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Öğe Attritional rupture of the extensor pollicis longus tendon due to calcified extensor carpi radialistendon group: a case report(Turkısh joınt dıseases foundatıon, bugday sokak 6-27, kavaklıdere, ankara 06700, turkey, 2017) Ertem, Kadir; Ozdemir, Zeynep Maras; Gormeli, Gokay; Koroglu, MuhammedIn this article, we report a case with spontaneous rupture of extensor pollicis longus tendon due to calcified extensor carpi radialis tendon group, which has not been published in the literature previously. Successful thumb extension was achieved in a 68-year-old male patient with the transfer of the extensor indicis proprius tendon at two months postoperatively. It appears that calcified extensor carpi radialis tendon group constitutes high risk for a possible attritional rupture of the extensor pollicis longus tendon.Öğe Bilateral thigh abscess due to rectal fistula: A rare case report with silent clinical presentation(2023) Koroglu, Muhammed; Dalda, Yasin; Ozdes, Huseyin Utku; Ozdemir, Zeynep Maras; Aslanturk, OkanA 53-year-old male patient who underwent a rectal cancer operation nine years ago was evaluated with complaints of pain and swelling in the lateral thigh. Radiological imaging revealed abscess foci in the right thigh muscles. Surgical drainage and debridement were performed but developed recurrence. Contrast-enhanced abdominal tomography was performed due to a positive medical history and it was seen that an enterocutaneous fistula was formed from the anastomosis site of previous cancer surgery to both sides of the thigh. Bilateral thigh abscesses were drained and radical debridement was performed in the same session with surgery for the fistula. Pathological examination of the surgical specimens showed no evidence of cancer and the patient was discharged on the 14th postoperative day with complete resolution of the infection. Hip abscesses are rare, delays in the diagnosis and treatment of the underlying cause in cases of abscess secondary to abdominal or pelvic pathologies lead to an increase in mortality. Therefore, it should be kept in mind that thigh abscesses may be another side of the coin besides being seen as an isolated infection.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 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 Extensor carpi radialis longus tendon ball interposition arthroplasty for treatment of late-stage Kienbock's disease: Short-term results of a novel technique(Sage Publications Ltd, 2018) Aslanturk, Okan; Ertem, Kadir; Ergen, Emre; Koroglu, MuhammedPurpose:The aim of this study was to evaluate short-term clinical and radiological results of extensor carpi radialis longus (ECRL) tendon ball arthroplasty for treatment of late-stage Kienbock's disease. Methods: We retrospectively reviewed data of 19 patients suffering from Kienbock's treated with ECRL tendon ball arthroplasty between December 2014 and December 2016. Patients' clinical functions were assessed using grip strength, range of motion (ROM) of the wrist, QuickDASH, Mayo wrist score, and visual analog scale score. Radiological examination was performed to assess carpal height ratio and progression of arthritis. Results: The median follow-up was 30 months (range, 12-36 months). At final follow-up, ROM of operated wrist was 71% of the nonoperated side. Thirteen (86.6%) patients were pain free. Carpal height ratio was statistically significantly reduced compared with preoperative values. All patients declared their satisfaction with the results due to their preoperative status. Conclusions: ECRL tendon ball arthroplasty is a new and good option for treatment of late-stage Kienbock's disease with low complication rate.Öğe Extensor carpi radialis longus tendon ball interposition arthroplasty for treatment of late-stagekienbock's disease: short-term results of a novel technique(Sage publıcatıons ınc, 2455 teller rd, thousand oaks, ca 91320 usa, 2018) Aslanturk, Okan; Ertem, Kadir; Ergen, Emre; Koroglu, MuhammedPurpose:The aim of this study was to evaluate short-term clinical and radiological results of extensor carpi radialis longus (ECRL) tendon ball arthroplasty for treatment of late-stage Kienbock's disease. Methods: We retrospectively reviewed data of 19 patients suffering from Kienbock's treated with ECRL tendon ball arthroplasty between December 2014 and December 2016. Patients' clinical functions were assessed using grip strength, range of motion (ROM) of the wrist, QuickDASH, Mayo wrist score, and visual analog scale score. Radiological examination was performed to assess carpal height ratio and progression of arthritis. Results: The median follow-up was 30 months (range, 12-36 months). At final follow-up, ROM of operated wrist was 71% of the nonoperated side. Thirteen (86.6%) patients were pain free. Carpal height ratio was statistically significantly reduced compared with preoperative values. All patients declared their satisfaction with the results due to their preoperatiÖğe Hair tourniquet syndrome of toe(Elsevier, 2023) Koroglu, Muhammed; Ozdes, Huseyin Utku; Ozbey, Rafet; Yilmaz, Ozgur; Ergen, Emre; Oklu, Yunus; Aslanturk, OkanIntroduction: Hair tourniquet syndrome (HTS) is a rare surgical emergency caused by a hair or thread wrapping around an appendage. We aimed to present our clinical experience with HTS of toes and attract physicians' attention to this rare entity.Methods: Between January 2012 and September 2022; 26 patients (25 pediatric and one adult case) were treated for HTS. All pediatric cases were treated surgically under loop magnification. The adult patient was treated nonsurgically. The patient's age, gender, affected appendage and side, duration of symptoms, and postoperative complications were recorded.Results: Thirty-six toes of 25 patients (13 boys, 11 girls, and a male adult) were included in the study. The mean age of pediatric patients was 126.6 days. The third toe was the most affected (n:16), followed by the fourth (n:8). In seven patients more than one was affected.Conclusion: HTS should be treated as soon as possible when diagnosed to prevent further complications including appendage loss.& COPY; 2023 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.Öğe Iliacus hematoma causing late femoral nerve palsy(Wiley, 2024) Al, Firat; Koroglu, Muhammed; Ozdes, Huseyin Utku; Aslanturk, OkanFemoral nerve palsy is rare and may progress insidiously, leading to late clinical presentation. Identifying the underlying cause is very important for treatment. An iliacus hematoma causing nerve palsy is perhaps the most innocent etiology. However, this hematoma sometimes causes only abdominal pain and may even be misdiagnosed as a late intra-abdominal pathology. imageÖğe The initial response of a local hospital in the earthquake zone during the February 6, 2023 Kahramanmaraş earthquakes: Injuries and challenges(Turkish Assoc Orthopaedics Traumatology, 2023) Koroglu, Muhammed; Karakaplan, Mustafa; Ergen, Emre; Ertem, Kadir; Coban, Idris; Kose, Harun; Yucel, NeslihanObjective: This study aimed to describe the type and number of traumatic injuries seen after devastating earthquakes and to evaluate the difficulties experienced in the treatment process in a primary affected center.Methods: Out of the 2176 patients who were treated in the emergency department, 372 (199 male and 173 female) patients with complete data were included in this single-center retrospective study. In addition to the demographic characteristics of the patients, orthopedic injuries, other organ system injuries, type of injury, treatments, mechanisms of injury, and time of presentation to the emergency depart-ment were recorded.Results: The most common age group for injury was 20-30 years old, consisting of 73 patients (19.62%), and the second most common age group was between 40 and 50, with 72 patients (19.35%). Injury after being trapped under rubble was seen in 152 (40.86%) patients, while non-debris causes were more common in 220 patients (59.14%). The most common site of injury was in the lower extremities, with 111 patients (29.84%), while multiple injuries were seen in 109 patients (29.3%). Lower extremity fractures were mostly seen in long bones such as the femur (12.28%) and tibia (11.4%). Upper extremity fractures, especially those due to falls, were most frequently in the distal radius (8.77%). After triage, 117 patients (31.45%) were hospitalized, whereas the majority of patients (58.33%) were discharged from the emergency department.Conclusion: This study has shown us that injuries following major earthquakes are of a wide spectrum and occur in large numbers and in a very short time. Even in a well-equipped hospital that is not affected by an earthquake, there are many barriers to appropriate man-agement. The first 24 hours after an earthquake are critical. This period should be kept in mind while organizing and taking necessary precautions, and early responses to earthquakes should be meticulously planned.Level of Evidence: Level IV, Diagnostic StudyÖğe Isolated Tuberculosis of Capitate and Triquetrum(Thieme Medical Publ Inc, 2017) Karakaplan, Mustafa; Koroglu, Muhammed; Ergen, Emre; Aslanturk, Okan; Ozdemir, Zeynep Maras; Ertem, KadirMusculoskeletal system is involved in about 20% of the patients diagnosed with tuberculosis. Although musculoskeletal tuberculosis generally affects spine and large joints (hip and knee), hand involvement of the tuberculosis is seen in 10% of the patients with musculoskeletal involvement and also isolated tuberculosis of hand or wrist is much rarer. In the following report, we discuss the case of a 23-year-old male patient who was diagnosed with isolated tuberculosis of the capitate and triquetrum bone. The patient presented with a nonhealing sinus on the left wrist joint. Imaging revealed lytic lesions of the capitate and triquetrum. The diagnosis of tuberculosis was confirmed by histopathological examination on the bone specimen obtained from the debridement and curettage. Antituberculosis therapy was started postoperatively and 1month later, healing of the sinus was observed. There was no sign of reactivation seen at follow-up 22 months after treatment.Öğe Letter to the editor regarding the article by Bonczar M. et al.: Evaluation of lateral epicondylopathy, posterior interosseous nerve compression, and plica syndrome as co-existing causes of chronic tennis elbow(Springer, 2023) Aslanturk, Okan; Ozdes, Huseyin Utku; Koroglu, Muhammed; Karakaplan, Mustafa; Ertem, Kadir[Abstract Not Available]Öğe Predictive factors for acute kidney injury and amputation in crush injuries from the Kahramanmaraş earthquakes(Turkish Assoc Trauma Emergency Surgery, 2024) Koroglu, Muhammed; Karakaplan, Mustafa; Barakat, Mohammed; Ergen, Emre; Aslanturk, Okan; Ozdes, Huseyin Utku; Bicakcioglu, MuratBACKGROUND: Crush syndrome (CS) is characterized by high morbidity and mortality due to severe electrolyte disorders, circulatory dysfunction, and multiple organ failure, secondary to severe rhabdomyolysis and reperfusion injuries. Acute kidney injury (AKI) related to crush syndrome is one of the life -threatening complications and is the most frequent cause of death following earthquakes, other than trauma. We conducted a retrospective study to identify predictive parameters from clinical and laboratory data that aid in recognizing CS, assessing its severity, and evaluating acute kidney injury and amputation indications in patients. METHODS: We retrospectively evaluated the clinical data and laboratory follow-up of 33 patients treated for crush syndrome within the first two weeks following the February 6, 2023 earthquake. Patients who underwent surgery for crush syndrome but could not be followed post -surgery were excluded. Laboratory parameters were analyzed upon admission and then daily over an average seven-day follow-up. A p -value of <0.05 was considered statistically significant. Data analysis was performed using IBM SPSS Statistics 26.0 and R Studio software. RESULTS: Of the 33 patients, 17 were male and 16 were female. The incidence of AKI was 35.7%, 66.7%, and 100% in patients with injuries to one, two, and three extremities, respectively. A significant correlation was observed between total entrapment time and the duration of required dialysis days; AKI risk significantly increased with more than six hours of total entrapment time. Regarding the initial blood values upon hospital admission, a myoglobin level exceeding 2330 mg/dL demonstrated the highest sensitivity for predicting AKI. An initial uric acid level (>6.36 mg/dL) on admission had the highest specificity for predicting AKI. The initial myoglobin level (>3450 mg/dL) showed the highest sensitivity in predicting the need for amputation. Meanwhile, the mean creatine kinase (CK) level (>34800 U/L) exhibited the highest specificity but the lowest sensitivity for amputation prediction. CONCLUSION: The study analyzed the effectiveness and predictability of clinical and laboratory findings concerning amputation and acute kidney injury in crush syndrome resulting from earthquakes. Effective amputation management is a crucial factor influencing prognosis and survival in patients with earthquake -induced crush syndrome.Öğe Primary Negative Prognostic Factors in Pediatric and Adult Patients Undergoing Trigger Finger Surgery(Springernature, 2024) Koroglu, Muhammed; Karakaplan, Mustafa; Yildiz, Mustafa; Eren, Mehmet; Ergen, Emre; Cicek, Ipek Balikci; Aslantuerk, OkanObjectives This study aims to investigate the negative prognostic indicators of pediatric and adult trigger finger surgery patients concerning complications, recurrence, and satisfaction. Methods A retrospective study was conducted on 61 patients with a total of 91 trigger fingers, including 31 in children and 30 in adult patients, all of whom were treated using a standardized surgical technique. The study considered several demographic and clinical factors, including age, gender, dominant hand, body mass index, occupation, history of trauma, single or multiple finger involvement, staging according to Green classification, diabetes mellitus, comorbidities, recurrence, revision surgery, utilization of non -surgical treatment methods, need for rehabilitation after surgery, time to return to work, the time interval from clinic initiation to the surgery, satisfaction and the duration of the follow-up period. In addition, the quick version of the disabilities of the arm, shoulder, and hand (QDASH); and the visual analog scale (VAS) were used to assess patients' data. Results In adult patients, a statistically significant relationship was observed between the increasing grade of the Green stage and complication rate (p<0.001), recurrence (p<0.001), and lower satisfaction (p<0.001). No statistically significant relationship was identified between Green's classification and complications (p=0.129), recurrence (p=0.854), or satisfaction (p=0.143) in pediatric patients. While a statistically significant relationship existed between the time interval from clinic initiation to surgery and complications (p=0.033) in adult patients, no significant relationships were observed for recurrence or satisfaction. Conversely, there was no statistically significant relationship between the time interval from clinic initiation to surgery and complications, recurrence, or satisfaction in pediatric patients. Conclusion This study demonstrates that increasing the grade of the Green stage and duration of symptoms before surgery were the substantial factors contributing to prognosis in adult patients but not in pediatric patients. These findings can assist physicians during patients' treatment management. We suggest that physicians consider these factors for patients' satisfaction.Öğe A rare complication of tension band fixation of olecranon osteotomy: Distal migration of K-wire(Turkish Joint Diseases Foundation, 2024) Koroglu, Muhammed; Karakaplan, Mustafa; Ergen, Emre; Eren, Mehmet; Alyousef, Abdulkarim; Oezdes, Huseyin Utku; Aslanturk, OkanTension band wiring (TBW) is one of the most commonly used fixation techniques to fix olecranon osteotomies. Hardware prominence has been the most commonly reported complication of TBW. However, distal migration of Kirschner (K) -wire after TBW fixation for olecranon osteotomy has not been reported. In this case report, we presented distal migration of K -wire detected nine months after initial surgery in a 46 -year -old male patient. The patient was operated on for an intraarticular distal humerus fracture using an olecranon osteotomy. The osteotomy was fixed with TBW fixation. The patient missed routine follow-ups and presented to the outpatient clinic with a complaint of skin irritation at the elbow nine months after the surgery. On radiological examination, distal migration of one K -wire was detected. The K -wire was surgically removed without any complication. Physicians should be aware of possible complications of TBW and remove fixation after fracture union to avoid unexpected complications.Öğe Reossification of the Achilles Tendon A Case Report(Amer Podiatric Med Assoc, 2022) Aslanturk, Okan; Koroglu, Muhammed; Karakaplan, Mustafa; Ozdemir, Zeynep MarasFracture of an ossified Achilles tendon is a rare clinical entity. Reossification after removal of the bony fragment was reported in only one case previously. In this study, we present a 49 -year-old man with a reossified Achilles tendon after the removal of a fractured and ossified Achilles tendon. Treatment of an ossified or fractured Achilles tendon should be selected on a patient-by-patient basis. Surgical treatment can be used when conservative treatment has failed. The possibility of reossification after surgical treatment, especially in patients with risk factors, should be kept in mind, and the patient should be informed about this possibility. (J Am Podiatr Med Assoc 112(3), 2022)Öğe The role of arthroscopy in the treatment of common wrist disorders: A retrospective clinical study(2021) Koroglu, Muhammed; Ertem, Kadir; Aslanturk, OkanAim: The purpose of this research was to evaluate clinical and functional results of patients that we treated them with wrist arthroscopy. Material and Methods: Patients treated with wrist arthroscopy between February 2012 and June 2017 were retrospectively evaluated. Patients’ disease, treatment, effected side, preoperative and postoperative Quick Disabilities of the Arm, Shoulder and Hand (Q-DASH) score and postoperative Mayo score were recorded. Results: There were 78 (49 female and 29 male) patients. Mean age was 38±14.91 (16-81 years) years. Mean follow-up time was 45,4±17.93 (range, 6-72 months) months. There were 22 (28.2%) ganglion cyst, 15 (19.2%) triangular fibrocartilage complex tears, 11 (14.1%) Kienböck’s disease and 8 (10.3%) intraarticular distal radius fracture. All patients Quick-DASH scores statistically significantly improved at final follow-up compared to preoperative status (p<0.001). There was no major complication in any of the patients. Conclusion: The wrist arthroscopy is efficient and minimal invasive technique with low complication rates and good clinical results for common wrist pathologies.Öğe Spontaneous extensor pollicis longus (EPL) tendon rupture after ironing(Bayrakol Medical Publisher, 2021) Karaman, Serdar; Koroglu, Muhammed; Ozdemir, Zeynep Maras; Ertem, KadirSpontaneous tendon ruptures can occur rarely. Distal radius fractures, steroid applications and systemic diseases are mostly attributed to its etiology. In the treatment of spontaneous tendon ruptures, primary repair is not possible and tendon transfer is often required. The EPL tendon is the main extensor of the thumb. This muscle originates from the interosseous membrane, especially the dorsal part of the ulna. The EPL passes from the third dorsal extensor compartment ulnar to the Lister's tubercle before returning to the thumb. Since spontaneous tendon ruptures often occur due to degeneration, the defect is large in the area of the rupture. Therefore, spontaneous tendon ruptures are treated with tendon transfer rather than end-to-end repair. In this case report, we aimed to present a case of extensor indicis proprius (EIP) tendon transfer to our 64-year-old female housewife who was admitted to our clinic with a spontaneous rupture of the EPL tendon a resulting from excessive ironing in a short term. As a result of the examination and radiological evaluation of the patient who applied to our clinic with the complaint of inability to extend the thumb extension, a spontaneous EPL tendon rupture was diagnosed and surgical treatment was decided. While making a diagnosis of spontaneous tendon rupture, it was learned that the patient had no trauma and rheumatologic disease in her anamnesis. Ultrasound and magnetic resonance imaging (MRI) were used to confirm the diagnosis radiologically. The spontaneous EPL tendon rupture treatment was successfully provided by the transfer of the extensor indicis proprius (EIP) tendon. At the six month of follow-up after the surgical treatment, it was observed that the finger regained its former function. In elderly patients, repetitive, forceful finger movements for a long time may cause spontaneous tendon rupture. Long-term coercive thumb movement is a risk factor for EPL spontaneous tendon rupture.Öğe Successful Management of a Pediatric Patient with Humeral Lateral Condyle Non-union, Elbow Valgus Deformity and Ulnar Neuropathy(Springer Heidelberg, 2024) Coban, Idris; Karakaplan, Mustafa; Ergen, Emre; Aslantuerk, Okan; Koroglu, Muhammed; Ertem, KadirBackgroundHumeral lateral condyle fracture is the most common elbow fracture in children after supracondylar fractures. Non-union of these fractures may cause ulnar nerve deficit, deformity and loss of joint motion, which are difficult to manage. Treatment of lateral condyle non-union can be done in two stages or one stage. However, despite all types of treatment, the chance of success is very variable. Many complications such as avascular necrosis, loss of motion, non-union, chronic pain, and heterotopic ossification have been reported as a result of surgeries performed for lateral condyle pseudoarthrosis.ObjectiveIn this article, we applied two-stage surgical treatment to a pediatric patient who developed ulnar neuropathy and elbow valgus deformity as a result of lateral condyle non-union.Case reportA 8-year-old boy with lateral condyle nonunion presented to our clinic with pain and deformity. After initial examination, two-stage surgical treatment was planned to achieve union and deformity correction. In the first stage, we performed pseudoarthrosis surgery and ulnar nerve anterior transposition, and in the second stage, we performed elbow valgus deformity correction surgery. In three year follow-up, the range of elbow was 130/5/0 flexion/extension, with full supnation and pronation. Carrying angle was same with the opposite side.ConclusionPediatric humeral lateral condyle nonunions cause deformity, pain, loss of motion, instability and neuropathy. Surgical treatment of nonunions with a careful planning provide excellent clinical and functional results.
