Makale Arama

Fractures of the clavic!e are common and make up a high percentage among the skeletal system tra-uma. They are well managed by conservative met-hods. 496 clavicular fractures of 493 patients were diagnosed between 1993 and 1997 in our dinle 357 of thern were men and 136 women. Average age was 38.5 (18-78). Years in 207 of them right side was affected and in 289 left. 3 of the cases had bi-lateral involvement. Conservative treatment included velpeau dressing or figure of eight bandage. 82 of the patients were lost to follow-up after the first exa-mination. Remaining 414 fractures of 411 cases were followed up at least 1.5 months 3 nonunions (%0.7) were detected_ Conservative treatment re-sulted in % 99.3 of union.

The Analysis Of 127 Patients With Congenital Dislocation Of The Hip 127 cases with congenital dislocation of the hip were determined at tlıe Department of Orthopedic Surgery of the Medical School of Selçuk University, between March 12, 1983 and November 11, 1984. 23 (18 per cent) were boys, 104 (82 per cent) were girl.s of the patients. The dislo-cation of the hip was on the right hip in 24 cases (18 per cent), on the left hip in 28 cases (23 per cent), and on the bilateral hip in 75 cases (59 per cent). 57 per cent of the cases were firt child of the family. The diag-nosis of congenital dislocation of the hip was made in 0 age period in 62.3 per cent of the cases. it has been determined that swadling clothes has been applicated in 97 per cent of the cases between one to eighteen months. 40 per cent of the cases were treated concervatively 26 per cent of the cases were treated by surgery (iliac osteotomy), in 15 per cent of the cases the treatment was delayed. and no treatment was performed in 19 per cent of the cases.

The results in 58 congenitally dislocated hips in 43 children who were between one and a half four years okl have been reviewed. There were 35 girls and 8 boys. Open reduciion (OR) was perfortned in one hip, Salter's innornintne osteolotny (S10) was perforrned in three hips, OR and SIO were perfortned in 43 hips, OR, SfO derotation varus and fernoral shortenin were performed 11 patients. Ali of the patients have been followed at least one yer (average nventy-two months). Using Severin classification of radiographic evalualion, 48 hips (83 per cent) vere telated as excellent, 6 hips (10 per cent) as good, one hip (2 per cent) as fair and three hips (5 per cent) as failure. Clinical avaluation was made using Mc Kay's criteria and 47 hips (81 per cera) were related as excellent. Seven hips (12 per sent) as good, three hips (5 per cent) as fair, one hip (2 per cent) as failure. Avascular necrosis developed in one mortn.al side, there was one redislocation

From June 1983 to September 1989, 51 patients with displaced fractures of the femoral neck were treated by Thornpson arihroplasty. The avarege age at operation was 64.8 years. There were 18 men (40 per sent) and 33 women (60 per cent) The postero-lateral approach to the hip was used at al! operations. There was one dead, one dislocation and one fibular nerve injury as early complication. The resulis after 34 hips studied at follow-up. Among 34 patients, 24 of !hem were controlled radiologically. One asetabular erosion, one asetabular protrusion and one loosening of prothesis were found as a lale complication.

35 cases with congenital dislocation of the hip were treated conser-vatively. 7 of the cases (20 per cent) were boys and 28 (80 per cent) were girls. The average age of the cases was 7.5 months (range, 2 to 24 months). The left hip was dislocated in 8 (23 per cent), the right in 7 (20 per cent) and both in 20 (57 per cent) patients. 14 cases were treated with von Rosen splint. In the other cases, skin traction was applied first. Then closed reduction and hip spica cast was applied ender general anesthesia in 19 cases, open reduction was applied in two cases. Adductor tenetorny was nessary in 7 patients (ten hips). The patients were followed average 6.5 months and avascular necro-sis was not determined. The conservative treatment was not sufficient in 2 patients.

Aim: Axillary defects mostly occur after burn contracture releases or hidradenitis suppurativa debridements. Reconstruction of this type of defect is a challenge since the ultimate aim is maintaining a pliable coverage with full mobility of the shoulder joint. Scapular flap is one of the reconstructive options in axillary defect coverage. This study is aiming to present reconstruction of axillary defects with scapular island flaps for different indications and to discuss the outcomes of the donor sites so as to suggest it as a workhorse flap in axillary reconstruction.
Patients and Methods: A total of 7 patients treated with 8 scapular island flaps between 2015 and 2019 were included retrospectively. Five patients were operated for hidradenitis suppurativa and 2 patients reconstructed for axillary contracture. All scapular flap pedicles were skeletonized and transferred to the axilla through the triangular space.
Results: Flap dimensions ranged from 84cm2 to 128 cm2 without exceeding 8cm of the width. Donor site scars widened between 3 months to 6 months post-operatively and independent of patient age. Donor site scars ranged from 1.5-2.6 cm after at least 3 months of follow-up. All flaps survived without any complication except one with a tip necrosis that healed with secondary intention.
Conclusion: Scapular island flaps can cover defects of the axilla created by various causes. Horizontal extension of the flap protects it from burn scar involvements of the posterior axillary line and the arm. Although widening of the scars seems to be a disadvantage, thin and pliable skin coverage with ease

Aim: The aim of this experimental study is to determine the relationship of the element levels in different tissues and the postmortem process and the reliability of this relationship in the determination of postmortem interval. Material and method: For this purpose, 52 three-month-old male Sprague-Dawley rats were sacrified by cervical dislocation and four of them were seperated for dissection. On the other hand, remaining 48 rats were divided into two groups for the purpose of investigating surrounding temperature the corps existed to the tissue element levels. One of the groups was kept at 4 ºC and the other at 18±2 ºC. Just after sacrifice, seperated four rats were dissected. Then the dissection was made at 6., 12., 24., 48., 72. and 96. hours four rats each among the groups kept in both temperatures. Brain, myocardium, liver, kidney and skeletal muscle samples were taken from each rat. Element levels were determined by ICP-AES in the samples which were prepared for analysing with microwave digestion method. The values acquired for Ca, Cu, Fe, K, Mg, Na, P, S and Zn were statistically evaluated by Kruskal-Wallis and Mann-Whitney tests. Results: When the findings of both temperatures were evaluated together in all tissues, it was determined that Fe, K, Na, Ca and Cu showed significant changes in more than one tissue at 4 ºC and 18±2 ºC. Conclusion: It was concluded that, the availability of tissue element levels as a reliable method in the determination of postmortem interval needs to be revealed by experimental studies that will be done on wider series and the analyses on the autopsy material.

We performed Salter innominate osteotomy in 29 patients with Congenital dislocation of the hip (34 hips) between March 1983- January 1985. We examined the secondary adaptive changes of the hip in 25 (30 hips) of these patients. 24 patients were girls (%96) and one patient was boy (%4) and the patients' ages ranged from 1.5 -6 (average, 3,1) yedı s. The findings of femoral head, anteversion, limbus, ligaınentum teres and ilio - psoas were presented and the results were discussed.

Patients with temporomandibular joint (TMJ) dysfunction have symptoms such as pain in the jaw and surrounding tissues, limitation in jaw movements and/or clicks, crepitation, head, neck, ear, toothache. Although there are publications on PRP injections in the treatment of temporomandibular joint (TMJ) dysfunction, there is no study on the effect of the use of concentrated growth factor (CGF) in the literature. In this study, it was aimed to analyze the efficacy of concentrated growth factor (CGF) in patients with TMJ disc displacement, disc dislocation with/without reduction and joint degeneration. Patients who did not respond to conservative treatment during the period of 2015-2016 and were complaining of TMJ pain, knocking in the joints, decreased mouth opening were included to the study. Magnetic resonance imaging results of before and after injections, age, gender, previous therapies, pain, click on the joint, mouth openness were recorded. The pain felt in the jaw joint in patients was scored according to the visual analogue scale (VAS) numbered 0-10. Mouth openness was measured. Before and the six months after CGF injections, TME magnetic resonance imaging was performed on all patients. All measurements were repeated at 6 months and 1 year after CGF injection. The mean age of the 10 patients (3 males, 7 females) was 30 and the mouth openness was 2.1 cm before injection. In the first year after injection, mouth openness was measured as 3 cm on average. Before injections, there was a clicking sound in all patients. However, at the end of the 1st year, only 2 patients had clicking. The mean VAS before and after injection injection was 8 and 3, respectively. In this study, it was determined that one intraarticular injection of 1 cc CGF in the patients with joint degeneration and TMJ disc displacement with/without reduction resulted in decrease of VAS score and click sound and increase of mouth openness. CGF injection may achieve symptomatic improvement in patients with TMJ dysfunction.

Facial asymmetry in new-born babies is not always due to facial paralysis. Congenital facial asymmetry, might as well as be due to depressor anguli oris muscle aplasia (DAOA), so called “congenital asymmetric crying facies”. Additional congenital anomalies like skeletal, cardiovascular, urogenital, respiratory or central nerve system anomalies can also accompany this disorder. Here, we present a case with DAOA whose cousin had aplasia of 8 fingers in two hands, hip dislocation, partial cutaneous syndactyly in bilateral feet fingers, and ASD. DAOA is a rare congenital anomaly with unknown etiology; therefore, screening tests should be done when encountered by otolaryngologists and pediatricians.

The Total dislocation of talus is a traurna that results always alrnos disabling. Fortunately it is rare. In this paper a cese 'with total dislocation of talus was presented and the subject was reviewed.

The most common site of ulnar nerve entrapment is at the elbow. Diagnostic approach to ulnar neuropathy mainly depends on needle electromyographic findings. This case report aims to highlight the susceptibility of nerves arising from brachial plexus to injuries varies beyond the literature knowledge.

One of the basic treatment techniques in cardiac conduction defects is pacemaker implantation. Although they were first used for the purpose of the treatment of bradyarrhythmias in 1958, they have had their current position for being applied to prevent and also to terminate the tachycardias in the course of time. Therefore, the rate of patients with permanent pacemaker in accordance with the increase in their use has been increasing at routine clinical practice recently. As a result, it is important to understand the possible ECG changes in these patients to determine any pathology on time. We are going to report a pacemaker lead dislocation detected with surface ECG change obtained during routine the pacemaker’s functions control in a patient with DDD pacemaker, who did not describe any complaint previously. In this case our aim is to emphasize the importance of 12-lead surface ECG to make diagnosis of pacemaker dysfunctions.

Two cases of dorsal dislocation of rhe lateral metatarso-phalangeal joints is reported because it is a very rare dislocation and the literatüre is reviewed.

İn the manegement of CDH, the first 18 monhs of lıfe i,r by far the most critical period. The ezcellent results that can be obtained by early treatment. The goal of treattnent is to return the femoral head to its normal relationship within the acetebulum and rnaintain 'his position until pathologic change reverse... The early results of 164 CD1-1 in 97 patients have been reviewed between 1983 and 1987. 68 patients who were between 6 days and 6 monihs old were treated by triple diapers, Wrejka pillows and vonRosen splints. 29 patients who were between 1,5 months and 17 months old. were treated by closed reduction under general anesthesia and immobolization in a hip-spica cast. All of the hips were normal clinically. Radiologically there were subluxation in one hip and avascular necrosis in three hips.

A patient presented with a gunshot injury to his left shoulder. On his examination, there were no symptoms or signs except an entrance hole in front of his left shoulder. There was no bullet exit hole. Radiologic examination revealed a left clavicular fracture and a dense image suggestive of a metal at the distal portion of the right clavicle just in front of the right glenohumoral joint. İt is very interesting and unusal that a bullet tracing its way from the left shoulder to the right vvithout damaging any internal organ, vascular structure and nerves.

Radiographic and ultrasonographic findings were discussed in 34 cases that were congenitaly dislocation of the hip joint. In 43 (%63) of 68 hips, correct diagnosis was determined by radiography and was determined by ultrasonography in 48 (%71). Ultrasonography is more accuracy than radiography during the early periods. It was obserwed that sonographically acetabular angle ıvas eighty percent larger than radiography. Labrioacetabular angle was found between 99 and 116 degree in 37 (%77) hips that congenital hip joint dislocation was diagnosed by ultrasonography.

Aim: The aim of this study was to evaluate the effects of intraarticular administration of sufentanil and morphine on postoperative pain and analgesic requirements after artroscopic knee procedures. Material and Method: Sixty patients scheduled for artroscopic knee surgery were randomised into three groups. A standart general anesthesia was used for all patients At the end the surgery , before the artroscope was removed the following solutions were administerd in 20 ml of normal saline. Group I:(n:20) 20 ml normal saline, Group II:(n:20) 10mg sufentanil, Group III:(n:20) 2 mg morphine. Awaken time of the patients was estimated as time 0 and Visual Analog Scale (VAS) scores were assesed. IV PCA (Patient Controlled Analgesia) was given as tramadol. The PCA deliveries at 30 min, 2 hours, 12 hours and 24 hours and total tramadol requirements for 24 hours were noted. Result: VAS scores were significantly lower in group II(p< 0.05). The consumption of tramadol at 30 min was also lower in group II when compared to group I and group III (p<0.05). Intraarticular sufentanil significantly reduced the postoperative consumption of analgesics (p<0.05). Conclusion: As a result we concluded that intraarticular sufentanil using in artroscopic knee procedures is simple, effective, safe and well tolerated analgesic techinique. This study showed that the onset of analgesia was faster and stronger with intraarticular sufentanil.

A screening program was perforrned at five hospital in Konya in which 4173 infants (range 3-24 months of age) were eamined. The goal of this study was to detection of incidense and related factors in the etiology of CDH. 56 infants with CDH were found (The incidense was 1.3%). The condition was 3 times more cornmon in girls than in boys (40 girls and 16 boys in this group). There was any infant with CDH who was delivered by ceserian section or breech presentation. Any teratologic CDH was detected. The relation of CDH with a definite family history and the hips were bundled in etension and adduction was found statistically significant.

Aim: The purpose of this study is to examine whether there is a difference between the sense of movement
of the glenohumeral joint of the dominant extremity and the sense of movement of the non-dominant
extremity.
Patientss and Methods: In the study, 20 healthy and sedentary, volunteer participants (10 males,
10 females) who did not have shoulder problems were included. Mean age of the participants were
23.60±3.64 years. Data collection were performed between July 6, 2020 and August 3, 2020. The sense
of movement of the dominant and non-dominant extremities of the glenohumeral joint was measured for
the participants. The measurement of sense of movement was done by using an isokinetic dynamometer
by measuring the passive sense of movement threshold value at an angular speed of 0.1°/s. The sense
of movement measurement was performed towards four directions: from 0° (0°-IR) and from 30° (30°-IR)
to internal rotation direction, and from 0° (0°-ER) and from 30 ° (30°-ER) to external rotation direction.
Results: The sense of movement of the participants for internal rotation at angles and directions of 0°-IR,
30°-IR were respectively 1.27±0.47, 1.30±0.45, and for external rotation at angles and directions of 0°-
ER, 30°-ER were respectively 1.25±0.39, 1.41±0.32 for the dominant side extremity, for internal rotation at
angles and directions of 0°-IR, 30°-IR were respectively 1.33±0,59°, 1.37±0,49°, and for external rotation
at angles and directions of 0°-ER, 30°-ER were respectively 1.39±0,49°, 1.18±0,42° for the non-dominant
side extremity. For neither of the two extremities, the differences between the sense of movement were
statistically significant (p<0.05).
Conclusion: According to the results of the study, shoulder proprioception of dominant and non-dominant
extremities is not different. The goal of proprioception in the rehabilitation of shoulder-related injuries;
regardless of whether the injured extremity is dominant or not, may be determined according to the
shoulder proprioception of the sturdy extremity .

Lymphangiomas are rare in adult patients. This is a case report of a 27-year-old female who developed lymphangioma in axillary area with shoulder pain. She was successfully treated with excision of the lymphangioma.

The purpose of this study is to compare the diagnostic value of clinical findings with arthroscopic findings in the knee pathologies. İn this prospectlve study, 666 knees of 666 patients were evaluated. By comparing the clinical findings with arthroscopic findings; the accuracy, sensitivity, specificity, positive and negative estimated values of the clinical findings in diagnosis were calculated. High accuracy rates were found in meniscal and anterior cruciate ligament lesions with clinical examination (78.9-92.4%). Hovvever, the accuracy rates in chondral, plica, synovial lesions, and loose body were found low (77-84.6%). The sensitivity rates of meniscal and anterior cruciate ligament were found high (81.1-78.2%). On the contrary, chondral, plica, and synovial lesions and loose body sensitivity rates were found low (44.6-51.9%). These findings suggested that clinical examination of meniscal lesions and anterior cruciate ligament tears were more valuable than other knee pathologies such as chondral, plica, and synovial lesions and loose body. They also can be helpful for accurate diagnosis when they are used with other diagnostic tools.

Surgical treatment was performed in 21 hips of 18 children aged 5-11 years with congenital hip dislocation. Open reduction, Salter or triple osteotomy and femoral osteotomies were performed. The patients, 15 girls and three boys, were followed for at least one year. It was evaluated radiologically according to the Severin classification and 19 hips (90%) were found to be very good and good, and two hips (10%) bad. Re-dislocations occurred in two hips and one of them developed avascular necrosis of the femoral head.

Familial mediterranean fever (FMF) is an autosomal recessivelytransmitted disease characterised by attacks of fever and serositis. Articular involvement is the second most common manifestation following abdominal pain. Articular involvement is commonly in the large joints of the lower extremities but may occur in other joints such as the ankle, shoulder, temporomandibular joint, or sternoclavicular joint. Here, we report a 25-year-old man of FMF with accompanying costochondritis. In conclusion, arthritis of FMF is clinically presented in various forms such as costochondritis

Subtalar dislocations are uncommon in juries. The case report. of a 20-years-old male who sus-tained a medial subtalar dislocation, is presented. In this discussion. the etiology and treatment of medial subtalar dislocation is reviewed to alert the cli-nicians for prompt evelnation