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    Does the wedge wing in the neck screw prevent cut-out failure in OTA/AO 31- A2 trochanteric fractures in elderly patients?
    (ARSMB-KVBMG aob.edit@skynet.be). amb@skynet.be Avenue W. Churchill-laan 11/30 Brussels B-1180, 2014) Günay, Cüneyd; Atalar, Hakan; Altay, Murat; Yavuz, Osman Yüksel; Yildirim, Ahmet Özgür; Öken, Fuad O.
    The purpose of this retrospective study was to evaluate the effects of Dyna Locking Trochanteric (DLT) nail (U & I Corporation 529-1, Yonghyun-dong, Uijungbu Kyunggi-Do, Korea 480-050) in 31-A1 and 31-A2 intertrochanteric femur fractures. Eightyseven patients (63 female and 24 male, mean age 77 years) were treated. The mean duration of followup was 16.6 ± 3.1 months (range, 12-24 months). There were 36 cases of 31-A1 and 51 cases of 31-A2 fractures. The duration of surgery, fluoroscopy screening time, the blood loss, the hospital stay, the tip-apex distance were significantly less in the 31-A1 fracture group compared with the 31-A2 fracture group (p < 0.001). Cut-out was observed in 13 patients (14.9%) above 80 years old with 31-A2 fractures. Especially in elderly patients with unstable 31-A2 fractures, the wedge wing on the neck screw does not work properly. Therefore further biomechanical investigations and also prospective clinical studies with larger series are needed to improve the device. © 2014, Acta Orthopdica Belgica. © 2014 Elsevier B.V., All rights reserved.
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    Does the wedge wing in the neck screw prevent cut-out failure in OTA/AO 31-A2 trochanteric fractures in elderly patients?
    (Acta Medica Belgica, 2014) Gunay, Cuneyd; Atalar, Hakan; Altay, Murat; Yavuz, Osman Yuksel; Yildirim, Ahmet Ozgur; Oken, Ozdamar Fuad
    The purpose of this retrospective study was to evaluate the effects of Dyna Locking Trochanteric (DLT) nail (U & I Corporation 529-1, Yonghyun-dong, Uijungbu Kyunggi-Do, Korea 480-050) in 31-A1 and 31-A2 intertrochanteric femur fractures. Eighty-seven patients (63 female and 24 male, mean age 77 years) were treated. The mean duration of follow-up was 16.6 +/- 3.1 months (range, 12-24 months). There were 36 cases of 31-A1 and 51 cases of 31-A2 fractures. The duration of surgery, fluoroscopy screening time, the blood loss, the hospital stay, the tip-apex distance were significantly less in the 31-A1 fracture group compared with the 31-A2 fracture group (p < 0.001). Cut-out was observed in 13 patients (14.9%) above 80 years old with 31-A2 fractures. Especially in elderly patients with unstable 31-A2 fractures, the wedge wing on the neck screw does not work properly. Therefore further biomechanical investigations and also prospective clinical studies with larger series are needed to improve the device.
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    Functional treatment of developmental hip dysplasia with the Tubingen hip flexion splint
    (Sage Publications Ltd, 2014) Atalar, Hakan; Gunay, Cuneyd; Komurcu, Mahmut
    Objective: Developmental dysplasia of the hip (DDH) is a deformity that may cause to serious disability. Early diagnosis and early treatment are very important. Our aim is to report the outcomes of infants with DDH who were treated with the Tubingen hip flexion splint. Materials and methods: Retrospectively, 49 patients (45 female, four male; 60 hips) diagnosed with DDH were included in the study. For diagnosis, all patients underwent ultrasonography of the hip performed according to the Graf method. Infants whose hips were Graf type 2b or worse underwent orthotic treatment. Treatment success was defined as development into a mature hip (Graf type 1 on ultrasonography and no acetabular dysplasia apparent on the latest radiograph). Results: Overall median age at the start of treatment was 18 weeks (14-25). Median total treatment time (from initial application of the splint to the end of weaning) was 17 weeks (14-20). Median duration of follow up was 13.5 months (8.5-31.5). Treatment was successful in 56/60 hips (93.3%). Of the 56 successfully treated patients, acetabular dysplasia was present early in follow up but later resolved in 4 patients. No complications were encountered in any patients in the study. Conclusion: The Tubingen splint proves abduction but due to its different design it offers the advantages of preventing hip adduction and leaving the knee and ankle joints free. Our findings suggest that in infants with DDH, the Tubingen hip flexion splint is an effective form of treatment.
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    Maternal Height and Infant Body Mass Index Are Possible Risk Factors for Developmental Dysplasia of the Hip in Female Infants
    (Okayama Univ Med School, 2015) Atalar, Hakan; Gunay, Cuneyd; Yavuz, Osman Yuksel; Camurdan, Aysu Duyan; Uras, Ismail; Eren, Ali
    Developmental dysplasia of the hip (DDH) is a wide-spectrum disease with a multifactorial etiology and, despite its prevalence, no definitive etiology has yet been established. The aim of this study was to investigate new risk factors for DDH by evaluating newly defined potential risk factors. A total of 71 infants were separated into 2 groups: Group 1, 28 female first-born infants diagnosed with DDH and their mothers; and Group II, 43 healthy female first-born infants and their mothers. The maternal height and weight before pregnancy, infant height and weight at birth, and body mass index (BMI) of both mother and infant were determined. Calculations were made of the ratios between these parameters. Of the examined risk factors, only maternal height and the ratio of maternal height to infant BMI (MH/I-BMI) were found to be significant for DDH in infants. In conclusion, the results of this study show that a short maternal height and a low MH/I-BMI increase the risk of DDH. Further studies with a larger series are necessary to confirm these results.
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    Maternal height and infant body mass index are possible risk factors for developmental dysplasia of the hip in female infants
    (Okayama University actamed@cc.okayama-u.ac.jp, 2015) Atalar, Hakan; Günay, Cüneyd; Yavuz, Osman Yüksel; Duyan-Çamurdan, Aysu; Uraş, Ismail; Eren, Ali
    Developmental dysplasia of the hip (DDH) is a wide-spectrum disease with a multifactorial etiology and, despite its prevalence, no definitive etiology has yet been established. The aim of this study was to investigate new risk factors for DDH by evaluating newly defined potential risk factors. A total of 71 infants were separated into 2 groups: Group I, 28 female first-born infants diagnosed with DDH and their mothers; and Group II, 43 healthy female first-born infants and their mothers. The maternal height and weight before pregnancy, infant height and weight at birth, and body mass index (BMI) of both mother and infant were determined. Calculations were made of the ratios between these parameters. Of the examined risk factors, only maternal height and the ratio of maternal height to infant BMI (MH/I-BMI) were found to be significant for DDH in infants. In conclusion, the results of this study show that a short maternal height and a low MH/I-BMI increase the risk of DDH. Further studies with a larger series are necessary to confirm these results. © 2016 Elsevier B.V., All rights reserved.
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    The Role of ADAMTS9 Gene Promoter (Ca) Repeat in Developmental Hip Dysplasia
    (Canadian Soc Clinical Investigation, 2015) Yilmaz, Ayse E.; Atalar, Hakan; Acar, Muradiye; Dogan, Mikail; Aytekin, Mahmut N.; Gunduz, Mehmet; Gunduz, Esra
    Purpose: The relationship between the number of cytosine-adenine base pair repetition [(CA)n] in the promoter zone of ADAMTS9 gene, which may affect the collagen structure, and the developmental hip dysplasia was investigated. Methods: Using DNA isolating from 26 patients diagnosed with developmental hip dysplasia (DDH) and 29 patients without DDH, the (CA) n in the promoter zone of ADAMTS9 was calculated. The distributions of groups were measured by Shapiro-Wilk test, and the average results of the groups in the state of their normal distributions were compared using parametric Student t test. Results: While the (CA) n values varied between 15 and 30, the group average was found to be 17.9. While the (CA) n values of the patient group varied between 11 and 20, its average was computed to be 17.3. The averages of groups were not statistically different (p = 0.960). Conclusion: According to the results of our study, AD-AMTS9 gene promoter (CA)n in the individuals with developmental hip dysplasia was not found to be different from that of healthy individuals. Nevertheless, when strong impact of ADAMTS9 gene on the ligament tissue is considered, it is necessary to evaluate ADAMTS9 gene role with different aspects.
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    Which modality is the best choice in distal radius fractures treated with two different Kirschner wire fixation and immobilization techniques?
    (Turkish Assoc Trauma Emergency Surgery, 2015) Gunay, Cuneyd; Oken, Ozdamar Fuad; Yavuz, Osman Yuksel; Gunay, Sinem Hursen; Atalar, Hakan
    BACKGROUND: The aim of the study was to investigate whether the number and position of Kirschner (K)-wires, and the manner and duration of immobilization influence radiologic and functional outcomes of distal radius fractures treated with percutaneous K-wire fixation. METHODS: Ninety-two patients were included into the study with a mean follow-up period of 19.84 +/- 5.22 months (range, 13-34 months). In Group I, forty-five patients were treated with 3 K-wires and supported with a volar semi-circular cast for the first 3 weeks followed by a removable splint for a further 3 weeks. In Group II, forty-seven patients were treated with 2 K-wires and supported with a below-elbow circular cast for 6 weeks postoperatively. RESULTS: No significant difference in grip strength and DASH scores was found between the two groups. In clinical examination, significantly better functional results were determined in patients supported with a removable volar splint. At 6 weeks postoperatively, volar tilt, radial inclination, and radial length were significantly better in Group I compared to Group II (all p values). CONCLUSION: Tripod technique with 3 K-wires is a safe and reliable procedure to achieve stability and good radiological results. The use of a removable splint also improves the functional outcomes in the treatment of both intra-and extra-articular distal radius fractures.