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Öğe Factors Affecting Outcomes of Adult Forearm Fractures Treated by Locking Compression Plate(İstanbul Gelişim Üniversitesi Yayınları / Istanbul Gelisim University Press, 2018-08-31) Utkan, Ali; Koçak, Burak; Ceritoğlu, Kubilay Uğurcan; Arslan, Aydın; Özkurt, BülentAim: Although internal fixation of forearm fractures by dynamic compression plates had been studied extensively, the details of optimal fixation by locking compression plates are not clearly defined. Besides the factors affecting the functional outcome is still the subject of considerable debate. The present study is designed to evaluate factors affecting the outcomes of adult forearm fractures treated via locking compression plate. Method: The patients with Gustillo Anderson type 3 open fractures or the ones treated in intensive care unit were excluded and thirty-six forearm fractures treated by locking compression plate were prospectively followed. Disability Arm Shoulder Hand (DASH) and Anderson criteria scores for assessment of outcomes obtained at sixth month were evaluated. The patients were followed up for 4 (3-6) years on average. Findings: In 18 (50%) patients, fractures were caused by simple fall. The mean healing time of the fractures was 13.2 ± 2.1 weeks. Patients, who smoked or had open fractures or complications, had longer healing time. Mean DASH score was calculated as 13.9 ± 5.9. Upon presence of open fracture or postoperative complication there was a significant deterioration in scores. Although the cause of the injury had some effect on functional results the mechanism (whether the injury was direct or indirect) made no difference. Conclusion: Fracture type was the most important factor affecting both healing time and outcome. Being an open fracture or the presence of postoperative complication deteriorates the outcome. The functional results were somewhat poorer in fractures caused by simple fall.Öğe Factors Affecting the Results of Tibial Pilon Fractures Treated With open Reduction Internal Fixation(Medicine Science International Medical Journal, 2018) Başer, Mehmet Yavuz; Arslan, Aydın; Utkan, Ali; Özkurt, BülentThe purpose of this study is to evaluate the short and medium term functional results of tibial pilon fractures treated in our clinic with the open reduction and internal fixation method and to investigate the factors affecting such results. 41 patients who were treated in our clinic between 1995 and 2009 with open reduction and internal fixation were included in this study. Looking at the postoperative radiographs, quality of reduction was evaluated as per the criteria of Ovadia and Beals. Functional results of the patients were assessed in line with the criteria of Teeny and Wiss. With the evaluation of postoperative radiographs, 17 (41.5%) excellent and good, 21 (51.2%) fair and 3 (7.3%) poor results were obtained. Functionally speaking, 26 patients (63.5%) displayed excellent and good, 8 displayed (19.5%) fair and 7 displayed (17%) poor results. It was found out that age, sex, the time spent before the operation, the period of immobilization following the operation and the presence of an accompanying fracture did not have a significant impact on the functional results. It was revealed that the type of fracture affects functional results. A positive correlation was found between the quality of reduction and the functional results. In the light of the findings of this study, it was concluded that in tibial pilon fractures treated with the internal fixation method, the type of fracture and the quality of reduction are important in identifying the short and medium term prognosis.Öğe Fit assessment of two different anatomically contoured distal femur plate sets on cadaveric bones(Bayçınar Tıbbi Yayıncılık, 2019) Utkan, Ali; İğdir, Volkan; Arslan, Aydın; Şen Esmer, Tülin; Özkurt, BülentObjectives: This study aims to investigate the fitness of two anatomic distal femoral plates with cadaveric femurs and to show whether current plates optimally match each femur. Materials and methods: Two different sets of plates with five, seven and nine shaft holes were applicated on 62 cadaveric femurs. Ball clay was molded onto the entire inner surfaces of the plates and then the plates were fixed to the bones using two self-locking nylon cable zip ties. The volume of ball clay sandwiched in between the plate and bone was calculated and used as a quantitative fit parameter. Data of each plate were analyzed separately. Results: Using Double Medical Technology IncorporatedTM plates, the mean plate to bone volumes were calculated as 8.4 mL (range, 5-14 mL), 10.0 mL (range, 6-17 mL), and 13.1 mL (range, 7-25 mL) in five, seven and nine-hole plates, respectively. Using Zimmer Biomet IncorporatedTM plates, the mean volumes were 10.5 mL (range, 6-21 mL), 12.7 mL (range, 7-22 mL) and 16.3 mL (range, 8-30 mL) in five, seven and nine-hole plates, respectively. Within each group, the measurements were significantly correlated positively with femoral length. Conclusion: Optimal fit may not be achieved in each femur using current distal femoral plate implant sets. Thus additional sizes of plates should be supplied in the implant sets.Öğe Is it Possible to Recover Cardiac Functions After Total Knee Arthroplasty?(The Open Orthopaedics Journal, 2018-06-21) Arslan, Aydın; Çuğlan, Bilal; Özkurt, Bülent; Utkan, Ali; Korkmaz, Mehmet Fatih; Koca, Tuba Tülay; Sevimli, ReşitBackground: Patients suffering from knee osteoarthritis lead a less active life than their healthy peers. It is well known that insufficient physical activity is the most common cause of chronic diseases. However, there is not enough research to enlighten the effect of increased functional capacity on cardiac functions after Total Knee Arthroplasty (TKA). This study aimed to investigate whether the orthopedic surgeons can predict that the patients will be healthier after TKA in terms of cardiac functions or not? Methods: 109 patients who underwent TKA were prospectively followed for one year. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and short form 36 (SF-36) surveys, BMI measures, average step count per day, the six-minute walking test (6MWT), the Five-Times-Sit-to-Stand Test (FTSST) and Doppler echocardiography were performed both in the preoperative and postoperative period. Results: After TKA, there was a substantial improvement in terms of WOMAC and SF36 survey scores. The average step count increased from 2199.6±690.8 steps/day to 4124.3±1638.8 steps/day. 6MWT and FTSST improved significantly as well. The average brisk walking time was 174.23±95.11 minutes/week. The means of early and late mitral inflow velocity ratios (E/A and Em/Am ratios) increased from 0.71±0.12 to 0.77±0.13 and from 0.66±0.13 to 0.76± 0.15 at the first year follow-up visit, respectively (p<0.001). Conclusion: In the first year, objective physical capacity measures increased together with the expected improvements in disease-specific and generic measures. After TKA, left ventricular diastolic functions may be considered to have recovered in the light of the healing signs via echocardiography.Öğe Total Hip Arthroplasty Performedi Secondary Hip Osteoarthritis Caused by Hartofilakidis Type 2 and Type 3 Developmental Dysplasia of the Hip; Evaluation of Outcomes and Comparison of Clinical Scores of These Two Types(Medicine Science International Medical Journal, 2018) Gülbahçe, Kemalettin; Arslan, Aydın; Utkan, Ali; Köse, Cem Cüneyt; Özkurt, BülentThe aim of this study was to evaluate the outcomes of Total hip arthroplasty (THA) performed for hip osteoarthritis caused by Hartofilakidis type 2 and 3 developmental dysplasia of the hip (DDH) and to compare these two types in terms of clinical scores. Thirty-six hips of thirty patients who suffered from hip osteoarthritis caused by DDH and who underwent THA operations from January 2005 to May 2010 were included in the study. In the case of insufficient coverage of the acetabular cup, roof reconstruction was performed using femoral head autografts. Subtrochanteric transverse femoral osteotomy was performed when required. Clinical evaluations were performed using Harris Hip Score (HHS). 3 male and 27 female patients were included in this study. Mean age was 57.2 (25-76) years. Mean follow up time was 34.3 (12–65) months. 24 hips were classified as Hartofiladikis type 2, and 12 as type 3. HHS was 43.2 (38-54) points and 90.1 (76-96) points at the preoperative and postoperative last control visits, respectively (p<0.001). Hartofilakidis type 2 hips scored 42.5(38-46) points and 89.9(78-96) points at preoperative and postoperative last control visits, respectively. Hartofilakidis type 3 hips scored 44.7 (38-54) points and 90.4 (76-96) points at preoperative and postoperative last control visits, respectively. There was no difference between the type 2 and type 3 in terms of clinical outcomes (p=0.23, p=0.81). If a proper acetabular reconstruction can be performed by taking into account the restoration of abductor force and the acetabular coverage also by considering acetabular cup position, and if a proper femoral reconstruction can be performed when required via the use of subtrochanteric transverse osteotomy and by considering anatomical changes, successful and similar clinical outcomes can be achieved in hip osteoarthritis secondary to Hartofilakidis type 2 or type 3 DDH.
