Oguz Cebesoy

Talonavicular Joint Approach to the Talar Body : A Cadaver Study

Background: Lesions of the talar dome or tumors within the talar body may require an open approach with medial or lateral malleolar osteotomies. The aim of this study was to evaluate the possibility and feasibility of a new minimally invasive approach without osteotomy, using the talonavicular joint (TJ) as the entry portal for lesions of the talar body. Materials and Methods: Nine cadaveric feet were used for this study. Using the TJ and a 5-mm skin incision we aimed to reach the superolateral, superomedial, inferolateral and inferomedial corners of the talar body under fluoroscopy. A 2-mm Kirshner wire and a 4-mm cannulated drill bit were used to reach the desired target area and an angled curette was used for curettage after reaching the target. The proximity of vascular structures to the entry portal was noted. The talar and navicular joint surfaces were checked for any damage. The articular areas of the talar heads and the defect areas were measured. Results: All 4 targets and even the posterior talus could be reached by this approach. The nearest neurovascular structures were the saphenous vein and the saphenous nerve. The navicular cartilage was not damaged in any specimen. The talar defect area corresponded to only 3.3% of the talar head cartilaginous area. Conclusion: The TJ approach can be used to reach lesions in all regions of the talar body without the need for an osteotomy. A mini-incision may be used to retract the saphenous nerve and vein. Damage to the talar head cartilage is minimal with this approach which requires no special equipments. Clinical Relevance: This study shows that talar dome lesions can be reached with a minimally invasive method.

AO Tip A Humerus Şaft Kırıklarında Konservatif Tedavi Sonuçlarımız

Amac: AO tip A humerus saft kiriklarinda konservatif tedavi sonuclari ve bu tedaviye hasta uyumu degerlendirildi. Calisma plani: Retrospektif olarak iki merkezde izlenen humerus cisim kirikli 20 hastada konservatif tedavi sonuclarini radyolojik ve klinik olarak degerlendirdik. Bulgular: 19 hastada (%95) ortalama 6,7 hafta sonrasinda radyolojik olarak cok iyi kaynama tespit edildi. 1 hasta(%5) kaynamama nedeniyle ameliyat edildi. 2 hastada reduksiyon sonrasi radial sinir paralizisi gelisti ancak konservatif takip edildiler. 4 hafta rehabilitasyon sonrasi ortalama dirsek fleksiyonu 138 dereceydi ve ekstansiyon kisitliligi yoktu. Sonuc: AO tip A humerus saft kiriklarinin mutlak cerrahi gerektiren durumlar disinda konservatif metodlarla cok iyi kaynadigi ayrica konservatif tedavinin dusuk maliyetli oldugunu ve hasta memnuniyetinin yuksek oldugu tespit ettik

Alt lumbar vertebranın akut burst kırığına anteriordan yaklaşım

Burst fracures of low lumbar vertebrae are uncommoninjuries of spine. Their management include conservativeor surgical especially in case of neurological symptoms.However, indications for surgical treatment were lesswell defined, because of different evaluation criteria ofrisk of future displacement and canal compromise. Wepresent a patient with burst fracture of fourth lumbarvertebra who was treated operatively although she hadno neurological symptoms. And we demonstrate thatwhy anterior aproach was performed to this patient.