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Öğe A case of multiple trigger digits of one hand(2017) Uzun, Erdal; Ekinci, Yakup; Ulusoy, Ersin Kasim; Yetis, MehmetThe trigger finger is a tenosynovitis that causes pain, stabbing and loss of function and occurs as a result of inflammation and hypertrophy in flexor tendon and tendon sheath at the level of A1 pulley. The annual incidence of the population is 28 / 100,000 and the risk of life-time is 2-3%. It can affect all fingers mostly involving the ring, middle fingers and the thumb. Trigger finger is more common in middle-aged women rather than men mostly with predisposing factors. The treatment consists of conservative and surgical treatment. A 74-year-old woman with no other illnesses except diabetes mellitus was presented with a single-handed, multiple-patterned, surgically treated trigger finger.Öğe Claudin-5 (tight junction) expression level changes in achilles tendon healing(2019) Cirakli, Alper; Cirakoglu, Derya; Erdem, Havva; Uzun, Erdal; Cankaya, SonerAim: This study aimed to reveal the relationship between changes in Claudin-5 expression and the duration of healing in Achilles tendon injury. Material and Methods: 18 Achilles tendons of Wistar-Albino rats were used in the study. Rats were divided into 3 groups as 6 rats in each group, group 1; sham group, group 2; tendon repair group (sacrificed after 3 weeks), group 3; tendon repair group (sacrificed after 6 weeks). Immunohistochemically, the tendons were stained with Claudin-5 and the degree of staining with light microscope was rated between 0 and 3. The obtained scores were compared with Kruskal Wallis test and Posthoc analysis. Results: The scores were 0.5 ± 1 (0-1) in group 1.1 ± 1 (1-2) in group 2 and 1.5 ± 1 (1-2) in group 3. A statistically significant difference was found between the groups (p = 0.026). In the posthoc analyzes, there was a significant difference between group 1 and 3, but there was no significant difference between groups 1 and 2 and between groups 2 and 3. Conclusion: The expression of claudins is regulated by many factors, including hormones, various cytokines, and epithelialmesenchymal transition-related transcription factors. In this study, the increase in the expression of Claudin-5 was noticed in proportion to the progress of primary wound healing. This relationship may be a part of the repair mechanism. The role of claudin levels in intercellular passage is crucial for function as it is important for cell signaling. Achilles tendon healing can be attributed to a laboratory parameter such as claudin. This can help to understand the recovery rate and can help early return to work or sport. We believe that as a laboratory parameter Claudin-5 may be useful in the evaluation of tendon healing.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 Is clinical evaluation sufficient enough to diagnose the cubital tunnel syndrome(2017) Cirakli, Alper; Ekinci, Yakup; Ulusoy, Ersin Kasim; Uzun, ErdalAim: The aim of the study was to determine the diagnostic value of clinical history and neurological examination for cubital tunnel syndrome. Materials and Methods: 132 limbs of 128 patients treated with electromyography with a preliminary clinical diagnosis of cubital tunnel syndrome between the years of January 2009 and January 2016 were evaluated. Patients were evaluated according to gender, affected side and electromyography results to assess the presence of neuropathy. The obtained data were statistically analyzed by Kormogonov-Smirnov and Shapiro-Wilk test. Results: 70 patients (54%) were male and 58 (46%) were female and the average age was 40.25±12.66. The affected side was right extremity in 70 (53%) of cases and left extremity in 62 (47%) who underwent electromyography with a preliminary diagnosis of neuropathy. Symptoms were bilateral in 4 cases. As a result of electromyography 43 (32.6%) (27 male, 16 female) patients had neuropathy. Affected side in 23 of these patients (53.5%) was left limb and 20 (46.5%) was right limb and 30 of involved patients were in the range of 30-60 years. Conclusion: According to the results of our study, we found that history and neurological examination have a low efficiency in the diagnosis of cubital tunnel syndrome. This may be associated with relatively subjective evaluation of neurological examination and history and also many pathologies in the differential diagnosis of cubital tunnel syndrome. We believe that electromyelography application is required in addition to a detailed physical examination for cubital tunnel syndrome in order to avoid delayed diagnosis and incomplete/incorrect treatment.Öğe Is clinical evaluation sufficient enough to diagnose the cubital tunnel syndrome?(2017) Çıraklı, Alper; Ekinci, Yakup; Ulusoy, Ersin Kasım; Uzun, ErdalAbstract:Aim: The aim of the study was to determine the diagnostic value of clinical history and neurological examination for cubital tunnel syndrome. Materials and Methods: 132 limbs of 128 patients treated with electromyography with a preliminary clinical diagnosis of cubital tunnel syndrome between the years of January 2009 and January 2016 were evaluated. Patients were evaluated according to gender, affected side and electromyography results to assess the presence of neuropathy. The obtained data were statistically analyzed by Kormogonov-Smirnov and Shapiro-Wilk test. Results: 70 patients (54%) were male and 58 (46%) were female and the average age was 40.25±12.66. The affected side was right extremity in 70 (53%) of cases and left extremity in 62 (47%) who underwent electromyography with a preliminary diagnosis of neuropathy. Symptoms were bilateral in 4 cases. As a result of electromyography 43 (32.6%) (27 male, 16 female) patients had neuropathy. Affected side in 23 of these patients (53.5%) was left limb and 20 (46.5%) was right limb and 30 of involved patients were in the range of 30-60 years. Conclusion: According to the results of our study, we found that history and neurological examination have a low efficiency in the diagnosis of cubital tunnel syndrome. This may be associated with relatively subjective evaluation of neurological examination and history and also many pathologies in the differential diagnosis of cubital tunnel syndrome. We believe that electromyelography application is required in addition to a detailed physical examination for cubital tunnel syndrome in order to avoid delayed diagnosis and incomplete/incorrect treatment.Öğe Is MR imaging correlated with mid-term clinical results after arthroscopic all-inside meniscal repair?(2019) Uzun, Erdal; Dogan, Serap; Guney, Ahmet; Akkurt, SonerAim: To research the correlation between clinical and radiological results after arthroscopic meniscus repair with all-inside suture technique and to assess the magnetic resonance imaging (MRI) diagnostic value on previously repaired meniscus.Materials and Methods: Fifty-two patients were included in the study.All-inside suture technique with a Fast-Fix suture device was used for all patients. After at least 24 months follow-up, the affected knee was checked with 1.5 Tesla MRI if there was an additional pathology or the meniscal pathology persisted with criteria of Crues et al. International Knee Documentation Committee (IKDC) and Lysholm scores were used for evaluation of the functional status of patients. Barrett’s criteria wascriteria were used for failure rates and clinical improvement. Correlation between clinical results and MRI findings were investigated.Results: The mean follow-up was 39.6 (range, 24–60) months. The mean age was 31.4 (range, 21–45) years. At the last time follow up the mean IKDC and Lysholm scores were improved significantly (p0.001). Healing in RR zone tears were significantly better than for the RW zone according to the clinical scores (p=0.02). MRI had one false negative and 11 false positive resultsresult when compared with the clinical results. In radiological results, repairs after at least 8 weeks were different from early repairs and had significantly higher failure rates (p=0.01).Conclusion: Clinical examination and radiological investigation for meniscal healing with 1.5 Tesla MRI gave significantly different healing and failure rates (p=0.006).Evaluating a previously repaired meniscus with MRI is controversial.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 Palmar lipoma causing ulnar neuropathy(2017) Ekinci, Yakup; Uzun, Erdal; Yetis, MehmetLipomas are the most common benign soft tissue tumors arising from mesenchymal fibroadipose tissue. Often they are observed in the upper limbs, but especially deep palmar hand placement of these tumors is rare and they rarely create symptoms by compressing the surrounding tissue. 52-year-old female patient was admitted to our clinic with palpable stiffness, pain and numbness in his left hand palm. In her history it was learned that she had had an operation because of similar complaints in the same area about 8 months ago in another center. On radiologic examination, about 3 * 4 cm mass was detected surrounding the 5. metacarpal bone in the palmar area. The mass was excised due to clinical findings of neuropathy and ulnar nerve was freed. At follow-up neuropathic symptoms did not encounter and the patient was completely recovered without any complications.Öğe A Repair Of Tibialis Anterior Hernia With Periosteal Turnover Flap(2017) Deveci, Mustafa; Cirakli, Alper; Uzun, Erdal; Oncel, Eyup SabriThe tibialis anterior muscle herniation was treated with the periosteal turnover flap technique, which has not been previously described in literature. The defect area covered with tibial periosteum by turning the raised flap over on itself at 180º after debridement of the defect edges. Four cases had a history of trauma and the herniation was in the mid-third of the tibia. The mean follow-up period was 84 months (range, 72-96 months) during which no complications or recurrence were observed. In this paper, the periosteal turnover flap technique is described for the first time in literature. The repair of tibialis anterior muscle herniation with periosteal turnover flap can be considered as a safe method.Öğe A repair of tibialis anterior hernia with periosteal turnover flap(Turgut Özal Tıp Merkezi Dergisi, 2017) Deveci, Mustafa; Çıraklı, Alper; Uzun, Erdal; Öncel, Eyüp SabriAbstract The tibialis anterior muscle herniation was treated with the periosteal turnover flap technique, which has not been previously described in literature. The defect area covered with tibial periosteum by turning the raised flap over on itself at 180º after debridement of the defect edges. Four cases had a history of trauma and the herniation was in the mid-third of the tibia. The mean follow-up period was 84 months (range, 72-96 months) during which no complications or recurrence were observed. In this paper, the periosteal turnover flap technique is described for the first time in literature. The repair of tibialis anterior muscle herniation with periosteal turnover flap can be considered as a safe method. Keywords: Tibialis Anterior; Herniation; Periosteal; Flap; Surgical TreatmentÖğe 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.Öğe Synovial hemangioma originating from the 4 th finger tendon sheath(2017) Uzun, Erdal; Ekinci, Yakup; Yetis, MehmetSynovial haemangiomas are benign vascular lesions that originate from any synovial tissue, which may behave like locally aggressive. Haemangiomas developing in the hand in relation to tendon and the tenosynovium (tendon sheath) are very rare. Among the differential diagnosis for lesions of the hand, synovial hemangioma of the articular surface and tendon sheath is often overlooked due to its rare nature. A 49 year-old woman applied for a mass on her right dominant hand forth finger above the flexor tendon at the 4th metacarpophalangeal joint site is presented in this study. An ultrasonography was planned which confirmed a soft tissue lesion above the 4th flexor tendon at the 4th metacarpophalangeal joint site with appearance similar to giant cell tumour of the tendon sheath. After excision, the histopathologic analysis demonstrated tenosynovial haemangioma. The rare causes of finger masses should be considered also during the differential diagnosis. Local invasions and recurrence may be prevented with early surgical treatment and total excision of the lesion.Öğe Trochanter minor avulsion fracture in an amateur football player(Turgut Özal Tıp Merkezi Dergisi, 2016) Uzun, ErdalApophysial avulsion fractures of the pelvis in adolescent period occur after sudden and violent contractions of the muscles with insertions in these areas. In this report we present trochanter minor avulsion fracture in a 13-year-old amateur football player. In his history he reported that a sudden pain occured in his left hip during a ball shot while playing football on a field. On physical examination, movements of the left hip were painful and on the radiologic imagination an avulsed bone fragment of trochanter minor of the left femur was observed. The patient was offered analgesic and anti-inflammatory drug treatment. Pain decreased after 2 weeks and the patient was allowed to mobilise with crutches without weight bearing. After 4 weeks he was allowed walking without support. At the end of the 6 weeks the patient was allowed to start athletic activity. Keywords: Avulsion Fracture; Adolescent; Trochanter Minor; Treatment; Conservative.
