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Öğe Do Reduction Maneuvers Affect Recurrence in Pediatric Radial Head Subluxation? A Ten-Year Retrospective Analysis(Springer Heidelberg, 2026) Boz, Mehmet; Boz, Gulseda; Altunkilic, Tarik; Ari, Bunyamin; Guzel, Ismail; Barbak, Umit YasinBackground This study aimed to determine whether the choice of reduction maneuver in patients presenting to the emergency department with nursemaid's elbow influences the likelihood of recurrent dislocation. Additionally, the study sought to describe the epidemiological characteristics of these cases. Methods This retrospective study included 1359 patients diagnosed with nursemaid's elbow who presented to the Emergency Department of Malatya Training and Research Hospital from January 2015 to June 2025. Data on demographics, side affected, radiographic evaluation, reduction maneuver, and recurrence were analyzed. The chi-square test was used for statistical analysis, with p < 0.05 considered significant. Results The median age was 2 years, with 61.2% female. Most cases (88.1%) were in the 0-3-year age group. Left-sided involvement accounted for 63.0%, right-sided involvement 37.0%. Hyperpronation was used in 68.4%, supination-flexion in 31.6%. Recurrence rate was 4.8%, higher with right elbows and supination-flexion (p < 0.05). Conclusion Nursemaid's elbow was more common in children under three, particularly girls, and affected the left arm. Recurrence was lower after hyperpronation than after supination-flexion. Level of Evidence Retrospective analysis study.Öğe Does Tourniquet Use Affect the Length of the Hamstring Tendon in Anterior Cruciate Ligament Reconstruction?(Mdpi, 2026) Altunkilic, Tarik; Ari, Bunyamin; Guzel, Ismail; Boz, Mehmet; Inceoglu, FeyzaBackground: The aim of the present study was to investigate whether the use of a tourniquet during anterior cruciate ligament reconstruction affects the length of the hamstring tendon used for autograft. Methods: Adult patients who were referred to the Orthopedics and Traumatology Department of The Malatya Turgut & Ouml;zal University hospital and were diagnosed with anterior cruciate ligament injury between 30 July 2025 and 30 December 2025 were included in the study. In total, 31 patients from whom the hamstring tendon was harvested without a tourniquet were placed in Group 1, and 36 patients from whom the hamstring tendon was harvested with a tourniquet were placed in Group 2. This study is a prospective, randomized, comparative study. These two groups were compared with respect to the lengths of the hamstring tendons used as autografts. Results: The semitendinosus and gracilis tendon lengths in Group 1 were 29.61 +/- 1.76 cm and 27.68 +/- 2.02 cm, respectively. In Group 2, the semitendinosus and gracilis tendon lengths were 25.67 +/- 1.45 cm and 23.72 +/- 1.06 cm, respectively. A statistically significant difference was observed between the semitendinosus and gracilis tendon lengths of the participants in Groups 1 and 2 (p < 0.05). Conclusions: These findings suggest that avoiding tourniquet use during hamstring tendon harvest may represent a simple technical modification that can influence harvested tendon length during anterior cruciate ligament reconstruction.Öğe Evaluation of the Efficacy of Prolotherapy in Patients With Lateral Epicondylitis Using Shear-Wave Elastography(Int Scientific Information, Inc, 2026) Boz, Mehmet; Akcicek, MehmetBackground: This study aimed to evaluate the effectiveness of prolotherapy in patients diagnosed with lateral epicondylitis and to objectively assess changes in tendon elasticity using shear-wave elastography (SWE). Material/Methods: This was a prospective, single-center, observational clinical study. Thirty-six patients diagnosed with lateral epicondylitis were included. Each received 3 prolotherapy sessions at 3-week intervals. The elasticity and thickness of the common extensor tendon (CET) were evaluated using SWE both before and after treatment. Pain intensity was measured using the Visual Analog Scale (VAS). The same orthopedic surgeon performed all prolotherapy injections, and the same radiologist performed all SWE evaluations. Data normality was assessed with the Shapiro-Wilk test. Normally distributed variables were analyzed using the t-test or Paired Sample t-test, while the Mann-Whitney U or Wilcoxon Signed-Rank tests were used for non-normal data. Correlations were evaluated using Pearson's or Spearman's correlation coefficient, and P<0.05 was considered statistically significant. Results: Prolotherapy resulted in a significant increase in CET elasticity (kPa) and tendon thickness (P<0.01). Male patients exhibited greater tendon thickness and stiffness than female patients. Overall, SWE proved to be a reliable quantitative tool for tracking treatment response. Conclusions: Prolotherapy is an effective treatment for lateral epicondylitis, contributing to pain reduction and structural improvement of the tendon. SWE offers a non-invasive, reliable imaging technique for objectively tracking changes in tendon elasticity. The combination of these methods provides valuable clinical and structural insights into the management of lateral epicondylitis.Öğe Lateral imaging technique of the femoral neck in a supine-semilithotomy position without a fracture table(İnönü Üniversitesi, 2020) Boz, Mehmet; Şahin, Abdullah AlperTreatment of proximal femoral fractures in the supine position poses has certain challenges, especially due to difficulties in lateral imaging of the femoral neck in cases where there is no fracture table, such as prolonging the surgery time and increasing the dose of radiation exposure. The purpose of this study is to present the lateral imaging technique of the femoral neck by fluoroscopy on the conventional operating table in the treatment of proximal femoral fractures. We applied proximal femoral nail by positioning the healthy leg in a semilithotomy position to facilitate lateral imaging of the femoral neck by fluoroscopy while the patients were in the supine position. The study analyzed 22 patients (12 women, 10 men) with femoral pertrochanteric and basicervical fractures with the following types of fractures (9 patients had AO type 31-A1, 9 patients had AO type 31-A2, 4 patients had AO type 31-B2.1), and with a mean age of 62.1 years (33-75 years). The preparation time of the supine-semilithotomy position was about 2 minutes, and the reduction was finished within 9 intraoperative fluoroscopy exposure times. No patient suffered from a postoperative complication. The mean surgery time was 20 minutes (18-22 minutes), the average number of scopy shots was 8 (7-9), and the mean hospital stay duration was 2 days (2-2 days). We believe that the supine-semilithotomy technique is a suitable treatment option for proximal femoral intramedullary nailing and cannulated screw application. Since the lateral view of the femoral neck is obtained quickly and clearly with this technique, fluoroscopy does not need to be performed repeatedly, so fluoroscopy time and the number of shots are reduced, and the time spent by the patient and the surgical team in the surgery is shortened.Öğe Open fractures associated with earthquakes and highenergy trauma: Clinical outcomes and management strategies(Turkish Assoc Trauma Emergency Surgery, 2025) Guzel, Ismail; Ari, Bunyamin; Altunkilic, Tarik; Ulusoy, Ibrahim; Boz, MehmetBACKGROUND: This study aimed to evaluate the epidemiological characteristics, infection rates, complication risks, and clinical management strategies of open fractures resulting from high-energy traumas. Special attention was given to the effects of the 2023 major earthquake on the incidence of open fractures and patient management, comparing different trauma mechanisms retrospectively. METHODS: This retrospective study included 512 patients admitted to a tertiary trauma center between 2019 and 2024. Patients were classified according to five different trauma mechanisms: traffic accidents, falls from height, occupational injuries, gunshot wounds, and earthquake-related traumas. Open fractures were assessed and classified using the Gustilo-Anderson classification to determine the severity of the injuries. Treatment protocols included early antibiotic administration, surgical debridement, wound management protocols, and surgical fixation methods. Statistical analyses were performed to compare differences between early surgical intervention (within 24 hours) and delayed surgical intervention (after 24 hours). Statistical tests used included T-test, Mann-Whitney U test, Chi-square test, and logistic regression analysis. A p-value of <0.05 was considered statistically significant. RESULTS: The mean age of the 512 patients was 37.4 +/- 12.6 years, with 68% males and 32% females. The most common trauma mechanism was traffic accidents (54.2%), followed by falls from height (27.8%), occupational injuries (12.5%), gunshot wounds (5.5%), and earthquake-related traumas (11.3%). A significant proportion of earthquake-related injuries were classified as Gustilo-Anderson Type III fractures (42.8%), which was notably higher than that of other trauma mechanisms (p<0.001). In earthquake-related cases, multiple fractures were present in 63.2% of patients, and bilateral extremity fractures were observed in 21.4% of cases. The infection rate was 11.4% in patients who received early antibiotic administration, compared to 27.8% in those with delayed administration (p<0.005). Early surgical intervention resulted in an infection rate of 15.2%, whereas delayed intervention showed an infection rate of 31.4% (p=0.002). Amputation rates were found to be 6.4% for the entire patient group, but 41.2% in the Gustilo-Anderson Type IIIC fracture group. Osteomyelitis rate was 18.6% in patients who underwent delayed wound closure, and 35% of these patients required prolonged intravenous antibiotic therapy. CONCLUSION: This study demonstrates that early antibiotic administration, early surgical intervention, and appropriate wound management strategies significantly reduce infection rates in open fractures resulting from high-energy traumas. Particularly, the high complication rates observed in earthquake-related cases highlight the need for systematic and carefully planned approaches in disaster-related patient management. The findings emphasize the importance of optimal surgical timing and proper antibiotic protocols in reducing infection risks and improving clinical outcomes. Further prospective studies are needed to validate these findings.Öğe Radiological Evaluation of the Relationship Between Plantar Fasciitis and Foot Arch Angles in Adults(Ordu Üniversitesi, 2023) Boz, Mehmet; Şahin, Abdullah Alper; Akçiçek, Mehmet[Abstract Not Available]Öğe Readability and quality levels of websites that contain written information about anterior cruciate ligament injury: A survey of Turkish websites(Turkish Assoc Orthopaedics Traumatology, 2022) Sahin, Abdullah Alper; Boz, Mehmet; Kececi, Tolga; Unal, Ahmet; Cirakli, AlperObjective: This study aimed to evaluate the contents and readability levels of informative texts about anterior cruciate ligament (ACL) on Turkish websites. Methods: In this cross-sectional study, online searches were performed using the Google, Yandex, and Yahoo search engines on 16, 17, and 18 November 2020, respectively. In these three search engines, 'anterior cruciate ligament', 'anterior cruciate ligament surgery', 'ACL', and 'ACL surgery' were entered in Turkish. The first 10 pages from each search on the websites were collected. The websites were divided into 3 groups according to their sources. Group 1 was classified as websites prepared by private hospitals or medical centers; group 2, as individual websites of orthopedics and traumatology physicians; and group 3, as non-profit websites providing general health information that does not fall into these two groups. The websites were analyzed based on both the website interface and a specific content scoring guide by two reviewers. The Flesch Kincaid (FK) grade level and the Flesch reading ease (FRE) score were used to determine the readability of information on the websites. Results: Eighty-five unique websites were evaluated. The mean quality score of all the websites was 10.4 +/- 4.5 with a maximum score of 25 (range = 3-21). No significant difference in quality score was found between the groups. The mean FK grade score of all the websites was 11.2 +/- 1.7 (range =7.9-15.3). The mean FRE score of all the websites was 46.8 +/- 7.7 (range = 24.1-63.7). No statistically significant differences in FK grade and FRE score were found between the groups. Although 59 websites (69%) had a third-party seal indicating the certification of one of the organizations established to provide a standard of health information on the Internet, only 21 websites (25%) were updated in the year before the search. Conclusion: The readability level of the informative texts about the ACL on the Turkish websites was above the educational level in Turkey. In addition, the quality score of the Turkish websites related to ACL was low. The content of the informative texts should be organized while taking into account the patients' literacy level.Öğe Retrograde Intramedullary Nailing vs. Lateral Locking Plate Fixation for Distal Femur Fractures: Which Technique is Superior?(Open Medical Publ Llc, 2025) Guzel, Ismail; Altunkilic, Tarik; Ari, Bunyamin; Boz, MehmetObjective Distal femur fractures are challenging to treat, especially in elderly osteoporotic patients. Retrograde intramedullary nailing (RIMN) and lateral locking plate (LP) fixation are commonly used surgical methods for these fractures. This study aimed to compare the clinical and radiological outcomes of these two techniques. Methods In this retrospective study, a total of 72 patients with distal femur fractures classified according to the AO/OTA system and treated surgically were included. Patients were divided into two groups: RIMN (n=36) and LP (n=36). Demographic data, fracture classification, surgical method, operative time, intraoperative blood loss, early weight-bearing status, knee range of motion, union time, and complication rates were evaluated. Additionally, union rate, infection, implant failure, and reoperation requirement were compared. A power analysis was conducted assuming 70% power to detect a clinically significant difference. Statistical analyses included T-test, Mann-Whitney U test, Chi-square test, and Fisher's exact test. Kaplan-Meier analysis was used to assess union time. A p-value <0.05 was considered statistically significant. Results The union rate was 86.1% in the RIMN group and 75.0% in the LP group. The average union time was 15.4 weeks for RIMN and 17.2 weeks for LP. Knee range of motion was significantly better in the RIMN group (115.2 degrees vs. 110.4 degrees, p=0.03). Early weight-bearing was achieved in 61.1% of RIMN patients and 44.4% of LP patients (p=0.11). The overall complication rate was 16.7% in the RIMN group and 25.0% in the LP group. Infection rates were 5.6% and 8.3%, respectively. Implant failure was observed in 5.6% of patients in both groups. Reoperation was required in 8.3% of RIMN and 13.9% of LP patients. Conclusion Our findings suggest that RIMN may offer advantages over LP in terms of higher union rates, shorter union time, and better functional outcomes, particularly in osteoporotic patients. However, both techniques demonstrated acceptable complication rates, and treatment choice should be tailored to the fracture pattern and patient characteristics. Further prospective, randomized studies are needed to support these findings.
