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Öğe Arthroscopy-aided fixation for metacarpophalangeal joint collateral ligament injury accompanied by osteochondral avulsion injury: Our results and surgical technique(2018) Güleç, Ali; Yıldırım, AhmetAim: Though metacarpophalangeal joint collateral ligament injuries are commonly observed, the presence of accompanying avulsed osteochondral fragment or aponeurosis injury in adult patients is a situation that may require definite surgical treatment. Our study investigated patients attending our clinic after acute hand trauma with radial or ulnar collateral ligament injury who underwent arthroscopy-aided surgical treatment and who regularly attended check-ups to examine the efficacy and results of arthroscopy-aided treatment for collateral ligament injury of the metacarpophalangeal joint.Material and Methods: The study assessed fracture healing, joint movement angles and complications of 11 patients who attended our hand surgery department from December 2015 to April 2018 who had ulnar or radial collateral ligament injury of the metacarpophalangeal joint with accompanying osteochondral avulsion fracture repaired with the aid of arthroscopy with at least 1 year of continuous attendance at check-ups.Results: Four patients had 1st proximal finger avulsion fracture accompanying ulnar collateral ligament injury, four patients had 2nd proximal finger avulsion fracture accompanying ulnar collateral ligament injury, 1 patient had 4th finger and 2 patients had 5th finger proximal phalanx fractures accompanying radial collateral ligament injury. The patients’ avulsion fractures and ligament injuries healed without problem, 2 patients had limited joint movement angles and 1 patient developed complex regional pain syndrome.Conclusion: It is considered that the results of arthroscopy-aided collateral ligament injury repair and avulsed fragment fixation are good and perfect healing.Öğe Clinical comparison of hook plate fixation versus extension block pinning for bony mallet finger: a retrospective comparison study(SAGE PUBLICATIONS LTD, 2015) Acar, Mehmet Ali; Güzel, Yunus; Güleç, Ali; Uzer, Gökçer; Elmadağ, Nuh MehmetThe aim of this retrospective study was to determine whether traumatic mallet fractures had better outcomes when treated by hook plate fixation (13 patients) or extension block pinning (19 patients). We assessed outcomes using Crawford's criteria; distal interphalangeal joint range of motion; the DASH score; and a visual analogue scale score for pain. We measured radiological parameters. No significant differences were observed in functional and clinical outcomes and in complications. Whereas the operative time was longer in the hook plate group, intraoperative fluoroscopy use, time to bone union and time to return to work were greater in the extension block group. Although the hook plate method is more technically demanding, it provides good stable reduction, earlier mobilization and an earlier return to work. The extension block pinning technique is easier and as effective but it requires greater peri-operative fluoroscopy.Öğe Clinical outcomes of the patients who underwent surgery for cerebral palsy scoliosis(2018) Güleç, Ali; Çiftçi, Sadettin; Odabaşı, Egemen; Yıldırım, AhmetIntroduction: Static encephalopathy developing linked to damage occurring in the immature brain for any reason is called cerebral palsy (CP). As CP patients have abnormal muscle tonus and linked posture disorders, scoliosis is frequently encountered. In this article, we retrospectively investigated CP scoliosis cases operated at our clinic and complications.Material and Method: Thirteen patients with surgical treatment at our clinic from 2011-2017 for CP scoliosis were retrospectively investigated. The surgical techniques, improvement rates, perioperative complications and long-term motor function changes (GMFCS) were assessed.Results: Nine males and 4 females were operated. Mean age was 14.3 years (range: 5-21), and mean Cobb angle was 79.3 (range: 45-135). The improvement amount in the Cobb angle was assessed as 48.2 (range: 20-70). Preoperative GMFCS score was 5 for 7 patients, 4 for 5 patients and 3 for 1 patient. One patient developed paraplegia in the 12th hour after correction (this patient was exitus in the postop 6th month due to later developing pulmonary complications). One patient developed urinary incontinence. Infection was not identified in any patient. One patient had level increased due to development of kyphosis in proximal neighboring segment.Conclusion: We believe encouraging improvements can be obtained with posterior instrumentation and fusion surgery in CP scoliosis patients minimizing complications including coronal balance, sagittal balance and pelvic obliquity and there is no major disadvantage compared to the unit rod instrumentation system.Öğe Closed extensor indicis proprius tendon rupture presenting mass clinic on dorsal side of the wrist(2013) Kütahya, Harun; Güleç, Ali; Acar, Mehmet Ali; Güzel, Yunus; Karalezli, Mustafa N.; Toker, SerdarA 28 years old male constructor referred to our clinic for a mass on the dorsal side of the left wrist. He has constricted his hand to the plaster cast machine in hyperflexion posture one month ago and swelling complaint has begun one week ago. MRI revealed tenosynovitis. A wide organized hematoma was appeared in the 4th extensor compartment in the surgical exploration of the patient and it was observed that extensor indicis proprius tendon has detached from the musculotendineous region. Common extensor tendon of the second finger was intact. Tenodesis to the distal end of the ruptured tendon to the intact common extensor tendon by side to side surgical suture technique was performed. There were complete extension in the 2nd finger at the 2nd month after the surgery.Öğe Closed extensor ındicis proprius tendon rupture presenting mass clinic on dorsal side of the wrist(2013) Kütahya, Harun; Güleç, Ali; Acar, Mehmet Ali; Güzel, Yunus; Karalezli, Mustafa N.; Toker, Serdar28 yaşında erkek işçi sol el bileğinde kitle şikayeti ile kliniğimize başvurdu. Hasta 1 ay önce elini hiperfleksiyon pozisyonun- da alçı karıştırma makinesine sıkıştırmış ve 1 hafta önce de şişlik şikayeti başlamış. MRG'de tenosinıvit gözlendi. 4. ekstensör kompartmanın cerrahi eksplorasyonunda geniş organize hematom ve ekstensör indicis proprius tendonunun muskulotendinöz bölgeden koptuğu görüldü. İşaret parmağı kommon ekstensör tendonunun sağlam olduğu görüldü. Kopuk olan ekstensör tendonun distal ucu yan-yana cerrahi dikiş tekniği kullanılarak sağlam olan kommon ekstensör tendona tenodez yapıldı. Ameliyat sonrası 2. ayda işaret parmağında tam ekstansiyon mevcuttu.Öğe Correlation of stability and complications measurements in traumatic hip dislocation cases associated with posterior wall acetabular fracture(2018) Güleç, Ali; Çiftçi, SadettinAim: To evaluate the relationship between stability criteria and complications in traumatic hip dislocations associatedwith posterior acetabular wall fracture.Material and Methods: The study retrospectively investigated 18 patients treated for posterior acetabulum fracture dislocation in the orthopedics and traumatology clinicfrom 2014-2017. All patients had wall defect, acetabular fracture index and coronal posterior acetabular arc angle (PAAA)assessed. Fracture types were determined according to Letournel’s definitions.Results: Preoperative radiological tests found the mean width of intact hip wall was 33.8 mm (range 31-39 mm), mean wall length in fracture hips was 13.7 mm (range 5-21 mm), and mean wall defect was measured as 59.1% (range 37.5-86%). When intact hips were assessed mean coronal PAAA was 54.2 degrees (range 41-65). For fractured hips, coronal PAAA was 18.2 degrees mean (range 6-29). Acetabular fracture index (AFI) was determined as mean 40.8 (range 14-62.5). Regarding complications in the postoperative period, one patient had avascular necrosis of the femoral head and 9 patients had osteoarthritis.Conclusion: Though Defect percentage, AFI and coronal PAAA values are important proven markers for stability, in our study there was no correlation identified with complications.Öğe Ipsilateral total hip replacement for femoral neck fracture in an above-the-knee amputee patient(Edizioni Minerva Medica, 2014) Acar, Mehmet Ali; Erkoçak, Ömer Faruk; Aydın, Kerem; Yılmaz, G.; Güleç, Ali[Abstract not Available]Öğe Lower limb injuries secondary to hoeing machine cccidents(2019) Güleç, Ali; Durgut, Fatih; Ozdemir, Ali; Yıldırım, Ahmet; Aydın, Bahattin KeremAgricultural accidents are important for Turkey as more than 20 million people are involved in agriculture. The aim of this study was to evaluate orthopaedic lower limp injuries related to hoeing machine from a trauma centre localized in Middle Anatolia Region. 15 patients who hospitalized for hoeing machine were included to study due to lower limp injuries between April 2012 and May 2017. All the medical records were scanned retrospectively to evaluate “the demographic, epidemiologic characteristics of patients, cause of accidents, type of injury, duration of hospital stay and also hospital costs were evaluated retrospectively “. According to database, fifteen patients were hospitalised for lower limp injuries (14 were male, 1 female). The mean age was 45.2 (19-64) years old. The most frequent injury was tibia fracture (64 %). The mean hospital stay time was 14 days (between 1and 53). The mean cost was 11.140,16 (500 and 27.115,08) Turkish Liras. The rate of knee dislocation was 26 %. Most prevalent injury was tibia fracture. Simple precautions can be effective for preventing this kind of injuries. Meticulous examination is important as the rate of knee dislocation is high in these types of traumas.Öğe Morphometric Evaluation of Thoracic Vertebrae Using Multidetector Computed Tomography in Patients with Scoliosis(Selçuk Üniversitesi, 2023 Ekim) Tatar, Mehmet Cengiz; Karabulut, Ahmet Kağan; Öztürk, Mehmet; Güleç, Ali; Fazlıoğulları, Zeliha; Ünver Doğan, NadireAim: Many people have congenital and acquired deformities associated with the vertebral column. Vertebral surgery is practiced in cases like scoliosis, traffic accidents, falling down from height, cancer, and disc hernia. We aimed to reduce morbidity and mortality by creating alternative predictions for surgery and treatment with the findings and results we obtained in our study in patients with scoliosis. Methods: Patients with scoliosis (eight male, eight female) who underwent thoracic vertebrae imaging by multidetector computed tomography at Selcuk University Faculty of Medicine between 2013 and 2017 and who were not operated and those without scoliosis (eight male and nine female) who underwent imaging for other reasons were retrospectively evaluated. The group aged >15 years was created in a similar way. Similarly, groups with thoracic X-ray and tomography were created; Cobb angles and the width, height, and distance between the dorsal tips of the transverse process were measured in 12 thoracic vertebrae. Lateral distances from the midline junction of the right lamina of vertebra to the lateral of the right transverse process and pedicle of vertebra junction were measured; measurements were repeated for the left side and recorded. Measurements were made in 780 thoracic vertebrae. Results: Mean Cobb angle of 8 in 10–14-year-old male patients with thoracic scoliosis was 30.9° and mean age was 13 years. Mean Cobb angle of 8 in 10–14-year-old female patients with thoracic scoliosis was 32.72° and the mean age was 12.75 years. Conclusion: Our findings will help for manufacturers create personalized screws and plates, and help surgeons make operational choices.Öğe Proksimal femur çivisi cerrahisinde C-Kollu floroskopi kullanımı ile ilgili sorunlar(2018) Özyalvaç, Osman Nuri; Çiftçi, Sadettin; Telatar, Atakan; Özkul, Barış; Güleç, Ali; Aşansu, Mustafa; Akpınar, EvrenAmaç: Bu çalışmada intertrokanterik femur kırığı cerrahisinde ameliyatboyunca C-kollu floroskopi cihazı kullanımı için harcanan zaman veradyasyon maruziyeti açısından yapılan çekim miktarlarının belirlenmesiamaçlanmıştır.Yöntemler: Femur intertrokanterik kırığı nedeni ile kapalı redüksiyonve intamedüller tespit yapılan 62 hastadan toplanan veriler çalışmayadahil edildi. Toplam ameliyat süresi, C-kollu floroskopi cihazı kullanımıiçin harcanan süre, yapılan çekim miktarı, cerrahın kıdemi, istenilengörüntü elde edilene kadar yapılan çekim miktarları, implantıyerleştirmeden önce yapılan kılavuz tel uygulama sayısı ve toplamfloroskopi çekim miktarı yardımcı sağlık personeli tarafından kayıtaltına alındı.Bulgular: Operasyon süresinin %53’ünün C-kollu floroskopi cihazıkullanımı için harcandığı, uygun pozisyonda birer adet ön-arka veyan grafi için ortalama 10 kez floroskopi çekimi yapıldığı, kılavuz telinortalama 3,7 denemede istenilen pozisyonda gönderildiği tespit edildi.Sonuç: C-kollu floroskopi cihazı kullanımında önemli bir ölçüde zamanharcandığı ve çekim miktarının gereğinden fazla yapıldığı saptandı.Cerrahi süreyi kısaltmak ve gereksiz radyasyon maruziyetindenkaçınmak adına C-kollu floroskopi cihazlarının bu konuda eğitim almışteknik personel tarafından kullanılması, cerrah ve röntgen teknisyeniarasında ortak bir dil oluşturulması, kullanımı daha pratik olangörüntüleme ünitelerinin geliştirilmesi gerektiği kanısındayız.Öğe Reconstruction of dorsal hand and finger defects with reverse radial fasciocutaneous forearm flaps(Springer-Verlag France, 2015) Acar, Mehmet Ali; Güleç, Ali; Aydın, Bahattin Kerem; Erkoçak, Ömer Faruk; Elmadağ, Mehmet; Türkmen, FaikObjectives: To evaluate the midterm outcome and the degree of satisfaction of patients who underwent reconstruction of dorsal hand and finger defects with reverse flow radial fasciocutaneous forearm flaps and to test whether or not this is a reliable method which can be applied without the need for microsurgery. Patients and methods: Eleven patients were admitted with post-traumatic complex hand defects and treated by reconstruction with reverse flow radial fasciocutaneous forearm flaps from January 2010 to May 2013. The patient demographics, size of the hand and finger defects, and complications were recorded. The functional status of each of the patients was evaluated using the quick disabilities of the arm, shoulder and hand (DASH) scoring system, and patient satisfaction was assessed using Likert scores. Results: The patients comprised nine males and two females with a mean age of 30.7 ± 9.7 years. The mean follow-up period was 18.4 ± 5.2 months. The average defect size was 41 ± 14.3 cm². None of the patients had circulation defects caused by the sacrifice of the radial artery. The mean quick DASH score was determined as 30.2 ± 15.3. The Likert patient satisfaction evaluation was good in one patient, and very good in ten patients. All flaps survived well with only two complications; superficial skin necrosis occurred at the suture site in one patient and venous insufficiency occurred in the other patient. Both complications recovered with secondary healing following wound debridement. Conclusions: The reverse-flow radial forearm flap is a reliable method in the management of dorsal defects of the hand and does not require micro-surgical techniques. © 2014, Springer-Verlag France.Öğe Reconstruction of multiple fingertip injuries with reverse flow homodigital flap(ELSEVIER SCI LTD, 2014) Acar, Mehmet Ali; Güzel, Yunus; Güleç, Ali; Türkmen, Faik; Erkoçak, Ömer Faruk; Yılmaz, GüneyAim: Hand trauma may lead to multiple fingertip defects, causing functional restrictions. We evaluated the use of reverse-flow homodigital flap reconstruction of the distal phalanx and pulp defects associated with multiple finger injuries. Methods: We retrospectively evaluated 11 male patients who presented at our emergency department (January 2011-March 2013) with multiple fingertip injuries and who were treated with a reverse-flow homodigital flap. Evaluations included age, sex, defect size, flap survival rate, complications, cold intolerance, two-point discrimination, range of motion (ROM), quick disabilities of the arm, shoulder, and hand (DASH) score, and return to work time. Results: Completely, 22 reverse-flow homodigital flaps were applied to at least two fingertip injuries at the distal phalanx. Ten flaps survived postoperatively. The exception was partial flap loss on one finger. The mean follow-up was 14.2 months. At the final follow-up, the mean static two-point discrimination value was 10.3 mm. Mean ROMs of interphalangeal joints were 65.31 degrees (distal) and 105.77 degrees (proximal). Donor sites were covered with full-thickness skin grafts from the wrist or antecubital area. There were no complications related to the donor site and no development of cold intolerance in any finger. The mean quick DASH score was 4.12. All patients returned to work in an average of 8.3 weeks. Conclusions: The reconstruction of multiple fingertip injuries with reverse-flow homodigital flaps is a safe, effective method that can be combined with other local finger flaps. These flaps can be applied to two consecutive fingers without reducing finger length or function. (C) 2014 Elsevier Ltd. All rights reserved.Öğe Removal of Cr(III) and Cr(VI) Through the Plasma Modified and Unmodified Ion-Exchange Membranes(Elsevier, 2010) Sardohan, Tuğba; Kır, Esengül; Güleç, Ali; Çengeloğlu, YunusThe removal of trivalent and hexavalent chromium ions through charged ion-exchange membranes by using two detachable compartments was studied under Donnan dialysis conditions. The surfaces of ion-exchange membranes were treated by electron cyclotron resonance plasma (ECR) to increase the performance. The effects of plasma modified ion-exchange membranes and pH on removal chromium ions were investigated at 25 degrees C. The flux values (J) and recovery factor (RF) of trivalent and hexavalent chromium ions before and after the plasma modification were obtained. The flux values and recovery factors for plasma modified SA(3)S. SA(3)T and SB-6407 ion-exchange membranes are higher than that of unmodified membrane. This can be explained by change of morphology of pores in the plasma modified membranes. The surface morphology of the plasma modified and unmodified ion-exchange membranes are characterized by SEM and AFM. Ion-exchange capacity, membrane potential measurement and sorption capacity measurements were carried out in order to understand how the plasma treatment affected on the membrane charge selectivity. As a result no change for charge selectivity was observed.Öğe Stewart treves syndrome: A case report(Oman Medical Specialty Board, 2014) Güleç, Ali; Kütahya, Harun; Karalezli, Nazım; Kaçıra, Burkay Kutluhan; Acar, Mehmet AliAngiosarcomas are malignant tumors, which originate from the vessel endothelium and resemble the vessel structure. Stewart- Treves syndrome is an angiosarcoma which in general, develops in female patients after mastectomy and axillary lymph node dissection and is associated with chronic lymphedema. The prognosis of this rare complication is very poor. We present the case of a 52-year-old female who had undergone mastectomy due to breast cancer and 13 years later required shoulder disarticulation due to Stewart-Treves syndrome. © OMSB, 2014.Öğe Ultrasound for the Detection of Retained Plastic and Undetected Metallic Foreign Bodies in the Foot(TIP ARAŞTIRMALARI DERNEĞİ, 2012) Acar, Mehmet Ali; Kerimoğlu, Ülkü; Karalezli, Nazım; Güleç, AliForeign bodies in soft tissue may cause serious problems for both emergency physicians and orthopaedic surgeons. Wooden or plastic foreign bodies which are diolucent can not be diagnosed with direct graphy and they are more prone to cause soft tissue complication unless they detect. We present two cases with retained plastic and metallic foreign bodies including in their right feet of a farmer and a constructor which could not diagnosed with plain film and magnetic resonance imaging (MRI). Definitive treatment was done after detecting the foreign bodies with ultrasonography (US).Öğe Ultrasound for the detection of retained plastic and undetected metallic foreign bodies in the foot(2012) Acar, Mehmet Ali; Kerimoğlu, Ülkü; Karalezli, Nazım; Güleç, AliYumuşak dokudaki yabancı cisimler hem acil hemde ortopedik cerrahlar için ciddi problemlere yol açabilirler. Tahta ve plastik yabancı cisimler radyolusen oldukları için direk grafilerle teşhis edilmezler ve daha fazla yumuşak doku problemlerine yol açarlar. Biz direk grafi ve magnetik resonans ile tespit edilememiş ayağında plastik ve metalik yabancı cisimleri olan ve kesin tedavileri ultrason ile tespit edildikten sonra yapılan iki olguyu sundukÖğe An unusual klebsiella septic bursitis mimicking a soft tissue tumor(2013) Acar, Mehmet Ali; Karalezli, Nazım; Güleç, Aliilt altı yerleşiminden dolayı prepatellar bursitlerde enfeksiyon görülmesi sık olur. Gram pozitif mikroorganizmalar, özellikle stafilokokkus aureus en sık etkendir. Tamirciler, halıcılar ve çiftçiler gibi travmaya çok maruz kalan meslek gruplarında direk olarak etken cilt florasından bursaya ulaşabilir. 71 yaşında erkek hasta 20 yılı aşan ağrı ve şişlik nedeni ile kliniğimize başvurdu. Diz üstündeki eritemli,ülseratif ve akıntılı kitle ilk bakışta yumuşak doku tümörüne benziyordu. Manyetik Rezonans incelemede 13*12*10cm boyutlarında iyi sınırlı,septalı,kapsüle sıvı dolu prepatellar bursanın tendinöz veya kas invazyonu yoktu. Kitle üzerin- deki cilt ile beraber çıkartıldı ve defekt kısmi kalınlıkta cilt grefti ile kapatıldı. Hastanın 45 gün sonraki kontrolünde 100 derece fleksiyonu ve tam ekstansiyonu vardı ve eski işini yapabiliyordu.Öğe An unusual klebsiella septic bursitis mimicking a soft tissue tumor(2013) Acar, Mehmet Ali; Karalezli, Nazım; Güleç, AliBecause of its subcutaneous location prepatellar bursitis is frequently complicated by an infection. Gram-positive organisms, primarily Staphylococcus aureus account for the majority of cases of septic bursitis. Local cutaneous trauma can lead to direct inoculation of the bursa with normal skin flora in patients with occupations, such as mechanics, carpenters and farmers. A 71-yearold male was admitted to our department with a history of pain and swelling of his right knee over a 20 year period. Physical examination revealed a swollen, suppurative mass with ulceration of the skin and local erythema which mimicked a soft tissue tumor at first sight. Magnetic resonance imaging of the knee revealed a 13*12*10cm well-circumscribed, septated, capsulated, fluid-filled prepatellar bursa without evidence of tendinous or muscular invasion. The mass was excised en bloc, including the bursa and the overlying skin. The defect was closed with a split thickness skin graft. The patient had 100 degrees flexion and full extension after 45 days postoperatively, and he continued to work as a farmer.
