Browsing by Author "Dundar, Abdulrahim"

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Acetabular Fractures From Judet and Letournel To the Present: Research Trends and Global Outcomes With Bibliometric Analysis During 1980 To 2022
(Lippincott Williams & Wilkins, 2023) Dundar, Abdulrahim; Ipek, Deniz; Kaya, Sehmuz
Fractures of the acetabulum are one of the most challenging injuries treated by orthopedic surgeons. However, a bibliometric analysis has not been performed in the literature on acetabular fractures, which seriously affect the quality of life of patients. The aim of this study was to summarize the bibliometric and intellectual structure, and determine and map the most recent trends on the topic of acetabular fractures by analyzing the social and structural relationships between the different research components of articles published on the acetabular fractures. 1599 articles on acetabular fractures published between 1980 and 2022 were extracted from the Web of Science (WoS) database and analyzed. Bibliometric visualization maps were used to reveal trending topics, citation analyses, and international collaborations. Spearman correlation analysis was performed for correlation investigations. The trend in the expected number of articles to be published over the next few years was displayed using the exponential smoothing estimator. The top 3 contributing countries to the literature were United States of America (USA) (551, 34.4%), China (170, 10.6%), and Germany (160, 10%). The most active author was Berton R. Moed (n = 29) and the most active institution was the University of California System (n = 41). A high-level statistically significant correlation was found between the number of articles on the topic of acetabular fractures published by nations and the gross domestic product (GDP) and GDP per capita values of those countries (R = 0.719, P < .001; R = 0.701, P < .001, respectively). The trending topics researched in recent years were 3D printing, 3-dimensional printing, outcomes, Open Reduction and Internal Fixation (ORIF), mortality, Kocher-Langenbeck, Pararectus approach, tranexamic acid, transfusion, epidemiology, fracture mapping, modified Stoppa approach, post-traumatic osteoarthritis, pelvis fracture, pelvic trauma, fracture reduction, and pelvic ring injury. The leading countries in research on the subject of acetabular fractures were seen to be western countries with large economies (especially the USA, European countries, and Canada) and China, India and Turkey.
Comparison of the Popliteal Artery and the Capsule of the Posterior Knee (Ipack) Block and the Genicular Nerve Block in Primary Total Knee Arthroplasty a Prospective Randomized Trial
(Saudi Med J, 2024) Dundar, Abdulrahim; Ipek, Deniz; Yalvac, Mehmet; Kaya, Sehmuz
Objectives: To compare the efficacy of genicular block and interspace between the popliteal artery and the posterior capsule (IPACK) block in the reduction of postoperative pain, the need for rescue analgesics, and the effects on a range of motion (ROM) in patients with TKA. Methods: This prospective randomized controlled study was carried out between February and May 2023. Based on the block method, 60 participants were divided into three equal groups. These groups included the IPACK block group (n=20), the genicular block group (n=20), and control group (n=20). Western Ontario and McMaster Universities Arthritis Index (WOMAC), Knee Society score (KSS) and Oxford Knee score (OKS) were used for clinical evaluation in the postoperative period. Results: The KSS and OKS scores of the IPACK and GNB were significantly lower than the control group ( p <0.001, p <0.001). The timed up and go (TUG) values of the IPACK and GNB groups at 12th and 24th hour were significantly lower than the control group ( p <0.001, p <0.001). The Tramadol rescue values of the IPACK block and control groups were significantly higher than the GNB group ( p =0.028, p =0.001, respectively). The ROM values of the IPACK and GNB groups were significantly higher than the control group ( p <0.001, p <0.001). Conclusion: Both GNB and IPACK blocks had a significant positive impact on postoperative pain scores within the initial 24 hours following total knee arthroplasty (TKA). In comparison with IPACK, GNB had lower opioid consumption in the early postoperative period while also promoting better mobilization.
Experimental Evaluation of Timing and Preference of Surgical Intervention for Crush Syndrome in Disaster Scenarios: Fasciotomy or Amputation? a Rat Model Study
(BMC, 2025) Kaya, Sehmuz; Unal, Yunus Can; Guven, Necip; Dundar, Abdulrahim; Keles, Omer Faruk; Basbugan, Yildiray
Background Crush syndrome is a severe condition caused by the systemic effects of rhabdomyolysis due to prolonged muscle compression. Common in disasters like earthquakes, it poses life-threatening risks, including acute renal failure, hyperkalemia, and metabolic acidosis. Although surgical interventions such as fasciotomy and amputation are critical in its management, the optimal timing and criteria remain unclear. This study investigates the impact of surgical intervention timing on crush syndrome outcomes, providing guidance through the first experimental rat model evaluating fasciotomy and amputation post-injury. Methods Forty-eight Wistar albino rats were divided into six groups. Rhabdomyolysis was induced experimentally, followed by amputation or fasciotomy at 0, 12, or 24 h. The control group underwent rhabdomyolysis induction without surgery. Weekly urine samples were collected during the study, and blood, muscle, and kidney tissues were examined biochemically and histopathologically at the experiment's end. Data analysis focused on the systemic and tissue-specific effects of intervention timing. Results Early intervention groups (0 h) demonstrated minimal muscle inflammation and necrosis, preserved muscle fiber arrangement, and more pronounced regeneration. Late interventions (12 and 24 h) were associated with intense inflammation, necrosis, edema, and hemorrhage in muscle tissue. Immediate amputation (0 h) limited toxic metabolite effects, reducing kidney inflammation and damage. Late interventions showed increased interstitial nephritis and inflammatory cell infiltration in kidney tissue. Biochemical analyses revealed that urinary myoglobin levels decreased and renal function was preserved in the early intervention groups. Conclusions The timing of surgical intervention is critical in managing crush syndrome. Early amputation and fasciotomy minimized necrosis and inflammation in muscle tissue, supported tissue regeneration, and reduced systemic complications by preventing toxic metabolite accumulation in the kidneys. Early amputation particularly showed superior renal protection and lower systemic complication risks compared to late interventions. These findings highlight the importance of timely surgical action and provide valuable insights for developing effective treatment strategies in disaster settings. However, the descriptive nature of the study and the fact that the data obtained from the experimental model cannot be directly applied to clinical practice should be taken into account. Therefore, the findings should be supported by future clinical trials.
Impact of Buried Versus Exposed Flexible Intramedullary Nails Osteosynthesis on Pediatric Forearm Fractures
(Soc Chilena Pediatria, 2024) Dundar, Abdulrahim; Kaya, Sehmuz
In elastic stable intramedullary nailing (ESIN), there are different opinions among surgeons on whether to leave the nail buried in the same arm or to leave it exposed. Objective: To determine the risk of re -fracture in patients with a nail buried directly into the amr or left exposed as a treatment for forearm fractures, and to investigate postoperative complications. Patients and Method: The study included 113 pediatric patients with a forearm fracture of both diaphyses. Two groups were formed according to whether the nail was buried (Group B, n: 53) in the same arm or left exposed (Group E, n: 60). Data on the number of open reductions, the time to nail removal, the anesthesia type used for its removal, the number of re -fractures, skin infection, and nail entry site irritation were analyzed. Results: The mean union times between the groups were not significantly different ( P = 0.371). The mean time of nail removal in group B (16.02 +/- 1.29 weeks) was significantly longer than that of group E (6.65 +/- 0.95 weeks) ( P < 0.001). Open reduction rates were similar between groups ( P = 0.401). The general anesthesia rate for nail removal in group B (77.4%) was significantly higher than group E (11.7%) ( P < 0.001). The re -fracture rate was higher in patients who underwent open reduction in both groups ( P < 0.001). Conclusion: The results of this study demonstrated that, despite the increased infection rate, leaving the nail exposed did not increase the re -fracture rate, which was associated with open reduction.
The Impact of Early Weight-Bearing on Results Following Anterior Cruciate Ligament Reconstruction
(Bmc, 2024) Kaya, Sehmuz; Unal, Yunus Can; Guven, Necip; Ozcan, Can; Dundar, Abdulrahim; Turkozu, Tulin; Gokalp, Mehmet Ata
Introduction Anterior cruciate ligament (ACL) ruptures are common injuries that typically affect young, physically active individuals and may require surgical reconstruction. Studies have shown that the long time success of ACL reconstruction depends on the surgical technique and the postoperative rehabilitation strategy. However, there is still no consensus on the content of rehabilitation programs. Hence, additional research is required to elucidate the significance of early weight-bearing in the rehabilitation process following ACL reconstruction. The aim of this article is to examine the impact of weight-bearing on the clinical results of ACL reconstruction.Materials and methods We retrospectively reviewed patient records who had undergone arthroscopic reconstruction using a semitendinosus-gracilis tendon graft for anterior cruciate ligament rupture between January 2018 and December 2020. The study included the data of 110 patients. The patients were split into two groups: Group 1 underwent early weight-bearing, while Group 2 followed a non-weight-bearing regimen for three weeks. We assessed the patients using the anterior drawer test, Lachman test, range of motion, Lysholm knee scale, Cincinnati scale, Tegner scale, International Knee Documentation Committee (IKDC) form and clinical records. Analytical tests were conducted to compare the results.Results The complication rates did not show a significant difference between the groups. Group 1 had higher frequencies of positive anterior drawer and Lachman tests. The Lysholm and Cincinnati knee scores of patients in Group 1 were notably lower than those of patients in Group 2. Additionally, the Tegner activity scores and IKDC scores of patients in Group 1 were also meaningfully lower than those of patients in Group 2. In Group 1 patients, there was no notable relationship observed between body mass index (BMI) and the results of the anterior drawer test (ADT) or Lachman test. However, patients with a BMI of 25 or higher in Group 1 showed a decrease in postoperative IKDC scores. In Group 2 patients, no significant relationship was identified between BMI and either the ADT or the Lachman test outcome.Conclusion Based on current literature and current rehabilitation guidelines following ACL reconstruction, the decision to initiate early weight-bearing is based on a limited number of studies with low levels of evidence. In our study, we found that patients who followed a non-weight-bearing regimen for 3 weeks after surgery had better mid-term results than those who were allowed to bear weight early. It appears that further prospective studies on this topic are needed to update rehabilitation guidelines in the next.