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Öğe Ayak parmağında tendon kılıfı dev hücreli tümörü : Üç olgu sunumu(2008) Kalaycı, Aydıner; Özkan, Cenk; Sevinç, Teoman Toni; Yanat, Ahmet NedimTendon kılıfı sinovyal hücrelerinden köken alan iyi huylu yumuşak doku tümörüdür. Ayak parmaklarında görülmesi nadirdir. Bu yazıda ayak parmakları tendon kılıfından köken alan dev hücreli tümör nedeniyle tedavi edilen üç olgu sunuldu. Olguların ikisi kadın (yaş 25 ve 50), biri erkekti (yaş 21). Üç hastada da ayak parmaklarında hafif ağrılı yumuşak doku kitlesi vardı. Manyetik rezonans görüntüleme ayırıcı tanıda yardımcı olmadı. Tanı tümüyle çıkarılan kitlelerin histopatolojik değerlendirilmesiyle kondu. Ortalama 18 aylık takipte hiçbir olguda lokal nüks görülmedi.Öğe Does strand configuration and number of purchase points affect the biomechanical behavior of a tendon repair? A biomechanical evaluation using different Kessler methods of flexor tendon repair(2008) Dogramaci, Yunus; Kalacı, Aydıner; Sevinç, Teoman Toni; Esen, Erdinc; Komurcu, Mahmut; Yanat, Ahmet NedimThis study compares the mechanical properties of modified Kessler and double-modified Kessler flexor tendon repair techniques and evaluates simple modifications on both methods. Forty fresh sheep flexor tendons were divided equally into four groups. A transverse sharp cut was done in the middle of each tendon and then repaired with modified Kessler technique, modified Kessler with additional purchase point in the midpoint of each longitudinal strand, double-modified Kessler technique, or a combination of outer Kessler and inner cruciate configuration based on double-modified Kessler technique. The tendons were tested in a tensile testing machine to assess the mechanical performance of the repairs. Outcome measures included gap formation and ultimate forces. The gap strengths of the double-modified Kessler technique (30.85 N, SD 1.90) and double-modified Kessler technique with inner cruciate configuration (33.60 N, SD 4.64) were statistically significantly greater than that of the two-strand modified Kessler (22.56 N, SD 3.44) and modified Kessler with additional purchase configuration (21.75 N, SD 4.03; Tukey honestly significant difference test, P < 0.000). There were statistically significant differences in failure strengths of the all groups (analysis of variance, P < 0.000). With an identical number of strands, the gap formation and ultimate forces of the repairs were not changed by additional locking purchase point in modified Kessler repair or changing the inner strand configuration in double-modified Kessler repair. The results of this study show that the number of strands across the repair site together with the number of locking loops clearly affects the strength of the repair; meanwhile, the longitudinal strand orientation and number of purchase points in a single loop did not affect its strength. © American Association for Hand Surgery 2008.Öğe Giant-cell tumor of the tendon sheath in the toe: A report of three cases(2008) Kalacı, Aydıner; Özkan, Cenk; Sevinç, Teoman Toni; Yanat, Ahmet NedimGiant-cell tumor of the tendon sheath is a benign, soft-tissue tumor usually arising from synovial cells of the tendon sheaths in the hand. Involvement of the toes is quite rare. We presented three patients including two women with ages 25 and 50 years, and one man aged 21 years, who underwent surgery for mass lesions originating from tendon sheaths of the toe. All the patients presented with a slightly painful soft tissue mass in the toe. Magnetic resonance imaging was not helpful in the differential diagnosis. Diagnosis of the tumors was made by histopathologic evaluation of completely excised lesions. No local recurrences were encountered during a mean follow-up of 18 months.Öğe Single side locking on the opposite of the modified Kessler tendon repair prevents gap formation and suture pull-out: A biomechanical evaluation in sheep tendons(2009) Doğramacı, Yunus; Kalacı, Aydıner; Sevinç, Teoman Toni; Süner, Ganim; Emir, Anıl; Yanat, Ahmet NedimObjectives: Locking loops are invented to prevent pull-out complication during early active rehabilitation after flexor tendon repair. This study compares the mechanical properties of the side-locking modified Kessler repairs with four- and two- side locking points. Materials and methods: Twenty fresh flexor digitorum profundus tendons of the healthy adult sheep forelimbs were sutured by the two-strand modified Kessler with the side-locking loop technique (group A: four locking points), and by the two-strand modified Kessler repair method with a side locking knot on the opposite corners of the repair (group B: two locking points). To assess the mechanical performance of the repairs, the tendons were subjected to a linear non-cyclic load-to-failure test using a material testing machine. Outcome measures included the 2.0 mm gap force at the tendon ends, the ultimate forces and the mode of failure. Results: The mean value for the 2.0 mm gap strength was 19.2±1.4 for group A and 19.3±1.9 for group B. The mean value of the failure strength was 33.1±2.6 for group A and 29.8±3.2 for group B. Regarding the 2.0 mm gap strength between the tendon ends, no significant difference was observed between the two groups. There were statistically significant differences in failure strengths of the two groups (p=0.019). As regards the mode of failure, no suture pull-out was observed. All the specimens failed due to suture breakage at the repair site. Conclusion: Results of this study revealed that gap formation and suture pull-out can be prevented using single side locking points on the opposite corners of the modified Kessler repair.Öğe Unusual origin of the motor branch of the ulnar nerve to the flexor carpi ulnaris(2009) Kalacı, Aydıner; Do?ramaci, Yunus; Sevinç, Teoman Toni; Yanat, Ahmet Nedim[No abstract available]
