Browsing by Author "Guner, Savas"

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An Alternative Method for the Treatment of Osteoid Osteoma
(Professional Medical Publications, 2011) Guner, Savas; Ceylan, M. Fethi; Guner, S. Ilkay; Kalender, Ali Murat; Sahan, Mehmet Hamdi
Osteoid osteoma is a small, self-limiting osteogenic tumor. The success of the treatment depends on complete resection or destruction of the nidus. Open excision or en bloc excision was the classical treatment of osteoid osteoma before the development of minimally invasive percutaneous methods. Computed tomography guidance is required in the operating room in most of the percutaneous procedures. This enables accurate localization of the tumor and tumor excision can be performed with less bone tissue resection. We performed an alternative treatment that enables surgeons working in clinics where this equipment does not exist, to perform easy resection of the tumor through a mini incision. Mini incisional surgery seems to be an efficient and reliable treatment for osteoid osteoma.
Analyzing the Effects of Platelet Gel on Knee Osteoarthritis in the Rat Model
(Sage Publications inc, 2013) Guner, Savas; Buyukbebeci, Orhan
Platelet gel (PG) includes concentrated dose of growth factors which plays role in physiological processes of healing. The goal of this study is to evaluate repairing effects of intra-articular injection of PG use in a rat model of knee osteoarthritis (OA). A total of 20 rats were randomly distributed into a PG group and a control group. Both the groups were induced OA in knee joints with intra-articular formaline injection. The rats in the PG group and the control group were injected in the knee joint with PG and 0.9% NaCl solution, respectively. Two weeks after last injections, all rats were sacrificed by ether asphyxiation. Tissue samples were obtained from the knee joints and were examined histopathologically. No statistically significant differences were found between the groups regarding cartilage healing (P > .05). We were unable to determine any beneficial or harmful effects of PG on joint cartilage healing in OA.
Are Consanguineous Marriage and Swaddling the Risk Factors of Developmental Dysplasia of the Hip
(Springer, 2013) Guner, Sukriye Ilkay; Guner, Savas; Peker, Erdal; Ceylan, Mehmet Fethi; Guler, Ayse; Turktas, Ugur; Kaki, Baris
The purpose of this study was to investigate prospectively the effects of swaddling and consanguineous marriage on developmental dysplasia of the hip and associated risk factors. We screened by ultrasound 265 infants using the Graf method. The Pediatrics Department referred all newborn infants with suspected instability or a recognized risk factor to the orthopedic clinic. Risk factors of developmental dysplasia of the hip were searched and noted in these patients. Swaddling and consanguineous marriage were also determined and noted. We observed 164 of 265 infants (61.9 %) who had been swaddled and that 64 of 265 infants' parents were in a consanguineous marriage (24.2 %). In the statistical analysis that was conducted for swaddling and consanguineous marriage, highly significant differences were found. Our study showed that the rate of developmental dysplasia of the hip is very high, 11.7 %, in our region, eastern Turkey. Also, we commonly see improper swaddling and consanguineous marriage in our region, which affects many infants.
Biomechanical Effects of Menopause in Ovariectomized Rats' Femurs
(informa Healthcare, 2014) Okyay, Ayse Guler; Kavak, Servet; Turktas, Ugur; Alkis, Ismet; Guner, Savas; Aksakal, Bunyamin
Objective: To demonstrate the biomechanical changes in rat bones occurred by surgical menopause and to search for correlation between biomechanical test results and bone mineral density (BMD) measurements. Methods: Thirty female Wistar-albino rats aged 6 months and weighed 250-300 g were randomized into ovariectomy, sham and control groups. After 6 months, rats were sacrificed and right femurs were extracted. BMD measurements and three point bending biomechanical tests were made in femurs. Results: The difference among the mean BMD measurements of three groups were found to be statistically significant (Pr>F value <0.0001). Mean elastic module, maximum elongation and femoral diameters were also found to be statistically significantly different (Pr>F value <0.05). Ovariectomised and sham-operated groups were significantly different in terms of elastic modulus. Ultimate force did not differ among the groups significantly. The difference between ultimate strain and maximum elongation of the ovariectomy and sham operated group was statistically significant. Conclusions: Bone quality was deteriorated and fragility was increased in rats 6 months after surgical menopause. Sole BMD measurement might not be reliable in evaluation of osteoporosis and fracture risk. Biomechanical quality of bone is more important than its mineral content in determining fragility.
Biomechanical Effects of Menopause in Ovariectomized Rats' Femurs (Vol 30, Pg 62, 2014)
(informa Healthcare, 2014) Okyay, Ayse Guler; Kavak, Servet; Turktas, Ugur; Alkis, Ismet; Guner, Savas; Aksakal, Bunyamin
A Case of Klippel-Feil Syndrome Causing a Mass Appearance in the Nape
(derman Medical Publ, 2013) Guner, Savas; Sahan, Mehmet Hami; Ceylan, Mehmet Fethi; Donmez, Fuldem Yildirim; Sirikci, Akif
Klippel-Feil Syndrome Is a syndrome arising from insufficiency of the normal segmentation and cleavage of the cervical vertebrae in the early weeks of fetal development, accompanied by multisystem abnormalities. In this paper, we pm sent a 14-year-old subject who referred to the orthopedics clinic concerned about the swelling and the mass in the cervical region possibly being malignant.
A Case of Wooden Foreign Body Retained in the Calcaneus
(Professional Medical Publications, 2011) Guner, Savas; Ceylan, M. Fethi; Isik, Daghan; Guner, S. Ilkay; Ediz, Levent
Detection of wooden foreign bodies in the extremities still remains a problem despite the developments in imaging methods. Direct X-Rays, ultrasonography, computed tomography and magnetic resonance imaging are utilized for detection of foreign bodies in the body. In this report, we have presented a case in which no findings suggestive of a foreign body were detected on ultrasonography and magnetic resonance imaging, and which underwent a surgical intervention with the prediagnosis of osteomyelitis of the calcaneus.
A Case Report of a Patient With Cleft Palate Carrying the Risk of Tetraplegia
(Alliance Communications Group Division Allen Press, 2011) Isik, Daghan; Guner, Savas; Avcu, Serhat; Goktas, Ugur; Atik, Bekir
Spondyloepiphyseal dysplasia congenita (SEDC) is an inherited disorder of bone growth that results in short-trunk dwarfism, skeletal abnormalities, disorders in vision and hearing, atlanto-axial instability, and cleft palate. This important anomaly of the cervical vertebrae carries the risk of tetraplegia during cleft palate operations. In this case report, we discuss a case of spondyloepiphyseal dysplasia congenita, the perioperative and postoperative measures, and the risk of tetraplegia.
A Clinical Analysis of Patients Undergoing Fasciotomy Who Experienced the 2011 Van Earthquake
(Turkish Joint Diseases Foundation, 2012) Gormeli, Gokay; Gormeli, Cemile Ayse; Guner, Savas; Ceylan, Mehmet Fethi; Dursun, Recep
Objectives: This study aims to investigate the clinical profile and prognosis of the patients with fasciotomy who were admitted to Van Training and Research Hospital following the 2011 Van earthquake. Patients and methods: Twenty-one patients (11 males, 10 females; mean age 38.3 years; range 18 to 60 years) who had urgent fasciotomy in our clinic following the earthquake were included. Medical records including demographic data, clinical characteristics and prognostic data of the patients were retrospectively analyzed. Results: Seven of 21 patients with fasciotomies underwent amputation. Fasciotomy incisions were closed with skingrafting in nine patients and with primary closure in three patients. Eight patients had full range of motion of the joint, while four patients had restricted range of motion of the joint and needed rehabilitation. Two patients had sensory loss. Conclusion: Compartment syndrome is one of the serious problems after the Van earthquake. The infection ratio was low, while the amputation ratio was high. The use of anticoagulants following compartment syndrome worsens the clinical presentation, increasing the intracompartmental pressure.
The Clinical Profile of Musculoskeletal Injuries Associated With the 2011 Van Earthquake in Turkey
(Turkish Joint Diseases Foundation, 2012) Gormeli, Gokay; Gormeli, Cemile Ayse; Guner, Savas; Ceylan, Mehmet Fethi; Dursun, Recep
Objectives: In this study, we aimed to evaluate the clinical profile of the patients with musculoskeletal injuries associated with the 2011 Van earthquake and treatment modalities applied. Patients and methods: Between 23.10.2012 and 28.10.2012, a total of 285 patients (151 males, 134 females; mean age 38.6, years; range 1 to 84 years) with musculoskeletal injuries associated with the earthquake who were admitted to Emergency Department of Van Training and Research Hospital were retrospectively analyzed. Medical records including the profile of injury, injury type, site of injury, treatment modalities applied and prognosis were evaluated. Results: Ninety-five of 285 patients had soft tissue damage, while 144 had fractures. Of these fractures, 81 required surgical treatment. Forty-six patients had crush injury, while 28 had compartment syndrome. Open and multiple fractures and fragmented fractures were common. The majority of the fractures involved limbs, indicating higher incidence of lower limb involvement rather than upper limb involvement. The incidence of infection was lower in the patients who experienced the earthquake. Conclusion: Orthopedic surgery is of utmost importance for the patients with musculoskeletal injuries associated with the earthquake. Appropriate triage should be performed and then the patients with open fractures and compartment syndrome should be given priority for surgery. In such cases, debridement, open reduction and internal fixation are the most common surgical treatments.
Clinical Results of Decortication With Bone Grafting Method Versus Extracorporeal Shock Wave Treatment in Long-Bone Pseudoarthrosis
(int Scientific information, inc, 2023) Gokalp, Mehmet Ata; Unsal, Seyyid Serif; Guner, Savas; Turkozu, Tulin; Guven, Necip
Background: Despite advanced treatment methods, the treatment of pseudoarthrosis still poses a significant challenge for orthopedists. In this study, we aimed to assess the clinical results of decortication and bone grafting and ex-tracorporeal shock wave treatment (ESWT) in long-bone pseudoarthrosis.Material/Methods: Between 2007 and 2015, 68 fractures of 66 patients treated for long-bone pseudoarthrosis were evaluated retrospectively. ESWT was used in 36 extremities and decortication and iliac bone grafting was used in 32. The treatment results of these patients were evaluated and compared with rates in the literature. Results: The mean patient age was 43.9 years (range, 21-69). The mean interval between the occurrence of the frac-ture and treatment with bone grafting or ESWT was 8.6 months and the mean interval between the procedure and achievement of union was 6.9 months. The patients were followed up for a mean period of 25.2 months. After the mean follow-up period, bone union had occurred in all 32 patients (100%) in the decortication and bone grafting group and in 28 (78%) of the 36 patients in the ESWT group (P=0.023).Conclusions: This study shows that extracorporeal shock wave treatment should be considered the first option in treatment of pseudoarthrosis as it is a non-invasive method and also provides good rates of union. In patients that do not heal with ESWT, decortication and bone grafting remains the criterion standard therapy.
Compartment Syndrome Due To Extravasation of Iodixanol Contrast Medium: Case Report
(Ortadogu Ad Pres & Publ Co, 2012) Guner, Savas; Ceylan, M. Fethi; Avcu, Serhat; Guner, S. Ilkay; Dogan, Ali
Compartment syndrome due to extravasation of contrast medium is quite rare. The content of the contrast medium, the osmolarity, the ionic/non-ionic structure and the amount of extravasated medium are important factors in the pathogenesis of extravasation injury. Many extravasations are of small volumes causing minimal swelling and erythema. Extravasations of large volumes are important in the development of compartment syndrome due to the non-ionic contrast medium. Early diagnosis is very important in the contrast medium extravasations and conservative treatment is effective in most of the patients. If compartment syndrome develops after extravasation, emergency fasciotomy should be performed immediately. To the best of our knowledge, compartment syndrome due to extravasation of a non-ionic contrast medium, iodixanol, has not previously been reported in the English literature. In this article, a case of extravasation and compartment syndrome due to the administration of iodixanol for thoracic tomography and its treatment was first reported.
The Effect of Gsm Mobile Phone Electromagnetic Field on Femur Fracture Healing in a Rat Model
(derman Medical Publ, 2012) Kalender, Ali Murat; Goktas, Ugur; Ozbag, Davut; Erturkr, Cemil; Okumus, Mehmet; Guner, Savas; Un, Ahmet
Aim: Biological effects of electromagnetic field (EMF) and their consequences on human health have been the subject of much interest and research in recent years. The aim of this study was to investigate the effects of 900 MHz EMF on femur fracture healing in a rat model. Material and Method: After sixty male Sprague-Dawley rats were exposed to a closed right femur fracture under anesthesia, the reduction and fixation were done with a 21 g needle. Then, 900 MHz radiation (2 W peak output power and 1.04 mW/cm2 power density) was applied to EM group for one hour/day for seven days. The healing was assessed using radiological (Lane and Sandhu classification), histological (Huo scale for callus evaluation), and biomechanical (3-point bending) measures at 2nd, 4th and 6th weeks after fracture. Results: Fracture healing, as assessed radiologically and histopathologically, in Group EM and control animals was similar at 2nd, 4th and 6th weeks. Fracture healing, as assessed biomechanically, was significantly better in Group EM compared to controls in those sacrificed at 2nd week post-procedure (p <0.05). Biomechanical strength was not different between the groups at 4th and 6th weeks. Discussion: 900 MHz EMF from a mobile phone in this rat femur fracture model resulted in no significant difference in healing from controls not exposed to EM radiation.
Effectiveness of Etofenamate for Treatment of Knee Osteoarthritis: a Randomized Controlled Trial
(Dove Medical Press Ltd, 2016) Guner, Savas; Gokalp, Mehmet Ata; Gozen, A. Bdurrahim; Unsal, Seyyid Serif; Guner, Sukriye Illkay
The intramuscular application of etofenamate in the treatment of knee osteoarthritis was not observed in the existing English language literature. The objectives of this study were to compare the efficacy of etofenamate versus hyaluronic acid ( HA) in reducing joint pain and functional improvement for mild to moderate knee osteoarthritis. The patients were randomly divided into etofenamate ( n=29) and HA ( n=30) groups. Intramuscular etofenamate injection was administered as a series of seven intramuscular injections at intervals of 1 day. Intra-articular HA injection was administered as a series of three intra-articular injections at intervals of 1 week. Clinical evaluation was made before the first injection and again both 6 and 12 months after the last injection. The evaluation consisted of patient-assessed pain on a visual analog scale ( VAS) and on the Western Ontario and McMaster Universities Osteoarthritis Index ( WOMAC). Statistical significance was found for the etofenamate group when comparing preinjection with 12 months postinjection VAS scores ( P<0.05). Statistical significance was also found for the HA group when comparing preinjection with 12 months postinjection VAS and WOMAC scores ( P<0.05). However, there was no significant difference between the etofenamate and HA groups in terms of VAS or WOMAC scores measured at 12 months after injection ( P>0.05). Results from this study indicated that, etofenamate treatment was not significantly more effective than HA treatment. However, both methods were effective and successful in treating knee osteoarthritis.
Effectiveness of Local Tenoxicam Versus Corticosteroid Injection for Plantar Fasciitis Treatment
(Slack inc, 2013) Guner, Savas; Onder, Haci; Guner, Sukriye Ilkay; Ceylan, Mehmet Fethi; Gokalp, Mehmet Ata; Keskin, Siddik
Plantar fasciitis is one of the most common causes of foot pain in adults. In this prospective study, the outcomes of local tenoxicam injection and corticosteroid therapy for the treatment of plantar fasciitis were compared. Patients were randomly assigned to either the tenoxicam or corticosteroid group. The tenoxicam group (n=31) was treated using a local injection of 1 mL of tenoxicam (20 mg/2 mL) and 1 mL of 2% lidocaine, whereas the steroid group (n=30) was treated with a local 1-mL injection containing 40 mg of methylprednisolone acetate and 1 mL of 2% lidocaine. Clinical evaluations, which were performed before the injection and 6 and 12 months after the injection, consisted of patient-assessed pain using a visual analog scale. In addition, patient satisfaction was measured using the Roles and Maudsley score. Comparison of pre- and posttreatment visual analog scale scores demonstrated a statistically significant difference in both groups (P<.05). Furthermore, no significant difference was found between the steroid and tenoxicam groups in terms of visual analog scale scores measured 12 months after injection (P>.05). The tenoxicam injection was not significantly more effective than the corticosteroid injection. However, both methods were effective and successful in treating patients with plantar fasciitis. Tenoxicam therapy appears to provide pain relief, but its effectiveness in the long term should be explored in additional studies.
Evaluation of Severity Score in Patients With Lower Limb and Pelvic Fractures Injured in Motor Vehicle Front-Impact Collisions
(int Scientific information, inc, 2016) Gokalp, Mehmet Ata; Hekimoglu, Yavuz; Gozen, Abdurrahim; Guner, Savas; Asirdizer, Mahmut
Background: Lower limb and pelvic injuries and fractures occur at a very high incidence in motor vehicle accidents. In this study, the characteristics (e.g., body side, bone location, and fracture severity) of lower limb and pelvic fractures that occurred during front-impact collisions were correlated with the injured patients' sex, age, and position in the vehicle. Material/ Methods: We retrospectively evaluated 191 patients (136 males, 55 females) who were injured in motor vehicle accidents, specifically in frontal collisions. Results: This study revealed that most of lower limb and pelvic fractures occurred in males (71.2%; p=. 000), 19-36 years old (55.5%; p=. 000), small vehicles (86.4%; p=. 000), and rear seat passengers (49.2%; p=. 000). Fractures most commonly occurred in the left side of the body (46.6%; p=. 000) and upper legs (37.7%; p=. 000). Severity scores were higher (2.76) in males than females (2.07). No statistically significant was found in severity scores of patients and other personal characteristics and fracture features of patients with lower limb and pelvic fractures who were injured in a vehicle during front-impact collisions (p> 0.05). Conclusions: The results of this study will be useful for the automobile industry, forensics and criminal scientists, and for trauma research studies.
Hip Dislocation and Physis Separation Related To the Delayed Diagnosis of Septic Arthritis - Case Re
(derman Medical Publ, 2014) Gokalp, Mehmet Ata; Ceylan, Mehmet Fethi; Guner, Savas; Turktas, Ugur; Ediz, Levent
If the diagnosis of the hip septic arthritis is delayed, serious complications such as the arthrosis in joint, the separation of epiphyseal, osteomyelitis and sepsis can develop. The presence of the accompanying infectious diseases contributes to the delay of the diagnosis. In order to get rid of the late period sequelaes of septic arthritis, the required tests should be asked for the differential diagnosis of this disease in each patient presenting with hip pain. In this paper we presented 13 years old pediatric patient who was treated with the diagnosis of pneumonia developed joint dislocation together with the physis separation of the femoral head because of delayed diagnosis of accompanying hip septic arthritis.
Mini Open Surgical Treatment of Knee Septic Arthritis With Local Anesthesia: a Prospective Preliminary Report
(derman Medical Publ, 2018) Ceylan, Mehmet Fethi; Guner, Savas; Turktas, Ugur; Ediz, Levent; Goktas, Ugur; Dogan, Ali
Aim: Good pain management is provided via spinal and general anesthesia during knee joint drainage to treat septic arthritis, but the side effects are greater than those associated with local anesthesia, and the preparation process is long. Arthroscopic drainage under local anesthesia for knee septic arthritis treatment have been described, but this method requires special equipment. In this study, we aimed to evaluate the applicability of mini-open surgery under local anesthetic infiltration in cases of septic knee arthritis. Material and Method: 14 consecutive patients (eight men, six women) were admitted for knee septic arthritis treatment. Patient age ranged from 18 to 56 years, with an average age of 33 years. Drainage procedure was performed under local anesthesia, and the results were evaluated clinically. Results: The visual analog scale scores were between two and four (mean 2.8). The follow-up period was 10-21 months (mean 14.3). The Tegner and International Knee Documentation Committee scores were acceptable except for one patient. Discussion: This prospective study included mini-open surgery performed under local anesthesia on 14 septic knees, and showed that this method is safe, effective, well tolerated and be alternative to conventional techniques.
A Modified Rotation Flap Design: the S-Flap
(Wiley-blackwell, 2011) Isik, Daghan; Guner, Savas; Kalender, A. Murat; Isik, Yasemin; Atik, Bekir
Our Ender Nailing Applications in Pediatric Tibial Shaft Fractures
(derman Medical Publ, 2012) Cakar, Albert; Ceylan, Mehmet Fethi; Guner, Savas; Gokalp, Mehmet Ata; Dogan, Ali
Aim: Although tibial shaft fractures in children are mostly treated conservatively. Surgical treatment should be considered in patients in school age with the tibial shaft fracture or with multiple long-bone fracture or who have organ injury. The patients treated their tibia shaft fractures with Ender nail are presented in this article. Material ans Method: Two tibia Ender nails been 3.5 mm in appropriate length were performed under general anesthesia to the 13 fractures of 12 patients, all of whom were children and 9 out of whom were men. Long-leg splint was used for 2 weeks after the surgery. The patients were allowed to go to school after 10 days. Patients were evaluated according to Flynn criteria in terms of the clinical outcome and infection with their follow-up X-rays and examination and the type of the fracture, duration of the union, shortening-length difference, rotation, limitation of the joint motion, refracture. Results: The mean age of the patients was 8,6 years (4-15). The type of the fracture was Winquist type 2 and 3 in all of the patients. The mean duration of the follow-up was 20 months (14-40). Two of the existing-open fractures were type 1 and one of them was type 2 in three patients. In the difference of the length and shortening in treated tibias in patients was an average of 7 mm (2-21), the difference of the rotation was 4 degrees (2-8), and the angulation of varus-valgus was an average of 5 degrees (2-10). None of the patients developed refractures. A perfect result in 5 fractures, a good result in 7 fractures and a bad result in 1 fracture were taken according to the criteria of Flynn. Discussion: Ender nail should first be considered in the surgical treatment of the tibial shaft fractures in children over the age 4 because of the early return to school, low of the refracture risk after the detection and the price advantage.