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Öğe An Alternative Technique for Microsurgically Unreplantable Fingertip Amputations(Lippincott Williams & Wilkins, 2006) Uysal, Afşin; Kankaya, Yüksel; Ulusoy, Mustafa Gürhan; Sungur, Nezih; Karalezli, Nazım; Kayıran, Oğuz; Koçer, UğurReattachment of the amputated fingertips as composite grafts has been performed for distal levels in children, with high rates of good outcome, but the majority of the reports emphasized that this procedure had success rates only up to 50% in adults. Several techniques to enhance composite graft take in adults have been defined. In this study, a technique to enhance nonmicrosurgical replantation of amputated fingertips as composite grafts is presented. Twenty-three patients were treated with this technique, 20 of which were adults. An area of skin on the amputation margin of the stump was deepithelized, and the amputated part was defatted to reattach the piece as a cap composite graft and to increase the contact area. The patients were evaluated after the operations regarding functional and esthetic outcome. Success rates of 86.95% in total and 85% in adults were achieved, with acceptable sensibility (with a mean value of 7.26 mm for the 2-point discrimination), minimal shortening (a mean value of 6.80 mm), and satisfactory esthetic outcome using this technique.Öğe Carpal Tunnel Syndrome and Flexion Contracture of the Digits in a Child With Familial Hypercholesterolaemia(Churchill Livingstone, 2006) Yensel, Uğur; Karalezli, NazımThis paper presents a 9 year-old girl who had flexion contracture of digits, carpal tunnel syndrome and multiple xanthomas covering the extremities.Öğe A Case of an Aneurysmal Bone Cyst of a Metatarsal: Review of the Differential Diagnosis and Treatment Options(ELSEVIER SCIENCE INC, 2009) İltar, Serkan; Alemdaroğlu, Kadir Bahadır; Karalezli, Nazım; İrgit, Kaan; Çaydere, Muzaffer; Aydoğan, Nevreş HürriyetAneurysmal bone cyst localized to the metatarsus, while not unheard of, is rather uncommon. The differential diagnosis for this lesion can be challenging, particularly in regard to the possibility of the presence of other giant cells containing tumors of bone, such as giant cell tumor, giant cell reparative granuloma, Brown's tumor of hyperparathyroidism, and telangiectatic osteosarcoma. We report a case of an aneurysmal bone cyst localized to the third metatarsal in a 14-year-old girl who presented with limping, progressively worsening local pain, and swelling in her left foot. The differential diagnosis for her condition was extensive. Ultimately, an en bloc resection was undertaken and the defect was replaced with tricortical iliac autograft. Pathological analysis of the resected tissue was consistent with aneurysmal bone cyst There was complete healing with no sign of recurrence 3 years after the surgery. Level of Clinical Evidence: 4 (The Journal of Foot & Ankle Surgery 48(1):74-79, 2009)Öğe Is the Rabbit Knee a Suitable Model for the Human Interphalangeal and Metacarphophalangeal Joints of the Hand?(TURKISH ASSOC ORTHOPAEDICS TRAUMATOLOGY, 2010) Karalezli, Nazım; Durduran, S. Savaş; Ogün, C. Tunç; Uysal, İsmihan İlknur; Ünver Doğan, Nadire; Öz, MehmetObjectives: The purpose of this study was to assess the suitability of the rabbit knee as a small joint model for the human interphalangeal and metacarphophalangeal joints of the hand. Methods: The proximal joint surface areas of 47 middle phalanges, the proximal and distal joint surface areas of 90 proximal phalanges, and the distal joint surface areas of 42 metacarpals of various human cadavers were calculated and compared with the distal femoral and proximal tibial joint surface areas of 20 knee of 10 New Zealand white rabbits by a photogrammetric method. Results: The mean joint surface area of the rabbit proximal tibia was larger than the proximal joint surface area of the middle phalanx, the distal joint surface area of the proximal phalanx, the proximal joint surface area of the proximal phalanx, and the distal joint surface area of the metacarpal. The mean joint surface area of the rabbit distal femur was larger than that of the middle phalanx, but similar to the proximal joint surface area of the proximal phalanx, and that of the distal metacarpal and distal proximal phalanx. Conclusion: The rabbit knee is not suitable model for the human interphalangeal and metacarphophalangeal joints of the hand. There is still a lack of an appropriate animal model for the small joints of the hand.Öğe Linburg-Comstock anomaly in musicians(ELSEVIER SCI LTD, 2006) Karalezli, Nazım; Karaköse, Serdar; Haykır, Rahime; Yağışan, Nihan; Kaçıra, Burkay Kutluhan; Tuncay, İbrahimAnomalous tendon connections from the flexor pollicis longus to the index finger flexor digitorum profundus cause lack of independent excursion of the flexor pollicis Longus, first described in 1979 by Linburg-Comstock. This anatomical variation is potentially problematic for musicians. The purpose of this study was to evaluate the incidence of this anomaly in musicians and to operate on the symptomatic patients with a limited incision with the help of magnetic resonance imaging. We studied the incidence of the anomaly among 136 musician volunteers. A tower incidence rate of the anomaly was determined in this study. One of the symptomatic musicians was operated on and the tendinous connection was excised. Clinical examination of 136 volunteers suggested that the anomaly was present in 13% of the volunteers; unilateral in 9% and bilateral in 4%. Follow-up of the patient who was operated on revealed full pain-free function without any complaint. Surgical treatment although rarely necessary, is simple and effective. (C) 2006 The British Association of Plastic Surgeons. Published by Elsevier Ltd. All rights reserved.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 Tavşan Diz Eklemi İnsan Elinin Metakarpofalengeal ve Interfalengeal Eklemleri için Uygun Bir Model Midir?(2010) Karalezli, Nazım; Durduran, Savaş S.; Ogün, Tunç C.; Uysal, İsmihan İlknur; Ünver Doğan, Nadire; Öz, MehmetAmac: Bu çalışmada, insan elindeki interfalengeal ve metakarpofalengeal eklemler için küçük eklem modeli olarak tavşan diz ekleminin uygunluğunun incelenmesi amaçlandı. Calışma planı: Farklı insan kadavradan 42 metakarpalin distal eklem yüzey alanı, 90 proksimal falanksın distal ve proksimal eklem yüzey alanı ve 47 orta falanksın proksimal eklem yüzey alanı ile 10 Yeni Zelanda beyaz tavşanının 20 dizinin proksimal tibia ve distal femur eklem yüzey alanları fotogrametrik yöntemle hesaplandı ve karşılaştırıldı. Sonuclar: Tavşan dizi proksimal tibia eklem yüzey alanı ortalaması, orta falanksın proksimal eklem yüzey alanından, proksimal falanksın distal eklem yüzey alanından, proksimal falanksın proksimal eklem yüzey alanından ve metakarpalın distal eklem yüzey alanından daha büyüktü. Tavşan femur distal eklem yüzey alanı ortalaması orta falanksınkinden daha büyük iken, proksimal falanksı n proksimal, metakarpalın distal ve proksimal falanksın distal eklem yüzey alanına benzerdi. Cıkarımlar: Sonuç olarak, tavşan diz eklemi ile insan elinin MP ve iP eklemleri arasında uyum bulunamamıştır. insan elindeki küçük eklemler için uygun bir hayvan modeli ihtiyacı devam etmektedir.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.Öğe A Very Uncommon Complication Following Vaccination: Necrotizing Fasciitis and Myonecrosis: Case Report(Ortadogu Ad Pres & Publ Co, 2010) Senaran, Hakan; Karalezli, Nazım; Öğün, Tunç CevatNecrotizing fasciitis (NF) and myonecrosis is a potentially lethal soft tissue infection characterized by extensive muscular, fascial and subcutaneous tissue necrosis. In this paper, we report an 18-month-old boy admitted to a health clinic three days after Hepatitis-B vaccine injection with cellulitis at his left lateral arm and axilla. He was recommended oral antibiotics, however in the fifth day after vaccination he became lethargic, there were pseudo-paralysis, edema, crepitus on palpation and cutaneous necrosis was observed at axillary region and at posterior arm. With the diagnosis NF and myonecrosis, all the necrotic tissue including pectoralis major, triceps brachii, and most of the rotator cuff muscles were excised. After cutaneous grafting, the wounds healed, but functional recovery of the shoulder joint was poor at 4 year follow-up. Early diagnosis of NF and myonecrosis with debridment of necrotic tissue can prevent severe life threatening complications.
