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    Recurrence and Factors Associated with Recurrence in Dupuytren's Disease Patients Treated with Percutaneous Needle Aponeurotomy
    (Pera Yayincilik Hizmetleri, 2024) Koroglu, Muhammed; Ertem, Kadir; Ozdemir, Ekrem; Taskiran, Gultekin; Karakaplan, Mustafa; Ergen, Emre; Cicek, Ipek Balikci
    Objective: Dupuytren>s disease (DD) is a progressive condition of the palmar fascia that limits finger extension. Percutaneous needle aponeurotomy has become increasingly popular in recent years. Despite appropriate treatment, recurrence is common. This study investigates recurrence development following percutaneous needle aponeurotomy and evaluates the relationship between patient characteristics, disease-related factors, and recurrence in DD. Methods: This retrospective study included 98 fingers from 41 patients diagnosed with Dupuytren>s disease who underwent percutaneous needle aponeurotomy at a hand surgery outpatient clinic between 2012 and 2022. Patient records were reviewed, and characteristics such as age, gender, occupation, and dominant hand were documented. The stage of DD was determined preoperatively. Functional outcomes were assessed using a subjective satisfaction scale, and postoperative complications and recurrences were analyzed. Results: Of the 41 patients, 32 (78%) were male and 9 (22%) were female. The mean age was 62 years (range, 44-82 years), and the mean follow-up period was 45 months (range, 9-138 months). Postoperative evaluations showed that 17 patients (41.5%) had excellent results, 19 patients (46.3%) had good results, and 5 patients (12.2%) had fair results. Recurrence of Dupuytren>s disease occurred in 24 (58.5%) patients. Among all patients, 30 (73.2%) were willing to undergo reoperation, regardless of recurrence. The recurrence rate was significantly lower after percutaneous needle release in stage 1 DD (p = 0.011). Conclusion: Percutaneous needle aponeurotomy offers high patient satisfaction and early discharge benefits, making it a preferred option for surgeons, despite the potential for recurrence. While the classification of recurrence as a complication is debated, it is a recognized outcome of progressive DD. Regardless of patient characteristics, performing percutaneous needle aponeurotomy at an early stage can significantly reduce recurrence rates.
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    The Relationship Between Femoral Head Avascular Necrosis and Erectile Dysfunction: A Retrospective Case-Control Study Conducted in Türkiye
    (Mdpi, 2025) Ozdemir, Ekrem; Ozdes, Ahmet Alper; Topsakal, Fatih Emre; Altay, Nasuhi; Ozdes, Huseyin Utku; Demirel, Esra
    Background/Objectives: Femoral head avascular necrosis (FAN) is a serious orthopedic disorder that causes the death of bone tissue as the outcome of the occlusion or insufficiency of the vessels supplying blood to the femoral head. It is especially common in middle-aged men. Factors such as alcohol consumption, corticosteroid use, trauma, and systemic diseases have influential roles in the development of FAN, and the ensuing vascular disruptions can also negatively affect the patient's broader systemic vascular health. Erectile dysfunction (ED) is a condition caused by an impairment in penile blood flow, which reduces quality of life in men and has psychosocial effects. This study examined the potential relationship between FAN and ED in consideration of the similar pathophysiological mechanisms of these conditions. Methods: The research was planned as a retrospective case-control study and conducted between January 2020 and December 2023. FAN was diagnosed based on the Ficat-Arlet classification using plain radiography and magnetic resonance imaging, and staging was performed with expert clinical evaluations. The International Index of Erectile Function (IIEF) scale was administered to evaluate ED. Data from 50 patients with FAN and 50 healthy men were evaluated using appropriate statistical methods, including univariate comparisons and correlation analysis. Results: The analysis demonstrated a significant association between increasing FAN stages and greater severity of erectile dysfunction (ED). ED was identified in 35 out of 50 patients in the FAN group (70%), compared to 15 out of 50 individuals in the control group (30%). This difference was statistically significant (p < 0.05), indicating a substantially higher prevalence of ED in patients with FAN. A significant negative correlation was also observed between the FAN stage and International Index of Erectile Function (IIEF) scores (Spearman's rho = -0.631; p = 0.001). The mean IIEF score was 23.4 in patients with FAN stage 1, which declined to 9.6 in those with stage 4, reflecting a marked deterioration in erectile function with advancing FAN stages. No statistically significant difference was found in the age distribution between the FAN and control groups (p > 0.05). Conclusions: This study demonstrates that, with the progression of FAN, systemic vascular deterioration affects penile blood flow, increasing the severity of ED. This finding highlights the common pathophysiological mechanisms of FAN and ED and reveals the importance of early diagnosis and multidisciplinary treatment approaches. This relationship should be examined in detail with larger samples and prospective designs in future studies.