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Öğe Closed posterior total(2017) Uzun, Erdal; Gunay, Ali Eray; Kizkapan, Turan Bilge; Mutlu, Mahmut; Misir, AbdulhamitMajor displaced fractures and dislocations of the talus are uncommon. Total talar dislocations are caused by high-energy traumas occuring as dislocations from all its surrounding articulations. Pathophysiologic mechanisms are still a subject of controversy. Most reported cases are open talus dislocations; closed dislocations are rarely seen. Here, we present a 25 year old male with an injury of closed posterior total talus dislocation with concomitant medial malleolus fracture. After closed reduction of talus, internal fixation of medial malleolus was performed. At the last visit, the ankle was painless, stable with mobility, and without any radiologic signs of avascular necrosis of talus.Öğe Closed posterior total (pan-talar) dislocation of the talus: an unusual injury patern(2017) Uzun, Erdal; Gunay, Ali Eray; Kızkapan, Turan Bilge; Mutlu, Mahmut; Misir, AbdulhamitAbstract:Major displaced fractures and dislocations of the talus are uncommon. Total talar dislocations are caused by high-energy traumas occuring as dislocations from all its surrounding articulations. Pathophysiologic mechanisms are still a subject of controversy. Most reported cases are open talus dislocations; closed dislocations are rarely seen. Here, we present a 25 year old male with an injury of closed posterior total talus dislocation with concomitant medial malleolus fracture. After closed reduction of talus, internal fixation of medial malleolus was performed. At the last visit, the ankle was painless, stable with mobility, and without any radiologic signs of avascular necrosis of talusÖğe Comparison of clinical and radiological outcomes after posterior acetabular fractures in patients younger and older than 40 years old(2020) Misir, Abdulhamit; Kizkapan, Turan Bilge; Ozcamdalli, Mustafa; Uzun, Erdal; Oguzkaya, Sinan; Argun, Ali Saltuk; Argun, MahmutAim: This study aimed to evaluate and compare the clinical and radiological outcomes of patients aged >40 years and ≤40 years old, who underwent open reduction internal fixation for posterior fracture and/or fracture dislocation of the acetabulum.Material and Methods: A total of 52 patients who underwent surgical treatment for posterior acetabular fracture and/or fracture dislocation between June 2006 and October 2013 were included in this study. The patients were divided into the following 2 groups: group I, patients aged 40 years (n = 27; mean age, 53.3; mean follow-up period, 36.8 months). The Judet–Letournel classification system was used in the radiological classification of acetabular fractures. Clinical and radiological evaluations were performed using the modified Merle D’Aubigne evaluation score and the criteria developed by Matta, respectively. In addition, radiological evaluation for heterotopic ossification was performed according to the Brooker scoring system.Results: No significant difference in the quality of reduction and clinical and radiological findings was found between the two groups (p>0.05). The modified Merle D’Aubigne clinical outcome distribution and the distribution of Matta radiological results in groups I and II did not differ significantly (p>0.05 and p>0.05, respectively). Moreover, no significant difference in the development of postoperative heterotopic ossification was observed between the groups (p>0.05). Conclusion: Clinical and radiological outcomes are not significantly different between patients younger and those older than 40 years. Nevertheless, the clinical outcome scores are better in patients aged ≤40 years.Öğe Evaluation of mid-term clinical and radiologic outcomes after open reduction and internal fixation of Lisfranc fracture-dislocations: A case series(2019) Uzun, Erdal; Misir, Abdulhamit; Kizkapan, Turan Bilge; Ozcamdalli, Mustafa; Arat, FeridunAim: To evaluate the mid-term clinical and radiologic outcomes after surgical treatment of Lisfranc fracture dislocations. Material and Methods: Twenty unstable Lisfranc joint fracture dislocation patients treated with open reduction and internal fixation (ORIF) were evaluated retrospectively. Kirschner wire, screw or a combination of Kirschner wire (K-wire) and screw fixation were used in the internal fixation. American Orthopedic Foot and Ankle Society - Midfoot Scale (AOFAS-MS) score, Maryland foot score, Visual Analog Scale (VAS) and SF-36 survey were obtained at the last follow-up. Nonunion, implant failure, reduction quality and the degree of posttraumatic arthritis were evaluated on the AP, lateral and oblique foot radiographs. The outcome measures included the Kellgren-Lawrence grading of osteoarthritis and the Stein’s criteria for anatomic reduction.Results: The mean follow-up duration was 3.7±1.4 years. Mean AOFAS and Maryland foot scores were 75.3±1.72 and 71.8±2.3, respectively. Nonunion was developed in three patients (15%) and posttraumatic arthritis was observed in 7 patients (35%).Conclusion: Good overall clinical and radiologic outcomes can be obtained in the mid-term follow up after open reduction and internal fixation of Lisfranc fracture dislocations. However, higher-energy injuries such as open fracture-dislocations and Myerson type C2 injuries have poor outcomes.Keywords: Fracture dislocation; lisfranc; open reduction; arthritis.Öğe Morphology of the incisura fibularis in the Turkish population(2021) Misir, Abdulhamit; Uzun, Erdal; Tokmak, Turgut TursemAim: Morphology of the distal tibiofibular syndesmosis plays an important role in the pattern of ankle fracture and reduction strategy. This study aimed to describe the normal morphology of the distal tibiofibular syndesmosis in a Turkish population. Materials and Methods: All analyzes were based on 349 computed tomography images, contributed by 265 male and 84 female patients. The following features were measured on axial images: the depth of the incisura fibularis, anterior tibiofibular depth, posterior tibiofibular depth, anterior-posterior length of the fibula, mediolateral width of the fibula, version of the incisura fibularis, anterior tubercle length, posterior tubercle length, and tibiofibular engagement. All measure ts were performed by an orthopedic surgeon and an experienced musculoskeletal radiologist, repeated at a 2-week interval. Results: The most common morphology of the incisura fibularis was concave (C-shape, depth >4 mm, 66.5%), followed by a shallow morphology (I-shape, depth 4 mm, 18.3%), and r-shape (15.2%). Significant between-sex differences were identified for depth of the incisura fibularis, posterior tibiofibular depth, anterior-posterior length of fibula, mediolateral width of the fibula, anterior tubercle length, posterior tubercle length, tibiofibular engagement, and incisura fibularis height. Across the three morphologies (C-, I- and r-shape), there was a significant difference in the anterior tibiofibular depth, anterior-posterior length of the fibula, degree of retroversion of the incisura fibularis, and extent of tibiofibular engagement (p0.001). Conclusions: Knowledge of the variability in the morphology and measurements of the features of the incisura fibularis can be useful in the diagnosis of syndesmosis injury and lowering the risk of malreduction during surgery of ankle fractures among Turkish individuals.Öğe Previous hip surgery due to developmental dysplasia of the hip affects major complication rates but not revision rates in total hip arthroplasty(2020) Buyukkuscu, Mehmet Ozbey; Camurcu, Ismet Yalkin; Misir, Abdulhamit; Gursu, S Sarper; Sahin, VedatAim: Total hip arthroplasty in patients with developmental dysplasia of the hip is challenging due to accompanying acetabular and femoral deformities, soft-tissue contractures and shortening of the affected limb. In addition, changed anatomy after pelvic and/or femoral osteotomies can also make the total hip arthroplasty procedure challenging. This study aimed to evaluate the effect of previous hip surgery on clinical and radiological outcomes after total hip arthroplasty in previously operated patients due to developmental dysplasia of the hip. Material and Methods: A total of 55 developmental dysplasia of the hip patients, twenty-five patients (29 hips) with a previous hip surgery (Group 1) and 30 patients (31 hips) without previous hip surgery (Group 2) were included. The primary outcome measures were major complication and revision rates. The secondary outcome measure was the Harris Hip Score.Results: Major complications were found significantly higher in group I (p = 0.009). However, no significant difference was observed between groups regarding revision rates (p = 0.514). No significant difference was observed between groups in the preoperative and the last follow-up Harris Hip scores.Conclusion: Although similar revision rates, patients with a previous hip surgery due to developmental dysplasia of the hip who underwent total hip arthroplasty are more prone to major complications than patients without previous hip surgery patients. Level of Evidence IV. Case-Control Study.Öğe Sex and side differences of three-dimensional Glenoid anthropometric parameters in a normal Turkish population(2019) Misir, Abdulhamit; Tokmak, Turgut Tursem; Kizkapan, Turan Bilge; Uzun, Erdal; Ozcamdali, MustafaAim: Due to anatomical differences, current baseplate designs may lead to incompatibilities in reverse shoulder arthroplasty in different populations. We hypothesized that glenoid anthropometric parameters in Turkish subjects would be different from that in other populations.Material and Methods: Three-dimensional morphology of 200 healthy Turkish shoulders (100 male and 100 females, 93 left and 107 right shoulders) was evaluated. Glenoid height, width, version, inclination, circumference, and surface area; glenoid depth, scapular neck length, and scapular neck angle were measured. Sex and side differences were assessed. The correlation between glenoid morphologic parameters and subject height was assessed. The height corresponding to a 25-mm glenoid width was predicted.Results: There was a significant difference between male and female subjects regarding glenoid height, width, version, depth, circumference, surface area, and patient height (p0.05). Also, there was a significant difference between right and left shoulders regarding glenoid height, glenoid width, glenoid version, glenoid surface area, superior depth, central depth, and inferior depth measurements (p0.05). The glenoid height, width, retroversion, depth, circumference and surface area was well correlated with subject height. The estimated body height value to be obtained for a 25 mm glenoid width value was calculated as 164.4 cm.Conclusion: Our results would be useful in patient selection, preoperative planning, determining the appropriate glenosphere sizes and glenoid component placement. The values of measurement parameters in this study may serve as reference values for normal Turkish population and may be helpful in the comparisons with other populations and osteoarthritic glenoids.
