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Öğe Cohesive taping and short-leg casting in acute low-type ankle sprains in physically active patients(Amer Podiatric Med Assoc, 2015) Uslu, Mustafa; İnanmaz, Mustafa Erkan; Özşahin, Mustafa; Işık, Cengiz; Arıcan, MehmetBackground: Cohesive taping is commonly used for the prevention or treatment of ankle sprain injuries. Short-leg cast immobilization or splinting is another treatment option in such cases. To determine the clinical efficacy and antiedema effects of cohesive taping and short-leg cast immobilization in acute low-type ankle sprains of physically active patients, we performed a preliminary clinical study to assess objective evidence for edema and functional patient American Orthopaedic Foot and Ankle Society (AOFAS) scores with these alternative treatments. Methods: Fifty-nine physically active patients were included: 32 in the taping group and 27 in the short-leg cast group within a year. If a sprain was moderate (grade II) or mild (grade I), we used functional taping or short-leg cast immobilization for 10 days. We evaluated the edema and the functional scores of the injured ankle using the AOFAS Clinical Rating System on days 1, 10, and 100. Results: In each group, edema significantly decreased and AOFAS scores increased indicating that both treatment methods were effective. With the numbers available, no statistically significant difference could be detected. Conclusions: Each treatment method was effective in decreasing the edema and increasing the functional scores of the ankle. At the beginning of treatment, not only the level of edema but also the initial functional scores of the ankle and examinations are important in making decisions regarding the optimal treatment option. (J Am Podiatr Med Assoc 105(4): 307-312, 2015)Öğe The effects of diabetes on symptoms of carpal tunnel syndrome treated with mini-open surgery(Acta Medica Belgica, 2013) Işık, Cengiz; Uslu, Mustafa; İnanmaz, Mustafa Erkan; Karabekmez, Furkan Erol; Köse, Kamil ÇağrıThis study aimed to evaluate the influence of type H diabetes mellitus (DM) on the postoperative outcomes of mini-open carpal tunnel syndrome (CTS) surgery. A total of 99 hands in 74 patients were included in the study. Of these, 36 patients (54 hands) had type H DM (Group A), and 38 patients (45 hands) had idiopathic CTS (Group B). Mini-open carpal tunnel release surgery was performed on all the hands. The night pain, weakness, paraesthesia, numbness complaints were significantly improved in both groups after surgery. However, thenar atrophy was improved significantly only in group A. Night pain, weakness, paraesthesia, numbness, and pillar pain were significantly worse in Group A than in Group B on postoperative examination. Postoperatively, Tinnel and Phalen tests were positive in 32 hands in Group A and 6 hands in Group B. Persistence of symptoms in diabetic patients was found to be more prevalent compared to non-diabetic controls after mini-open carpal tunnel release.Öğe Erişkin radius distal uç kırıklarında konservatif tedavi sonuçlarının, karşı taraf el bileği ile karşılaştırılması: Radyolojik ve fonksiyonel değerlendirme(2014) Uslu, Mustafa; Arıcan, Mehmet; Işık, Cengiz; Sarman, Hakan; Boyraz, İsmailAmaç: Erişkin hastalarda kapalı redüksiyon ve uzun kol alçı ile tedavi edilen distal radius uç kırıklarının radyolojik ve fonksiyonel sonuçları karşı taraf el bileği ile karşılaştırılarak değerlendirildi.Yöntemler: Ocak 2010-Aralık 2010 tarihleri arasında 77 hastaya distal radius uç kırığı için konservatif tedavi uygulandı. Kırıklar prospektif olarak incelendi ve AO ile Frykman sınıflama sistemi kullanıldı. Radyolojik ve anatomik sonuçlar Stewart skorlama kriteri ile değerlendirildi. Fonksiyonel sonuçlar kol, omuz ve el sakatlık sorgulaması (Q-DASH) ve Stewart II skorlama kriterleri değerlendirildi. Hastaların ortalama takip süresi 12 aydı.Bulgular: 40 hastanın sağ el bileğinde, 37 hastanın sol el bileğinde kırık mevcuttu. Frykman sınıflamasına göre 46 olgu tip I-II kırık, AO sınıflamasına göre 59 olguda 23,A2,1 ve 23,A2,2 kırık tespit edildi. Stewart radyolojik ve anatomik skorlama kriterine göre 77 hastanın toplam 57'sinde mükemmel, 17'sinde iyi, 3'ünde orta sonuç elde edildi. Stewart II'ye göre fonksiyonel skorlama kriterler sonuçları değerlendirildiğinde, 57 hastada mükemmel, 8 hastada iyi, 12 hastada orta sonuç alındı. Q-DASH skoru ortalama puanı 6,37 olarak bulundu. Komplikasyon oranlarımız %12,98 idi. İki hastada median sinirde hafif derecede tuzaklanma, dört hastada ulna stiloidinde kaynamama, bir hastada distal radioulnar eklemde hassasiyet, üç hastada distal radioulnar eklemde hassasiyet ve median sinirde hafif derecede tuzaklanma idi.Sonuç: Distal radius kırıkları tedavisinde kapalı redüksiyon ve alçılı tespit halen etkin ve son derece ucuz bir tedavi yöntemi olarak görülmektedirÖğe Erythropoietin stimulates patellar tendon healing in rats(Elsevier Science Bv, 2015) Uslu, Mustafa; Kaya, Ertuğrul; Yaykaşlı, Kürşat Oğuz; Oktay, Murat; Inanmaz, Mustafa Erkan; Işık, CengizBackround: Erythropoietin (EPO), regulating erythropoiesis, is used to provide protective and regenerative activity in non-haematopoietic tissues. There is insufficient knowledge about the role of EPO activity in tendon healing. Therefore, we investigated the effect of EPO treatment on healing in rat patellar tendons. Methods: One hundred and twenty-six, four-month-old male Sprague-Dawley rats were randomly assigned to three experimental groups: 1, no treatment; 2, treatment with isotonic saline (NaCl) and 3, treatment with EPO. Each group was randomly subdivided into two groups for sacrifice at three (1a, 2a, 3a) or six weeks (1b, 2b, 3b). Complete incision of the left patellar tendon from the distal patellar pole was performed. We applied body casts for 20 days after the incised edges of the patellar tendon were brought together with a surgical technique. Both legs were harvested and specimens from each group underwent histological, biomechanical, and protein mRNA expression analyses. Results: There were statistically significant differences in the ultimate breaking force between the EPO group and others at both weeks three and six (p<0.05); significant differences in fibroblast proliferation, capillary vessel formation, and local inflammation were found between groups 1 a and 3a, and 2a and 3a (p<0.05). There were statistical differences between la, 3a and 2a, 3a for Col III, TGF-beta 1, and VEGF and between 1b, 3b and 2b, 3b for Col I, Col III, TGF-beta 1, and VEGF mRNA expressions. Conclusion: EPO had an additive effect with surgery on the injured tendon healing process in rats compared to the control groups biomechanically, histopathologically and with tissue protein mRNA expression. (C) 2015 Elsevier B.V. All rights reserved.Öğe Extracorporeal shockwave increases the effectiveness of systemic antibiotic treatment in implant-related chronic osteomyelitis : experimental study in a rat model(Wiley, 2014) İnanmaz, Mustafa Erkan; Uslu, Mustafa; Işık, Cengiz; Kaya, Ertuğrul; Taş, Tekin; Bayram, RecepImplant-related chronic osteomyelitis is a serious complication of orthopedic surgery requiring implant removal and radical debridement. Extracorporeal shockwave (ESW) have demonstrated significant bactericidal effectiveness in vitro and effectiveness and safety were evaluated in an animal model of osteomyelitis. In this experimental study, we aimed to test our hypothesis that the use of ESW together with systemic antibiotic treatment will provide synergy for the treatment of implant-related chronic osteomyelitis caused by methicillin-susceptible Staphylococcus aureus (MSSA). The proximal tibia of 32 rats was contaminated with (10)8CFU/ml methicillin-sensitive S. aureus (MSSA-ATCC 29213) and Kirschner-wires were placed into the medulla of the tibia. After 4 weeks, Kirschner-wires were removed and the rats were randomly divided into four groups: group I, untreated contaminated control group; group II, receiving only ESW therapy; group III, receiving only systemic teicoplanin; group IV, treated with a combination of ESW and systemic teicoplanin. ESW was applied twice to the infected limbs and all rats were sacrificed at the end of 8th week. The degree of tibial osteomyelitis was assessed by quantitative culture analysis. Bacterial counts in groups III and IV were significantly reduced relative to the control (p=0.002 and 0.001, respectively). The decrease in bacterial counts was more pronounced and significant in group IV compared to group III (p=0.024). In group II, bacterial counts also decreased, but the differences were in significant (p=0.068). Our experimental model suggests that ESW provides significant synergy for systemic antibiotic treatment. However, further clinical trials are required in order to use this treatment modality safely in patients, even though our study demonstrated successful results in the treatment of implant-related chronic osteomyelitis in rats. (c) 2014 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 32:752-756, 2014.Öğe Flexor tendons repair : effect of core sutures caliber with increased number of suture strands and peripheral sutures. A sheep model(Elsevier Masson, Corporation Office, 2014) Uslu, Mustafa; Işık, Cengiz; Özşahin, Mustafa; Özkan, Arif; Yaşar, Mehmet Akif; Sarman, HakanBackground: Surgeons have aimed to achieve strong repair so as to begin early active rehabilitation programs for flexor tendon injury. Multi-strand suture techniques were developed to gain improved gap resistance and ultimate force compared with the respective two-strand techniques. In vivo studies indicate that multiple strands may cause ischemia during the intrinsic healing process by decreasing the total cross-sectional area of the injured site, unless the total cross-sectional area of the sutures is not decreased. Hypothesis: The hypothesis was to design an in vitro study to understand the biomechanical relationship between suture calibers of core sutures with increased number of suture strands and peripheral suture on final repair strength. Materials and methods: Sixty fresh sheep forelimb flexor digitorum profundus tendons were randomly placed into three groups (A, B, and C), each containing 20 specimens, for tendon repair. Two-, four-, and eight-strand suture techniques were respectively used in Groups A, B, and C. A simple running peripheral suture technique was used in Subgroups A2, B2, and C2. For each repaired tendon, the 2-mm gap-formation force, 2-mm gap-formation strength, maximum breaking force and maximum breaking strength were determined. Results: Differences in 2-mm gap-formation force and 2-mm gap-formation strength were found between Subgroups A1 and A2, B1 and B2, and Cl and C2. Between Groups A and B, A and C, and B and C, there was no difference as well. Conclusion: Both the number of strands and the ratio between the total suture volume and tendon volume at the repair site are important for ideal repair. If the total cross-sectional area of the sutures is equal in 2-strand, 4-strand, and 8-strand procedure, there is no difference in the strength of the repair. A decrease in caliber size suture requires more passes to achieve the same strength. Instead, it is much better to use peripheral suture techniques to improve the strength of the repair with larger diameter 2-strand core sutures. (C) 2014 Published by Elsevier Masson SAS.Öğe High tibial osteotomy using a locking titanium plate with or without autografting(Atha Comunicacao & Editora, 2019) Sarman, Hakan; Işık, Cengiz; Uslu, Mustafa; İnanmaz, Mustafa ErkanObjective: To postoperatively evaluate knee scores, radiological assessment results, deficit correction, patellar height change, bone healing time, and weight bearing time in patients undergoing high tibial osteotomy (HTO) with/without autologous iliac bone grafting. Methods: This retrospective examination of treated controls from a randomized controlled study included 63 knees of 58 patients aged 46-59 years who underwent HTO with locking open wedge osteotomy plates. The patients were divided into two groups: Group A, HTO with autologous iliac bone grafts (n = 31); and Group B, HTO without autologous iliac bone grafts (n = 32). Clinical and radiological data were evaluated prospectively at the preoperative consultation and again at 6, 9, and 12 weeks, 6 months, and 1 year after the surgery (and annually thereafter). Results: There were no significant intergroup differences in the radiological assessment, deficit correction, patellar height change, bone-healing time, and weight-bearing time at any time after surgery. The knee scores changed positively in both groups (p < 0.001). Conclusions: There was no difference in the results of patients undergoing HTO with open wedge osteotomy titanium locking plates with or without autografting, and comorbidities resulting from autografts were eliminated with the use of locking plates.
