Browsing by Author "Korkmaz, Mahmut"

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Biomechanical Comparison of Achilles Tenotomy and Achilloplasty Techniques in Young Rats an Experimental Study
(Amer Podiatric Med Assoc, 2009) Dogan, Ali; Korkmaz, Mahmut; Cengiz, Nurettin; Kalender, A. Murat; Gokalp, M. Ata
Background: Tendo Achillis lengthening is performed by means of Z-plasty in the classic treatment of clubfoot. In the Ponseti method for treating clubfoot, Achilles tenotomy is performed percutaneously for residual equine deformity. A randomized study was designed to compare tendon healing after tenotomy versus Z-plasty. Methods: Thirty-six Sprague-Dawley rats were divided randomly into two groups. On the first day, while the right tendo Achillis of group 1 rats underwent tenotomy, those of group 2 rats underwent Z-plasty. Nine rats from each group were humanely killed on days 21 and 45 postoperatively. The two groups were compared with each other biomechanically and histologically. The Achilles tendons of eight rats in each group were evaluated biomechanically, and the remaining rat in each group underwent histologic evaluation. Results: Mean +/- SD maximum load at rupture of the treated tendons on days 21 and 45 in the tenotomy group was 26.38 +/- 7.31 N and 47.16 +/- 15.36 N, respectively, and in the Z-plasty group was 27.37 +/- 5.20 N and 45.27 +/- 9.59 N, respectively. The biomechanical evaluation revealed no significant difference in terms of breaking forces between the two groups. The difference between breaking forces on days 21 and 45 was statistically significant for both groups. Conclusions: Tendons in the tenotomy group healed as well as those in the Z-plasty group, and Achilles tenotomy in the rat was similar to Z-plasty for Achilles tendon lengthening. Human correlation may or may not exist, but this study suggests that it should be considered and investigated. (J Am Podiatr Med Assoc 99(3): 216-222, 2009)
A New Method in Tendon Repair - Angular Technique of Interlocking (Atik)
(Lippincott Williams & Wilkins, 2008) Atik, Bekir; Tan, Onder; Dogan, Ali; Kalender, Murat; Tekes, Lufti; Korkmaz, Mahmut; Uslu, Mustafa
Background: The risk of adhesion following flexor tendon repair, despite provision of rehabilitation by mobilization of the tendon with passive exercises without the risk of rupture, is not negligible. Active mobilization of tendons has recently been more frequently recommended to prevent adhesions of tendons. The tendon repair zone, which should withstand active traction forces, should maintain its strength until complete recovery of the tendon. For this purpose, a new treatment method named angular technique of interlocking (ATIK) has been developed. This method was compared with the Modified Kessler method, in vivo and in vitro. Materials and Methods: In four groups, each consisting of 10 chickens, severed flexor tendons repaired with the Modified Kessler and ATIK techniques were compared for biomechanical properties. Results: Although there were no differences between these techniques in vitro, this new technique's superiority was statistically significant in in vivo studies. Conclusions: The second and third postoperative weeks are periods during which the number of fibroblasts and the amount of collagen, are the highest. In these periods, edema resolves and sutures begin to loosen. In this situation, the force withstanding the active movements is the support of the suture materials and the degree of recovery of the tendon. Following this recommended suture technique and active movements, the healing potential of the tendon increases and the risk of tendon rupture owing to decrease in the force exerted per unit area decreases.