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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 Comparison of medium-term revision rates after autograft and allograft anterior cruciate ligament reconstruction(Edizioni Luigi Pozzi, 2020) Sevimli, Resit; Gormeli, Gokay; Polat, Haci; Kilinc, Oner; Turkmen, Ersen; Aslanturk, OkanAim: The present study investigates time until revision and revision rates, and their relationship with gender and age, among 267 patients with anterior cruciate ligament tears treated with autograft and allograft reconstructions. MATERIALS AND METHODS: A retrospective evaluation was carried out based on data collected on 269 knees (bone-patellar tendon-bone autograft in 25, gracilis-semitendinosus autograft in 136, quadriceps autograft in two, allograft in 106) belonging to 267 patients who underwent an anterior cruciate ligament reconstruction between 2009 and 2018. RESULTS: Of the 269 knees of the 267 patients (22 women and 247 men) operated on for an anterior cruciate ligament rupture, an autograft was used in 163, and nine of those required revision, while an allograft was used in 106 knees, and seven required revision. Revision surgery was necessary for six out of the 22 female patients and for only 10 out of the 247 male patients (p<0.001). CONCLUSION: Each type of graft used for treatment is associated with certain advantages and disadvantages. Hamstring autografts and allografts were the most commonly used grafts during the anterior cruciate ligament reconstruction surgeries carried out at our clinics. The rate of re-rupture was quite low with use of both graft types, leading us to believe that the type of graft preferred for anterior cruciate ligament reconstruction surgery should be based on a common decision of the surgeon and patient.Öğe The effect of perineural application of bupivacaine combined with sodium bicarbonate on the synatic nerve block in rabbits after sevofluran anesthesia(2020) Sevimli, Reşit; Ozkan, Ahmet Selim; Akbas, Sedat; Alan, Saadet; Turkmen, ErsenAim: The aim of this study was to investigate the effect of combining sodium bicarbonate with bupivacaine on prolonging peripheral nerve block time.Material and Method: Following the approval of the required Ethics Committee, 24 male New Zealand rabbit (4250-5350 g) were randomized and divided into three groups. Group 1 sham n:8; Group 2 (bupivacaine): 0.5 mL of 0.5% bupivacaine (0.5 mg / kg) injected into the perineural area. n:8; and Group 3 (bupivacaine + sodium bicarbonate): 0.5 ml of 0.5% bupivacaine + sodium bicarbonate (125 ml of 8.4% injected into the perineural area. n: 8. After the skin was closed in all groups, the paw pull response was monitored and recorded every 30 minutes until the sensory block of the experimental animal returned back. Hot-plate test was used for analgesia evaluation. In addition, tissue histopathology was examined for histopathological evaluation of the injection site. Sensory block was evaluated with claw tightening test and claw pull test (hot-plate) response. The measurements were carried out every 30 minutes for 120 minutes or until the block was completely resolved.Results: 30., 60. and 90.min paw pull response in Group 2 and Group 3 showed statistically significant elongation when compared to Group 1, this difference disappeared in 120 minutes. Compared to the sham group, the 30 min hot plate and claw pull response was significantly longer in group 3 (sodium bicarbonate and bupivacaine), this difference disappeared in 60 minutes (p = 0.018).Conclusion: When sodium bicarbonate and bupivacaine are combined, it was seen in this study that the sensory block was prolonged. We believe that the current results can be used as a guide for future studies.Öğe The effect of the use of herbal supply on daily life activities containing OTC (chondroitin sulfate(Bayrakol Medical Publisher, 2020) Sevimli, Resit; Guler, Ahmet; Canakci, Mehmet; Emeli, Adem; Turkmen, ErsenAim: In this study, we aimed to compare pain, functional capacity, and quality of life of patients with knee osteoarthritis (OA), determine the factors affecting them, and investigate the effect of over-the-counter (OTC)-containing herbal supplementation on daily living activities in patients with knee OA. Materials and Methods: The study included 102 patients with the diagnosis of knee OA according to the American College of Rheumatology (ACR) criteria who were admitted to our orthopedics and traumatology outpatient clinic between March 2019 and September 2019. Demographic data were recorded. The visual analog scale (VAS), the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), medical outcomes study short-form health survey (SF-36) were used. The Kellgren-Lawrence scale was used for radiological evaluation. Information about the patients was determined by the questionnaire method and the patients were evaluated according to recruitment/exclusion criteria. In the study group, 102 patients with knee OA were included. On the other hand, 100 patients received a placebo as a control group. After three months of OTC supplementation, daily life activities and functional tests were performed and data were collected. Both subjective and objective data were calculated, compared, and analyzed. Results: It was observed that more than 80% of the patients with OA included in the study relieved pain with our food supplement components. There was an improvment in functional abilities of the patients with chronic OA as compared to standard medical treatment, and the pain level decreased significantly with test scores and scales after supplementary foods. The secondary endpoint was also noticed. We noticed that our subjects actually lost an average of 1.5 kg over the course of the study. Discussion: OA is the most common form of arthritis and the leading cause of disability among middle-aged and elderly people. We can develop theoretical strategies for primary prevention of joint damage through the reduction of obesity and joint trauma in particular. Effective chondroprotective therapies will be most useful when applied to high-risk individuals before the emergence of symptomatic OA. Conclusion: We concluded that food supplementation that was used in our study seemed to be beneficial in patients with knee ailments such as OA. It was equally interesting to observe that the majority of patients lost weight while taking these supplements. Although the study was underpowered, it shed light on supplements containing glucosamine. We believe that further larger series studies in the near future can help us to obtain more objective findings.Öğe Flexion contracture in 2-5 digits following hypothenar flap(Bayrakol Medical Publisher, 2022) Kose, Harun; Ekrem, Serhat; Sagir, Ahmet; Turkmen, Ersen; Ertem, KadirWe aimed to discuss a case of severe flexion contractures affecting 2nd-5th fingers as a late complication of a hypothenar skin flap that we applied to a patient with a fingertip injury that ended with tissue loss in the tip of the fifth finger of the right hand. Soft tissue defects of the little finger are challenging, especially when a bone, tendon or vascular pedicle is exposed because of trauma. The hypothenar random flap is easy to harvest and has a good color and texture match to the little finger pulp. For this complication, which did not improve sufficiently with physical therapy methods, contractures were tried to be eliminated by open surgical release of the 2nd-5th fingers to the proximal interphalangeal joints.Öğe Median nerve transection following carpal tunnel release with an unusual surgical approach: A case study(Bayrakol Medical Publisher, 2021) Turkmen, Ersen; Sakci, Mehmet S.; Ertem, KadirMultiple mini-invasive surgical approaches have been proposed to reduce the complications accompanied by or emerging from traditional open release of the carpal tunnel. The vertical mini-open blind technique using a short palmar incision distal to the wrist crease has been shown to be safe and easily reproducible with a short recovery period. In the literature, complications involving median nerve injury following carpal tunnel release using the mini-open blind technique through a small incision proximal to the wrist crease are extremely rare or nonexistent. The authors report a case of an incomplete transection of the median nerve following surgery with the mini-invasive (or mini-open) technique through an incision at an unusual site (proximal to the flexion wrist crease).Öğe Our clinical outcomes in patients operated with the diagnosis of pigmented villonodular synovitis(2019) Sevimli, Reşit; Alan, Saadet; Eriten, Semih; Polat, Haci Yusuf; Turkmen, ErsenAbstract: The aim of this study was to evaluate the clinical and surgical results of 21 cases treated with pigmented Villonodular Synovitis in our clinic between 2010 and 2018 and to share these results with the literature. The 5-year follow-up results of 21 cases with pigmented Villonodular Synovitis were evaluated retrospectively. Only patients undergoing surgical treatment were included in the study. The patients were investigated in terms of age, gender, anatomical region, size of the tumor, a surgical technique applied and recurrence. The involved joints are in turn; seven knees, five ankles, four feet, two hands, two hips, and one shoulder joints. The patients’ ages ranged from 9 to 81 years (mean 45). 11 of them were male, and 10 were female. Clinically; Pain and swelling in the involved joints were the most common complaints, and the most common symptom was the compression effect of the mass. The most commonly involved anatomic region was the knee joint. The majority of patients had no history of trauma. Recurrence was found in 23.8% of patients who underwent surgical treatment. Pigmented Villonodular Synovitis is a middle-aged disease that causes severe morbidity and compromises the quality of life. Arthroscopic and open surgical synovectomy can be performed successfully in the treatment of this condition.Öğe Scoliosis secondary to osteoid osteoma: A case report of delayed diagnosis and 5-year follow-up(Bayrakol Medical Publisher, 2020) Ceylan, M. Fethi; Yildirim, Emrah; Turkmen, ErsenOur case of study is a 17 years old female patient who presented with painful scoliosis secondary to osteoid osteoma. The patient remained undiagnosed for years complaining of non-subsiding lumbar pain. Three years later, a thorough physical assesment and advanced radiological examination revealed that the patient's complaint was related to an osteoid osteoma accompanying scoliosis. Surgical resection, fusion and instrumentation were applied.Öğe Subdural hematoma and death due to unnoticed dural injury during spine surgery: A case report(Bayrakol Medical Publisher, 2020) Ceylan, Mehmet Fethi; Turkmen, Ersen; Durak, Mehmet AkifUnwanted dural injury in spinal surgery has been reported at varying rates and is seen extremely often. Death as a consequence of subdural hematoma following incidental dural injury is a very rare complication. The purpose of this study is to present a case of fatal subdural hematoma as a complication of dural injury which was not noticed during surgery. Here, we present a 40-year old female with congenital kyphosis of approximately 100 degrees at the T9-L2 level who underwent corrective spinal surgery in the form of laminectomy, foraminectomy, and partial corpectomy. The patient experienced a rapid deterioration in her level of consciousness and died within 3 days. We conclude that incidental dural injury which has not been noticed during the operation with subsequent subdural hematoma can be a fatal complication related to CSF leakage.
