Browsing by Author "Keskinoz, Elif Nedret"

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A comparison of EFECE systems with tension band wiring for patella fracture fixation in cadavers
(BMC, 2020-01-01) Karadeniz, Emre; Keskinoz, Elif Nedret
BackgroundEFECE systems are newly defined internal fixation systems, which are suitable for patella fracture fixation. The aim of this study was to compare the fixation strength of EFECE Systems with tension band wiring for transverse patellar fracture simulation on fresh frozen cadaver models.MethodsQuadriceps tendon-patella-patellar tendon (QT-P-PT) complex was prepared from human cadavers. After simulation of a transverse patella fracture, in group 1, 5 patella were fixed with a pair of 1.2mm EFECE wires and 4 EFECE devices. In group 2, 5 patella were fixed with a pair of 1.2mm Kirschner wires (K-wire) and a cerclage wire according to the tension band technique.Using a testing device with custom-made jaws, increasing distraction force was applied to these QT-P-PT complexes. Extension of these complexes with the distraction forces was observed. The maximum distraction force and the elongation during maximum force were evaluated.ResultsAfter 5 experiments with the EFECE systems, there was no EFECE wire breakage or EFECE wire-EFECE device catching failure. The median maximum force was 740N (720-810N). During maximum distraction force the median extension was 2.5mm (1.6-2.5mm). After 5 experiments with the tension band technique, there was no K-wire breakage. The median maximum force was 330N (240-510N). During this maximum distraction force the median extension was 3.4mm (2.2-3.8mm).ConclusionsBased on the biomechanical advantages, patella fracture treatment with EFECE systems may constitute a reasonable alternative in the treatment of patella fractures.
Analysis of Subcutaneous Anterior Transposition versus in-situ Decompression of Ulnar Nerve with Force Transducer in Cadaver Specimen
(TURKISH NEUROSURGICAL SOC, 2020-01-01) Kilinc, Bekir Eray; Celik, Haluk; Oc, Yunus; Unlu, Ruhat; Keskinoz, Elif Nedret; Yilmaz, Baris
AIM: To evaluate the changes in the pressure values of the ulnar nerve after in-situ decompression and anterior subcutaneous transposition of the ulnar nerve. MATERIAL and METHODS: The ulnar nerve was released in the postcondylar groove. An ultrathin (100 lm) force transducer was embedded between the posterior of the ulnar nerve and the anterior of the medial epicondyle. The elbow joint was flexed from full extension position to maximum flexion and was measured to obtain the maximum stress at 0 degrees, 45 degrees, 90 degrees, and 135 degrees of flexion. Then, the ulnar nerve was transposed anterior subcutaneously. The same measurement was applied to the two procedures. Data were compared between the two surgical techniques. RESULTS: Our study was performed on the right upper extremities of eight (seven men and one woman) fresh frozen cadavers. The mean age of the cadavers was 67.25 +/- 12.2 years. Mean values of 0 degrees, 45 degrees, 90 degrees, and 135 degrees of flexion after the ulnar nerve insitu decompression were 0.41, 0.9, 1.7, and 4.3 N, respectively. Mean values of 0 degrees, 45 degrees, 90 degrees, and 135 degrees of flexion after anterior transposition of the ulnar nerve were 0.3, 0.73, 1.63, and 2.15 N, respectively. No significant difference was noted between the two groups in terms of 0 degrees, 45 degrees, and 90 degrees of flexion values. However, there was a significant difference between the two groups in the 135 degrees of flexion measurement values. CONCLUSION: Anterior transposition is a more appropriate technique than in-situ decompression in the treatment of cubital tunnel syndrome that does not respond to conservative treatment regardless of the severity of the symptom.
Early Onset of Atherosclerosis of The Carotid Bifurcation in Newborn Cadavers
(PREMCHAND SHANTIDEVI RESEARCH FOUNDATION, 2016-01-01) Uslu, Bahar; Cakmak, Yusuf Ozgur; Sehirli, Umit; Keskinoz, Elif Nedret; Cosgun, Erdal; Arbak, Serap; Yalin, Aymelek
Introduction: The anatomy of arterial bifurcations affects blood flow and has a significant role in the development of vascular disease. Therefore, it is important to know the structural characteristics of the Common Carotid Artery (CCA) and its branches for early onset of atherosclerosis in newborns. Aim: The present study was conducted to evaluate the characteristics of CCA in newborn cadavers. Materials and Methods: Eight carotid arteries obtained from newborn cadavers were used. The outflow to inflow area ratios was calculated to evaluate vessel diameters. Additionally, scanning electron and light microscopic investigations were conducted with tissue samples. The brachial artery of each cadaver was used as controls. Correlation between area ratios and atherosclerotic endothelial damage was determined. Results: Light microscopic investigations demonstrated that control group sections showed no positivity for Oil red O staining, while carotid bifurcation regions depicted widespread occurrence of intimal lipid accumulations. Scanning electron microscopic examination of control group sections presented regular endothelial topography, while carotid bifurcation region topography exhibited numerous blood cells and separated endothelial cells. Fibrin accumulation on endothelial surface in low area ratios was another important finding in the examination of its endothelial surface degeneration. The above-mentioned morphological findings seemed to be quite parallel to outflow to inflow area ratio data favouring low area and degeneration. Conclusion: The correlation between area ratios and the histological characteristic of cerebral vessels of newborn cadavers indicate that early stages of atherosclerosis began in early embryologic life.
Hamstring autograft and anatomical footprint evaluation for anterior talofibular ligament reconstruction: Cadaveric study
(SAGE PUBLICATIONS LTD, 2020-01-01) Karahan, Nazim; Kaya, Murat; Yilmaz, Baris; Kurdal, Demet Pepele; Keskinoz, Elif Nedret; Cicek, Esma Esin Derin
Purpose: The aim of the study was to evaluate whether or not there was any incompatibility between two-strand hamstring tendons taken from the same knee and the ATFL and it was the determination of suitable footprint points in the fibula and talus for anatomical ATFL reconstruction. Methods: 16 fresh frozen cadaver specimens were dissected to gracilis and semitendinosus tendons and the anterior talofibular ligament. The origins, insertions, distances from osseous landmarks of fibular talus of ATFL were determined. The diameters of gracilis, semitendinosus and ATFL were calculated. There was a moderate correlation between body height and the distance between the distal of inferior lateral malleolus and the fibular adhesion site of ATFL (r: 36.5 p: 0.036). There was a weak correlation between body height and the distance between the apex of the lateral talar process and the talus adhesion site of ATFL in a single bundle (r: 28.4 p: 0.002). There was no correlation between the distance from proximal and distal adhesion side of ATFL and body height in the double bundle (p: 0.241). Results: There was no significant relationship between ATFL diameter and gracilis, semitendinosus and both hamstring in women. A significant relationship at 80.5\% was determined between the ATFL and the gracilis diameter in man. A significant relationship at 92.6\% was determined between the ATFL and the semitendinosus diameter in man. Conclusion: It was determined that there is not compatibility between the gracilis tendons, the semitendinosus tendon and ATFL in women. It should be supported by biomechanical and clinical studies whether this incompatibility has a clinical effect or not.
Is denervation surgery possible in the treatment of hallux rigidus? An anatomic study of cadaveric specimens
(TURKISH ASSOC ORTHOPAEDICS TRAUMATOLOGY, 2021-01-01) Catal, Bilgehan; Keskinbora, Mert; Keskinoz, Elif Nedret; Tumentemur, Gamze; Azboy, Ibrahim; Demiralp, Bahtiyar
Objective: The aim of this study was to provide anatomic considerations in the first metatarsophalangeal joint (FMPJ) innervation and to evaluate the feasibility of the denervation surgery in the treatment of hallux rigidus. Methods: In this cadaveric study, 14 fresh frozen cadaveric transtibial amputation specimens was used. For nerve dissection, dorsal and plantar longitudinal incision centered over the FMPJ were performed. Deep peroneal and dorsomedial cutaneous nerves were dissected in the dorsal aspect of the joint. Medial plantar nerve branches, medial and lateral hallucal nerves, were dissected in the plantar aspect of the joint. The presence, number, and location of articular branches to the FMPJ capsule were recorded. Dorsal and plantar incision length for proper dissection were also recorded. Results: Nerve dissection of the 14 specimens revealed the following number of articular branches from the relevant nerves: 14 from dorsomedial cutaneous nerves, 11 from deep peroneal nerves, 6 from medial hallucal nerve, and 5 from lateral hallucal nerve. Dorsal incision mean length was 60.53 (range, 42.48-85.12) mm, and the plantar incision mean length was 88.08 (range, 77.32-111.21) mm. Conclusion: Evidence from this study has shown that partial dorsal denervation of the FMPJ may be a technically feasible procedure along with the presence of superficially easily dissected nerves with relatively small incision.
Morphometric Analysis of the Inferior Vena Cava Related to Lumbar Vertebra and the Aortic Bifurcation on Multidetector Computed Tomography (MDCT)
(SOC CHILENA ANATOMIA, 2016-01-01) Keskinoz, Elif Nedret; Salbacak, Ahmet; Akin, Duygu; Kabakci, Anil Didem Aydin; Yilmaz, Mehmet Tugrul; Cicekcibasi, Aynur Emine; Ozbek, Orhan
Vascular structures are in greater danger during lumbar surgery. The purpose of this study is to describe the morphology of the inferior vena cava (IVC) related to the lumbar vertebra and aortic bifurcation (AB) and assessing the role of demographic values in these relations to decrease the risk of complications in the surgical interventions. The study was performed on Multidetector Computed Tomography (MDCT) images of 100 male and 100 female cases with an age range from 50 to 84 years. The morphometric values of the IVC obtained from the coronal, sagittal and the axial reformatted images were measured and compared with the demographic values. The distance from the IVC to the 1st lumbar vertebra (L1) and 2nd lumbar vertebra (L2) were measured as (26.5 mm and 18.1 mm) in males and (21.1 mm and 14.2 mm) in females with a high level of significance between genders