Mehmet Fethi Ceylan

Review of Van earthquakes form an orthopaedic perspective: a multicentre retrospective study

PurposeThis is a descriptive analysis, of victims of Turkey’s October 23, 2011 and November 21, 2011 Van earthquakes. The goal of this study is investigated the injury profile of the both earthquakes in relation to musculoskeletal trauma.MethodsWe retrospectively reviewed medical records of 3,965 patients admitted to in seven hospitals. A large share of these injuries were soft tissue injuries, followed by fractures, crush injuries, crush syndromes, nerve injuries, vascular injuries, compartment syndrome and joint dislocations. A total of 73 crush injuries were diagnosed and 31 of them were developed compartment syndrome.ResultsThe patients with closed undisplaced fractures were treated with casting braces. For closed unstable fractures with good skin and soft-tissue conditions, open reduction and internal fixation was performed. All patients with open fracture had an external fixator applied after adequate debridement. Thirty one of 40 patients with compartment syndrome were treated by fasciotomy. For twelve of them, amputation was necessary. The most common procedure performed was debridement, followed by open reduction and internal fixation and closed reduction-casting, respectively.ConclusionsThe results of this study may provide the basis for future development of strategy to optimise attempts at rescue and plan treatment of survivors with musculoskeletal injuries after earthquakes.

Effectiveness of Local Tenoxicam Versus Corticosteroid Injection for Plantar Fasciitis Treatment

Plantar fasciitis is one of the most common causes of foot pain in adults. In this prospective study, the outcomes of local tenoxicam injection and corticosteroid therapy for the treatment of plantar fasciitis were compared. Patients were randomly assigned to either the tenoxicam or corticosteroid group. The tenoxicam group (n=31) was treated using a local injection of 1 mL of tenoxicam (20 mg/2 mL) and 1 mL of 2% lidocaine, whereas the steroid group (n=30) was treated with a local 1-mL injection containing 40 mg of methylprednisolone acetate and 1 mL of 2% lidocaine. Clinical evaluations, which were performed before the injection and 6 and 12 months after the injection, consisted of patient-assessed pain using a visual analog scale. In addition, patient satisfaction was measured using the Roles and Maudsley score. Comparison of pre- and posttreatment visual analog scale scores demonstrated a statistically significant difference in both groups (P<.05). Furthermore, no significant difference was found between the steroid and tenoxicam groups in terms of visual analog scale scores measured 12 months after injection (P>.05). The tenoxicam injection was not significantly more effective than the corticosteroid injection. However, both methods were effective and successful in treating patients with plantar fasciitis. Tenoxicam therapy appears to provide pain relief, but its effectiveness in the long term should be explored in additional studies.

A randomized controlled trial of electrostimulation effects on effussion, swelling and pain recovery after anterior cruciate ligament reconstruction: a pilot study:

Objective: To evaluate rehabilitation results of electrostimulation especially on joint effusion, swelling and pain recovery after anterior cruciate ligament reconstruction. Design: A randomized controlled trial; the assessor was not blinded to the group allocation. Setting: Orthopaedics-traumatology and physical medicine-rehabilitation departments. Subjects: Twenty-nine consecutive patients underwent anterior cruciate ligament reconstruction. Interventions: Both groups began the voluntary exercise protocol one day post-surgery. The intervention group (n = 15) also received 30 sessions electrostimulation treatment protocol started four days after the operation. Main measures: Numerical bulge-dancing patella signs for effusion assessment; differences in circumferences of the mid-centre of the patella between operated and non-operated knees for swelling assessment. Aself-report of average daily resting pain assessed by visual analogue scale; Intenational Knee Documentation Committee scoring system and Tegner Activity Scale for subjective response assessment. Results: Twenty-six subjects including 13 patients from the intervention group completed the study. Significantly less effusion and swelling were determined in the intervention group after seven days (1.8 ± 1.3 versus 2.4 ± 1.7 for effusion and 1.7 ± 1.2 versus 3.4 ± 1.5 for swelling) to 12 weeks (0.2 ± 0.7 versus 0.6 ± 0.8 for effusion and 0.2 ± 0.8 versus 0.8 ± 0.9 for swelling) postoperative (P < 0.05). Patients treated with electrostimulation had significantly lower pain scores from seven days up to 12 weeks after the operation (P < 0.05). Conclusion: Electrostimulation along with exercise therapy appears superior to exercise alone regarding knee effusion, swelling and pain recovery after anterior cruciate ligament reconstruction. Still, there is need for further clinical studies using a radiologic method to demonstrate this effect of electrostimulation.

Restless Legs Syndrome in Behçet's Disease

The prevalence of restless legs syndrome (RLS) and its association with the clinical features of Behçets disease (BD) has not previously been elucidated. The inflammatory character, central nervous system involvement and neuropathies of BD led to this investigation of RLS risk in BD patients. A total of 116 BD patients and 104 healthy control subjects were included; seven BD patients were excluded because of concurrent diseases, pregnancy or alcohol misuse that might cause RLS symptoms, and the remaining 109 BD patients were included in the analysis. The prevalence of RLS was significantly higher in patients with BD (32/109; 29.4%) than in controls (5/104; 4.8%). No significant differences were found between BD patients with and without RLS with regard to the clinical features of BD. RLS severity positively correlated with age in BD patients. In conclusion, BD-related RLS should be considered in symptomatic RLS secondary to rheumatological disorders and BD patients should be examined for RLS. Further studies are needed to clarify the pathogenetic mechanisms underlying BD-related RLS.

The Effect of Sildenafil on Recuperation from Sciatic Nerve Injury in Rats

BACKGROUND Severe functional and anatomical defects can be detected after the peripheral nerve injury. Pharmacological approaches are preferred rather than surgical treatment in the treatment of nerve injuries. AIMS The aim of this study is to perform histopathological, functional and bone densitometry examinations of the effects of sildenafil on nerve regeneration in a rat model of peripheral nerve crush injury. STUDY DESIGN Animal experiment. METHODS The study included a total of thirty adult Sprague-Dawley rats that were divided into three groups of ten rats each. In all rats, a crush injury was created by clamping the right sciatic nerve for one minute. One day before the procedure, rats in group 1 were started on a 28-day treatment consisting of a daily dose of 20 mg/kg body weight sildenafil citrate given orally via a nasogastric tube, while the rats in group 2 were started on an every-other-day dose of 10 mg/kg body weight sildenafil citrate. Rats from group 3 were not administered any drugs. Forty-two days after the nerve damage was created, functional and histopathological examination of both sciatic nerves and bone densitometric evaluation of the extremities were conducted. RESULTS During the rotarod test, rats from group 3 spent the least amount of time on the rod compared to the drug treatment groups at speeds of 20 rpm, 30 rpm and 40 rpm. In addition, the duration for which each animal could stay on the rod throughout the accelerod test significantly reduced in rats from group 3 compared to rats from groups 1 and 2 in the 4-min test. For the hot-plate latency time, there were no differences among the groups in either the basal level or after sciatic nerve injury. Moreover, there was no significant difference between the groups in terms of the static sciatic index (SSI) on the 42(nd) day (p=0.147). The amplitude was better evaluated in group 1 compared to the other two groups (p<0.05). Under microscopic evaluation, we observed the greatest amount of nerve regeneration in group 1 and the lowest in group 3. However, this difference was not statistically significant. Moreover, there was no significant difference in the bone mineral density (BMD) levels among the groups. CONCLUSION We believe that a daily single dose of sildenafil plays an important role in the treatment of sciatic nerve damage and bone healing and thus can be used as supportive clinical treatment.

Biepicondylar fracture presenting with elbow dislocation: a case report

IntroductionBiepicondylar fracture of the elbow is very rare, and to date there have only been three reports of this injury and its treatment in the English scientific literature. This case report evaluates the surgical internal fixation of a biepicondylar fracture of the elbow with an associated dislocation.Case presentationWe report the case of a 15-year-old Turkish girl with a biepicondylar fracture dislocation of the left elbow. Open reduction and an internal fixation operation were applied. There were no complications.ConclusionIn these injuries, open reduction and internal fixation appear to be a good method to restore elbow stability and function.

Hip Dislocation and Physis Separation Related to the Delayed Diagnosis of Septic Arthritis - Case Re

Mehmet Ata Gokalp1, Mehmet Fethi Ceylan2, Savas Guner2, Ugur Turktas2, Levent Ediz3 1Baskale Devlet Hastanesi Ortopedi ve Travmatoloji Servisi, 2Ortopedi ve Travmatoloji AD Yuzuncu Yil Universitesi Tip Fakultesi, 3Fizik Tedavi ve Rehabilitasyon AD Yuzuncu Yil Universitesi Tip Fakultesi, Van, Turkiye Hip Dislocation and Physis Separation Related to the Delayed Diagnosis of Septic Arthritis Case Report

Removal of metallic foreign bodies embedded in soft tissues by stereotaxic approach

BACKGROUND A trial fibrillation (AF) is the most common cardiac arrhythmia and increases the risk of stroke and death. Patients with hypertensive have an increased risk of developing atrial fibrillation. RDW (Red blood cell distribution width) levels are elevated in cardiovascular disorders including heart failure, stable coronary disease, acute coronary syndrome, slow coronary flow and stroke. OBJECTIVE To investigate the relation between RDW and AF in patients with hypertensive. METHOD We retrospectively examined 126 consecutive hypertensive patients (63 hypertensive patients with AF and 63 hypertensive patients without AF matched with age and sex. RESULTS The mean age of the study population was 71,09± 8,50 (af group) and 70,97±8,24 (non-af group) years. RDW level was different among patients with atrial fibrillation and without atrial fibrillation.(15,13±1,58 and 14,05±1,15 p<001). Logistic regression analysis showed that RDW and left atrial dimension were only independently risk factory associated with atrial fibrillation. (Rdw odds ratio:1,846 CI; 1,221-2,793 p<0,05). Roc curve analyses were applied to determine the cut-off point. Cut-off point was at 14,195 and Sensitive, specificity was %71,4, %56 respectively. CONCLUSION RDW levels were higher in hypertensive patients with atrial fibrillation. An increased RDW level in the patient with hypertension may alert physician on developing or presence of atrial fibrillation.

A Case of Klippel-Feil Syndrome Causing a Mass Appearance in the Nape

Savas Guner1, Mehmet Hamdi Şahan2, Mehmet.Fethi Ceylan1, Fuldem Yildirim Donmez3, Akif Şirikci4 1Department of Trauma and Orthopedic Surgery, Medical School of Yuzuncu Yil University, Van, 2Department of Radiology, Kizilaslan Medical Center, Gaziantep, 3Department of Radiology, Medical School of Baskent University, Ankara,4Department of Radiology, Medical School of Gaziantep University, Gaziantep, Turkey A Case of Klippel-Feil Syndrome Causing a Mass Appearance in the Nape

Delayed Diagnosed Subclinic von-Willebrand Disease- Case Report

DOI: 10.4328/JCAM.719 Received:15.06.2011 Accepted: 07.07.2011 Printed: 01.09.2013 J Clin Anal Med 2013;4(5): 415-7 Corresponding Author: Mehmet Fethi Ceylan, Hafiziye Mah. Kazim Karabekir Cad., Arastirma Hastanesi Ortopedi Klinigi, Van, Turkiye. T.: +905359524440 F.: +90 4322168352 E-Mail: mfethiceylan@hotmail.com Ozet Opere edilecek hastalarin preoperatif kanama diyatezi acisindan degerlendirilmesi bir zorunluluktur. Bu degerlendirme; anamnez, fizik muayene ve hemostaz testlerini icermektedir. Bu testler arasinda rutin olarak kullanilanlar; platelet sayisi, protrombin zamani, aktive parsiyel tromboplastin zamani ve INR degerleridir. Bu degerlendirmelere ragmen kanama-pihtilasma bozukluklarinin tamami tespit edilememektedir. Bu nedenle tanisi atlanmis kanama diyatezi sebebiyle ortopedik girisimlerde postoperatif donemde hemartroz, kas ici hematom ve abondan kanamalar gelisebilir. Bu komplikasyonlar morbidite ve mortalite sebepleridir. Femur diafizinde osteokondromu bulunan ayrica preoperatif anamnezi, fizik muayenesi ve belirtilen hemostaz testleri dogal olan bir olgumuzda, postoperatif donemde cerrahi sahada tekrarlayan kanama ve hematom gelisti. Kanama diyatezi dusunulerek yapilan incelemede von Willebrand hastaligi saptandi. Sonuc olarak, toplum taramasinda % 1 oraninda gorulen, en sik kalitsal kanama diatezi olan von Willebrand hastaliginin subklinik olgularinda erken tani konabilmesi ve komplikasyonlarin onlenebilmesi icin iyi bir hasta anamnezi alinmali ayrica taniya yonelik gerekli testler yapilmalidir.