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Öğe Axial external fixator in humerus shaft fractures(2023) Ulusoy, İbrahim; güzel, ismailThe causes of humeral shaft fractures are mostly high-energy traumas such as falling, hitting, traffic accident, and gunshot wounds. It may also occur as a result of simple falls due to osteoporosis in elderly patients. In surgical treatment, there are options such as intramedullary nail, plate-screw fixation and external fixator treatment. External Fixator Treatment it is the primary treatment option for soft tissue damage, open fractures, gunshot wounds, segmental bone loss, pseudoarthrosis, nonunion, and major vascular injuries. The purpose of the present study was to present the functional results of Axial External Fixator Treatment, which we often apply in humerus shaft fractures in our clinic. A total of 30 patients, who had gunshot wounds, multisystem injuries, open fractures, and advanced age comorbid problems, and who underwent Axial External Fixator Treatment due to humerus shaft fracture between January 2016 and January 2019 were included in the study. Disabilities of the Arm, Shoulder, and Hand (DASH) scores were used in clinical evaluations. Visual Analogue Scale (VAS) was used to evaluate the pain intensity in patients subjectively. Also, the results of patients with advanced age comorbid problems were compared with other patients. After a 12-month follow-up, significant improvements were detected in DASH scores. Although fracture union was later in patients with advanced age comorbid problems than in other patients, no differences were detected between union rates, clinical outcomes, and the surgical processes.We think that it is a more appropriate surgical technique than other surgical methods, due to its shorter surgical time and less invasiveness in patients with advanced age, high comorbidity and multisystem damage.Öğe Clinical Comparison of Patients Undergoing Anterior Cruciate Ligament Reconstruction Using an Allograft or Autograft(2022) Altunkılıç, Tarık; Arı, Bünyamin; şahin, ercan; güzel, ismail; İnceoğlu, FeyzaAim: The purpose of this study was to examine the clinical results of individuals who underwent an autograft or allograft repair of the anterior cruciate ligament (ACL). Material and Methods: Retrospective analysis was done on the patient files of patients who underwent ACL reconstruction between 2014 and 2020 using semitendinosus-gracilis tendon autografts (SGT-A) and tibialis anterior tendon allografts (TAT-A). In this study, the data of 30 patients in each group were included. Knee laxity tests, the Lysholm knee grading system, the Tegner activity score, and the International Knee Documentation Committee (IKDC) score were used to compare patient results. Results: While there was no significant difference in the Tegner activity score between the preoperative and the final measurement (p=0.241), the IKDC scores and the Lysholm knee ratings changed statistically significantly between the preoperative measurement and the last control visit (p=0.020, and p=0.038, respectively) for both groups in this study. The SGT-A group’s Lysholm knee score had a preoperative value of 60.97% and a final control value of 90.48%. The preoperative Lysholm knee score for the TAT-A group was 61.31%, and the final control value was 95.03%. The anterior drawer and Lachman test findings showed statistically significant intergroup (autograft and allograft) alterations in both the autograft and allograft groups (both p<0.001). Conclusion: In terms of knee function and laxity, this study achieved a better clinical outcome in the allograft group compared to the autograft group.Öğe Epidemiological characteristics of orthopedic trauma patients admitted to emergency department in Coronavirus disease 2019 pandemic: A retrospective and comparative study(2022) güzel, ismail; boz, mehmetAim: The aim of the present study was to compare the data and epidemiological char- acteristics of orthopedic trauma patients who presented to the emergency room in the period of pandemic year with the year before the pandemic. Materials and Methods: In the present study, epidemiological characteristics of pa- tients with orthopedic trauma who applied to the emergency department during the COVID-19 year (March 24-July 1, 2020) and the same period of the previous year (March 24-July 1, 2019) were compared. The patients were divided into two groups as pandemic period patients and pre-pandemic group patients (control group). Demographic char- acteristics, injury mechanisms, fracture types, fracture areas, simultaneous fractures, the locations where the fracture occurred, open fracture types, trauma scores and osteoporosis characteristics were evaluated. Results: 15.245 patients were evaluated, and 36.5% of these patients were the ones who were admitted to our hospital in the pandemic period while 63.5% of the patients were the ones who were admitted to our hospital in the pre-pandemic period. During the pandemic period, 67.2% of the patients visited due to the low-energy traumas, 14.3% high- energy traumas. In the pre-pandemic group, on the other hand, the cause was low-energy traumas in 58.4% of the patients, high-energy traumas in 17.8%. 44% of the patients in the pre-pandemic group and 61% in the pandemic group were evaluated to have osteoporotic fractures. In the pre-pandemic group, on the other hand, 36.2% of the patients had minor, 46.4% serious and 17.4% critical injuries. Conclusion: During the COVID-19 pandemic, because of the effects of long-term in- activity and stress factors, changes were observed in the distribution of the traumatized patients. It should be concluded that people at high risk of osteoporotic fractures should be allowed to practice their physical activities such as walking and exercising at certain time intervals during curfew times such as pandemics.Öğe Surgical Fixation with Cannulated Screws in the Adult Femoral Neck Fractures(2023) güzel, ismail; BELHAN, OKTAY; Altunkılıç, TarıkAim: Femoral neck fractures are common injuries in orthopedic practice and result in significant morbidity and mortality. They are fractures in the intra-capsule area of the proximal femur. They usually occur in the elderly patient group. However, younger age groups could also experience femoral neck fractures as a result of high-energy traumas. The aim of the present study was to compare with the literature the outcomes in adult patients for whom surgical fixation was performed after femoral neck fracture using cannulated screws in our clinic.Materials and Methods: The study included patients for whom surgical fixation was performed for femoral neck fractures using cannulated screws between August 2010 and August 2012. Fracture non-union, delayed union, avascular necrosis and arthrosis were evaluated in patients. Avascular necrosis evaluation was performed using Ficat and Arlet classification. Functional outcomes were evaluated using Harris hip score.Results: The average follow-up period of our patients was 32 months (range: 24-48 months). Follow-ups indicated that 16 patients recovered without problems, walked with a double wand starting from about the third month with respect to the bone union status and full union was achieved in an average of six months. Non-union was observed in four patients. Ficat and Arlet avascular necrosis classification showed that four patients had avascular necrosis. The average time for these patients to be admitted to surgery was seven days. Five of our patients developed superficial wound infections. Antibiotic treatment and wound care were applied to our patients. When the patients were evaluated based on Harris hip score numerical rating chart, it was found that excellent outcomes were obtained in five patients, very good results in eight patients, good results in four patients, moderate results in two patients and poor results in one patient.Conclusion: Femoral neck fractures are a common type of injury in orthopedic practice and they result in significant morbidity and mortality when treated inappropriately. In order to reduce the rate of bone non-union, avascular necrosis or other complications that could be observed in patients who underwent surgical fixation after femoral neck fractures, and appropriate and acceptable reduction of femoral neck fracture should be realized as soon as possible, and stable fixation should be achieved.Öğe Surgical treatment options for AC joint dislocation: Comparison of clinical outcomes of TightRope and hook plate methods(2025) güzel, ismail; Altunkılıç, Tarık; Arı, Bünyamin; boz, mehmet; çakır, mehmetAcromioclavicular (AC) joint dislocations frequently occur in young and active individuals, resulting in pain, restricted movement, and functional limitations. Among surgical treatments, TightRope and hook plate methods are commonly used. However, their comparative effectiveness remains a topic of debate. To retrospectively compare the clinical outcomes of TightRope and hook plate methods in the surgical treatment of AC joint dislocations, focusing on complication rates, recovery time, and functional outcomes. This retrospective study included 60 patients (30 TightRope, 30 hook plate) treated between 2018 and 2023 for Rockwood Type III-V AC joint dislocations. Complication rates, time to return to daily activities and sports, and Constant-Murley Shoulder Scores were analyzed. Data were statistically evaluated using chi-square and independent t-tests, with significance set at pÖğe Treatments for Knee Cartilage Injuries in Athletes Using PRP and Hyaluronic Acid: A Retrospective Analysis(2025) güzel, ismail; YILMAZ, Mehmet; Altunkılıç, Tarık; Ulusoy, İbrahimAim: This retrospective study seeks to evaluate the clinical outcomes and imaging findings in athletes with knee cartilage injuries treated using autologous platelet-rich plasma (PRP) and hyaluronic acid (HA) injections. Material and Method: Sixty athletes participated in this investigation, with 30 individuals in the PRP group and 30 in the HA group. PRP was administered via ultrasound-guided intra-articular injections over three sessions, spaced at three-week intervals. Similarly, HA was injected using high molecular weight hyaluronic acid following the same schedule. Clinical evaluation was performed using the Visual Analog Scale (VAS) for pain assessment and the Knee Injury and Osteoarthritis Outcome Score (KOOS) for functional evaluation. Radiological changes were assessed through magnetic resonance imaging (MRI). Results: Both VAS and KOOS scores demonstrated a greater improvement in the PRP group compared to the HA group (p<0.05). MRI findings revealed more pronounced cartilage regeneration in the PRP group (p<0.05). No statistically significant differences were found between the two groups regarding age, gender, or career duration (p>0.05). Conclusion: For sportsmen with knee cartilage problems, PRP therapy has been found to be a more successful treatment alternative than HA. PRP offers better outcomes for cartilage regeneration, pain management, and functional enhancement. The long-term effectiveness of these results may be further assessed in prospective randomized studies in the future.Öğe Use of external fixator combined with titanium elastic nails in the treatment of tibia shaft fractures in children(2023) güzel, ismail; Ulusoy, İbrahimTibia shaft fractures are common in all age groups. For these fractures; Conservative and surgical treatment methods are available. In surgical treatment, numerous surgical methods such as plate screw fixation, external fixator, and titanium elastic nail and K-wire fixation have been defined. The aim of the present study was to present the results of patients for whom external fixator combined with titanium elastic nails or titanium elastic nails alone were applied due to tibia shaft fractures. The study included 40 patients treated for tibia shaft fracture in our clinic between January 2016 and January 2019. Combined external fixator (EF) fixation was applied to patients who were found to be instable after Titanium elastic nail (TEN) application during the surgery. In clinical evaluation, Flynn classification, time to fracture union, fluoroscopy count, reoperation and time to full weight bearing were used. The results of patients for whom EF combined with TEN were applied were compared with the patients who had only TEN. Thirty patients were treated using TEN and 10 patients using EF combined with TEN. After 12 months of follow-ups, fracture union was achieved in all patients. There were 5% sagittal and 2.5% coronal plane angulation. Patients developed angular deformity of an average of 2.43 ± 1.9 degrees in the coronal plane and 2.65 ± 1.9 degrees in sagittal plane. Lower percentages of angular and rotational deformity were observed compared to the literature. Despite the disadvantages of using a greater number of fluoroscopy and longer operation periods in patients who underwent TEN+EF, these patients were mobilized earlier. It was concluded that combined EF application is a more feasible method in patients with pediatric tibia shaft fracture for whom stable fixation cannot be achieved with TEN.
