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Öğe Application of hybrid external fixation by the “joystick method” in bicondylar tibial plateau fractures: Technical note(2018) Kuyucu, Ersin; Kara, Adnan; Say, Ferhat; Erdil, Mehmet; Bülbül, Murat; Gülenç, BarışBACKGROUND: This study aimed to present clinical outcomes in patients with tibial plateau fractures who were treated with hybrid external fixators and describe the details of our technique. Schanz screws were synchronously applied and used as a joystick for fracture reduction. METHODS: The study population included 72 patients with bicondylar tibial plateau fractures classified as type 41-C2 according to the AO classification. Joint reduction was maintained using Schanz screws transmitted through tibial condyles as a joystick under fluoroscopy. The patients then underwent surgery with these Schanz screws and a hybrid external fixation system. RESULTS: The median age of the patients was 39 (21–67) years, and the median follow-up time was 21 (12–35) months. The mean knee flexion and extension were 105° (80°–125°) and 0° (?5°–7°), respectively. The mean varus laxity and valgus laxity were 4.30° (2°–7°) and 3.10° (2°–5°), respectively. Four patients had leg shortness of 0.4–1.1 cm. The external fixators were removed between 8 and 16 weeks (mean = 11 weeks) postoperatively. The KSS scores at the end of 1 year were “excellent” for 48 patients, “good” for 19 patients, and “inadequate” for 5 patients. CONCLUSION: With the synchronous application of the two Schanz screws of 6.5-mm thickness and the two-drill technique under fluoroscopic guidance, we obtained stable reductions over a short period. No patient experienced major complications, and this enabled early weight bearing and a return to daily living activities.Öğe Causes of open fractures: orthopaedic injuries related to home-made agricultural vehicles in the eastern Black Sea region of Turkey(Tubitak Scientific & Technical Research Council Turkey, 2016) Say, Ferhat; Coşkun, Hüseyin Sina; Erdoğan, Murat; Bülbül, Ahmet Murat; Gürler, DenizBackground/aim: Small vehicles known locally as pat-pats, which are used in agricultural work, are forbidden in traffic. The inherent instability of the vehicle may result in accidents, both on farmland and in traffic. The aim of this study was to evaluate orthopaedic injuries related to pat-pats. Materials and methods: Patients hospitalised for pat-pat accidents in two central hospitals in Samsun between December 2006 and October 2013 were scanned using ICD codes. A total of 46 patients with orthopaedic injuries (43 male, 3 female) with a mean age of 36 ± 13.3 years were evaluated. Results: The most injured age group was between 10 and 49 years (n = 40, 87%), and accidents occurred most in summer (n = 30, 65%). Open fractures were determined in 42 (91%) patients. Amputation was necessary in 4 (8%) patients. The hospitalisation period was a mean of 17.1 ± 14 days. A statistically significant relationship was determined between open fracture type and the hospitalisation period (P < 0.001). Conclusion: As most of the orthopaedic injuries related to home-made agricultural machines are open fractures, it is important to guard against these types of injuries. The regulations that these machines are not used in traffic should be enforced and safer practices should be applied for use in agriculture.Öğe Comparision of platelet-rich plasma and steroid injection in the treatment of chronic lateral epicondylitis(Edizioni Minerva Medica, 2014) Say, Ferhat; İnkaya, Erkan; Arslan, E.; Bülbül, Murat; Malkoç, MelihAim. Platelet rich plasma (PRP) is a biologi cal treatment which stimulates the recovery response by the expression of growth fac tors from activated thrombocytes. This study aimed to compare the effects of PRP and steroid injections in patients diagnosed with and being followed-up for chronic lateral epi condylitis. Methods. This prospective study included 60 patients diagnosed with and being followed up for chronic lateral epicondylitis. In the PRP group (N.=3O), blood taken from the pa tients was centrifuged to separate PRP, which was then activated by calcium chloride and a single dose injection was applied using the peppering technique. In the steroid group (N.=3O) a single dose methylprednisolone with local anesthetic injection was applied using the peppering technique. Clinical evaluation was made by the Mayo elbow score and a visual analogue scale (VAS). Results. No major complications were seen in any patient. Both groups Mayo elbow score was increased and VAS score was decreased and no statistically significant difference was detected between the groups at six weeks. Statistically significant better results in the Mayo elbow score and VAS score was deter mined in PRP group than steroid group at six months. Conclusion. In the treatment of chronic lateral epicondylitis, although in the early stages the application of PRP showed similar effects to steroid injection, in the longer term PRP was more effective than steroid injection. PRP reduced pain and increased function in the treatment of chronic lateral epicondylitis. The application of PRP is à safe and effective method. Further studies are required to support the findings of this study.Öğe Comparison of medial arch-supporting insoles and heel pads in the treatment of plantar fasciitis(University of Kragujevac, Faculty of Science, 2015) Malkoç, Melih; Korkmaz, Özgür; Kara, Adnan; Oltulu, İsmail; Say, FerhatPlantar fasciitis is a disorder caused by inflammation of the insertion point of the plantar fascia over the medial tubercle of the calcaneus. Foot orthotics are used to treat plantar fasciitis. Heel pads medialise the centre of force, whereas medial arch supporting insoles lateralise the force. We assessed the clinical results of the treatment of plantar fasciitis with silicone heel pads and medial arch-supported silicone insoles. We retrospectively reviewed 75 patients with heel pain. A total of 35 patients in the first group were treated with medial arch supporting insoles, and 40 patients in the second group were treated with heel pads. The patients were evaluated with the Visual Analogue Scale (VAS) and the Foot and Ankle Ability Measure (FAAM) at the first and last examinations. The mean VAS score in the first group was 8.6±1,2 (6-10); the FAAM daily activity score was 66.2±16 (41.2-95.0), and the sporting activity score was 45.4±24,4 (0.1-81) before treatment. At the last follow-up in this group, the mean VAS score was 5.3±1,5 (0-9); the FAAM daily activity score was 83,0±15,1 (55,9-100), and the sporting activity score was 73,5±26,2 (25-100). The mean VAS score in the second group was 8,6±0,9 (7-10); the FAAM daily activity score was 66.4±17 (41.4-95.2), and the sporting activity score was 45.8±24,2 (0.8-81, 3) before the treatment. At the last followup in this group, the mean VAS score was 5.5±1,2 (0-9); the FAAM daily activity score was 83.4±14,9 (60, 2-100), and the sporting activity score was 73.8±26 (28-100). There was no significant difference in the clinical results of both groups. The force distribution by the use of silicone heel pads and medial arch-supported silicone insoles had no effect on the clinical results of the treatment of plantar fasciitis.Öğe Comparison of minimally invasive plate versus intramedullary nailing in the treatment of distal tibial metaphyseal fractures(Acta Medica Belgica, 2020) Say, Ferhat; İnkaya, Erkan; Gürler, Deniz; Bülbül, Murat; Gültaç, EmreTreatment was made by locked anatomic tibial plate with MIPO technique on 17 patients (Group1), closed intramedullary nailing on 18 patients (Group2). The cases were evaluated with the AFAS score.The median operation duration was 90(59-139)mins in Group1, 77.5(59-145)mins in Group2. The median union time was 15(11-20)weeks in Group1, 18(1222)weeks in Group2. The median AFAS score was 84(47-90) in Group1, 82(65-90) in Group2. The most common complication was infection in Group1 and malunion in Group2. Only the difference in operation time was found to be statistically significant between the two groupsThe clinical and functional results of both treatment methods were similar and effective. Malalignment should be kept in mind when treating with intramedullary nail; infection when treating with MIPO.Öğe Comparison of platelet-rich plasma and steroid injection in the treatment of plantar fasciitis(Turkish Association of Orthopaedics and Traumatology, 2014) Say, Ferhat; Gürler, Deniz; İnkaya, Erkan; Bülbül, MuratObjective: The aim of this study was to compare the effects of platelet-rich plasma (PRP) and steroid injections in patients diagnosed with plantar fasciitis. Methods: A total of 50 patients with chronic plantar fasciitis were included in the study and divided into 2 groups. In the PRP group (n=25), PRP taken from the patients' blood was activated using calcium chloride and injected in a single dose. In the steroid group (n=25), a single dose methylprednisolone with local anesthetic injection was given. Clinical evaluation was made using the American Foot and Ankle Score (AFAS) and the visual analog scale (VAS). Results: No complications were seen in any patients. Mean AFAS was 85.5±4.2 at 6 weeks and 90.6±2.6 at 6 months in the PRP group and 75.3±4.8 and 80.3±4.7, respectively, in the steroid group (p<0.001). The difference in the mean VAS between the PRP group (2.4±0.8 and 1±0.8) and the steroid group (4±1.1 and 2.6±0.9) at the 6th week and 6th month was statistically significant (p<0.001). Changes in AFAS and VAS scores were significantly higher in the PRP group (p<0.001). Conclusion: The application of PRP appears to be more effective than steroid injection in terms of pain and functional results in the treatment of chronic plantar fasciitis.Öğe Findings related to rotational malalignment in tibial fractures treated with reamed intramedullary nailing(Springer, 2014) Say, Ferhat; Bülbül, MuratIntroduction: Rotational malalignment following closed intramedullary nailing of tibial fractures does not attract attention but is a complication which may lead to serious results. This study aimed to present findings related to rotational malalignment from rotational alignment measurements made clinically and with computerised tomography (CT) in patients who had undergone locked intramedullary nailing for tibial fracture.Materials and methods: A total of 26 patients (male/female: 23/3) were evaluated after application of reamed locking intramedullary nailing to a diagnosed tibial shaft fracture. The mean age was determined as 37.5 ± 15.6 years. Rotational alignment was measured in both lower extremities clinically as thigh-foot angle (TFA) and radiologically with CT. Rotational malalignment was accepted as a more than 10º difference between the two lower extremities.Results: Malrotation was determined at more than 10º from TFA in two (7 %) of 26 patients and from CT in five (19 %) of 26 patients. In three of them, the malrotation was >15º. Of the patients determined with malrotation with CT, it was determined from clinical measurements in 40 %. The mean rotational difference was determined as greater with CT measurement (4.7° ± 9.5) compared to the TFA (1.1° ± 5.6) (p < 0.001). No statistically significant relationship was determined between a rotational difference over 10º and the AO fracture type, fracture location and fibula fixation.Conclusions: A significant number of patients treated with intramedullary nailing for a tibial fracture may result in rotational malalignment. To determine rotational malalignment, a thorough clinical evaluation must be made and different kinds of clinical measurements taken and, when suspicions remain, determination should be made by CT.Öğe Giant epidermal cyst of the foot(Srpsko Lekarsko Društvo, 2014) Malkoç, Melih; Korkmaz, Özgür; Genç, Yıldıray; Say, Ferhat; Aytekin, Mahmut NedimIntroduction Epidermoid inclusion cysts are usually composed of epidermal elements implanted into the dermal layers. Patients are seen in the outpatient clinics with a mass. Most of the complaints are mechanical and cosmetic problems. Case Outline A 34-year-old female patient was admitted to our clinic because of swelling and pain in her right foot. A palpable mass was detected in the first web. On the x-rays of the foot no osseous lesion was detected. There was a soft tissue mass in the first web according to MRI report. Soft tissue mass was excised and sent to pathology. According to pathology report the mass was an epidermoid cyst 5x2x1.5 cm in size. There were no problems during follow-up of the patient for 6 months after surgery. The patient had no swelling in the foot and had no additional complaints on checkup. Conclusion In the differential diagnosis, we should take into consideration epidermoid cyst of large soft tissue masses of the foot. Surgical excision should be done within the appropriate limits.Öğe Hybrid external fixation via a minimally invasive method for tibial pilon fractures -Technical note(Elsevier, 2015) Bülbül, Murat; Kuyucu, Ersin; Say, Ferhat; Kara, Adnan; Erdil, Mehmet EminIntroduction: We aimed to present the clinical and radiological outcomes of patients with tibial pilon fractures who were treated with hybrid external fixators. Shanz screws were applied synchronously and used as joysticks for fracture reduction. Radiological evaluations were conducted on roentgenograms at the second week, sixth week, third month and first year. Material and methods: The study group included 42 patients with tibial pilon fractures that were classified as 43C according to the AO/OTA classification system. We used 2-hydroxyapatite-coated Schanz screws for the tibial pilon reduction. Schanz screws fixated to two separate motors were synchronously passed through the fracture fragments. An external fixator was applied after the fracture was stabilized with Schanz screws. Results and discussion: The mean operation duration was 45 min Fracture healing was observed in all patients, and the mean fracture healing time was 17 (range, 12-32 weeks) weeks. The mean lateral distal tibial angle was 89°. Joint surface irregularity was not observed in any patient. All of the patients had 0-15° of ankle dorsiflexion. None of the patients had restricted ankle plantar flexion. No wound complications were observed. According to the AOFAS scoring system, the clinical evaluation was excellent in 26 patients, good in 14 patients and fair in 2 patients. Malunion and nonunion may necessitate additional surgical procedures, delay the return to activities of daily living, and increase treatment costs. Good alignment was achieved, with a mean lateral distal tibial angle of 89 (range, 84-92) degrees. Conclusion: Permanent hybrid external fixator applied using Schanz screws via a mini open technique is a fast, easily applied alternative with low morbidity and satisfying results.Öğe Is platelet-rich plasma injection an effective choice in cases of non-union?(Galen s.r.o., 2014) Say, Ferhat; Türkeli, Erdinç; Bülbül, MuratPURPOSE OF THE STUDY: By the expression of several growth factors from activated thrombocytes, the application of Platelet Rich Plasma (PRP) stimulates angiogenesis and regeneration thus stimulating recovery through cell differentiation. This study aimed to evaluate the effects of PRP injection on patients who had undergone surgery for fracture and in whom delayed union or nonunion had been determined.MATERIAL AND METHODS: The study comprised 20 patients (male 17, female 3; median age 33.5 range 15-77) who had undergone lower extremity fracture surgery and were diagnosed with aseptic delayed union (8 patients) or non-union (12 patients). Blood taken from the patients was centrifuged to separate PRP, which was then activated by calcium chloride. The prepared PRP was injected into the fracture line under fluoroscopy guidance for totally three times once a week. The application of PRP was made at median 6 (range 6-8) months after fracture surgery. All patients were followed-up with clinical examinations and radiographs over a median period of 11 (range 8-12) months.RESULTS: Fracture union was achieved in six patients at median 15 (range 8-24) weeks. There was non-union of the fracture in eleven patients during the follow-up period and these patients underwent revision surgery. Sufficient union was not determined radiologically and clinically in three patients. Fracture union was achieved in six of eight patients in the delayed union group. There was no patient in the non-union group with fracture union.CONCLUSIONS: Fracture healing is a process affected by many factors. Although PRP has been reported in literature to be a biological treatment which increases healing, adequate healing was not determined in the treatment of non-union with PRP injection. However, in selected patients determined with delayed union, PRP injection can be recommended in non-surgical treatment.Öğe Myositis ossificans on the forearm in a 10-year-old girl(Lippincott Williams and Wilkins, 2015) Say, Ferhat; Coşkun, Sina; Bülbül, Murat; Alıcı, ÖmerMyositis ossificans is a rarely encountered benign lesion characterized by a non-neoplastic heterotopic bone formation in both soft tissue and skeletal muscle. Three subgroups of myositis ossificans are identified: myositis ossificans progressiva, which is hereditary; nontraumatic or pseudomalignant myositis ossificans, which is developed in the absence of any trauma; and myositis ossificans circumscripta, which is related to evident and direct trauma. In this case report, we present a girl with a swelling on the forearm who was finally diagnosed with nontraumatic myositis ossificans.Öğe Platelet-rich plasma injection is more effective than hyaluronic acid in the treatment of knee osteoarthritis(Galen S.R.O., 2013) Say, Ferhat; Güler, Deniz; Yener, Kamil; Bülbül, Murat; Malkoç, MelihPURPOSE OF THE STUDY: There is increasing use of platelet-rich plasma (PRP) in orthopaedics as it is a simple, cheap and minimally invasive technique. This study aimed to compare the effects of the use of PRP and hyaluronic acid (HA) injections in the knee of patients diagnosed with and being followed-up for degenerative arthritis. MATERIALS AND METHODS: This prospective study included 90 patients with complaints of knee pain with findings of mild or moderate degenerative arthritis. In the PRP group (n = 45), one intra-articular injection was applied and in the HA group (n = 45), three doses of intra-articular injection were applied. Clinical evaluation was made by Knee Injury and Osteoarthritis Outcome Score (KOOS) and avisual pain scale. RESULTS: No severe adverse events was observed. Statistically significant better results in the KOOS score and visual pain scale was determined in PRP group than HA group at 3 months and 6 months follow up. The cost of the application for the PRP group was lower than that of the HA group. CONCLUSION The results of this study have shown the application of single dose PRP to be a safe, effective and low-cost method for treating OA. However, further studies are required for amore clear result.Öğe Platelet-rich plasma versus steroid injection for subacromial impingement syndrome(SAGE Publications Inc, 2016) Say, Ferhat; Gürler, Deniz; Bülbül, MuratPurpose. To compare the 6-week and 6-month outcome in 60 patients who received a single-dose injection of platelet-rich plasma (PRP) or steroid for subacromial impingement syndrome (SIS). Methods. 22 men and 38 women (mean age, 49.7 years) opted to receive a single-dose injection of PRP (n=30) or steroid (n=30) for SIS that had not responded to conservative treatment for >3 months. The PRP or a mixture of 1 ml 40 mg methylprednisolone and 8 ml prilocaine was administered via a dorsolateral approach through the interval just beneath the dorsal acromial edge. Both groups were instructed to perform standard rotator cuff stretching and strengthening exercises for 6 weeks. The use of non-steroid anti-inflammatory drugs was prohibited. Patients were evaluated before and 6 weeks and 6 months after treatment using the Constant score, visual analogue scale (VAS) for pain, and range of motion (ROM) of the shoulder. Results. No local or systemic complication occurred. Improvement in the Constant score and VAS for pain at week 6 and month 6 was significantly better following steroid than PRP injection. The difference in the Constant score was greater than the mean clinically important difference of 10.4. Nonetheless, the 2 groups were comparable for improvement in ROM of the shoulder. Conclusion. Steroid injection was more effective than PRP injection for treatment of SIS in terms of the Constant score and VAS for pain at 6 weeks and 6 months.Öğe Reverse shoulder arthroplasty-early results(Ondokuz Mayıs Üniversitesi, 2021) Say, Ferhat; Kuyubaşı, Numan; Pişkin, Ahmet; Bülbül, MuratAlthough reverse shoulder arthroplasty is used in massive rotator cuff tears, it is also used in proximal humerus fractures and shoulder arthroplasty revision. In this study, we aimed to examine the early radiological and clinical results of patients undergoing reverse shoulder arthroplasty with different diagnoses. Between 2010 and 2013, reverse shoulder arthroplasty was applied to 10 patients (4 men, 6 women) with the diagnosis of arthropathy due to rotator cuff tear (n: 7), multi-fragmentary proximal humerus fracture (n: 2) and hemiarthroplasty revision (n: 1). The median age of the patients was 74 (64-85) years and the median follow-up was 15.5 (3-35) months. Patients were assessed in terms of joint range of motion, Constant score and Visual Pain Scale (VAS) and radiological examinations before and after surgery. Preoperative active shoulder flexion, abduction, internal and external rotation degrees of the patients were 65, 30, 40 and 50 degrees, and 105, 95, 30, 57.5 degrees respectively in their final controls. Constant score was 20.5 (14-63) preoperatively, and 54.5 (38-64) in the final controls (p<0.05). While the preoperative VAS was 7 (3-9), it was found to be 1.5 (1-3) in the final controls (p<0.05). As a complication, scapular notching was observed in one patient. Internal external rotation values were better in the rotator cuff arthropathy group than the fracture group. Reverse shoulder arthroplasty, especially in the treatment of patients with rotator cuff arthropathy, has good early results and a low complication rate. We recommend paying attention to the glenoid component location to avoid scapular notching.Öğe Solitary plasmacytoma of the femur: a case report(Ondokuz Mayıs University, 2014) Say, Ferhat; Gürler, Deniz; Bülbül, MuratSolitary plasmacytoma (SP) is a rare type of myeloma which is a hematologic malign tumour originated from plasma cells. It is an isolated tumour which myeloma signs are not observed. SP primarily affects axial skeleton and involvement of extremity is seen rarely. We report a case of SP of proximal femur origin in a 52-year-old woman. The patient was treated with cemented modüler tumour prosthesis following tumour excision. In a one year follow up period, no recurrens or multiple myeloma signs were observed and the patient was able to walk without support and without pain so the treatment resulted successfully.Öğe Surgical treatment of nail bed subungual exostosis(Singapore Medical Association, 2016) Malkoç, Melih; Korkmaz, Özgür; Keskinbora, Mert; Şeker, Ali; Oltulu, Ismail; Bülbül, Ahmet Murat; Say, Ferhat; Çakır, AslıINTRODUCTION A subungual exostosis (SE) is a bony overgrowth that is permanently attached to the tip of the distal phalanx. Its pathology differs from osteocartilaginous exostoses in that it mainly involves the overgrowth of normal bone, which may present beneath the toenail or on the sides of the toe. This retrospective study aimed to report the results of surgical treatment when the diagnosis of SE was delayed; the condition was initially considered to be another pathology affecting a different nail or the terminal toe. METHODS A total of 17 patients (12 female, five male) were included in the study. All surgical resections were performed by the same surgeon using the same surgical technique, with the patient under digital anaesthesia. The patients were evaluated pre- and postoperatively (on Weeks 1 and 6, the first year, and the last follow-up visit) using the American Orthopaedic Foot and Ankle Society questionnaire and the Visual Analogue Scale score. RESULTS The patients underwent surgery for SE removal between December 2009 and October 2012. Their mean age was 21.3 +/- 4.4 (range 14-29) years and the mean follow-up period was 27.1 +/- 7.8 (range 18-45) months. Clinical or radiological recurrence was not observed in any of the patients during the follow-up period. Four patients had superficial infections, which were treated using appropriate antibiotic therapies. CONCLUSION As SE is an uncommon benign lesion, its diagnosis may be delayed. Radiography may be useful in obtaining a differential diagnosis.Öğe Surgical treatment results of carpal tunnel syndrome in patients with and without type 2 diabetes mellitus(Srpsko Lekarsko Društvo, 2014) Malkoç, Melih; Korkmaz, Özgür; Oltulu, İsmail; Şeker, Ali; Say, Ferhat; Bülbül, Ahmet MuratIntroduction Carpal tunnel syndrome (CTS) is the most commonly seen peripheral nerve compression syndrome and CTS surgery is the most common surgery done for peripheral nerve compression syndromes. Type 2 diabetes mellitus (DM) is a systemic disease with a component of peripheral neuropathy. Objective We aimed to investigate the effects of type 2 DM on functional results in type 2 DM patients who underwent carpal tunnel surgery. Methods The study included 39 patients with carpal tunnel syndrome which was confirmed by electromyography. Twenty-one patients did not have DM, 18 patients had type 2 DM that were treated for DM and had regulated blood glucose levels. Assessments were done with the Boston scale. All operations were done by the same surgical team using the same surgical technique. Functional and symptomatic scores between the two groups were compared with the Mann-Whitney U test which is the non-parametric version of the Student's t test, and 95% confidence interval p<0.05, which is considered as statistically significant. Results In patients with type 2 DM, preoperative mean Symptom Severity Score was 3.6 +/- 0.35 (2.9 to 4.2) in the last control mean Symptom Severity Score was 1.2 +/- 0.16(1.0-1.7), and preoperative mean functional status score was 3.3 +/- 0.56(2.3 to 4.5) and in the last control mean functional status score was 1.3 +/- 0.36 (1.0 to 2.4). The patients without DM, preoperative mean Symptom Severity Score was 3.5 +/- 0.45 (2.8 to 4.2) in the last control mean Symptom Severity Score was 1.2 +/- 0.19 (1.0 to 1.6), and preoperative functional status score was 3.2 +/- 0.47 (2.4 to 4.6) in the last control mean functional status score was 1.3 +/- 0.35 (1.0 to 2.5). There was no statistically significant difference between the two groups. Conclusion Type 2 DM patients with regulated blood glucose levels can be operated without additional procedure during and after surgery for carpal tunnel syndrome like in carpal tunnel syndrome patients without DM.Öğe Which treatment option for paediatric femoral fractures in school-aged children: Elastic nail or spica casting?(Springer-Verlag France, 2014) Say, Ferhat; Gürler, Deniz; İnkaya, Erkan; Yener, Kamil; Bülbül, MuratObjective: Titanium elastic nails and immediate spica casts are treatment options for femoral fractures in school-aged children (6-12 years). This study aimed to compare the results of elastic nail and immediate spica cast methods for treating femoral fractures in school-aged children. Materials and methods: A retrospective evaluation was made of patients who underwent immediate spica cast (20 patients) or titanium elastic nail (22 patients) for femoral fracture. Groups were compared in terms of clinical and radiographic union, duration of hospitalisation, range of knee motion, walking independently and complications. The mean age was 9.8 ± 1.3 years for the elastic nail group and 6.4 ± 1 for the cast group. The mean follow-up period was 12.6 ± 5.2 months for the elastic nail group and 14.3 ± 6 months for the cast group. Results: All fractures in both group were healed. Duration of hospitalisation was shorter (2.2/7.1) and range of knee motion was better (132°/129°) in the cast group. The duration for independent walking was shorter (49.2/79.8) in the nail group. These differences were significant (p < 0.001). Two superficial infections and two malalignment were detected in the nail group. Three superficial infections and four malalignment were detected in the cast group. Conclusion: We detected that both treatment options were similar with regard to complications and results. Although the complications are similar in two treatment methods, complications of elastic nail are more challenging and may require new surgical procedure. If the elastic nail is selected, surgical complications should not be underestimated.Öğe Which unicondylar prosthesis is better in the mid- term in obese patients: Fixed or mobile?(Acta Medica Belgica, 2018) Kuyucu, Ersin; Bülbül, Ahmet Murat; Kara, Adnan; Say, Ferhat; Erdil, MehmetAs it is mentioned in the literature, rates of complications and revision are higher in the obese compared to non-obese patients, although obesity does not a contraindication for unicompartmental knee arthroplasty and successful outcomes are achieved. However, there is not any study in the literature comparing the outcomes of fixed and mobile unicompartmental prostheses which are applied in the obese patients. Objective of this study was to compare outcomes of our obese patients who we applied fixed or mobile unicompartmental arthroplasty and followed up for 8 years and over. Of 293 patients in whom we performed unicompartmental knee prosthesis due to medial gonarthrosis between 2003 and 2014, 239 patients who were regularly followed-up at least for 18 months were included in this study. Total 248 knees with 193 (77.8%) fixed including bilateral prosthesis in 9 patients and 55 (22.2%) mobile prostheses were retrospectively assessed. The study included 57 patients having BMI >30 kg/ m2 who were regularly followed-up. In the final controls; mean flexion was found as 107° (100-128°)(p < 0.05), mean extension as 3° (0-5°) and mean tibio femoral angle as 4° (1-5°) (p < 0.05) valgus. Postoperative mean WOMAC value was found as 91.23 ± 3.02 (92-96) (p < 0.05) and mean KSS score as 88.3 ± 3.94 (85-100) (p < 0.05). In the final controls, respective knee flexions were seen to be 105° (100-125°) and 108°(105-128°) in the fixed and mobile insert subgroups (p > 0.05). Unicompartmental knee prosthesis is a good treatment option which can be applied also in obese patients and has high survival rates. No significant difference was found between the prostheses with fixed and mobile insert in terms of function and knee scores. However, fixed unicompartmental prosthesis should primarily be preferred in obese patients because of the challenging surgical technique, difficult learning curve and insert dislocation that we encounter with mobile prostheses.Öğe Which unicondylar prosthesis is better in the mid-term in obese patients : Fixed or mobile?(Acta Medica Belgica, 2017) Kuyucu, Ersin; Kara, Adnan; Say, Ferhat; Erdil, Mehmet; Bülbül, Ahmet MuratAs it is mentioned in the literature, rates of complications and revision arc higher in the obese compared to non-obese patients, although obesity does not a contraindication for unicompartmental knee arthroplasty and successful outcomes are achieved. However, there is not any study in the literature comparing the outcomes of fixed and mobile unicompartmental prostheses which are applied in the obese patients. Objective of this study was to compare outcomes of our obese patients who we applied fixed or mobile unicompartmental arthroplasty and followed up for 8 years and over.Of 293 patients in whom we performed unicompartmental knee prosthesis due to medial gonarthrosis between 2003 and 2014, 239 patients who were regularly followed-up at least for 18 months were included in this study. Total 248 knees with 193 (77.8%) fixed including bilateral prosthesis in 9 patients and 55 (22.2%) mobile prostheses were retrospectively assessed. The study included 57 patients having BMI >30 kg/ m2 who w ere regularly followed-up.In the final controls; mean flexion was found as 107 degrees (100-128 degrees)(p<0.05), mean extension as 3 degrees (0-5 degrees) and mean tibio femoral angle as 4 degrees (1-5 degrees) (p<0.05) valgus. Postoperative mean WOMAC value was found as 91.23 +/- 3.02 (92-96) (p<0.05) and mean KSS score as 88.3 +/- 3.94 (85-100) (p<0.05). In the final controls, respective knee flexions were seen to be 105 degrees (100-125 degrees) and 108 degrees(105-128 degrees) in the fixed and mobile insert subgroups (p>0.05).Unicompartmental knee prosthesis is a good treatment option which can be applied also in obese patients and has high survival rates. No significant difference was found between the prostheses with fixed and mobile insert in terms of function and knee scores. However, fixed unicompartmental prosthesis should primarily be preferred in obese patients because of the challenging surgical technique, difficult learning curve and insert dislocation that we encounter with mobile prostheses.
