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  • Küçük Resim
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    Endobutton technique for the treatment of acute acromioclavicular joint dislocations
    (2014) Özden, Raif; Uruç, Vedat; Duman, İbrahim Gökhan; Doğramacı, Yunus; Kalacı, Aydıner; Kömürcü, Erkam
    Amaç: Akromioklaviküler eklem çıkıkları daha çok genç atletlerde sık görülen bir yaralanmadır. Bu çalışmanın amacı endobutton sistemi ile tespit edilmiş akut akromioklaviküler eklem çıkıklarının postoperatif fonksiyonel sonuçlarını değerlendirmektir. Yöntemler: Bu tespit yöntemi 10 hastaya uygulandı. Rockwood sınıflamasına göre yedi has-tada tip V, üç hastada tip III çıkık vardı. Korakoklaviküler aralık ve akromioklaviküler eklem iki endobutton kullanılarak redükte edildi. Bir endobutton klavikulanın üzerine ikincisi korakoid çı- kıntının altına yerleştirildi. Sonuçlar Constant omuz skoru ve vizüel analog skala ile değerlendirildi. Bulgular: Tüm hastaların intraoperatif olarak fiksasyonunun sağlam olduğu görüldü. Ameliyattan hemen sonra, 6. haftada ve 1 yıl sonra çekilen grafilerde, korakoklaviküler aralık ve akromioklaviküler eklemin yeterli derecede redükte olduğu tespit edildi. Ortalama Constant omuz skoru ameliyatlı omuzda 89 (88-92), sağlam omuzda ise 90 (88-93) olarak bulundu. Constant omuz skoru ile değerlendirildiğinde akromioklaviküler çıkık olan taraf ile normal taraf arasında anlamlı istatiksel fark bulunamadı ve herhangi bir komplikasyonla karşılaşılmadı. Sonuçlar: Bu metod akromioklaviküler eklemin tespiti için güvenli ve etkin bir yöntemdir.
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    Öğe
    Management of fracture and dislocation associated with vascular injuries
    (Anatolian Journal of Clinical Investigation, 2014) Kömürcü, Erkam; Özden, Raif; Kaymaz, Burak; Gölge, Umut Hatay; Göksel, Ferdi; Özcan, Sedat; Yener, Ali Ümit
    The purpose of this study is to identify the factors that affect mortality and morbidity and that contribute to disability in vascular injuries associated with fracture and dislocation. Ninety-seven patients with vascular injuries associated with orthopedic fracture and dislocation in the study by searching hospital files retrospectively.Sixtytwo and thirty-five patients were male and female, respectively. Mean age of the patients was 36.6±12.1 years. The time elapsed between injury and surgical intervention was 3.6±1.9 hours. Tibia, femur and humerus fractures were the most encountered injuries with MESS value of 6.2±2. 2. External fixation and internal fixation osteosynthesis were used in 76 and 12 patients respectively. Vascular injuries were localized most frequently in femoral artery, popliteal artery. Preoperative arteriography was performed in 22 patients. 41 patients had isolated arterial injuries, 54 patients both artery and vein injuries. Priority was given to vascular repair in 68 patients; orthopedic stabilization was performed before the vascular treatment only in 22 patients. Only 4 patients lost their life in the postoperative period. Vascular injuries associated with fracture and dislocation, are major pathologies that must be diagnosed without delay and repaired urgently. There are still disputed issues in the algorithm of the treatment of these injuries and prospective studies are needed with wide patient series. © 2014, Anatol J Clin Investig. All rights received.
  • Küçük Resim
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    Safety and feasibility of lumbar spine for intralaminar screw fixation : a computed tomography-based morphometric study
    (2015) Kömürcü, Erkam; Kaymaz, Burak; Adam, Gürhan; Gölge, Umut Hatay; Göksel, Ferdi; Özden, Raif
    Objective: The use of intralaminar screws (ILS) in spinal surgery has experienced a recent increase in popularity. The aim of this study is to define the morphological parameters of the lumbar laminas so that guidance may be defined for ILS placement.Methods: The study involved the evaluation of lumbar computed tomography (CT) images of patients. Two hundred thirty-five patients (127 male, 108 female) were included in the study. The mean patient age was 44.2 years (19-78 years). The measured parameters of the lamina were the transverse inner diameter, transverse outer diameter (lamina width), lamina length, subdural space (safe zone), and spinolaminar angle for each lumbar level (L1-L5).Results: The mean transverse outer diameter (L1-L5) ranged from 7.2-7.8 mm, and mean transverse inner diameter ranged from 2.5-3.0 mm. The lamina of L3 had the largest width and the lamina of L1 and L5 the smallest. The mean lamina length was 26.6 mm, ranging from 21.0-34.0 mm, and the mean spinolaminar angle was 124.7°, ranging from 111-135°. The L1 level had the shortest mean lamina length and L4 the lowest spinolaminar angle. Mean subdural space (safe zone), which was narrowest at the L5 level, was 2.4 mm, ranging from 1.3-3.6 mm.Conclusion: ILS of the appropriate size (3.5-4.5 mm) and length (20 and 25 mm) can be used safely in the lumbar spine. However, further biomechanical studies should be performed to measure strength of the fixation