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Öğe Çocuklarda asetabulum kırığı: ender bir olgu sunumu(2013) Başaran, Serdar Hakan; Bilgili, Mustafa Gökhan; Kural, Cemal; Bayrak, Alkan; Avkan, Mustafa CevdetAsetabulum kırığı çocuklarda ve adolesanlarda oldukça nadir görülür. Bu kırık genellikle yüksekenerjili travma sonrası ortaya çıkar ve uzun dönem prognoz hastanın kırık anındaki yaşına,asetabulum Y kıkırdağının zedelenmesine ve deplasman miktarına göre değişir. Bu çalışmada yediyaşında kız çocuğunun yüksekten düşme sonucu gelişen, nondeplase iliak kanat kırığı ile birlikteolan sol asetabulum anterior duvar kırığının traksiyon tedavisinin sonuçları fonksiyonel veradyolojik olarak değerlendirildi.Öğe Fourth and fifth carpometacarpal fracture dislocations(Turkish Assoc Orthopaedics Traumatology, 2014) Kural, Cemal; Baaran, Serdar Hakan; Ercin, Ersin; Bayrak, Alkan; Bilgili, Mustafa Gokhan; Baca, EmreObjective: The aim of this study was to evaluate the mid-term results of patients with surgically treated 4th and 5th carpometacarpal (CMC) fracture dislocation. Methods: The study included 9 CMC dislocation patients (9 males; mean age: 31.2 years, range: 20 to 40 years) treated with open reduction and internal fixation between 2008 and 2012. Mean follow-up period was 19.4 months. Mean interval between trauma and operation was 10.7 (range: 3 to 35) days. Radiological evaluation was performed at the final follow-up. Hand grip power was measured using a hand dynamometer and the injured and uninjured sides were compared. Methods: There was a statistically significant difference compared to the injured side in hand dynamometer measurements (p<0.05). Three patients experienced pain during heavy labor. Among these cases, 2 had delayed diagnosis and 1 a comminuted CMC dislocation and was unable to return to his previous job. There were no recurrent dislocations or revision surgery due to complications. Conclusion: Early diagnosis and treatment of 4th and 5th CMC dislocation results in good anatomical and functional results. Delayed or incorrect diagnosis of this region causes severe radiological and functional problems. Detailed physical and radiological examination can prevent CMC dislocation from being overlooked.Öğe Fourth and fifth carpometacarpal fracture dislocations(2014) Kural, Cemal; Başaran, Serdar Hakan; Erçın, Ersin; Bayrak, Alkan; Bilgili, Mustafa Gökhan; Baca, EmreObjective: The aim of this study was to evaluate the mid-term results of patients with surgically treated 4th and 5th carpometacarpal (CMC) fracture dislocation. Methods: The study included 9 CMC dislocation patients (9 males; mean age: 31.2 years, range: 20 to 40 years) treated with open reduction and internal fixation between 2008 and 2012. Mean follow-up period was 19.4 months. Mean interval between trauma and operation was 10.7 (range: 3 to 35) days. Radiological evaluation was performed at the final follow-up. Hand grip power was measured using a hand dynamometer and the injured and uninjured sides were compared. Methods: There was a statistically significant difference compared to the injured side in hand dynamometer measurements (p<0.05). Three patients experienced pain during heavy labor. Among these cases, 2 had delayed diagnosis and 1 a comminuted CMC dislocation and was unable to return to his previous job. There were no recurrent dislocations or revision surgery due to complications. Conclusion: Early diagnosis and treatment of 4th and 5th CMC dislocation results in good anatomical and functional results. Delayed or incorrect diagnosis of this region causes severe radiological and functional problems. Detailed physical and radiological examination can prevent CMC dislocation from being overlooked.Öğe Medial mini-open versus percutaneous pin fixation for type iii supracondylar fractures in children(2016) Erçın, Ersin; Bilgili, Mustafa Gökhan; Baca, Emre; Başaran, Serdar Hakan; Bayrak, Alkan; Kural, Cemal; Avkan, Mustafa CevdetAMAÇ: Bu çalışmada, çocukluk çağında görülen suprakondiler humerus kırıklarında medial mini açık teknikle perkütan tekniği karşılaştırıldı, floros-kopi zamanı, cerrahi süre ve iyatrojenik ulnar sinir hasarı araştırıldı.GEREÇ VE YÖNTEM: 2011 ve 2013 yılları arasında ameliyat edilen 104 adet Gartland tip III suprakondiler humerus kırığı ileriye yönelik olarak incelendi. Birinci gruptaki (Grup A) 41 hastaya medial mini açık insizyonla medialden bir ve lateralden iki adet pin ile fiksasyonu yapıldı. İkinci gruptaki (Grup B) 63 hastaya tüm pinler perkütan yerleştirildi. Ortalama takip süresi Grup A'da 14.1±1.2 ay ve Grup B'de 14.6±2.1 aydır. Cerrahi sonrası hastalar sinir yaralanması açısından motor ve duyu muayeneleri yapıldı. Cerrahinin süresi, toplam floroskopi süresi, medial pin için floroskopi süresi, Baumann açısı, humerokapitallar açı, son taşıma açısı ve eklem hareket açıklığı değerlendirildi.BULGULAR: Duyu incelemesinde Grup A'da üç kötü ve bir orta sonuç, Grup B'de iki kötü ve bir orta sonuç elde edildi. İstatististiksel olarak fark saptanmadı. Gruplar arasında cerrahi süre ve toplam floroskopi süresi açısından fark saptanmadı. Medial mini açık yapılan grupta medial pin fiksas-yonu sırasında floroskopi süresi daha kısa saptandı.TARTIŞMA: Medial mini açık teknik ve perkütan tekniğin her ikisin dede iyatrojenik ulnar sinir yaralanma riski mevcuttur. Medial mini açık teknikte medial pin yerleştirme işlemi daha kısa süre floroskopi kullanımı açısından avantajlıdırÖğe Medial mini-open versus percutaneous pin fixation for type III supracondylar fractures in children(Turkish Assoc Trauma Emergency Surgery, 2016) Ercin, Ersin; Bilgili, Mustafa Gokhan; Baca, Emre; Basaran, Serdar Hakan; Bayrak, Alkan; Kural, Cemal; Avkan, Mustafa CevdetBACKGROUND: The present objective was to compare medial mini-open and percutaneous treatment of pediatric supracondylar fractures according to fluoroscopy time, duration of surgery, and iatrogenic ulnar nerve injury. METHODS: A total of 104 Gartland type III supracondylar humerus fractures were prospectively evaluated between 2011 and 2013. Patients were divided into 2 groups according to type of fixation. In Group A (41 patients), medial pin was inserted with mini-open incision with 2 lateral pins inserted percutaneously. In Group B (63 patients), all pins were inserted percutaneously. Mean follow-up time was 14.1 +/- 1.2 months in Group A, and 14.6 +/- 2.1 months in Group B. All patients were postoperatively evaluated for nerve injury with both motor and sensory function assessment. Length of surgery, total fluoroscopy time, fluoroscopy time for medial pin insertion, Baumann's angle, humeral capitellum angle, final carrying angle, and range of motion were recorded. RESULTS: Sensorial evaluation showed that Group A had 3 poor, and 1 fair results, and Group B had 2 poor, and 1 fair results. No statistically significant differences were observed, including no differences in either surgery or total fluoroscopy times between groups. However, fluoroscopy time during medial pin placement was significantly lower in the mini-open group. CONCLUSION: In conclusion, similar results of both techniques were observed, and both carry risk of iatrogenic ulnar nerve injury. Medial pin placement is easier and less demanding when used with mini-open technique.Öğe The outcome and parents-based cosmetic satisfaction following fixation of paediatric supracondylar humerus fractures treated by closed method with or without small medial incision(Springer International Publishing Ag, 2016) Basaran, Serdar Hakan; Ercin, Ersin; Bayrak, Alkan; Bilgili, Mustafa Gokhan; Kizilkaya, Cemal; Dasar, Uygar; Avkan, Mustafa CevdetSupracondylar humerus fractures are common in children. Displaced fractures are usually treated with closed reduction and cross pin fixation. But, medial pinning may cause the ulnar nerve injury. The aim of this study was to compare the parents-based cosmetic satisfaction of the incision scars in children with displaced supracondylar humerus fractures treated by closed reduction and cross pin fixation with or without small medial incision. We retrospectively reviewed the medical records of 72 children with displaced supracondylar humerus fractures treated two different closed reduction and percutaneous pinning methods at our institution from January 2010 through December 2013. A group has 36 patients treated with small medial incision and crossed K-wires fixation after closed reduction. The other group has 36 patients treated with closed reduction and K-wires fixation. At the final follow-up, the patients were evaluated radiologically and clinically with Flynn's criteria. Furthermore, a visual analogue scale was used to determine of the parents-based cosmetic satisfaction score. All fractures healed without major complications at the final clinical and radiological assessment. Although, between the two groups did not differ in terms of Flynn cosmetic and functional outcomes, there were statistically significant differences between both groups according to the parents-based cosmetic satisfaction scores. The closed reduction and crossed pin fixation without small medial incision should be preferred first because of better the parents-based cosmetic satisfaction.Öğe Treatment and results in pediatric traumatic hip dislocation: Case series and review of the literature(Turkish Assoc Trauma Emergency Surgery, 2014) Basaran, Serdar Hakan; Bilgili, Mustafa Gokhan; Ercin, Ersin; Bayrak, Alkan; Ones, Halil Nadir; Avkan, Mustafa CevdetBACKGROUND: Six acute traumatic hip dislocations in pediatric patients were retrospectively analyzed. Types of dislocations, associated lesions, treatment methods, complications, and clinical and radiological outcomes were reviewed. METHODS: Six child patients treated due to traumatic hip dislocation between 2007 and 2011 in our clinic were included in the study. While five of the patients were male, one was female; the average age was 8 years and 8 months. The mean follow-up was 25.2 +/- 10 months. There were posterior dislocations in five cases and transepiphyseal fractured dislocation in one case. Four cases were treated by closed reduction while two cases were treated with open reduction method. RESULTS: In the last control of the patients, asymmetric widening in the hip joint was found due to osteochondral fracture in one patient and coxa magna occurred in one patient. Avascular necrosis developed in one case with transepiphyseal fractured dislocation. Harris hip score evaluation was found excellent in five cases and bad in the case with fractured dislocation. CONCLUSION: Traumatic hip dislocation is a rare condition. It should be treated with preferably closed method as soon as possible. Repetitive reduction trials should be avoided. Open reduction should be performed to recognize accompanying lesions after advanced radiologic examinations such as computerized tomography and magnetic resonance imaging.Öğe Treatment and results in pediatric traumatic hip dislocation: case series and review of the literature(2014) Başaran, Serdar Hakan; Bilgili, Mustafa Gökhan; Erçın, Ersin; Bayrak, Alkan; Önes, Halil Nadir; Avkan, Mustafa CevdetAMAÇ: Akut travmatik kalça çıkığı olan altı çocuk hasta geriye dönük olarak incelendi. Bu hastalarda çıkığın tipi, ilişkili lezyonlar, tedavi yöntemleri, komplikasyonlar, klinik ve radyolojik sonuçlar değerlendirildi. GEREÇ VE YÖNTEM: Kliniğimizde 2007 ile 2011 tarihleri arasında travmatik kalça çıkığı nedeniyle tedavi edilmiş olan altı çocuk hasta çalışmaya alındı. Hastaların beşi erkek, biri kız, ortalama yaş 8 yıl 8 ay (dağılım; 5 yıl 9 ay-10 yıl 11 ay). Olguların ortalama takip süreleri 25.2±10 aydı. (dağılım 12-40 ay). Beş olguda posterior çıkık, bir olguda ise transepifizyal kırıklı çıkık mevcuttu. Dört olgu kapalı, iki olgu ise açık redüksiyon yöntemiyle tedavi edildi. BULGULAR: Hastaların son takibinde, bir hastada osteokondral kırığa bağlı eklem mesafesinde asimetrik genişleme saptandı, diğer bir hastada koksa magna gelişti. Transepifizyal kırıklı çıkığı olan bir olguda avasküler nekroz gelişti. Beş olguda Harris hip skoru değerlendirmesi mükemmel, kırıklı çıkık olgusunda ise kötü olarak bulundu. TARTIŞMA: Bu oldukça nadir karşılaşılan olgular mümkün olan en kısa sürede öncelikle kapalı yöntemle tedavi edilmelidir. Tekrarlayan kapalı redüksiyon denemelerinden kaçınılmalı, redükte olmayan olgularda eşlik eden lezyonların önceden tanınması için mümkünse BT ve MR görüntüleme gibi ileri incelemeler yapıldıktan sonra açık redüksiyona geçilmelidir.
