Wos İndeksli Açık & Kapalı Erişimli Yayınlar
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Item Polytrauma in the Geriatric Population: Analysis of Outcomes for Surgically Treated Multiple Fractures with a Minimum 2 Years of Follow-Up(2022) Sahin, Orcun; https://orcid.org/0000-0002-6035-6258; 35294739; AAF-4032-2021Introduction This study analyzed the clinical and radiological outcomes of geriatric polytrauma patients who had multiple fractures surgically treated and a minimum of 2 years of follow-up. Methods Eighty-six geriatric patients with polytrauma and multiple fractures which were surgically treated in orthopedics and who had a minimum of 2 years of follow-up were retrospectively analyzed. Patients' demographic characteristics, comorbidities, and follow-up time were recorded. The mechanism of injury, fracture type and location, Injury Severity Score (ISS), American Society of Anesthesiologists (ASA) score, duration of hospital stay, complications, and 1-year mortality were also recorded. Fracture union, implant failure, and refractures/misalignment were analyzed from radiographs. Results There were 34 (39.5%) male and 52 (60.5%) female patients. Mean age was 73.5 years with an average follow-up time of 32.9 months. Patients had more low-energy traumas and more lower extremity, comminuted fractures. On the contrary, high-energy traumas and femur/pelvic fracture surgeries had higher associated mortality. The mean ISS score was 26.3. The most common ASA score was ASA 3 (75.8%). The most common clinical and radiological complications were prolonged wound drainage and implant failure. The total 1-year mortality rate was 22.1%. Patients with high ASA scores and patients with lower extremity fractures (femoral/pelvic fractures) also had significantly increased mortality rates. No significant relation was detected between mortality and ISS, fracture type, number of fractures, and duration of hospital stay. Conclusion Orthopedic surgeons must be alert about the possible complications of femoral fractures and comminuted fractures including pelvic girdle. Surgically treated, multifractured patients with high-energy trauma, advanced age, and high ASA scores are also at risk for mortality regardless of the ISS, comorbidities, and duration of hospital stay. Pulmonary thromboemboli must be kept in mind as a significant complication for mortality.Item The Effect of Smoking on Septoplasty and Septorhinoplasty Outcomes(2022) Erol, Ozan; Koycu, Alper; 0000-0003-1290-3509; 34988636; AAF-3650-2021Background There have been many studies in the literature describing the techniques, the associated comorbidities and the outcomes related to septoplasty and septorhinoplasty, while there have been few studies evaluating the effects of cigarette smoking on septorhinoplasty. The present study evaluates the effect of cigarette smoking on complication and revision rates and compares the functional results of smoking and non-smoking patients. Method The data of 598 patients were retrospectively analyzed, and the age, gender, cigarette smoking status, type of operation, NOSE scores, complications and revision rates were recorded. For the purpose of the study, three different patient groups were defined, being those who had never smoked, those who smoked in the past but had quit and active cigarette smokers. The preoperative and postoperative 6th month Nasal Obstruction Symptom Evaluation (NOSE) Questionnaire scores were compared, and the three groups were compared in terms of complications and the need for revision. Results No differences were identified in the complication rates or revision requirements of the three groups with different cigarette smoking statuses (p=0.17 and p=0.74, respectively). The NOSE scores of the surgery groups and cigarette smoking categories improved significantly after the operation (p=0.01). No difference was identified in the NOSE scores of the groups with different cigarette smoking statuses (p>0.05). Conclusion Active cigarette smoking has no effect on the functional results and rates of complication/revision after septoplasty or septorhinoplasty operation. That said, surgeons should suggest that patients quit smoking preoperatively in order to minimize the general systematic effects of cigarette smoking.Item Effects of Orthopedic Instruments Breakage During Surgery: A Minimum Five-Year Follow-Up(2021) Haberal, Bahtiyar; Beyaz, Salih; 0000-0002-1668-6997; 0000-0002-5788-5116; W-9080-2019; K-8820-2019Aim: The present study aims to investigate the the long-term effect of metallic orthopedic instruments that were broken and not removed during surgery on the health status of patients. Material and Methods: Radiographs of 12,601 patients (5765 females and 6836 males; mean age: 48.9 years; range: 0-105) who underwent orthopedic surgery in our clinic between January 2009 and January 2015 were screened. Thirty-six patients (13 females and 23 males; mean age: 45.3 years; range: 12-82) with metallic instruments, broken and not removed during surgery, were included in the study and minimum five-year follow-up radiographs of the patients were examined. Results: The rate of orthopedic instrument breakage during surgery was 0.28%. This was 0.64% in trauma cases and 0.08% in elective surgery cases. The broken instrument was a Kirschner wire (K-wire) in 16 (44.4%) cases, a screw in 14 (38.9%), and a drill bit in 6 (16.6%). The rate of instrument breakage was 7.44 times higher in trauma cases than in elective surgery cases, which was statistically significant (p = 0.001). Only 1 patient required reoperation for the broken instrument 7 years later. No surgical notes regarding broken implants were identified in patient files. Discussion: Instruments that are broken and not removed during surgery do not cause any complication if they are entirely within the bone. Nevertheless, any instance of instrument breakage should be documented, and the patient should be informed about the condition and followed closely.Item Anterior Spinal Artery Syndrome: Rare Precedented Reason of Postoperative Plegia After Spinal Deformity Surgery: Report of 2 Cases(2020) Bahadir, Sinan; Nabi, Vugar; Adhikari, Prashant; Ayhan, Selim; Acaroglu, Emre; 0000-0003-0153-3012; 32502625; U-5409-2018BACKGROUND: Complications in spinal deformity surgery vary from insignificant to severe. Apart from direct mechanical insult, ischemia can also cause spinal cord injury. Ischemic injury may be detected during surgery or may manifest itself postoperatively. We present 2 cases of anterior spinal artery syndrome. CASE DESCRIPTION: In the first case, a 12-year-old girl developed anterior spinal artery syndrome resulting in total quadriplegia 8 hours after spinal deformity surgery. She was treated with a steroid, immunoglobulin, and lowmolecular-weight heparin. She showed complete recovery at 1 year postoperatively both clinically and radiographically. In the second case, a 62-yearold woman experienced sudden loss of motor evoked potentials intraoperatively during dural tear repair after sagittal and coronal alignment was established. The paraplegic patient was diagnosed with anterior spinal artery syndrome at the thoracic level postoperatively. She was treated with a steroid and heparin. At 1 year postoperatively, she has gained much of her strength and has myelomalacia in her spinal cord. CONCLUSIONS: Anterior spinal artery syndrome is a serious condition with a generally poor prognosis. Though treatment should be directed at the underlying cause, the best strategy is to prevent it from occurring. Peroperative blood pressure control, intraoperative neuromonitoring, avoidance from mechanical stress during surgery, and close neurologic and hemodynamic monitorization postoperatively should be performed.Item The results of interventional catheterization in infants weighing under 2,000 g(2019) Varan, Birgul; Tokel, N. Kursad; Yakut, Kahraman; Erdogan, Ilkay; Ozkan, Murat; 32082877Background: The aim of this study was to evaluate the early and mid-term results of interventional cardiac catheterization and procedure-related complications in infants weighing <2,000 g. Methods: Between May 1998 and April 2017, 22 patients (14 males, 8 females; mean age 14 +/- 8.4 days; range, 1 to 30 days) weighing < 2,000 g who underwent a total of 23 interventional cardiac catheterization were retrospectively analyzed. Procedures were balloon coarctation angioplasty in 14, balloon atrial septostomy in five, balloon aortic valvuloplasty in one, balloon pulmonary valvuloplasty in one, patent ductus arteriosus closure in one, and stent placement in the ductus in one patient. Another patient underwent balloon coarctation angioplasty and balloon aortic valvuloplasty in the same session. Results: The overall success rate of the interventional procedures was 95.6%. The mean follow-up was 3.2 +/- 1.6 years (range, 1 to 5.5) for 18 patients with available records. The rate of serious complications was 18%. The most frequent complications in the early period were low hemoglobin levels requiring erythrocyte suspension transfusion (54.5%) and vascular injury (54.5%). Two patients required reintervention, one patient required surgery after the second intervention, and three patients required only surgery. Six patients underwent palliative interventional procedures, and interventional procedures led to definitive treatment in five patients. Conclusion: The mortality and morbidity rate of surgery is high in premature under 2,000 g infants and interventional heart catheterization can be life-saving in this patient group, although it is associated with significant complications in low birth weight newborns.Item A rare complication of total knee arthroplasty: Type l complex regional pain syndrome of the foot and ankl(2016) Soylev, Gozde Ozcan; Boya, Hakan; 0000-0001-6110-4004; 0000-0001-8742-5543; 27726920; W-7391-2019; AAJ-4917-2021Complex regional pain syndrome (CRPS) is a painful and disabling disorder that usually affects the extremities. This complication may affect the knee joint after total knee arthroplasty (TKA). We report a unique case of CRPS of the foot and ankle, which was an unusual involvement site for CRPS after TKA. (C) 2016 Publishing services by Elsevier B.V. on behalf of Turkish Association of Orthopaedics and Traumatology.Item Comparison of Tunnel and Crestal Incision Techniques in Reconstruction of Localized Alveolar Defects(2017) Altiparmak, Nur; Uckan, Sina; Bayram, Burak; Soydan, Sidika; 28520823Purpose: The aim of this study was to compare the complication rates of recipient sites prepared using two incision techniques: crestal and tunnel. Materials and Methods: In this prospective study, patients underwent augmentation procedures (68 patients; 75 sites) by the same surgeon that were performed consecutively using the crestal incision technique (27 horizontal, 10 vertical; crestal group) or the tunnel incision technique (27 horizontal, 11 vertical; tunnel group). Autogenous bone block grafts were harvested with a piezoelectric surgical device, and the grafts were fixed at the recipient sites by two titanium screws in both groups. The authors evaluated minor exposure, transient paresthesia, major exposure, permanent paresthesia, gingival recession at adjacent teeth, surgery time, and visual analog scale pain scores. Results: Soft tissue dehiscence and graft failure were significantly lower in patients undergoing the tunnel technique. Conclusion: The tunnel incision technique significantly decreased soft tissue exposure, the most common complication of augmentation procedures with autogenous onlay bone grafts. This technique should be considered an alternative to the crestal incision technique for preparation of the recipient site.