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  • Küçük Resim
    Öğe
    Comparison of functional outcomes in patients fixed with dynamic hip screw and proximal femur nail-anti-rotation in A1 and A2 type intertrochanteric femur fractures
    (2020) Sevinç, Hüseyin Fatih; Çırpar, Meriç; Canbeyli, İbrahim Deniz; Dağlar, Bülent; Oktaş, Birhan; Durusoy, Serhat
    BACKGROUND: We aimed to compare clinical and functional outcomes between patients treated with Dynamic hip screw (DHS) and Proximal Femoral Nail-Antirotation (PFN-A) implants. METHODS: This study included 122 patients (66 men [54.1%] and 56 women [45.9%]) who underwent surgery with DHS and PFN-A for an intertrochanteric femur fracture and had at least 12 months follow-up. Reduction assessment, femoral neck-shaft angle and tip-apex distance measurements were performed in early postoperative radiographs. On control visits in months 1, 3, 6 and 12, range of motion, thigh or hip pain, and Trendelenburg positivity were assessed in clinical examination and reduction assessment, femoral neck-shaft angle and tip-apex distance measurements were performed on radiographs after the union. Patients were assessed using Hip Harris Score after the union. RESULTS: Regardless of implant type used, mean tip-apex distance measured at the immediate postoperative period was 27.6 in patients with implant failure, whereas 21.6 in patients without, indicating a significant difference. Again, mean femoral neck-shaft angle measured at the immediate postoperative period was 123 degree in patients with implant failure, whereas 130 degree in those without, indicating a significant difference. It was found that the femoral neck-shaft angle was <128 degree in all patients with implant failure whereas it was >128 degree in 94% of patients without implant failure at immediate postoperative period. CONCLUSION: The findings regarding femur neck-shaft angle at the immediate postoperative period was <128 degree in all patients with implant failure and that it was ?128 degree in 94% of patients without implant failure emphasize the importance of anatomic restoration in femur neck-shaft angle during surgery. The finding that mean tip-apex distance was 27.6 mm in patients with implant failure and 21.6 mm in patients without implant failure indicates that the technique is as important as implant type selected for treatment success of the implantation.
  • Küçük Resim
    Öğe
    Congenital extensor tendon dislocation causing pseudotriggering of the little finger
    (2017) Çırpar, Meriç; Dağlar, Bülent; Oktaş, Birhan
    The main complaints in extensor tendon dislocations are pain, swelling, sense of discomfort, snapping and difficulty in writing and forceful flexion. However, congenital extensor tendon subluxations may present with triggering of the fingers due to tendon dislocations. Unnecessary A1 pulley release may be performed for pseudotriggerring with unsuccessful results. Here, we report an unusual case of congenital extensor tendon subluxation of multiple digits with triggering of the left little finger and aim to attract notice to pseudotriggering of the digits due to tendon dislocations. An extensor hood reconstruction performed by an extensor digitorum communis tendon slip which is passed beneath the deep intermetacarpal ligament is a successful choice of treatment for these patients.
  • Küçük Resim
    Öğe
    Ters Hill-Sachs lezyonlarında kemik greftlemesi olmaksızın rafting tekniği
    (2017) Çırpar, Meriç; Oktaş, Birhan; Dağlar, Bülent
    Bu çalışmada, sağ tarafta eklem yüzeyinin %25-50'si ve sol tarafta %50'si kadar ters Hill-Sachs lezyonu olan çift taraflı bir posterior omuz instabilitesi olgusu bildirildi. Defektler tüberkulum minus osteotomisi sonrası eklem yüzeyinin yükseltilmesi ve greft kullanılmadan raft vidaları ile desteklenmesi yoluyla anatomik olarak yeniden yapılandırıldı. Ameliyat sonrası üçüncü günde pandüler omuz egzersizleri ile erken rehabilitasyona başlandı. Ameliyat sonrası altıncı haftada hastanın hareket açıklığı instabilite ve ağrı olmaksızın tam idi. Ameliyat sonrası 18. ayda hastanın fizik muayenesi normal ve constant omuz skoru yaş ve cinsiyet dengi popülasyonun %92.4'ü olacak şekilde 86 idi. Kemik greftlemesi olmaksızın rafting tekniği, posterior omuz instabilitesinde orta ila büyük boyutlu ters Hill-Sachs lezyonlarında tatmin edici klinik sonuçları ile bir tedavi alternatifi oluşturabilir