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Biomedical subjects

Fahir Demirkan

Publications and source records attributed to Fahir Demirkan.

8 recordsLinked to original sources

The relation of joint laxity and trunk rotation.

A study was designed to evaluate the joint laxity during scoliosis screening, and to show if there is a relation of joint laxity values to the trunk rotation. One thousand, two hundred and seventy-three children (598 females, 675 males) with an average age of 10.4 years were screened with a scoliometer and forward bending for trunk rotations. Scapular and shoulder elevations, flexible pes planus were recorded and joint laxity was evaluated with the Beighton score. There was high inter-observer and intra-observer reliability for both scoliometer and Beighton scores. In 41 children (3.2%) with Beighton score 7 or higher, trunk rotation measurements were higher than for the rest of the children. Trunk rotation measurements of 7 degrees or higher were found in 30 children, who were more lax than the rest of the group and were invited for radiography, with a detection of curves between 11 and 18 degrees in 10 of them. The Beighton score is a practical and reliable method for defining joint laxity. Although the number of patients with scoliosis was limited, there are findings supporting the relation between joint laxity and scoliosis. Moreover, there was increased laxity in children with increased trunk rotations. Ligamentous laxity may be one of the causes changing the contour of the back.

Adolescent↗

The acetabular teardrop and ultrasonography of the hip.

The acetabular teardrop is an important tool for the diagnosis of acetabular dysplasia. Since it was first described by Köhler its widespread use has not become established due to the relative subjectivity in classification of the types. The acetabular teardrop angle (ATA) is proposed for this purpose, and to show the teardrop's direct relation to acetabular development by correlating it with hip ultrasonography results. Patients (51 male, 53 female) included in this study received hip ultrasonography and concomitant pelvic radiography. In the 296 hips, alpha and beta angles were measured from ultrasonography, whilst the acetabular index (AI), ATA, teardrop distance and the transverse diameter of the most upper, most widened part of the teardrop were measured from the radiographs. The enlarged, and triangle-shaped teardrop is seen later than normal ones, and the triangle-shaped-teardrop hips have a higher AI than the normal hips. The ATA is in good correlation with the widest diameter, showing this to be a reliable tool for describing the teardrop. The ATA also has a positive correlation with the beta angle denoting its significance to acetabular development. High-risk babies should be followed-up primarily with ultrasonography wherever possible. The AI from radiographs and the acetabular teardrop may be used as a helper tools in decision-making, with the guides of the ATA and the transverse diameter of the most upper, most widened part of the teardrop, as proposed in this study.

Acetabulum↗

Biomechanical evaluation of flexor tendon function after hamate hook excision.

PURPOSE: Hamate hook fractures are uncommon injuries for which treatment is controversial. Excision of the hamate hook is considered to be the preferred method of treatment but the effects of hamate excision are not clearly delineated. The purpose of this study was to determine what effect, if any, excision of the hamate has on flexor tendon function. METHOD: The biomechanical effects of hamate hook excision on flexor tendon function were studied in fresh cadaveric forearm specimens with wrists fixed in 3 positions (neutral, 30 degrees extension, 30 degrees extension with 30 degrees ulnar deviation). Flexor tendon force, flexor tendon excursion, and flexor tendon shift were evaluated. RESULTS: Flexor tendon force decreased after hamate hook excision (11% in neutral, 14% in 30 degrees extension, and 15% in 30 degrees extension with 30 degrees ulnar deviation). The flexor profundus tendons had a 7- to 11-mm increase in proximal tendon excursion after hamate hook excision depending on the position of the wrist, and the flexor profundus tendons of the small finger shifted 4 to 5 mm in ulnar direction. CONCLUSIONS: The hamate hook provides some biomechanical advantage for flexor tendon function and cadaveric changes in tendon force after its excision suggest that power grip may be decreased after hamate hook excision.

Biomechanical Phenomena↗

The use of amniotic membrane in flexor tendon repair: an experimental model.

BACKGROUND: The objective of this study was to investigate the use of amniotic membrane as a long-term bioprosthesis in hand surgery. The role of the amniotic membrane was investigated in chickens with regard to the prevention of adhesion formation following tendon repair in zone II. METHODS: In the control group, the flexor tendon sheath was excised and the tendon repaired. In group II, both the flexor digitorum profundus tendon and its sheath were repaired. In group III, the repaired tendon was covered with amniotic membrane. Histological evaluation of the repaired tendons were done at 3, 6 and 12 weeks. RESULTS: Results of histologic examination demonstrated that use of the amniotic membrane significantly reduced the amount of adhesion compared with the other groups. Three months after implantation no remnants of amniotic membrane could be identified at the tendon repair site. CONCLUSIONS: Amniotic membrane is easily prepared, and because of its cost effectiveness, its use in the prevention and treatment of adhesions should always be kept in mind.

Animals↗

[Stress fracture of the fifth metatarsophalangeal sesamoid bone: a case report].

There is a paucity of published literature on the injuries of the lesser toe sesamoids of the foot. A fifty-six-year-old male patient without a major trauma history was diagnosed as having a stress fracture of the fifth metatarsophalangeal joint medial sesamoid bone. Conservative treatment was employed and the patient was followed-up for 25 months without any complaints. The sesamoid bone injury of the fifth toe should be included in the differential diagnosis of lateral forefoot pain.

Diagnosis, Differential↗

Comparison of injection modalities in the treatment of plantar heel pain: a randomized controlled trial.

In a prospective randomized study of plantar heel pain, 44 patients were treated with injection of 1 mL of 2% prilocaine using the peppering technique, 1 mL of 2% prilocaine combined with 2 mL of autologous blood, or 1 mL of 2% prilocaine mixed with 40 mg of methylprednisolone acetate. At 6-month follow-up, clinical improvement was evaluated by using a 10-cm visual analog scale and the rearfoot score of the American Orthopaedic Foot and Ankle Society. Results were analyzed using sample t-tests within groups and repeated-measures analyses of variance between groups. Mean +/- SD visual analog scale scores in the peppering technique, autologous blood injection, and corticosteroid injection groups improved from 6.4 +/- 1.1, 7.6 +/- 1.3, and 7.28 +/- 1.2 to 2.0 +/- 2.2 (P < .001), 2.4 +/- 1.8 (P < .001), and 2.57 +/- 2.9 (P < .001), respectively. Mean +/- SD rearfoot scores in the same groups improved from 64.1 +/- 15.1, 71.6 +/- 1, and 65.7 +/- 12.7 to 78.2 +/- 12.4 (P = .018), 80.9 +/- 13.9 (P = .025), and 80.07 +/- 17.5 (P = .030), respectively. There were no statistically significant differences among the groups. Good outcomes have been documented using the peppering technique and autologous blood injection for the treatment of lateral epicondylitis. Although the curative mechanisms of both injection modalities are based on a hypothesis, they seem to be good alternatives to corticosteroid injection for the treatment of plantar heel pain.

Adult↗

Distribution of the metatarsophalangeal sesamoids in Turkish subjects.

No statistically significant pattern of metatarsophalangeal sesamoid distribution has been reported in the literature in relation to genetic pool or group, unilaterality or bilaterality, or sesamoid division. A study was undertaken to evaluate the presence and distribution of the metatarsophalangeal sesamoid bones of the foot in Turkish subjects. A total of 602 foot radiographs from 371 patients without forefoot complaints other than those of the hallux were included in the study. Absence or hypoplasia of the first-ray sesamoids was seen on 0.7% of the radiographs, and second-, third-, fourth-, and fifth-ray sesamoids were present on 2.8%, 0.5%, 1.0%, and 15.1% of the radiographs, respectively. Fifth-ray sesamoids were more prevalent in men (odds ratio, 2.71; 95% confidence interval, 1.52-4.84). The frequency of a normal foot profile (two sesamoids in the first ray) was 83.2%. Divisions of the sesamoids were seen on 4.0% of the radiographs at the first ray and on 20.9% at the fifth ray. Distribution and division of sesamoids were predominantly bilateral (kappa = 0.91, 0.91, and 0.95 for the first, second, and fifth digits, respectively; P < .001).

Adult↗