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Permanent URI for this collectionhttps://hdl.handle.net/11443/932

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    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.
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    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.
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    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.