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  • Küçük Resim
    Öğe
    Bipediküllü fibular flep ile tibia rekonstrüksiyonu
    (2016) Kahraman, Ahmet; Yüce, Serdar; Tekin, Hakan; Canbaz, Yasin; Sultanoğlu, Yılmaz
    Tibia kemik kayıpları konjenital, enfeksiyon, tümöral oluşumlar ve travmalara bağlı olarak gelişebilir. Ekstremite kaybını önlemek için tibial kemiğin rekonstrüksiyonu şarttır. Rekonstrüksiyon için, distraksiyon osteogenezis, otojen kemik greftleri veya kemik flepleri kullanılabilir. Tibia yerine geçebilecek büyüklükte ve dayanıklılıkta otojen bir kemik bulmak oldukça zordur. Özellikle büyük tibia defektlerinde fibula kemik flebi rekonstrüksiyonda sıklıkla kullanılır. En büyük dezavantajı kalınlığının yeterli olmaması sebebi ile stres kırıklarına maruz kalabilmesidir. Burada sunulan olguda 22 yaşında sağ tibiada Gustilo tip III yaralanması olan hastanın 15 cm boyutundaki tibial kemik ve cilt-yumuşak doku defekti vardı. Aynı bacaktan hazırlanan bipediküllü fibula filebi ile onarım yapıldı. Cilt defekti örtümü için serbest anterolateral uyluk flebi (ALT) ile kapatıldı. Fibula flebi başarılı oldu. ALT flebi ise 72. saatte kullanıldı. Fibula üzeri ikinci seans uygulama ile kısmi kalınlıkta cilt grefti ile kapatıldı. Hastanın 12 aylık düzenli takibinde fibulaya kontrollü yük uygulandı. X-ray görünümünde fibula tamamen tibiaya adapte olmuş ve kalibrasyonu orijinal tibia çapının ¾ seviyesine ulaşmış olduğu görüldü. Her iki ekstremite boyu eşitti. Hasta desteksiz şekilde ayakta durabiliyor ve yürüyebiliyordu. Cerrahinin süresinin kısa olması, güvenilir ve dönor alan morbiditesinin düşük olması tekniğin avantajı iken kalibrasyon zayıflığına bağlı stres kırıklarına karşı dayanıksız olması dezavantajıdır
  • Küçük Resim
    Öğe
    Comparison of the Fistula Risk Associated With Rotation Palatoplasty and Conventional Palatoplasty for Cleft Palate Repair
    (Lippincott Williams & Wilkins, 2014) Kahraman, Ahmet; Yuce, Serdar; Kocak, Omer Faruk; Canbaz, Yasin; Guner, Sukriye Ilkay; Atik, Bekir; Isik, Daghan
    The aims of the cleft palate repair techniques are to reduce the velopharyngeal insufficiency risk and oronasal fistula development to minimal levels without affecting the maxillofacial development. In this article, we present a retrospective study comparing the conventional palatoplasty techniques with the new technique of rotation palatoplasty for the risk of development of oronasal fistula. Materials and Methods: Of the 100 patients who were operated on because of cleft palate between the years 2002 and 2008, 12 patients had Furlow palatoplasty, and 88 patients received the Veau-Wardill-Kilner (V-Y pushback) operation (group C). A total of 67 patients who were operated on between 2008 and 2011 had rotation palatoplasty (group R). Results: One hundred patients were men, and 67 were women. Among all the patient groups, 22.8% were classified as Veau 1, 24.6% were classified as Veau 2, 37.1% were classified as Veau 3, and 15.6% were classified as Veau 4. The rate of fistula was found to be 17.7% in all patients. Fistula development was found in 6% of the patients in group R (4/67) and in 18% of the patients in group C (18/100). The difference between group R and group C regarding the number of patients who developed fistula was statistically significant (P = 0.011). Conclusions: The Veau classification of the cleft palate affects the risk of fistula development, and the risk for fistula after rotation palatoplasty is lower than that associated with the V-Y pushback technique.
  • Küçük Resim
    Öğe
    Congenital Lateral Cleft Palate of Unknown Etiology
    (Lippincott Williams & Wilkins, 2015) Kahraman, Ahmet; Yuce, Serdar; Kocak, Omer Faruk; Canbaz, Yasin; Isik, Daghan
    The term cleft palate (CP) refers to midline defects extending from the prealveolar ark to the uvula, and these defects present with varying degrees. CP may be complete, incomplete, unilateral, bilateral, or submucosal. It is often observed with cleft lip (CL). In various studies, the incidence of isolated CP has been reported as 1.3 to 25.3 per 1000 births. 1,2 As a result of deterioration of the anatomical structure of the palate, illnesses such as regurgitation, respiratory tract infections, otitis, and speech disorders may occur. These defects are often observed in the midline and are rarely laterally localized. Cleft palates with lateral localization are outside the natural midline cleft closure line and cause clinical complaints similar to other types of CP. Two cases of laterally localized CP have previously been published in the literature. 3,4 The case presented here is the third known case to be reported.
  • Küçük Resim
    Öğe
    Reconstruction of the Tibia with a Bipedicle Fibular Flap
    (Medknow Publications & Media Pvt Ltd, 2016) Kahraman, Ahmet; Yuce, Serdar; Tekin, Hakan; Canbaz, Yasin; Sultanoglu, Yilmaz
    Tibial defects can be caused by trauma, congenital, osteomyelitis, or cancers. The tibia is the main bone for bearing the body. It is a big bone, and the difficulty of the reconstruction of tibia is importance to repair it. The fibular bone is a good provider for repairing the tibia defects. Generally, the repair was planned be a free vascularized flap. The most important disadvantage is the low calibration. In early age in particular, the original thickness of the tibia is reached after the surgery with a good follow-up process and rehabilitation. In this case; a 22-year-old female patient had a multi-part post-traumatic fracture of the left tibia and was administered to our plastic surgery inpatient clinic. The bone defect was reconstructed with a bipedicle fibular flap taken from the same leg. The fibula was embedded into the medulla with a screw plate, and fixation was applied with an external fixator. Wherefore the loss of skin, skin flap of fibula bottomed of perforators was not used. A vascularized anterolateral thigh flap, which was obtained from the other leg, was used to reconstruct the skin defect. One year after surgery, the bone viability was perfect. The integrity of the skeleton was created without shortening the leg. The rehabilitation of the patient was continued for repowering and resizing the fibula up to tibia. In this case report, we wanted to share our experience for repairing the tibia defect with using a bipedicle fibular flap.