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Öğe A Comparison of Three Different Surgical Treatments in Late Stage Kienböck's Disease(Thieme Medical Publ Inc, 2026) Ozdemir, Ferdi; Ozdes, Huseyin Utku; Karakaplan, Mustafa; Ergen, Emre; Aslanturk, Okan; Cicek, Ipek Balikci; Ertem, KadirObjective Different treatment options exist for the late-stage Kienb & ouml;ck disease (KD). The functional outcomes of patients undergoing scaphocapitate fusion (SCF), tendon ball arthroplasty (TBA), and radius metaphyseal core decompression in stages 3 to 4 KD were investigated. Materials and Methods This is a retrospective study spanning similar to 11 years, conducted at our clinic, involving the operated patient KD. The study included 51 patients with an average follow-up duration of 68 months (range: 16-130 months). Patients who underwent SCF, TBA, and radius metaphyseal core decompression were divided into three groups based on the surgical approach. The range of motion of the wrist joint and grip strength of the operated wrists were assessed alongside the unaffected wrist during follow-up evaluations. Satisfaction levels among patients were measured by comparing groups internally and based on disease stages. Functional outcomes were evaluated using quick disabilities of the arm, shoulder, and hand (Q-DASH) and Mayo wrist scoring scales. Results Of the patients, 28 were female (54.9%) and 23 were male (45.1%). The mean age was 34 years (range: 19-62 years). There were 12 patients (23.53%) in the radial decompression group, 10 patients (19.61%) in the SCF group, and 29 patients (56.86%) in the TBA group. When the wrist joint Range of motion (ROM)s are analyzed, the losses in both stages 3A and 3B disease are significant compared with the intact wrist in all three surgical methods. When the groups were compared, a higher loss of wrist joint ROM was observed in the TBA group, especially in Kienb & ouml;ck stage 3B patients ( p < 0.001). Furthermore, there were no differences between patient scores in stage 3A when assessments were made using Q-DASH and Mayo scores ( p = 0.156 for Q-DASH and p = 0.060 for Mayo). In stage 3B, Mayo's results were similar, while the radial decompression group was reported to be more favorable in terms of Q-DASH scores ( p = 0.035). Conclusion KD is surgically treated with various operations identified. In terms of functional outcomes, all three surgeries are considered satisfactory. However, in young and active patients, even in advanced stages of the disease, metaphyseal core decompression should be attempted as an initial treatment due to its easier approach and the avoidance of direct manipulation of the carpus.Öğe A rare mass with atypical localization: Heterotopic ossification associated with flexor hallucis longus(Turkish Joint Diseases Foundation, 2024) Koroglu, Muhammed; Karakaplan, Mustafa; Ozdes, Huseyin Utku; Ozdemir, Zeynep MarasHeterotopic ossification (HO), characterized by the formation of ectopic bone, is a benign mass observed in soft tissues. Depending on its location, it can cause symptoms beyond compression, such as mechanical blockage when associated with joints, leading to limitations in joint movements. In the majority of cases, involvement of the hip and elbow joints is common, while HO can sometimes be observed in atypical locations. Trauma, head injury, and spinal cord injuries are well-recognized risk factors for HO development. However, on rare occasions, in non-traumatic cases are identified without any known risk factors. Herein, we present a rare non-traumatic HO case associated with the flexor hallucis longus (FHL) tendon in a 58-year-old female patient. She complained of pain under the first toe of her right foot while wearing shoes for a year, and a mass was detected on the plantar surface of the foot along with limitation of movement in the first metatarsophalangeal joint. Further examinations revealed that the identified mass was a mature HO lesion. Surgical treatment was performed, and during one-year follow-up, the pain subsided, and joint movements returned to normal, resulting in a satisfactory outcome. In conclusion, although many cases of HO are associated with traumatic injuries, it can sometimes be idiopathic, as in our case, and rarely it is accompanied tendon such as FHL in the foot.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 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 Fourteen-year outcome of unilateral leg replantation after bilateral lower leg and unilateral upper extremity amputation following traumatic injury(Turkish Assoc Trauma Emergency Surgery, 2025) Ozdes, Huseyin Utku; Ergen, Emre; Coban, Idris; Koroglu, Muhammed; Karakaplan, Mustafa; Ertem, KadirIn cases of traumatic major extremity amputations, particularly ofthe lower extremity, every stage-from decision-making to implementation and outcomes-remains a matterof debate. Managing such cases, which carry high mortality rates, is extremely challenging both at the time of injury and throughout treatment. We present a rare and severe case of a 30-year-old patient who sustained injuries from a concrete machine, resulting in bilateral lower extremity amputations and a unilateral proximal arm amputation. A replantation was successfully performed at the proximal ankle level on one side. Our patient has been followed for 14 years, during which we achieved a satisfactory outcome through meticulous surgical intervention, evaluated using the American Orthopaedic Foot & Ankle Society (AOFAS) and Maryland foot scores. We attained a limb with intact plantar sensation and near-complete range of motion in the ankle and toe joints. Although the clinical application of the Mangled Extremity Severity Score (MESS) score has established criteria for replantation in traumatic amputation cases, we believe there maybe relative indications for limb salvage, particularly in cases of multiple traumatic amputations, especially bilateral lower extremity amputations. In such injuries, the patient's life should be prioritized. Subsequently, at least one amputated extremity and its stump should be thoroughly evaluated. Rather than opting for stump closure, we advocate attempting replantation.Öğe 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 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 Surgical Management of Sacroiliac Joint Dislocations and Crescent Fractures: A Nine-Year Clinical Follow-Up(Mdpi, 2025) Ozdes, Huseyin Utku; Koroglu, Muhammed; Coban, Idris; Harma, Ahmet; Aslanturk, OkanBackground: Pelvic injuries of the sacroiliac joint are unstable and require surgical intervention following high-energy trauma. In this study, we aimed to present the long-term clinical outcomes of patients with sacroiliac joint separation and sacroiliac fracture dislocation (crescent) injury. We compared the surgical interventions performed on the sacroiliac joint based on patient clinical data. Methods: By reviewing the records of 850 pelvic fractures treated in our clinic between 2000 and 2020, we identified 110 patients with sacroiliac joint injuries who were included in the study. The fractures were classified based on patient files and radiographs. The patients were categorized according to the surgical interventions performed on the sacroiliac joint into two groups: closed reduction with percutaneous iliosacral screws and open reduction with plates and screws. We further divided the patients who underwent open reduction and plate-screw fixation into anterior and posterior surgical approaches. Clinical outcomes were obtained by evaluating patients using a subjective pelvic scoring system. Additionally, complications observed after surgeries were investigated. Results: A total of 121 fractures from 110 patients were included in the study. Eleven of the patients had bilateral sacroiliac joint injuries, for which bilateral surgery was performed. The mean age of the patients at the time of injury was 35.15 years (range from 6 to 80 years). The mean follow-up period was 103.45 months (range from 16 to 253 months). According to the scoring system, the highest success rate was observed in plate-screw operations performed through the anterior approach to the sacroiliac joint, with excellent to good results in approximately 92% of patients. Both open reduction and internal fixation through the posterior approach and closed reduction and percutaneous iliosacral screw surgery yielded successful functional results, with no statistically significant difference between the methods (p = 0.880). Regarding complications, the most important problems were infections associated with plate-screw procedures using the posterior approach and neurologic injuries resulting from closed reduction screw surgery. Conclusions: Effective management of sacroiliac joint injuries requires surgical expertise and individualized treatment strategies. With appropriate technique and fixation, both open and closed surgical methods can achieve satisfactory anatomical reduction and functional outcomes. Although standardized treatment protocols may be developed, tailoring the approach to each patient is more important for optimal clinical success.Öğe The Arthroscopic Wafer Procedure in Patients with Ulnar Impaction Syndrome(Thieme Medical Publ Inc, 2025) Ergen, Emre; Ertem, Kadir; Al, Firat; Kilic, Murat; Kabadayi, Bilal; Cicek, Ipek Balikci; Ozdes, Huseyin UtkuAim We aimed to show the outcomes of patients with ulnar impaction syndrome who had surgical treatment with the arthroscopic wafer procedure between 2013 and 2024. Materials and Methods We analyzed data from 22 patients (22 wrists) treated with the arthroscopic wafer procedure. Visual analogue scale (VAS) score, Disabilities of Arm, Shoulder and Hand (DASH), and Mayo Wrist scoring systems were used for clinical evaluation, grip strength, and wrist range of motion (ROM) were compared with the nonoperative side, local tenderness examination at triangular fibrocartilage complex location between pisiform bone and ulnar head and ulnar grind test were evaluated. Patients were also asked to rate their satisfaction with the surgery. In radiological evaluations, preoperative and postoperative ulnar variance was measured. Results The mean follow-up period was 58.6 months. The mean VAS score was 2.86, the mean DASH score was 24.58, and the mean MAYO score was 72.64. There was no significant difference in wrist ROM between the operated side and the contralateral side ( p > 0.05). The mean time to return to work after surgery was 6 weeks. A total of 77.3% of the patients had good or very good results. No complications were encountered in our study. Conclusion According to our study findings, arthroscopic wafer procedure as a minimally invasive method provided satisfactory clinical and functional results with lower complication rates in patients with ulnar impaction syndrome.Öğe 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, EsraBackground/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.
