Yazar "Yavuz, Umut" seçeneğine göre listele
Listeleniyor 1 - 4 / 4
Sayfa Başına Sonuç
Sıralama seçenekleri
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 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 The results of treatment in pediatric Monteggia equivalent lesions(Turkish Assoc Orthopaedics Traumatology, 2008) Guven, Melih; Eren, Abdullah; Kadioglu, Baris; Yavuz, Umut; Kilincoglu, Volkan; Ozkan, KorhanObjectives: We evaluated the results of conservative and surgical treatment of pediatric Monteggia equivalent lesions. Methods: The study included 13 children (3 females, 10 males; mean age 8 years; range 4 to 13 years) who underwent treatment for Monteggia equivalent lesions. Seven patients (53.9%) had Bado type I and six patients (46.2%) had type 3 equivalent lesions. Two patients with type 3 equivalent lesions also had a lateral humeral condyle fracture. On presentation, one patient (7.7%) had radial nerve palsy. Primarily, closed reduction was attempted in all the patients except for one patient who underwent urgent debridement and irrigation for an open fracture-dislocation. Reduction was successful in eight patients (61.5%). Upon failure of closed reduction, four patients (30.8%) underwent surgery within the first 24 hours of injury. Functional assessment was made according to the Reckling's criteria. The mean follow-up period was 4.1 years (range 2 to 7 years). Results: None of the patients had nonunion. Conservative treatment did not result in loss of reduction of the radius head or limitation in the range of motion of the elbow joint. Except for the patient with an open fracture-dislocation leading to a poor functional result, the results were good in all the patients receiving conservative or surgical treatment. One patient (7.7%) treated conservatively developed cubitus varus (5 degrees) and posterior angulation (20 degrees) of the ulnar fracture line. One patient treated surgically had limitation of supination (10 degrees) without limitation of flexion or extension of the elbow joint. Accompanying radial nerve palsy in this patient disappeared in the postoperative third month. Conclusion: Closed reduction is the first choice of treatment in pediatric Monteggia equivalent lesions. Surgical treatment becomes necessary if closed reduction fails.Öğe Successful treatment of bilateral open calcaneal fractures with concomitant lower extremity injuries: a case report(BioMed Central Ltd., 2014) Güven, Melih; Özkan, Namık Kemal; Çakar, Murat; Yavuz, Umut; Akman, Budak; Kadıoğlu, BarışOpen calcaneal fractures are high morbidity injuries and the risk of complications depends on the concomitant injuries, on the size and the position of the traumatic wound. A 53-year-old male patient with bilateral open calcaneal fractures and associated concomitant lower extremity injuries such as subtalar dislocation, talonavicular dislocation and open distal tibial metaphyseal fracture was immediately operated by percutaneous Kirschner wire fixation combined with external fixators. He was able to walk with full weight bearing without any assistance at the end of the first postoperative year. Early aggressive debridement and irrigation followed by fixation with percutaneous Kirschner wires and external fixator can supply bony alignment in open comminuted calcaneal fractures associated with concomitant lower extremity injuries and should be considered for the healthy and active patients before primary arthrodesis.
