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Öğe Çocuklarda araç dışı trafik kazası nedeniyle gelişen tibia şaft kırıklarının titanyum elastik çiviyle tedavisi(2016) Başaran, Serdar Hakan; Erçın, Ersin; Çümen, Hüseyin; Dasar, Uygar; Bilgili, Mustafa Gökhan; Avkan, Mustafa CevdetAmaç: Bu çalışmada çocuklarda yüksek enerjili araç dışı trafik kazası nedeniyle gelişen tibia şaft kırıklarının titanyum elastik çiviyle (TEN) tedavisinin güvenilirliğini ve etkinliğini araştırdık. Gereç ve Yöntem: Haziran 2010-Aralık 2012 tarihleri arasında araç dışı trafik kazası nedeniyle gelişen ve TEN ile tedavi edilen instabil tibia şaft kırıklı çocuk hastaları geriye dönük olarak taradık. On bir hasta çalışmaya dahil edildi. Bu hastaların altısı (%54.5) erkek, beşi (%45.5) kız idi. Hastaların ortalama yaşı 7.4 (dağılım 3-12 yıl) bulundu. Gustilo-Anderson sınıflamasına göre altı hastada (%54.5) açık kırık, beş hastada (%45.5) kapalı kırık mevcuttu. Hastalar takiplerde klinik ve radyolojik olarak değerlendirildi. Hastaların son takiplerinde rezidüel rotasyonel deformiteyi de değerlendirmek için manyetik rezonans incelemesi (MRI) yapıldı. Bulgular: Hastaların tümünde radyolojik ve klinik olarak kaynama elde edildi. Son takipte, kırıkların ortalama koronal plan açılanması 1.5 derece (0-3.9 derece), ortalama sagittal plan açılanması 2.6 derece (0-8.4 derece) bulundu. Dört hastada (%36.4) 10 mm'den fazla bacak uzunluk eşitsizliği mevcuttu. Ayrıca, üç hastada (%27.3) 10 dereceden fazla eksternal tibial torsion deformitesi tespit ettik. Sonuç: Çocuk hastalarda araç dışı trafik kazası sonucu gelişen yüksek enerjili açık veya kapalı tibia şaft kırıklarının TEN ile tedavisi etkili ve güvenilir bir yöntemdir. Bununla birlikte, bu yöntemle tedavide tibial torsiyonel deformite gelişebileceği akılda tutulmalıdır.Öğe Does THA Improve Social Status Among Turkish Women With Developmental Dysplasia of the Hip?(Lippincott Williams & Wilkins, 2018) Mutlu, Tansel; Dasar, Uygar; Bicimoglu, AliBackground In traditional societies, patients who reach adulthood with developmental dysplasia of the hip (DDH) may be labeled disabled and may be considered defective, causing them psychologic pain and problems with social interactions. In some patriarchal societies, women disproportionately experience these problems, because they may be seen as insufficient in terms of marriage and sexual intercourse owing to hip-related limitations, and they may be married through arranged marriages to people who also have disabilities. This patriarchal structure limits the ways women can engage in society and may lower their quality of life (QOL). The degree to which THA can improve the lives of women in these specific ways in a patriarchal culture has not, to our knowledge, been studied. Questions/purposes (1) Does THA improve the social standing of young women with DDH in Turkey? (2) Does THA improve QOL of young women with DDH in Turkey? (3) Does THA improve pain and physical function in these patients? Methods This study was a retrospective, comparative study performed at Karabuk University Research and Training Hospital in Karabuk, Turkey, from 2012 to 2017. A total of 217 women with DDH were followed at our center between the study dates. All of these patients were evaluated for inclusion into the study. Among these, 175 women with DDH (aged 20-45 years) were included in the study according to inclusion/exclusion criteria. We offered THA to all patients in whom surgery was technically feasible; 84 chose to undergo THA, whereas 91 declined the procedure. Whether THA had any effects on the study questions was determined by comparison of the following findings at baseline and after intervention. The social standing of patients was assessed through their marital status and proportions of employment and depression; the patients' QOL was assessed with the SF-36 at baseline for all patients and at 1 year postoperatively for those who underwent THA; and pain and dysfunction were evaluated by determination of the proportion of patients who had scoliosis, knee valgus, and knee and lumbar pain. At baseline, patients were not different in regard to all parameters except knee and lumbar pain, which were greater in those who had decided to undergo THA. The SF-36 scores of patients who underwent THA were compared with their postoperative scores as well as with the baseline scores of patients who did not undergo THA. Results In terms of measures of social standing, women who underwent THA appeared better at followup than did the patients who did not undergo THA. Those who underwent THA had higher percentages of marriage and employment and less depression. Regarding QOL, postintervention comparisons revealed that women who underwent THA had higher SF-36 scores compared with the initial results of women who did not have surgery. Compared with preoperative scores, the highest improvements were found in social role function (mean difference 6 standard error [SE] = 58.64 +/- 0.88; 95% confidence interval [CI], 56.91-60.37; p < 0.001) and mental health (mean difference +/- SE = 53.00 +/- 0.86; 95% CI, 51.31-54.69; p < 0.001) subdimensions of the SF-36. Finally, patients who underwent THA had improvements in pain and function as measured by Harris hip score than did patients who did not undergo THA. At initial evaluation, two groups were found to be similar in terms of Harris hip scores (THA: 61.6 +/- 7.4 versus non-THA: 63.7 +/- 7.6, p = 0.066), whereas the THA group was found to be superior at followup evaluation (THA: 83.5 6 6.2 versus non-THA: 62.1 +/- 7.8, p = 0.001). Conclusions Young women with DDH are severely affected by social and cultural norms in Turkey, which is an example of a patriarchal culture. We believe that in this setting, some patients who improve their appearance, gait, and physical function through THA may benefit from a better social perception and higher self-esteem, which may, in turn, increase their QOL and provide more freedom in terms of life choices.Öğe EARLY BLOOD TRANSFUSION MAY PREVENT POSTOPERATIVE COGNITIVE DYSFUNCTION AFTER HIP ARTHROPLASTY IN ELDERLY PATIENTS(Gunes Kitabevi Ltd Sti, 2018) Mutlu, Tansel; Dasar, UygarIntroduction: The number of joint arthroplasties in the elderly continues to increase with the increase in elderly population. Postoperative cognitive dysfunction is an important complication after surgery in elderly patients. However, the exact cause of postoperative cognitive dysfunction and factors contributing to its development remain unknown. We aimed to determine whether blood loss during or after surgery and the approach for the replacement of this loss affected postoperative cognitive dysfunction frequency and duration. Materials and Method: A prospective study of elderly (>75 years) patients who underwent total/partial hip arthroplasty due to femoral neck or intertrochanteric fractures was conducted. Patients were randomised into two groups. The first group underwent transfusion when haemoglobin values reduced below 9.0 mg/dL, whereas the second group underwent earlier blood transfusion according to the volume of blood loss during and after surgery. All groups were similar in terms of factors considered to be associated with postoperative cognitive dysfunction. An experienced neurologist assessed patients' cognitive functions using the Standardized Mini-Mental Status Examination test and clinical examinations pre- and postoperatively. Results: In total, 48 patients in the first group and 13 in the second group (early intervention group) were diagnosed with postoperative cognitive dysfunction. The duration of cognitive dysfunction was significantly lower in the second group (10.8 +/- 1.2 vs. 8.9 +/- 1.5 days; p<0.001). Conclusion: Although the causal relationship between blood loss and postoperative cognitive dysfunction has not been elucidated in this study, our results demonstrate that postoperative cognitive dysfunction frequency and duration may be reduced by early replacement of blood loss in elderly patients who undergo total/partial hip arthroplasty.Öğe Effect of Wearable Vibration Therapy on Muscle Soreness, Joint Position Sense and Dynamic Balance(Ataturk Univ, 2024) Ozmen, Tarik; Contarli, Nurcan; Gunes, Musa; Simsek, Ayse; Yana, Metehan; Dasar, UygarThe aim of this study is to investigate the effects of wearable local vibration therapy (VT) on muscle soreness, joint position sense, and dynamic balance in recovery after squat exercise. Twenty males (age: 22.25 +/- 1.97 years) participated in the study. Muscle soreness, joint position sense, and dynamic balance were evaluated before exercise, 24 and 48 hours after exercise. All participants performed six sets of 10 repetitions of squat exercises. VT was applied to one thigh of the participants randomly for 10 minutes after exercise, and the other thigh was determined as the control. The muscle soreness increased significantly for VT (p<.001) and control (p=.014) at 24 hours after exercise. However, there were no significant differences 48 hours after exercise for both conditions (p>.05). No significant difference was found between VT and control (p>0.05). No significant difference was found after exercise at knee joint position sense for both conditions (p>.05). No significant difference was observed between VT and control (p>.05). There was a significant difference between before exercise and 48 hours after exercise at anterior direction of the modified Star Excursion Balance Test for VT (p=.033). A significant difference was found between before exercise and 24 hours after exercise at posteromedial (p=.012) direction for VT. There was only significant difference at posteromedial (p=.028) direction at 24 hours after exercise between VT and control. The wearable local VT after squat exercise did not affect muscle soreness and knee joint position sense. However, local VT contributed to the improvement of dynamic balance.Öğe Erişkin tibia diafiz kırıklarının cerrahi tedavisinde kilitli intramedüller çivi uygulaması(2018) Dasar, Uygar; Mutlu, Tansel; Ülker, Ahmet; Satılmıs, Ahmet Burak; Ersan, ÖnderAmaç: Erişkin tibia cisim kırıklarında uygulanan oymalı kilitli intramedüller çivi kullanımınınyerini ve etkisini değerlendirmek.Hastalar ve Yöntem: Tibia diafiz kırığı nedeniyle oymalı kilitli intramedüller çiviuygulaması yapılan toplam 48 erişkin hasta çalışmaya dâhil edildi. Hastaların 27'si(%56,25) erkek, 21’i (%43,75) kadındı. Hastalarımızın yaş ortalaması 42,6(18-59) olarak tespit edildi. 29 kırık vakası sağ bacakta iken 19’u sol bacakta idi. Kırıksınıflamasında AO sınıflaması kullanılmış olup iki vaka dışında tüm vakalara fibulakırığı eşlik etmekteydi. Hastaların yaralanma mekanizması, başvuru zamanı, ameliyattarihi, kaynama zamanı olarak röntgenogramda 3 kortekste köprüleşme görülmesi,işe geri dönüş zamanı, dizilim bozukluğu ve eklem hareket açıklığına bakıldı.Bulgular: Hastalarda ortalama kaynama zamanı 14,2±2,5 hafta, ortalama işe dönüşzamanı ise 18,4±3,6 hafta olarak bulundu. Açık kırık olan 10 hastadan bir tanesindeyüzeyel enfeksiyon, iki tanesinde psödoartroz, bir tanesinde ise kaynama gecikmesiolmuştur. Dört hastada ise distal kilitleme vidasında kırılma meydana geldi. Yüzeyelenfeksiyon gelişen hastada kaynama 22 ay gecikme şeklinde oldu; dinamizasyonsağlanarak ve parenteral antibiyotik tedavisi verilerek tedavi edildi.Sonuç: Erişkin tibia cisim kırıklarında uygulanan intramedüller çivileme tedavisininyüksek başarı oranı ve komplikasyon oranının düşüklüğü nedeniyle uygun bir cerrahitedavi metodu olduğu ve halen altın standart tedavi olarak kabul edilmesi sonucunavarılmıştır.Öğe HIP FRACTURE SURGERY IN PATIENTS OLDER THAN 90 YEARS: EVALUATION OF FACTORS THAT AFFECT 30-DAY MORTALITY IN A PARTICULARLY RISKY GROUP(Gunes Kitabevi Ltd Sti, 2018) Mutlu, Tansel; Dasar, UygarIntroduction: To date, hip fracture-related mortality studies are generally conducted on patients over 65 years of age. In our study, we predicted that factors affecting hip injury-related mortality may differ from the current literature and aimed to determine these factors in patients over 90 years of age who were hospitalized due to hip fracture. Materials and Method: The data of 118 patients who were operated for hip fracture at Karabuk University Training and Research Hospital between 2011 and 2014 were retrospectively reviewed. Each patient's age, sex, preoperative period, American Society of Anesthesiologists (ASA) score, type of anesthesia, comorbid diseases, blood transfusion requirements, fracture type, and mortality time were recorded. Results: The age difference between patients who died (death group) and survivors (survivor group) was statistically significant (p=0.004). The ejection fraction (EF) values of patients who died within the first 30 days after surgery were significantly lower (p=0.012) than those of the survivor group, and more comorbid diseases were seen in the death group (p=0.014). In addition, the median ASA score of the death group was higher than that of the survivor group (p=0.006). Conclusions: The 30-day mortality rate in our study was 27.9%, which is significantly higher compared with previous studies. To cope with high mortality rates in elderly patients with hip fracture, the patients' general medical conditions should be assessed in detail before surgical intervention and medical problems should be stabilized as early as possible.Öğe Karpal tünel sendromu dekompresyon cerrahisinde diyabetes mellitus’un sonuçlara etkisi(2018) Dasar, Uygar; Mutlu, TanselAmaç: Kiniğimizde Karpal Tünel Sendromu (KTS) nedeniyle cerrahi olarak müdahale edilenlerininsonuçlarının diyabetes mellituslu (DM) olup olmamaya göre karşılaştırılması.Materyal ve Metot: 2009?2013 yılları arasında Karabük Üniversitesi Tıp Fakültesi Eğitim AraştırmaHastanesi Ortopedi ve Travmatoloji Kliniği’ne başvuran KTS tanısı almış hastalar bu retrospektifaraştırmanın çalışma grubunu oluşturdu. Çalışma grubu 3 ayrı gruba ayrıldı; DM teşhisi olmayan grup(Grup 1, n=50), DM teşhisi olup polinöropatisi bulunmayan grup (Grup 2, n=45), DM teşhisi oluppolinöropatisi olan grup (Grup 3, n=28). Hastaların semptomları operasyon öncesi ve sonrasıkaydedilerek karşılaştırmalar yapıldı.Bulgular: Çalışmamızdaki gruplar yaş, cinsiyet, eğitim durumu, semptomların dağılımı açısındanameliyat öncesinde benzer bulundu. Hastaların semptomlarının son bir yıl içerisindeki değişimleriincelendiğinde, ağrı sempromunun Grup 1 (p=0,001) ve Grup 2’de (p=0,004) anlamlı seviyede azaldığıgörülürken, Grup 3’te (p=0,581) değişmediği görüldü. Parestezi semptomunun, Grup 1 (p=0,001) ve Grup2’de (p=0,017) anlamlı seviyede azaldığı görülürken, Grup 3’te (p=0,344) değişmediği görüldü. Ayrıca,güçsüzlük semptomunun Grup 1’de (p=0,029) anlamlı seviyede azaldığı izlenirken, Grup 2 (p=0,064) veGrup 3’te (p=0,057) değişmediği izlendi.Sonuç: Çalışmada DM teşhisli hastaların polinöropatisinin olup olmamasının KTS sonucuna anlamlıderecede etki ettiğini izlenmiştir. Operasyon öncesinde ve sonrasında kişiler DM’li olsalar bile nöropatidüzeylerinin izlemi yararlı olabilir.Öğe ONE-YEAR RETROSPECTIVE EVALUATION OF HIP FRACTURE PATIENTS AGED MORE THAN 80 YEARS AND POSTOPERATIVELY MONITORED IN THE INTENSIVE CARE UNIT(Gunes Kitabevi Ltd Sti, 2018) Dasar, UygarIntroduction: As in all the world, expected life time has extended in our country as well which increases yearly operated elderly patient rate. Surgical intervention for hip fracture is one of the most common operations among them Materials and Method: This study was done between 2014 and 2015 at Karabuk Education and Research Hospital ICU. Who were older than age of 80, operated for hip surgery and monitorized at ICU postoperatively included to study. Results: The mean age of our patients was 84.65 +/- 3.36 years, and 50 of them were female (69.44%). 40 patients showed trochanteric femur fracture and 32 showed femoral neck fracture. Proximal femoral nail was implanted in 38 patients and partial hip prosthesis in 34. Regional anesthesia was administered to 57 patients and general anesthesia to 15. The hospital mortality rate was 16.6%. When we grouped the patients as surviving (60) or died (12), we found that the time before surgery was significantly longer for the died patients than for the surviving ones. The need for MV, duration of MV, and the need for inotropic agents were higher in died patients. The duration of ICU follow-up and hospital stay were longer for died patients. Other parameters showed no significant differences. Conclusion: In our study, mental status of our patients and post-discharge conditions could not be evaluated. Not describing the cause of delay to the surgery and not recording patient satisfaction was other limitations. Therefore, we have decided to form a new research protocol for evaluating patient satisfaction and causes of delay to the surgery.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 Postoperatif yoğun bakim ünitesinde takip edilen 80 yaş üstü kalça kirikli hastalarinbir yillik retrospektif değerlendirilmesi(2018) Dasar, UygarGiriş: Tüm dünyada olduğu gibi ülkemizde de beklenen yaşam süresinin uzaması yıllık opere edilen yaşlı hasta yüzdesini artırmaktadır. Bu operasyonlar arasında en sık yapılanlardan biri kalça kırıklarına bağlı cerrahi girişimlerdir.Gereç ve Yöntem: Bu araştırma, 2014-2015 yılları arasında Karabük Eğitim ve Araştırma Hastanesi Yoğun Bakım Ünitesinde yapılmıştır. Çalışmamıza, 80 yaş üzerinde, kalça kırığı nedeniyle operasyon geçirmiş olan ve postoperatif Yoğun Bakım Ünitesinde takibi yapılan hastalar alındı.Bulgular: Hastaların yaş ortalaması 84.65±3.36 yıl idi ve bunların 50 si kadındı. 40 hastada trokanterik femur kırığı ve 32 hastada femur boyun kırığı vardı. Proksimal femur çivisi 38 ve parsiyel kalça protezi 34 hastaya uygulandı. 57 hastaya rejyonel anestezi 15 hastaya genel anestezi verildi. Hastane mortalitesi %16.6 idi. Hastalar yaşayan (60) ve ölenler (12) olarak gruplandırıldığında; ameliyat öncesi sure ölenlerde yaşayanlara göre uzundu. Mekanik ventilatör ihtiyacı ve mekanik ventilatör süresi ve inotrop ihtiyacı ölen hastalarda yüksekti. Yoğun bakım ünitesi ve hastanede yatış süreleri de ölen hastalarda uzundu. Diğer parametrelerde anlamlı bir fark yoktu.Sonuç: Çalışmamızda hastalarımızın mental değerlendirmeleri ve taburcu edildikten sonraki değerlendirmeleri yapılamamıştır. Operasyon gecikme nedenlerinin tanımlanmamış ve hastamemnuniyetinin kaydedilmemiş olması diğer bir kısıtlılıklarındandır. Bunedenle operasyon gecikmenedenlerini ve hasta memnuniyetini değerlendirmek için yeni bir araştırmaprotokolü oluşurmaya karar verdikÖğe The role of wrist circumference (regional obesity versus local swelling) in conservatively treated distal radius fractures: a single center experience(2023) Özdemir, Erdi; Altun, Ozan; Ergısı, Yılmaz; Dasar, Uygar; Yalçın, Muhammed NadirAim: Regional obesity around the wrist due to local excessive fat or local swelling due to edema has not been studied as a risk factor to predict the possibility of reduction loss during conservative treatment of distal radius fractures. We aimed to investigate the impact of wrist circumference on reduction loss risk in conservatively treated distal radius fractures. Material and Methods: Patients with distal radius fractures who were conservatively in our institution between January 2021 and December 2021 are retrospectively reviewed. Patients’ demographics, wrist circumference, radiographic parameters were obtained from hospital registry notes. Wrist circumference was measured with an unstretchable tape positioned on a line passing from lister tubercle of the distal radius and distal ulna. The difference in the wrist circumferences between the injured and uninjured extremities represented local swelling. The association of these factors with reduction loss was evaluated. Results: A total of 73 consecutive patients (19 male, 54 female) with a mean age of 61.1 ± 12.9 were included. There were 18 reduction losses. There was no association with reduction loss between injured and uninjured wrist circumferences (p>0.05). However, local swelling, initial displacement at dorsal angulation and radial inclination, presence of dorsal comminution, and accompanying ulnar styloid fracture were associated with reduction loss (p<0.05). Local swelling had an odd ratio of 6.661 (1.848 – 24.006, p= 0.004). Conclusion: Excessive local swelling is found to be a risk factor to predict reduction loss in conservative treatment of distal radius fractures while regional obesity is not.Öğe A strong and reliable indicator for early postoperative major cardiac events after elective orthopedic surgery: Aortic arch calcification(Mosby-Elsevier, 2019) Adar, Adem; Onalan, Orhan; Cakan, Fahri; Akbay, Ertan; Colluoglu, Tugce; Dasar, Uygar; Mutlu, TanselBackground: Cardiovascular events after orthopedic surgery may result in mortality. Therefore, predictors of early cardiovascular events after elective orthopedic surgery are required. Aim: The aim of this study is to investigate the relationship between aortic arch calcification and 30-day major adverse cardiac events following elective orthopedic surgery. Methods: Patients who had undergone orthopedic surgery were screened. Preoperative detailed anamnesis was taken. Echocardiography and standard chest x-ray were performed. Patients were followed in terms of perioperative 30-days major cardiac events and were classified into two groups according to development of perioperative major adverse cardiac events. Aortic arch calcification was evaluated by two cardiologists, blinded to study findings and was graded as 0 to 3 on chest x-ray. Results: A total of 1060 patients were approached for the study participation. Of these 714 were included in the study (mean age: 70.43, 65% female). Cardiovascular events occurred in 33 patients. As compared to the patients without cardiac events, the prevalence of aortic arch calcification, coronary artery disease, hypertension, and smoking were higher in patients with cardiac events. In addition, Lee index, left ventricular end systolic, end-diastolic and left atrial diameter were significantly higher, GFR values were significantly lower in the group with cardiac events. Multivariate regression analysis showed that smoking (OR 5.031, 95% CI 1.602 to 15.794), presence of hypertension (OR 5.133, 95% CI 1.297 to 20.308) and aortic arch calcification (OR 6.920, 95% CI 3.890 to 12.310) are independent predictors of major cardiac events within 30-day of elective orthopedic surgery. Conclusions: Presence of aortic arch calcification is associated with development of major cardiac events within 30-days after elective orthopedic surgery. (C) 2018 Elsevier Inc. All rights reserved.Öğe The titanium elastic nailing in pediatric tibia fractures caused pedestrian versus motor vehicle accidents(Yerkure Tanitim & Yayincilik Hizmetleri A S, 2016) Basaran, Serdar Hakan; Ercin, Ersin; Cumen, Huseyin; Dasar, Uygar; Bilgili, Mustafa Gokhan; Avkan, Mustafa CevdetObjective: The aim of our study was to investigate safety and effectiveness of titanium elastic nailing (TEN) in paediatric tibia shaft fractures caused by high-energy pedestrian versus motor vehicle accidents. Material and Methods: We conducted a retrospective review for children with unstable tibial shaft fractures treated with TEN caused by pedestrian versus motor vehicle accidents between June 2010 and December 2012. Eleven patients were included in study. Six patients (54.5%) were boys and five patients (45.5%) were girls. The mean age of the patients was 7.4 years (3-12). Five patients (45.5%) had closed and six patients (54.5%) had open fractures according to Gustilo-Anderson classification. At the follow-ups, patients were evaluated clinically and radiologically. Also, we investigated tibial torsion deformity by using MRI in our patients at last follow-up. Results: In all patients were obtained complete bone healing radiologically and clinically. In our patients, the average angulation was 1.5 degrees (0-3.9) on the coronal plane and the average angulation was 2.6 degrees (0-8.4) on the sagittal plane at the last follow-up. In four patients (36.4%) were found more than 10 mm the tibial length discrepancy. Also, we encountered more than 10 degrees the external tibial torsion deformity in three patients. Conclusion: TEN is a safe and effective treatment options in the high-energy pediatric open or closed tibia shaft fractures caused by pedestrian versus motor vehicle accidents. It should be kept in mind that these fractures also might develop in the tibial torsional deformity.Öğe Total kalça artroplastisi sonrasi komplikasyon oranlarini etkileyen sosyal ve demografik faktörler(2016) Çankaya, Deniz; Devecı, Alper; Bıngol, Olgun; Özdemir, Güzelali; Dasar, Uygar; Turan, SualpAmaç: Sosyal ve demografik faktörler değişik tıbbi durumlarda sonuçu etkileyen önemli faktörlerdir, ancak total kalça artroplastisi sonrası bu faktörlerin sonuçlara etkisi çok da iyi anlaşılamamıştır. Bu çalışmada; sosyal, demografik ve klinik faktörlerin, total kalça artroplastisi (TKA) sonrası komplikasyon oranlarına etkisini değerlendirdik.Gereç ve Yöntemler: Bu çok merkezli retrospektif çalışmaya; TKA uygulanan 38 erkek ve 69 kadın olmak üzere 107 hasta (ortalama yaş; 66, aralık:54-80 yaşlar) alındı. Hastaların vücut kitle indeksi (VKİ), anestezi tipi, Amerikan Anestezistler Derneğinin (ASA -American Society of Anesthesiologists) skoru (ASA), ameliyat süreleri ve ağrının kronikleşme süresi klinik kayıtlarından tarandı. Medeni durum, eğitim düzeyi, sigara alışkanlığı ve hastaların yaşam şekli gibi veriler kaydedildi. İlk iki yıllık takip sürecinde görülen komplikasyonlar da kaydedildi.Bulgular: Cinsiyet, yaş, eğitim düzeyi, anestezi tipi ve operasyon süresi yönünden ameliyat sonrası komplikasyon görülen ve görülmeyen hastalar arasında fark yoktu (p>0.05). Komplikasyon görülen hastalarda, daha yüksek VKİ (p=0.016), ASA skoru (p=0.037) ve kronik ağrı süresi (p=0.000) vardı. Yalnız ya da huzurevinde yaşayan, evli olmayan ve sigara kullanan hastalarda daha yüksek komplikasyon oranları (p <0.05) vardı.Sonuç: Postoperatif komplikasyon oranı, hastanın cinsiyeti ve yaşıyla, eğitim düzeyiyle, anestezi tipi ve çalışma süresi ile ilişkili değildir. Yüksek VKİ, ASA skoru ve kronik ağrı süresi, tek başına veya huzurevinde yaşıyor olmak ve sigara kullanımı TKA sonrası komplikasyon oranlarını arttırmaktadır. Hastalar; TKA sonrası komplikasyonları önleme stratejisinin bir parçası olarak, bu risk faktörleri hakkında bilgilendirilmelidir
