whom complained of functional problems in daily life at follow-up. There was no complication after the first stage. But after the second stage, there was one bowstringing and one adhesion that require tenolysis. Conclusions: Hunter technique is still the reference procedure for the reconstruction of flexor tendons. The results of our study showed that two-stage tendon reconstruction which is applied in patients with tendon sheath disruption as a result of acute or delayed tendon injuries which are not possible for primary repair is reliable and satisfactory.
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    What are the Factors that Impact the Outcomes of Arthroscopic Rotator Cuff Repair?
    (Wolters Kluwer Medknow Publications, 2024) Kilinc, O.; Ertem, K.; Ergen, E.; Aslanturk, O.
    Background:The cuff is a complex structure with many factors affecting it. How much it is affected after repair is still being investigated. Aim:The aim of this study was to analyze the functional results of individuals who received arthroscopic rotator cuff repair and assess the various factors that could impact these outcomes. Methods:The study included 57 patients with a mean age of 58.8 years (range: 39-71) who underwent arthroscopic rotator cuff repair between 2013 and 2020, with a minimum of 6 months after the operation. Functional and clinical outcomes of the patients were evaluated using preoperative and postoperative scores (QDASH, ASES, and VAS). The study also analyzed how demographic factors, type and duration of the tear, comorbidities such as diabetes mellitus (DM) and hypertension (HT), and other pathologies may have affected the patients' scores. Results:The effect of the operation on the scores in rotator cuff tears was highly significant (P < 0.05). Age, gender, tear size, fatty degeneration, anchor configuration, comorbidities, and additional procedures presented variable values on postoperative scores, but were not statistically significant. The effect of DM and HT on VAS scores was statistically significant (P < 0.05). Conclusion:The results of rotator cuff repair appear to be influenced by several factors, including the sex of the patient, type and duration of tear, comorbidities, and surgical procedures used. Although these factors had an effect on the scores, they were not statistically significant.