Browsing by Author "Gokalp, M.A."

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Family Factor, Treatment Options and Evaluation of Results in Pes Equinovarus Disease
(Yuzuncu Yil Universitesi Tip Fakultesi, 2015) Gozen, A.; Gokalp, M.A.; Unsal, S.Ş.; Guner, S.
In this study, we analyzed the patients who had applied to Yüzüncü Yıl University Medical Faculty due to pes equinovarus between 2011 and 2013 and treated with the Ponseti method. Thus we evaluated 56 feet of 38 patients in the early-treatment period and the factors affecting the treatment. All of the patients were systematically examined before and after the treatment. For the feet that had anomaly we used the scale that was used by Dimeglo et.al. Averagely 7.5 plaster casts were applied to the feet of the patients (range: 3-16). In patients with PEV, after the recovery of hindfoot varus and forefoot adduction in 48 feet in which equine deformity, achillotomy operation was applied under local anesthesia with mini open technique. After plastering, Steenbeek orthosis was applied to the feet. Average follow-up time was 14 months (range 5-28 months). In patients with PEV, the most commonly recurred component was metatarsus adductus. While this rate was 36% in idiopathic PEVs, in complex PEVs it was 83%. The plantigrade walking ratio in patients with idiopathic PEV was 92%. In patients with idiopathic PEV, the compliance with orthosis was 81% whereas in patients with complex PEV it was 33%. In addition to this, except one patient, in all patients with complex PEV recurrence was observed and additional treatments were made for these patients. The final Dimeglio score of the patients with idiopathic PEV was very good in 16 feet, good in 6 feet. On the other hand, in patients with complex PEV, this score was very good in 4 feet, good in 3 feet, and bad in 1 foot. The most important recurrence reason for PEV was non-compliance with orthosis. The reasons for non-compliance with foot abduction orthosis are as follows: long processing time the negative psychological effects of orthosis on families and considering orthosis as unnecessary since the correction in the feet was seen by the family. The education level of the family is an important risk factor for the development of recurrence. In this sense, it was determined that the recurrence risk was 10 times higher in the families whose education level was high school and below in comparison to the families with university degree. We achieved success at a rate of 92% in manipulation and plastering treatment of PEV which was materialized by Ponseti method. The most important factor affecting the treatment was the continuity of the treatment and the compliance with orthosis. © 2015, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.
Results of Treatment of Chronic Osteomyelitis by "gutter Procedure and Muscle Flap Transposition Operation
(Springer-Verlag France, 2014) Gokalp, M.A.; Guner, S.; Ceylan, M.F.; Doğan, A.; Sebik, A.
Introduction: The aim of this study was to evaluate the outcomes of creation of a gutter and muscle flap transposition method for the treatment of long-bone chronic osteomyelitis. Patients and methods: A total of thirty chronic osteomyelitis patients (thirty-one extremities), who had undergone the gutter creation and muscle flap transposition procedure between 2005 and 2009, were included in the study (19 male, 11 female; mean age 24.4 years; age range 2-75 years). Osteomyelitis of the long bones involved the femur in 13 patients, the tibia in 13, the humerus in 2, the fibula in 2 and the ulna in 1 patients, respectively. All the patients received post-operative antibiotic therapy of at least 6 weeks. The mean follow-up period was 28.7 months (6-53 months). At the end of this follow-up period, the patients were evaluated using clinical, laboratory and screening methods. Results: Complete pain relief, disappearance of toxic symptoms, improvement in radiological findings, fistula closure and return of the blood parameters to normal ranges were accepted as successful treatment when all the afore-mentioned had been fulfilled. According to these criteria, 29 of the 30 patients had been cured. Discussion: The gutter creation and muscle flap transposition method in the treatment of long-bone chronic osteomyelitis may be a successful mode of therapy when performed correctly and supported by long-term antibiotherapy. © 2013 Springer-Verlag.