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Öğe An undescribed monteggia type 3 equivalent lesion: Lateral dislocation of radial head with both-bone forearm fracture(Hindawi Publishing Corporation, 2016) Kara, Adnan; Kayaalp, Mahmut Enes; İşyar, Mehmet; Sever, Cem; Malkoç, Melih; Mahiroğulları, MahirMonteggia fractures are accepted as hard-to-recognize and easy-to-handle fractures. Adequate radiographic investigations and clinical examinations are necessities. This case holds unique features involving diagnosis and treatment. In this case, the radial head was dislocated laterally while both bones were fractured in the proximal diaphysis, being the first to be mentioned in the literature. Closed reduction of the ulna is the preferred method of handling and almost always results in reduction of the radial head. Literature obligates ulnar reduction as a preliminary to reduce and stabilize the radial head. Closed reduction reduced the ulna but the radial head was not reduced. Hence an intramedullary K-wire was used to reduce the radial head and a long arm cast was used to stabilize the reduction. The operation was successful and follow-up showed no complications.Öğe Clinical and radiological results of microsurgical posterior lumbar interbody fusion and decompression without posterior instrumentation for lateral recess stenosis(Korean Society of Spine Surgery, 2015) Demirayak, Mehmet; Şişman, Lokman; Türkmen, Faik; Efe, Duran; Pekince, Oğuzhan; Göncü, Recep Gani; Sever, CemStudy Design: A single-center, retrospective patient review of clinical and radiological outcomes of microsurgical posterior lumbar interbody fusion and decompression, without posterior instrumentation, for the treatment of lateral recess stenosis. Purpose: This study documented the clinical and radiological results of microsurgical posterior lumbar interbody fusion and decompression of the lateral recess using interbody cages without posterior instrumentation for the treatment of lateral recess stenosis. Overview of Literature: Although microsurgery has some advantages, various complications have been reported following microsurgical decompression, including cage migration, pseudoarthrosis, neurologic deficits, and persistent pain. Methods: A total of 34 patients (13 men, 21 women), with a mean age of 56.65±9.1 years (range, 40-77 years) confirmed spinal stability, and preoperative radiological findings of lateral recess stenosis, were included in the study. Interbody polyetheretherketone cages and auto grafts were used in all patients. Posterior instrumentation was not used because of limited resection of the posterior lumbar structures. Preoperative and postoperative radiographs, computed tomography scans, and magnetic resonance imaging were assessed and compared to images taken at the final follow-up. Functional recovery was also evaluated according to the Macnab criteria at the final follow-up. Results: The average follow-up time was 35.05±8.65 months (range, 24-46 months). The clinical results, operative time, intraoperative blood loss, and duration of hospital stay were similar to previously published results; the fusion rate (85.2%) was decreased and the migration rate (5.8%) was increased, compared with prior reports. Conclusions: Although microsurgery has some advantages, migration and pseudoarthrosis remain challenges to achieving adequate lumbar interbody fusion.Öğe Diz manyetik rezonans görüntüleme bulguları ve fizik muayene bulgularının artroskopik bulgular ile karşılaştırılması(2013) Malkoç, Melih; Korkmaz, Özgür; Sever, CemFizik muayene bulguları ile birlikte manyetik rezonans (MR) görüntüleme sonuçlarının artroskopik cerrahi yapılması kararı üzerine olan etkilerini belirlemek. Yöntem: Kliniğimizde diz artroskopisi yapılan hastaların ameliyat öncesi fizik muayene bulguları ile MR tetkiki sonuçları referans artroskopi alınarak retrospektif olarak istatistiksel değerlendirilmesi yapıldı. Bulgular: Çalışmaya katılan hastalrın yaş ortalaması 47,2 (22,73) olarak belirlendi. Çalışmadaki hastaların 25’i kadın, 20’si erkek, 27sol dize, 18 sağ dize artroskopik cerrahi yapıldı. Medial menisküs yırtığı olan hastalarda Mc murray testinin duyarlılığı %69,8 medial eklem çizgisi hassasiyetinin duyarlılığı %97,7 MR görüntüleme yönteminin duyarlılığı %93 olarak belirlenmiştir. Lateral menisküs yırtığı olan hastalarda Mc murray testinin duyarlılığı %71,4 lateral eklem çizgisi hassasiyetinin duyarlılığı %100 MR görüntüleme yönteminin duyarlılığı %85,7 olarak belirlenmiştir. Medial ve lateral menisküs yırtıklarında ayrım yapılmaksızın Mc murray testinin duyarlılığı %68,9 eklem çızgısı hassasiyetinin duyarlılığı %97,8 Mr görüntüleme yönteminin duyarlılığı %93,3 olarak belirlenmiştir. Sonuç: Dikkatli yapılan bir fizik muayenenin menisküs patolojilerini belirlemede en etkin tanı yöntemi olduğunu düşündürmektedir ve gereksiz yere MR tetkiki istemi oranlarını azaltabileceğini düşünmekteyiz.Öğe Ganglion cysts in the lateral portal region of the knee after arthroscopy: Report of two cases(Clinical Case Report, 2015) Sever, Cem; Malkoç, Melih; Acar, Türker; Türkmen, Faik; Korkmaz, Özgür; Oto, OnurA ganglion cyst (GC) is a mucinous or gelatinous-filled benign tumor overlying a joint or tendon sheath, which commonly arises in the dorsal and volar wrist side but may occur anywhere in the body. Although cystic lesions around the knee are common, the occurrence of GCs are rare. Ganglia may arise from intra or extra-articular, soft tissue, intraosseous, or periosteal location. Symptoms may vary according to the size and location. After the more frequent performance of magnetic resonance imaging for the assessment of a knee joint, the number of incidental, asymptomatic lesions have been increasingly diagnosed. The etiology of GC remains unclear; however, trauma and a flaw in the joint tissues may explain its appearance. The authors report two cases of women aged 47 years and 37 years who presented pain and swelling in their left knees following arthroscopic partial medial meniscectomy. The former was surgically treated and had a favorable outcome, while the latter had conservative treatment and a gloomy outcome.Öğe İleri yaş hastalarda kalça kırığı cerrahisi ve sonrası kan transfüzyonu(Galenos, 2013) Malkoç, Melih; Korkmaz, Özgür; Sever, Cem; Oltulu, İsmail; Genç, YıldırayAmaç: Çalışmamızın amacı, ileri yaş grubundaki kollum femoris ve intertrokanterik femur kırığı nedeniyle parsiyel kalça protezi yapılan hastaların kan transfüzyonu miktarlarını belirlemek ve her iki grup arası kan transfüzyonu miktarlarının karşılaştırmaktır. Yöntem: Ameliyat öncesi ve hastaların transfüzyonlar sonrası taburculuk öncesi son hemoglobin ve hematokrit değerleri belirlendi. T-testinin non-parametrik karşılığı olan Mann-Whitney U testi ve eşleştirilmiş T-testinin non-parametrik karşılığı olan Wilcoxon testi ile istatistiksel değerlendirme yapıldı. Bulgular: Kollum femoris kırığı nedeniyle ameliyat edilen hastaların yaş ortalaması 84.3 yıl (77-96)dır. İntertrokanterik femur kırığı nedeniyle ameliyat edilen hastaların yaş ortalaması 83.3 yıl (78- 89) olarak belirlendi. Kollum femoris kırığı olan grupta ortalama ameliyat öncesi hemoglobin 12g/dl (10.5-15.2) hematokrit 37.6 (31.1-48.4), taburculuk öncesi son hemoglobin 11.1g/dl (9.2- 12.6) hemotokrit 34.2 (29.5-38.8) olarak ölçüldü. İntertrokanterik kırığı olan grupta ameliyat öncesi hemoglobin 11.4g/dl (9.9-13) hematokrit 35,8 (31-41.3), taburculuk öncesi son hemoglobin 11g/dl (9.5-12.6) hematokrit 33.4 (29.9-38.9) olarak belirlendi. Kollum femoris grubundaki hastalara ortalama 1.7 (0-5) ünite kan transfüzyonu intertrokanterik kırığı olan hastalara ise ortalama 1.9 (1-5) ünite kan transfüzyonu yapıldı. Sonuç: Kollum femoris ve intertrokanterik femur kırığı olan ve parsiyel kalça protezi yapılan ileri yaş grubundaki hastalarda kan transfüzyonu miktarları arasında bir fark yoktur ve ameliyat öncesi 2 ünite eritrosit süspansiyonu hazırlanmalıdırÖğe The effect of glenoid cavity depth on rotator cuff tendinitis(Springer Verlag, 2016) Malkoç, Melih; Korkmaz, Özgür; Örmeci, Tuğrul; Sever, Cem; Kara, Adnan; Mahiroğulları, MahirIntroduction: Some of the most important causes of shoulder pain are inflammation and degenerative changes in the rotator cuff (RC). Magnetic resonance imaging (MRI) is a noninvasive and safe imaging modality. MRI can be used for the evaluation of cuff tendinopathy. In this study, we evaluated the relationship between glenoid cavity depth and cuff tendinopathy and we investigated glenoid cavity depth on the pathogenesis of cuff tendinopathy. Materials and methods: We retrospectively evaluated 215 patients who underwent MRI. Of these, 60 patients showed cuff tendinopathy (group A) and 54 patients showed no pathology (group B). Glenoid cavity depth was calculated in the coronal and transverse planes. Results: The mean axial depth was 1.7 ± 0.9 and the mean coronal depth 3.8 ± 0.9, for group A. The mean axial depth was 3.5 ± 0.7 and the mean coronal depth 1.5 ± 0.8, for group B. There were significant differences in the axial and coronal depths between the two groups. Conclusion: High coronal and low axial depth of the glenoid cavity can be used to diagnose RC tendinitis.Öğe Vertebral hydatid disease and its treatment by anterior-posterior radical excision, fusion and chemotherapy with albendazole: Case report - eleven years follow - up result(2013) Erdem, Mehmet Nuri; Sever, Cem; Korkmaz, Mehmet Fatih; Oltulu, İsmail; Gürgen, Erkan; Tezer, MehmetHydatid cyst is a zoonosis caused by the larval form of parasitic tapeworm Echinococcus granulosus. We present a case of vertebral hydatid cyst with paravertebral abscesses operated 11 years ago. A 32 year old woman presented multiple giant paravertebral abscesses at the level of T11-12 and L1 vertebrae and pathological fracture of L1 vertebra because of vertebral hydatid cyst. Posterior instrumentation and fusion followed by anterior L1 corpectomy and fusion were done. Patient was pain-free at eleven-year follow-up. There was no radiological evidence of relapse. Hydatid disease of the spine is rare, misdiagnosis and therefore inadequate treatment and recurrence is frequent. Maintaining the stability of the spine and achieving a fusion mass is important in the decision of surgical technique in vertebral type of hydatidosis.
