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    The Prevalence of the Palmaris Longus Agenesis: A Study in Afghan Population
    (Ortadogu Ad Pres & Publ Co, 2010) Dogramaci, Yunus; Kalacı, Aydıner; Savas, Nazan; Esen, Erdinc; Ucar, Edip; Duman, I. Gokhan; Kanatli, Ulunay
    Objective: Palmaris longus (PL) is a structure often used in reconstructive surgery mainly in the setting of tendon grafting. The palmaris longus agenesis varies depending on the race/ethnicity. Awareness of the prevalence in the treated population or ethnic group is important. The prevalence of palmaris longus agenesis has, to the best of the authors' knowledge, not been reported in Afghan population. Material and Methods: Four-hundred and thirty healthy Afghan subjects (215 males and 215 females) were clinically examined for the presence or absence of palmaris longus. The examination entailed observation of the volar aspect of the wrist, looking for the palmaris longus tendon using Schaeffer's test and Mishra's second test. Results: PL tendon was found to be absent unilaterally in 7.7% and bilaterally in 14.2% of study participants. The overall prevalence of absence of PL (unilateral or bilateral) was 21.9%. Bilateral absence of PL was statistically more frequent than the unilateral absence. The prevalence of absence of PL was statistically similar between the genders and the sites. Conclusion: The prevalence of the palmaris longus agenesis in the Afghan subjects was found to be much higher than the reported average prevalence in the Asian population.
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    Treatment of lateral epicondilitis using three different local injection modalities: a randomized prospective clinical trial
    (Springer, 2009) Dogramaci, Yunus; Kalacı, Aydıner; Savas, Nazan; Duman, I. Gokhan; Yanat, A. Nedim
    To determine the effectiveness of three different local injection modalities in the treatment of lateral epicondilitis. In a prospective randomized study on lateral epicondilitis, 75 patients were divided into three equal groups A, B and C (n = 25) and were treated using three different method of local injection. The patients in group A were treated with local injection of a steroid (1 mL triamcinolone) combined with local anaesthetic (1 mL lidocaine), those in group B were treated with injection of local anaesthetic (1 mL lidocaine) combined with peppering technique and those in group C with local injection of a steroid (1 mL triamcinolone) combined with local anaesthetic (1 mL lidocaine) and peppering technique. The outcome was defined by measuring the elbow pain during the activity using a 10-cm visual analogue scale (VAS) and satisfaction with the treatment using a scoring system based on the criteria of the Verhaar et al. at 3 weeks and 6 months after the injection and compared with the pre-treatment condition. There were significant (P = 0.006) differences in the successful outcomes between the three groups at 6 months. In group C in which local steroid + peppering injection technique were used; excellent results were obtained in 84% of patients comparing to 36% and 48% for patients in groups A and B, respectively. The successful outcomes were statistically higher in group C comparing to group A (P = 0.002) and group B (P = 0.011). In all groups, there was a significantly lower pain (VAS) at the 3-week and 6-month follow-ups comparing to the pre-treatment condition. VAS measured at 6-month follow-up were significantly lower in group C comparing to other groups (P = 0.002). In the treatment of lateral epicondilitis, combination of corticosteroid injections with peppering is more effective than corticosteroid injections or peppering injections alone and produces better clinical results.