Browsing by Author "Tosun, N"

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Anatomical Characteristics of the Tibial Medullary Canal and Their Implications for Intramedullary Fixation
(Sage Publications Ltd, 2003) Tosun, N; Aydinlioglu, A; Akpinar, F; Dogan, A; Islam, C
The use of intramedullary fixation methods in the tibia is limited by the anatomical characteristics of this bone. In this study, the shape and degree of axial lateral rotation of the medullary canal were determined in 45 human dry cadaver bones using X-ray and computed tomography examinations and direct measurement of rotation in inserted nails. Forty bones (88.8%) had slight and five bones (11.1%) had excessive anterior bowing along the tibial shaft. Six of the 45 bones (13.3%) had an extremely narrow medullary canal. Axial lateral rotation was demonstrated in the middle third of the medullary canal, being on average (+/- SD) 32.35 +/- 16.25degrees (range 10 - 75degrees). This study revealed that extreme narrowing of the medullary canal, axial lateral rotation of the medullary canal, and extreme anterior bowing of the tibial shaft are the anatomical characteristics most likely to cause difficulties when using intermedullary fixation in the tibia.
Bilateral Median Nerve Compression at the Level of Struthers' Ligament - Case Report
(Amer Assoc Neurological Surgeons, 2000) Aydinlioglu, A; Cirak, B; Akpinar, F; Tosun, N; Dogan, A
Struthers' ligament syndrome is a rare cause of median nerve entrapment. Bilateral compression of the median nerve is even more rare. It presents with pain, sensory disturbance, and/or motor function loss at the median nerve's dermatomal area. The authors present the case of a 21-year-old woman with bilateral median nerve compression caused by Struthers' ligament. She underwent surgical decompression of the nerve on both sides. To the authors' knowledge, this case is the first reported bilateral compression of thp median nerve caused by Struthers' ligament. The presentation and symptomatology of Struthers' ligament syndrome must be differentiated from median nerve compression arising from other causes.
Effect of Intra-Articular Administration of Hyaluronan and Cortisone on Secondary Osteoarthritis of the Infected Rabbit's Knee
(Tohoku Univ Medical Press, 2001) Karakok, M; Ugras, S; Tosun, N; Fuat, A; Aydin, A
Hyaluronan is known to play an important role in the healing of degenerative osteoarthritis. But there is no clear consensus how it effects on osteoarthritis compare to cortisone. The purpose of the research was to determine the comparative effects of hyaluronan and cortisone on the healing of degenerative osteoarthritis. A rabbit model used in which & degenerative osteoarthritis were created in the articular cartilage by the inoculation of Staphylococcus Aureus (S. Aureus). The rabbits divided into two groups namely injected with hyaluronan (group A) and cortisone (group B) at days 20, 23 and 26. After hyaluronan and cortisone injections for treatment of osteoarthritis at day of 25 and 35 six rabbits (each of three injected with hyaluronan and cortisone) and at day 50 (six of injected with hyaluronan and five of cortisone) were sacrified. In biopsies obtained from these knees both articular cartilage degeneration and inflammation around the joint were examined by light microscopy. It was seen that the histopathologic findings were consistent with active chronic inflammation at day 10, followed by chronic inflammation. At day 5 of treatment the degeneration decreased (60%) in group A, and clinical findings disappeared after day 9 of treatment. At day 15 of hyaluronan treatment the degeneration degree regressed and at day 30 absolutely healed (all except :)ne). In group B, at day 5 of treatment, the clinical findings disappeared and the healing rate was 72%. At day 15 of cortisone treatment, the degeneration slightly increased and at day 30 the degeneration degree increased more than that day of 15. The results showed that cortisone is effective in the treatment of cartilage degeneration and inflammation early in the course of the septic arthritis whereas the therapeutic effect of hyaluronan is higher late in the course of the disease. Further studies are required in order to understand the effectiveness of the combined or consecutive use of these drugs in degenerative osteoarthritis.
Effects of Glutaraldehyde on Synovial Tissue
(Cambridge Med Publ, 2003) Tosun, N; Akpinar, F; Dogan, A
This study investigated the effect of glutaraldehyde on the synovial tissue of rabbits. Four different concentrations of glutaraldehyde solution were injected into one knee and the contralateral glenohumeral joint of rabbits in group A to group D. The concentration levels used in group A and group B were 1000 ppm and 100 ppm, respectively. For group C and group D, samples of rinsing solutions obtained by rinsing arthroscopic equipment with 1 1 or 2 1 of isotonic saline, respectively, after immersion in 2% glutaraldehyde were used. The contralateral knee and ipsilateral glenohumeral joint of the same rabbits were injected with saline and used as control sites. Rabbits were sacrificed after 1 day, 7 days or 15 days and the histopathological changes in the synovial tissues were compared. The most dramatic inflammatory changes were observed in group A and group B. The histopathological changes were-greater after 7 days than after 1 day or 15 days. Group C and group D showed no significant differences when compared with normal synovium. A correlation between the concentration of the glutaraldehyde solution and the number of inflamed joints was observed. Very few or no inflamed joints were seen when samples from rinsing solutions of 11 or 2 1 of saline, respectively, were used.
Entrapment of the Sensory Branch of the Radial Nerve (wartenberg's Syndrome): an Unusual Cause
(Tohoku Univ Medical Press, 2001) Tosun, N; Tuncay, I; Akpinar, F
Isolated neuropathy of the cutaneous branch of the radial nerve is a rarely recognized pathology. It was described in 1932 by Wartenberg, who suggested the name cheiralgia paraesthetica. The syndrome is described as known the entrapment of the superficial branch of the radial nerve. Many different etiologic factors for chronic nerve entrapment have been described, however our case has an unusual cause. A 52 year old man had pain and paresthesia in the area over the lateral aspect of the wrist, thumb and first web six months after Colles' fracture. The patient underwent bony spike resection after fi re months with ineffective conservative treatment. He has satisfied after this operation. The case was presented because of disappearing his preoperative complaints after the operation with respect to Wartenberg's syndrome constituted a rare cause of bone spike which has not been mentioned in the literature.
Mathematical Relations Between the Lengths of the Metacarpal Bones and Phalanges: Surgical Significance
(Tohoku Univ Medical Press, 1998) Aydinlioglu, A; Akpinar, F; Tosun, N
The mathematical relationship between the lengths of the metacarpals and phalanges is important in hand surgery because of its role in determining the lengthening of the tubular bone size or the length of a prosthesis. The purpose of the present study is to perform the measurements on the hand radiographs, and to determine possible mathematical relations between the lengths of the metacarpals and phalanges. The lengths and widths of metacarpals and phalanges were measured in millimeters on hand roentgenograms of 100 normal voluntary subjects (50 men, 50 women) and the results were evaluated with a descriptive analysis test. The relations between the lengths of the metacarpals and phalanges were mathematically investigated on several sets of data. Unchangeable proportions between the metacarpals and phalanges lengths were found and formulated. Because any defects or faults of the hand, especially shortness, can corrected with current improved surgical techniques, a knowledge of the morphometric relations between the lengths of metacarpals and phalanges may be useful for such surgical interventions.
Morphologic Evaluation of the Ulna
(Taylor & Francis As, 2003) Akpinar, F; Aydinlioglu, A; Tosun, N; Tuncay, I
Intramedullary ulnar nailing may be technically difficult. We used various methods and measurements to determine the ideal nail entry point and the shape, length, diameter and curvature of the medullary canal in 44 human cadaver ulnas. We found that the ideal nail entry point was, on average, 7 mm proximal and 3 mm lateral to the most prominent area of the olecranon. A nail of 3 mm diameter could easily be inserted through a hole at the proximal-lateral side of the most prominent part of the olecranon, but only 20% of all nails could be easily inserted through a hole in the middle of the olecranon. We found that correct selection of a nail of proper length and diameter, as well as an ideal nail entry point on the olecranon are essential to successful nailing.
A Morphometric Study on the Humerus for Intramedullary Fixation
(Tohoku Univ Medical Press, 2003) Akpinar, F; Aydinlioglu, A; Tosun, N; Dogun, A; Tuncay, I; Ünal, Ö
In recent years, the popularity of intramedullary humeral nailing is on the rise in spite of its handicaps. There are many problems in intramedullary humeral. stabilization because of the anatomic structure of the bone. We performed various methods and measurements to determine shape, length and diameter and curvature of the medullary canal of the humerus in 57 human dry cadaver bones. Anterior angulation with an average of 21 cm apart from greater tubercle was found at 1/3 distal part. Mean degree of angulation was 9degrees (max: 15, minutes: 5, S.D.: 2.84). Humerus bones with septal aperture (supratrochlear foramen) at the fossa coronoidea were observed to have very narrow medullary canal. The best point for nail insertion was found to be an area on the line from greater tubercle anteromedially to caput humeri. This study revealed that carefully evaluated structure of humeral medullary canal and various congenital constructions such as septal aperture, and correct selection of a nail with proper length and diameter are essential for successful nailing.
Severe Peripheral Polyneuropathy in a Child With Infective Endocarditis Caused by Staphylococcus Aueus
(Acta Medica Belgica, 2004) Çaksen, H; Üner, A; Arslan, S; Anlar, Ö; Odabas, D; Tosun, N; Akgün, C
Although central nervous system complications such as stroke, encephalopathy and meningitis are commonly described in Staphylococcus aureus endocarditis, peripheral nervous system involvement is rarely reported in the literature. In this article we report on a 13-year-old boy with infective endocarditis caused by Staphylococcus aureus in whom severe polyneuropathy developed during hospitalization. To the best of our knowledge this is the first child case with infective endocarditis associated with peripheral polyneuropathy in the literature.
Symptomatic Os Triangulare. (Case Report)
(Masson Editeur, 1999) Akpinar, F; Aydinlioglu, A; Tosun, N
Os triangulare is an accessory bone found in the triangular cartilage of the wrist just distal to the end of the ulna and is generally asymptomatic. A case report of symptomatic Os triangulare is reported. Treatment associated immobilization and anti-inflammatory medication.