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Biomedical subjects

Fuat Akpinar

Publications and source records attributed to Fuat Akpinar.

8 recordsLinked to original sources

Morphometric study of the human metatarsals and phalanges.

Mathematical relation between metatarsals and between phalanges in terms of their lengths and widths in themselves is considered to be significant with respect to its functional and aesthetic roles. The objective of this study is to conduct measurements for determining lengths and widths of metatarsals and phalanges on the foot radiographs and to determine possible mathematical correlations between metatarsals themselves and between phalanges themselves in terms of their lengths and widths. Anteroposterior right and left foot radiographs were taken from 100 volunteers (50 men and 50 women). Lengths and widths of the metatarsals and phalanges were measured in millimeter on radiographs. The mean, minimum and maximum values, and standard deviations of each bone's length and width were studied and data were put into formulation. The results were evaluated by Regression statistical test, and the relation between metatarsals and between phalanges in terms of their lengths and widths was studied. As a result of the measurements, we found fixed proportions between metatarsals in themselves and between phalanges in themselves in terms of their lengths and widths. Knowing these morphometric relations may be useful for performing any surgical procedures designed to manage any defects or imperfections of the foot, chief among them is shortness.

Adult↗

Rocky form giant synovial chondromatosis: a case report.

We report a case of painless synovial chondromatosis with an extremely large mass at the popliteal area related to the right knee joint. A hard mass at the posterior aspect of the knee was the only complaint reported by the patient. Plain X-ray studies revealed punctuated calcifications both intra-articularly and around the knee joint. With the surgical procedure performed subsequently, multiple rocky-hard giant chondroid nodules were excised from the posterior aspect of the knee. After 9 months following the surgery, the patient had full range of motion, and no complaints. We emphasize on the importance this case because these lesions may simulate tumors, and lead to misdiagnosis.

Chondromatosis, Synovial↗

MRI demonstration of cervical spondylodiscitis and distal full-length bilateral paraspinal cold abscesses successfully treated by drug regimen only.

OBJECTIVE: Cold abscesses, although common in spinal tuberculosis, are usually localized to the level of infection, follow tissue planes, and may extend into the spinal canal at any level. They may cause symptoms resulting from neurovascular compression, hemorrhage, and direct mass effect. DESIGN AND PATIENTS: We present an unusual case of cervical tuberculous spondylodiscitis in a 25-year old man with a cold abscesses involving the retropharyngeal, mediastinal, and retroperitoneal areas bilaterally. The abscess tracked from the neck to the psoas muscles bilaterally. Following the diagnosis the patient received 9 months of antituberculous therapy. RESULTS: MRI showed resolution on medical treatment alone. CONCLUSIONS: Even in the presence of massive paravertebral cold abscesses medical treatment alone may well suffice for this common worldwide disorder. MRI is ideal for monitoring regression of massive abscesses in deep anatomical locations.

Abscess↗

[Tibial osteomyelitis following intraosseous infusion: a case report].

Fluids, medications, and blood products can be rapidly administered via intraosseous infusion under emergency conditions, particularly to pediatric patients aged from 0 to 2 years. A five-month-old infant who had been hospitalized with a diagnosis of sepsis developed swelling and hyperemia at the infusion site 10 days after an intraosseous infusion in the right proximal tibia. Physical examination showed a serous discharge from a fistula on the anteromedial side of the right proximal cruris. Plain radiographs demonstrated periosteal reaction in the right tibia and osteolytic areas in the proximal metaphysis. With a diagnosis of acute osteomyelitis, drainage and medullary irrigation were performed and parenteral antibiotic treatment was initiated. Cultures from the surgical site yielded Candida albicans, upon which fluconazole (8 mg/kg) treatment was administered for four weeks. A complete clinical and radiographic improvement was observed at the end of a 12-month follow-up.

Antifungal Agents↗

Morphologic evaluation of the ulna.

Intramedullary ulnar nailing may be technically difficult. We used various methods and measurements to determine the ideal nail entry point and the shape, length, diameter and curvature of the medullary canal in 44 human cadaver ulnas. We found that the ideal nail entry point was, on average, 7 mm proximal and 3 mm lateral to the most prominent area of the olecranon. A nail of 3 mm diameter could easily be inserted through a hole at the proximal-lateral side of the most prominent part of the olecranon, but only 20% of all nails could be easily inserted through a hole in the middle of the olecranon. We found that correct selection of a nail of proper length and diameter, as well as an ideal nail entry point on the olecranon are essential to successful nailing.

Adult↗

A morphometric study on the humerus for intramedullary fixation.

In recent years, the popularity of intramedullary humeral nailing is on the rise in spite of its handicaps. There are many problems in intramedullary humeral stabilization because of the anatomic structure of the bone. We performed various methods and measurements to determine shape, length and diameter and curvature of the medullary canal of the humerus in 57 human dry cadaver bones. Anterior angulation with an average of 21 cm apart from greater tubercle was found at 1/3 distal part. Mean degree of angulation was 9 degrees (max: 15, minutes: 5, S.D.: 2.84). Humerus bones with septal aperture (supratrochlear foramen) at the fossa coronoidea were observed to have very narrow medullary canal. The best point for nail insertion was found to be an area on the line from greater tubercle anteromedially to caput humeri. This study revealed that carefully evaluated structure of humeral medullary canal and various congenital constructions such as septal aperture, and correct selection of a nail with proper length and diameter are essential for successful nailing.

Adult↗

[Preliminary results for treatment of tibial plateau fractures with the Ilizarov technique of ligamentotaxis].

BACKGROUND: The results of the eight patients who admitted to emergency room with tibial plateau fractures and treated with Ilizarov technique, were retrospective evaluated both clinically and radiologically. METHODS: Seven (87%) men and one (13%) woman ranging in age from 23 to 38, were evaluated. All the cases were between type IV to VI according to Hohl classification preoperatively. Closed indirect reduction by ligamentotaxis was attempted in all fractures, no open technique was performed. RESULTS: Three (38%) cases had open fractures (type I according to Gustilo-Andersen Classification) preoperatively. Six (75%) traffic accident and two (25%) falling from a height were detected as etiology. The cases, whose average follow up was 14 (6-28) months, were evaluated according to Iowa knee score scale and seven (87%) cases were good and excellent. Both clinical and radiological solid fusion were obtained in all cases after removing the frame. Although all the cases had minimal to moderate pin tract infection, all were resolved with dressing and oral antibiotherapy without removing the wires. CONCLUSIONS: Closed reduction with Ilizarov technique is appropriate for treatment of plateau tibia fractures with minimal morbidity.

Adult↗

Effects of hyaluronic acid on postoperative adhesion of tendo calcaneus surgery: an experimental study in rats.

Adhesions are a significant problem after tendon surgery. The effects of hyaluronic acid on adhesion formation of the tendo calcaneus were investigated in this study. Twenty Wistar rats were utilized. Both tendo calcanei were incised transversely, and then repaired. Hyaluronic acid (0.2 cc) was injected into peritendinous tissue on the right side, while the same amount of normal saline was injected to the left side as a control. The animals were sacrificed 40days after the experiment. Both the right and left tendon adhesions were evaluated both macroscopically and microscopically for the presence of adhesions (grading scale 0-4). Throughout the experimental period, there was no difference in range of motion of the ankle between the two groups. Macroscopically, there were fewer adhesions in the experimental group (mean 0.6 +/- 0.8) compared to the controls (mean 1.1 +/- 0.2). This difference was not statistically significant (p = .096). Histopathologically, these parameters were similar in both the experimental (mean 1.15 +/- 0.98) and the control groups (mean 1.9 +/- 1.25). This difference was significant (p = .043). Hyaluronic acid may be effective for prevention of adhesions in the tendo calcaneus though this effect could not be demonstrated experimentally.

Adjuvants, Immunologic↗