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Öğe An aggressive aneurysmal bone cyst of the proximal humerus and related complications in a pediatric patient(2012) Güven, Melih; Demirel, Murat; Özler, Turhan; Başsorgun, İbrahim Cumhur; İpek, Serdar; Kara, SadullahClinical behavior of aneurysmal bone cyst (ABC) in younger patients can be more aggressive than that in older children and adults. Angular deformity and shortening can occur due to growth plate destruction or tumor resection. A 11-year-old boy who had been operated twice in another center for an ABC located in the left proximal humerus presented to the author's institution with complaints of pain, deformity and shortening of the left arm. Plain radiographs revealed left proximal humerus nonunion with a large defect. Reconstruction with nonvascularized fibular autograft was applied and left upper extremity was immobilized in a velpou bandage. At the third-month follow-up, graft incorporation was observed in the distal part; however, proximal part did not show adequate healing on radiographs. Additional immobilization in a sling for 3 months was advised to the patient and his family. However, they were lost to follow-up and readmitted to the author's institution at the 12th month postoperatively. Radiographs showed failure of the fibular graft fixation and nonunion of the humerus. Autogenic bone grafts, either vascularized or nonvascularized are the best treatment method for the large defects after tumor curettage or resection. Nonvascularized grafts are technically much easier to use than vascularized grafts and provide excellent structural bone support at the recipient side. However, they may take several months to be fully incorporated. In addition, good therapeutic outcomes require patience and collaboration with the patient and parents. Most importantly, the patient should be monitored closely.Öğe Allogeneic blood transfusion decreases with postoperative autotransfusion in hip and knee arthroplasty(Turkish Assoc Orthopaedics Traumatology, 2010) Atay, Evren Fehmi; Güven, Melih; Altıntaş, Faik; Kadıoğlu, Barış; Ceviz, Emrah; İpek, SerdarObjectives: We aimed to evaluate the effectiveness of postoperative autotransfusion method on prevention of the need of allogeneic blood transfusion in hip and knee arthroplasty. Methods: Seventy-four patients who underwent 77 hip and knee arthroplasty operations were randomized into control and study groups, and evaluated prospectively. In the knee group (39 patients; 30 females, 9 males; mean age 66.6 years), cemented, cruciate retaining, and bicompartmental arthroplasty was performed under tourniquet control; whereas in the hip group (35 patients; 24 females, 11 males; mean age 59.3 years) cementless arthroplasty with posterolateral approach was performed. None of the patients received preoperative and intraoperative allogeneic blood transfusion. The collected blood in the surgical area was transfused with autotransfusion system to the patients in the study groups at the end of the fourth hour postoperatively. The mean amounts of autotransfused blood in hip and knee groups were 413 mL and 480 mL, respectively. Allogeneic blood transfusion was applied to the patients with hemoglobin level below 8 g/dL, hematocrit level below 25%, and clinical symptoms of anemia. Results: Preoperative and postoperative hemoglobin-hematocrit levels did not differ significantly between study and control groups. Allogeneic blood transfusion was applied to one patient (5%) in study and 8 patients (38%) in control groups during knee arthroplasty (p=0.01); whereas 9 patients (53%) in study and 15 patients (79%) in control groups received allogeneic blood transfusion during hip arthroplasty (p=0.044). The amount of allogeneic blood transfusion in study groups was significantly lower than that in control groups (p=0.008 for knee arthroplasty, p=0.048 for hip arthroplasty). Conclusion: The need and amount of allogeneic transfusion were reduced with postoperative autotransfusion in both knee and hip arthroplasty groups with greater extent in knee arthroplasty.Öğe Can bone quality be predicted accurately by Singh Index in patients with rheumatoid arthritis?(Springer London Ltd, 2012) Bes, Cemal; Güven, Melih; Akman, Budak; Atay, Evren Fehmi; Ceviz, Emrah; Soy, MehmetThe aim of this study was to evaluate Singh index as a simple and inexpensive means of estimation of bone quality in patients with rheumatoid arthritis. Singh index evaluation was made on digital pelvis radiographs in 50 consecutive patients by three observers. Bone mineral density T scores of the spine and left proximal femur were assessed using dual energy X-ray absorptiometry. Singh index was correlated with densitometry measurements after grouping the patients as normal, osteopenia and osteoporosis. Intra-and interobserver agreements were evaluated by kappa correlations. Sensitivity, specificity, positive and negative predictive values and likelihood ratio's of Singh index were calculated. Both intra-and interobserver agreements were 0.71 (range, 0.69 to 0.72) on average. Singh index proved highly sensitive for the diagnosis of osteopenia at the proximal femur (91%) and spine (90%), whereas the specificity of Singh index for identifying of osteoporosis at the femoral neck (93%) and spine (91%) was higher than sensitivity. Predictive values for osteoporosis at the proximal femur and spine were acceptable and positive likelihood ratios of Singh index for osteopenia and osteoporosis at the proximal femur were 2.4 and 10.1, respectively. Singh index can identify osteoporosis with a high specificity in patients with rheumatoid arthritis. However, the patients who are graded as osteopenia by the Singh index should undergo further evaluation with dual energy X-ray absorptiometry.Öğe A case of piezogenic pedal papules associated with mitral valve insufficiency(Turkish Soc Dermatology Venerology, 2012) Polat, Mualla; Kaya, Hatice; Güven, Melih; Gürel, Kamil; Parlak, Ali HaydarPiezogenic pedal papules are hemiations of subcutaneous fat into the dermis. They are soft skin-colored papules and nodules, which appear on the side of the heel when the subject is standing and disappear when weight is taken off the foot Here, we present a 40-year-old male patient with mitral valve insufficiency and piezogenic pedal papules and discuss piezogenic pedal papules in the light of literature.Öğe Çocuklardaki Monteggia eşdeğer lezyonlarında tedavi sonuçları(2008) Güven, Melih; Eren, Abdullah; Kadıoğlu, Barış; Yavuz, Umut; Kılınçoğlu, Volkan; Özkan, KorhanAmaç: Monteggia eşdeğer lezyonlu çocuklarda konservatif ve cerrahi tedavi sonuçları değerlendirildi. Çalışma planı: Çalışmaya, Monteggia eşdeğer kırıklıçıkığı nedeniyle tedavi edilen 13 çocuk hasta (3 kız, 10 erkek; ort. yaş 8; dağılım 4-13) alındı. Yedi hastada (%53.9) Bado tip 1, altı hastada (%46.2) ise tip 3 eşdeğer lezyon vardı. Tip 3 eşdeğer lezyonlu hastaların ikisinde aynı zamanda humerus lateral kondil kırığı saptandı. Bir hastada (%7.7) radial sinir felci vardı. Açık kırıklı-çıkık nedeniyle acil debridman ve irigasyon uygulanan bir hasta dışında, tüm hastalarda öncelikle kapalı redüksiyon denendi. Sekiz hastada (%61.5) konservatif tedaviyle yeterli redüksiyon sağlandı. Dört hastada (%30.8) redüksiyon sağlanamaması nedeniyle, yaralanmadan sonra ilk 24 saat içinde cerrahi girişim uygulandı. Fonksiyonel değerlendirme Reckling evrelemesine göre yapıldı. Ortalama takip süresi 4.1 yıl (dağılım 2-7 yıl) idi. Sonuçlar: Hiçbir olguda kaynamama gözlenmedi. Konservatif tedavi gören hastaların hiçbirinde radius başında redüksiyon kaybıyla karşılaşılmadı ve dirsek hareketlerinde kısıtlılık gözlenmedi. Bir hastada (%7.7) dirsekte 5° kubitus varus deformitesi, radyografik olarak ise ulnada kırık hattında 20° posteriora açılanma saptandı. Konservatif tedavi gören hastaların hepsinde fonksiyonel sonuçlar iyi idi. Cerrahi tedavi uygulanan dört hastada fonksiyonel sonuçlar iyi iken, açık kırıklı-çıkığı olan olguda kötü sonuç alındı. Bir hastada 10° supinasyon kısıtlılığı vardı. Dirsek eklemi hareket genişliğinde fleksiyon ve ekstansiyon kısıtlılığı yoktu. Başvuru anında radial sinir felci olan bu hastada sinir lezyonu ameliyat sonrası üçüncü ayda düzeldi. Çıkarımlar: Çocuklardaki Monteggia eşdeğer lezyonlarda öncelikli tedavi kapalı redüksiyondur. Redüksiyon sağlanamaması durumunda cerrahi tedavi gündeme gelir.Öğe Comparison of the magnetic resonance imaging and knee arthroscopy findings of the menisci and ligamentous injuries(Duzce University Medical School, 2012) Özturan, Kutay Engin; Yücel, Istemi; Çakici, Hüsamettin; Güven, Melih; Gürel, KamilPurpose: Magnetic resonance imaging is frequently used in the diagnosis of the meniscal and ligamentous injuries. The aim of this study is to compare the results of the knee arthroscopy and magnetic resonance imaging findings retrospectively. Methods: Of the sixty-two patients 37 (59.7%) were male and 25 (40.3%) were female. The average age was 36.8 years (range 18-69 years). Patients who had been clinically diagnosed with meniscal and/or ligamentous injuries and subsequently undergone further magnetic resonance imaging examination were included to the study. The left knee was involved in 35 (56.5%) and the right knee in 27 (43.5%) cases. Patients had gone to knee arthroscopy according to clinical examination and magnetic resonance imaging findings, and the results were evaluated. Results: 35 (56.4%) of the 62 patients had isolated medial meniscal tear, 11 (17.7%) isolated lateral meniscal tear and 5 (8%) had isolated complete anterior cruciate ligament injury. 2 (3.2%) had medial meniscal tear and anterior cruciate ligament complete injury, 2 (3.2%) had lateral meniscal tear and complete anterior cruciate ligament injury and 5 (8%) had medial and lateral meniscal tear. 2 (3.2%) had medial meniscal tear, anterior and posterior cruciate ligament complete injuries. Magnetic resonance imaging evaluation of the medial meniscus, lateral meniscus, anterior cruciate ligament and posterior cruciate ligament revealed sensitivity 95.5%, 72.2%, 90.9%, 100%, specificity 76.4%, 93.1%, 88.2%, 98.3%, positive predictive value 91.4%, 81.2%, 62.5%, 66.6%, negative predictive value 86.6%, 89.1%, 97.8%, 100%, and accuracy 90.3%, 87.0%, 88.7%, 98.3% respectively. Conclusion: Magnetic resonance imaging is a safe and appropriate evaluation in the diagnosis of the meniscal and ligament injuries of the knee. © 2012 Düzce Medical Journal.Öğe The effects of leukotriene receptor antagonist montelukast on histological, radiological and densitometric parameters of fracture healing(2011) Çakıcı, Hüsamettin; Hapa, Onur; Gideroğlu, Kaan; Özturan, Kutay; Güven, MelihAmaç: Bu çalışmada lökotrien reseptör antagonisti montelukastın kırık iyileşmesi üzerine olan etkileri incelendi ve sıçan tibia kırık modelinde montelukastla artmış kırık iyileşmesi görülebileceği hipotezi araştırıldı. Gereç ve yöntemler: Altmış erişkin (6 aylık) dişi Wistar albino cinsi sıçan (ortalama ağırlıkları 220 g, dağılım 210-270 g) rastgele şekilde iki gruba ayrıldı: montelukast grubu (n=30) ve kontrol grubu (n=30). Kapalı tibia kırığı oluşturuldu ve intramedüller Kirschner teliyle fikse edildi. Kırıktan üç ve altı hafta sonra sıçanlar sakrifiye edildi. Radyolojik ve histolojik değerlendirmeler yapıldı ve kemik mineral yoğunlukları ölçüldü. Bulgular: Çalışma sırasında montelukast grubunda üç, kontrol grubunda ise yalnızca bir sıçan öldü. Gruplar arasında hayvanların başlangıç, 3. hafta ve 6. haftadaki ağırlıkları açısından istatistiksel bir fark bulunmadı (p>0.05). Kemik mineral yoğunluğu kontrol ve çalışma grubunda sırasıyla 3. haftada 0.13±0.009 g/cm2 ve 0.13±0.01 g/cm2, 6. haftada ise 0.16±0.02 g/cm2 v e 0 .13±0.01 g /cm2 olarak bulundu. Histopatolojik skor kontrol ve çalışma gruplarında sırasıyla 3. haftada 3.42±0.6 ve 3.0±0.0, 6. haftada ise 3.5±0.5 ve 3.4±0.8 olarak bulundu. Radyolojik skor kontrol ve çalışma gruplarında sırasıyla 3. haftada 1.19±0.6 ve 1.0±0.6, 6. haftada ise 3.0±0.8 ve 2.9±0.9 olarak bulundu. Değerlendirilen hiçbir parametre açısından her iki zaman aralığında iki grup arasında anlamlı fark saptanmadı (p>0.05). Sonuç: Bizim çalışmamızda lökotrien reseptör antagonistinin 3. ve 6. haftalarda kırık iyileşmesine olumlu etkisi olmadığı görüldü.Öğe Efficacy of moxifloxacin compared to teicoplanin in the treatment of implant-related chronic osteomyelitis in rats(Wiley, 2010) Özturan, Kutay Engin; Yücel, İstemi; Koçoğlu, Esra; Çakıcı, Hüsamettin; Güven, MelihTreatment of implant-related chronic osteomyelitis is often difficult and usually consists of implant removal, extensive surgical debridement, and prolonged antibiotic use This study was performed to assess the efficacy of moxifloxacin compared to a glycopeptide, teicoplanin in chronic implant-related methicillin-sensitive Staphylococcus aureus (MSSA) osteomyelitis The left femoral medullar cavities of 60 Wistar male rats were contaminated with 100 mu l of 10(8) cfu/ml methicillin-sensitive S aureus (ATCC 29213) and Kirschner wires were placed into the medulla of the femur Alter 6 weeks, rats were randomly divided into five groups In two groups, the Kirschner wires were removed Experimental groups were as follows group 1 contaminated, Kirschner wire inside, received teicoplamn, group 2 contaminated, Kirschner wire removed, received teicoplanin, group 3 contaminated, Kirschner wire inside, received moxifloxacm; group 4 contaminated, Kirschner wire removed, received moxifloxacm, group 5 contaminated, Kirschner wire inside, no antibiotics (control group) Groups 1 and 2 received teicoplanin (20 mg/kg once daily), whereas groups 3 and 4 received moxifloxacin (10 mg/kg twice daily) intraperitoneally for 28 days At the end of the treatment, animals were sacrificed by inhalation anesthesia with ether and femora were retrieved and bacterial counts (cfu/g) were determined Bacterial counts in all study groups were significantly reduced relative to the control The decrease of bacterial counts was more prominent in group 4 compared to group 1 (p = 0 001) and group 2 = 0 003) Moxifloxacin therapy is an effective alternative to teicoplamn for chronic implant-related MSSA osteomyelitis (C) 2010 Orthopaedic Research Society Published by Wiley Periodicals, Inc J Orthop Res 28 1368-1372, 2010Öğe "Floating arm" injury in a child with fractures of the proximal and distal parts of the humerus: A case report(2009) Güven, Melih; Akman, Budak; Kormaz, Tanzer; Poyanlı, Oğuz; Altıntaş, FaikIntroduction. Simultaneous supracondylar humerus fracture and ipsilateral fracture of the proximal humerus in children is rare. Case presentation. A 10-year-old Turkish boy with an extension type supracondylar humerus fracture and ipsilateral fracture at the proximal metaphyseal-diaphyseal junction of the humerus was treated by closed reduction and percutaneous Kirschner wire fixation. Closed reduction was performed using a Kirschner wire as a "joystick" to manipulate the humeral shaft after some swelling occurred around the elbow and shoulder. Conclusion. The combination of fractures at the proximal and distal parts of the humerus can be termed as "floating arm" injury. Initial treatment of this unusual injury should be focused on the supracondylar humerus fracture. However, closed reduction can be difficult to perform with the swelling around the elbow and shoulder. A temporary Kirschner wire can be used as a "joystick" to fix and reduce the fracture. © 2009 Güven et al.; licensee Cases Network Ltd.Öğe Hip osteonecrosis in Cushing's disease treated with bone-preserving procedures(Springer Tokyo, 2009) Güven, Melih; Ünay, Koray; Beş, Cemal; Poyanlı, Oğuz; Akman, BudakÖğe Importance of screw position in intertrochanteric femoral fractures treated by dynamic hip screw(Elsevier Masson, Corporation Office, 2010) Güven, Melih; Yavuz, Umut; Kadıoğlu, Barış; Akman, Budak; Kılınçoğlu, VolkanBackground: Tip-apex distance greater than 25 mm is accepted as a strong predictor of screw cut-out in patients with intertrochanteric femoral fracture treated by dynamic hip screw. The aim of this retrospective study was to evaluate the position of the screw in the femoral head and its effect on cut-out failure especially in patients with inconvenient tip-apex distance. Patients and methods: Sixty-five patients (42 males, 23 females; mean age of 57.6 years) operated by dynamic hip screw for intertrochanteric femoral fractures were divided in two groups taking into consideration the tip-apex distance less (Group A; 14 patients) or more (Group B; 51 patients) than 25 mm. Patient's age and gender, follow-up period, fracture type, degree of osteoporosis, reduction quality of the fracture, position of the screw in the femoral head, number of patients with cut-out failure and Harris hip score were compared. Results: The average follow-up time was 41.7 months. The mean tip-apex distance was 17.14 mm in Group A and 36.67 mm in Group B. One (7.1%) patient in Group A and three (5.8%) patients in Group B had screw cut-out. Except the screw position, no statistical differences were observed between two groups with regards to study data's. The screw was placed in femoral head more inferiorly (p = 0.045) on frontal and more posteriorly (p = 0.013) on sagital planes in Group B, while central placement of the screw was present in Group A. The common characteristic of three patients with screw cut-out in Group B was the position of the screw which was located in femoral head more superiorly and anteriorly after an acceptable fracture reduction. Conclusions: Peripheral placement of the screw in femoral head increases tip-apex distance. However, posterior and inferior locations may help to support posteromedial cortex and calcar femoral in unstable intertrochanteric fractures and reduce the risk of cut-out failure. Level of evidence: Level IV, retrospective series. (C) 2009 Elsevier Masson SAS. All rights reserved.Öğe Kalça ve diz artroplastisinde ameliyat sonrası ototransfüzyon allojenik kan transfüzyonunu azaltır(2010) Atay, Evren Fehmi; Güven, Melih; Altıntaş, Faik; Kadıoğlu, Barış; Ceviz, Emrah; İpek, SerdarAmaç: Bu çal›flmada kalça ve diz artroplastisinde ameliyat sonras› uygulanan ototransfüzyon yönteminin allojenik kan transfüzyonu ihtiyac›n› önlemedeki etkinli¤inin de¤erlendirilmesi amaçlanm›flt›r. Çal›flma plan›: Total kalça ve diz artroplastisi uygulanm›fl 74 hasta (77 artroplasti giriflimi) ça- l›flma ve kontrol gruplar›na randomize edilerek prospektif olarak de¤erlendirildi. Diz grubunda (39 hasta; 30 kad›n, 9 erkek; ortalama yafl 66.6) standart yaklafl›mla turnike kontrolünde çimen- tolu, kalça grubundaysa (35 hasta; 24 kad›n, 11 erkek; ortalama yafl 59.3) posterolateral yakla- fl›mla çimentosuz artroplasti uyguland›. Hiçbir hastaya ameliyat öncesinde ve s›ras›nda allojenik kan transfüzyonu yap›lmad›. Çal›flma gruplar›ndaki hastalarda ameliyat sonras› 4. saatte cerrahi sahada biriken kan ototransfüzyon seti ile transfüze edildi. Kalça ve diz çal›flma gruplar›nda or- talama ototransfüzyon miktarlar› s›ras›yla 413 mL ve 480 mL idi. Banka kan› transfüzyonu; he- moglobin 8 gr/dL’nin, hematokrit ise %25’in alt›nda oldu¤u ve klinik olarak anemi bulgular›n›n efllik etti¤i hastalarda uyguland›. Sonuçlar: Çal›flma ve kontrol gruplar› aras›nda ameliyat öncesi ve sonras› hemoglobin-hematok- rit de¤erlerinde istatistiksel anlaml› fark yoktu. Diz hastalar›nda çal›flma grubunda 1 (%5), kon- trol grubunda 8 (%38) (p=0.01); kalça hastalar›nda ise çal›flma grubunda 9 (%53), kontrol gru- bunda 15 (%79) hastada (p=0.044) banka kan› transfüzyonu yap›ld›. Çal›flma gruplar›nda alloje- nik transfüzyon miktar› kontrol gruplar›na göre anlaml› olarak düflüktü (diz grubu p=0.008, kal- ça grubu p=0.048). Ç›kar›mlar: Diz ve kalça artroplastisinde ototransfüzyon yöntemiyle diz artroplastisinde daha belirgin olmak üzere allojenik kan transfüzyonu ihtiyac› ve transfüzyon miktar› azalmaktad›r.Öğe Menisküs ve bağ yaralanmalarının Manyetik Rezonans Görüntüleme ve Artroskopik Cerrahi bulgularının karşılaştırılması(2012) Özturan, Kutay Engin; Yücel, İstemi; Çakıcı, Hüsamettin; Güven, Melih; Gürel, KamilAmaç: Manyetik rezonans görüntüleme dizde menisküs ve bağ yaralanmalarının tanısında sıklıkla kullanılmaktadır. Bu çalışmadaki amacımız dizdeki bu tip patolojilerin artroskopi sonuçları ile manyetik rezonans görüntüleme verilerinin retrospektif olarak karşılaştırılmasıdır. Yöntem: Travma sonrası klinik olarak menisküs ve/veya bağ yaralanması düşünülen ve manyetik rezonans görüntüleme tetkiki yapılmış 62 hasta çalışmaya dahil edildi. Hastaların ortalama yaşı 36.8 (dağılım 18–69 yaş) idi. Hastaların 37’si (%59.7) erkek iken 25’si (%40.3) kadın idi. 35 (%56.5) sol, 27 (%43.5) sağ dizde yaralanma mevcuttu. Klinik değerlendirmede ve manyetik rezonans görüntülemede patoloji düşünülüp diz artroskopisi yapılmış hastaların manyetik rezonans görüntüleme ve artroskopi sonuçları değerlendirildi. Bulgular: Artroskopi sonuçlarına göre 35 (%56.4) hastada izole medial menisküs yırtığı, 11 (%17.7) hastada izole lateral menisküs yırtığı, 5 (%8) hastada izole ön çapraz bağ yaralanması, 2 (%3.2) hastada medial menisküs yırtığı ve ön çapraz bağ yaralanması, 2 (%3.2) hastada lateral menisküs yırtığı ve ön çapraz bağ yaralanması, 5 (%8) hastada medial menisküs ve lateral menisküs yırtığı, 2 (%3.2) hastada medial menisküs, ön çapraz bağ ve arka çapraz bağ yırtığı tespit edildi. Yapılan değerlendirmede manyetik rezonans görüntülemede medial menisküs için sensitivite %95,5, spesifite %76,4, pozitif prediktif değeri (PPD) %91.4, negatif prediktif değeri (NPD) %86.6, doğruluk oranı %90,3; lateral menisküs için sensitivite %72.2, spesifite %93.1, PPD %81.2, NPD %89,1, doğruluk oranı %87; ön çapraz bağ için sensitivite %90.9, spesifite %88.2, PPD %62.5, NPD %97.8, doğruluk oranı %88.7; arka çapraz bağ için sensitivite %100, spesifite %98.3, PPD %66.6, NPD %100, doğruluk oranı %98.3 olarak tespit edilmiştir. Sonuç: Manyetik rezonans görüntüleme dizde menisküs ve bağ yaralanmalarının tanısında güvenle kullanılabilecek bir tetkikdir.Öğe Mitral kapak yetmezliği ile birliktelik gösteren piezojenik pedal papül olgusu(2012) Polat, Mualla; Kaya, Hatice; Güven, Melih; Gürel, Kamil; Parlak, Ali HaydarPiezojenik pedal papüller subkütan yağ dokusunun dermise herniasyonudur. Şeffaf, deri renginde papül ve nodüller olup, topukta kişi ayağa kalktığında ortaya çıkarlar, ağırlık ortadan kalkınca da kaybolurlar. Burada mitral kapak yetmezliğinin eşlik ettiği 40 yaşında piezojenik pedal papül tanısı konan erkek sunulacak ve piezojenik pedal papül literatür ışığında tartışılacaktırÖğe A new radiographic measurement method for evaluation of tibial torsion: a pilot study in adults(Lippincott Williams & Wilkins, 2009) Güven, Melih; Akman, Budak; Ünay, Koray; Özturan, Engin Kutay; Çakıcı, Hüsamettin; Eren, AbdullahComputed tomography (CT) frequently is used to determine torsional abnormalities. However, its use in clinical practice may be limited. We present a new method for measuring tibial torsion using conventional radiographs. We compared the method with several clinical methods and with CT measurement in 44 lower extremities of 25 subjects. The radiographic method agreed well with all of the clinical methods, and this agreement was better than agreement between CT and clinical examination. The best agreement was between thigh-foot angle and the radiographic method. The proposed radiographic measurement is a practical method for evaluation of tibial torsion in outpatient clinics without the need for specialized equipment. Level of Evidence: Level II, diagnostic study. See the Guidelines for Authors for a complete description of levels of evidence.Öğe A new screw fixation technique for minimally invasive percutaneous plate osteosynthesis(Acta Medica Belgica, 2008) Güven, Melih; Ünay, Koray; Çakıcı, Hüsamettin; Özturan, Engin Kutay; Özkan, Namık KemalMinimally invasive percutaneous plate osteosynthesis (MIPPO) has well-documented biological advantages and appears to be a reasonable treatment option for complex femoral and tibial fractures. However additional radiation exposure during reduction of the fracture, application of the plate to the bone and screw fixation is one of the disadvantages of this technique. We describe a technical trick for screw fixation in MIPPO with locking compression plates which decreases the duration of fluoroscopy use during the operation.Öğe No evidence of infection after retrograde nailing of supracondylar femur fracture in gunshot wounds(Lippincott Williams & Wilkins, 2010) Poyanlı, Oğuz; Ünay, Koray; Akan, Kaya; Güven, Melih; Özkan, KorhanBackground: The aim of the study was to determine whether osteomyelitis of the femur or septic arthritis of the knee develops after retrograde intramedullary nailing of the femur performed within 7 days of supracondylar femur fracture, secondary to gunshot wounds, without skin defects. Methods: Fifteen patients with a mean age of 27.8 years (range, 18-52 years), with supracondylar fractures of the femur due to gunshot wounds and without skin defects. Retrograde intramedullary nails were inserted through the intercondylar notch of the femur. We evaluated whether osteomyelitis of the femur or ipsilateral septic arthritis of the knee joint developed postoperatively. Results: None of the patients who were followed up for a mean period of 11.7 months (range, 9-16 months) showed evidence of ipsilateral septic arthritis of the knee or osteomyelitis of the femur. Conclusion: Retrograde intramedullary nailing of the femur can be performed in patients with supracondylar fractures of the femur due to gunshot wounds, and without skin defects, in the first 7 days after the trauma. Neither osteomyelitis of the femur nor septic arthritis of the knee develops in these patients. Key Words: Osteomyelitis, Septic arthritis, Gunshot, Nailing, Femur, Retrograde.Öğe Patellar tendinopathy caused by a para-articular/extraskeletal osteochondroma in the lateral infrapatellar region of the knee: A case report(2009) Özturan, Kutay Engin; Yücel, İstemi; Çakıcı, Hüsamettin; Güven, Melih; Gürel, Kamil; Dervişoğlu, SergülenPatellar tendinopathy is characterized by activity-related anterior knee pain. It is most commonly related to sports activity, but has also been reported in the non-athletic population. Most injuries are caused by microtrauma, resulting in tendinitis or tendinosis. Extraskeletal paraarticular osteochondromas, which occur in the soft tissues near the joint, are rare. The infrapatellar fat pad and joint capsule are the most common sites of these tumors. Here, a case of patellar tendinitis caused by an extraskeletal paraarticular osteochondroma is reported. The symptoms included intensifying pain upon flexion and a palpable click that was located at the medial side of the mass. The patient was pain-free within 3 weeks after excision of the tumor and the clicking disappeared. To our best knowledge, no other case of patellar tendinitis caused by an extraskeletal paraarticular osteochondroma has been reported in the English literature. © 2009 Ozturan et al; licensee BioMed Central Ltd.Öğe The relationship between bone marrow edema size and knee pain(Springer, 2009) Ünay, Koray; Poyanlı, Oğuz; Akan, Kaya; Güven, Melih; Demirçay, CanThe purpose of our study was to determine the changes in the size of the edema observed on MRI scans and its relation to the activity pain of the patient and the rest pain in bone marrow edema (BME). A total of 51 patients were followed up at 3-month intervals for a period of 1 year. During the follow-ups, MRI scans of the patients' knees were obtained; the scores obtained on the Stanmore functional rating scale and visual analog scale were determined. The changes in these parameters and the correlation between them were examined. The following are the observations recorded during the bone marrow edema follow-ups: the size of the edema as observed on MRI scans decreased, and the activity pain and the rest pain decreased. While there is a correlation between the decrease in the edema size observed on MRI scans and decrease in the activity pain, there is no correlation between the decrease in the edema size observed on MRI scans and the decrease in rest pain. No changes were observed after a particular period of time with regard to decrease in the edema size observed on MRI scans, decrease in activity pain, and decrease in rest pain in follow-ups of BME patients.Öğe Steroid-induced bicondylar osteonecrosis of both femurs in a patient with Behcet's disease(Clinical & Exper Rheumatology, 2010) Polat, Mualla; Beş, Cemal; Güven, Melih; Çakar, Murat; Soy, Mehmet[No Abstract Available]
