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Öğe Comparison of K-wire fixation methods in terms of stability in Salter iliac osteotomies [Salter iliyak osteotomisinde K-teli ile yapilan tespit yöntemlerinin stabilite açisindan karşilaştirilmasi.](2007) Senaran H.; Karalezli M.N.; Simşek S.; Arazi M.; Kapicio?lu M.I.OBJECTIVES: We compared the stability of K-wire fixation methods used in Salter iliac osteotomies in developmental dysplasia of the hip (DDH) to determine the most appropriate method for stabilization of the acetabular fragment. METHODS: The study included 425 hips of 331 patients (63 boys, 268 girls; mean age 23.3 months; range 17 to 35 months) who underwent iliac osteotomies for DDH with appropriate indications described by Salter. Fixation of the graft was made with the use of one or two K-wires. All the patients were assessed postoperatively with anteroposterior pelvic radiographs obtained before a hip spica cast was applied and after it was removed. The patients were divided into four groups based on the fixation methods used, namely, one or two K-wires directed either to the triradiate cartilage or to the roof of the acetabulum. On postoperative pelvic radiographs, we assessed the relation between the proximal and distal iliac fragments, position of the graft in the osteotomy area, medialization of the distal iliac bone corner at the sciatic notch, and coverage of the femoral head. RESULTS: Fixation with two K-wires resulted in no graft displacement. Of 381 hips in which a single K-wire was used, 15 hips (3.9%) exhibited graft displacement due to fixation instability. Orientation of the K-wire fixation was toward the triradiate cartilage in eight hips (2.9%), and toward the roof of the acetabulum in seven hips (6.4%). No significant differences were found between the four groups in terms of fixation instability. CONCLUSIONS: The absence of fixation failure with the use of two K-wires suggests that this method provides a more stable fixation of iliac osteotomy and bone graft.Öğe Osteomusculocutaneous flap for clavicular reconstruction: a case report [Osteomuskülokütanöz flep ile klavikula rekonstrüksiyonu: Olgu sunumu.](2007) Yel M.; Karalezli M.N.; Tosun Z.; Sezgin S.; Savaci N.Radiotherapy for tumors can cause soft tissue necrosis, osteonecrosis, and pathologic fractures. A 47-year-old woman presented with a pathologic fracture of the left clavicle 10 years after radiotherapy following radical mastectomy for breast cancer. She was treated with a compound rib-latissimus dorsi osteomusculocutaneous flap with a 4-cm segment of the sixth rib. Fusion of the bones was achieved in three months. Donor site morbidity was cosmetically acceptable and function of the shoulder was improved. The Constant shoulder score which was 36 preoperatively increased to 88 after 38 months of follow-up.