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Öğe Better short-term outcomes of mini-open rotator cuff repair compared to full arthroscopic repair(Korean Shoulder And Elbow Soc, 2024) Akdemir, Mehmet; Kılıç, Ali Ihsan; Kurt, Cengizhan; Çapkın, SercanBackground: Rotator cuff tears commonly cause shoulder pain and functional impairment, prompting surgical intervention such as mini-open and arthroscopic methods, each with distinct benefits. This study aimed to compare the clinical outcomes and complications of these two approaches. Methods: A retrospective analysis was conducted on 165 patients who underwent rotator cuff repair using either arthroscopic-assisted mini-open or full arthroscopic approaches. Patient demographics, tear characteristics, clinical outcomes, and complications were assessed, with statistical analyses conducted to discern differences between the groups. Results: Among the patients, 74 (53.2%) received the mini-open approach, while 65 (46.8%) underwent arthroscopic repair, with a mean follow-up of 19.91 months. The mini-open group exhibited significantly higher postoperative American Shoulder and Elbow Surgeons (ASES) scores compared to the arthroscopic group (P=0.002). Additionally, the mini-open group demonstrated a more significant improvement in ASES scores from preoperative to postoperative assessments (P=0.001). However, the arthroscopic method had a significantly longer operative time (P<0.001). Complications, including anchor placement issues, frozen shoulder, infection, and re-rupture, occurred in 17.3% of patients overall. Re-rupture rates were 13.5% for mini-open and 6.2% for full arthroscopic repair, with no significant difference between the two methods (P=0.317). Conclusions: Both the mini-open and arthroscopic methods yielded favorable clinical outcomes for rotator cuff tear treatment, but the mini-open group exhibited superior results. Surgeons should consider patient characteristics, tear attributes, and surgical expertise when selecting the appropriate technique.Öğe Characteristics of femoral neck fractures in osteogenesis imperfecta: Series of four-teen consecutive hips in twelve patients(Elsevier Sci Ltd, 2024) Vahabi, Arman; Kaya, Huseyin; Cagiran, Zeynep; Sozbilen, Murat Celal; Kurt, Cengizhan; Gunay, HuseyinIntroduction: While long bone fractures are commonly seen in individuals with Osteogenesis Imperfecta (OI), femoral neck fractures (FNF) are exceedingly rare. There is a lack of comprehensive data regarding the etiology of FNFs, their characteristics, and the treatment protocols. Our aim was to determine the characteristics of femoral neck fractures in children with OI. Materials and methods: This study was conducted as retrospective series covering period of January 2011December 2022. Total of 14 femoral neck fractures in 12 patients were included into final analysis. Age, gender, fracture location, ambulation level, injury mechanism, Sillence type, pre-fracture collo-diaphyseal angle, presence of previous implants and applied treatments were noted. Results: The mean age was 9.3 (range: 3 -16), 8 out of 12 patients were males. Sillence type 3 OI was most common (50 %) type. Among 12 patients, 2 (16.6 %) were restricted ambulatory while 5 (41.6 %) were nonambulatory. Seven patients had prior femoral implants. Six fractures were managed non-operatively, while others underwent surgery, with cannulated screws (42.8 %) or plate osteosynthesis (7.1 %). All eight cases (100 %) with minor trauma or unknown origin were Sillence type 3 -4, displaying varus deformity. FNFs that occured in mobile patients required higher-energy traumas. Conclusion: Femoral neck fractures in OI showed differing trauma mechanisms in ambulatory vs. non-ambulatory patients. Non-surgical treatment may be considered with in patients with high-risk anesthesia concerns, requiring higher level clinical studies.Öğe Comparison of the complications of knee replacementu using fixed or mobile inserts(Galenos Publ House, 2024) Akdemir, Mehmet; Kaya, Erol; Kılıç, Ali İhsan; Kurt, Cengizhan; Çapkın, SercanBACKGROUND/AIMS: Knee replacement surgery or total knee arthroplasty is a widely performed procedure to alleviate pain and improve function in patients with severe knee joint degeneration or injury. The choice between fixed and mobile inserts for knee replacement implants remains critical. Fixed-bearing implants provide stability, whereas mobile-bearing implants offer increased conformity and potential for improved range of motion. This study aimed to compare the complications of knee replacement using fixed and mobile inserts. MATERIALS AND METHODS: A retrospective analysis was conducted on 412 knee replacement patients who underwent surgery between 2011 and 2021 using either the Smith & Nephew GENESIS-II fixed insert knee prosthesis or Zimmer-Mobile insert knee prosthesis. Data collection involved rigorous evaluation of patient files, radiographs, and postoperative outcomes. Data on age, gender, side of the knee prosthesis, preoperative and postoperative tibiofemoral angle, proximal tibia angle, osteolysis around the prosthesis, and complications, such as instability, infection, extensor mechanism problems, aseptic loosening, and radiological osteolysis, were recorded. Complications requiring surgical intervention were also noted. RESULTS: The mean age of patients was 65.18 years, and 88.5% were female. The mobile insert group included younger patients with a higher incidence of bilateral knee arthroplasties. Radiological evaluation revealed a higher incidence of patella changes and subsequent patella replacement in the mobile insert group. However, the overall complication rate was not significantly different between the two groups. Although postoperative joint alignment did not significantly differ between the groups, the postoperative proximal tibial angles were higher in the osteolysis, did not significantly differ between the two groups. CONCLUSION: The choice of fixed or mobile insert during knee replacement did not significantly affect the incidence of specific complications. Surgeons should consider individual patient factors, surgeon preference, and technical expertise when selecting the appropriate implant type for knee replacement surgery.Öğe Effect of ultrasound-guided pericapsular nerve group (PENG) block on pain during patient positioning for central nervous blockade in hip surgery: a randomized controlled trial(Bmc, 2023) Aygun, Hakan; Tulgar, Serkan; Yigit, Yavuz; Tasdemir, Ayse; Kurt, Cengizhan; Genc, Caner; Bilgin, SezginBackground Most patients with hip fractures are elderly patients with comorbidities, and well-managed pain management is associated with positive postoperative outcomes. In recent years, new indications for regional anesthesia techniques have been defined, and they have found more place in clinical practice. Herein we investigate the effect of US-guided PENG block on positioning pain and compare that effect to intravenous opioid in patients undergoing surgery under spinal anesthesia for hip fractures. Additionally, we sought to investigate the effect of PENG block on pain scores, opioid intake, time to first analgesic requirement, and quality of recovery within the first 24 h following surgery. Methods In this study, patients were divided into the PENG (n = 42) and control group (n = 42) one hour prior to surgery. A team who was blinded to the assigned groups, collected and evaluated all data such as spinal anesthesia positioning pain, postoperative pain, opioid requirement. Results Patients that underwent PENG had statistically significantly lower NRS scores after interventions, immediately before positioning, at positioning and at end of spinal anesthesia. Pain scores during positioning for spinal anesthesia were statistically significantly lower in the PENG group than in the control group (p < 0.001). Total morphine use over the first 24 h was extremely statistically significantly lower in the PENG group (p < 0.001). Conclusions Positive outcomes of PENG block in patient positioning pain before spinal anesthesia, postoperative pain scores, and morphine consumption are consistent with similar studies. High patient satisfaction in patients who underwent PENG block contributes to the literature. Trial Registration ClinicalTrials.gov Identifier: NCT04871061Öğe Neonatal clavicular fracture: Can induction of labor be a risk factor?(2024) Özdoğar, Batuhan; Kurt, Cengizhan; Ayar, Murat; Olukman, OzgurPerinatal clavicular fracture is the most common birth injury that may cause neonatal morbidities such as obstetric brachial palsy (OBP) ranging from 0.2 to 3.5%. We aimed to compare the relationship between perinatal clavicular fracture and induced vaginal delivery. All the live births and the neonatal outpatient clinic admissions between June 2016 and December 2022 have been investigated retrospectively. A total of 185 newborn infants with a mean gestational age of 38.3±1.6 weeks and a mean birth weight of 3,451±430.10 grams were enrolled. When compared to all in-born live births, the overall incidence of clavicular fracture was 0.78%. One hundred eighty-one (97.8%) infants were born vaginally and 4 (2.2%) were born by cesarean sections (C-sections). The incidence of clavicular fracture among in-born vaginally delivered infants was 1.26% (n=153) and among C-section deliveries was 0.04% (n=3). In vaginal deliveries, 54.7% (n=99) had prolonged labor, 71.8% (n=130) had received labor induction and 7.7% (n=14) had a history of instrumental intervention. A statistically significant relationship was found between clavicular fracture and prolonged labor, labor induction, increased birth weight, and low Apgar scores (p<0.001). While 21 infants (11.4%) had cephalohematoma, 8 infants (4.3%) presented with symptoms of OBP. Although high birth weight, prolonged labor, and ventouse delivery are the already known major risk factors for neonatal clavicular fractures, induced vaginal delivery has been defined as a new and important risk factor. Induction of labor should be decided when the benefits of immediate delivery outweigh the risks of continuing the pregnancy for fetal and maternal health.Öğe Open reduction and plate fixation, external fixator, and conservative treatment for intra- articular distal radius fractures(Springernature, 2024) Akdemir, Mehmet; Kılıç, Ali Ihsan; Kurt, Cengizhan; Çapkın, SercanBackground Distal radius fractures are common fractures. Treatment of intra-articular fractures is controversial, with treatment modalities including closed reduction and casting, open reduction and plating, and closed reduction and fixation with an external fixator. In this study, we compared the clinical and radiological outcomes of our patients treated with three different methods for intra-articular distal radius fractures. We hypothesize that open reduction and plate application are superior. Methodology Adult patients with intra-articular (AO type B and C) fractures of the distal radius and treated with closed reduction-casting, volar locking plate, and external fixator were identified. Radiologically, joint stepping at the end of treatment, radial inclination, radial height, volar tilt, and distal ulna fracture were examined. For clinical scoring, Quick Disabilities of the Arm, Shoulder and Hand (Q-DASH) scores were computed. Obtained data were compared statistically between groups. Results A total of 164 patients were included in the study. Overall, the treatment modality was conservative in 61, volar with plating in 78, and external fixation in 25. The mean age of the patients was 53.7 years (range = 20-82 years). Overall, 39.6% of the patients were male and 60.4% were female. The mean follow-up period of the patients was 16.7 months (range = 12-28 months). No statistically significant difference was found between Q-DASH scores in the statistical evaluation (p > 0.05). There was a statistically significant difference between the groups in the radiological evaluation. When conservative treatment and the volar plate group were compared, the volar plate was superior in all radiological parameters (p < 0.05). Compared with conservative treatment and external fixation, only volar tilt and radial inclination angle were different. External fixation was better (p < 0.05). Radial length, volar compared to plate and external fixation tilt, and ulnar variance were better in the plate group (p < 0.05). Regarding joint stepping and radial, there was no difference in inclination between the two groups (p > 0.05). Reflex sympathetic dystrophy was seen in a total of 10 (6.1%) patients. Pin-site infection was seen in three (12%) patients in the external fixator group. Implant removal was performed in seven (9.0%) patients who developed plaque due to irritation and tenosynovitis. Early arthrosis was seen in three (4.3%) patients. Conclusions The treatment of distal radius intra-articular fractures should be evaluated and decided individually for each patient. No single method is directly superior to other methods. However, in some cases, the best results radiologically in the treatment of comminuted intra-articular fractures have been obtained in patients with volar plates.Öğe Resistive Warming Mattress, Forced-Air Warming System, or a Combination of the Two in the Prevention of Intraoperative Inadvertent Hypothermia: A Randomized Trial(Elsevier Science Inc, 2023) Alcan, Aliye Okgun; Aygun, Hakan; Kurt, CengizhanPurpose: To prevent intraoperative inadvertent hypothermia (IIH), resistive products and forced-air warming systems are often used simultaneously. There is insufficient evidence to show whether this application is clinically more effective than a single active warming device. The aim of this study is to compare the efficacy a single intraoperative active warming method with combined methods in IIH prevention.Design: A randomized, prospective, experimental study.Methods: This study was conducted between June and October 2021 in the operating room of a training and research hospital. The study sample consisted of 123 patients who underwent scheduled orthopedic surgery under spinal anesthesia, were young (18-64), and had an ASA risk score of I to III. The patients were divided into three groups preoperatively according to the stratified randomization technique. To prevent IIH, a resis-tive warming mattress was used in group 1; a forced-air warming system was used in group 2; and a combi-nation of the two methods were used in group 3. The body temperatures of the patients were measured and recorded every 15 minutes from admission to the operating room until the end of surgery.Findings: The mean intraoperative body temperature of the patients was 36.6 & PLUSMN;0.15 & DEG;C for group 1; 36.6 & PLUSMN;0.1 & DEG;C for Group 2 and 36.6 & PLUSMN; 0.15 & DEG;C for Group 3. There was no difference between the groups in terms of body tem-perature. The overall incidence of IIH was 8.1%; 9.8% in group 1, 9.8% in group 2 and 4.9% in group 3. There was no statistically significant difference between the groups in terms of IIH (p < .05).Conclusions: This study supports the efficacy of using resistive warming mattress and forced-air warming sys-tems in preventing IIH. The use of both methods together made no difference in terms of IIH development.& COPY; 2022 American Society of PeriAnesthesia Nurses. Published by Elsevier Inc. All rights reserved.
