Browsing by Author "Uslu, Mustafa"

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Amputations in Eastern Turkey (Van): a Multicenter Epidemiological Study
(Turkish Assoc Orthopaedics Traumatology, 2008) Dogan, Ali; Sungur, Ibrahim; Bilgic, Serkan; Uslu, Mustafa; Atik, Bekir; Tan, Onder; Akpinar, Fuat
Objectives: The indications for amputations vary among countries and different regions depending on many factors. This study was designed to evaluate amputations performed in the province of Van and to determine specific causes of amputations associated with geographical and. cultural characteristics of the region. Methods: A total of 475 amputations were performed in 440 patients (345 males, 95 females; mean age 28.5 years; range 3 months to 85 years) in medical institutions of Van between 1995 and 2005. The patients were evaluated with respect to age and sex, etiology, side and level of amputations, and surgical interventions performed. Results: Amputations were the most common in the 21 to 30-year age group with 109 patients. Pediatric patients below the age of 10 years accounted for 13.4%. Of all the amputations, 218 (45.9%) involved the upper extremity, and 257 (54.1%) involved the lower extremity. Amputations were right-sided in 223, left-sided in 188 patients, and 29 patients underwent multiple amputations. Trauma was the most common cause of amputations (n=177, 40.2%), with leading etiologies as gunshot injuries (n=45), land mine (n=3.3) and hand grenade (n=7) blasts. Other frequent indications apart from traumatic causes were diabetes mellitus (n=86), congenital diseases (n=33), and peripheral vascular disease (n=30). Causes more specific to regional characteristics were tandoor burns (n=7), mistreatment by traditional bonesetters (n=3), and frostbites (n=3). Replantation was performed in 24 patients, of which 15 (62.5%) were successful. Conclusion: Our region features gunshot injuries and land mine blasts as the most common traumatic causes of amputations.
Comparison of Anti-Edema Effects of Iloprost and Diclofenac Sodium on Traumatic Rat Paw Edema
(Turkish Assoc Orthopaedics Traumatology, 2010) Uslu, Mustafa; Kilincoglu, Volkan; Toker, Serdar; Kalender, Ali Murat; Dogan, All; Sebik, Ahmet
Objectives: The aim of this study was to compare the anti-edema effects of a stable prostacyclin analogue, iloprost, with parenteral and local forms of a non-steroidal anti-inflammatory drug, diclofenac sodium, on traumatic soft tissue edema. Methods: Thirty-two adult male rats were randomly divided into 4 equal groups. Traumatic edema in one paw of each rat was produced by established protocol. Different drugs were then administered to each group: intraperitoneal (i.p.) saline (group 1, control group), topical diclofenac gel (group 2), i.p. diclofenac sodium (group 3), and i.p. iloprost (group 4). The volume of the paws was measured at baseline (before trauma) and at 1 hour, 2 hours, 4 hours, 8 hours, 24 hours, 48 hours, and 72 hours after trauma. The anti-edema effects of these 3 drugs (diclofenac gel, diclofenac sodium i.p., iloprost i.p.) were compared to each other and to the control group. Results: The greatest increase in paw edema in the first, second and fourth hours was seen in the control and iloprost groups. At the 4-hour measurement, edema levels were all equal except control group. Following 4- and 8-hour measurements, edema began to decrease in all groups. After 8 and 24 hours, the fastest decrease in edema was in iloprost group, with complete resolution of edema by 72 hours. The next fastest decrease in paw volume was seen with i.p. diclofenac sodium, followed by diclofenac gel. Conclusion: Iloprost has experimentally higher anti-edema effect than diclofenac sodium for the conservative treatment of the traumatic soft tissue edema.
Middle Phalangectomy: a Functional and Aesthetic Cure for Macrodactyly
(informa Healthcare, 2006) Tan, Onder; Atik, Bekir; Dogan, Ali; Alpaslan, Suleyman; Uslu, Mustafa
Macrodactyly is a rare congenital anomaly of the extremities. Some treatments such as debulking, epiphysiodesis, stripping or resection of the digital nerve, shortening of the fingers, amputation, and angulation osteotomy have been tried. We describe a patient with a giant digit in the hand, and present middle phalangectomy as a suitable treatment.
Mini-Open Technique for the Achilles Tenotomy in Correction of Idiopathic Clubfoot - a Report of 25 Cases
(Amer Podiatric Med Assoc, 2008) Dogan, Ali; Kalender, Ali Murat; Seramet, Ebubekir; Uslu, Mustafa; Sebik, Ahmet
Achilles tenotomy is performed for the residual equinus deformity in the Ponseti method of clubfoot treatment. In the present article, we describe a mini-open Achilles tenotomy technique to prevent complications that could occur during tenotomy. This technique was performed on 15 patients (25 feet) during a 3-year period in our clinic on patients whose equinus deformities could not have been corrected by manipulations. Clear improvement (mean angle, 30) was observed in equinus in our patients, and we have not seen any complication in this method. We conclude that direct visualizing of the tendon with mini-open incision may reduce the risk of neurovascular injury, especially for surgeons who are not experienced.
Mitchell's Osteotomy With Mini-Plate and Screw Fixation for Hallux Valgus
(Sage Publications inc, 2013) Kalender, Ali Murat; Uslu, Mustafa; Bakan, Betul; Ozkan, Fuat; Erturk, Cemil; Altay, Mehmet Akif; Kalender, Mahmut
Background: The aim of this study was to evaluate the use of mini-plate and screw fixation to stabilize the first metatarsal osteotomy in patients undergoing Mitchell bunionectomy, with the outcomes of interest being radiological alignment and the time to bony union. Methods: We used mini-plates and screws in 43 feet of 25 patients to avoid cast immobilization and prevent osteotomy displacement. The mean age at operation was 45.4 +/- 13.4 years (range, 17.0-65.0 years). The mean follow-up was 16.9 +/- 3.6 months (range, 12.0-30.0 months). The hallux valgus angles, intermetatarsal angles, and American Orthopaedic Foot and Ankle Society (AOFAS) forefoot scores were evaluated preoperatively and at postoperative month 12. Results: The mean preoperative value for the hallux valgus angle was 35.9 +/- 4.4 degrees (range, 26.0-45.0 degrees) and for the intermetatarsal angle was 12.1 +/- 1.4 degrees (range, 10.0-15.0 degrees). The mean postoperative value for the hallux valgus angle was 16.0 +/- 2.12 degrees (range, 12.0-20.0 degrees) and for the intermetatarsal angle was 7.7 +/- 1.2 degrees (range, 5.0-10.0 degrees). The mean AOFAS score was 50.5 +/- 12.8 points (range, 30.1-76.0 points) preoperatively and 75.9 +/- 11.3 points (range, 43.3-92.3 points) at postoperative month 12. Improvement of range of motion of the metatarsophalangeal joint, pain relief, and satisfactory alignment of the first ray were achieved in 41 feet (95.3%). Conclusions: We recommend this fixation for Mitchell's bunionectomy because it provided stable fixation without the need for casting.
Morphometric Study of the Human Metatarsals and Phalanges
(Wiley-liss, 2007) Dogan, Ali; Uslu, Mustafa; Aydinlioglu, Atif; Harman, Mustafa; Akpinar, Fuat
Mathematical relation between metatarsals and between phalanges in terms of their lengths and widths in themselves is considered to be significant with respect to its functional and aesthetic roles. The objective of this study is to conduct measurements for determining lengths and widths of metatarsals and phalanges on the foot radiographs and to determine possible mathematical correlations between metatarsals themselves and between phalanges themselves in terms of their lengths and widths. Anteroposterior right and left foot radiographs were taken from 100 volunteers (50 men and 50 women). Lengths and widths of the metatarsals and phalanges were measured in millimeter on radiographs. The mean, minimum and maximum values, and standard deviations of each bone's length and width were studied and data were put into formulation. The results were evaluated by Regression statistical test, and the relation between metatarsals and between phalanges in terms of their lengths and widths was studied. As a result of the measurements, we found fixed proportions between metatarsals in themselves and between phalanges in themselves in terms of their lengths and widths. Knowing these morphometric relations may be useful for performing any surgical procedures designed to manage any defects or imperfections of the foot, chief among them is shortness.
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.
Parmak Ucu Amputasyonlarında Subdermal Paket Metodu ile Rekonstrüksiyon
(2006) Tan, Önder; Dogan, Ali; Uslu, Mustafa; Atik, Bekir; Tekeş, Lütfi
Parmak ucu amputasyonlarında mikrocerrahi ile damar anastomozlu replantasyon yapmak zordur. Bu tip hastalarda damar anastomozsuz cilt altı paket metot kullanımı uygundur. Nisan 2005-Nisan 2006 tarihleri arasında parmak ucu amputasyonlu 12 hastaya cilt altı paket metot uyguladık. Hastaların 10'u erkek 2'si kadındı. Kesilerin 8'i keskin, 4'ü ezilme tarzındaydı. Ortalama yaş 15 idi. Başparmak amputasyonlu 4 hastada paket alanı olarak karın bölgesi, diğer parmak amputasyonlu hastalarda paket alanı olarak avuç içi kullanıldı. Bu metot ile 7 (%58) hastada tam iyileşme, 3 (%25) hastada kısmi nekroz ve 2 (%17) hastada total nekroz ile tam kayıp gelişti. Cilt altı paket metodunun parmak distal uç amputasyonlu hastalarda uygulanması kolay, ucuz ve az takip gerektiren bir metot olduğu sonucuna vardık.
Postoperative Dynamic Extension Splinting Compared With Fixation With Kirschner Wires and Static Splinting in Contractures of Burned Hands: a Comparative Study of 57 Cases in 9 Years
(informa Healthcare, 2007) Tan, Onder; Atik, Bekir; Dogan, Ali; Uslu, Mustafa; Alpaslan, Suleyman
Skin grafting is widely used for the treatment of postburn contractures. Their main disadvantage, a tendency to contract again, can be reduced and better outcomes achieved by postoperative splinting. In this study we compared the outcomes of dynamic and static splinting postoperatively. Of the 57 patients managed by split grafts, 36 (44 hands) had Kirschner (K) wires applied with static splints, whereas 21 (26 hands) had dynamic splinting. The mean age was 11 (range 2-37) and 15 (range 2-50) years in the two groups. Before and after the operation, basic hand functions were evaluated clinically, and the results analysed statistically. The mean follow-up times were 18 and 14 months respectively, and recurrence rates were 22% and 14%. We think that the postoperative dynamic splinting is superior to fixation with K-wires with or without static splints.
Sıçanlarda Travmatik Ayak Ödeminin Tedavisinde İloprost ve Diklofenak Sodyum'un Karşılaştırılması ( Deneysel Çalışma )
(2006) Uslu, Mustafa; Sebik, Ahmet
2. ÖZETÇalışmada stabil bir prostasiklin analoğu olan iloprost'un ( İlomedinÂ® ) ve steroidolmayan yangı baskılayıcı ilaçlar'dan diklofenak sodyum'un parenteral ve jel şekillerinin(Voltaren amp., Voltaren-Emuljel ) travma sonrası gelişen yumuşak doku ödemi tedavisindeetkilerinin değerlendirilmesi amaçlandı.Çalışmada 32 adet Sprague-Dawley cinsi, genç-erişkin ve erişkin erkek sıçankullanıldı. Sıçanların ortalama ağırlıkları 187 gr. idi. ( En fazla 260 gr. ve en az 122 gr. idi.)Sıçanlar rastgele seçilen sekizerli gruplar halinde dört ayrı gruba ayrıldı. Hazırlanan özel birdüzenek yardımı ile sıçan ayaklarında travma gerçekleştirildi. Travma sonrası gruplara ilaçlarıverilmeye başlandı. Kontrol grubu için izotonik sodyum klorür periton içine, diğer gruplariçin sırası ile diklofenak jel travma bölgesine yerel olarak sürülerek, diklofenak sodyumperiton içine ve iloprost periton içine verildi. Başlangıçta, 1., 2., 4., 8., 24., 48., 72. saatlerdesıçan ayaklarının hacimleri ölçüldü. Üçüncü günün sonunda sıçanlar öldürülerek ayaklarınınradyografileri çekildikten sonra, histopatolojik inceleme yapıldıÇalışma sonucunda kontrol grubuna göre; bu üç ilacın travmatik yumuşak doku ödemiüzerinde etkileri klinik ve histopatolojik olarak değerlendirildi. Klinik ve histopatolojik olarak72. saat sonunda ödem üzerine en etkili ilacın iloprost olduğu saptandı. Parenteral olarakuygulanan diklofenak sodyumun jel şekline göre ödemi azaltıcı etkisinin daha fazla olduğugörüldü. Jel şeklinin sıçan cildinden emiliminin yeteri kadar olmadığı düşünüldü. İloprost veparenteral verilen diklofenak sodyum gruplarında yapılan histopatolojik çalışmada yumuşakdoku ödeminin kontrol grubuna göre belirgin oranda azaldığı saptandı. İloprostun, klinikkullanımda insanlarda altı saatlik damar içi infüzyon şeklinde ve iki-üç hafta süre ileverilmesi önerilmektedir. Bu durum hastanın ilacı kullanabilmesini güçleştirmektedir.Hastanın tedaviye uyumunu sağlamak için, bu ilacın hasta tarafından daha kolay şekilde vekısa sürede alınabilecek ticari formüllerinin geliştirilmesine ihtiyaç vardır.4
Van Bölgesindeki Amputasyonlar: Çokmerkezli Epidemiyolojik Çalışma
(2008) Çoban, Hüseyin; Sungur, İbrahim; Uslu, Mustafa; Uluç, Dinçay; Özgökçe, Salih; Bilgiç, Serkan; Atik, Bekir
Amaç: Amputasyonların etyolojileri birçok faktöre bağlı olarak ülkelere ve bölgelere göre farklılık göstermektedir. Bu çalışmada, Van ilindeki merkezlerde yapılan amputasyonlar geriye dönük olarak incelendi ve bölgemizin coğrafi ve kültürel özelliklerinden kaynaklanan amputasyon nedenleri ortaya konmaya çalışıldı. Çalışma planı: 1995-2005 yılları arasında Van ilindeki sağlık merkezlerinde toplam 440 hastada (345 erkek, 95 kadın; ort. yaş. 28.5; dağılım 3 ay-85 yaş) yapılan 475 amputasyon, hastaların yaş ve cinsiyeti, amputasyonun etyolojisi, taraf ve seviyesi ve uygulanan cerrahi girişimler yönünden geriye dönük olarak incelendi. Sonuçlar: Yaş açısından en büyük grubu 21-30 yaş grubundaki olgular (n=109) oluşturuyordu. On yaş altı çocukların tüm hastalara oranı %13.4 idi. Amputasyonların 218’i üst ekstremitede (%45.9), 257’si alt ekstremitede (%54.1) uygulandı. Olguların 223’ünde sağ, 188’inde sol, 29’unda birden fazla ekstremite amputasyonu yapıldı. En yaygın amputasyon nedeni travma (n=177, %40.2) idi. Ateşli silah yaralanması (n=45), mayın (n=33) ve el bombası (n=7) patlamaları travmatik nedenler içinde ilk sırayı almaktaydı. Travma nedenli amputasyonları diyabet (n=86), doğuştan hastalıklar (n=33) ve periferal vasküler hastalık (n=30) nedeniyle yapılan amputasyonlar izlemekteydi. Bölgeye özgü amputasyon nedenleri olarak tandır fırını yanıkları (n=7), sınıkçı müdahalelerine bağlı yanlış uygulamalar (n=3) ve donma (n=3) gözlendi. Yirmi dört olguda replantasyon yapıldı ve bunların 15’inde (%62.5) başarı sağlandı. Çıkarımlar: Bölgemizde ateşli silah yaralanması ve mayın patlamalarına bağlı travmatik amputasyonlar sık görülmektedir.