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Öğe A novel reduction support frame for management of unstable tibial fractures with intramedullary nail: Preliminary report(Turkish Assoc Trauma Emergency Surgery, 2022) Canbeyli, İbrahim Deniz; Çırpar, Meriç; Baysan, Caner; Oktaş, Birhan; Soy, FurkanBACKGROUND: Management of unstable tibial fractures (UTF) can be challenging due to widening of the proximal and distal metaphyseal zone, soft tissue problems, and poor vascularity. We aimed to compare the effect of novel tibial orthopedic reduction support (TORS) frame constructed by re-used tubular external fixator systems and manual traction with regard to the quality of reduction, and fracture healing. METHODS: A total of 65 patients who were admitted with UTF and underwent intramedullary nailing were assessed; 43 patients underwent manual traction technique, and 22 patients underwent TORS technique. The sagittal and coronal plane angulations were evaluated in initial postoperative radiographs, and radiologic union scores for tibial fractures (RUST) were compared at follow-up X-rays. RESULTS: The mean age of patients was 43.49 +/- 19.09 years in the manual-traction group and 43.41 +/- 16.8 years in the TORS group. The mean coronal plane angulation was 1.84 +/- 3.16 in the manual traction group and 1.86 +/- 4.21 in the TORS group. The mean sagittal plane angulation was 1.19 +/- 1.93 in manual traction group and 0.32 +/- 0.65 in the TORS group. The number of coronal and sagittal plane angulations >5 degrees was higher in manual traction group than TORS group. The mean RUST was significantly higher in the TORS group than in the manual traction group at 6th, 9th, and 12th -month controls. The union rates were also higher in the TORS group at 9th and 12th-month controls. CONCLUSION: TORS frame is a simple and cheap technique and should be considered as reduction support in the management of UTF by intramedullary nailing.Öğe Analysis of factors among 30-day and 1-year mortality rates in patients with borderline stable-unstable intertrochanteric hip fracture(Turkish Assoc Orthopaedics Traumatology, 2021) Canbeyli, Ibrahim Deniz; Çırpar, Meriç; Oktaş, Birhan; Çoban, MehmetObjective: This study aimed to evaluate the possible effects of surgical procedures on mortality and to identify the possible risk factors for mortality in the management of geriatric hip fractures. Methods: A total of 191 patients (105 women and 86 men: mean age 82.26 +/- 9.681 [60-108] years) with AO/OTA 31A2.2 intertrochanteric fractures and treated with sliding hip screw, proximal femoral nail, or hemiarthroplasty were included in this retrospective cohort study. The treatment type was decided by the responsible surgeon according to the patients' pre-injury activity level, bone quality, and features of the fracture. Age, sex, type of fracture. type of surgery performed, American society of anesthesiology (ASA) grade, type of anesthesia, time to surgery, type of physical therapy, length of hospital stay, and number of comorbidities were documented. We evaluated the 30-day and 1-year mortality of patients treated with sliding hip screw (SHS), proximal femoral nail antirotation (PFN-A), or hemiarthroplasty and identified the possible risk factors for mortality. Results: A total of 49 patients underwent SHS, 58 underwent PFN-A, and 84 underwent hemiarthroplasty. Of these, 2 patients with SHS, 2 with PFN-A, and 11 with hemiarthroplasty died within 30 days after surgery, whereas 7 patients with SHS, 15 with PFN-A, and 23 with hemiarthroplasty died 1 year after surgery. The 30-day and 1-year overall mortality rates were 7.9% and 23.6%, respectively. Both the 30-day and 1-year mortality risks were higher in patients undergoing hemiarthroplasty than in patients undergoing SHS (p=0.068 versus 0.058). The 30-day mortality was higher in patients receiving general anesthesia than in those receiving combined spinal and epidural anesthesia (p=0.009). The 1-year mortality risk was higher in patients with ASA grade 4 than in those with grade 1 and 2 (p=0.045). Advanced age (p=0.022) and male sex (p=0.007) were also found to be the risk factors for 1-year mortality. Conclusion: We demonstrated that higher ASA grade, male sex, general anesthesia, and hemiarthroplasty procedures are associated with higher mortality rates in elderly patients with hip fractures. Thus, we highly recommend orthopedic surgeons to consider all these factors in the management of intertrochanteric hip fractures in the geriatric population.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, SerhatBACKGROUND: 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.Öğe Comparison of Kinesiotaping, Exercise and Subacromial Injection Treatments on Functionality and Life Quality in Shoulder Impingement Syndrome: A Randomized Controlled Study(SPRINGER HEIDELBERG, 2021) Vergili, Özge; Oktaş, Birhan; Canbeyli, İbrahim DenizPurpose Disturbance of scapulohumeral rhythm has been shown to play a major role in subacromial impingement syndrome. Exercise, taping and subacromial injection are first ray conservative treatment modalities. We aimed to correct scapulohumeral rhythm with kinesio taping and exercise program via focusing on especially periscapular muscles not on glenohumeral structures to achieve scapulothorasic stabilization. Material and Methods Seventy five patients were divided into three groups randomly with different treatment modalities which are only exercise group (Group 1), kinesiotaping + exercise group (Group 2), and injection + exercise group (Group 3). Western Ontario Rotator Cuff Index (WORCI), Quick Disability of arm, shoulder, hand (Q-DASH), Constant- Murley Scores (CMS) were evaluated for each patient at the beginning, 15th and 60th days and compared in time and technique manner. Scores were analyzed statistically with One-way ANOVA and Chi-square tests. Results All the three groups had better results in short and long term follow ups as compared to initial admission. But in the second group 15th and 60th day results were superior to other groups significantly (p < 0,001). Conclusions Most of recent studies using kinesio taping were focused on mechanical correction of humerus which will be an impaired treatment to correct the main cause of impingement. Not only mechanical correction of periscapular muscles and also stabilization of scapulae will help to gain scapulohumeral rhythm.Öğe Comparison Of Short-Term Effects Of Virtual Reality and Short Foot Exercises In Pes Planus(Churchill Livingstone, 2021) Yıldırım Şahan, Tezel; Aydoğan Arslan, Saniye; Demirci, Cevher; Oktaş, Birhan; Sertel, MeralBackground: Virtual reality exercises (VRE) offers functional, multipurpose usage with a motivational approach. This study aimed to compare VRE and short foot exercises (SFE) in individuals with flexible pes planus. Methods: Forty participants with pes planus were assigned to the SFE group (n = 20) or VR exercise group (n = 20). Both groups performed exercises three times a week for four weeks. The groups were assessed with a navicular drop test for the height of the medial longitudinal arch, craig Test for femoral anteversion, Star Excursion Test for balance,10 step test for performance. Results: For two groups there is a statistically significant difference between before and after treatments(p < 0.05). There is no difference between VRE and SFE groups after treatments for all parameters(p > 0.05). Conclusions: Two different 4-week-exercise programs for pes planus have a similar effect on performance, balance, and navicular drop values in both groups. It was considered that the practice of VR exercises like short foot exercises could also address rehabilitation goals, which included improving balance, performance, and foot posture. ClinicalTrials.gov Identifier: NCT04283357. © 2021 Elsevier LtdÖğe Comparison of two medial epicondylectomy techniques in cubital tunnel syndrome(2017) Çırpar, Meriç; Özüak, Cem Seyfi; Oktaş, Birhan; Canbeyli, İbrahim DenizAmaç: Bu çalışmada parsiyel medial epikondilektomi (PMe) ve distal medial epikondilektomi (DMe) teknikleri duyusal ve motor düzelme, fonksiyonel sonuçlar ve komplikasyonlar açısından karşılaştırıldı.Hastalar ve yöntemler: Çalışmaya toplam 59 kübital tünel sendromu hastası (37 erkek, 22 kadın, ort. yaş 42,3 yıl; dağılım 23-80 yıl) dahil edildi. Hastaların 30'una DMe, 29'una PMe uygulandı. Hastalar ameliyat öncesinde ve ameliyat sonrası üç, altı ve 12. aylarda Wilson Krout skorları, Semmes-Weinstein Monofilaman (SWM) testi ve kaba kavrama ve ince kavrama gücü ölçümleri ile değerlendirildi. Her iki grubun ameliyat öncesi ve sonrası grup içi ve gruplar arası sonuçları karşılaştırıldı.Bulgular: Ameliyat sonrası kontrollerde Wilson Krout skorları PMe'ye kıyasla DMe ile daha iyi idi. SWM testi skorlarındaki düzelme sadece DMe için istatistiksel olarak anlamlı idi. DMe grubunda kavrama, lateral ve terminal çimdikleme ölçümlerindeki düzelme ameliyat sonrası üçüncü ayda anlamlı idi. PMe grubunda bu ölçümler için anlamlı düzelme ameliyat sonrası altıncı ayda elde edildi. DMe ile görülen tek komplikasyon medial epikondil üzerinde ortaya çıkan hassasiyet idi. PMe grubunda dört hastada parestezinin eşlik ettiği ağrılı sinir subluksasyonu saptandı.Sonuç: PMe ile karşılaştırıldığında DMe daha tatmin edici sübjektif sonuçlar ortaya koymaktadır. DMe ile motor fonksiyonel iyileşme daha erken ortaya çıkmaktadır. DMe daha düşük komplikasyon oranlarına sahip görünmektedir.Öğe Congenital extensor tendon dislocation causing pseudotriggering of the little finger(2017) Çırpar, Meriç; Dağlar, Bülent; Oktaş, BirhanThe 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.Öğe Eklem içi hiyaluronik asit uygulamasından sonra akut aseptik artrit(2017) Kaçmaz, Birgül; Oktaş, Birhan; Tiftikçi, Uğur; Balcı, Mahi; Gül, Serdar; Aslan, AyşegülDiz ekleminde gelişen osteoartrit tedavisinde eklem içi hiyaluronik asit (HA) uygulanabilmektedir. Yan etki genellikle görülmemekle birlikte tekrarlayan uygulamalar sonrasında 24-48. saatte nadiren aseptik artrit gelişebilmektedir. Bu raporda ilk kez diz eklemine HA uygulanan bir hastada, 3-4 saatte gelişen, septik artriti taklit eden akut aseptik artrit olgusu sunulmuşturÖğe Eklem İçi Uygulanan Trombositten Zengin Plazmanın (TZP) Etkisinin Diz Osteoartritinin Şiddeti ile İlişkisi(2020) Oktaş, Birhan; Canbeyli, İbrahim DenizAmaç: Trombositten zengin plazma uygulamaları son dönemdediz osteoartritinde cerrahi dışı tedaviler arasında yer almayabaşlamıştır. Plasebo ve proloterapi gibi tedavilere üstünlüğügösterilmiştir. Ancak halen erken dönem ve geç dönem dizosteoartriti üzerine etkisinin değişiklik gösterip göstermediğitam net değildir. Biz bu çalışmamızda farklı evredeki dizosteoartriti olan hastalarda tek doz trombositten zengin plazmauygulamasının etkinliğini karşılaştırmayı amaçladık.Gereç ve Yöntemler: Tek dizine tek doz trombositten zenginplazma uygulanmış ve enjeksiyon öncesi Lysholm dizfonksiyonelliği skoru anketi doldurulmuş olan toplam 80 hastaçalışmaya dahil edildi. Bu hastaların daha önce çekilmişgrafileri üzerinden Kallgren-Lawrence osteoartrit sınıflamasıkullanılarak sınıflama yapıldı. Evre I ve II osteoartriti olanlar 1.gruba dahil edilirken, evre III ve IV osteoartriti olanlar 2. grubadahil edildi. Bu hastaların enjeksiyon öncesi ve sonrasındadoldurulmuş olan Lysholm diz fonksiyonelliği anketlerideğerlendirildi. Elde edilen veriler her iki grup arasında varyansanalizi kullanılarak (ANOVA) karşılaştırıldı.Bulgular: Her iki grubun Lysholm skorlarında enjeksiyonsonrası iyileşme mevcuttu. Her iki grupta da hem ağrı hemfonksiyonellik açısından daha iyi sonuçlar elde edildi.Enjeksiyon öncesi ve sonrası skorlardaki değişim elealındığında, birinci gruptaki değişim ikinci gruba göre anlamlıolarak daha fazlaydı. (p<0,05)Sonuç: Trombositten zengin plazma uygulaması erken evre dizosteoartritli hastalarda daha etkili idi. Tek doz uygulama hemağrının azaltılmasında hem de fonksiyonelliğin artırılmasındayeterli bulunmuştur. Ancak ileri evre osteoartritli hastalarda enaz 3 doz yapılması, cevap alınamadığında bir sonraki tedaviyöntemlerinin düşünülmesi gereklidir.Öğe Ekstrakorporeal şok dalga tedavisinin periostu sağlam olan ve periostu eksize edilmiş sıçan femurlarında kırık iyileşmesine etkisi(2014) Oktaş, Birhan; Orhan, Zafer; Erbil, Barış; Değirmenci, Erdem; Üstündağ, NilAmaç: Bu çalışmada ekstrakorporeal şok dalga tedavisinin (ESWT) periostu sağlam olan ve periostu eksize edilmiş olan kırıklar üzerine etkisi karşılaştırıldı.Gereç ve yöntemler: Otuz yedi Wistar albino sıçan dört gruba randomize edildi. Ketamin anestezisi altında tüm sağ femurlara osteotomi ve intramedüller olarak Kirschnerteli tespiti uygulandı. İlk grup (n10) kontrol grubu olarak tanımlandı. İkinci grupta (n10), osteotomi hattındaki periost cerrahi sırasında çevresel olarak eksize edildi. Üçüncü grupta (n9), periost sağlam bırakılarak ESWT uygulandı. Dördüncü grupta (n8), tüm sıçanların periostları eksize edildi ve ESWT uygulandı. Tüm kırık hatları iki haftada bir radyolojik olarak ve altıncı haftada histolojik olarak değerlendirildi. Sonuçlar istatistiksel olarak değerlendirildi.Bulgular: Yumuşak doku defektli açık kırık modelini temsil eden, periostu eksize edilen grupta, ESWT uygulaması kırık iyileşmesi üzerinde anlamlı şekilde olumlu bir histolojik etkiye sahipti. Ancak radyolojik değerlendirme periostu sağlam olan ve eksize edilen gruplar arasında istatistiksel olarak anlamlı bir fark göstermedi.Sonuç: Bulgularımıza göre, yumuşak doku ve periost hasarının eşlik ettiği açık kırık tedavisinde, kırık iyileşmesini hızlandırmak ve psödoartroz oluşumunu engellemek amacıyla ESWT kullanılabilir. Ancak ESWT'nin rutin uygulamaya dahil edilebilmesi için daha fazla klinik çalışma gereklidir.Öğe HIGH RATES OF REDUCTION IN CONSERVATIVE TREATMENT OF GERIATRIC DISTAL RADIUS FRACTURES(2020) Canbeyli, İbrahim Deniz; Oktaş, Birhan; Pehlivan, OzanObjective: The aim of this study is to evaluate the earlyreduction results in conservative treatment of distal radialfractures in geriatric patients.Material and Methods: Patients aged over 60 years withdisplaced distal radius fractures who were treated withconservative treatment were included in the study. Follow-up Xraysof the patients at the 1st week were evaluated. Patients’ datawere obtained from hospital information management system.We evaluated the patient's age, sex, fracture side, the mechanismof injury, type of AO/OTA classification, loss of reduction, andtreatment methods.Results: One hundred and nineteen patients of 132 geriatricpatients with distal radius fracture were elligible for theinclusion criteria. 97.6% of patients with AO type 2R3Afracture were found to be within acceptable degrees of reductionin the 1st week of conservative treatment. Seven patients had aloss of reduction. Six had a high degree of dorsal angulation,and one had over 2mm step off. There was no significantdifference in terms of conservative treatment success betweenextra-articular fractures and partial and complete intra-articularfractures (p=0.584).Conclusion: We demonstrated that initial closed reduction andcast immobilization is an effective treatment method in themanagement of elderly patients with AO type 2R3A, 2R3B, and2R3C distal radius fractures.Öğe KALKANEAL EPİN HASTALARINDA FİZİKSEL AKTİVİTE DÜZEYİNİN AYAK AĞRISI VE FONKSİYONEL PERFORMANS ÜZERİNDEKİ ETKİSİ(2020) Vergili, Özge; Oktaş, Birhan; Aktaş, Fatma Cansu; Arıkan, Halime; Deveci, HülyaAMAÇ: Kalkaneal epin, hastalara ciddi anlamda rahatsızlık vererek günlük yaşam aktivitelerini kısıtlar. Çalışmamızın amacı bu bireylerde fiziksel aktivite düzeyinin ağrı ve fonksiyonellik yanıtları üzerindeki etkisini araştırmaktı. GEREÇ VE YÖNTEM: Çalışma kalkaneal epin tanısı konmuş 41 birey ile yapıldı. Bireylerin yaş, cinsiyet, boy, kilo, beden kütle indeksi (BKİ) ve topuk ağrılarına ilişkin niteliksel ve niceliksel özellikleri sorgulandı. Bireylerin fiziksel aktivite düzeylerini değerlendirmek için Uluslararası Fiziksel Aktivite Anketi (UFAA) kullanıldı. Ayak ağrısını değerlendirmek için algometre, fonksiyonel performanslarını belirlemek için 6 dakika yürüme testi ve topuk yükseltme testi kullanıldı. BULGULAR: Bireylerin 8’i (%19,5) düşük düzeyde aktivite, 26’sı (%63,4) orta düzeyde aktivite ve 7’si (%17,1) yüksek düzeyde aktiviteye sahipti. Fiziksel aktivite düzeylerine göre sınıflandırılan bireylerde ayak ağrısı ve fonksiyonel performans parametreleri açısından anlamlı bir fark görülmedi. SONUÇ: Farklı fiziksel aktivite düzeyine sahip gruplar arasında ağrı ve fonksiyonel performans açısından farklılık çıkmamış olsa da çok yüksek düzeyde fiziksel aktivitenin topuk ağrısı / plantar fasit / kalkaneal epin gelişimi için önemli bir risk faktörü olduğu, bunun özellikle de yüksek BKİ’ye sahip kişilerde daha sık görüldüğü bilinmektedir. Aktif bir yaşamın ve egzersiz alışkanlığının sistemik endokrin yanıtlar, kas iskelet sistemi ve vücut kompozisyonu üzerindeki olumlu etkileri ile söz konusu şikayetlerin görülme sıklığını azaltabileceği unutulmamalıdır.Öğe KALKANEAL EPİN HASTALARINDA VÜCUT KOMPOZİSYONU İLE AYAK AĞRISI ARASINDAKİ İLİŞKİNİN İNCELENMESİ(2019) Vergili, Özge; Oktaş, Birhan; Arıkan, Halime; Aktaş, Fatma CansuAmaç: Kalkaneal epin özellikle fazla kilolu ve obez erişkinpopülasyonda sık görülen ve bireyin yaşam kalitesini ciddiölçüde etkileyen bir hastalıktır. Çalışmamızın amacı bu hastapopülasyonunda ayak ağrısı ile vücut kompozisyonu arasındakiilişkiyi incelemektir.Gereç ve Yöntemler: Kalkaneal epin tanısı almış olan 25-55yaş arasındaki 44 birey üzerinde gerçekleştirilmiş olançalışmada ağrı şiddeti ve ağrılı bölge sayısı ayak ağrısınıdeğerlendirme parametreleri olarak ele alınırken, vücut kitleindeksi, bel kalça oranı, deri altı yağ dokusu ölçümlerinden eldeedilen yağ yüzdesi, yağ ağırlığı, yağsız vücut ağırlığı verileri iseadipoz dokuyu değerlendirmek amacıyla kullanılmıştır.Bulgular: Obez olan hastalarda kronik hastalık görülme sıklığıkalkaneal epin tanılı diğer bireylere nazaran daha yüksekbulunmuştur. Ayak ağrısına ilişkin parametreler ile vücutkompozisyonu parametreleri arasında anlamlı bir ilişkisaptanmamıştır.Sonuç: Bu çalışmada adipoz dokuya ait yağ yüzdesi, yağağırlığı, yağsız vücut ağırlığı gibi parametreler ile ayak ağrısıarasında bir ilişki olmadığı belirlenmiş olup, adipoz dokunundeğerlendirilmesinde daha objektif ölçüm yöntemleri üzerindeodaklanılması gerekliliği bir kez daha vurgulanmıştır.Öğe Pycnodysostosıs: Surgıcal Challenges Of Intramedullary Naılıng For Long Bone Fractures: A Case Report(2017) Canbeyli, İbrahim Deniz; Çırpar, Meriç; Oktaş, Birhan; Ökkeşim, Cüneyt EmrePycnodysostosis, known as osteopetrosis acro-osteolytica, is a rare sclerotic bone disease with an autosomal recessive heritage pattern. Characteristic features of the disease are short stature, delayed closure of cranial sutures, partial or total dysplasia of the phalanges, obtuse mandibular angle, skeletal abnormalities and increased bone density. Type I collagen catabolism and bone resorption are defective in these patient due to lysosomal cysteine protease and cathepsin K enzyme defects resulting in dense and more brittle bones. Herein, we report a 45-year-old pycnodysostozis patient with a subtrochanteric transverse fracture of the left femur. We aim to reveal the difficulties encountered during intramedullary nailing of long bone fractures of patients with pycnodysostosis.Öğe Ters Hill-Sachs lezyonlarında kemik greftlemesi olmaksızın rafting tekniği(2017) Çırpar, Meriç; Oktaş, Birhan; Dağlar, BülentBu 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 oluşturabilirÖğe The effect of manual lymphatic drainage on the postoperative recovery process following total knee arthroplasty(2022) Vergili, Özge; Canbeyli, İbrahim Deniz; Oktaş, Birhan; Özsar, Barış Kemal; Keskin, SavaşBackground: Knee joint has great importance on daily living activities thus gonarthrosis does affect quality of life of patients very dramatically. Total knee arthroplasty \r(TKA) is accepted as gold standard in order to cope with pain, deformity and instability especially in patients with gonarthrosis who are in terminal stage. Physical therapy \rand rehabilitation programs are known to increase the success of this surgical procedure. As edema around knee joint is one of the major postoperative complications, which \rprolong recovery process, it is important to use therapeutic modalities against this problem.\rObjective: In this study it was aimed to evaluate the effectiveness of manual lymphatic drainage (MLD) following TKA on edema, range of motion, pain, independence of \rdaily living activities, gait distance and knee functionality.\rMaterial and Method: 16 patients with TKA were divided into two groups while one of them is applied standard postoperative rehabilitation procedure (exercise therapy, \rcryotherapy and positioning) and the other group had MLD therapy on the second and fourth days of the postoperative process for thirty minutes and in one session during \rthe day in addition to standard protocol. On post-op 2nd, 4th, and 6th days, the volumetric changes were calculated based on a formula of Sitzia et al. for each 4 cm segment of \rthe lower extremity, active ROM and knee posture at rest were measured by a universal goniometer, pain by using visual analog scale (VAS), walking distance by calculating \rtotal walking distance in a day, independence level in daily living activities by using Functional independence measurement (FIM) scale. In addition, Lysholm knee score was \rcalculated on postoperative 15th day in order to evaluate functionality of knee joint.\rResults: At postoperative 2nd day, 4th day and 6th day, the mean of FIM (p=0.972, p=0.575, p=0.398, respectively), active ROM (p=0.288, p=0.522, p=0.622, respectively), \rknee posture (p=0.870, p=0.521, p=0.445, respectively), gait distance (p=1.000, p=0.258, p=0.113, respectively), volume of the operated lower extremity (p=0.451, p=0.384, \rp=0.268, respectively), VAS for pain daytime (p=0.192, p=0.488, p=0.506, respectively) and night (p=0.137, p=0.562, p=0.748, respectively) were similar in both MLD and \rnon-MLD groups. The mean of Lysholm score was 46.25±24.50 in MLD group and 61.12±17.70 in non-MLD group (p=0.186).\rConclusion: Although there is no significant difference between groups, the effectiveness of MLD can be showed in studies which will be performed with a larger sample sizeÖğe The effect of the platelet-rich plasma on osteogenicpotential of the periosteum in an animal bone defect model(2021) Oktaş, Birhan; Çırpar, Meriç; Canbeyli, İbrahim Deniz; Şanlı, Elif; Bozdoğan, ÖnderObjectives: This study aims to investigate whether plasma-richplasma (PRP) enhances the osteogenic potential of periostealgrafts used to repair bone defects and maintains both histologicallyand biomechanically more durable bone tissue. Materials and methods: A standard bone defect was formed tothe left femurs of 54 Sprague-Dawley rats and three groups wereformed. In the first group (n=18), no periosteal repair was donefor bone defect. In the second group (n=18), periosteal graft tissuewas sutured to cover the defect entirely. In the third group (n=18),before periosteal repair, a 1 mL of PRP fibrin was applied into thebone defect. All femoral specimens were compared histologicallyat four and six weeks and biomechanically by three-pointbending test at six weeks after treatment. Results: In the PRP applied group, healing of the bone defectat four weeks was significantly better than the other groups interms of histological new bone formation (p<0.05). At six weeks,new bone formation in both of the periosteum preserved groupswas superior to the first group (p<0.05, for both). There was nostatistically significant difference between the second and thirdgroups at the end of the sixth week in the biomechanical analysis,although both groups were significantly stronger than the firstgroup (p<0.05). Conclusion: Stimulation of the periosteum with PRP applicationcauses early osteogenic differentiation of precursor cells.Although, at biomechanical basis, PRP application does notcreate any significant difference, in the recovery of the bonedefects at very early period, application of PRP may play a role toaccelerate fracture healing and to decrease nonunions.Öğe Who Tweets About Diabetic Foot on Twitter and Which Tweets Are More Attractive?(SAGE PUBLICATIONS INC, 2020) Karahan, İrfan; Yürekli, Aybüke; Özcömert, Ömer Recep; Oktaş, Birhan; Çifci, AydınDiabetic foot is a serious problem for health care systems. Twitter can provide communication between people and it might be an informative tool for health care management. The purpose of this study is detecting the people or organizations that tweet about diabetic foot and analyze the interactions of these tweets on Twitter. All tweets containing the keyword "diabetic foot" in April 2019 were collected. The users were separated into 7 groups: patients with diabetes, health care providers, nongovernmental organizations, information sites and communication media, private companies, medical students, and others. Health care professionals and nonprofessionals were evaluated in likes, mentions, and retweets. The major group was health care providers. By 2-group comparisons of professionals and nonprofessionals, all likes, mentions, and retweets were significantly different (P = .02, P = .04, P < .001, respectively). We concluded that the tweets of health care professionals get more interaction than others. Twitter might be a useful tool to distinguish accurate information about diabetic foot. Also, health care professionals should use for making people aware of the diabetic foot and shed light on society.
