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Cuma Kayikçi

Publications and source records attributed to Cuma Kayikçi.

6 recordsLinked to original sources

[Minimally invasive plate osteosynthesis in the treatment of femur fractures due to gunshot injuries].

OBJECTIVES: The results of treatment with minimally invasive plate osteosynthesis were evaluated in open comminuted femur fractures due to high-velocity gunshot injuries. METHODS: Seventeen patients (15 males, 2 females; mean age 34 years; range 15 to 67 years) with open comminuted femur fractures due to high-velocity gunshot injuries were included. The fractures were classified according to the AO system. Timing of minimally invasive percutaneous plate fixation was determined according to the classification of open fractures in the Gustilo-Anderson system. There were seven subtrochanteric, seven supracondylar, and three diaphyseal fractures. During surgical exploration, two patients underwent vascular repair for related pathologies. No exploration was performed in two cases with neurological damage. Seven patients were operated on in the early period (mean 1.3 days; range 1 to 2 days) and 10 patients in the late period (mean 11.1 days; range 7 to 15 days). The mean follow-up was 25 months (range 14 to 42 months). RESULTS: Union was obtained in a mean of 4.4 months (range 2.5 to 7 months) in 16 patients. Autogenous grafting was performed in four patients who presented with a cavitation and defect in the late period and in one patient due to delayed union in the postoperative fourth month. Complications included superficial infection in one patient (5.9%), deep infection in one patient, and leg length discrepancy (0.5 cm to 2 cm) with a varus-valgus angulation (mean 5 degrees , range 3 to 8 degrees ) in eight patients (47.1%). No refractures occurred during the follow-up period. CONCLUSION: Minimally invasive percutaneous plate fixation can be considered an alternative technique in type IIIA and IIIB open fractures resulting from high-velocity gunshot injuries.

Adolescent↗

Early prophylactic autogenous bone grafting in type III open tibial fractures.

The authors report the results achieved in patients with type III open tibial fractures who underwent primary autogenous bone grafting at the time of debridement and skeletal stabilisation. Twenty patients with a mean age of 35.8 years (range, 24-55) were treated between 1996 and 1999. Eight fractures were type IIIA, 11 were type IIIB, and 1 was type IIIC. At the index procedure, wound debridement, external fixation and autogenous bone grafting with bone coverage were achieved. The mean follow-up period was 46 months (range, 34-55). The mean time to fixator removal was 21 weeks (range, 14-35), and the mean time to union was 28 weeks (range, 19-45). Skin coverage was achieved by a myocutaneous flap in 2 patients, late primary closure in 4, and split skin grafting in 14. One (5%) of the patients experienced delayed union, and 1 (5%) developed infection. In tibial type III open fractures, skin coverage may be delayed, using the surrounding soft tissue to cover any exposed bone after thorough débridement and wound cleansing. Primary prophylactic bone grafting performed at the same time reduces the rate of delayed union, shortens the time to union, and does not increase the infection rate.

Adult↗

Congenital patellar aplasia in conjunction with trisomy 8. A case report.

Congenital patellar aplasia and hypoplasia are quite rare. Bilateral flexion deformity of the fifth finger, patellar aplasia in the right knee and patellar hypoplasia in the left knee were noted in a 6-year-old boy brought in for treatment of curvature of both little fingers. Active and passive movements of the knees were within normal range, and the quadriceps muscle was of normal strength. Trisomy 8 was determined on chromosome analysis. In contrast with the literature, the patellar abnormality was not concomitant with any other syndromes in our case, and most clinical findings of trisomy 8 were absent.

Abnormalities, Multiple↗

Treatment of refracture occurring after external fixation in paediatric femoral fractures.

With a mean follow-up of four years, we assessed the outcomes of 11 refractures which occurred following paediatric femoral fractures treated by external fixation; the refractures were treated conservatively with simple immobilisation in a spica cast. A total number of 104 children with a femoral fracture were treated with external fixation between 1993 and 2000 in our institution. Refracture occurred in 11 cases after fixator removal. These patients were immediately placed in a hip spica cast. All 11 patients were boys, with a mean age of 7.3 years (range: 6 to 9), and the mean follow-up time was 4 years (range: 2 to 7). Mean hospitalisation time after refracture was 2 days (range: 0 to 4). Refractures occurred an average of 8 days (range: 1 to 21) after fixation removal. The mean time to union after refracture was 55 days (range: 35 to 62). On final evaluation, a mean limb length discrepancy of 0.9 cm (range: 0 to 2.5) was noted. Radiological study showed a mean lateral angulation of 5.6 degrees (range : 0 to 17) and a mean anterior angulation of 7.4 degrees (range: 0 to 20). Based on these findings, we believe that closed reduction and spica cast immobilisation is sufficient in cases with refracture of the femur after external fixation, but the option of surgical treatment should be considered when satisfactory anatomic reduction is not achieved.

Accidental Falls↗

Problem fractures associated with gunshot wounds in children.

Twenty-seven fractures in 22 children (14 female, 8 male; average age: 10.5) who suffered gunshot wounds were retrospectively evaluated. Fourteen of the fractures were caused by high-velocity weapons, four by low-velocity weapons, and nine by shotguns. One of the fractures was undisplaced, two were displaced, 10 were comminuted, seven were comminuted and displaced, and seven had bony defects. Accompanying pathologies included four physeal, three articular, four visceral, four arterial, six peripheral nerve, and one spinal cord injury. Initial treatment involved external fixation in 15 patients and internal fixation in one patient for bone stabilization, while the remaining patients were treated conservatively.Late-stage surgery was necessary to achieve soft-tissue coverage in three patients and to achieve union in six patients. Major complications included amputation in one patient, non-union in two, delayed union in one, osteomyelitis in one, paraplegia in one, and loss of peripheral nerve functions in three. The treatment of fractures associated with firearm injuries in children is never simple. Fracture defects, accompanying peripheral nerve damage and involvement of the joint negatively is affect the outcome, increasing the chance that late-stage surgery will be necessary. Internal bone transport appears to be an efficacious technique in the treatment of bone and soft-tissue defects associated with firearm injuries in children.

Adolescent↗

Floating knee in children.

The outcomes of 18 ipsilateral displaced femoral and tibial fractures in 17 children are assessed and a new classification system is proposed. Average age was 8.75 years, and follow-up averaged 3.2 years. In the modified Bohn and Durbin classification used, eight cases were type I, four were type II, three were type IIIa, one was type IIIb, and two were type IV. In tibial fractures there was angulation in three cases, and in femoral fractures there were dislocation and angulation in four cases, refracture in one case, leg length discrepancy in four cases, and asymptomatic knee ligament injury and meniscal tearing in five cases. According to Yue et al's criteria, seven outcomes were excellent, eight were good, two were fair, and two were poor. The cases with poor outcomes were those with open knee injury, and those with fair outcomes were those with angulation. It was concluded that knee ligament injuries do not affect the outcome of floating knee trauma in children, although they do in adults, but that open knee injuries do affect the outcome, and operative treatment of the femoral fracture is the treatment of choice for all ages.

Adolescent↗