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Öğe Comparison of three fixation methods in transverse fractures of the patella in a calf model(2006) Cekin, Tacettin; Tükenmez, Mehmet; Tezeren, GündüzOBJECTIVES: We evaluated the strength of three different fixation methods against distraction forces in a transverse fracture model of calf patellae. METHODS: Thirty calf patellae were randomly divided into three groups equal in number. Transverse fractures were induced at the same localization in all the samples. The fractures were fixed with a modified anterior tension band technique, Acutrak 4/5 screws, and a combination of Acutrak 4/5 screws and tension band technique in three groups, respectively. Following fixation, each patella was mounted in a compression-distraction testing machine from the quadriceps and patellar tendons on each side of the patella, and equal distraction forces were applied to each patella. The average load to failure at the fracture site was calculated and the results were compared with the Friedman test. RESULTS: The mean failure loads were significantly different in three groups, being 288.8+/-40.1 newton (N), 878.5+/-68.6 N, and 938.6+/-38.8 N, respectively (p<0.001). The most efficient stabilization was obtained in the third group in which Acutrak 4/5 screws and the tension band application were used in combination, while the modified anterior tension band technique alone was found to be the weakest fixation technique. CONCLUSION: Our results showed that Acutrak 4/5 screws enabled a rigid fixation in the surgical treatment of patellar fractures.Öğe Evaluation of urinary bladder function after acute spinal cord injury: An experimental study(Turkish Joint Diseases Foundation, 2010) Öztemür, Zekeriya; Tezeren, Gündüz; Ba?civan, Ihsan; Saraç, Bülent; Durmuş, Nedim; E?ilmez, ReyhanObjectives: The aim of this study was to evaluate the efficacy of early surgical decompression of acute spinal cord injury through the evaluation of urinary bladder function in rabbits. Materials and methods: The study was done with 21 New Zealand male rabbits which were 9 to 12 months in age, and weighed an average of 2438 grams (range 2150 to 3550 g). The animals were assigned into four groups as follows: a control group (n=5), a laminectomy group (n=6), a 15-second compression group (n=5) and a 60-second compression group (n=5). A 60 gram compression force was applied on both compression groups with aneurysm clips. All rabbits were sacrificed seven days postoperatively. Urinary bladder tissues were dissected and in vitro relaxation and contraction tests were performed in organ baths. Results: At the beginning of each experiment, 80 mM KCl was added to the isolated organ bath with no significant difference among all four groups (p>0.05). Carbachol was then added to the organ bath and contraction responses were obtained. Carbachol contraction responses were calculated as the percentage of the 80 mM KCl contraction responses, with compression groups showing significant difference from control and sham-operated groups (p<0.05). Electrical field stimulation responses were obtained for all group preparations at 4, 8, 16, 32 Hz frequencies, and showed significant difference in the 15 and 60-second compression groups (p<0.05). The contractility was assessed using E-max and pD2 values. All groups exhibited same pD2 values. Conclusion: The study demonstrated a slightly better outcome for bladder contractility with early decompression. However, there was no significant difference between early and delayed decompression groups.Öğe Measurement of the carrying angle of the elbow in 2,000 children at ages six and fourteen years(2004) Tükenmez, Mehmet; Demirel, Hüseyin; Perçin, Sitki; Tezeren, GündüzOBJECTIVES: It is important to know the carrying angles of both elbows in the evaluation of deformities which may be seen after treatment of distal humerus fractures. This study was performed to determine the basal values of the carrying angle in specific age groups. METHODS: The carrying angles of both elbows were measured with the use of a goniometry in 2000 students of randomly selected primary schools in Sivas and its nearby districts. Measurements were performed in those who completed the ages of six (500 girls, 500 boys) and 14 (500 girls, 500 boys) years, with the elbow in full extension and forearm in supination. The mean carrying angles of dominant and non-dominant elbows were analyzed in eight groups. RESULTS: The mean angles measured from dominant arms were significantly greater than those of the contralateral side in both sexes and age groups (p<0.05). The mean angles of both elbows were greater in girls than those of the corresponding elbows in boys at six years of age, while vice versa was the case at 14 years of age; however, these differences did not reach significance (p>0.05). Finally, both boys and girls at 14 years of age had significantly greater angles in dominant and non-dominant elbows compared to corresponding sex and elbow side in six-year groups (p<0.001). CONCLUSION: Our results are consistent with the literature data showing that the carrying angle increases with age and that it is always greater on the dominant side.Öğe The outcomes of salter innominate osteotomy in the treatment of developmental dysplasia of the hip(Turkiye Klinikleri, 2006) Tükenmez, Mehmet; Perçin, Sitki; Tezeren, Gündüz; Cingöz, Mehmet AkifObjective: The aim of treatment in developmental dysplasia of the hip (DDH) is the reduction of the hip joint and by maintaining the reduction, enabling the physiological development of the hip. Salter innominate osteotomy (SIO) is one of the surgical methods that is used in certain age groups with this aim. In this study, we examined the results of the SIO technique that we had used in the treatment of patients at a certain age. Material and Methods: Seventy-nine hips in 61 patients who underwent SIO due to DDH between the years 1994-2002 were included in the study. The acetabular angle and the center-edge angle were measured before the procedure and at the final follow-up visit in all patients. Clinical assessment was made using McKay's criteria in the follow-ups. Radiological assessment was made using Sever criteria. In addition, Kalamchi and MacEven radiological criteria were used in assessing the presence of aseptic necrosis. Results: The mean age was 29.2 ± 12.7 (16-84) months at the time of operation and 91.2 ± 37.2 (30-180) months at the final follow-up visit. Before the operation, the mean of the acetabular angle was 38.7 ± 5.9, whereas at the last follow-up the mean of the acetabular angle and the center-edge angle were 20.9 ± 7.6 and 35.1 ± 11.3, respectively. Patients were followed for an average of 60.5 ± 35.1 (6-107) months. In the follow-up visits, redislocation in one hip (1.3%), subluxation in 2 hips (2.6%), deformation in the acetabulum in 2 hips (2.6%), fibre migration in 3 hips (3.9%) and a broken femur resulting from taking off the plaster of the lower extremity in 1 patient (1.3%) were determined. In addition, avascular necrosis (AVN) was present in 10 hips (12.6%). Clinical assessment revealed that 36 hips (45.5%) were excellent, 28 hips (35.5%) were good, 12 hips (15.1%) were fair and 3 hips (3.9%) were poor. Conclusion: We saw, by assessing clinical, radiographic results and complications, that the SIO technique was effective in the surgical treatment of patients with DDH in the 1.5-6 age group. Copyright © 2006 by Türkiye Klinikleri.Öğe The results of short-segment posterior fusion in thoracolumbar burst fractures(2006) Tükenmez, Mehmet; Tezeren, Gündüz; Çekin, Tacettin; Perçin, SitkiBackground: While there are many treatment choices for thoracolumbar burst fractures various criteria are used to choose the most appropriate treatment. Patients and Methods: 16 out of 30 neurologically intact patients who were sustained with thoracolumbar burst fractures and underwent short-segment posterior fixation and fusion according to McCormack scores, were investigated between January 1998 and. December 2001 in our department. Results: Nine of 16 patients were female and 7 of them were male. Localisations of burst fractures were as follows: T12 in 3 cases, L1 in 6 cases, L 2 in 2 cases, and L3 in 2 cases, L4 in 2 cases and L5 in one case. 9 fractures were Denis A type, 6 were Denis B type and one was Denis C type. Preoperative mean of McCormack score was 5,2. Post-operative mean local hypnosis angle, SI and ratio of anterior and posterior body height measurements were 2,38°, 6,85° and 0,82 respectively while those were 8,98°, 13,35° and 0,69 respectively before operation. Those were 3,94°, 8,31° and 0,80 in recent radiographic examination. Conclusion: Short-segment posterior instrumentation and fusion was a reliable and efficient choice of treatment for the patients who have 6 or less McCormacks.Öğe The treatment of adult segmented tibial shaft fractures with ilizarov circular external fixator(Turkiye Klinikleri, 2007) Tükenmez, Mehmet; Tezeren, GündüzObjective: We aimed to determine the outcomes of patients with tibial segmental (type C) fractures that were treated with Ilizarov circular external fixators primarily. Material and Methods: The present study included 10 male patients. The mean age was 35 years (18-75 years). All fractures were type C according to AO/ATO classification. Nine out of them were open fractures, whereas one was closed fracture. Open fractures were classified according to Gustilo-Anderson classification. The mean time between onset of injury and operation was 17,8 days (11-27 days). The mean follow-up was 37 months (21-68 months). Clinical outcomes were assessed according to Karstrom-Olerud criteria. Results: Complete union was achieved in 9 fractures. Infected non-union developed in only one patient. Twenty-nine out of 110 pins used (26.4%) had pin tract infections (15 were grade I; 9 were grade II; 5 were grade 3). There was no neurological complication such as peroneal nerve palsy. Clinical results according to Karstrom-Olerud criteria were good in 4 patients, satisfactory in 2 patients, fair in 3 patients, poor in 1 patient. Conclusion: Besides several disadvantages of circular external fixator, closed reduction with concomitant fixation with circular external fixator is an efficient treatment method for the management of open or closed tibial segmental shaft fractures. Copyright © 2007 by Türkiye Klinikleri.
