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    Comparison of the efficacy of extracorporeal shock wave therapy and trigger point dry needling in the treatment of Calcaneal Epin- A randomized trial
    (Sage Publications Inc, 2025) Arpaci, Muhammed Furkan; Dogru, Feyzi; Deniz, Mine Argali; Cicek, Ipek Balikci; Baykara, Rabia Aydogan; Erdem, Cumali; Tas, Ferhat
    Background: Dry needling (DN) and Extracorporeal shock wave therapy (ESWT) are common in calcaneal epin treatment. Objective The aim of the study was to compare the effects of both treatments on proprioception, balance, pain, and functional status. Methods: 90 patients which consist of 45 patients as DN + self stretching and 45 patients as ESWT + self stretching. Patients in each group were treated 1 session per week for 4 weeks. Assessments of 15 degrees ankle dorsiflexion and plantar flexion proprioception, one leg standing test (OLST), foot function index (FFI), visual analog scale (VAS) (first step, resting, activity), quality of life scale (SF-36) were performed. The outcomes were recorded at pre-treatment, post-treatment, and 4 weeks after the post-treatment. Results: Statistically significant differences were determined in VAS (resting, first step, activity) and FFI values in both treatment methods (p < 0.05). In OLST, SF-36, and FFI evaluations, DN was statistically more effective than the ESWT method (p < 0.001). In the 15 degrees proprioception evaluations, a significant difference was observed in the patient's ankle in both methods, while the DN method is more effective in the indicated stages of evaluation. Conclusions: Both methods applied to epin calcanei patients were effective, but the DN method is a more effective treatment method than the ESWT method in terms of balance, proprioception, foot function, and quality of life.
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    Nervus ischiadicus variations and clinical importance: A cadaver and MRI study
    (Bayrakol Medical Publisher, 2025) Tas, Ferhat; Ozbag, Davut; Ogeturk, Murat; Ozdemir, Zeynep Maras; Karatoprak, Nur Betul; Cevirgen, Furkan; Arpaci, Furkan
    Aim: In this study, the variations, bifurcation levels, morphometric and topographic features of the ischiadicus nerve (NI), which has an important role in its protection, were investigated. Material and Methods: In eighteen cadaver limb dissections, variations related to NI and musculus piriformis (MP) and NI bifurcation levels, morphometric and topographic features of NI were investigated. At the foramen infrapiriforme (FI) exit, the distance between NI and trochanter major (TM), spina iliaca anterior superior (SIAS), crista iliaca (CI), spina iliaca posterior superior (SIPS), hiatus sacralis (HS) and tuber ischiadicum (TI) was measured. NI variations were investigated in 115 hip MRIs of 59 patients in the radiology archives. Results: No variation was encountered in NIs other than Type A, which is the most common and considered normal. In all lower extremities, it was observed that the NI bifurcated in the distal 1/3 of the thigh (Group E). FI-TM: 71 +/- 9.62 mm, FI-SIAS: 129.56 +/- 8.98 mm, FI-CI: 134.6 +/- 6.33 mm, FI-SIPS: 80.77 +/- 10.40 mm, FI-HS: 78.16 +/- 10.54 mm and FI-TI: 55.11 +/- 5.56 mm was found. 115 Magnetic resonance radiographs (MRI) showed Type B variation in 5 hips (4.34%) and Type A variation in the others (95.65%). Discussion: We think that our cadaver and MRI study can serve as a guide during clinical practice and will be useful in reducing NI injuries.