Ugur Turktas

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.

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.

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

Biomechanical effects of menopause in ovariectomized rats’ femurs

Abstract Objective: To demonstrate the biomechanical changes in rat bones occurred by surgical menopause and to search for correlation between biomechanical test results and bone mineral density (BMD) measurements. Methods: Thirty female Wistar-albino rats aged ∼6 months and weighed ∼250–300 g were randomized into ovariectomy, sham and control groups. After 6 months, rats were sacrificed and right femurs were extracted. BMD measurements and three point bending biomechanical tests were made in femurs. Results: The difference among the mean BMD measurements of three groups were found to be statistically significant (Pr > F value <0.0001). Mean elastic module, maximum elongation and femoral diameters were also found to be statistically significantly different (Pr > F value <0.05). Ovariectomised and sham-operated groups were significantly different in terms of elastic modulus. Ultimate force did not differ among the groups significantly. The difference between ultimate strain and maximum elongation of the ovariectomy and sham operated group was statistically significant. Conclusions: Bone quality was deteriorated and fragility was increased in rats 6 months after surgical menopause. Sole BMD measurement might not be reliable in evaluation of osteoporosis and fracture risk. Biomechanical quality of bone is more important than its mineral content in determining fragility.

Clinical Evaluation of the Joints of Patients with Hemophilia

Objective: Hemophilia is the most common and serious disease of congenital coagulation factor deficiency and causes arthropathy by hemarthrosis. A proper and timely treatment can decrease morbidity in patients. The objective of this study to evaluate the joints of patients with hemophilia in the Van region. Method: 30 patients of hemophilia who applied to our clinic between March 2009 and October 2010 were included to study. The patients were between 18–60 years old (the mean age is 29,9) and, based on clinical and radiological criteria, were diagnosed with hemophilic arthropathy. The clinical examination of the patients’ joints, frequency of intra-articular bleeding, age of diagnosis and factor levels were evaluated, and whether patients were given prophylaxis or not was taken in consideration. Results:. 25 of the patients (83,3%) had severe hemophilia and their factor level was below 1%. The mean diagnosis age of our patients was 11,1. 7 of the patients (23,3%) were not given prophylaxis treatment. Limited range of motion of the joints, except shoulders, was statistically meaningful when compared to the control group (p

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.

Restless Legs Syndrome in Multiple Myeloma Patients

Background Restless legs syndrome (RLS) is a common neurological condition characterized by uncomfortable and unpleasant sensations in the legs that are relieved by movement. It is frequently idiopathic, sometimes associated with specific disorders such as malignancies. Because there is no study relevant to RLS in Multiple Myeloma (MM), we aimed to evaluate the frequency of RLS in MM patients during chemotherapy and examined the relationship between presence of RLS and depression and anxiety in these patients. Methods We enrolled a population of 62 adult MM patients for RLS features. RLS was ascertained in MM patients by both the presence of the four essential International RLS Study Group diagnostic criteria and neurological examination. The International RLS Study Group rating scale was used to measure RLS severity. Hospital Anxiety and Depression Scale (HADS) was used to evaluate the levels of depression and anxiety and Short Form-36 (SF-36) to evaluate health related quality of life (HRQOL). Results A total of 62 MM patients were evaluated. Among them 11 were identified by the screening questionnaire to meet the criteria for RLS (17.74%). MM patients with RLS had higher levels of depression (P < 0.01) and anxiety (P < 0.01) and poorer HRQOL compared with those without RLS. Conclusions The frequency of RLS in MM patients is higher than that of expected in the general population. MM patients afflicted by RLS have significantly higher levels of depression, anxiety and poorer HRQOL. Recognition and treatment of RLS in MM patients may be an important target in clinical management and may improve overall health outcomes in these patients.

The development of giant lipoma on the BCG vaccine caused scar.

Lipoma is the most common mesenchymal tumors that accounts for about 6% of all soft-tissue tumors in children. The lesion size is usually around 1–2 cm that rarely reaches the bigger diameter. A 14-month-old baby girl was brought to our clinic for a progressively growing lesion on the left shoulder. The lesion started 4 months ago, and then was rapidly growing that caused pain and movement restriction. On the same site, there was a scar of BCG vaccination. The clinical and histopathological findings of the lesion were consistent with lipoma. The lesion was totally resected with no recurrence within 12 months. There are several complications related to BCG vaccination. However, the occurrence of lipoma on BCG vaccine caused scar has not been reported in literature. We reported this case because of its rarity and to emphasize that lipoma can present as a giant lesion in child.