Biomedical subjects

Cengiz Sen

Publications and source records attributed to Cengiz Sen.

28 records · Page 2Linked to original sources

PubMed2003

Correction of ankle and hindfoot deformities by supramalleolar osteotomy.

Ankle and hindfoot deformities in 11 patients with a mean age of 15 (range, four to 35) have been gradually corrected by an llizarov external fixator. In all patients, supramalleolar osteotomy was utilized by percutaneous drilling and osteotomy technique. The patients were evaluated clinically by the AOFAS scoring system and radiologically by malorientation and malalignment tests described by Paley. The purpose of the current study is to evaluate the efficacy of supramalleolar osteotomy and correction by an Ilizarov device in treating hindfoot and ankle deformities. The mean external fixation period was five (2.5 to eight) months. The mean interval between the operation and last follow-up examination was 19 (13 to 26) months. The patients improved an average of 30 points after the operation regarding to AOFAS score. A plantigrade foot was achieved in the whole group. Radiologically, no malalignment or malorientation was measured. Equal leg lengths were achieved in all nine patients with one exception. Complications were graded after Paley as minor problems in 11 patients and as obstacles requiring surgical interventions in four patients. Sequelae remained in only one patient. Ankle and hindfoot deformities caused by various etiologies are complicated by poor soft tissue condition and a short foot. A supramalleolar osteotomy and Ilizarov external fixator can safely and effectively correct these deformities.

Adolescent↗

PubMed2003

[Bone lengthening of congenitally short metacarpus and metatarsus by the callus distraction technique].

OBJECTIVES: We evaluated the results of lengthening of congenitally short metacarpus and metatarsus by the callus distraction technique. METHODS: We treated congenitally short metacarpus (n=7) and metatarsus (n=4) of five patients (4 females, 1 male; mean age 15 years; range 10 to 21 years) by callotasis. Callus distraction was performed with the use of mini-Orthofix or Ilizarov type semicircular external fixators. The distraction rate was 0.25x2 mm/day for both types. The mean follow-up period was 23 months (range 12 to 33 months). RESULTS: The mean metacarpal and metatarsal lengthenings were 20 mm (range 15 to 25 mm) and 25 mm (range 20 to 30 mm), respectively. The mean healing index was 1.4 months/cm for metacarpal lengthening, and 1.8 months/cm for metatarsal lengthening. No neurovascular complications were encountered. One patient required autogenous fibular grafting for union. Pin tract infections were found in three patients. The overall complication rate was 36%. CONCLUSION: Callotasis is an effective and reliable method for lengthening of short metacarpal and metatarsal bones. In addition, it preserves the periosteal bone tissues, which has a favorable effect on the duration of treatment.

Adolescent↗

PubMed2002

Kotz and Ganz osteotomies in the treatment of adult acetabular dysplasia.

In hips with acetabular dysplasia, we performed Kotz osteotomy (group 1) in 22 hips (20 patients; mean age 24.3 years) and Ganz osteotomy (group 2) in 23 hips (22 patients; mean age 23.1 years). Group 1 was followed 83.3 (56-112) months and group 2 40.9 (24-66) months. In group 1, Harris hip score improved from average 74.9 to 86.9, mean center edge (CE) angle from -4.5 degrees to 30.3 degrees, and mean vertical center edge (VCE) angle from 5.3 degrees to 36.2 degrees. In group 2, Harris hip score improved from average 76.6 to 91.1, mean CE angle from -5.9 degrees to 32.0 degrees, and mean VCE angle from 5.0 degrees to 41.3 degrees. Using Pauwels criteria, regression was observed in 12 hips in group 1 and one progressed. In group 2, 15 hips showed regression and three progressed. In patients treated with Ganz osteotomy, the complication rate was higher and the complications more serious than in patients treated with Kotz osteotomy. Most complications were, however, seen among the first ten patients treated with Ganz osteotomy. Although we detected no significant difference between the two groups in terms of clinical and radiological findings, we believe the outcome to be slightly better after a properly performed Ganz osteotomy.

Acetabulum↗

PubMed2002

Arthroscopic meniscal repair using T-fix.

We evaluated the arthroscopic meniscal repair using T-fix and present our preliminary results. The series included 47 consecutive patients who underwent meniscal repair using T-fix. Mean follow-up was 26 months (range 12-42 months). The overall number of T-fixes used in the repairs was 163, with a mean of three (range two to five) per patient. Patients were evaluated according to the modified Marshall scoring system. Results were rated as excellent in 32, good in 10, fair in 2, and poor in 3 patients. Second-look arthroscopy was performed in 18 patients as the part of our protocol. In 15 patients meniscal tears were considered to be healed, according to Henning's criteria. Six of those who underwent anterior cruciate ligament reconstruction healed completely. There were no neurovascular complications. Repair of the menisci using T-fix proved successful and reliable. In view of satisfactory functional results and the observation of healing of tears on second-look arthroscopy, we believe that preservation and repair of menisci should be attempted in appropriate cases.

Adolescent↗

PubMed2002

Surgical management of intraarticular fractures of the calcaneus.

In this study we evaluated the interim results of surgical management of intraarticular calcaneal fractures in 26 feet in 19 patients. The mean age of the 15 male and 4 female patients in our series was 28.3 (range 17-54) years. There were 7 bilateral and 12 unilateral fractures. We obtained anteroposterior (AP), lateral, and skyline views and computed tomography (CT) scans of all patients preoperatively. According to Sanders CT classification, we detected type II, III, and IV fractures in 12, 10, and 4 cases, respectively. We performed extended lateral incisions in all patients but one and used Sherman plate, screw, and staples to achieve anatomic reduction. The mean follow-up period was 38.2 (range 18-50) months. Patients were evaluated by X-ray, CT, and Maryland foot score. We found that anatomic reduction had been achieved in 20 cases as confirmed by X-ray and CT postoperatively. With regard to the Maryland foot score, excellent, good, fair, and poor results were obtained in 9, 11, 4, and 2 cases, respectively. None of our patients required secondary intervention. We conclude that in order to obtain satisfactory results in the management of intraarticular calcaneal fractures, anatomic reduction must be achieved and maintained using strength hardware.

Activities of Daily Living↗

PubMed2002

The Ilizarov hip reconstruction osteotomy for hip dislocation: outcome after 4-7 years in 14 young patients.

Treatment of neglected high dislocation of the hip is difficult in adults. We performed hip reconstruction osteotomy, consisting of a proximal abduction and extension osteotomy, and a distal varisation and lengthening osteotomy, utilizing the Ilizarov external fixator in 14 (12 women) patients having a mean age of 20 (12-33) years. The most frequent preoperative complaints were pain, leg-length discrepancy, limping, reduced activity and limited abduction of the hip. After an average follow-up of 68 (55-81) months, the outcome was satisfactory; pain subsided in all patients, the Trendelenburg sign became negative in all but 3 patients, no patient had limb-length discrepancy, and alignment of the extremity was reestablished. However, 3 patients still complained of lurch.

Adolescent↗

PubMed2002

[Arthroscopic meniscal repair with the use of conventional suturing materials].

OBJECTIVES: We evaluated the mid-term clinical results of patients who underwent arthroscopic meniscal repair. METHODS: Sixty-one patients (43 males, 18 females; mean age 26.9 years; range 17 to 42 years) underwent meniscal repair using conventional suture techniques for unstable vertical longitudinal meniscal tears in the peripheral vascular zone, measuring more than 1 cm. All patients had an adequate follow-up. The involved side was right in 34 patients, and left in 27 patients. The localization was medial in 36 tears, and lateral in 25 tears. Arthroscopic meniscal repair technique was inside-out in 47 cases, and outside-in in 14 cases. Associated lesions were anterior cruciate ligament tears in 24 patients, and tibial plateau fractures in five patients, all of which were treated simultaneously. The patients were evaluated with the use of a modified Marshall knee scoring system. The mean follow-up was 44 months (range 12 to 72 months). RESULTS: The results were excellent in 41 patients, good in 14 patients, fair in three patients, and poor in three patients. Limited range of motion seen in four knees postoperatively was successfully treated by arthroscopic release and an intense rehabilitation program. All patients returned to sports activities within a mean of six months. Second-look arthroscopy performed in 20 patients after a mean of six months postoperatively showed complete healing of the involved menisci in 17 patients. CONCLUSION: Meniscal tears occurring in the peripheral vascular zone without any injury to the meniscal body can be successfully repaired using conventional suture techniques.

Adolescent↗

PubMed2002

[The reliability of percutaneous osteotomy with the Gigli saw technique in the proximal tibia. A cadaveric study].

OBJECTIVES: To evaluate the reliability of percutaneous osteotomy with the use of a Gigli saw in the proximal tibia. METHODS: Forty-two attendants comprising of residents or consultants without any prior experience were assigned to 14 cadaveric models to perform percutaneous osteotomy. The technique was first described by an experienced specialist and then illustrated on a cadaver specimen. Thereafter, the attendants performed osteotomy using a Gigli saw without any help by the instructors. Finally, exploration of the deep and superficial branches of the fibular nerve, posterior tibial nerve, posterior and anterior artery and vein was made with regard to any injury caused during osteotomy. RESULTS: There were ten incisional injuries in three specimens due to erroneous determination of the osteotomy level or incision. A mean of 3.5 cm (range 2.5 to 4.0 cm) incision length was observed in four specimens. No procedure-associated injuries to major nerves and vessels were documented except for those to the cutaneous branch of the superficial peroneal nerve in two specimens, and to the extensor hallucis longus muscle in one specimen. There was no incidence of incomplete osteotomy. CONCLUSION: Despite the lack of any prior experience with the osteotomy method with the Gigli saw on the part of the attendants, the full success in performing osteotomy confirms the reliability of the technique. Moreover, if this method is to be used by experienced surgeons, excellent results can be achieved without any injuries to cutaneous nerves and surrounding muscles.

Cadaver↗

PubMed2002

[Surgical management of intraarticular calcaneus fractures].

OBJECTIVES: We evaluated the midterm results of surgical treatment for intraarticular calcaneal fractures. METHODS: This study included 19 feet of 14 patients with intraarticular fractures of the calcaneus. Twelve patients were males and two were females (mean age 28.3 years; range 17 to 54 years). The fractures were bilateral in five patients. In one patient the contralateral foot was treated conservatively. Anteroposterior, lateral, and tangential radiographs and computed tomography (CT) scans were obtained in all patients preoperatively. According to the Sanders CT classification, there were 10 type II, five type III, and four type IV fractures. An extensile lateral incision was performed in all patients but one to provide an anatomic reduction with the use of Sherman plates, screws, and staples. The patients were followed-up by radiographs and CT. The results were evaluated using the Maryland Foot Score. The mean follow-up was 32.7 months (range 24 to 43 months). RESULTS: Radiographs and CT scans obtained in the early postoperative period showed that a complete anatomic reduction was achieved in 13 feet. According to the Maryland Foot Score, the results were excellent in five, good in eight, fair in four, and poor in two feet. None of the patients required a subsequent operation due to surgery-associated causes. CONCLUSION: The success of surgical treatment of intraarticular calcaneal fractures depends only on the achievement of an anatomic reduction and on maintaining it with a stable osteosynthesis using appropriate strength hardware.

Adolescent↗

PubMedDate not supplied

Ultrasonographic appearance of the plantar fasciitis.

PURPOSE: To study high frequency sonographic in the examination of plantar fasciitis (PF), which is a common cause of heel pain. MATERIALS AND METHODS: Our study was done with 25 PF (21 unilateral, 4 bilateral) and 15 control cases of similar age, weight and gender. In this study, the plantar fascial thickness (mainly), fascial echogenity and biconvexity were examined using 7.5 MHz linear phase array transducer. Perifascial fluid collection, fascial rupture and fascial calcification that are rarely seen were also examined. RESULTS: The fascial thickness ranges for the PF cases: for the symptomatic heels: 3.9-9.1 mm (mean: 4.75 +/- 1.52 mm), for the asymptomatic heels: 2.0-5.9 mm (mean: 3.37 +/- 1.0 mm) and for the control group: 2.1-4.7 mm (3.62 +/- 0.68 mm). The results were significantly different in Group I for symptomatic heels and the control group statistically for PF (P < .05). The echogenity of plantar fascia and biconvexity of plantar fascia were the major criteria for symptomatic heels. In three heels (10%), perifascial fluid was diagnosed, in three heels (10%) fascial calcification, in one heel (3%) partial fascial rupture. Subcalcaneal spur was encountered sonographically in both cases of Groups I and II. CONCLUSION: Ultrasonography (US) is the first step for PF, because of its easy and quick performance, availability and high sensitivity of diagnosis, low-cost and free radiation.

Case-Control Studies↗