Araştırma Çıktıları
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Item Complications during removal of stainless steel versus titanium nails used for intramedullary nailing of diaphyseal fractures of the tibia(ELSEVIER SCI LTD, 2018-01-01) Seyhan, Mustafa; Guler, Olcay; Mahirogullari, Mahir; Donmez, Ferdi; Gereli, Arel; Mutlu, SerhatObjectives: Intramedullary nailing is the treatment of choice for fractures of the tibial shaft, which might necessitate the nail removal due to complications in the long-term. Although considered as a low-risk procedure, intramedullary nail removal is also associated with certain complications. Here, we compared the most commonly used stainless steel and titanium nails with respect to the complications during removal and clinical outcome for intramedullary nailing of diaphyseal fractures of the tibia. Patients and methods: Sixty-two patients (26 females, 36 males) were included in this retrospective study. Of the removed nails, 24 were of stainless steel and 38 of titanium. Preoperative and intraoperative parameters, such as implant discomfort, anterior knee pain, operating time and amount of bleeding, and postoperative outcomes were evaluated for each patient. Results: Titanium nail group had more, but not statistically significant, intraoperative complications than stainless steel group during the removal of nails (p = .4498). Operating time and amount of intraoperative bleeding were significantly higher in titanium group than stainless steel group (p = .0306 and p < .001, respectively). Preoperative SF-36 physical component and KSS scores were significantly lower in patients who had removal of titanium nails than those of stainless steel nails, whereas there was no difference in terms of postoperative SF-36 and KSS scores. Conclusion: In conclusion, although greater bone contact with titanium increases implant stability, nail removal is more difficult, resulting in more longer surgical operation and more intraoperative bleeding. Therefore, we do not recommend titanium nail removal in asymptomatic patients.Item The effect of organic silicon injection on Achilles tendon healing in rats(TURKISH ASSOC ORTHOPAEDICS TRAUMATOLOGY, 2014-01-01) Gereli, Arel; Akgun, Umut; Uslu, Serap; Agir, Ismail; Ates, Filiz; Nalbantoglu, UfukItem The effect of femoral nerve block on fracture healing via expressions of growth factors and beta-catenin(VIA MEDICA, 2016-01-01) Uslu, Serap; Irban, Arzu Gercek; Gereli, Arel; Aydinlar, Elif Ilgaz; Elpen, Pinar; Ince, UmitIntroduction. Many patients of all ages are admitted to hospital due to bone fractures. The etiology of fracture has a very wide spectrum, ranging from motor accidents to pathological conditions such as tumors, osteoporosis, and others. Bone fracture healing is a well-programmed and well-organized process, but is also long and intractable. The outcome of this process is therefore affected by many factors, such as the patient's age, ethnicity, nutritional status, and extent of the fracture. At present, regional analgesic techniques are frequently applied in order to avoid the complications of systemic opioid administration, central block applications. Femoral block is one of the regional analgesic techniques frequently applied by anesthesiologists when the lower extremities are involved. In this study, we evaluated the effect of femoral nerve block on the healing of an experimental non-stabilized femur fracture via expression of TGF-beta, VEGF, and beta-catenin and bone histomorphometry in rats. Material and methods. In the control group, only the femoral fracture was performed and the bone was not fixated, similarly as in other groups. In the One-Day Block group, a one-time femoral nerve block was applied after the femoral fracture. In the Three-Day Block group, a daily femoral nerve block was performed for three days after the femoral fracture. On Days 4, 7, and 13, femurs were excised. The bone sections were stained with hematoxylin-eosin to evaluate bone tissue and Safranin O to assess callus tissue, cartilaginous tissue, and new bone areas. TGF-beta, VEGF, and beta-catenin were assessed by immunohistochemistry. Results. Histomorphometric analysis revealed that femoral block application had a positive impact on bone healing. TGF-beta expression in the One-Day and Three-Day Block Groups was significantly higher than in the control group at all times, as was also the case with VEGF expression. On day 13, beta-catenin expression was significantly higher in the Three-Day Block group than the others. Conclusions. The results of the study suggests that the applications of a femoral nerve block for perioperative analgesia, for either one day or three days, resulted in better and more rapid bone healing.Item Fracture-dislocations of the proximal ulna(TURKISH ASSOC ORTHOPAEDICS TRAUMATOLOGY, 2015-01-01) Gereli, Arel; Nalbantoglu, Ufuk; Dikmen, Goksel; Seyhan, Mustafa; Turkmen, MetinObjective: To investigate the relationship between injury patterns, complications, and the functional outcomes of patients with proximal-ulna fracture-dislocations. Methods: Retrospective analysis of 15 patients (10 men, 5 womenItem Warm irrigation fluid does not raise the subacromial temperature to harmful levels while using radiofrequency device(MEDKNOW PUBLICATIONS \& MEDIA PVT LTD, 2015-01-01) Gereli, Arel; Kocaoglu, Baris; Guven, Osman; Turkmen, MetinItem Comparison of Third Generation Proximal Femoral Nails in Treatment of Reverse Oblique Intertrochanteric Fractures(BEZMIALEM VAKIF UNIV, 2019-01-01) Ulku, Tekin Kerem; Tok, Okan; Seyhan, Mustafa; Gereli, Arel; Kaya, AlperObjective: The purpose of the study is to evaluate the treatment results of reverse oblique AO/OTA 31A1 fractures that have highly mechanical instability risk with two third generation intramedullary nails. Methods: Twenty-eight patients (8 men, 20 women) treated by third generation proximal femoral nails {[}proximal femoral anti-rotation (PFNA)(R) or Intertan (R)] followed minimum one year were included. Average age was 65.0 (31-93) years. Clinical and radiological results, screw migration at one year and complications were recorded. Results: Mean operation time was 72.2 and 72.5 minutes, flouroscopy time was 64.4 and 64.7 seconds, mobilisation time was 2.1 and 2.2 days, full weight bearing time was 8.6 and 8.5 weeks, tip-apex distance was 20.1 and 20.2 mm, fracture healing time was 10.5 and 10.2 weeks, Harris hip score at one year was 80.5 and 83.5, neck-shaft angle difference at one year was 1.6 and 1.1 mm, screw migration at one year was found in 10 and 3 patients and mean migration distance was 3.1 and 0.4 mm for PFNA and Intertan nails respectively. No complications recorded that needs secondary intervention. Fracture healing obtained in all patients. Conclusion: Reverse oblique intertrochanteric fractures can be effectively treated with third generation intramedullary nails. More screw migration was seen in PFNA than Intertan nails after the operation in this study.Item Comparison of headless screws used in the treatment of proximal nonunion of scaphoid bone(SPRINGER, 2011-01-01) Gereli, Arel; Nalbantoglu, Ufuk; Sener, Ismail Ugur; Kocaoglu, Baris; Turkmen, MetinScrews with different levels of compression force are available for scaphoid fixation and it is known that the Acutrak screw generates greater compression than the Herbert screw. We retrospectively compared two types of headless compression screw for their effectiveness in the repair of scaphoid nonunion. Twenty-nine cases of proximal scaphoid nonunion were surgically treated with non-vascularised bone graft: the Acutrak screw was used in 17 patients and the cannulated Herbert screw in 12 patients. Wrist range of motion, Mayo wrist score, grip strength and QuickDASH scores were indicators used for the functional evaluation. Radiographic findings were assessed for consolidation of nonunion and signs of arthrosis. The mean follow-up time was 49.2 months (range 12-96). Statistically, there was no significant difference between the Acutrak and Herbert screw types in terms of functional evaluation and time required for consolidation. Greater compression did not influence the functional outcome, consolidation rate or time to consolidation. The need for greater compression in the treatment of proximal scaphoid nonunions is thus questionable because it may increase the risk of proximal fragment communition.Item Open reduction and low-profile plate and/or screw fixation in the treatment of phalangeal fractures(TURKISH ASSOC ORTHOPAEDICS TRAUMATOLOGY, 2009-01-01) Nalbantoglu, Ufuk; Gereli, Arel; Cilli, Feridun; Ucar, Bekir Yavuz; Turkmen, MetinObjectives: We evaluated the functional results and the effectiveness of open reduction and low-profile plate and/or screw fixation in the treatment of phalangeal fractures. Methods: The study included 17 patients (5 women, 12 menItem Comparison of palmar locking plate and K-wire augmented external fixation for intra-articular and comminuted distal radius fractures(TURKISH ASSOC ORTHOPAEDICS TRAUMATOLOGY, 2010-01-01) Gereli, Arel; Nalbantoglu, Ufuk; Kocaoglu, Baris; Turkmen, MetinObjectives: This study was designed to compare the results of palmar locking plate and K-wire augmented external fixation in the treatment of intra-articular comminuted distal radius fractures. Methods: The study included 30 patients with intra-articular comminuted distal radius fractures. Sixteen patients (11 men, 5 women