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    Indirect impact of the COVID-19 pandemic on diabetes-related lower extremity amputations: A regional study
    (Turkish Joint Diseases Foundation, 2022) Ergisi, Yilmaz; Ozdemir, Erdi; Altun, Ozan; Tikman, Mesut; Korkmazer, Selcuk; Yalcin, Muhammed Nadir
    Objectives: This study aims to evaluate the indirect impact of the novel coronavirus disease 2019 (COVID-19) pandemic on diabetes-related lower extremity amputations. Patients and methods: Patients who underwent lower limb amputation due to complications of diabetes between August 2019 and February 2020 (control group) and August 2020 and February 2021 (pandemic group) were retrospectively reviewed. None of the patients had a previous COVID-19 infection. Patients' amputation level and latest diabetes follow-up date until amputation were recorded. Results: A total of 19 feet of 19 patients (14 males, 5 females; mean age: 70.0 +/- 10.5 years; range, 53 to 91 years) in the control group and 18 feet of 18 patients (12 males, 6 females; mean age: 70.4 +/- 11.3 years; range, 54 to 91 years) were included. There was no statistically significant difference in amputation levels between the two groups (p=0.959). The mean time elapsed from the last diabetes control in the control and the pandemic group was 5.9 +/- 12.8 months and 8.2 +/- 9.8 months, respectively (p=0.038). A total of eight (42.1%) patients in the control group and seven (38.9%) patients in the pandemic group did not have a follow-up for diabetes in the last year prior to amputation (p=0.842). Conclusion: Although the COVID-19 pandemic seems to cause a delay in the routine medical care of patients with diabetes, it appears not to have an indirect effect on the lower extremity amputation level and incidence. Patients' adherence may be the major determinant in amputation surgery.
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    Radiological Evaluation of Distal Tibiofibular Joint Anatomy Variations in Patients with and Without Syndesmotic Injury
    (Springer Heidelberg, 2023) Ataoglu, Muhammet Baybars; Tokgoz, Mehmet Ali; Ozer, Mustafa; Kokturk, Anil; Yaka, Haluk; Ergisi, Yilmaz
    IntroductionSyndesmosis injuries are a common and debilitating problem affecting the ankle joint, but the precise causes of these injuries remain unclear. In the current retrospective study, it was aimed to investigate the relationship between variations in the distal tibiofibular syndesmosis and surgically proven syndesmosis injuries.Patients and MethodA total of 57 patients with surgically proven syndesmosis injuries and 51 patients without syndesmosis injuries were included as the control group. Computed tomography (CT) scans were used to measure six anatomical features 1 cm proximal to the tibiotalar joint, including the anterior facet length (a), posterior facet length (b), angle between the anterior and posterior facets (c), fibular incisura depth (d), tibia thickness (e), and fibula thickness (f).ResultsComparing the measurements of the patients with and without syndesmosis injury, it was demonstrated that the anterior facet length (a) (p = 0.022) was shorter and the a-b difference (anterior facet length-posterior facet length difference) (p = 0.010) tended toward negative values. Pearson correlation analysis demonstrated that a (r = - 0.211, p < 0.033) and a-b (r = - 0.254, p = 0.010) measurements were strongly negatively correlated with syndesmosis injury.DiscussionOur study findings suggest that the shortness of the anterior facet and the difference in length are related to syndesmosis injuries. To the best of our knowledge, this is the first study to report this relationship with syndesmosis. This study sheds light on the underlying mechanisms of syndesmosis injury, which could help clinicians in the diagnosis, treatment, and prevention of this common ankle injury.Level of evidence: Level 4: case-control study.
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    Revisiting the surgical indication of mid-shaft clavicle fractures: Clavicle asymmetry
    (Turkish Joint Diseases Foundation, 2023) Ergisi, Yilmaz; Ozdemir, Erdi; Tikman, Mesut; Korkmazer, Selcuk; Kekec, Halil; Yalcin, Nadir
    Objectives: The aim of the study was to investigate whether clavicular symmetry was a valid assumption and to assess the factors that could predict clavicular asymmetry. Patients and methods: Between January 2021 and April 2021, a total of 100 consecutive patients (61 males, 39 females; mean age: 63.6 +/- 15.5 years; range, 27 to 94 years) whose both clavicles were adequately seen on chest computed tomography (CT) were retrospectively analyzed. Clavicular lengths were measured on three-dimensional (3D) reconstruction of chest CTs by two independent orthopedic surgeons on two separate occasions. The longest distance passing the straight line between the most lateral part of the clavicle at the acromioclavicular joint and the most medial point of the clavicle on the sternoclavicular joint was given as the clavicle length after adjusting tilt of convertible 3D CTs. Clavicular length difference was calculated by subtracting the short clavicle's length from the long clavicle's length. Patients' age and sex were noted. The calculated clavicular length differences were assigned into three groups: =5 mm, > 5 mm and =10 mm, and > 10 mm. Results: The mean right and left clavicle lengths were 13.9 +/- 1.3 cm and 14.1 +/- 1.2 cm, respectively (p < 0.001). A total of 29 patients (29%) had > 5 mm clavicle asymmetry and six patients (6%) had more than 10 mm clavicular length difference. Age, sex, and clavicular length were not associated with the clavicular length difference. Conclusion: Our study results showed that 29% of the patients had > 5 mm clavicular length asymmetry. The clavicular symmetry may not be a valid assumption in the decision making for the surgical treatment of mid-shaft clavicle fractures; thus, this assumption may lead to maltreatment. More factors that can
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    What is the clinical and functional effect of performing suspension arthroplasty with abductor pollicis longus tendon slip to carpometacarpal joint osteoarthritis of the thumb?
    (Turkish Joint Diseases Foundation, 2022) Hatipoglu, Mustafa Yasin; Yapar, Aliekber; Ergisi, Yilmaz; Tokgoz, Mehmet Ali; Yapar, Dilek; Ozturk, Akif Muhtar
    Objectives: This study aims to investigate the clinical, radiological, and functional results of trapeziectomy, ligament reconstruction and suspensionplasty surgery with abductor pollicis longus (APL) tendon slip autograft to thumb carpometacarpal (CMC) osteoarthritis. Patients and methods: Between January 2011 and June 2017, a total of 25 hands of 25 patients (4 males, 21 females; mean age: 63.6 +/- 5.8 years; range, 54 to 76 years) were included. All patients underwent trapeziectomy and ligament reconstruction and suspensionplasty procedure due to the diagnosis of thumb CMC joint osteoarthritis. The patients were administered the Patient-Rated Wrist Evaluation Questionnaire (PRWE), Quick Disabilities of the Arm, Shoulder, and Hand (Q-DASH), and Visual Analog Scale (VAS). Scaphometacarpal distance (SMD), Kapandji opposition score, thumb range of motion (ROM), grip strength, tip pinch, lateral pinch, and palmer pinch values were measured for both hands. The values calculated for the operated and contralateral hands of the patients were compared. Results: The ROM measurements, Kapandji opposition scores, and pinch values of the operated hands of the patients were found to be statistically significant lower compared to the contralateral hands (p<0.001, p<0.001, p=0.002; respectively). The grip strength values were similar for both hands (p=0.147). The median SMD in the operated hand was found to be 7.5 mm and 12.1 mm in the contralateral hand (p<0.001). Conclusion: The ROM, strength and functional results were reached a satisfactory level, particularly in the patients with a follow-up period of >= 36 months. In patients with thumb CMC joint osteoarthritis, ligament reconstruction and suspensionplasty using APL tendon slip are considered to be a useful and preferable surgical technique modification.
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    What is the importance of distal nail diameter in the treatment of intertrochanteric femur fractures?
    (Turkish Joint Diseases Foundation, 2022) Ergisi, Yilmaz; oezdemir, Erdi; Korkmazer, Selcuk; Kekec, Halil; Altun, Ozan; Yalcin, Nadir
    Objectives: The aim of this study was to investigate the effect of distal nail diameter in the treatment of geriatric intertrochanteric femur fractures (ITFFs).Patients and methods: Between January 2017 and January 2021, a total of 91 patients (34 males, 57 females; mean age: 80.6 +/- 7.8 years; range, 65 to 96 years) who had osteosynthesis due to an ITFF with a short cephalomedullary nail (CMN) were retrospectively analyzed. The patients were divided into two groups: Group 1 (n=18) included patients with a distal nail diameter of <= 10 mm and Group 2 (n=73) included patients with a distal nail diameter of >10 mm. Patients' age, sex, fracture type according to AO classification, intramedullary femoral canal diameter, canal fit ratio, operation duration, reduction quality, the distal diameter of the CMN, and complications were evaluated.Results: There was no statistically significant difference between Group 1 and Group 2 in terms of the mean age, sex, fracture type, mean intramedullary canal diameter, reduction quality, and implant failure (p>0.05). The mean operation duration was significantly shorter in Group 2 (112.9 +/- 39.9 min) compared to Group 1 (128.8 +/- 36.4 min) (p=0.048). A total of three intraoperative peri-implant fractures occurred which included one 9 mm nail, one 12 mm nail, and one 14 mm nail.Conclusion: Our study results suggest that there is no advantage of using a >10-mm CMN in the treatment of geriatric ITFFs in terms of reducing the implant failure rate. However, the utility of a >10-mm CMN can reduce the operation duration.