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Öğe Comparison of Hemiarthroplasty, total hip arthroplasty, and internal fixation for hip fractures in patients over eighty years of age: factors affecting mortality: a nationwide cohort study of fifty three thousand, four hundred and ninety five patients from Türkiye(2025) Uzel, Kadir; Birinci, Murat; Hakyemez, Ömer Serdar; Bostancı, Bilal; Bingöl, İzzet; Öktem, Umut; Azboy, İbrahimPurpose: Hip fractures are a common cause of mortality in elderly patients. This study aimed to determine the predictive factors affecting mortality among patients over the age of 80 who underwent surgical treatment for hip fractures. Methods: We searched the Turkish Ministry of Health’s e-health database to identify patients over 80 years old who had undergone surgery for proximal femoral fractures from 2016 to 2022. This process yielded 53,495 patients. Demographic data as well as comorbidities, blood transfusions, postoperative 90 days medical complications, and mortality was investigated. Multivariate logistic regression analysis was performed to identify risk factors for one year mortality in patients undergoing surgical treatment for proximal hip fractures. Results: The mortality rate was 37.2% in the first year. The mean Charlson comorbidity index(CCI) was 6.8 (range: 4–22). In the postoperative period, 68.6% of the patients received blood transfusions. Logistic regression analysis identified significant predictors of one-year mortality in surgical patients, including male gender, increased age, higher CCI scores, AKI, PE, pneumonia, electrolyte imbalance, gastrointestinal bleeding, blood transfusion, and increased mortality risks with hemiarthroplasty and internal fixation compared to total hip arthroplasty. (p < 0.001 for all). Conclusions: This large cohort study demonstrated that the mortality rate is high and that the type of surgery, male gender, older age, blood transfusion requirements, and high CCI score are associated with mortality in patients over 80 years of age who have undergone surgery for hip fractures. Preoperative optimization and postoperative care are critical for these vulnerable elderly patients.Öğe Functional and radiologic results of posteromedial limited surgery in developmental dysplasia of the hip(NLM (Medline), 2023) Uzel, Kadir; Gem, Mehmet; Şahin, İlhami; Ziyadanoğulları, Mehmet Onur; Eskandari, Mohammad Mehdi; Arslan, H.PURPOSE OF THE STUDY In treatment algorithm of developmental dysplasia of the hip, posteromedial limited surgery is placed between closed reduction and medial open articular reduction. The aim of the present study was to assess the functional and radiologic results of this method. MATERIAL AND METHODS This retrospective study was performed in 37 Tönnis grade II and III dysplastic hips of 30 patients. The mean age of the patients at operation was 12.4 months. The mean follow-up time was 24.5 months. Posteromedial limited surgery was applied when sufficient stable concentric reduction was not achieved by closed technique. No pre-operative traction was applied. Postoperatively, human position hip spica cast was applied for 3 months. Outcomes were evaluated regarding modified McKay functional results, acetabular index and presences of residual acetabular dysplasia or avascular necrosis. RESULTS Thirty-six hips had satisfactory and one hip had poor functional result. The mean pre-operative acetabular index was 34.5 degrees. It improved to 27.7 and 23.1 degrees at the postoperative 6th month and the last control X-Rays. The change in acetabular index was statistically significant (p<0.05). At the last control, 3 hips had findings of residual acetabular dysplasia and 2 hips had avascular necrosis. CONCLUSIONS Posteromedial limited surgery for developmental dysplasia of the hip is indicated when closed reduction remains insufficient and medial open articular reduction remains unnecessarily invasive. This study, in line with the literature, provides evidences that this method might decrease the incidences of residual acetabular dysplasia and avascular necrosis of the femoral head.Öğe Posterior vertebral column resection: Exploring practical uses in clinical settings(2024) Çaçan, Mehmet Akif; Birinci, Murat; Mertsoy, Yılmaz; Uzel, Kadir; Bostancı, Bilal; Uçar, Bekir YavuzBackground: The purpose of this study was to present our experience in patients who had been treated with posterior vertebral column resection (PVCR) for various spinal deformities. Methods: Thirty-seven patients who performed PVCR between 2015 and 2018 were evaluated retrospectively. The mean follow-up period was 24 months (range: 12-50 months). The demographic data of the patients, mean blood loss, amount of blood replacement, duration of operation, intensive care and hospitalization period, PVCR level, instrumentation level, amount of preoperative curvature, amount of postoperative curvature improvement, preoperative and postoperative neurological status, and complications were examined. Angular measurements were performed on X-ray. Results: The mean age of the patients was 37.5 years (range: 3-80 years). PVCR was applied to patients due to different pathologies (congenital, tumor metastasis, posttraumatic kyphosis, revision scoliosis, and infection). The mean operation time was 445.5 min (260-720) with an average blood loss of 1903 ml (400-7000 ml). It was observed that the average local kyphosis angle decreased from 67.65° to 7.42° in 26 patients who were operated for advanced deformity (P < 0.001). When these values were compared in all 34 patients, the preoperative angle value decreased from 55.1° to 3.5° (P < 0.001) and decreased from 70° to 0° in 13 congenital kyphosis patients. Conclusion: PVCR is an effective method for correcting severe spinal deformities and can be used to correct curvature in different patient groups. Level of Evidence: Level 3.Öğe Quality and reliability of trigger finger youtube videos(EDRA S.p.A, 2023) Uzel, Kadir; Yılmaz, Mehmet Kürşat; Çaçan, Mehmet Akif; Artuç, MerdanIntroduction. Orthopedic video contents published on YouTube are not scanned and do not go through an editorial evaluation process. It is important to determine the quality and content accuracy of health-related videos. Trigger finger is a common disease and the deterioration in quality of life. However, the quality, content and adequacy of YouTube videos as a source of information about this disease have not been evaluated. The aim of this study is to investigate the quality and adequacy of the medical content of the videos on YouTube about trigger finger disease. Methods. In September 2022, the phrase “trigger finger” was entered in the YouTube search bar and the 50 most watched videos were included in the study, provided that the language of the video was English. Who uploaded the videos, real or animated content, number of views, upload date, number of comments, number of like-dislikes and video length were recorded. 3 orthopedic surgeons and 1 hand surgeon watched the videos simultaneously and separately. JAMA, DISCERN and GQS scores were calculated. Results. Average length of 50 videos is 321 seconds, number of views is 244,150, number of days from upload date to evaluation date is 1,789 days, VPI was 94, view ratio was 300. The average scores of 4 different surgeons from the parameters used for the quality and relevance analysis of the videos: JAMA 2, DISCERN 36, and GQS 2. The scores of 4 different surgeons were statistically compatible with each other (p = 0.000). The interclass correlation coefficient (ICC) was 0.906 for the JAMA score, 0.889 for the DISCERN score, and 0.831 for the GQS score. Conclusions. YouTube videos about trigger finger were low quality and unreliable. In the light of our study and other studies, the possibility of high-quality and reliable videos for patients can be increased by the evaluation and inspection of videos present-ed by YouTube.Öğe Sonar mining of deeply located foreign bodies in the musculoskeletal system(2024) Çaçan, Mehmet Akif; Birinci, Murat; Uzel, Kadir; Yılmaz, Mehmet Kürşat; Kemah, Bahattin; Tuğrul, Ali İhsanIntroduction: Foreign body (FB) injuries constitute an important part of admission to emergency and orthopedic clinics in daily practice. The localization and removal of FBs can be difficult. Ultrasound (USG) plays an important role in the localization of FBs. In this study, we aimed to present the results of patients who underwent US-guided FB extraction. Methods: Fifty-seven patients who were admitted to the emergency service and orthopedic outpatient clinic due to FB trauma to soft tissue were retrospectively evaluated. USG-guided removal was performed under local anesthesia. The number, size, shape, structure, distance to the skin, and integrity of the FB were determined using USG guidance. Patient satisfaction was evaluated with Results: The mean duration of surgery was 7 min (range; 5 to 20 minutes), and the mean incision size was 11 mm (range; 5 to 25 mm). Forty-seven of the patients underwent an outpatient procedure and were discharged on the same day. No postoperative complications were observed. Fifty one of 57 (89.5%) were very satisfied with the surgery. Conclusion: Consequently, USG-guided FB extraction is a safe, fast, and comfortable option for the patient and the physician. Orthopedic physicians should receive USG training starting from their assistantship, and its use in daily practice should be increased.Öğe Venous thromboembolism in orthopedic surgery: Global guidelines(AVES, 2023) Uzel, Kadir; Azboy, İbrahim; Parvizi, JavadVenous thromboembolism (VTE) is a severe complication that can occur after major orthopedic procedures. As VTE-related morbidity and mortality are a significant concern for both medical professionals and patients, and preventative measures are typically employed. Multiple organizations, including the American College of Chest Physicians (ACCP) and the American Academy of Orthopedic Surgeons (AAOS), have developed guidelines for VTE prophylaxis specifically in patients undergoing joint replacement procedures. However, recently, the International Consensus Meeting (ICM) was convened, which brought together over 600 experts from 68 countries and 135 international societies. These experts, spanning a range of medical disciplines including orthopedic surgery, anesthesia, cardiology, hematology, vascular, and internal medicine, conducted a comprehensive review of the literature using a strict Delphi process to generate practical recommendations for VTE prophylaxis across all types of orthopedic procedures. This review article summarizes some of the recommendations of the ICM.
