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Öğe Clinical and radiological significance of posteromedial fragment in tibial plateau fractures(Elsevier, 2022) Akdemir, Mehmet; Turken, Mehmet Aykut; Turan, Ahmet Cemil; Bicen, Ahmet Cagdas; Kilic, Ali IhsanIntroduction: The effect of joint fragmentation, especially the posteromedial fragment, on treatment outcomes in tibial plateau fractures has been better understood in recent years. In this study, we wanted to examine whether the accompanying posteromedial fragment has an effect on clinical and radiological results. Patients and methods: Patients who underwent open reduction and internal fixation with plate and screw due to tibial plateau fracture were retrospectively screened. The patients were divided into two groups as with and without posteromedial fragment. Clinical, radiological and complications were compared statistically. Results: 38 out of 52 patients were included in the study. The mean age of the patients was 46.08, 26 (68.42%) were female and 12 (31.58%) were male. Mean follow-up was 18.55 months. Posteromedial fragment was present in 21 (55.6%) patients, but not in 17 (44.4%) patients. When the two groups were compared according to the Rasmussen clinical and radiological criteria, no statistically significant difference was found. There was no statistically significant difference between the two groups in the rates of infection, non-union, malunion, joint separation, early arthrosis and arthrofibrosis (p > 0.05). A statistically significant difference was found between the two groups in terms of reduction loss rates (p < 0.05). Conclusions: The accompanying tibial plateau fractures of the posteromedial fragment are characteristic fractures. Care should be taken to maintain the stability of the fracture fixation.Öğe Comparison of Conservative and Arthroplasty Treatment for 3 or 4 Part Proximal Humerus Fractures in the Elderly(2024) Akdemir, Mehmet; Biçen, Ahmet Çagdaş; Turan, Ahmet Cemil; Ekın, Ahmet; Kılıç, Ali Ihsan; Unal, MericAim: Proximal humerus fractures are common injuries in the elderly population. This study hypothesizes that arthroplasty is not superior to conservative treatment in the management of multi-part proximal humerus fractures in elderly patients. Material and Method: Patients aged 65 and above with 3–4-part proximal humerus fractures, treated either conservatively or with arthroplasty, were included in the study. The minimum follow-up period was set at 12 months. Functional evaluations of the patients were performed using the Quick Disabilities of Arm, Shoulder and Hand (Q-DASH) scoring system. Statistical analysis comparing the two groups was conducted using the SPSS software. The mean values of numerical data were analyzed using the Mann-Whitney U test, while categorical data were compared using the Chi-square test. A significant level of 0.05 was considered. Results: A total of 67 patients who received adequate clinical follow-up were included in the study (50 conservative 17 arthroplasty). The average age of the patients was 76.12 years, with 9 male and 58 female patients. The average follow-up period was 22.61 months (range: 12-82). There were no statistically significant differences in age, gender, side, follow-up period, and fracture type distribution between the two groups. However, a significant difference in Q-DASH scores was observed (p<0.05). Conclusion: In the treatment of proximal humerus fractures, even when they are multi-part fractures, conservative treatment should may be the first choice. We think that the early results of conservative treatment are better than arthroplasty.Öğe Retrospective comparison of open and percutaneous repair methods in acute achilles- tendon repair(2022) Kılıç, Ali İhsan; Akdemir, Mehmet; Turan, Ahmet CemilPurpose: In recent years Achilles’ tendon tears are becoming more common. Open and percutaneous repair methods have been described in the surgical treatment of tendon tears. The aim of this study is to determine whether there is a difference between open repair and percutaneous repair. Methods: Patients who underwent surgical repair due to acute Achilles’ tendon full-thickness rupture in our clinic, were included in the study. Open repair was performed for one group of patients and percutaneous repair was performed for the other. At the end of follow-up, clinical scores and complication rates were compared statistically. Results: Thirty-six patients with a mean age of 46.3 years were included in the study. Nineteen patients were treated with the open method and seventeen patients with the percutaneous method. The mean follow-up period was 27.3 months for both groups. Mean Leppilahti scores were 94.71 in the percutaneous repair group and 90.79 in the open repair group (p>0.05). Re-rupture, deep infection and DVT rates were similar (p>0.05). Skin necrosis was more common in the open repair group (p<0.05). While sural nerve neuropraxia was more common in percutaneous repair (p<0.05). Conclusion: In the surgical treatment of acute Achilles’ tendon tears, the percutaneous method should be the first choice with its low complication rate and good clinical results. It is necessary to pay attention to the sural nerve during surgery.Öğe RETROSPECTIVE COMPARISON OF TWO DIFFERENT FIXATION METHODS FOR FIRST METATARSOPHALANGEAL JOINT ARTHRODESIS(Dokuz Eylul Univ Inst Health Sciences, 2023) Akdemir, Mehmet; Turan, Ahmet Cemil; Kilic, Ali IhsanPurpose: Arthrosis of the first MTP joint is a common condition. Among the available arthrodesis methods, plate/screw and screw methods are the current treatment methods of choice. In this study, we investigated whether there is a difference between these two methods. Material and Methods: Thirty-four toes of 32 patients with advanced arthrosis were included in the study. Eighteen arthrodesis were fixed with locking plates/screws and 16 with cross-screws. In the radiological evaluations, malunion and nonunion were examined. Clinical evaluation was made according to AOFASResults: The mean age of the patients was 57.74 +/- 10.079 years and the mean follow-up period was 22.21 +/- 9.108 months. There was no statistically significant difference in clinical scores or union times between the two groups. As complications, superficial skin problems developed in 2 (5.9%) cases, deep infection in 3 (8.8%) cases, and nonunion in 3 (8.8%) cases. There was no statistically significant Conclusion: Plate/screw and cross-screw techniques give similar clinical and radiological results in cases of arthrodesis of the first MTP joint. The cross-screw technique, which can be performed more easily and
