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    The Biocompatibility of Nitinol in Knee Joint Spaces and Femoral Tunnels: An Experimental Study in Rats
    (Journal Hard Tissue Biology, 2014) Kalacı, Aydıner; Uruc, Vedat; Ozden, Raif; Duman, Ibrahim Gokhan; Dogramaci, Yunus; Karapinar, Serhat; Yaldiz, Mehmet
    Currently the most common method of reconstructing a ruptured anterior cruciate ligament (ACL) is by using bone-patellar tendon-bone (BPTB) or semitendinosus, gracilis tendon autografts. Although good results are reported, donor morbidity continues to be a problem. To overcome these complications, synthetic grafts have been investigated. However, to date no prosthetic graft has been developed as an alternative to patellar or hamstring tendon autografts. The aim of the present study was to assess the biocompatibility of nitinol in rat knee joint spaces and distal femoral bones. Ten male, healthy Wistar albino rats, weighing between 300-350 g, were used. The right knee joint of each rat was reached by medial longitudinal parapatellar dissection. The femur distal was penetrated by a size 0.5 mm of Kirshner wires. Twenty nitinol wires were placed in the bone tunnel (0.125 mm in diameter and 5 mm long). In addition one nitinol wire was placed in the joint space. Following hemostasis, the layers were closed with interrupted sutures. The same procedure was repeated for the left side without placing any nitinol wire. The rats were allowed unrestricted weight bearing. Two animals died of unknown reasons during follow-up. The remaining rats were sacrificed 8 weeks after surgery. The knees were removed by careful dissection and the nitinol wires were removed. The sections taken from these specimens were stained with Standard hematoxylin and eosin and with Mason trichrome and examined under the light microscope. The bone tunnels were filled with osteocytes and chondrocytes. In two specimens of the nitinol group, moderate synovitis was detected. The synovitis rate in the study group was found to be statistically insignificant. In conclusion, the short term biocompatibility of nitinol in the rat knee joint space and femoral tunnel was found to be within acceptable limits.
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    Major musculoskeletal injuries and applied treatments in the current conflicts in Syria
    (Acta Medica Mediterranea, 2014) Uruc, Vedat; Ozden, Raif; Duman, Ibrahim Gökhan; Dogramaci, Yunus; Yengil, Erhan; Karapinar, Serhat; Karakus, Ali
    Aims: The aim of this study was to document the types of musculoskeletal injuries, mechanism of injuries and applied treatments during the Syrian civil war. Materials and methods: 579 (520 male, 59 female) Syrian civilian war victims who were treated in our clinic from December 16, 2011 till August 17, 2013. The mean age was 30 years (range: 1-90 years). Anatomic distribution and mechanism of injuries, and applied treatments were the main outcomes. Results: 449 subjects were wounded by gunshot, 44 by blast injuries and 86 by other causes. 668 open fractures and 98 closed fractures were treated. 514 grade 3a open fractures which were relatively clean and early-admitted were treated as immediate aggressive debridement and internal fixation. Early infection rate was 2.7% (n=14). Eight subjects had 10 grade 3b open fractures. Seventy patients presented with 99 grade 3c open fractures. Totally 84 external fixations were applied. 138 major amputations were done in 69 subjects. Wound infections were seen in 77 patients (13.2%). 29 of them were previously operated under non-sterile conditions in Syria. Debridement & irrigation (D&I) was the most commonly applied treatment. Conclusion: In conclusion gunshot was the main wounding agent in the recent Syrian conflicts, D&I was the most commonly applied treatment. In the treatment of relatively clear and early arrived grade 3a open fractures, internal fixation, after aggressive debridement and irrigation, resulted with low infection rates and it can be considered as a good choice of treatment. Prior interventions under non-sterile conditions were associated with 63% of resistant infections and extend the duration of hospital stay. Early evacuation and thorough debridement will result in lower infection rates.
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    MAJOR MUSCULOSKELETAL INJURIES AND APPLIED TREATMENTS IN THE CURRENT CONFLICTS IN SYRIA
    (Carbone Editore, 2014) Uruc, Vedat; Ozden, Raif; Duman, Ibrahim Gokhan; Dogramaci, Yunus; Yengil, Erhan; Karapinar, Serhat; Karakus, Ali
    Aims: The aim of this study was to document the types of musculoskeletal injuries, mechanism of injuries and applied treatments during the Syrian civil war. Materials and methods: 579 (520 male, 59 female) Syrian civilian war victims who were treated in our clinic from December 16,2011 till August 17,2013. The mean age was 30 years (range: 1-90 years). Anatomic distribution and mechanism of injuries, and applied treatments were the main outcomes. Results: 449 subjects were wounded by gunshot, 44 by blast injuries and 86 by other causes. 668 open fractures and 98 closed fractures were treated. 514 grade 3a open fractures which were relatively clean and early-admitted were treated as immediate aggressive debridement and internal fixation. Early infection rate was 2.7% (n=14). Eight subjects had 10 grade 3b open fractures. Seventy patients presented with 99 grade 3c open fractures. Totally 84 external fixations were applied. 138 major amputations were done in 69 subjects. Wound infections were seen in 77 patients (13.2%). 29 of them were previously operated under non-sterile conditions in Syria. Debridenzent & irrigation (D&I) was the most commonly applied treatment. Conclusion: In conclusion gunshot was the main wounding agent in the recent Syrian conflicts, D&I was the most commonly applied treatment. In the treatment of relatively clear and early arrived grade 3a open fractures, internal fixation, after aggressive debridement and irrigation, resulted with low infection rates and it can be considered as a good choice of treatment. Prior interventions under non-sterile conditions were associated with 63% of resistant infections and extend the duration of hospital stay. Early evacuation and thorough debridement will result in lower infection rates.