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Öğe Arthrodesis for tuberculous coxarthritis - Good outcome in 32 adolescents(TAYLOR & FRANCIS AS, 2004) Ozdemir, HM; Yensel, U; Ogun, TC; Senaran, H; Kutlu, ABackground There is no consensus on best treatment of advanced tuberculous coxarthritis in young patients. Patients and methods We report our results concerning hip arthrodesis for advanced tuberculous arthritis of the hip in 32 adolescents. The operation was preceded by standard antituberculous chemotherapy for 4 weeks, which was continued for 12 months after surgery. At the last follow-up, clinical and radiographic examinations of the ipsilateral knee, contralateral hip and lower back were done. We evaluated function, limitations, and presence of pain with our usual questions. Results Their average age at the time of operation was 16 (12-18) years and the average duration of follow-up 12 (10-18) years. Solid bony fusion occurred in all patients after mean 5 months and no complications developed in the postoperative period. 28 patients were satisfied with the fused hip. No patients had reactivation of tuberculosis in any part of their body. The results were comparable to those of arthrodesis performed for other causes. Interpretation Hip arthrodesis is an alternative method of treatment for advanced stages of tuberculous coxarthritis in the adolescent.Öğe Intracortical epidermoid cyst of the tibia(SPRINGER, 2004) Ozdemir, HM; Senaran, H; Ogun, TC; Oltulu, PEpidermoid cyst in a long bone is an extremely rare condition. The authors describe such a tumor located in the cortex of the tibia in a 21-year-old woman. She was successfully treated with curettage and autogenous bone grafting.Öğe A lasting solution is hard to achieve in primary hydatid disease of the spine - Long-term results and an overview(LIPPINCOTT WILLIAMS & WILKINS, 2004) Ozdemir, HM; Ogun, T; Tasbas, BStudy Design. Retrospective evaluation of patients with primary hydatid disease was done, with an overview of the pertinent literature. Objectives. To determine the results of surgical decompression and antihelminthic treatment. Summary of Background Data. Bone involvement in hydatid disease has been reported to be only 0.5 to 4%. Spinal involvement is found in 50% of these cases, with mortality over 50%. Paraplegia is the most serious complication of the disease, caused by compression of the spinal cord by the cysts. Aggressive surgery combined with antihelminthic therapy is recommended to eradicate the disease and prevent recurrence. Methods. Three patients with primary spinal hydatid disease were operated on several times for multiple recurrences. Combined chemotherapy with either mebendazole or albendazole was also given. The mean age was 52 years, and the mean follow-up time was 92 months. Results. Surgery and chemotherapy improved the symptoms in all cases but could not prevent recurrences and multiple operations. Conclusions. Primary spinal echinococcosis must be considered in the preoperative differential diagnosis of the atypical presentation of vertebral lesions, especially in patients with risk factors. Early diagnosis and preferably anterior radical surgery combined with antihelminthic therapy of sufficient duration are mandatory to at least halt the progression of symptoms, but these measures could not provide a lasting solution for the patients described here.Öğe The role of anterior spinal instrumentation and allograft fibula for the treatment of Pott disease(LIPPINCOTT WILLIAMS & WILKINS, 2003) Ozdemir, HM; Us, AK; Ogun, TStudy Design. The authors retrospectively reviewed 28 patients with multilevel Pott disease who underwent anterior radical debridement, decompression, and fusion with anterior spinal instrumentation and fibular allograft replacement. Objectives. To assess the efficacy of allograft fibular fusion and anterior spinal stabilization as an alternative treatment of spinal tuberculosis. Summary of Background Data. The results of anterior surgery in preventing late or early spinal deformity from Pott disease have been closely related to the status of the segmental stability and graft materials, especially in cases of multisegmental involvement. The use of allograft and anterior spinal instrumentation in tuberculous spondylitis remains controversial because of the risk of persistence and recurrence of infection in the presence of devitalized bone graft, which may also be prone to poor incorporation. Methods. Between 1993 and 1998, a total of 28 patients with Pott disease (two or more segments involved) underwent anterior debridement, allograft fusion, and stabilization. The patients were given antituberculosis treatment in the postoperative period according to a standardized protocol. The authors retrospectively analyzed their experience in tuberculous spondylitis, with particular attention to method, allograft incorporation, and anterior spinal instrumentation. Incorporation of the allograft was evaluated by either static or dynamic (flexion/extension) radiographs. Results. None of the patients used external support in the postoperative period. A minimum of 3 years' follow-up was achieved in 26 patients. The overall fusion rate was 96%. There were no graft problems. Two patients died in the early postoperative period as a result of multiorgan failure. One patient suffered from an instrumentation failure. No other complications were observed. The segmental correction was maintained successfully in all of the patients. The mean correction loss was 6degrees. Conclusions. The use of anterior spinal stabilization accompanied with a structural allograft fibula is effective after proper radical debridement for interbody fusion, deformity correction, and maintenance in cases of multisegment involved Pott disease.Öğe Value of limited hip abduction in developmental dysplasia of the hip(WILEY, 2004) Senaran, H; Ozdemir, HM; Ogun, TC; Kapicioglu, MISBackground: Developmental dysplasia of the hip (DDH) continues to be missed by routine physical examination in up to 50% of cases. Ultrasound (US) supplementation is the best method of screening for DDH, but the resources required should not be underestimated. Limited abduction of the hip (LHA) in an infant triggers suspicion, and often an urge to treat, in most orthopaedic surgeons and pediatricians alike. This study aimed to document the value of unilateral LHA in the diagnosis and decision making of DDH, and the correlation between LHA and US. Methods: In total, 464 infants referred from the pediatrics clinic with LHA, aged between 30 and 120 days, were included in the study. Results: Physical examination revealed LHA in 186 (41%) infants, 26 of which were unilateral and 160 were bilateral. US examination showed that 13 (8.1%) patients in the bilateral LHA group and 18 (69.2) patients in the unilateral LHA group, had DDH (total number 31, 7%). Conclusion: Unilateral limitation of hip abduction was found to be a sensitive sign for developmental hip dysplasia, but US could be defined once again as the best golden standard before initiating treatment.
